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.

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.