Montana scope of practice bill HB500 defeated again after reconsideration

Montana’s chiropractic scope of practice expansion bill, HB500, has failed its third reading for the second time, by a margin of single vote.

Introduced by Greg Oblander, DC, the Montana Chiropractic Association’s Chiropractor of the Year for 2024, HB500 would have significantly updated DCs’ state-licensed scope of practice, going beyond treatment of the spine, even offering DCs the ability to prescribe certain drugs, such as muscle relaxants and NSAIDs, once they applied for and received a prescriptive license endorsement. The possibility of prescriptive authority has made HB500 controversial within the chiropractic industry.

On March 5, HB500 failed by a vote of 48-50.

The next day, March 6, Rep. Oblander called for a reconsideration and the bill was restored to its previous third-reading status by a vote of 54-44.

On March 7, HB500 again failed, this time by a vote of 49-50.

By Montana statute, March 12 is the general bill transmittal deadline.

“Transmittal marks the deadline for general bills to pass through at least one chamber, or the bill is considered dead,” wrote journalist Micah Drew in the Daily Montanan, a nonprofit, nonpartisan news source covering legislative news in the state.

Opposition to Montana HB500

The International Chiropractors Association (ICA) has opposed the bill, sending board member Hugo M. Gibson, DC, to testify against it. Gibson expressed his concerns about giving DCs prescriptive authority; read the entirety of his and the ICA’s concerns about the scope of practice expansion on the ICA website.

“While ICA is happy with the outcome, we are concerned that the vote was so close,” the ICA’s post noted. “The idea that so many legislators were ready to expand the Montana scope to include drug prescribing with a list of drugs that included products with mandatory Black Box warnings from the FDA is a wake-up call to the need for our entire community to engage and ensure legislators understand that chiropractic is and should remain a drug-free profession.”

Pending legislation in other states and at the federal level also seeks to update DCs’ scope of practice. The Chiropractic Medicare Coverage Modernization Act of 2025 (HR539/S106), reintroduced in January and currently in committee, seeks to bring the chiropractic services covered by Medicare in line with those MD-provided services already covered, so that seniors with Medicare will have a broader choice of service providers for more of their health needs.

The state of New York also introduced a scope modernization bill earlier this year; in addition to extensive updates to DCs’ scope of practice it defines and codifies the chiropractic assistant’s role.

Chiropractic Economics staff will update this article with any new developments on the status of scope-of-practice expansion efforts in Montana.