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An Act
ENROLLED HOUSE
BILL NO. 2584 By: Hilbert of the House
and
Paxton of the Senate
An Act relating to physician assistants; amending 59
O.S. 2021, Sections 353.1, as amended by Section 6,
Chapter 288, O.S.L. 2022 and 353.1a (59 O.S. Supp.
2024, Section 353.1), which relate to the Oklahoma
Pharmacy Act; updating and clarifying certain defined
terms; specifying who pharmacists may dispense
certain prescriptions to; amending 59 O.S. 2021,
Sections 519.2, 519.3, 519.6 and 519.11, as amended
by Section 1, Chapter 164, O.S.L. 2022 (59 O.S. Supp.
2024, Section 591.11), which relate to the Physician
Assistant Act; updating, deleting, and clarifying
certain defined terms; increasing number of Physician
Assistant Committee members; exempting physician
assistants from being supervised by delegating
physicians under certain circumstances; establishing
procedures to report completion of postgraduate
clinical practice experience hours to the State Board
of Medical Licensure and Supervision; directing the
Board to maintain and update a list of certain
physician assistants on its website; requiring the
Board to prescribe certain reporting form;
prohibiting the assessment of fees related to the
filing of reporting forms; authorizing physician
assistants to maintain practice agreements; providing
an exception; requiring supervision of physician
assistants under certain circumstances; clarifying
manner by which physician assistants may practice
under the supervision of delegating physicians;
providing specific limitations on physician
assistants and their ability to prescribe drugs;
deleting certain prescription writing requirements;
requiring certain physician assistants to carry
malpractice insurance or demonstrate proof of
financial responsibility; providing exceptions;
deleting certain construing provision; amending 63
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O.S. 2021, Section 1-317, as last amended by Section
133, Chapter 452, O.S.L. 2024 (63 O.S. Supp. 2024,
Section 1-317), which relates to the filing of death
certificates; providing statutory reference; amending
63 O.S. 2021, Sections 2-101, as last amended by
Section 1, Chapter 308, O.S.L. 2024 and 2-312, as
amended by Section 2, Chapter 184, O.S.L. 2022 (63
O.S. Supp. 2024, Sections 2-101 and 2-312), which
relate to the Uniform Controlled Dangerous Substances
Act; clarifying certain defined term; authorizing
physician assistants to prescribe and administer
controlled dangerous substances subject to certain
restrictions; and repealing 59 O.S. 2021, Section
521.4, which relates to physician supervision and
practice agreements of physician assistants.
SUBJECT: Physician assistants
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. 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
purposes of the Oklahoma Pharmacy Act shall be considered the same
as a pharmacist, except where otherwise specified;
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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
including the preparation and delivery of a drug or device to a
patient or a patient’s agent in a suitable container appropriately
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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;
18. “Drug sample” means a unit of a prescription drug packaged
under the authority and responsibility of the manufacturer that is
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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. a physician assistant,
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. (1) under the supervision of an Oklahoma licensed
practitioner a supervising physician, by an Oklahoma
licensed advanced practice registered nurse, or
(2) by an Oklahoma licensed physician assistant
pursuant to a practice agreement, or
c. 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;
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 as defined in Section 567.3a
of this title,
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and who is not in training as an intern, resident, or fellow. To be
eligible to supervise an advanced practice registered nurse, such
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
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.
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SECTION 2. AMENDATORY 59 O.S. 2021, Section 353.1a, is
amended to read as follows:
Section 353.1a A. Prescribing authority shall be allowed,
under the medical direction of a supervising physician, for an
advanced practice 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. The advanced practice 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 and the advanced practice nurse shall be identified at the
time of origination of the prescription and the name of the advanced
practice nurse shall be printed on the prescription label.
B. Pharmacists may dispense prescriptions for non-controlled
prescription drugs authorized by an advanced practice nurse or
physician assistant, not located in Oklahoma, provided that they are
licensed in the state in which they are actively prescribing.
C. Pharmacists may only dispense prescriptions for controlled
dangerous substances prescribed by an:
1. An advanced practice nurse or physician assistant licensed
in the State of Oklahoma and supervised by an Oklahoma-licensed
practitioner; or
2. A physician assistant licensed in the State of Oklahoma and
supervised by an Oklahoma-licensed practitioner.
SECTION 3. AMENDATORY 59 O.S. 2021, Section 519.2, is
amended to read as follows:
Section 519.2 As used in the Physician Assistant Act:
1. "Board" means the State Board of Medical Licensure and
Supervision;
2. "Committee" means the Physician Assistant Committee;
3. "Practice of medicine" means services which require training
in the diagnosis, treatment and prevention of disease, including the
use and administration of drugs, and which are performed by
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physician assistants so long as such services are within the
physician assistants' skill,. For a physician assistant required to
practice under supervision of a delegating physician, services form
a component of the physician's scope of practice, and are provided
with physician supervision, including authenticating by signature
any form that may be authenticated by the delegating physician's
signature with prior delegation by the physician;
4. "Patient care setting" means and includes, but is not
limited to, a physician's office, clinic, hospital, nursing home,
extended care facility, patient's home, ambulatory surgical center,
hospice facility or any other setting authorized by the delegating
physician;
5. "Physician assistant" means a health care professional,
qualified by academic and clinical education and licensed by the
State Board of Medical Licensure and Supervision, to practice
medicine with physician supervision as a physician assistant;
6. 5. "Delegating physician" means an individual holding a
license in good standing as a physician from the State Board of
Medical Licensure and Supervision or the State Board of Osteopathic
Examiners, who supervises one or more physician assistants and
delegates decision making pursuant to the practice agreement;
7. 6. "Supervision" means overseeing or delegating the
activities of the medical services rendered by a physician assistant
through a practice agreement between a medical doctor or osteopathic
delegating physician performing procedures or directly or indirectly
involved with the treatment of a patient, and the physician
assistant working jointly toward a common goal of providing
services. Delegation shall be defined by the practice agreement.
