1.
Licensure
A mail order contact lens supplier that fills contact lens
prescriptions by mail or carrier for a patient who resides in this State shall
provide the following information on forms supplied by the board, along with
such other information as the board may require. Applications will not be
considered for approval until they are complete. Incomplete applications will
be returned to the applicant.
A. The
name, physical address, contact address, telephone number, email address and
world wide web address of the mail order contact lens supplier;
B. All trade or business names used by the
mail order contact lens supplier;
C. Type of ownership or operation (i.e.,
partnership, corporation, or sole proprietorship); and
D. The name(s) of the owner and/or operator
of the mail order contact lens supplier, including:
(1) If a partnership, the name, contact
address, telephone number and employer identification number of the
partnership, and the name and contact address of each partner;
(2) If a corporation, the name, contact
address, telephone number and employer identification number of the
corporation; the name of the parent company, if any; the name, contact address
and title of each corporate officer and director; the name and contact address
of each shareholder owning 10% or more of the voting stock of the corporation,
including over-the-counter stock, unless the stock is traded on a major stock
exchange and not over-the-counter; a certificate of existence from the
corporation's state of organization and, for corporations not organized under
Maine law, a certificate of authority from the Maine Secretary of State if such
certificate is required by
13-C M.R.S.A.
§1501;
(3) If a sole proprietorship, the name,
contact address, telephone number and social security number of the sole
proprietor and the name of the business entity.
E. The DEA number; if applicable;
F. Verification of licensure for all
jurisdictions in which the mail order contact lens supplier has at any time
been licensed;
G. The name, contact
address, telephone number and email address of the person responsible for
licensure of the mail order contact lens supplier; and
H. A copy of the most recent inspection
report from the state in which the mail order contact lens supplier is located,
if an inspection requirement exists; and
I. The fee required by Chapter 10 of the
rules of the Department of Professional and Financial Regulation, Office of
Licensing and Registration, entitled "Establishment of License Fees."
2.
Additional
Qualifications
The board will consider the following additional factors
in determining the applicant's eligibility for registration as a mail order
contact lens supplier:
A. The
applicant's past experience in the dispensation of contact lenses or
prescription drugs;
B. The
furnishing by the applicant of false or fraudulent material in any application
made in connection with the dispensation of contact lenses or prescription
drugs;
C. Suspension or revocation
by federal, state or local government of any license currently or previously
held by the applicant for the dispensation of contact lenses or prescription
drugs;
D. Compliance with
previously granted licenses of any kind; and
E. Compliance with the requirements to
maintain and/or to make available to the board or to federal, state or local
law enforcement officials those records required to be maintained by mail order
contact lens suppliers or mail order prescription pharmacies.
3.
Separate Applications
for Separate Facilities
The owner must file a separate application for each
facility that dispenses contact lens to Maine residents.
4.
Toll-Free Telephone Access to
Qualified Representative
The mail order contact lens supplier shall provide a
toll-free telephone number to enable communication between a Maine patient and
a qualified representative of the contact lens supplier who has access to the
patient's records. The toll-free telephone number must appear on all product
packaging. Toll-free telephone access to a qualified representative must be
available for a minimum of 40 hours per week.
