Revision: Jan. 5, 2026, 1:52 p.m.
Rep. Barton, Graf. 1
January 5, 2026
2026-0031h
05/07
Floor Amendment to HB 349-FN
Amend the bill by replacing all after the enacting clause with the following:
1 New Sections; Authorization to Perform Ophthalmic Laser Procedures. Amend RSA 327 by inserting after section 6-c the following new sections:
327:6-d Authorization to Perform Ophthalmic Laser Procedures.
I. Notwithstanding any other provision of this chapter, an optometrist licensed under this chapter shall be authorized to perform the following ophthalmic laser procedures upon certification by the board:
(a) Laser capsulotomy.
(b) Laser trabeculoplasty.
(c) Laser peripheral iridotomy.
II. Authorization under this section shall be conditional and subject to the limitations and requirements of this section.
III. An optometrist authorized under this section may perform only the procedures expressly listed in paragraph I and no others. Nothing in this section shall be construed to authorize incisional surgery or management of surgical complications beyond the scope expressly permitted.
IV.(a) The board shall not certify an optometrist to perform any procedure under this section unless the optometrist has completed, at a minimum:
(1) Procedure-specific didactic education;
(2) A minimum number of supervised live procedures for each authorized laser procedure, performed under direct supervision of a New Hampshire-licensed ophthalmologist approved by the board; and
(3) Objective demonstration of competency documented in writing.
(b) The board shall not waive or reduce these requirements by rule.
V.(a) Each optometrist certified under this section shall maintain a formal, written referral and escalation arrangement with a New Hampshire-licensed ophthalmologist that provides for:
(1) Same-day consultation in the event of complications; and
(2) Timely transfer of care when medically indicated.
(b) Failure to maintain such arrangement shall constitute grounds for immediate suspension of certification and discipline.
VI. An optometrist certified under this section shall not perform any authorized procedure on patients with:
(a) Advanced or secondary glaucoma;
(b) Significant ocular comorbidities increasing risk of complication;
(c) Prior ocular surgery other than uncomplicated cataract extraction, except for laser capsulotomy; or
(d) Any other high-risk condition expressly excluded by statute.
VII. The board shall adopt rules under RSA 541-A establishing the criteria for certification of an optometrist to perform ophthalmic laser procedures with proficiency, including:
(a) Establishment of minimum education, training, and live experience requirements for a licensee to perform such procedures with proficiency;
(b) Criteria for requiring proctoring and criteria for proctors; and
(c) Outcome reporting requirements for such procedures performed by certificate holders.
VIII. No optometrist shall perform ophthalmic laser procedures under this section unless the optometrist has submitted evidence of satisfactory completion of all requirements for specific procedures and the board has certified the optometrist as qualified.
327:6-e Outcomes Registry and Reporting.
I. The board shall establish and maintain a mandatory, statewide registry for all ophthalmic laser procedures performed under RSA 327:6-d.
II. Reporting shall include, at a minimum:
(a) Procedure type and clinical indication;
(b) Intraocular pressure outcomes where applicable;
(c) Complications or adverse events;
(d) Repeat or additional laser procedures; and
(e) Referrals or transfers of care to ophthalmologists within 90 days.
III. Beginning November 1, 2026, the board shall submit an annual, de-identified report of aggregate outcomes to the speaker of the house of representatives, the senate president, the house clerk, the senate clerk, and the policy committee in each body with jurisdiction over occupational regulation and the practice of optometry.
2 Repeal. The following are repealed:
I. RSA 327:6-d, relative to authorization to perform ophthalmic laser procedures.
II. RSA 327:6-e, relative to the outcome registry and reporting requirement for ophthalmic laser procedures.
I. Section 2 of this act shall take effect January 1, 2032.
II. The remainder of this act shall take effect 60 days after its passage.
2026-0031h
AMENDED ANALYSIS
This bill:
I. Authorizes optometrists who meet criteria established in statute and administrative rules to perform certain ophthalmic laser procedures.
II. Establishes a statewide registry for ophthalmic laser procedures and requires the board to submit an annual report of outcomes to the general court.
III. Prospectively repeals the authorization, registry, and reporting requirement in 5 years.