The physical presence of the delegating physician is not required as
long as the delegating physician and physician assistant are or can
be easily in contact with each other by telecommunication. At all
times a physician assistant required to practice under supervision
shall be considered an agent of the delegating physician;
8. 7. "Telecommunication" means the use of electronic
technologies to transmit words, sounds or images for interpersonal
communication, clinical care (telemedicine) and review of electronic
health records; and
9. 8. "Practice agreement" means a written agreement between a
physician assistant and the a delegating physician concerning the
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scope of practice of the physician assistant to only be determined
by the delegating physician and the physician assistant based on the
education, training, skills and experience of the physician
assistant. The agreement shall involve the joint formulation,
discussion and agreement on the methods of supervision and
collaboration for diagnosis, consultation and treatment of medical
conditions and shall include the scope of and any limitations on
prescribing. A practice agreement is required for a physician
assistant as described in subsection C of Section 519.6 of this
title.
SECTION 4. AMENDATORY 59 O.S. 2021, Section 519.3, is
amended to read as follows:
Section 519.3 A. There is hereby created the Physician
Assistant Committee, which shall be composed of seven (7) nine (9)
members. Three Five members of the Committee shall be physician
assistants appointed by the State Board of Medical Licensure and
Supervision from a list of qualified individuals submitted by the
Oklahoma Academy of Physician Assistants. One member shall be a
physician appointed by the Board from its membership. One member
shall be a physician appointed by the Board from a list of qualified
individuals submitted by the Oklahoma State Medical Association and
who is not a member of the Board. One member shall be a physician
appointed by the State Board of Osteopathic Examiners from its
membership. One member shall be a physician appointed by the State
Board of Osteopathic Examiners from a list of qualified individuals
submitted by the Oklahoma Osteopathic Association and who is not a
member of said board.
B. The term of office for each member of the Committee shall be
five (5) years.
C. The Committee shall meet at least quarterly. At the initial
meeting of each calendar year, the Committee members shall elect a
chair from the physician assistant members. The chair or his or her
designee shall represent the Committee at all meetings of the Board.
Four Five members shall constitute a quorum for the purpose of
conducting official business of the Committee.
D. The State Board of Medical Licensure and Supervision is
hereby granted the power and authority to promulgate rules, which
are in accordance with the provisions of Section 519.1 et seq. of
this title, governing the requirements for licensure as a physician
assistant, as well as to establish standards for training, approve
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institutions for training, and regulate the standards of practice of
a physician assistant after licensure, including the power of
revocation of a license.
E. The State Board of Medical Licensure and Supervision is
hereby granted the power and authority to investigate all
complaints, hold hearings, subpoena witnesses and initiate
prosecution concerning violations of Section 519.1 et seq. of this
title. When such complaints involve physicians licensed by the
State Board of Osteopathic Examiners, the State Board of Osteopathic
Examiners shall be officially notified of such complaints.
F. 1. The Committee shall advise the Board on all matters
pertaining to the practice of physician assistants.
2. The Committee shall review and make recommendations to the
Board on all applications for licensure as a physician assistant and
all applications to practice which shall be approved by the Board.
When considering applicants for licensure, to establish standards of
training or approve institutions for training, the Committee shall
include the Director, or designee, of all Physician Assistant
educational programs conducted by institutions of higher education
in the state as members.
3. The Committee shall assist and advise the Board in all
hearings involving physician assistants who are deemed to be in
violation of Section 519.1 et seq. of this title or the rules of the
Board.
SECTION 5. AMENDATORY 59 O.S. 2021, Section 519.6, is
amended to read as follows:
Section 519.6 A. No health care services may be performed by a
physician assistant unless a current license is on file with and
approved by the State Board of Medical Licensure and Supervision.
B. A physician assistant with six thousand two hundred forty
(6,240) or more hours of postgraduate clinical practice experience
who has reported those hours to the Board shall not be required to
practice under the supervision of a delegating physician.
1. A physician assistant may report the completion of
postgraduate clinical practice experience to the Board at any time
after completion of at least six thousand two hundred forty (6,240)
such hours.
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2. Hours earned prior to the effective date of this act shall
be counted towards the six thousand two hundred forty (6,240) hours.
3. The Board shall maintain, make available, and keep updated,
on the Internet website of the Board, a list of physician assistants
who have reported completion of six thousand two hundred forty
(6,240) or more postgraduate clinical practice experience hours.
4. The Board shall prescribe a form for reporting postgraduate
clinical practice experience by a physician assistant. The Board
shall make available and keep updated on the Internet website of the
Board the prescribed form. This reporting form may be filed
electronically. The Board shall not charge a fee for reporting
hours or filing of the prescribed form.
5. Nothing in this subsection shall prohibit a physician
assistant from maintaining a practice agreement; however, such an
agreement is not required for a physician assistant with the
reported six thousand two hundred forty (6,240) hours of
postgraduate clinical practice experience, provided any practice
agreements are subject to the requirements of paragraphs 1, 2, 3,
and 4 of subsection C of this section.
6. Nothing in this subsection shall restrict the ability of the
Board to require supervision as a part of disciplinary action
against the license of a physician assistant.
C. A physician assistant with less than six thousand two
hundred forty (6,240) hours of postgraduate clinical practice
experience or who has completed six thousand two hundred forty
(6,240) hours but has not reported those hours to the Board shall
practice under the supervision of a delegating physician with the
following requirements:
1. All practice agreements and any amendments shall be filed
with the State Board of Medical Licensure and Supervision within ten
(10) business days of being executed. Practice agreements may be
filed electronically. The State Board of Medical Licensure and
Supervision shall not charge a fee for filing practice agreements or
amendments of to practice agreements.;
B. 2. A physician assistant may have practice agreements with
multiple allopathic or osteopathic physicians. Each physician shall
ENR. H. B. NO. 2584 Page 16
be in good standing with the State Board of Medical Licensure and
Supervision or the State Board of Osteopathic Examiners.;
C. 3. The delegating physician need not be physically present
nor be specifically consulted before each delegated patient care
service is performed by a physician assistant, so long as the
delegating physician and physician assistant are or can be easily in
contact with one another by means of telecommunication. In all
patient care settings, the The delegating physician shall provide
appropriate methods of participating in health care services
provided by the physician assistant including:
a. being responsible for the formulation or approval of
all orders and protocols, whether standing orders,
direct orders or any other orders or protocols, which
direct the delivery of health care services provided
by a physician assistant, and periodically reviewing
such orders and protocols,
b. regularly reviewing the health care services provided
by the physician assistant and any problems or
complications encountered,
c. being available physically or through telemedicine or
direct telecommunications for consultation, assistance
with medical emergencies or patient referral,
d. reviewing a sample of outpatient medical records.
