CS/CS/HB 449 revises Florida’s optometry practice act in a broad way, expanding the scope of practice for certified optometrists and creating a new certification track for optometrists certified in ophthalmic procedures. The bill updates definitions, board membership requirements, rulemaking authority, licensure standards, and practice rules. It also authorizes certified optometrists to administer and prescribe ocular pharmaceutical agents under specified conditions, and it establishes a new pathway for trained optometrists to perform certain board-approved laser and non-laser ophthalmic procedures and therapies.
The bill requires additional coursework and an examination for certification to prescribe oral ocular pharmaceutical agents and, separately, for certification to perform ophthalmic procedures. It also creates a joint committee of physicians and optometrists to develop the ophthalmic procedures course and exam, excludes a list of major eye surgeries and other invasive procedures from optometric practice, and adds requirements for financial responsibility through insurance, escrow, or letter of credit. Other changes include new title and abbreviation rules, expanded duties for nonlicensed supportive personnel under indirect supervision, and a requirement that non-certified licensed practitioners post signs informing patients of their limitations.
The bill amends multiple sections of chapter 463, Florida Statutes, and makes conforming changes to chapter 641. It changes who may be licensed as an optometrist in Florida, what certified optometrists may prescribe and perform, how the Board of Optometry may regulate the profession, and what disclosures and financial safeguards apply. It also affects health maintenance organizations by requiring coverage arrangements that offer optometrist services when optometry benefits are included. The act takes effect July 1, 2025, and applies new licensure, renewal, and certification requirements to future applicants and existing certified optometrists who have not already completed the required training.
The bill appears to have generally favorable support in the House, as reflected by committee and floor votes that advanced it with clear majorities. It passed the House Health Professions & Programs Subcommittee 12-6, the House Health & Human Services Committee 17-7, and the House on third reading 88-24. The vote pattern suggests broad support for expanding optometric authority, while also indicating a meaningful minority of members remained concerned about the scope of the changes.
The main points of contention are the expansion of optometrists’ authority into procedures traditionally associated with ophthalmology, especially the new authorization for certain laser and non-laser ophthalmic procedures. Opponents are likely concerned about patient safety, training standards, and whether optometrists should be allowed to perform procedures that approach surgery, even with exclusions for major operations. Supporters appear to favor increased access to eye care, broader use of optometrists’ training, and clearer certification pathways. Additional debate may center on the new financial responsibility requirements, the mandatory signage for non-certified practitioners, and the role of the joint physician-optometrist committee in setting training and exam standards.