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An Act
ENROLLED HOUSE
BILL NO. 2298 By: Hilbert, Fetgatter,
Cornwell, Turner, Cantrell,
Munson, and Kelley of the
House
and
Paxton, Murdock, Coleman,
Mann, and Green of the
Senate
An Act relating to the practice of nursing; providing
for independent prescriptive authority of Advanced
Practice Registered Nurses who meet certain
requirements; stating application criteria;
specifying duration of authority; providing for
disciplinary action; authorizing certain fee;
prescribing certain malpractice insurance
requirements; directing promulgation of certain
advertising rules; requiring certain disclosure;
providing penalties; defining terms; providing
eligibility requirements for supervising physicians;
requiring specified supervision agreement;
authorizing supervision fees subject to certain
conditions; requiring certain notices; prohibiting
certain fees; directing promulgation of certain
rules; providing for disciplinary action; requiring
certain reporting; directing online publication of
certain list; amending 59 O.S. 2021, Section 353.1,
as amended by Section 6, Chapter 288, O.S.L. 2022 (59
O.S. Supp. 2024, Section 353.1), which relates to
definitions used in the Oklahoma Pharmacy Act;
modifying and adding definitions; amending 59 O.S.
2021, Section 353.1a, which relates to prescriptive
authority of Advanced Practice Registered Nurses;
modifying prescriptive authority of certain Advanced
Practice Registered Nurses; updating statutory
language; amending 59 O.S. 2021, Section 567.3a,
which relates to definitions used in the Oklahoma
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Nursing Practice Act; modifying and adding
definitions; amending 59 O.S. 2021, Section 567.4a,
which relates to prescriptive authority; specifying
authority of the Oklahoma Board of Nursing to grant
prescriptive authority; directing the Board to
promulgate certain rules; clarifying certain
educational requirement; requiring the Formulary
Advisory Council to develop, update, and publish
certain guidelines; modifying references; conforming
language; amending 59 O.S. 2021, Section 567.5a, as
amended by Section 1, Chapter 94, O.S.L. 2024 (59
O.S. Supp. 2024, Section 567.5a), which relates to
Advanced Practice Registered Nurse license; providing
for independent prescriptive authority by
endorsement; amending 63 O.S. 2021, Section 2-312, as
amended by Section 2, Chapter 184, O.S.L. 2022 (63
O.S. Supp. 2024, Section 2-312), which relates to
controlled dangerous substances; conforming language;
limiting effect of certain authority; updating
statutory references and language; providing for
codification; and providing an effective date.
SUBJECT: Practice of nursing
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 567.4c of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. An Advanced Practice Registered Nurse recognized by the
Oklahoma Board of Nursing as a Certified Nurse Practitioner,
Clinical Nurse Specialist, or Certified Nurse-Midwife who has
completed a minimum of six thousand two hundred forty (6,240)
clinical practice hours with prescriptive authority supervised by a
physician may apply to the Oklahoma Board of Nursing for authority
to prescribe and order independent of supervision.
B. The application for independent prescriptive authority shall
include proof that the Certified Nurse Practitioner, Clinical Nurse
Specialist, or Certified Nurse-Midwife:
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1. Holds a valid, current license in the appropriate Advanced
Practice Registered Nurse role issued by the Board and is in good
standing with the Board; and
2. Has completed a minimum of six thousand two hundred forty
(6,240) clinical practice hours with prescriptive authority
supervised by a physician. This paragraph shall not be construed to
exclude practice hours with supervised prescriptive authority
obtained prior to the effective date of this act from being counted
toward the hours required in this paragraph.
C. Independent prescriptive authority granted under this
section shall be valid until the expiration of the current license
to practice and may be renewed upon application to the Board at the
same time and for the same period as the renewal of the license to
practice.
D. The Board may suspend or revoke independent prescriptive
authority granted under this section in accordance with the
Administrative Procedures Act for violation of the provisions of, or
the rules promulgated under, the Oklahoma Nursing Practice Act.
E. The Board may assess a reasonable fee for the review of
initial and renewal applications under the provisions of this
section.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 567.5b of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. An Advanced Practice Registered Nurse, or the employer of
the Advanced Practice Registered Nurse on his or her behalf, shall
carry malpractice insurance or demonstrate proof of financial
responsibility in a minimum amount of One Million Dollars
($1,000,000.00) per occurrence and Three Million Dollars
($3,000,000.00) in the aggregate per year. This requirement shall
apply only to the Advanced Practice Registered Nurse and shall not
be construed as to require the Advanced Practice Registered Nurse to
provide malpractice insurance coverage to any supervising physician.
B. An Advanced Practice Registered Nurse who is employed by or
under contract with a federal agency that carries malpractice
insurance in any amount on behalf of the Advanced Practice
Registered Nurse shall be deemed in compliance with subsection A of
this section when practicing under such federal employment or
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contract. However, to the extent the Advanced Practice Registered
Nurse practices outside of such federal employment or contract, the
Advanced Practice Registered Nurse, or his or her employer, shall
comply with subsection A of this section.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 567.5c of Title 59, unless there
is created a duplication in numbering, reads as follows:
A. The Oklahoma Board of Nursing shall promulgate rules
governing the advertising of health care services by Advanced
Practice Registered Nurses to include, but not be limited to, the
specialty areas or types of health care services Advanced Practice
Registered Nurses may advertise based on their training or
experience.
B. Any such advertisement shall clearly state that the person
providing such services is an Advanced Practice Registered Nurse and
shall not imply that the Advanced Practice Registered Nurse is a
physician or that he or she may perform any medical service or
prescribe any medication beyond those authorized under state law or
in a manner otherwise inconsistent with state law.
C. An Advanced Practice Registered Nurse who violates the
provisions of this section shall be subject to disciplinary action
by the Oklahoma Board of Nursing which may include, but not be
limited to, revocation of licensure.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 479.1 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” has the same meaning as
defined in Section 567.3a of Title 59 of the Oklahoma Statutes,
except that such term does not include a Certified Registered Nurse
Anesthetist;
2. “Board” means the State Board of Medical Licensure and
Supervision or the State Board of Osteopathic Examiners, or both, as
the context indicates; and
3. The terms “supervising physician” and “supervision” have the
same meaning as defined in Section 567.3a of Title 59 of the
Oklahoma Statutes.
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B. To be eligible to serve as a supervising physician for an
Advanced Practice Registered Nurse who has not obtained independent
prescriptive authority under Section 1 of this act, the physician
shall meet the following criteria:
1. Have possession of a full and unrestricted license to
practice allopathic or osteopathic medicine issued by the State
Board of Medical Licensure and Supervision or the State Board of
Osteopathic Examiners;
2. Have possession of a valid registration to prescribe
controlled substances issued by the Drug Enforcement Administration
and the Oklahoma State Bureau of Narcotics and Dangerous Drugs
Control; and
3. Be trained and fully qualified in the field of the Advanced
Practice Registered Nurse’s specialty as determined by the
physician’s respective Board; provided, however, a supervising
physician for a Certified Nurse-Midwife may be a family practice
physician, obstetrician, or gynecologist.
