How to answer questions about LensCrafters/NAOO
On Tuesday, the State of California Attorney General’s office announced the NAOO litigation that
challenged the constitutionality of B&P Codes 655 and 2556 is now over. These laws prohibit certain
relationships between optometrists and registered dispensing opticians (RDOs). The State Board of
Optometry may now take action to enforce these state laws against individual optometrists who
practice unlawfully. Below are some questions your society members might get and how we are
answering them on behalf of the Association. Feel free to refer anyone who has a concern about this
issue or COA policy to Kristine Shultz at 916-266-5027.
Q: What is COA’s position on B&P 655 and 2556?
A: COA supports these laws and believes the laws should be enforced.
Q: What business modes could work in California?
A: Current regulations (16 CCR 1514) allow for a retail co-location business model. Basically, an RDO and
an optometrist can lease space next door to each other if the optometrist operates his/her practice
completely independent and not subject to control by an RDO or optical company. This is the model that
is legally authorized.
Q: Would COA be considered as promoting private practice doctors at the expense of doctors who are
employed in retail settings?
No. COA’s position has always been to protect the independent clinical judgment of the optometrists
working in various settings. Our association is not plotting against retail optical companies to get them
to go out of business; we just want them to follow the law.
Q: Is it COA’s position that LensCrafters doctors are giving brief eye exams geared only toward the sale
of eyeglasses?
A: No. But there have been problems reported in the past as highlighted in the litigation.
Q: As an associate, I have pressure to sell eyeglasses too. How is what I’m doing different?
A doctor has taken an oath to have the interest of the patient first and foremost. If the corporation is in
charge, typically they only keep the interest of their shareholders first. The corporation’s only goal is to
generate higher profits. They have no responsibility to the patient’s best interest; to them, the patients
are considered consumers of materials (i.e. eyeglasses).
Q: Is this going to put LensCrafters out of business?
No. California is a big marketplace. LensCrafters has very skilled attorneys that can help them
restructure their business to stay in California.
Q: Does Costco have the same legal issues as LensCrafters?
A: No. However, no one is sure if or how Costco is impacted.
Q: Explain why are retail co-location business models are problematic?
The AG has submitted official court evidence of real harm that occurred when patients believed they
were receiving a comprehensive eye exam that in a traditional setting would detect eye disease and end
up receiving a cursory exam that is given to only sell eyeglasses and other product. In fact, the AG first
initiated litigation because they found that the poor quality eye exam at Pearle Vision was responsible
for a patient’s blindness.
Q: How many people will this decision impact?
A: According to the Attorney General’s office, there are just under 1000 retail operations in California
and about 25-35 percent of the optometric profession works in a retail setting. According to
LensCrafters, they serve more than a million patients in California per year.
Q: Are retail co-location business models different in other states?
A: While all states, including California, allow some retail co-location models, each state regulates the
relationship differently. Other models include franchise, direct employment, and lease arrangements.
Q: What does co-location mean?
A: It refers to a business model where an optometrist is located directly next to a RDO.
Q: Why was B&P 655 necessary?
A: According to the Attorney General’s office, the statute has three reasons:
1. Ensure patients have a comprehensive eye exam
2. Ensure independent clinical judgment of ODs
3. Prevent overprescribing of materials to consumers
Q: What does NAOO stand for?
A: NAOO stands for National Association of Optometrists and Opticians. It is a trade organization
representing retail optometry stores like LensCrafters, Walmart, Costco. We don’t know for sure but
believe there are eight members total in the NAOO.
Q: Is COA working with the SBO to try and keep ODs from getting fired?
A: COA does not control the SBO - we are separate entities. The SBO is the regulatory agency for the
profession of optometry. COA represents the optometric profession.