Q: If I provide telemedicine services from home, do I need an office license?
A: Yes. Under the NCSBEO Telemedicine Position Statement, the practice of optometry occurs at both the optometrist’s location and the patient’s location. If you conduct telehealth sessions from your home (or any non-clinical setting), that location must be licensed as either a Main Office or a Branch Office, even if no in-person consultations take place there. This ensures compliance with Board regulations and keeps an accurate record of all practice locations.
Q: How do I know whether my home office should be listed as a Main Office or a Branch Office?
A:
You should consider your main office where you provide care to the majority of your patients.
If the majority of your patients are seen by telemedicine at a home office, that should be your main office.
Any other office where you provide care and receive remuneration for that care should be considered a branch office.
Q: Will my home address be visible to the public if I list it as an office?
A: No. if requested, the Board can redact your address from the public “Locate a Doctor” feature on the website to protect your privacy. Please note this preference either in the notes section of your branch application or by sending an email once your home office is added.
Q: What if I provide telehealth services from outside of North Carolina?
A: If you are physically located outside of North Carolina when providing telehealth services to NC patients, you must:
Be licensed in North Carolina, and
Maintain a main or branch office in the location where you are primarily located while seeing patients (home office or otherwise)
If you are traveling away from the location where you primarily see patients, and still outside of NC, an additional branch office license is not required.
Obtain a branch office license for any location where North Carolina patients are served.
Q: Where can I review the full Telemedicine Position Statement?
A: The complete NCSBEO Telemedicine Position Statement. is available on the Board’s website. Please review it carefully to ensure full compliance.
Q: Are optometrists required to pay a privilege tax in North Carolina?
A: No. As of July 1, 2024, the North Carolina General Assembly repealed the professional privilege license tax requirement.
Q: Can optometrists perform post-operative adjustments for Light Adjustable Lenses (LAL)?
A: Yes, under specific conditions:
The optometrist must collaborate with the surgeon to establish a post-operative protocol.
The protocol should include detailed guidelines for adjustments.
It is up to the surgeon to check with the Medical Board regarding the surgeons responsibility before implementation. This collaborative approach ensures compliance with professional standards.
Q: Can an optometrist in North Carolina self-prescribe medication?
A: While, there is no rule or law that prevents an optometrist from self-prescribing, it is not recommended. If self-prescribing is necessary for an unusual circumstance, the optometrist should document the condition and treatment in detail, just as they would for a patient. Self-prescribing controlled substances is strictly prohibited.
Q: Can an optometrist treat or prescribe medication for a family member?
A: Yes, optometrists can treat and prescribe medication for family members, but they must follow the same standards as they would with any other patient; this includes creating a detailed medical record of the encounter. To prevent the perception of drug diversion, prescribing controlled substances for a family member is highly discouraged.
Remember, your prescriptive authority only extends to treatment of abnormal conditions of the eye and its adnexa.
Q: Where can I find more information on this topic?
A: This topic was covered in the 2021 Jurisprudence and Medical Errors Course. Optometrists can review the relevant slide through their online portal on the Board’s website under the Courses Tab.
Q: Can my spouse inherit and continue my optometry practice if I pass away?
A: No. Only a licensed optometrist (O.D.) or ophthalmologist may own and operate an optometric practice in North Carolina. A non-optometrist spouse cannot directly succeed to ownership of the practice.
Q: Can my spouse inherit other business interests tied to the practice?
A: Yes. If you own entities such as a partnership, corporation, or LLC that hold the building, equipment, or other assets and lease them to the practice, your spouse may succeed to ownership of those entities. However, this does not include the professional practice itself.
Q: What happens to my practice if I die without a buy-sell agreement?
A: The practice becomes an asset of your estate; the executor or administrator of the estate is responsible for arranging the sale of the practice (either the corporate entity or its assets) to a qualified buyer. The practice cannot pass directly to your spouse unless they are a licensed optometrist or ophthalmologist.
Q: What does the Board require during this process?
A: The Board’s primary concern is ensuring patients have timely access to their records so they can continue care with another provider. The Board does not impose a strict time limit for the sale or transfer of the practice. The estate must ensure records are accessible both before and after the sale.
Q: What should I do now?
A: Consult your estate planning attorney about succession planning. Consider putting a buy-sell agreement in place to streamline the process. Your attorney may contact the Board’s counsel for additional guidance if needed.