C. A supervising physician shall enter into a written
supervision agreement with each Advanced Practice Registered Nurse
he or she supervises. The supervising physician shall file the
supervision agreement with his or her respective Board in the manner
prescribed by such Board. The supervision agreement shall specify:
1. Any fees charged to the Advanced Practice Registered Nurse
for supervision services in accordance with subsection D of this
section;
2. The scope of the Advanced Practice Registered Nurse’s
prescriptive authority, subject to any limits on scope of
prescriptive authority provided by the rules of the Oklahoma Board
of Nursing;
3. A description of the extent of the supervision required;
4. The duties and responsibilities of the supervising
physician;
5. Procedures for notice to be provided by the supervising
physician to Advanced Practice Registered Nurses for periods of
absence in accordance with subsection E of this section; and
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6. One or more alternate physicians designated to supervise the
Advanced Practice Registered Nurse in such periods of absence in
accordance with the rules promulgated under subsection H of this
section.
D. 1. A supervising physician may charge a reasonable fee to
the Advanced Practice Registered Nurse for his or her supervision
services. Any such fees shall be:
a. disclosed in the supervision agreement required under
subsection C of this section,
b. appropriate based on the actual duties and
responsibilities of the supervising physician as
outlined in the supervision agreement, and
c. a fair market value hourly rate in accordance with the
rules promulgated under subsection H of this section,
or by mutual agreement between the Advanced Practice
Registered Nurse and supervising physician.
2. The provisions of this subsection shall apply only to
compensation received by the supervising physician directly from the
Advanced Practice Registered Nurse. This subsection shall not be
construed to:
a. preclude a supervising physician from entering into a
payment arrangement for supervision fees to be paid by
his or her employer or health care entity in lieu of
the Advanced Practice Registered Nurse,
b. preclude an employer or health care entity of a
supervising physician from prohibiting, limiting, or
otherwise addressing such supervision fees through
policies, contracts, or bylaws, or
c. apply to or impact any compensation a supervising
physician receives from his or her employer or health
care entity for supervision services.
E. A supervising physician shall notify all Advanced Practice
Registered Nurses under his or her supervision of reasonably
anticipated periods of unavailability or incapacity on the part of
the supervising physician. Notice shall be given by the method
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agreed to by the supervising physician and the Advanced Practice
Registered Nurse within the written supervision agreement.
F. The supervising physician shall report to his or her
respective Board, and shall notify all Advanced Practice Registered
Nurses under his or her supervision of, any changes to the
supervising relationship within thirty (30) calendar days including,
but not limited to, the addition or removal of an Advanced Practice
Registered Nurse under the physician’s supervision or a change to
the physician’s practice address or contact information. The
physician’s supervision agreements shall be amended as necessary to
reflect any such changes.
G. The State Board of Medical Licensure and Supervision and the
State Board of Osteopathic Examiners shall not charge any fees to
supervising physicians or Advanced Practice Registered Nurses for
the maintenance or oversight of supervision agreements or other
administrative functions related to the implementation or
enforcement of this section.
H. The State Board of Medical Licensure and Supervision and the
State Board of Osteopathic Examiners shall promulgate a uniform set
of rules establishing standards for proper supervision of Advanced
Practice Registered Nurses who have not obtained independent
prescriptive authority under Section 1 of this act, including:
1. The charging of reasonable fees to provide supervision
services. The rules shall establish a fair market value hourly rate
for such fees, which shall be redetermined biennially;
2. Continuous availability of direct communications either in
person or by electronic communications between the Advanced Practice
Registered Nurse and supervising physician;
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 the
formulary established by the Oklahoma Board of Nursing;
4. Review of prescribing patterns of the Advanced Practice
Registered Nurse;
5. The delineation of a plan for emergencies; and
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6. The designation of one or more alternate physicians in the
absence of the supervising physician.
I. A supervising physician may be subject to disciplinary
action by his or her respective Board for failure to comply with the
provisions of, or the rules promulgated under, this section
including, but not limited to, failure to provide proper
supervision.
J. If either Board imposes limits through rule on the number of
Advanced Practice Registered Nurses that a supervising physician may
supervise, such limits shall not apply when an Advanced Practice
Registered Nurse is practicing in a hospital licensed by the State
Department of Health.
K. The Executive Director of each Board shall report annually
to the respective Board the number of complaints received in
relation to this section.
L. The State Board of Medical Licensure and Supervision and the
State Board of Osteopathic Examiners shall each create and maintain
on the respective Board’s website a list of physicians who are
available to supervise Advanced Practice Registered Nurses.
SECTION 5. AMENDATORY 59 O.S. 2021, Section 353.1, as
amended by Section 6, Chapter 288, O.S.L. 2022 (59 O.S. Supp. 2024,
Section 353.1), is amended to read as follows:
Section 353.1. For the purposes of the Oklahoma Pharmacy Act:
1. “Accredited program” means those seminars, classes,
meetings, work projects, and other educational courses approved by
the Board State Board of Pharmacy for purposes of continuing
professional education;
2. “Act” means the Oklahoma Pharmacy Act;
3. “Administer” means the direct application of a drug, whether
by injection, inhalation, ingestion, or any other means, to the body
of a patient;
4. “Assistant pharmacist” means any person presently licensed
as an assistant pharmacist in the State of Oklahoma this state by
the Board pursuant to Section 353.10 of this title and for the
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purposes of the Oklahoma Pharmacy Act shall be considered the same
as a pharmacist, except where otherwise specified;
5. “Board” or “State Board” means the State Board of Pharmacy;
6. “Certify” or “certification of a prescription” means the
review of a filled prescription by a licensed pharmacist or a
licensed practitioner with dispensing authority to confirm that the
medication, labeling, and packaging of the filled prescription are
accurate and meet all requirements prescribed by state and federal
law. For the purposes of this paragraph, “licensed practitioner”
shall not include optometrists with dispensing authority;
7. “Chemical” means any medicinal substance, whether simple or
compound or obtained through the process of the science and art of
chemistry, whether of organic or inorganic origin;
8. “Compounding” means the combining, admixing, mixing,
diluting, pooling, reconstituting, or otherwise altering of a drug
or bulk drug substance to create a drug. Compounding includes the
preparation of drugs or devices in anticipation of prescription drug
orders based on routine, regularly observed prescribing patterns;
9. “Continuing professional education” means professional,
pharmaceutical education in the general areas of the socioeconomic
and legal aspects of health care; the properties and actions of
drugs and dosage forms; and the etiology, characteristics, and
therapeutics of the diseased state;
10. “Dangerous drug”, “legend drug”, “prescription drug”, or
“Rx Only” means a drug:
a. for human use subject to 21 U.S.C., Section 353(b)(1),
or
b. is labeled “Prescription Only”, or labeled with the
following statement: “Caution: Federal law restricts
this drug except for to use by or on the order of a
licensed veterinarian.”;
11. “Director” means the Executive Director of the State Board
of Pharmacy unless context clearly indicates otherwise;
12. “Dispense” or “dispensing” means the interpretation,
evaluation, and implementation of a prescription drug order
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including the preparation and delivery of a drug or device to a
patient or a patient’s agent in a suitable container appropriately
labeled for subsequent administration to, or use by, a patient.
Dispense includes sell, distribute, leave with, give away, dispose
of, deliver, or supply;
13. “Dispenser” means a retail pharmacy, hospital pharmacy, a
group of chain pharmacies under common ownership and control that do
not act as a wholesale distributor, or any other person authorized
by law to dispense or administer prescription drugs, and the
affiliated warehouses or distributions of such entities under common
ownership and control that do not act as a wholesale distributor.
