How ODs and MDs compromised in Nebraska

The major provisions of two bills introduced in 2013 on behalf of Nebraska Optometric Association (NOA) were combined into LB 526 during the course of the 2014 legislative session. The combined bill would have removed current restrictions on prescribing oral steroids, oral glaucoma agents, and oral immunosuppressives (ODs in NE can prescribe any oral medication except these); authorized specific procedures for treating eyelid cysts; and authorized injections into the eyelid related to those procedures, along with injections for treating anaphylaxis. Language in the amended bill was modified to reflect recommendations that resulted from last year’s administrative review of our proposed changes.

LB 526 advanced from committee on a 4-0 vote and received first-round approval from the legislature on March 26. The bill was intensely lobbied by ophthalmology, including an extensive and misleading media campaign designed to generate public reaction.

However, it did not come up for second-round consideration until April 9, which was the 58th day of the 60-day legislative session and the last day that a bill could advance and still have a chance for passage.

Ophthalmology offered a compromise, agreeing to lift the remaining restrictions on oral medications (oral steroids, oral glaucoma medications and oral immunosuppressives) and to authorize injections for treating anaphylaxis, and acknowledging that no specific additional education or training would be required relative to this authority.

The compromise enabled NOA to assure an expedited approval of the bill in the waning hours of the session and removed any chance of a gubernatorial veto following adjournment. The compromise removed the provisions involving minor surgical procedures and injections into the eyelid, and the amended bill was sent to final-round consideration and passed on the final day of the session on a 45-0-1 vote. The governor signed it into law on April 22.

LB 526 takes another step toward addressing our concern for increasing access to care. It certainly does not accomplish all of our goals in that regard, and the NOA remains committed to pursuit of the additional updates to our practice act that will enable our doctors to serve primary-care needs of their patients.ODT