Such reviews shall take place at a site agreed upon
between the delegating physician and physician
assistant in the practice agreement which may also
occur using electronic or virtual conferencing, and
e. that it remains clear that the physician assistant is
an agent of the delegating physician; but, in no event
shall the delegating physician be an employee of the
physician assistant.;
D. 4. In patients with newly diagnosed complex illnesses, the
physician assistant shall contact the delegating physician within
forty-eight (48) hours of the physician assistant's initial
examination or treatment and schedule the patient for appropriate
evaluation by the delegating physician as directed by the physician.
The delegating physician shall determine which conditions qualify as
ENR. H. B. NO. 2584 Page 17
complex illnesses based on the clinical setting and the skill and
experience of the physician assistant.
E. 1. D. A physician assistant under the direction of a
delegating physician not practicing under a practice agreement may
prescribe written and oral prescriptions and orders. The physician
assistant not practicing under a practice agreement may prescribe
medical supplies, services, and drugs, including controlled
medications in Schedules II III through V pursuant to Section 2-312
of Title 63 of the Oklahoma Statutes, and medical supplies and
services as delegated by the delegating physician and as approved by
the State Board of Medical Licensure and Supervision after
consultation with the State Board of Pharmacy on the Physician
Assistant Drug Formulary. Physician assistants not practicing under
a practice agreement may not dispense drugs, but may request,
receive, and sign for professional samples and may distribute
professional samples to patients.
2. A physician assistant may write an order for a Schedule II
drug for immediate or ongoing administration on site. Prescriptions
and orders for Schedule II drugs written by a physician assistant
must be included on a written protocol determined by the delegating
physician and approved by the medical staff committee of the
facility or by direct verbal order of the delegating physician.
Physician assistants may not dispense drugs, but may request,
receive, and sign for professional samples and may distribute
professional samples to patients.
F. E. A physician assistant may perform health care services in
patient care settings as authorized by the delegating physician
practicing under a practice agreement may prescribe written and oral
prescriptions and orders. The physician assistant practicing under
a practice agreement may prescribe medical supplies, services, and
drugs, including controlled medications in Schedules II through V
pursuant to Section 2-312 of Title 63 of the Oklahoma Statutes,
written and oral prescriptions and orders only as delegated by the
delegating physician, and prescriptions and orders for Schedule II
drugs written by such physician assistant shall be included on a
written protocol determined by the delegating physician. Physician
assistants practicing under a practice agreement may not dispense
drugs, but may request, receive, and sign for professional samples
and may distribute professional samples to patients. Provided that
a physician assistant practicing under a practice agreement may not
prescribe any controlled medications in a Schedule that the
delegating physician is not registered to prescribe.
ENR. H. B. NO. 2584 Page 18
G. F. Each physician assistant licensed under the Physician
Assistant Act shall keep his or her license available for inspection
at the primary place of business and shall, when engaged in
professional activities, identify himself or herself as a physician
assistant.
H. G. A physician assistant shall be bound by the provisions
contained in Sections 725.1 through 725.5 of Title 59 of the
Oklahoma Statutes this title.
H. 1. A physician assistant not practicing under a practice
agreement, or the employer of such physician assistant 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
not apply to a physician assistant practicing under a practice
agreement.
2. A physician assistant who is employed by or under contract
with a federal agency that carries malpractice insurance in any
amount on behalf of the physician assistant shall be deemed in
compliance with paragraph 1 of this subsection when practicing under
such federal employment or contract. However, to the extent the
physician assistant practices outside of such federal employment or
contract, the physician assistant, or his or her employer, shall
comply with paragraph 1 of this subsection.
SECTION 6. AMENDATORY 59 O.S. 2021, Section 519.11, as
amended by Section 1, Chapter 164, O.S.L. 2022 (59 O.S. Supp. 2024,
Section 519.11), is amended to read as follows:
Section 519.11 A. Nothing in the Physician Assistant Act shall
be construed to prevent or restrict the practice, services or
activities of any persons of other licensed professions or personnel
supervised by licensed professions in this state from performing
work incidental to the practice of their profession or occupation,
if that person does not represent himself or herself as a physician
assistant.
B. Nothing stated in the Physician Assistant Act shall prevent
any hospital from requiring the physician assistant or the
delegating physician to meet and maintain certain staff appointment
ENR. H. B. NO. 2584 Page 19
and credentialing qualifications for the privilege of practicing as,
or utilizing, a physician assistant in the hospital.
C. Nothing in the Physician Assistant Act shall be construed to
permit a physician assistant to practice medicine or prescribe drugs
and medical supplies in this state except when such actions are
performed under the supervision and at the direction of a physician
or physicians approved by the State Board of Medical Licensure and
Supervision.
D. Nothing herein shall be construed to require licensure under
the Physician Assistant Act of a physician assistant student
enrolled in a physician assistant educational program accredited by
the Accreditation Review Commission on Education for the Physician
Assistant.
E. D. Notwithstanding any other provision of law, no one who is
not a physician licensed to practice medicine in this state may
perform acts restricted to such physicians pursuant to the
provisions of Section 1-731 of Title 63 of the Oklahoma Statutes.
This paragraph subsection is inseverable.