For the purposes of this paragraph, “dispenser” dispenser does not
mean a person who dispenses only products to be used in animals in
accordance with 21 U.S.C., Section 360b(a)(5);
14. “Distribute” or “distribution” means the sale, purchase,
trade, delivery, handling, storage, or receipt of a product, and
does not include the dispensing of a product pursuant to a
prescription executed in accordance with 21 U.S.C., Section
353(b)(1) or the dispensing of a product approved under 21 U.S.C.,
Section 360b(b); provided, taking actual physical possession of a
product or title shall not be required;
15. “Doctor of Pharmacy” means a person licensed by the Board
to engage in the practice of pharmacy. The terms “pharmacist”,
“D.Ph.”, and “Doctor of Pharmacy” shall be interchangeable and shall
have the same meaning wherever they appear in the Oklahoma Statutes
and the rules promulgated by the Board;
16. “Drug outlet” means all manufacturers, repackagers,
outsourcing facilities, wholesale distributors, third-party
logistics providers, pharmacies, and all other facilities which are
engaged in dispensing, delivery, distribution, or storage of
dangerous drugs;
17. “Drugs” means all medicinal substances and preparations
recognized by the United States Pharmacopoeia Pharmacopeia and
National Formulary, or any revision thereof, and all substances and
preparations intended for external and/or internal use in the cure,
diagnosis, mitigation, treatment, or prevention of disease in humans
or animals and all substances and preparations, other than food,
intended to affect the structure or any function of the body of a
human or animals;
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18. “Drug sample” means a unit of a prescription drug packaged
under the authority and responsibility of the manufacturer that is
not intended to be sold and is intended to promote the sale of the
drug;
19. “Durable medical equipment” has the same meaning as
provided by Section 2 of this act Section 375.2 of this title;
20. “Filled prescription” means a packaged prescription
medication to which a label has been affixed which contains such
information as is required by the Oklahoma Pharmacy Act;
21. “Hospital” means any institution licensed as a hospital by
this state for the care and treatment of patients, or a pharmacy
operated by the Oklahoma Department of Veterans Affairs;
22. “Licensed practitioner” means:
a. an allopathic physician,
b. an osteopathic physician,
c. a podiatric physician,
d. a dentist,
e. a veterinarian or,
f. an optometrist, or
g. an Advanced Practice Registered Nurse,
licensed to practice and authorized to prescribe dangerous drugs
within the scope of practice of such practitioner;
23. “Manufacturer” or “virtual manufacturer” means with respect
to a product:
a. a person that holds an application approved under 21
U.S.C., Section 355 or a license issued under 42
U.S.C., Section 262 for such product, or if such
product is not the subject of an approved application
or license, the person who manufactured the product,
b. a co-licensed partner of the person described in
subparagraph a of this paragraph that obtains the
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product directly from a person described in this
subparagraph or subparagraph a of this paragraph,
c. an affiliate of a person described in subparagraph a
or b of this paragraph who receives the product
directly from a person described in this subparagraph
or in subparagraph a or b of this paragraph, or
d. a person who contracts with another to manufacture a
product;
24. “Manufacturing” means the production, preparation,
propagation, compounding, conversion, or processing of a device or a
drug, either directly or indirectly by extraction from substances of
natural origin or independently by means of chemical or biological
synthesis and includes any packaging or repackaging of the
substances or labeling or relabeling of its container, and the
promotion and marketing of such drugs or devices. The term
“manufacturing” manufacturing also includes the preparation and
promotion of commercially available products from bulk compounds for
resale by licensed pharmacies, licensed practitioners, or other
persons;
25. “Medical gas” means those gases including those in liquid
state upon which the manufacturer or distributor has placed one of
several cautions, such as “Rx Only”, in compliance with federal law;
26. “Medical gas order” means an order for medical gas issued
by a licensed prescriber;
27. “Medical gas distributor” means a person licensed to
distribute, transfer, wholesale, deliver, or sell medical gases on
drug orders to suppliers or other entities licensed to use,
administer, or distribute medical gas and may also include a patient
or ultimate user;
28. “Medical gas supplier” means a person who dispenses medical
gases on drug orders only to a patient or ultimate user;
29. “Medicine” means any drug or combination of drugs which has
the property of curing, preventing, treating, diagnosing, or
mitigating diseases, or which is used for that purpose;
30. “Nonprescription drugs” means medicines or drugs which are
sold without a prescription and which are prepackaged for use by the
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consumer and labeled in accordance with the requirements of the
statutes and regulations of this state and the federal government.
Such items shall also include medical and dental supplies and
bottled or nonbulk chemicals which are sold or offered for sale to
the general public if such articles or preparations meet the
requirements of the Federal Food, Drug, and Cosmetic Act, 21
U.S.C.A., Section 321 et seq.;
31. “Outsourcing facility” including “virtual outsourcing
facility” means a facility at one geographic location or address
that:
a. is engaged in the compounding of sterile drugs,
b. has elected to register as an outsourcing facility,
and
c. complies with all requirements of 21 U.S.C., Section
353b;
32. “Package” means the smallest individual saleable unit of
product for distribution by a manufacturer or repackager that is
intended by the manufacturer for ultimate sale to the dispenser of
such product. For the purposes of this paragraph, “individual
saleable unit” means the smallest container of a product introduced
into commerce by the manufacturer or repackager that is intended by
the manufacturer or repackager for individual sale to a dispenser;
33. “Person” means an individual, partnership, limited
liability company, corporation, or association, unless the context
otherwise requires;
34. “Pharmacist-in-charge” or “PIC” means the pharmacist
licensed in this state responsible for the management control of a
pharmacy and all other aspects of the practice of pharmacy in a
licensed pharmacy as defined provided by Section 353.18 of this
title;
35. “Pharmacy” means a place regularly licensed by the State
Board of Pharmacy in which prescriptions, drugs, medicines,
chemicals, and poisons are compounded or dispensed or such place
where pharmacists practice the profession of pharmacy, or a pharmacy
operated by the Oklahoma Department of Veterans Affairs;
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36. “Pharmacy technician”, “technician”, “Rx tech”, or “tech”
means a person issued a Technician technician permit by the State
Board of Pharmacy to assist the pharmacist and perform
nonjudgmental, technical, manipulative, non-discretionary functions
in the prescription department under the immediate and direct
supervision of a pharmacist;
37. “Poison” means any substance which when introduced into the
body, either directly or by absorption, produces violent, morbid, or
fatal changes, or which destroys living tissue with which such
substance comes into contact;
38. “Practice of pharmacy” means:
a. the interpretation and evaluation of prescription
orders,
b. the compounding, dispensing, administering, and
labeling of drugs and devices, except labeling by a
manufacturer, repackager, or distributor of
nonprescription drugs and commercially packaged legend
drugs and devices,
c. the participation in drug selection and drug
