Bill
HB 349
Authorship of ophthalmic laser procedures would be expanded to qualified optometrists with required training, supervision rules, and safety safeguards.
HB 349 (2026) — Summary
Jurisdiction: New Hampshire
Subject: Relative to the practice of optometry and authorization to perform ophthalmic laser procedures
Overview
HB 349 proposes changes to the practice of optometry in New Hampshire, including authorization for optometrists to perform certain ophthalmic laser procedures. The bill underwent committee review and legislative action in 2025-2026, including amendments and a veto by the Governor in March 2026, with a veto sustained in April 2026. This summary outlines the bill’s stated purpose, key provisions, who would be affected, and timing considerations.
1) Purpose and intent
- Expand scope of optometric practice to include specified ophthalmic laser procedures.
- Establish regulatory parameters to ensure patient safety and professional standards in the expanded area of practice.
- Clarify qualifications, supervision, and procedural requirements for optometrists performing laser procedures on the eye.
2) Key provisions and changes (highlights)
- Scope expansion:
- Allows licensed optometrists to perform defined ophthalmic laser procedures that are currently outside the traditional optometry scope, subject to statutory and regulatory controls.
- Certification and training:
- Specifies required training, continuing education, and credentialing for optometrists seeking authorization to perform laser procedures.
- May include minimum education hours, completion of approved courses, and demonstration of competency.
- Procedure limitations:
- Sets boundaries on which laser procedures are authorized (e.g., certain refractive, diagnostic, or therapeutic laser applications) and may exclude highly invasive or high-risk procedures that would require medical doctor (MD/DO) oversight.
- Supervision and collaboration:
- Defines whether procedures require physician supervision, co-signature, or on-call arrangements with ophthalmologists or medical doctors.
- Safety and patient protection:
- Establishes safety standards, informed consent requirements, patient selection criteria, and post-procedure care protocols.
- May address reporting of adverse events and quality assurance mechanisms.
- Licensing and enforcement:
- Outlines enforcement provisions, potential penalties for noncompliance, and processes for changing scope of practice through rulemaking or board actions.
- Regulatory framework:
- Likely references the relevant New Hampshire boards (e.g., Optometry Board, or board with jurisdiction over optometrists) for licensure, credentialing, and disciplinary actions.
- Effective date and transition:
- Provides effective date for changes and any transition timelines for optometrists to obtain necessary certifications to perform laser procedures.
3) Who would be affected
- Practicing optometrists:
- Those who already hold active licenses in New Hampshire and who seek authorization to perform ophthalmic laser procedures, subject to training and credentialing requirements.
- Ophthalmologists and medical doctors:
- May experience changes in supervision or collaboration arrangements for laser procedures traditionally performed by ophthalmologists but now accessible to optometrists.
- Patients:
- Potentially greater access to certain laser procedures performed by optometrists, with specified safety and consent protections.
- Regulatory and licensing bodies:
- State boards overseeing optometry and medical practice, which would implement rules, credentialing standards, and enforcement mechanisms.
4) Procedural and timeline aspects
- Introduction and referral:
- Introduced January 7-8, 2026; referred to Health and Human Services and Finance committees (varied initial committee paths noted in the record).
- Committee action:
- Health/Human Services committee reported “Ought to Pass” with amendments in February 2026.
- Subsequent amendments (noted as 2025-2969h and 2026-0032h) were considered during committee and floor actions.
- Floor and enrollment:
- Passed enrolled status in March 2026, with floor actions indicating adoption and resistance to amendments in the Senate/House as applicable.
- Governor action and veto:
- Governor vetoed the bill on March 27, 2026.
- House sustained the veto on April 9, 2026, with a vote tallied at RC 145-206, indicating that the two-thirds threshold for a veto override was not met.
- Current status:
- With veto sustained, HB 349 did not become law in its current form. Further legislative action would be required to modify and potentially re-enact the bill, or to pursue an override if a sufficient vote could be achieved in both chambers.
Notes
- The summary reflects the known action history up to the veto sustain in April 2026. The bill’s specific language, including which laser procedures are authorized and the exact training requirements, would be in the enrolled/amended text and related rulemaking proposals, which should be consulted for precise details.
If you’d like, I can pull together a side-by-side comparison of the bill’s proposed provisions with the current statute to illustrate exact changes and potential regulatory impacts.
Compiled from official sources — confirm details with the bill’s official record.
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