Healthcare

HB 218 revises the practice of optometry by expanding the scope of services licensed optometrists can provide. It permits optometrists to perform certain in-office surgical procedures and laser surgical procedures, specifically limited to the anterior segment of the eye and adnexa. However, the bill explicitly excludes penetrating intraocular surgery, intravitreal injection, and refractive surgery. To perform laser surgical procedures, optometrists must be certified by the board after completing required didactic and clinical training. This act takes effect on July 1, 2025.

HB 399 revises prior authorization laws for health insurance issuers, aiming to simplify access to certain prescription drugs for covered individuals. The bill prohibits prior authorization for oral and inhaled generic prescription drugs, inhaled medications for asthma or chronic lung diseases, and insulin for diabetes patients. It also restricts prior authorization for generic drugs used consistently for six months and for dosage adjustments within approved limits. If an insurer makes an adverse determination for a prescription drug, the decision must be made by a specialist physician, and the insurer must provide a list of covered therapeutic alternatives.

SB 82 establishes a new program within Montana's Department of Public Health and Human Services to support individuals under age 55 with severe visual impairments in achieving independent living goals. The bill defines "severe visual impairment" as a disability that significantly hinders daily tasks even with correction, and outlines specific services including mobility training, Braille instruction, assistive technology, and peer counseling. Eligibility is determined by the department based on established criteria, with services provided based on available funds and consumer needs, while also guaranteeing a fair hearing for those disagreeing with decisions. The program takes effect July 1, 2025, and applies to Montana residents meeting the defined criteria.

This bill makes Montana's community health aide program permanent by removing its previously scheduled expiration date. It directs the Department of Public Health and Human Services to apply for Medicaid coverage for services provided by certified community health aides. The change directly affects community health aides and their patients, particularly in rural and tribal communities, ensuring continued access to essential healthcare services without future legislative renewal.

HB 41 adds gabapentin to Montana's Schedule V list of controlled substances under the "depressants" category. This change directly affects medical providers who prescribe gabapentin (used for nerve pain, seizures, and other conditions), pharmacists who dispense it, and patients using the medication. The bill amends Montana Code § 50-32-232 to explicitly include gabapentin - identified by its chemical name "1-(aminomethyl)cyclohexaneacetic acid" - in Schedule V depressants alongside drugs like pregabalin. This policy update standardizes gabapentin's regulatory classification without altering its medical use or prescribing rules.