(a) Except as provided in subsection (d) of this section, each physician who performs an eye examination and fits a patient for contact lenses shall, on request, prepare and give a contact lens prescription to the patient, and as directed by any person designated to act on behalf of the patient, provide the prescription or verify the prescription as provided by Tex. Occ. Code Section 353.1015. The physician may exclude categories of contact lenses if the exclusion is clinically indicated. The physician may not charge the patient a fee for providing the contact lens prescription but may charge a fee for examination and a fee for fitting of contact lenses as a condition for giving a contact lens prescription to the patient.
(b) If a patient requests a contact lens prescription during an initial or annual examination, the physician must prepare and give the contact lens prescription to the patient at the time the physician determines all of the parameters of the contact lens prescription, as that term is defined in section 181.2 of this title (relating to definitions). If the physician has delegated the fitting of the contact lens as authorized by the Texas Contact Lens Prescription Act, the physician is not required to provide the prescription for the patient.
(c) If the patient does not request or receive an original contact lens prescription during the patient's initial or annual examination, the patient may request the patient's contact lens prescription at any time during which the prescription is valid. On receipt of a request, the physician shall provide the patient with a contact lens prescription if the physician has fit the patient. If the patient requests the physician to deliver the prescription to the patient or to another person, the physician may charge the cost of delivery to the patient.
(d) A physician may refuse to give a contact lens prescription to a patient if:
  (1) the patient's ocular health presents a contraindication for contact lenses;
  (2) refusal is warranted due to potential harm to the patient's ocular health;
  (3) the patient has not paid for the examination and fitting, or has not paid other financial obligations to the physician if the patient would have been required to make an immediate or similar payment if the examination revealed that ophthalmic goods were not required;
  (4) the patient has an existing medical condition that indicates that the patient's ocular health would be damaged if the prescription were released to the patient, or if further monitoring of the patient is needed; or
  (5) the request is made after the first anniversary date of the patient's last eye examination.
(e) Subsection (d) of this section does not prohibit a physician from giving a patient the patient's contact lens prescription.
(f) A physician may not condition the availability to a patient of an eye examination, a fitting for contact lenses, the issuance or verification of a contact lens prescription, or any combination of these services on a requirement that the patient agree to purchase contact lenses or other ophthalmic goods from the physician.
(g) Unless a shorter prescription period is warranted by the patient's ocular health or by a potential harm to the patient's ocular health, a physician may not issue a contact lens prescription that expires before the first anniversary of the date the person's prescription parameters are determined. The physician may extend the expiration date of the prescription without completing another eye examination or may require the patient to undergo another eye examination.
(h) If a physician refuses to give a patient the patient's contact lens prescription for a reason permitted under subsection (d) of this section or writes the prescription for a period of less than one year, the physician must:
  (1) give the patient a verbal explanation of the reason for the action at the time of the action; and
  (2) maintain in the patient's records a written explanation of the reason.

Source Note: The provisions of this §181.3 adopted to be effective March 4, 1998, 23 TexReg 1950; amended to be adopted March 7, 2002, 27 TexReg 1488; amended to be effective September 20, 2007, 32 TexReg 6315