utilization reviews,
d. the proper and safe storage of drugs and devices and
the maintenance of proper records thereof,
e. the responsibility for advising by counseling and
providing information, where professionally necessary
or where regulated, of therapeutic values, content,
hazards, and use of drugs and devices,
f. the offering or performing of those acts, services,
operations, or transactions necessary in the conduct,
operation, management, and control of a pharmacy, or
g. the provision of those acts or services that are
necessary to provide pharmaceutical care;
39. “Preparation” means an article which may or may not contain
sterile products compounded in a licensed pharmacy pursuant to the
order of a licensed prescriber;
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40. “Prescriber” means a person licensed in this state who is
authorized to prescribe dangerous drugs within the scope of practice
of the person’s profession;
41. “Prescription” means and includes any order for drug or
medical supplies written or signed, or transmitted by word of mouth,
telephone, or other means of communication:
a. by a licensed prescriber,
b. under the supervision of an Oklahoma licensed
practitioner, an Oklahoma licensed advanced practice
registered nurse or an Oklahoma licensed by a
physician assistant pursuant to a practice agreement,
or
c. (1) under the supervision of a supervising physician,
by a Certified Nurse Practitioner, Clinical Nurse
Specialist, or Certified Nurse-Midwife licensed
in this state who has not obtained independent
prescriptive authority under Section 1 of this
act, or
(2) by a Certified Nurse Practitioner, Clinical Nurse
Specialist, or Certified Nurse-Midwife licensed
in this state who has obtained independent
prescriptive authority under Section 1 of this
act, or
d. by an Oklahoma licensed wholesaler or distributor as
authorized in Section 353.29.1 of this title;
42. “Product” means a prescription drug in a finished dosage
form for administration to a patient without substantial further
manufacturing, such as capsules, tablets, and lyophilized products
before reconstitution. “Product” Product does not include blood
components intended for transfusion, radioactive drugs or biologics
and medical gas;
43. “Repackager”, including “virtual repackager”, means a
person who owns or operates an establishment that repacks and
relabels a product or package for further sale or distribution
without further transaction;
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44. “Sterile drug” means a drug that is intended for parenteral
administration, an ophthalmic or oral inhalation drug in aqueous
format, or a drug that is required to be sterile under state and
federal law;
45. “Supervising physician” means an individual holding a
current license to practice as a physician from the State Board of
Medical Licensure and Supervision, pursuant to the provisions of the
Oklahoma Allopathic Medical and Surgical Licensure and Supervision
Act, or the State Board of Osteopathic Examiners, pursuant to the
provisions of the Oklahoma Osteopathic Medicine Act, who supervises
an advanced practice registered nurse a Certified Nurse
Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife
as defined in Section 567.3a of this title who has not obtained
independent prescriptive authority under Section 1 of this act, and
who is not in training as an intern, resident, or fellow. To be
eligible to supervise an advanced practice registered nurse, such
The supervising physician shall remain in compliance with the rules
promulgated by the State Board of Medical Licensure and Supervision
or the State Board of Osteopathic Examiners;
46. “Supportive personnel” means technicians and auxiliary
supportive persons who are regularly paid employees of a pharmacy
who work and perform tasks in the pharmacy as authorized by Section
353.18A of this title;
47. “Third-party logistics provider” including “virtual third-
party logistics provider” means an entity that provides or
coordinates warehousing, or other logistics services of a product in
interstate commerce on behalf of a manufacturer, wholesale
distributor, or dispenser of a product but does not take ownership
of the product, nor have responsibility to direct the sale or
disposition of the product. For the purposes of this paragraph,
“third-party logistics provider” third-party logistics provider does
not include shippers and the United States Postal Service;
48. “Wholesale distributor” including “virtual wholesale
distributor” means a person other than a manufacturer, a
manufacturer’s co-licensed partner, a third-party logistics
provider, or repackager engaged in wholesale distribution as defined
by 21 U.S.C., Section 353(e)(4) as amended by the Drug Supply Chain
Security Act;
49. “County jail” means a facility operated by a county for the
physical detention and correction of persons charged with, or
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convicted of, criminal offenses or ordinance violations or persons
found guilty of civil or criminal contempt;
50. “State correctional facility” means a facility or
institution that houses a prisoner population under the jurisdiction
of the Department of Corrections;
51. “Unit dose package” means a package that contains a single
dose drug with the name, strength, control number, and expiration
date of that drug on the label; and
52. “Unit of issue package” means a package that provides
multiple doses of the same drug, but each drug is individually
separated and includes the name, lot number, and expiration date.
SECTION 6. AMENDATORY 59 O.S. 2021, Section 353.1a, is
amended to read as follows:
Section 353.1a. A. Prescribing 1. Prescriptive authority
shall be allowed, under the medical direction of a current
supervision agreement with a supervising physician, for an advanced
practice nurse a licensed Advanced Practice Registered Nurse
recognized by the Oklahoma Board of Nursing in one of the following
categories: advanced registered nurse practitioners, clinical nurse
specialists, or certified nurse-midwives as a Certified Nurse
Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife
who has not obtained independent prescriptive authority under
Section 1 of this act.
2. Prescriptive authority shall be allowed, independent of a
current supervision agreement with a supervising physician, for a
licensed Advanced Practice Registered Nurse recognized by the
Oklahoma Board of Nursing as a Certified Nurse Practitioner,
Clinical Nurse Specialist, or Certified Nurse-Midwife who has
obtained independent prescriptive authority under Section 1 of this
act.
B. The advanced practice nurse Advanced Practice Registered
Nurse may write or sign, or transmit by word of mouth, telephone, or
other means of communication an order for drugs or medical supplies
that is intended to be filled, compounded, or dispensed by a
pharmacist. The supervising physician, if applicable, and the
advanced practice nurse prescribing Advanced Practice Registered
Nurse shall be identified at the time of origination of the
prescription and the name of the advanced practice nurse prescribing
ENR. H. B. NO. 2298 Page 18
Advanced Practice Registered Nurse shall be printed on the
prescription label.
B. C. Pharmacists may dispense prescriptions for non-controlled
prescription drugs authorized by an advanced practice nurse Advanced
Practice Registered Nurse or physician assistant, not located in
Oklahoma this state, provided that they are licensed in the state in
which they are actively prescribing.
C. D. 1. Pharmacists may only dispense prescriptions for
controlled dangerous substances prescribed by an advanced practice
nurse or physician assistant Advanced Practice Registered Nurse
licensed in the State of Oklahoma and supervised by an Oklahoma-
licensed practitioner this state who meets the criteria in paragraph
1 or 2 of subsection A of this section.
2. Pharmacists may only dispense prescriptions for controlled
dangerous substances prescribed by a physician assistant licensed in
this state pursuant to a practice agreement.
