Laser Bills in Kansas, New Hampshire Await Governor Approval

At least eight states are actively pursuing legislation that would add laser and other ophthalmic surgical procedures to their optometric practice scope. Photo: Nate Lighthizer, OD. Click image to enlarge. In recent years, the push for scope expansion among optometrists has gained significant momentum across the US. Last year alone, more than a dozen bills were introduced, culminating in the successful passage of two bills that established West Virginia and Montana as the 13th and 14th states to authorize laser procedures for ODs. This legislative wave continues into the current year, with at least eight states actively pursuing scope expansion, each navigating different stages of the legislative process.Most of these bills are already making significant headway, with two already sitting on the governor’s desk for consideration in Kansas and New Hampshire. However, not all initiatives are progressing as hoped; New Mexico's proposal was hindered by a brief legislative session, ultimately concluding before it could be considered by the Senate. Below, we’ll review what happened there, along with an update on where the other active bills currently stand.New MexicoPractice regulations for optometrists in this state have remained unchanged for over a decade, despite persistent advocacy efforts. Last year, both the House and Senate passed a laser bill, though New Mexico Governor Michelle Lujan Grisham chose to veto it due to safety concerns.After working closely with Governor Lujan Grisham over the last several months, stakeholders introduced similar legislation this year—HB 213—which incorporated additional safeguards through strong, enforceable certification and oversight requirements.The New Mexico Optometric Association (NMOA) reports that the bill received "do-pass" votes from both the House Health and Human Services Committee and the House Judiciary Committee, subsequently passing the House with a vote of 56-10.Moving to the Senate, Richard Montoya, executive director of the NMOA, says, “We had great momentum, but the 2026 legislative session was a short 30-day session, and ultimately, the session ended before HB 213 was heard in the Senate.” With growing support within the legislature, New Mexico ODs remain optimistic about future advancements.New HampshireOptometrists in New Hampshire practice under one of the most restrictive scopes in the country, but there’s a glimmer of hope for change on the horizon. The state’s laser bill, HB 349, has made significant strides this year, successfully passing both the Senate and House after being carried over from 2025. Now, its fate lies in the hands of Governor Kelly Ayotte, who has just a few days to sign or veto the proposed legislation.KansasHouse Bill 2223 has been in play in Kansas since February of last year, proposing to grant the state’s ODs the authority to perform subcutaneous injections of the eye and adnexa, skin lesion removal and biopsy and three optometric laser procedures: SLT, capsulotomy and LPI.After passing both the state’s House and Senate last month, the bill was sent to Governor Laura Kelly on March 3. According to Kansas law, Governor Kelly has until this Friday to determine the legislation’s fate.New JerseyThis state had two identical scope bills—one in the Senate and one in the Assembly—in play from 2024 to 2025, but by the time last year’s legislative session adjourned, both were still awaiting consideration in their respective committees. Continuing these efforts, a carryover bill was introduced in New Jersey this past January. Filed as Senate Bill 178, the document proposes adding several practice privileges—the same as those advocated for in previous bills—to the state’s scope of practice for optometrists. This includes three laser procedures—SLT, capsulotomy and LPI—removal of styes and skin tags and an expansion of vaccine and prescription authority. SB 178 is currently pending in the Senate Commerce Committee.OhioThe fight to expand the practice scope for Ohio optometrists will continue this year with SB 36. The bill was first introduced in January 2025, but the Ohio Optometric Association (OOA) reports that just a few weeks ago, a new substitute bill with stricter trainer requirements was entered into the Senate Health Committee, where proponent testimony was heard on March 4.“Based on feedback from the Senate Health Committee regarding patient safety and optometric training, a substitute bill was drafted to enhance and strengthen the patient safety and training in SB 36,” the OOA comments. The substitute bill rules that certification training must be conducted by accredited institutions or organizations. It also requires trainees complete a designated number of supervised operations for certain procedures, with additional procedures mandated if proficiency is not demonstrated.South CarolinaOptometrists in South Carolina are hopeful that HB 4103, introduced in February 2025, will finally allow them to practice to the fullest extent of their training and education. The bill proposes adding ophthalmic surgery, including the use of lasers, to the optometric scope. It currently resides in the Labor, Commerce and Industry subcommittee in the state’s House of Representatives.“SCOPA (South Carolina Optometric Physicians Association) has been working hard to move the bill within this committee and has a lot of support from members of the entire committee and the SC House of Representatives,” says Kevin Campbell, OD, president of the SCOPA Board of Directors. He explains, “H.4103 will improve patient care in South Carolina by allowing better access for patients and will provide patients with more choices for high-quality eye care in our state. Doctors of Optometry are coming out of school with an extremely high degree of education, and our current practice act limits the way they can use their education to provide the highest standard of care.”Dr. Campbell remarks that the bill “will have a positive impact on patients and doctors of optometry in South Carolina” and hopes to see it cross the finish line before the 2026 legislative session adjourns in May.VermontIntroduced in February 2025, Vermont’s two-year laser bill, HB 241, is continuing to progress through the legislature. The document aims to substantially broaden practice privileges for ODs there, who provide care to patients in the most rural state in the country.The bill will be up for mark-up and a vote this week in the Senate Health and Welfare Committee. If passed, the Vermont Optometric Association expects it to land in the House Healthcare Committee before the end of May.Other EffortsTwo more states—Tennessee (HB 1952/SB 2076) and Maine (SB 1803)—filed laser bills in the last few weeks. Tennessee is on the calendar to be heard by the House Health Committee next week, while legislation in Maine is currently pending in the Senate Joint Health Coverage, Insurance and Financial Services Committee.In Missouri, ODs are in the midst of fighting two anti-optometry bills—HB 2999 and SB 1254—that propose removing surgical privileges already included in the state’s optometric practice scope. Ophthalmologists lobbying for this legislation also wish to specifically exclude lasers from optometric practice regulations in Missouri. The state’s optometric association is actively fighting these bills in hopes that they won’t proceed. We’ll continue to report on the matter in our online News Feed as developments arise. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.