1-800 Contacts Legislation/HB 4356

Updated 4/14/2021

While it is frustrating that House Bill 4356, supported by 1-800 Contacts, passed in the Michigan House of Representatives by a slim margin (51-56), the bill is now before Senate Health and Human Services CommitteeODs MUST VOICE CONCERNS ABOUT PATIENT SAFETY!! Although the bill is still in committee, and likely to have a hearing toward the end of April or beginning of May, it is important to voice your concerns to your Senator
 

These Senators sit on the Health Policy and Human Services Committee, so it is even more crucial to reach out to them at this stage. 

Please contact your Michigan Senator today and ask them to oppose HB 4356Key Talking Points Against HB 3456 to share with your State Senator:

  • This puts patients at extreme risk by placing a virtual eye screening by a computer application within the definition of an actual eye exam in Michigan law. The bill allows a computer to virtually write and issue prescriptions for contact lens, a class II or III medical device. This technology is not FDA tested or approved. 
  • Although these telehealth companies claim to have an "ophthalmologist review," the review is done without company liability, without direct patient contact, without patient relationship, and without a physical evaluation of the eye itself with the proper tools and technology
  • This bill encourages individuals to avoid medically-recommended exams, increases future costs of care for many patients, and provides no patient protections to ensure quality care
  • The main company supporting this and wanting to offer virtual exams and write medical prescriptions is 1-800-Contacts, but their own Terms of Use state, "Any information supplied through the website or any of our employees or agents . . . is for informational purposes or general guidance and does not constitute medical or other professional advice. Health related information provided . . . is not a substitute for medical advice . . . We do not warrant the accuracy, completeness, or usefulness of this information. Any reliance you place on such information is strictly at your own risk. We disclaim all liability and responsibility arising from any reliance placed on such materials by you."
  • The CDC, the FDA, Ophthalmologists, and Optometrists all recommend that contact lens wearers see their in-person eye care provider annually for an exam to ensure the correct contact lens prescription is being used, to analyze the health of the eye, and to monitor for any full-body health concerns. 
  • This bill is written in the interest of big business (a sales company that wants to write medical prescriptions, all while disclaiming liability for any medical/professional advice), and is missing basic patient protections and safeguards. It allows these companies to operate free from medical liability, with little to no patient recourse if there is harm or injury.  
  • It is true that many other states (over 30) allow this type of technology for virtual vision screens, HOWEVER, many of those states have additional safeguards in place to ensure a separation of the screening verses an exam and to ensure patients are protected when they choose to use this service. (Some examples include age limits, exam verifications, partnerships with in-person providers, face-to-face interaction requirements, notices to the patient, licensure or registration for enforcement, assignment of liability, fines)
  • A patient can already purchase their contact lenses online. A patient leaves an eye care provider with a copy of their prescription, so they are already able to shop around for the best deal for their particular lenses.  
  • Although the bill's supporters claim that this "would not replace the need for a comprehensive eye exam," since it is simply a "check on visual acuity," this encourages a patient to skip or avoid their regularly-scheduled and medically important exams. 
    • The typical process for contacts prescriptions:
      • An initial comprehensive eye exam, followed by a contact lens prescription, which is typically good, valid, and safe for approximately 1 year
      • When the contacts prescription is up for renewal, a review comprehensive eye exam  is conducted to determine if the same prescription is appropriate and to check for any developed issues or concerns
      • This process repeats to continuously ensure no complications or changes in eye or vision health exist
    • The bill allows for only a single, initial comprehensive eye exam, followed by years and years of unchecked eyes and vision, putting a patient at significant risk. 
    • This policy does not even require companies to verify that a person has had their initial comprehensive eye exam. Yes, a company may choose to do this verification by their own decision, but nothing is requiring them to do so
    • The regularly recommended and scheduled comprehensive eye exams help to, not only monitor ongoing eye and vision health itself, but also can detect a body's undiagnosed systemic disease through examination of the retina
  • The bill also does not define any "standard of care"
    • Although a given company may establish their own "standard of care," there is nothing in the bill to actually hold them to that standard or ensure that a standard of care is appropriate for patient safety and equal treatment
    • With no defined standard of care, a patient is at risk of whatever "standard" the company desires and is left with no real recourse if something goes wrong
  • Online contact renewal sounds simple and easy, but without an actual, in person evaluation, it puts patients at further risk of developing undetected eye problems over time
  • It is true that this type of telemedicine may be available at some point in the future, BUT the technology is not yet developed enough to properly and medically evaluate ocular health in a virtual setting

Please let Tara, our Grassroots Optometry! Coordinator know if you have reached out to your lawmaker. Even if they don't respond to your email or phone call, it is very important that we know who has been contacted. Tara can be reached at paksi.t@gcsionline.com or (517) 575.9687

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HB 4356 Narrowly Passes in House - Contact Your Senator to Vote NO

 
On March 24, 2021, House Bill 4356 (Meerman) narrowly passed the Michigan House with a vote of 56-51. This bill is being pushed by 1-800-Contacts and would allow patients to use an online mobile platform to obtain a contact lens prescription.

Click here for a breakdown of how the House members voted

The bill now moves over to the Michigan Senate, and will likely be referred to the Senate Health Policy Committee chaired by Senator Curt VanderWall. We urge all optometrists to reach out to their State Senators to inform them of the public-safety dangers of this policy and to continue advocating for alternative options. To find your State Senator go to https://www.senate.michigan.gov/fysbyaddress.html

 If you would like more information on the bill prior to contacting your Senator please contact Jeff Towns, MOA Executive Director at jeff@themoa.org 
The Legislature is now on a planned spring in-district work period ("spring break") extending until April 12th. This legislative "down time" is a great opportunity to prepare yourself for participating in Senate advocacy surrounding HB 4356. The MOA will continue to fight against this unsafe policy and continue to advocate for real, patient-centered suggestions that improve this bill.
 
If you are able to connect with your State Senator it is important you let Tara Paksi, MOA GO! Coordinator, know how your communication went. Please email or call paksi.t@gcsionline.com or 517.575.9687.  

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