SECTION 7. AMENDATORY 59 O.S. 2021, Section 567.3a, is
amended to read as follows:
Section 567.3a. As used in the Oklahoma Nursing Practice Act:
1. “Board” means the Oklahoma Board of Nursing;
2. “The practice of nursing” means the performance of services
provided for purposes of nursing diagnosis and treatment of human
responses to actual or potential health problems consistent with
educational preparation. Knowledge and skill are the basis for
assessment, analysis, planning, intervention, and evaluation used in
the promotion and maintenance of health and nursing management of
illness, injury, infirmity, restoration or of optimal function, or
death with dignity. Practice is based on understanding the human
condition across the human lifespan and understanding the
relationship of the individual within the environment. This
practice includes execution of the medical regime including the
administration of medications and treatments prescribed by any
person authorized by state law to so prescribe;
3. “Registered nursing” means the practice of the full scope of
nursing which includes, but is not limited to:
ENR. H. B. NO. 2298 Page 19
a. assessing the health status of individuals, families,
and groups,
b. analyzing assessment data to determine nursing care
needs,
c. establishing goals to meet identified health care
needs,
d. planning a strategy of care,
e. establishing priorities of nursing intervention to
implement the strategy of care,
f. implementing the strategy of care,
g. delegating such tasks as may safely be performed by
others, consistent with educational preparation and
that do not conflict with the provisions of the
Oklahoma Nursing Practice Act,
h. providing safe and effective nursing care rendered
directly or indirectly,
i. evaluating responses to interventions,
j. teaching the principles and practice of nursing,
k. managing and supervising the practice of nursing,
l. collaborating with other health professionals in the
management of health care,
m. performing additional nursing functions in accordance
with knowledge and skills acquired beyond basic
nursing preparation, and
n. delegating those nursing tasks as defined in the rules
of the Board that may be performed by an advanced
unlicensed assistive person Advanced Unlicensed
Assistant;
4. “Licensed practical nursing” means the practice of nursing
under the supervision or direction of a registered nurse Registered
ENR. H. B. NO. 2298 Page 20
Nurse, licensed physician, or dentist. This directed scope of
nursing practice includes, but is not limited to:
a. contributing to the assessment of the health status of
individuals and groups,
b. participating in the development and modification of
the plan of care,
c. implementing the appropriate aspects of the plan of
care,
d. delegating such tasks as may safely be performed by
others, consistent with educational preparation and
that do not conflict with the Oklahoma Nursing
Practice Act,
e. providing safe and effective nursing care rendered
directly or indirectly,
f. participating in the evaluation of responses to
interventions,
g. teaching basic nursing skills and related principles,
h. performing additional nursing procedures in accordance
with knowledge and skills acquired through education
beyond nursing preparation, and
i. delegating those nursing tasks as defined in the rules
of the Board that may be performed by an advanced
unlicensed assistive person Advanced Unlicensed
Assistant;
5. “Advanced Practice Registered Nurse” means a licensed
Registered Nurse:
a. who has completed an advanced practice registered
nursing education program in preparation for one of
four recognized advanced practice registered nurse
Advanced Practice Registered Nurse roles,
b. who has passed a national certification examination
recognized by the Board that measures the advanced
practice registered nurse Advanced Practice Registered
ENR. H. B. NO. 2298 Page 21
Nurse role and specialty competencies and who
maintains recertification in the role and specialty
through a national certification program,
c. who has acquired advanced clinical knowledge and
skills in preparation for providing both direct and
indirect care to patients; however, the defining
factor for all Advanced Practice Registered Nurses is
that a significant component of the education and
practice focuses on direct care of individuals,
d. whose practice builds on the competencies of
Registered Nurses by demonstrating a greater depth and
breadth of knowledge, a greater synthesis of data, and
increased complexity of skills and interventions, and
e. who has obtained a license as an Advanced Practice
Registered Nurse in one of the following roles:
Certified Registered Nurse Anesthetist, Certified
Nurse-Midwife, Clinical Nurse Specialist, or Certified
Nurse Practitioner.
Only those persons who hold a license to practice advanced
practice registered nursing in this state shall have the right to
use the title “Advanced Practice Registered Nurse” Advanced Practice
Registered Nurse and to use the abbreviation “APRN”. Only those
persons who have obtained a license in the following disciplines
shall have the right to fulfill the roles and use the applicable
titles: Certified Registered Nurse Anesthetist and the abbreviation
“CRNA”, Certified Nurse-Midwife and the abbreviation “CNM”, Clinical
Nurse Specialist and the abbreviation “CNS”, and Certified Nurse
Practitioner and the abbreviation “CNP”.
It shall be unlawful for any person to assume the role or use
the title Advanced Practice Registered Nurse or use the abbreviation
“APRN” APRN or use the respective specialty role titles and
abbreviations or to use any other titles or abbreviations that would
reasonably lead a person to believe the user is an Advanced Practice
Registered Nurse, unless permitted by the Oklahoma Nursing Practice
Act. Any individual doing so shall be guilty of a misdemeanor,
which shall be punishable, upon conviction, by imprisonment in the
county jail for not more than one (1) year or by a fine of not less
than One Hundred Dollars ($100.00) nor more than One Thousand
Dollars ($1,000.00), or by both such imprisonment and fine for each
offense;
ENR. H. B. NO. 2298 Page 22
6. “Certified Nurse Practitioner” is means an Advanced Practice
Registered Nurse who performs in an expanded role in the delivery of
health care:
a. consistent with advanced educational preparation as a
Certified Nurse Practitioner in an area of specialty,
b. functions within the Certified Nurse Practitioner
scope of practice for the selected area of
specialization, and
c. is in accord with the standards for Certified Nurse
Practitioners as identified by the certifying body and
approved by the Board.
A Certified Nurse Practitioner shall be eligible, in accordance
with the scope of practice of the Certified Nurse Practitioner, to
obtain recognition as authorized by the Board to prescribe, as
defined by the rules promulgated by the Board pursuant to this
section and subject to the medical direction of a supervising
physician Section 567.4a of this title and Section 1 of this act.
This authorization shall not include dispensing drugs, but shall not
preclude, subject to federal regulations, the receipt of, the
signing for, or the dispensing of professional samples to patients.
The Certified Nurse Practitioner accepts responsibility,
accountability, and obligation to practice in accordance with usual
and customary advanced practice registered nursing standards and
functions as defined by the scope of practice/role definition
statements for the Certified Nurse Practitioner;
7. a. “Clinical Nurse Specialist” is means an Advanced
Practice Registered Nurse who holds:
(1) a master’s degree or higher in nursing with
clinical specialization preparation to function
in an expanded role,
(2) specialty certification from a national
certifying organization recognized by the Board,
and
(3) an Advanced Practice Registered Nurse license
from the Board, and
ENR. H. B. NO. 2298 Page 23
(4) any.
Any nurse holding a specialty certification as a
Clinical Nurse Specialist valid on January 1, 1994,
granted by a national certifying organization
recognized by the Board, shall be deemed to be a
Clinical Nurse Specialist under the provisions of the
Oklahoma Nursing Practice Act.
b. In the expanded role, the Clinical Nurse Specialist
performs at an advanced practice level which shall
include, but not be limited to:
(1) practicing as an expert clinician in the
provision of direct nursing care to a selected
population of patients or clients in any setting,
including private practice,
(2) managing the care of patients or clients with
complex nursing problems,
(3) enhancing patient or client care by integrating
the competencies of clinical practice, education,
consultation, and research, and
(4) referring patients or clients to other services.
c. A Clinical Nurse Specialist in accordance with the
scope of practice of such Clinical Nurse Specialist
shall be eligible to obtain recognition as authorized
by the Board to prescribe, as defined by the rules
promulgated by the Board pursuant to this section, and
subject to the medical direction of a supervising
physician Section 567.4a of this title and Section 1
of this act. This authorization shall not include
dispensing drugs, but shall not preclude, subject to
federal regulations, the receipt of, the signing for,
or the dispensing of professional samples to patients.
d. The Clinical Nurse Specialist accepts responsibility,
accountability, and obligation to practice in
accordance with usual and customary advanced practice
nursing standards and functions as defined by the
ENR. H. B. NO. 2298 Page 24
scope of practice/role definition statements for the
Clinical Nurse Specialist;
8. “Nurse-Midwife” is “Certified Nurse-Midwife” means a nurse
who has received an Advanced Practice Registered Nurse license from
the Oklahoma Board of Nursing who possesses evidence of
certification according to the requirements of the American College
of Nurse-Midwives.
