Supervision of Advanced Practice Registered Nurses; definitions; eligibility requirements for physicians; limits; exceptions; responsibilities; disciplinary action; penalties; effective date.

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STATE OF OKLAHOMA

1st Session of the 60th Legislature (2025)

HOUSE BILL 1812 By: Newton

AS INTRODUCED

An Act relating to supervision of Advanced Practice
Registered Nurses; providing definitions; providing
eligibility requirements for physicians; providing
limits; providing for exceptions; providing certain
responsibilities; providing for disciplinary action;
authorizing penalties; providing for codification;
and providing an effective date.

BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 479 of Title 59, unless there is
created a duplication in numbering, reads as follows:
A. As used in this section:
1. "Advanced Practice Registered Nurse" or "(APRN)" means a
registered nurse who has obtained a license from the Oklahoma Board
of Nursing to practice advanced registered nursing;
2. "Board" means the State Board of Osteopathic Examiners or
State Board of Medical Licensure and Supervision;
3. "Mid-level provider" means a licensed Advanced Practice
Registered Nurse by the Oklahoma Board of Nursing or a Physician's

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Assistant licensed by the Oklahoma Board of Medical Licensure and
Supervision;
4. "Proper physician supervision" means that the supervising
physician routinely reviews the prescribing patterns of an Advanced
Practice Registered Nurse under his or her supervision and that the
supervising physician is available to the Advanced Practice
Registered Nurse for consultation in-person or by telemedicine
within a reasonable timeframe not exceeding forty-eight (48) hours;
5. "Supervising physician" means a licensed allopathic or
osteopathic physician in good standing who is responsible for
supervising and overseeing the prescribing practices of an Advanced
Practice Registered Nurse; and
6. "Verified complaint" means the formal allegation of at least
one violation of statutes or administrative rules against a
physician filed by the board.
B. To be eligible to serve as a supervising physician for an
Advanced Practice Registered Nurse, an allopathic or osteopathic
physician shall meet the following criteria:
1. Have possession of a full and unrestricted Oklahoma license
to practice allopathic or osteopathic medicine;
2. Have possession of a valid permit to prescribe controlled
drugs with the Drug Enforcement Agency (DEA) and Oklahoma Bureau of
Narcotics and Dangerous Drugs Control (OBNDD); and

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3. Be fully trained and qualified in the field of the APRN's
specialty or in the services and procedures the APRN is to provide.
C. A supervising physician may charge a reasonable fee to the
APRN for his or her supervision services, which shall be disclosed
in a written agreement. Any fees charged by a supervising physician
shall be appropriate based on the actual duties and responsibilities
of the supervising physician as outlined in a written agreement.
The fees charged shall be a fair-market-value hourly rate as defined
by the respective board biannually. A supervising physician who
charges an Advanced Practice Registered Nurse for supervision
services and fails to provided proper physician supervision may be
subject to discipline by the physician's respective board. This
subsection does not relate to or impact any compensation a
supervising physician receives from his or her employer or health
care entity for supervision services. It only pertains to
compensation received directly from the APRN.
D. All supervising physicians shall have a written agreement
with each APRN he or she supervises. The written agreement shall
outline any fees charged for supervision services, the scope of the
Advanced Practice Registered Nurse's practice, including any
limitations on prescribing controlled drugs, and the extent of the
supervision required. The physician shall file the written
agreement with the respective licensing board.

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E. A supervising physician shall notify Advance Practice
Registered Nurses under his or her supervision of reasonably
anticipated periods of unavailability or incapacity on the part of
the supervising physicians. Notice shall be given by the method
agreed to by the supervising physician and the Advanced Practice
Registered Nurse within the written supervision agreement.
F. The supervising physician shall report to the Board and
Advanced Practice Registered Nurse any changes to the supervising
relationship within fourteen (14) days, including the addition or
removal of an Advanced Practice Registered Nurse or changes to the
practice address, cell phone numbers, the scope of the supervision
relationship, or prescriptive authority.
G. The Board shall not charge any fees to supervising
physicians or Advanced Practice Registered Nurses for the
maintenance and tracking of the supervision relationship.
H. The Board shall promulgate rules establishing the
expectations for providing proper supervision to Advanced Practice
Registered Nurses, including:
1. The charging of reasonable fees to provide supervision
services;
2. Continuous availability of direct communications either in
person or by electronic communications between the APRN and
supervising physician;

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3. Oversight and acceptance of responsibility for the ordering
and transmission of written, telephonic electronic, or oral
prescriptions for drugs and other medical supplies, subject to a
defined formulary in Section 567.3a of Title 59 of the Oklahoma
Statutes;
4. Regular chart review;
5. The delineation of a plan for emergencies; and
6. The designation of an alternate physician in the absence of
the supervising physician.
I. Failure to comply with these rules may result in
disciplinary action by the board.
J. The Executive Director of the respective board shall report
annually to the Board the number of complaints received in relation
to this section of law.
K. The Executive Director of the respective board shall create
and maintain a list of physicians on the agency's official website
who are willing to serve as a supervising physician to an Advanced
Practice Registered Nurse licensed in Oklahoma.
SECTION 2. This act shall become effective November 1, 2025.

60-1-10618 TJ 01/14/25