Generally revise laws relating to chiropractic practitioners
HB 929 revises Montana law governing chiropractic practice to create an optional prescriptive authority endorsement for chiropractors. A chiropractor could apply to the Board of Chiropractors for this endorsement and, if approved, prescribe, obtain, and administer only a limited formulary of noncontrolled, nonscheduled drugs for musculoskeletal treatment and pain. The bill specifically lists over-the-counter analgesics, prescription NSAIDs, muscle relaxants, topical analgesics and anti-inflammatories, and topical and oral corticosteroids. It also authorizes the board to charge an application fee and to adopt rules governing applications, education, continuing education, prescribing protocols, and other implementation requirements.
The bill amends existing chiropractic statutes to carve out this limited prescriptive authority from the general prohibition on chiropractors prescribing drugs. It updates the definition of chiropractic and the practice limitations in Title 37, chapter 12, MCA, while making clear that chiropractors who do not obtain the endorsement remain prohibited from advertising or implying that they can prescribe. The board is also given authority to expand the formulary by rule to include additional FDA-approved noncontrolled, nonscheduled drugs that fit within the bill’s limits.
The stated policy rationale is to improve access to care, reduce delays and costs for patients, and address physician shortages by allowing chiropractors to handle certain common medications without referring patients elsewhere. Legislative action suggests the bill had meaningful support in the House, passing committee and both floor readings, but it ultimately died in a Senate standing committee. That outcome indicates the measure advanced farther than many bills but did not secure final enactment.
Because there is no committee transcript provided, the main points of contention must be inferred from the bill’s structure and legislative path. Likely concerns include whether chiropractors should have any prescriptive authority at all, whether the training and rulemaking safeguards are sufficient, and whether expanding scope of practice could affect patient safety or overlap with physicians and other prescribers. Support appears to have centered on access to care, continuity of treatment, and allowing a narrowly tailored, optional endorsement rather than a broad expansion of chiropractic practice.
HB 929 would amend Montana’s chiropractic statutes in Title 37, chapter 12, MCA, to create a new prescriptive authority license endorsement administered by the Board of Chiropractors. It would change the existing prohibition on chiropractors prescribing drugs by allowing endorsed chiropractors to prescribe only specified noncontrolled, nonscheduled medications for musculoskeletal diagnosis and treatment, while preserving the general prohibition for all other chiropractors. The bill also gives the board rulemaking authority over qualifications, education, protocols, fees, and implementation, and it could affect chiropractors, patients seeking pain and musculoskeletal care, and the broader health care delivery system.
The overall sentiment appears generally supportive, especially in the House, where the bill passed committee and both floor readings with majority support. The bill’s findings emphasize access to care, physician shortages, and continuity of treatment, suggesting a favorable view of the measure as a limited and optional scope expansion. However, its later death in a Senate standing committee indicates that support was not sufficient to carry it through the full legislative process, implying at least some institutional hesitation or opposition in the Senate.
The main contention is the scope-of-practice question: whether chiropractors should be allowed to prescribe any drugs, even in a narrow and regulated form. Supporters argue the endorsement is optional, limited to noncontrolled medications, and designed to reduce delays and costs for patients with musculoskeletal pain. Potential opponents likely worry about training standards, patient safety, regulatory oversight, and the precedent of expanding prescriptive authority beyond traditional chiropractic practice. The bill attempts to address those concerns by limiting the formulary, requiring board-approved education and protocols, and allowing only endorsed chiropractors to prescribe.