A Certified Nurse-Midwife in accordance with the scope of
practice of such Certified Nurse-Midwife shall be eligible to obtain
recognition as authorized by the Board to prescribe, as defined by
the rules promulgated by the Board pursuant to this section and
subject to the medical direction of a supervising physician Section
567.4a of this title and Section 1 of this act. This authorization
shall not include the dispensing of drugs, but shall not preclude,
subject to federal regulations, the receipt of, the signing for, or
the dispensing of professional samples to patients.
The Certified Nurse-Midwife accepts responsibility,
accountability, and obligation to practice in accordance with usual
and customary advanced practice registered nursing standards and
functions as defined by the scope of practice/role definition
statements for the Certified Nurse-Midwife;
9. “Nurse-midwifery practice” means providing management of
care of normal newborns and women, antepartally, intrapartally,
postpartally, and gynecologically, occurring within a health care
system which provides for medical consultation, medical management,
or referral, and is in accord with the standards for nurse-midwifery
practice as defined by the American College of Nurse-Midwives;
10. a. “Certified Registered Nurse Anesthetist” is means an
Advanced Practice Registered Nurse who:
(1) is certified by the National Board of
Certification and Recertification for Nurse
Anesthetists as a Certified Registered Nurse
Anesthetist within one (1) year following
completion of an approved certified registered
nurse anesthetist Certified Registered Nurse
Anesthetist education program, and continues to
maintain such recertification by the National
Board of Certification and Recertification for
Nurse Anesthetists, and
ENR. H. B. NO. 2298 Page 25
(2) administers anesthesia in collaboration with a
medical doctor, an osteopathic physician, a
podiatric physician, or a dentist licensed in
this state and under conditions in which timely
onsite on-site consultation by such doctor,
osteopath, podiatric physician, or dentist is
available.
b. A Certified Registered Nurse Anesthetist, in
collaboration with a medical doctor, osteopathic
physician, podiatric physician, or dentist licensed in
this state, and under conditions in which timely, on-
site consultation by such medical doctor, osteopathic
physician, podiatric physician, or dentist is
available, shall be authorized, pursuant to rules
adopted by the Oklahoma Board of Nursing, to order,
select, obtain, and administer legend drugs, Schedules
II through V controlled substances, devices, and
medical gases only when engaged in the preanesthetic
preparation and evaluation; anesthesia induction,
maintenance, and emergence; and postanesthesia care.
A Certified Registered Nurse Anesthetist may order,
select, obtain, and administer drugs only during the
perioperative or periobstetrical period.
c. A Certified Registered Nurse Anesthetist who applies
for authorization to order, select, obtain, and
administer drugs shall:
(1) be currently recognized as a Certified Registered
Nurse Anesthetist in this state,
(2) provide evidence of completion, within the two-
year period immediately preceding the date of
application, of a minimum of fifteen (15) units
of continuing education in advanced pharmacology
related to the administration of anesthesia as
recognized by the National Board of Certification
and Recertification for Nurse Anesthetists, and
(3) complete and submit a notarized application, on a
form prescribed by the Board, accompanied by the
application fee established pursuant to this
section.
ENR. H. B. NO. 2298 Page 26
d. The authority to order, select, obtain, and administer
drugs shall be terminated if a Certified Registered
Nurse Anesthetist has:
(1) ordered, selected, obtained, or administered
drugs outside of the Certified Registered Nurse
Anesthetist scope of practice or ordered,
selected, obtained, or administered drugs for
other than therapeutic purposes, or
(2) violated any provision of state laws or rules or
federal laws or regulations pertaining to the
practice of nursing or the authority to order,
select, obtain, and administer drugs.
e. The Oklahoma Board of Nursing shall notify the State
Board of Pharmacy after termination of or a change in
the authority to order, select, obtain, and administer
drugs for a Certified Registered Nurse Anesthetist.
f. The Board shall provide by rule for biennial
application renewal and reauthorization of authority
to order, select, obtain, and administer drugs for
Certified Registered Nurse Anesthetists. At the time
of application renewal, a Certified Registered Nurse
Anesthetist shall submit documentation of a minimum of
eight (8) units of continuing education, completed
during the previous two (2) years, in advanced
pharmacology relating to the administration of
anesthesia, as recognized by the Council on
Recertification of Nurse Anesthetists or the Council
on Certification of Nurse Anesthetists National Board
of Certification and Recertification for Nurse
Anesthetists.
g. This paragraph shall not prohibit the administration
of local or topical anesthetics as now permitted by
law. Provided further, nothing in this paragraph
shall limit the authority of the Board of Dentistry to
establish the qualifications for dentists who direct
the administration of anesthesia.
h. As used in this paragraph, “collaboration” means an
agreement between a medical doctor, osteopathic
ENR. H. B. NO. 2298 Page 27
physician, podiatric physician, or dentist performing
the procedure or directly involved with the procedure
and the Certified Registered Nurse Anesthetist working
jointly toward a common goal providing services for
the same patient. This collaboration involves the
joint formulation, discussion, and agreement of the
anesthesia plan by both parties, and the collaborating
medical doctor, osteopathic physician, podiatric
physician, or dentist performing the procedure or
directly involved with the procedure and that
collaborating physician shall remain available for
timely onsite on-site consultation during the delivery
of anesthesia for diagnosis, consultation, and
treatment of medical conditions;
11. “Supervising physician” means an individual holding a
current license to practice as a physician from the State Board of
Medical Licensure and Supervision or the State Board of Osteopathic
Examiners, who supervises a Certified Nurse Practitioner, a Clinical
Nurse Specialist, or a Certified Nurse-Midwife who has not obtained
independent prescriptive authority under Section 1 of this act, and
who is not in training as an intern, resident, or fellow. To be
eligible to supervise such Advanced Practice Registered Nurse, such
The supervising physician shall remain in compliance with the rules
promulgated by the State Board of Medical Licensure and Supervision
or the State Board of Osteopathic Examiners;
12. “Supervision of an Advanced Practice Registered Nurse with
prescriptive authority” “Supervision” means overseeing and accepting
responsibility for the ordering and transmission by assuring
availability of the supervising physician to a Certified Nurse
Practitioner, a Clinical Nurse Specialist, or a Certified Nurse-
Midwife of who has not obtained independent prescriptive authority
under Section 1 of this act through direct contact,
telecommunications, or other appropriate electronic means for
consultation, assistance with medical emergencies, or patient
referral with respect to written, telephonic, electronic, or oral
prescriptions for drugs and other medical supplies, subject to a
defined formulary; and
13. “Advanced Unlicensed Assistant” means any person who has
successfully completed a certified training program approved by the
Board that trains the Advanced Unlicensed Assistant to perform
specified technical skills identified by the Board in acute care
ENR. H. B. NO. 2298 Page 28
settings under the direction and supervision of the Registered Nurse
or, Licensed Practical Nurse, or Advanced Practice Registered Nurse.
