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Beshear signs bill letting optometrists perform surgery
By John Cheves

FRANKFORT — Gov. Steve Beshear on Thursday signed into law a controversial measure that will let optometrists perform some laser eye surgeries.

Ophthalmologists — eye surgeons who graduated from medical school — fought the bill, arguing that optometrists are not qualified to perform surgery. Optometrists do not attend medical school, but they do receive four years of optometry training after graduating from college and are trained to detect vision defects and prescribe corrective lenses.

But Beshear sided with the optometrists, who promoted Senate Bill 110 as offering better access to health care. Many rural areas of the state have optometrists but not ophthalmologists, optometrists told lawmakers.

“Access to quality health care is a critical issue for families across the commonwealth,” Beshear said in a statement. “After careful consideration, along with meetings with many interested parties, today I signed Senate Bill 110 to give Kentuckians greater access to necessary eye care.”

The law will let optometrists remove lumps and bumps and use lasers to treat a few specified conditions, although they cannot perform Lasik corrective surgery, which uses a laser to change the shape of the cornea, or any other procedure requiring general anesthesia.

The legislature passed SB 110 quickly and overwhelmingly following a lobbying blitz and big campaign donations by optometrists to Beshear and legislators. On Thursday, the Legislative Ethics Commission said the Kentucky Optometric Association increased its Frankfort lobbying force from four to 18 lobbyists this session, including 13 lobbyists who started Feb. 1.

Optometrists and their political action committee have upped their donations to state elected leaders over the past year, campaign finance records show. In 2010, optometrists gave $250,000 to all political candidates, compared with just less than $50,000 in 2009, according to the Kentucky Registry of Election Finance.

Meanwhile, one senator who raised objections to SB 110 is quietly attaching amendments to other bills that, if passed, essentially would undo the measure.

Sen. Julie Denton, R-Louisville, referred to a Senate committee as a “kangaroo court” earlier this month when it brushed aside medical concerns and rushed the bill to the Senate floor. Now Denton is filing floor amendments that would require the state to issue a certificate of need for eye surgery using a laser unless a clinic offers such services already — as only ophthalmologists do — or unless they are performed by an ophthalmologist.

The state issues certificates of needs in some instances, such as adding hospital beds or expensive medical equipment, to prevent the costly proliferation of certain items and services.

Denton said Thursday that she isn’t passing judgment on the qualification of optometrists. But the state Medicaid program could lose money if optometrists rush out to purchase expensive laser equipment and then feel pressured to perform many surgeries, billing Medicaid, in order to pay for their new equipment.

“Having a certificate of need required for expensive medical equipment is not out of the ordinary,” Denton said.

As of Thursday, Denton had attached her amendment to at least five House bills and one Senate bill awaiting action in the Senate. The bills’ subjects include insurance payments to chiropractors, elder abuse and a bill to establish every Sept. 11 as “9/11 First Responders Day” in Kentucky.

Legislators sometimes attach floor amendments to otherwise routine bills as a way to force action on a subject, although there are maneuvers Senate and House leaders can use to attempt to scrape off the amendment and avoid any floor action on the subject.