F. E. Nothing in the Physician Assistant Act shall limit the
activities of a physician assistant in the performance of their
duties if the physician assistant is employed by or under contract
with the United States Department of Veterans Affairs or if the
physician assistant is employed by, under contract with, or
commissioned by one of the uniformed services; provided, the
physician assistant must be currently licensed in this state or any
other state or currently credentialed as a physician assistant by
the United States Department of Veterans Affairs or the applicable
uniformed service. Any physician assistant who is employed by or
under contract with the United States Department of Veterans Affairs
or is employed by, under contract with, or commissioned by one of
the uniformed services and practices outside of such employment,
contract, or commission shall be subject to the Physician Assistant
Act while practicing outside of such employment, contract, or
commission. As used in this subsection, "uniformed services" shall
have the same meaning as provided by Title 10 of the U.S. United
States Code.
SECTION 7. AMENDATORY 63 O.S. 2021, Section 1-317, as
last amended by Section 133, Chapter 452, O.S.L. 2024 (63 O.S. Supp.
2024, Section 1-317), is amended to read as follows:
ENR. H. B. NO. 2584 Page 20
Section 1-317. A. A death certificate for each death which
occurs in this state shall be filed with the State Department of
Health, within three (3) days after such death.
B. The funeral director shall personally sign the death
certificate and shall be responsible for filing the death
certificate. If the funeral director is not available, the person
acting as such who first assumes custody of a dead body in
accordance with Section 1158 of Title 21 of the Oklahoma Statutes
shall personally sign and file the death certificate. The personal
data shall be obtained from the next of kin or the best qualified
person or source available. The funeral director or person acting
as such shall notify the person providing the personal data that it
is a felony to knowingly provide false data or misrepresent any
person’s relationship to the decedent. The certificate shall be
completed as to personal data and delivered to the attending
physician or the medical examiner responsible for completing the
medical certification portion of the certificate of death within
twenty-four (24) hours after the death. No later than July 1, 2012,
the personal data, and no later than July 1, 2017, the medical
certificate portion, shall be entered into the prescribed electronic
system provided by the State Registrar of Vital Statistics and the
information submitted to the State Registrar of Vital Statistics.
The resultant certificate produced by the electronic system shall be
provided to the physician or medical examiner for medical
certification within twenty-four (24) hours after the death.
C. The medical certification shall be completed and signed
within forty-eight (48) hours after death by the physician,
physician assistant, or advanced practice registered nurse in charge
of the patient’s care for the illness or condition which resulted in
death, except when inquiry as to the cause of death is required by
Section 938 of this title. No later than July 1, 2017, the medical
certification portion of certificate data shall be entered into the
prescribed electronic system provided by the State Registrar of
Vital Statistics and the information submitted to the State
Registrar of Vital Statistics.
D. In the event that the physician, physician assistant, or
advanced practice registered nurse in charge of the patient’s care
for the illness or condition which resulted in death is not in
attendance at the time of death, the medical certification shall be
completed and signed within forty-eight (48) hours after death by
the physician, physician assistant, or advanced practice registered
nurse in attendance at the time of death, except:
ENR. H. B. NO. 2584 Page 21
1. When the patient is under hospice care at the time of death,
the medical certification may be signed by the hospice’s medical
director; and
2. When inquiry as to the cause of death is required by Section
938 of this title.
Provided, that such certification, if signed by other than the
attending physician, physician assistant, or advanced practice
registered nurse, shall note on the face the name of the attending
physician, physician assistant, or advanced practice registered
nurse and that the information shown is only as reported.
E. A certifier completing cause of death on a certificate of
death who knows that a lethal drug, overdose or other means of
assisting suicide within the meaning of Sections 3141.2 through
3141.4 of this title caused or contributed to the death shall list
that means among the chain of events under cause of death or list it
in the box that describes how the injury occurred. If such means is
in the chain of events under cause of death or in the box that
describes how the injury occurred, the certifier shall indicate
“suicide” as the manner of death.
F. The authority of a physician assistant subject to subsection
C of Section 519.6 of Title 59 of the Oklahoma Statutes to carry out
the functions described in this section shall be governed by the
practice agreement as provided by Section 519.6 of Title 59 of the
Oklahoma Statutes.
SECTION 8. AMENDATORY 63 O.S. 2021, Section 2-101, as
last amended by Section 1, Chapter 308, O.S.L. 2024 (63 O.S. Supp.
2024, Section 2-101), is amended to read as follows:
Section 2-101. As used in the Uniform Controlled Dangerous
Substances Act:
1. “Acute pain” means pain, whether resulting from disease,
accidental trauma, intentional trauma, or other cause that the
practitioner reasonably expects to last only a short period of time.