SECTION 8. AMENDATORY 59 O.S. 2021, Section 567.4a, is
amended to read as follows:
Section 567.4a. The Oklahoma Board of Nursing may grant
prescriptive authority through the Advanced Practice Registered
Nurse license to Certified Nurse Practitioners, Clinical Nurse
Specialists, and Certified Nurse-Midwives who meet the requirements
for prescriptive authority identified by law and in the Board’s
rules. The rules regarding prescriptive authority recognition
promulgated by the Oklahoma Board of Nursing pursuant to paragraphs
6 through 9, 11 and 12 of this section, Section 567.3a of this
title, and Sections 1 and 4 of this act shall:
1. Define the procedure for documenting supervision by a
supervising physician licensed in Oklahoma to practice by the State
Board of Medical Licensure and Supervision or the State Board of
Osteopathic Examiners, as defined in Section 567.3a of this title,
of a Certified Nurse Practitioner, Clinical Nurse Specialist, or
Certified Nurse-Midwife who has not obtained independent
prescriptive authority under Section 1 of this act. Such procedure
shall include a written statement supervision agreement that defines
appropriate referral, consultation, and collaboration between the
Advanced Practice Registered Nurse, recognized to prescribe as
defined in paragraphs 6 through 9, 11 and 12 of Section 567.3a of
this title, and the supervising physician. The written statement
shall include a method of assuring availability of the supervising
physician through direct contact, telecommunications or other
appropriate electronic means for consultation, assistance with
medical emergencies, or patient referral meets the requirements of
Section 4 of this act. The written statement supervision agreement
shall be part of the initial application and the renewal application
submitted to the Board for recognition for prescriptive authority
for the Advanced Practice Registered Nurse. Changes to the written
statement supervision agreement shall be filed with the Board within
thirty (30) days of the change and shall be effective on filing;
2. Define procedures for assessing the qualifications of
applicants for independent prescriptive authority as provided by
Section 1 of this act;
3. Define minimal requirements for initial application for
prescriptive authority which shall include, but not be limited to,
evidence of completion of a minimum of forty-five (45) contact hours
ENR. H. B. NO. 2298 Page 29
or three (3) academic credit hours of education in
pharmacotherapeutics, clinical application, and use of
pharmacological agents in the prevention of illness, and in the
restoration and maintenance of health in a program beyond basic
registered nurse preparation, approved by the Board. Such contact
hours or academic credits shall be obtained within a time period of
three (3) years immediately preceding the date of application for
prescriptive authority;
3. 4. Define minimal requirements for application for renewal
of prescriptive authority which shall include, but not be limited
to, documentation of a minimum of:
a. fifteen (15) contact hours or one (1) academic credit
hour of education in pharmacotherapeutics, clinical
application, and use of pharmacological agents in the
prevention of illness, and in the restoration and
maintenance of health in a program beyond basic
registered nurse preparation, and
b. two (2) hours of education in pain management or two
(2) hours of education in opioid use or addiction,
unless the Advanced Practice Registered Nurse has
demonstrated to the satisfaction of the Board that the
Advanced Practice Registered Nurse does not currently
hold a valid federal Drug Enforcement Administration
registration number,
approved by the Board, within the two-year period immediately
preceding the effective date of application for renewal of
prescriptive authority. Such minimal requirements for renewal of
prescriptive authority for an Advanced Practice Registered Nurse who
has obtained independent prescriptive authority under Section 1 of
this act shall include, but not be limited to, documentation that
the Advanced Practice Registered Nurse has successfully earned at
least forty (40) hours of Category I continuing medical education
hours within the two-year period immediately preceding the effective
date of application for renewal of independent prescriptive
authority, which may include the continuing education described in
subparagraphs a and b of this paragraph if such continuing education
meets the criteria for Category I continuing medical education;
4. 5. Require that beginning July 1, 2002, an Advanced Practice
Registered Nurse shall demonstrate demonstrates successful
completion of a master’s degree or higher in a clinical nurse
ENR. H. B. NO. 2298 Page 30
specialty one of the following Advanced Practice Registered Nurse
roles:
a. Certified Nurse Practitioner,
b. Clinical Nurse Specialist, or
c. Certified Nurse-Midwife,
in order to be eligible for initial application for prescriptive
authority under the provisions of the Oklahoma Nursing Practice Act;
5. 6. Define the method for communicating authority to
prescribe or termination of same, and the formulary to the State
Board of Pharmacy, all pharmacies, and all registered pharmacists;
6. 7. Define terminology used in such rules;
7. 8. Define the parameters for the prescribing practices of
the Advanced Practice Registered Nurse;
8. 9. Define the methods for termination of prescriptive
authority for the Advanced Practice Registered Nurse; and
9.
10. a. Establish a Formulary Advisory Council that shall
develop and submit to the Board recommendations for an
exclusionary formulary that shall list drugs or
categories of drugs that shall not be prescribed by an
Advanced Practice Registered Nurse recognized to
prescribe by the Oklahoma Board of Nursing. The
Formulary Advisory Council shall also develop and
submit to the Board recommendations for practice-
specific prescriptive standards for each category of
Advanced Practice Registered Nurse recognized to
prescribe by the Oklahoma Board of Nursing pursuant to
the provisions of the Oklahoma Nursing Practice Act.
The Board shall either accept or reject the
recommendations made by the Council. No amendments to
the recommended exclusionary formulary may be made by
the Board without the approval of the Formulary
Advisory Council.
ENR. H. B. NO. 2298 Page 31
b. The Formulary Advisory Council shall be composed of
twelve (12) members as follows:
(1) four members, to include a pediatrician, an
obstetrician-gynecological physician, a general
internist, and a family practice physician;
provided, that three of such members shall be
appointed by the Oklahoma State Medical
Association, and one shall be appointed by the
Oklahoma Osteopathic Association,
(2) four members who are registered pharmacists,
appointed by the Oklahoma Pharmaceutical
Pharmacists Association, and
(3) four members, one of whom shall be a Certified
Nurse Practitioner, one of whom shall be a
Clinical Nurse Specialist, one of whom shall be a
Certified Nurse-Midwife, and one of whom shall be
a current member of the Oklahoma Board of
Nursing, all of whom shall be appointed by the
Oklahoma Board of Nursing.
c. All professional members of the Formulary Advisory
Council shall be in active clinical practice, at least
fifty percent (50%) of the time, within their defined
area of specialty. The members of the Formulary
Advisory Council shall serve at the pleasure of the
appointing authority for a term of three (3) years.
The terms of the members shall be staggered. Members
of the Council may serve beyond the expiration of
their term of office until a successor is appointed by
the original appointing authority. A vacancy on the
Council shall be filled for the balance of the
unexpired term by the original appointing authority.
d. Members of the Council shall elect a chair and a vice-
chair vice chair from among the membership of the
Council. For the transaction of business, at least
seven members, with a minimum of two members present
from each of the identified categories of physicians,
pharmacists, and advanced practice registered nurses
Advanced Practice Registered Nurses, shall constitute
a quorum. The Council shall recommend and the Board
shall approve and implement an initial exclusionary
ENR. H. B. NO. 2298 Page 32
formulary on or before January 1, 1997. The Council
and the Board shall annually review the approved
exclusionary formulary and shall make any necessary
revisions utilizing the same procedures used to
develop the initial exclusionary formulary.
SECTION 9. AMENDATORY 59 O.S. 2021, Section 567.5a, as
amended by Section 1, Chapter 94, O.S.L. 2024 (59 O.S. Supp. 2024,
Section 567.5a), is amended to read as follows:
Section 567.5a. A. All applicants for a license to practice as
an Advanced Practice Registered Nurse shall be subject to Section
567.8 of this title.
