States all over the country have been addressing telehealth online
prescribing rules in recent months. Some states have left their rules more
broad, while others have narrowed them to specific situations. Consider
Indiana’s online prescribing statute (revisions to be effective July 2019, as
highlighted in a recent San Francisco Chronicle article): “[a]
prescriber may issue a prescription…through the use of telemedicine…if the
following conditions are met: not
for an opioid…not for an abortion inducing drug, [and]….”not
for an ophthalmic device.” The last portion of the statute, concerning
online prescription of an ophthalmic device, has recently come under fire. The trend
among the majority of states has been to “allow doctors to conduct vision examinations
online,” with 39 states currently doing so. It seems like Indiana is in the
minority, hence, why its statute is under litigation concerning its
Petitioners to the pending litigation feel the ban is very biased. Specifically, they argue ophthalmic devices do not carry the same potential issues as opioid drugs or abortion inducing drugs. They do not seem to be in the same category, they argue—and yet eye devices and exams prescribed and performed through telehealth are banned. Furthermore, plaintiffs assert that the ban was only included due to heavy pressure from brick-and-mortar optometrists worried about the potential competition that could arise from allowing online exams. Additionally, an argument was made concerning the purpose of the state’s telehealth rules: “Indiana’s law was designed to increase access to health care, particularly for patients in rural areas and those who might struggle to be able to afford to travel to a doctor’s office.” If that is really the case, then, the ban seems contrary to the purpose of the telehealth statute. Conversely, defendants maintain their position that including the ban on ophthalmic devices was merely an effort to protect patients’ health and safety.
This is probably just the beginning of litigation revolving around state telehealth prescribing rules. Both sides of the Indiana situation seem to have valid arguments. If the purpose truly is to increase patients’ access to care, there does not seem to be much of a logical reason to prohibit eye exams and subsequent prescriptions. However, the Indiana legislation may also have a very valid reason for including eye exams and prescriptions in its limitations on telehealth. It is not a matter of one side being right or the other being wrong; it is a matter of figuring out what is best for everyone when it comes to the practice of telehealth. Sometimes, that involves a bit more than a conversation.