Acute pain does not include chronic pain, pain being treated as part
of cancer care, hospice or other end-of-life care, or pain being
treated as part of palliative care;
ENR. H. B. NO. 2584 Page 22
2. “Administer” means the direct application of a controlled
dangerous substance, whether by injection, inhalation, ingestion or
any other means, to the body of a patient, animal or research
subject by:
a. a practitioner (or, in the presence of the
practitioner, by the authorized agent of the
practitioner), or
b. the patient or research subject at the direction and
in the presence of the practitioner;
3. “Agent” means a peace officer appointed by and who acts on
behalf of the Director of the Oklahoma State Bureau of Narcotics and
Dangerous Drugs Control or an authorized person who acts on behalf
of or at the direction of a person who manufactures, distributes,
dispenses, prescribes, administers or uses for scientific purposes
controlled dangerous substances but does not include a common or
contract carrier, public warehouser or employee thereof, or a person
required to register under the Uniform Controlled Dangerous
Substances Act;
4. “Anhydrous ammonia” means any substance that exhibits
cryogenic evaporative behavior and tests positive for ammonia;
5. “Board” means the Advisory Board to the Director of the
Oklahoma State Bureau of Narcotics and Dangerous Drugs Control;
6. “Bureau” means the Oklahoma State Bureau of Narcotics and
Dangerous Drugs Control;
7. “Chronic pain” means pain that persists beyond the usual
course of an acute disease or healing of an injury. Chronic pain
may or may not be associated with an acute or chronic pathologic
process that causes continuous or intermittent pain over months or
years;
8. “Coca leaves” includes cocaine and any compound,
manufacture, salt, derivative, mixture or preparation of coca
leaves, except derivatives of coca leaves which do not contain
cocaine or ecgonine;
9. “Commissioner” or “Director” means the Director of the
Oklahoma State Bureau of Narcotics and Dangerous Drugs Control;
ENR. H. B. NO. 2584 Page 23
10. “Control” means to add, remove or change the placement of a
drug, substance or immediate precursor under the Uniform Controlled
Dangerous Substances Act;
11. “Controlled dangerous substance” means a drug, substance or
immediate precursor in Schedules I through V of the Uniform
Controlled Dangerous Substances Act or any drug, substance or
immediate precursor listed either temporarily or permanently as a
federally controlled substance. Any conflict between state and
federal law with regard to the particular schedule in which a
substance is listed shall be resolved in favor of state law;
12. “Counterfeit substance” means a controlled substance which,
or the container or labeling of which without authorization, bears
the trademark, trade name or other identifying marks, imprint,
number or device or any likeness thereof of a manufacturer,
distributor or dispenser other than the person who in fact
manufactured, distributed or dispensed the substance;
13. “Deliver” or “delivery” means the actual, constructive or
attempted transfer from one person to another of a controlled
dangerous substance or drug paraphernalia, whether or not there is
an agency relationship;
14. “Dispense” means to deliver a controlled dangerous
substance to an ultimate user or human research subject by or
pursuant to the lawful order of a practitioner, including the
prescribing, administering, packaging, labeling or compounding
necessary to prepare the substance for such distribution.
“Dispenser” is a practitioner who delivers a controlled dangerous
substance to an ultimate user or human research subject;
15. “Distribute” means to deliver other than by administering
or dispensing a controlled dangerous substance;
16. “Distributor” means a commercial entity engaged in the
distribution or reverse distribution of narcotics and dangerous
drugs and who complies with all regulations promulgated by the
federal Drug Enforcement Administration and the Oklahoma State
Bureau of Narcotics and Dangerous Drugs Control;
17. “Drug” means articles:
a. recognized in the official United States Pharmacopeia,
official Homeopathic Pharmacopoeia of the United
ENR. H. B. NO. 2584 Page 24
States, or official National Formulary, or any
supplement to any of them,
b. intended for use in the diagnosis, cure, mitigation,
treatment or prevention of disease in man or other
animals,
c. other than food, intended to affect the structure or
any function of the body of man or other animals, and
d. intended for use as a component of any article
specified in this paragraph;
provided, however, the term drug does not include devices or their
components, parts or accessories;
18. “Drug paraphernalia” means all equipment, products, and
materials of any kind which are used, intended for use, or fashioned
specifically for use in planting, propagating, cultivating, growing,
harvesting, manufacturing, compounding, converting, producing,
processing, preparing, testing, analyzing, packaging, repackaging,
storing, containing, concealing, injecting, ingesting, inhaling, or
otherwise introducing into the human body, a controlled dangerous
substance in violation of the Uniform Controlled Dangerous
Substances Act including, but not limited to:
a. kits used, intended for use, or fashioned specifically
for use in planting, propagating, cultivating,
growing, or harvesting of any species of plant which
is a controlled dangerous substance or from which a
controlled dangerous substance can be derived,
b. kits used, intended for use, or fashioned specifically
for use in manufacturing, compounding, converting,
producing, processing, or preparing controlled
dangerous substances,
c. isomerization devices used, intended for use, or
fashioned specifically for use in increasing the
potency of any species of plant which is a controlled
dangerous substance,
d. testing equipment used, intended for use, or fashioned
specifically for use in identifying or in analyzing
ENR. H. B. NO. 2584 Page 25
the strength, effectiveness, or purity of controlled
dangerous substances,
e. scales and balances used, intended for use, or
fashioned specifically for use in weighing or
measuring controlled dangerous substances,
f. diluents and adulterants, such as quinine
hydrochloride, mannitol, mannite, dextrose, and
lactose used, intended for use, or fashioned
specifically for use in cutting controlled dangerous
substances,
g. separation gins and sifters used, intended for use, or
fashioned specifically for use in removing twigs and
seeds from, or in otherwise cleaning or refining,
marijuana,
h. blenders, bowls, containers, spoons, and mixing
devices used, intended for use, or fashioned
specifically for use in compounding controlled
dangerous substances,
i. capsules, balloons, envelopes, and other containers
used, intended for use, or fashioned specifically for
use in packaging small quantities of controlled
dangerous substances,
j. containers and other objects used, intended for use,
