Senate approves expansion of optometrists' scope of practice after extended debate

The West Virginia Senate on March 7 passed Engrossed Senate Bill 565, relating generally to the practice of optometry, by a roll-call vote of 22 ayes, 11 nays and 1 absent not voting.

The bill amends the state definition of the practice of optometry to add therapeutic laser procedures and permits licensing boards to certify licensees to perform specified laser and surgical procedures when the applicant meets education, training and examination requirements. The bill also allows licensing boards to require jurisprudence examinations for out-of-state applicants and mandates quarterly reporting of such applications to legislative committees.

Supporters, led by the bill presenter identified in the transcript as Senator from Ohio, said the change expands access to care and economic opportunity. "This is an economic development bill. This is an access to care bill," the Senator from Ohio said on the floor, and urged passage citing studies and access delays to ophthalmologists.

Opponents and questioning senators focused on statutory language and disciplinary safeguards. The senior senator from the fourth cautioned that the bill's definition could be read broadly: "What this says is anything the schools teach then becomes scope of practice for an optometrist in West Virginia," the senior senator from the fourth said, arguing that the phrasing could import any procedure taught in any U.S. optometry school into state law. Multiple senators urged use of the Performance and Implementation Review Division (PIRD) or a more specific statutory scope before changing practice acts.

Floor exchange also addressed possible fiscal impacts. A senator asked why no fiscal note accompanied the bill; the presenter said she had no information. Other senators said prior experience in other states showed procedure volume could rise and recommended review by the finance committee to assess potential Medicaid or private insurance cost impacts.

The Senate rejected motions to postpone or send the measure to additional review and ultimately approved the bill. The transcript records multiple requests for clarifying changes that were discussed but not adopted on the floor.

What the bill does not change on the floor: it does not create a coverage mandate, and, as the presenter said, issuance of licenses remains subject to licensing boards' jurisdiction and malpractice and liability regimes in place for health-care providers.

Votes at a glance: Engrossed Senate Bill 565 — passed 22 ayes, 11 nays, 1 absent not voting.

The bill will be communicated to the House of Delegates for its action.