Expanded Scope of Practice - Laser Surgical Endorsement (HB 218; ARM 24.168.801)
What HB 218 added
HB 218 created a laser surgical endorsement layered on top of the optometry license. ARM 24.168.801 implements the endorsement. The exam tests the distinction between ordinary therapeutic optometry and laser surgery: laser privileges are not automatic and are limited to the procedures and conditions the statute and rule authorize.
Endorsement requirements
- Hold an active Montana optometry license.
- Complete Board-approved didactic and clinical training for the specific laser procedures.
- Pass any required examination or practical assessment.
- Submit the endorsement application and fee.
- Maintain any malpractice coverage the rule requires and comply with recordkeeping, informed consent, complication management and referral standards.
- Renew the endorsement and complete related CE.
Worked example
An optometrist wants to perform a laser procedure such as selective laser trabeculoplasty. Reasoning: confirm the procedure is within the endorsed list; complete the required training and examination; obtain the endorsement before treating; verify insurance and follow the rule's pre- and post-operative standards. The base license alone is insufficient.
Traps
- Confusing authority to prescribe drugs with authority to use lasers.
- Performing a procedure before the endorsement is issued.
- Assuming one laser course covers every procedure.
- Skipping informed consent or referral documentation.
- Letting the endorsement lapse while continuing laser cases.