or fashioned specifically for use in parenterally
injecting controlled dangerous substances into the
human body,
k. hypodermic syringes, needles, and other objects used,
intended for use, or fashioned specifically for use in
parenterally injecting controlled dangerous substances
into the human body, except as authorized by Section
2-1101 of this title,
l. objects used, intended for use, or fashioned
specifically for use in ingesting, inhaling, or
otherwise introducing marijuana, cocaine, hashish, or
hashish oil into the human body, such as:
ENR. H. B. NO. 2584 Page 26
(1) metal, wooden, acrylic, glass, stone, plastic, or
ceramic pipes with or without screens, permanent
screens, hashish heads, or punctured metal bowls,
(2) water pipes,
(3) carburetion tubes and devices,
(4) smoking and carburetion masks,
(5) roach clips, meaning objects used to hold burning
material, such as a marijuana cigarette, that has
become too small or too short to be held in the
hand,
(6) miniature cocaine spoons and cocaine vials,
(7) chamber pipes,
(8) carburetor pipes,
(9) electric pipes,
(10) air-driven pipes,
(11) chillums,
(12) bongs, or
(13) ice pipes or chillers,
m. all hidden or novelty pipes, and
n. any pipe that has a tobacco bowl or chamber of less
than one-half (1/2) inch in diameter in which there is
any detectable residue of any controlled dangerous
substance as defined in this section or any other
substances not legal for possession or use;
provided, however, the term drug paraphernalia shall not include
separation gins intended for use in preparing tea or spice, clamps
used for constructing electrical equipment, water pipes designed for
ornamentation in which no detectable amount of an illegal substance
is found or pipes designed and used solely for smoking tobacco,
traditional pipes of an American Indian tribal religious ceremony,
ENR. H. B. NO. 2584 Page 27
antique pipes that are thirty (30) years of age or older, or drug
testing strips possessed by a person for purposes of determining the
presence of fentanyl or a fentanyl-related compound;
19. “Drug-dependent person” means a person who is using a
controlled dangerous substance and who is in a state of psychic or
physical dependence, or both, arising from administration of that
controlled dangerous substance on a continuous basis. Drug
dependence is characterized by behavioral and other responses which
include a strong compulsion to take the substance on a continuous
basis in order to experience its psychic effects, or to avoid the
discomfort of its absence;
20. “Harm-reduction services” means programs established to:
a. reduce the spread of infectious diseases related to
injection drug use,
b. reduce drug dependency, overdose deaths, and
associated complications, and
c. increase safe recovery and disposal of used syringes
and sharp waste;
21. “Hazardous materials” means materials, whether solid,
liquid, or gas, which are toxic to human, animal, aquatic, or plant
life, and the disposal of such materials is controlled by state or
federal guidelines;
22. “Home care agency” means any sole proprietorship,
partnership, association, corporation, or other organization which
administers, offers, or provides home care services, for a fee or
pursuant to a contract for such services, to clients in their place
of residence;
23. “Home care services” means skilled or personal care
services provided to clients in their place of residence for a fee;
24. “Hospice” means a centrally administered, nonprofit or for-
profit, medically directed, nurse-coordinated program which provides
a continuum of home and inpatient care for the terminally ill
patient and the patient’s family. Such term shall also include a
centrally administered, nonprofit or for-profit, medically directed,
nurse-coordinated program if such program is licensed pursuant to
the provisions of the Uniform Controlled Dangerous Substances Act.
ENR. H. B. NO. 2584 Page 28
A hospice program offers palliative and supportive care to meet the
special needs arising out of the physical, emotional and spiritual
stresses which are experienced during the final stages of illness
and during dying and bereavement. This care is available twenty-
four (24) hours a day, seven (7) days a week, and is provided on the
basis of need, regardless of ability to pay. “Class A” Hospice
refers to Medicare-certified hospices. “Class B” refers to all
other providers of hospice services;
25. “Imitation controlled substance” means a substance that is
not a controlled dangerous substance, which by dosage unit
appearance, color, shape, size, markings or by representations made,
would lead a reasonable person to believe that the substance is a
controlled dangerous substance, or is a drug intended solely for
veterinary purposes that is not a controlled dangerous substance and
is being used outside of the scope of practice or normal course of
business, as defined by the State Board of Veterinary Medical
Examiners, or is a federal Food and Drug Administration-approved
drug that is not a controlled dangerous substance and is being used
outside the scope of approval for illicit purposes such as
adulterating or lacing other controlled dangerous substances. In
the event the appearance of the dosage unit or use is not reasonably
sufficient to establish that the substance is an imitation
controlled substance, the court or authority concerned should
consider, in addition to all other factors, the following factors:
a. statements made by an owner or by any other person in
control of the substance concerning the nature of the
substance, or its use or effect,
b. statements made to the recipient that the substance
may be resold for inordinate profit,
c. whether the substance is packaged in a manner normally
used for illicit controlled substances,
d. evasive tactics or actions utilized by the owner or
person in control of the substance to avoid detection
by law enforcement authorities,
e. prior convictions, if any, of an owner, or any other
person in control of the object, under state or
federal law related to controlled substances or fraud,
and
ENR. H. B. NO. 2584 Page 29
f. the proximity of the substances to controlled
dangerous substances;
26. “Immediate precursor” means a substance which the Director
has found to be and by regulation designates as being the principal
compound commonly used or produced primarily for use, and which is
an immediate chemical intermediary used, or likely to be used, in
the manufacture of a controlled dangerous substance, the control of
which is necessary to prevent, curtail or limit such manufacture;
27. “Initial prescription” means a prescription issued to a
patient who:
a. has never previously been issued a prescription for
the drug or its pharmaceutical equivalent in the past
year, or
b. requires a prescription for the drug or its
pharmaceutical equivalent due to a surgical procedure
or new acute event and has previously had a
prescription for the drug or its pharmaceutical
equivalent within the past year.