Q: Can the above procedures be used to treat abnormal conditions of the eyelids and ocular adnexa?
A: Yes. Conditions such as Dry Eye, MGD, Ocular Rosacea, Hordeolum, Chalazion, and Lid Laxity are permissible to be treated using the above instruments. The following should be observed:
There should be a written protocol for all such procedures;
Any individual performing the treatments should be certified by the company selling the instrument and the Certification should be displayed.
If treating ocular rosacea, it is advisable to follow an established protocol such as the Toyos Protocol.
Remember, when considering purchasing an instrument, check with the Board as far as approved indications since instrument companies may promote a non-approved indication.
Q: What steps should be taken if a prescription pad is stolen?
A: If a prescription pad is stolen, the following steps must be taken to comply with reporting requirements:
File a police report in the city where the pad was stolen and where any attempted use occurred.
Create a forgery alert with the NC Controlled Substance Registry.
Report the theft to the North Carolina State Bureau of Investigation (SBI).
Once these steps are completed, provide the Board with details of the incident to have the situation documented. Keep the Board updated on the status of these reports as necessary. For further questions or concerns, contact the Board directly.
Does a guardian need to be present at the appointment?
No. A guardian does not need to be physically present when services are provided.
Does a guardian still have to give permission?
Yes. A guardian must consent before optometric services are provided to a minor.
Can a minor consent on their own?
Generally, no. While there are limited exceptions for certain health services, optometric services are not one of them.
What forms of guardian consent are acceptable?
Guardian consent may be provided through:
a signed consent form
a written note from the guardian
a telephone call with the guardian
How should a phone consent be handled?
It should be documented in the patient record. It is also a good idea to have two staff members on the call.
A: No. North Carolina optometry laws and rules do not specifically designate who must accompany a minor or incapacitated adult to a medical appointment.
The key issue is whether the accompanying adult has the legal authority to consent or act on the patient’s behalf.
For minors, that is typically a parent or legal guardian, unless another adult has valid authorization to consent to health care for the minor.
For incapacitated adults, that is generally a court-appointed guardian of the person or a valid health care agent acting under a health care power of attorney.
Adult siblings, grandparents, aunts, uncles, or other adult family members may accompany the patient, but whether that is sufficient depends on whether that person has the legal authority to provide consent in the particular situation.
If there is uncertainty, the licensee should consult private legal counsel and review any applicable custody, guardianship, or authorization documents.
Q: What must an optometrist do when ceasing practice at a primary or branch office?
A: The optometrist must notify the Board in writing within 10 days of ceasing practice. The notice must include the reason for discontinuing practice and the disposition of the patient records. If a duplicate license was issued for that location, it must be destroyed.
Q: What are the requirements for patient records when an optometrist ceases practice?
A: The licensee must maintain control and custody of the patient records for that location until the records are transferred to the patient or to another similarly licensed practitioner. If the licensee retains patient records, patients must be notified of the disposition or availability of those records. Notice may be provided by direct mail, email, or by publication in a newspaper of general circulation in the county or counties where the patients reside. If notice is published, it must appear at least weekly for at least 90 days, and the licensee must retain proof that notice was given.
Q: What happens to patient records if an optometrist dies while still practicing?
A: The optometrist’s estate must comply with the patient notice requirement. If no patient directions are received, the estate must make reasonable efforts to place the records with a nearby optometrist or ophthalmologist as soon as possible. Any records retained by the estate must be maintained for the required retention period.
Reference: 21 NCAC 42B .0204, Ceasing Practice.
Q: Do I need to update my name with the Board if my legal name has changed?
A: Yes. If your legal name changes for any reason, including marriage, divorce, or another legal name change, you should update your name with the Board so our records match your current legal name, or a variation of that legal name.
Q: Does the name in the Board’s records need to match the name I use for Medicaid or credentialing?
A: Yes. The name in the Board’s records should match the name you use for Medicaid, credentialing, and other verification services. If the names do not match, delays or issues can occur when license verifications are completed.
Q: Can I still use part of my previous name?
A: Only if it is still a variation of your current legal name. For example, middle names may be dropped, but the name on record must still reflect your legal name.
Q: Do I need a new license certificate after a name change?
A: Not necessarily. The Board can issue a new large certificate showing your updated name for a fee of $100, but this is optional. However, after a name change, the small license renewal card must be reprinted and affixed to the main license to reflect the change.