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CAEPS closely follows bills moving through the California Legislature of interest to Ophthalmology and the field of Medicine in general. Of interest currently are the following bills:

AB 744 (Aguiar-Curry) -- This is a CMA-sponsored bill that would require a health care service plans and insurers to reimburse a health care provider for services appropriately delivered through telehealth services on the same basis and to the same extent as for the same service through in-person diagnosis, consultation, or treatment. The COA is concerned, however, that this might require payment for online refraction services, and is working with CMA and CAEPS on potential amendments that would potentially address its concerns without inviting a flood of similar exclusionary amendments.

AB 947 (Quirk-Silva) -- This bill would authorize school districts, county offices of education, and charter schools to consider elements of the expanded core curriculum when developing individualized education programs for a pupil who is blind, has low vision, or is visually impaired. It would also require that certain evaluations required for a pupil occur in familiar and unfamiliar environments, in varying lighting conditions, and in the home, school, and community, as appropriate. Our organization has a long history of supporting efforts to improve the well-being of the visually impaired, and believe this legislation to be in that spirit.

AB 1264
 (Petrie-Norris) -- This legislation would specify that an appropriate prior examination for the purpose of prescribing a dangerous drug does not require a synchronous interaction between the patient and a licensee, and can be achieved through the use of telehealth provided the appropriate standard of care is met. While this is potentially a positive move since it may increase access, because the standard of care is determined on a case by case basis by the various regulatory boards, CAEPS is concerned this may provide a false sense of protection to licensees.

AB 1467 (Salas) is a "spot" (placeholder) bill that would ultimately contain any agreed upon terms of changes to the Optometric Practice Act that might result from ongoing discussions between CAEPS, the California Medical Association (CMA), and the California Optometric Association (COA). The bill's author and the involved stakeholders have agreed that the bill will only contain items agreed to by all parties.

Of specific interest to the COA is the ability of optometrists to perform laser surgical procedures for glaucoma and posterior capsule opacity, scalpel surgical removal and other treatment of eye lesions, and various types of injections (including intravitreal) related to these surgical procedures and the treatment of diseases an optometrist is (or could be) authorized to treat.

While essentially a "shell," the bill references the concept of a "Delegated Services Agreement" under which an optometrist could perform the above-referenced procedures (and others) in conjunction with a physician and surgeon. However, conversations about this concept have exposed many technical issues that make it unlikely to be workable. This realization has redirected the conversation to appropriate substantial training for any new privileges.

Although discussions will continue, the bill has become a "Two-Year" bill that can still be considered in January 2020. However, it remains possible that another active bill could still be used to achieve any unmet goals before the session ends in September.

CAEPS will continue to work with the CMA and the American Academy of Ophthalmology to prevent the granting of surgical procedures without appropriate training and clinical experience.

SB 639 (Mitchell) This bill would have eliminated or placed severe restrictions on the ability of a health care provider to offer or make available to patients open-end credit (e.g. Care Credit). The bill has since been amended in cooperation with stakeholders to provide additional patient protections, but not eliminate the option.

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