When determining whether a patient was previously issued a
prescription for a drug or its pharmaceutical equivalent, the
practitioner shall consult with the patient and review the medical
record and prescription monitoring information of the patient;
28. “Isomer” means the optical isomer, except as used in
subsections C and F of Section 2-204 of this title and paragraph 4
of subsection A of Section 2-206 of this title. As used in
subsections C and F of Section 2-204 of this title, isomer means the
optical, positional, or geometric isomer. As used in paragraph 4 of
subsection A of Section 2-206 of this title, the term isomer means
the optical or geometric isomer;
29. “Laboratory” means a laboratory approved by the Director as
proper to be entrusted with the custody of controlled dangerous
substances and the use of controlled dangerous substances for
scientific and medical purposes and for purposes of instruction;
30. “Manufacture” means the production, preparation,
propagation, compounding or processing of a controlled dangerous
substance, either directly or indirectly by extraction from
substances of natural or synthetic origin, or independently by means
ENR. H. B. NO. 2584 Page 30
of chemical synthesis or by a combination of extraction and chemical
synthesis. “Manufacturer” includes any person who packages,
repackages or labels any container of any controlled dangerous
substance, except practitioners who dispense or compound
prescription orders for delivery to the ultimate consumer;
31. “Marijuana” means all parts of the plant Cannabis sativa
L., whether growing or not; the seeds thereof; the resin extracted
from any part of such plant; and every compound, manufacture, salt,
derivative, mixture or preparation of such plant, its seeds or
resin, but shall not include:
a. the mature stalks of such plant or fiber produced from
such stalks,
b. oil or cake made from the seeds of such plant,
including cannabidiol derived from the seeds of the
marijuana plant,
c. any other compound, manufacture, salt, derivative,
mixture or preparation of such mature stalks (except
the resin extracted therefrom), including cannabidiol
derived from mature stalks, fiber, oil or cake,
d. the sterilized seed of such plant which is incapable
of germination,
e. for any person participating in a clinical trial to
administer cannabidiol for the treatment of severe
forms of epilepsy pursuant to Section 2-802 of this
title, a drug or substance approved by the federal
Food and Drug Administration for use by those
participants,
f. for any person or the parents, legal guardians or
caretakers of the person who have received a written
certification from a physician licensed in this state
that the person has been diagnosed by a physician as
having Lennox-Gastaut syndrome, Dravet syndrome, also
known as severe myoclonic epilepsy of infancy, or any
other severe form of epilepsy that is not adequately
treated by traditional medical therapies, spasticity
due to multiple sclerosis or due to paraplegia,
intractable nausea and vomiting, appetite stimulation
with chronic wasting diseases, the substance
ENR. H. B. NO. 2584 Page 31
cannabidiol, a nonpsychoactive cannabinoid, found in
the plant Cannabis sativa L. or any other preparation
thereof, that has a tetrahydrocannabinol concentration
not more than three-tenths of one percent (0.3%) and
that is delivered to the patient in the form of a
liquid,
g. any federal Food and Drug Administration-approved drug
or substance, or
h. industrial hemp, from the plant Cannabis sativa L. and
any part of such plant, whether growing or not, with a
delta-9 tetrahydrocannabinol concentration not more
than three-tenths of one percent (0.3%) on a dry-
weight basis which shall only be grown pursuant to the
Oklahoma Industrial Hemp Program and may be shipped
intrastate and interstate;
32. “Medical purpose” means an intention to utilize a
controlled dangerous substance for physical or mental treatment, for
diagnosis, or for the prevention of a disease condition not in
violation of any state or federal law and not for the purpose of
satisfying physiological or psychological dependence or other abuse;
33. “Mid-level practitioner” means an Advanced Practice
Registered Nurse as defined and within parameters specified in
Section 567.3a of Title 59 of the Oklahoma Statutes, or a certified
animal euthanasia technician as defined in Section 698.2 of Title 59
of the Oklahoma Statutes, or an animal control officer registered by
the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control
under subsection B of Section 2-301 of this title within the
parameters of such officer’s duties under Sections 501 through 508
of Title 4 of the Oklahoma Statutes;
34. “Narcotic drug” means any of the following, whether
produced directly or indirectly by extraction from substances of
vegetable origin, or independently by means of chemical synthesis,
or by a combination of extraction and chemical synthesis:
a. opium, coca leaves and opiates,
b. a compound, manufacture, salt, derivative or
preparation of opium, coca leaves or opiates,
ENR. H. B. NO. 2584 Page 32
c. cocaine, its salts, optical and geometric isomers, and
salts of isomers,
d. ecgonine, its derivatives, their salts, isomers and
salts of isomers, and
e. a substance, and any compound, manufacture, salt,
derivative or preparation thereof, which is chemically
identical with any of the substances referred to in
subparagraphs a through d of this paragraph, except
that the words narcotic drug as used in Section 2-101
et seq. of this title shall not include decocainized
coca leaves or extracts of coca leaves, which extracts
do not contain cocaine or ecgonine;
35. “Opiate” or “opioid” means any Schedule II, III, IV or V
substance having an addiction-forming or addiction-sustaining
liability similar to morphine or being capable of conversion into a
drug having such addiction-forming or addiction-sustaining
liability. The terms do not include, unless specifically designated
as controlled under the Uniform Controlled Dangerous Substances Act,
the dextrorotatory isomer of 3-methoxy-n-methyl-morphinan and its
salts (dextromethorphan). The terms do include the racemic and
levorotatory forms;
36. “Opium poppy” means the plant of the species Papaver
somniferum L., except the seeds thereof;
37. “Palliative care” means a specialized medical service for
people of any age and at any stage of a serious illness or life-
altering medical event that focuses on navigating complex medical
decisions while providing patient autonomy and access to
information. Utilizing a holistic and interdisciplinary team
approach, palliative care addresses physical, intellectual,
emotional, social, and spiritual needs. Palliative care may be
provided in the inpatient, outpatient, or home care setting and
strives to improve quality of life for both the patient and the
family;
38. “Patient-provider agreement” means a written contract or
agreement that is executed between a practitioner and a patient
prior to the commencement of treatment for chronic pain using an
opioid drug as a means to:
ENR. H. B. NO. 2584 Page 33
a. explain the possible risk of development of physical
or psychological dependence in the patient and prevent
the possible development of addiction,
b. document the understanding of both the practitioner
and the patient regarding the patient-provider
agreement of the patient,
c. establish the rights of the patient in association
with treatment and the obligations of the patient in
relation to the responsible use, discontinuation of
use, and storage of opioid drugs, including any
restrictions on the refill of prescriptions or the
acceptance of opioid prescriptions from practitioners,
