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GLAUCOMA CERTIFICATION
INFORMATION
Effective in June, 2006, there were MAJOR changes in the optometry law
which significantly altered the way New Hampshire ODs can become
certified to treat primary open-angle glaucoma (TPA/g). You are urged
to read the law, and to ask any member of the Board of Examiners about
anything that is unclear to you.
The New Hampshire glaucoma certification process is
overseen by the Joint Pharmaceutical Formulary and Credentialing
Committee ("JPFCC"). Here is a summary of information on the process,
prepared by David Caban, O.D., JPFCC Secretary.
The Board of Optometry shall waive (emphasis
added) the course and co-management requirement for 2002 grads (and
after) and for OD’s with credentialed glaucoma privileges
from the Department of Defense, the VA, or the Indian Health services.
The JPFCC may waive or reduce (to any
number including zero) the requirements of the course and co-management
for the following categories:
An OD
with proof of 12 month's practice in another “glaucoma” state, or
An OD who
has completed an accredited and relevant residency program.
Those OD’s who must complete the co-management process
are required to show evidence of successful co-management of 25 cases, a
maximum of 5 of which may be existing cases. In essence, a "new" case is
one where you began your glaucoma care for the patient on or after the
law took effect (July 17, 2002), whether it was you or another doctor
(MD or OD) who made the initial glaucoma diagnosis of that patient. An
"existing" case is one where the patient was already diagnosed and
co-managed by you prior to the effective date of the law
(July 17, 2002). Each case, "new" or "existing," must be co-managed for
18 months.
After TPA/g certification, for a period of 24 months, the
OD shall consult with (not "refer to") an ophthalmologist for
confirmation of the diagnosis and treatment plan for all new glaucoma
patients.
All TPA/g certified OD’s shall consult with an
ophthalmologist if there is documented progression of optic nerve head
damage or progression of VF loss on maximal medical therapy. This
requirement never goes away.
During the co-management period, the OD shall use the
forms recommended and designed by the JPFCC (forms =
Consent Form,
Co-Management Form and
Summary Report Form). However
there is general agreement by the committee members that if other forms
of communication are used, TPA/g certification will not be reasonably
denied. In addition, there is no requirement to submit any paperwork
other than the “Glaucoma Summary Report Forms.” The audit requirement
has been eliminated. It is the JPFCC’s position that the sign-off by the
MD on each Glaucoma Summary Report Form is sufficient to certify
successful co-management of that case.
After the OD co-manages each of the 25 required patients
for eighteen months, s/he must submit a written request to the Board of
Optometry for TPA/g certification. The OD will include with the request
one “Glaucoma Summary Report Form" for each patient. The form shall be
filled out by the OD and signed by both the OD and the MD. The JPFCC
will then review only the completed “Glaucoma Summary
Report Forms” at its regularly scheduled quarterly meetings. The OD is
not required to appear at the meeting of the JPFCC. The OD will
generally be notified by the Board of Optometry that they have received
TPA/g certification within one to two weeks.
The TPA/g process has been significantly streamlined and
should be attainable by any OD who wishes to obtain TPA/g certification.
We urge each and every New Hampshire optometrist to go
through the process and become TPA/g certified. The NHOA worked very
hard to make the process as smooth as possible. Many of your colleagues
are enjoying the benefits of having their TPA/g certification - you can
too!
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