B. An applicant for an initial license to practice as an
Advanced Practice Registered Nurse shall:
1. Submit a completed written application and appropriate fees
as established by the Oklahoma Board of Nursing;
2. Submit a criminal history records check that complies with
Section 567.18 of this title;
3. Hold a current Registered Nurse license in this state;
4. Have completed an advanced practice registered nursing
education program in one of the four advanced practice registered
nurse Advanced Practice Registered Nurse roles and a specialty area
recognized by the Board. Effective January 1, 2016, the applicant
shall have completed an accredited graduate level advanced practice
registered nursing education program in at least one of the
following population foci: family/individual across the lifespan,
adult-gerontology, neonatal, pediatrics, women’s health/gender-
related, or psychiatric/mental health;
5. Be currently certified in an advanced practice specialty
certification consistent with educational preparation and by a
national certifying body recognized by the Board; and
6. Provide any and all other evidence as required by the Board
in its rules.
C. The Board may issue a license by endorsement to an Advanced
Practice Registered Nurse licensed under the laws of another state
ENR. H. B. NO. 2298 Page 33
if the applicant meets the qualifications for licensure in this
state. An applicant by endorsement shall:
1. Submit a completed written application and appropriate fees
as established by the Board;
2. Submit a criminal history records check that complies with
Section 567.18 of this title;
3. Hold a current Registered Nurse license in this state;
4. Hold recognition as an Advanced Practice Registered Nurse in
a state or territory;
5. Have completed an advanced practice registered nursing
education program in one of the four roles and a specialty area
recognized by the Board. Effective January 1, 2016, the applicant
shall have completed an accredited graduate level advanced practice
registered nursing education program in at least one of the
following population foci: family/individual across the lifespan,
adult-gerontology, neonatal, pediatrics, women’s health/gender-
related, or psychiatric/mental health;
6. Be currently certified in an advanced practice specialty
certification consistent with educational preparation and by a
national certifying body recognized by the Board;
7. Meet continued competency requirements as set forth in Board
rules; and
8. Provide any and all other evidence as required by the Board
in its rules.
D. The Board may issue prescriptive authority recognition by
endorsement to an Advanced Practice Registered Nurse licensed as an
APRN-CNP Advanced Practice Registered Nurse-Certified Nurse
Practitioner (APRN-CNP), APRN-CNS Advanced Practice Registered
Nurse-Clinical Nurse Specialist (APRN-CNS), or APRN-CNM Advanced
Practice Registered Nurse-Certified Nurse-Midwife (APRN-CNM) under
the laws of another state if the applicant meets the requirements
set forth in this section. An applicant for prescriptive authority
recognition by endorsement shall:
1. Submit a completed written application and appropriate fees
as established by the Board;
ENR. H. B. NO. 2298 Page 34
2. Hold current Registered Nurse and Advanced Practice
Registered Nurse licenses (APRN-CNP, APRN-CNS, or APRN-CNM) in the
state;
3. Hold current licensure or recognition as an Advanced
Practice Registered Nurse in the same role and specialty with
prescribing privileges in another state or territory;
4. Submit documentation verifying successful completion of a
graduate level graduate-level advanced practice registered nursing
education program that included an academic course in
pharmacotherapeutic management, and didactic and clinical
preparation for prescribing incorporated throughout the program;
5. Submit a written statement from an Oklahoma licensed
physician supervising prescriptive authority all supervision
agreements entered into with supervising physicians as required by
the Board in its rules Section 4 of this act, or submit
documentation that the applicant meets the requirements for
independent prescriptive authority under Section 1 of this act;
6. Meet continued competency requirements as set forth in Board
rules; and
7. Provide any and all other evidence as required by the Board
in its rules.
E. An Advanced Practice Registered Nurse license issued under
this section shall be renewed concurrently with the registered nurse
Registered Nurse license, provided that qualifying criteria continue
to be met.
F. The Board may reinstate a license as set forth in Board
rules.
SECTION 10. AMENDATORY 63 O.S. 2021, Section 2-312, as
amended by Section 2, Chapter 184, O.S.L. 2022 (63 O.S. Supp. 2024,
Section 2-312), is amended to read as follows:
Section 2-312. A. A physician, podiatrist, optometrist, or a
dentist who has complied with the registration requirements of the
Uniform Controlled Dangerous Substances Act, in good faith and in
the course of such person’s professional practice only, may
prescribe and administer controlled dangerous substances, or may
ENR. H. B. NO. 2298 Page 35
cause the same to be administered by medical or paramedical
personnel acting under the direction and supervision of the
physician, podiatrist, optometrist, or dentist, and only may
dispense controlled dangerous substances pursuant to the provisions
of Sections 355.1 and 355.2 of Title 59 of the Oklahoma Statutes.
B. A veterinarian who has complied with the registration
requirements of the Uniform Controlled Dangerous Substances Act, in
good faith and in the course of the professional practice of the
veterinarian only, and not for use by a human being, may prescribe,
administer, and dispense controlled dangerous substances and may
cause them to be administered by an assistant or orderly under the
direction and supervision of the veterinarian.
C. An advanced practice nurse Advanced Practice Registered
Nurse who is recognized to prescribe by the Oklahoma Board of
Nursing as an advanced registered nurse practitioner, clinical nurse
specialist or certified nurse-midwife, who is subject to medical
direction by a supervising physician, pursuant to Section 567.3a of
Title 59 of the Oklahoma Statutes, a Certified Nurse Practitioner,
Clinical Nurse Specialist, or Certified Nurse-Midwife and who has
complied with the registration requirements of the Uniform
Controlled Dangerous Substances Act, in good faith and in the course
of professional practice only, may prescribe and administer Schedule
III, IV, and V controlled dangerous substances. If the Advanced
Practice Registered Nurse has not obtained independent prescriptive
authority under Section 1 of this act, he or she may only prescribe
and administer such controlled dangerous substances under the
supervision of a supervising physician in accordance with the
Oklahoma Nursing Practice Act and Section 4 of this act and shall
not prescribe or administer any controlled dangerous substance in a
schedule that the supervising physician is not registered to
prescribe and administer.
D. An advanced practice nurse Advanced Practice Registered
Nurse who is recognized to order, select, obtain, and administer
drugs by the Oklahoma Board of Nursing as a certified registered
nurse anesthetist Certified Registered Nurse Anesthetist pursuant to
Section 353.1b of Title 59 of the Oklahoma Statutes and who has
complied with the registration requirements of the Uniform
Controlled Dangerous Substances Act, in good faith and in the course
of such practitioner’s professional practice only, may order,
select, obtain, and administer Schedules II through V controlled
dangerous substances in a preanesthetic preparation or evaluation;
anesthesia induction, maintenance, or emergence; or postanesthesia
ENR. H. B. NO. 2298 Page 36
care setting only. A certified registered nurse anesthetist
Certified Registered Nurse Anesthetist may order, select, obtain,
and administer such drugs only during the perioperative or
periobstetrical period.
E. A physician assistant who is recognized to prescribe by the
State Board of Medical Licensure and Supervision under the medical
direction of a supervising physician, pursuant to Section 519.6 of
Title 59 of the Oklahoma Statutes, and who has complied with the
registration requirements of the Uniform Controlled Dangerous
Substances Act, in good faith and in the course of professional
practice only, may prescribe and administer Schedule II through V
controlled dangerous substances.
SECTION 11. This act shall become effective November 1, 2025.
ENR. H. B. NO. 2298 Page 37
Passed the House of Representatives the 21st day of May, 2025.
Presiding Officer of the House
of Representatives
Passed the Senate the 8th day of May, 2025.
Presiding Officer of the Senate
OFFICE OF THE GOVERNOR
Received by the Office of the Governor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _________
day of ___________________, 20_______, at _______ o'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this __________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________