d. identify the specific medications and other modes of
treatment, including physical therapy or exercise,
relaxation, or psychological counseling, that are
included as a part of the patient-provider agreement,
e. specify the measures the practitioner may employ to
monitor the compliance of the patient including, but
not limited to, random specimen screens and pill
counts, and
f. delineate the process for terminating the agreement,
including the consequences if the practitioner has
reason to believe that the patient is not complying
with the terms of the agreement. Compliance with the
consent items described in this paragraph shall
constitute a valid, informed consent for opioid
therapy. The practitioner shall be held harmless from
civil litigation for failure to treat pain if the
event occurs because of nonadherence by the patient
with any of the provisions of the patient-provider
agreement;
39. “Peace officer” means a police officer, sheriff, deputy
sheriff, district attorney’s investigator, investigator from the
Office of the Attorney General, or any other person elected or
appointed by law to enforce any of the criminal laws of this state
or of the United States;
ENR. H. B. NO. 2584 Page 34
40. “Person” means an individual, corporation, government or
governmental subdivision or agency, business trust, estate, trust,
partnership or association, or any other legal entity;
41. “Poppy straw” means all parts, except the seeds, of the
opium poppy, after mowing;
42. “Practitioner” means:
a. (1) a medical doctor or osteopathic physician,
(2) a dentist,
(3) a podiatrist,
(4) an optometrist,
(5) a veterinarian,
(6) a physician assistant or an Advanced Practice
Registered Nurse under the supervision of a
licensed medical doctor or osteopathic physician,
or a physician assistant,
(7) a scientific investigator, or
(8) any other person,
licensed, registered or otherwise permitted to
prescribe, distribute, dispense, conduct research with
respect to, use for scientific purposes or administer
a controlled dangerous substance in the course of
professional practice or research in this state, or
b. a pharmacy, hospital, laboratory or other institution
licensed, registered or otherwise permitted to
distribute, dispense, conduct research with respect
to, use for scientific purposes or administer a
controlled dangerous substance in the course of
professional practice or research in this state;
43. “Production” includes the manufacture, planting,
cultivation, growing or harvesting of a controlled dangerous
substance;
ENR. H. B. NO. 2584 Page 35
44. “Serious illness” means a medical illness or physical
injury or condition that substantially affects quality of life for
more than a short period of time. Serious illness includes, but is
not limited to, Alzheimer’s disease or related dementias, lung
disease, cancer, heart failure, renal failure, liver failure, or
chronic, unremitting, or intractable pain such as neuropathic pain;
45. “State” means the State of Oklahoma or any other state of
the United States;
46. “Straw person” or “straw party”, also known as a “front”,
means a third party who:
a. is put up in name only to take part in a transaction
or otherwise is a nominal party to a transaction with
no actual control,
b. acts on behalf of another person to obtain title to
property and executes documents and instruments the
principal may direct respecting property, or
c. purchases property for another for the purpose of
concealing the identity of the real purchaser or to
accomplish some purpose otherwise in violation of the
Oklahoma Statutes;
47. “Surgical procedure” means a procedure that is performed
for the purpose of structurally altering the human body by incision
or destruction of tissues as part of the practice of medicine. This
term includes the diagnostic or therapeutic treatment of conditions
or disease processes by use of instruments such as lasers,
ultrasound, ionizing, radiation, scalpels, probes, or needles that
cause localized alteration or transportation of live human tissue by
cutting, burning, vaporizing, freezing, suturing, probing, or
manipulating by closed reduction for major dislocations or
fractures, or otherwise altering by any mechanical, thermal, light-
based, electromagnetic, or chemical means;
48. a. “Synthetic controlled substance” means a substance:
(1) the chemical structure of which is substantially
similar to the chemical structure of a controlled
dangerous substance in Schedule I or II,
ENR. H. B. NO. 2584 Page 36
(2) which has a stimulant, depressant, or
hallucinogenic effect on the central nervous
system that is substantially similar to or
greater than the stimulant, depressant, or
hallucinogenic effect on the central nervous
system of a controlled dangerous substance in
Schedule I or II, or
(3) with respect to a particular person, which such
person represents or intends to have a stimulant,
depressant, or hallucinogenic effect on the
central nervous system that is substantially
similar to or greater than the stimulant,
depressant, or hallucinogenic effect on the
central nervous system of a controlled dangerous
substance in Schedule I or II.
b. The designation of gamma-butyrolactone or any other
chemical as a precursor, pursuant to Section 2-322 of
this title, does not preclude a finding pursuant to
subparagraph a of this paragraph that the chemical is
a synthetic controlled substance.
c. Synthetic controlled substance does not include:
(1) a controlled dangerous substance,
(2) any substance for which there is an approved new
drug application,
(3) with respect to a particular person any
substance, if an exemption is in effect for
investigational use, for that person under the
provisions of Section 505 of the Federal Food,
Drug, and Cosmetic Act, 21 U.S.C., Section 355,
to the extent conduct with respect to such
substance is pursuant to such exemption, or
(4) any substance to the extent not intended for
human consumption before such an exemption takes
effect with respect to that substance.
d. Prima facie evidence that a substance containing
salvia divinorum has been enhanced, concentrated, or
chemically or physically altered shall give rise to a
ENR. H. B. NO. 2584 Page 37
rebuttable presumption that the substance is a
synthetic controlled substance;
49. “Tetrahydrocannabinols” means all substances that have been
chemically synthesized to emulate the tetrahydrocannabinols of
marijuana, specifically including any tetrahydrocannabinols derived
from industrial hemp; and
50. “Ultimate user” means a person who lawfully possesses a
controlled dangerous substance for the person’s own use or for the
use of a member of the person’s household or for administration to
an animal owned by the person or by a member of the person’s
household.
SECTION 9. 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
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 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, and
who has complied with the registration requirements of the Uniform
Controlled Dangerous Substances Act, in good faith and in the course
ENR. H. B. NO. 2584 Page 38
of professional practice only, may prescribe and administer Schedule
III, IV and V controlled dangerous substances.
D. An advanced practice nurse who is recognized to order,
select, obtain and administer drugs by the Oklahoma Board of Nursing
as a 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 care setting
only. A 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 subject to the restrictions in
Section 519.6 of Title 59 of the Oklahoma Statutes.
SECTION 10. REPEALER 59 O.S. 2021, Section 521.4, is
hereby repealed.
ENR. H. B. NO. 2584 Page 39
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: _________________________________