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ENGROSSED HOUSE
BILL NO. 3645 By: Stinson, Archer, Fugate of
the House
and
Howard of the Senate
An Act relating to hospice care; amending 63 O.S.
2021, Section 1-860.4, which relates to hospice
requirements; allowing for hospice determination by
physicians in certain situations; and providing an
effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 63 O.S. 2021, Section 1-860.4, is
amended to read as follows:
Section 1-860.4. A. A hospice shall comply with the following:
1. A hospice shall coordinate its services with those of the
patient's primary or attending physician;
2. A hospice shall coordinate its services with professional
and nonprofessional services already in the community. A hospice
may contract for some elements of its services to a patient and
family, provided direct patient care is maintained with the patient
and the hospice team so that overall coordination of services can be
maintained by the hospice team. The majority of hospice services
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available through a hospice shall be provided directly by the
licensee. Any contract entered into between a hospice and health
care provider shall specify that the hospice retain the
responsibility for planning, coordinating and prescribing hospice
services on behalf of a hospice patient and the hospice patient's
family. No hospice may charge fees for services provided directly
by the hospice team which duplicate contractual services provided to
the patient or the patient's family;
3. The hospice team shall be responsible for coordination and
continuity between inpatient and home care aspects of care;
4. A hospice shall not contract with a health care provider or
another hospice that has or has been given a conditional license
within the last eighteen (18) months;
5. Hospice services shall provide a symptom control process, to
be provided by a hospice team skilled in physical and psychosocial
management of distressing signs and symptoms;
6. Hospice care shall be available twenty-four (24) hours a
day, seven (7) days a week;
7. A hospice shall have a bereavement program which shall
provide a continuum of supportive and therapeutic services for the
family;
8. The unit of care in a hospice program shall be composed of
the patient and family;
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9. A hospice program shall provide a continuum of care and a
continuity of care providers throughout the length of care for the
patient and to the family through the bereavement period;
10. A hospice program shall not impose the dictates of any
value or belief system on its patients and their families;
11. a. Admission to a hospice shall be upon the order of a
physician licensed pursuant to the laws of this state
and shall be dependent on the expressed request and
informed consent of the patient and family. If no
legal guardian, power of attorney, next-of-kin, or
health care proxy is appointed by the patient or is
not available to elect hospice benefits for a patient,
the following individuals may elect hospice benefits
on behalf of the patient:
(1) a licensed long-term care administrator who has
been responsible for overseeing the patient's
care needs for no less than six (6) months and
has documented evidence that two physicians have
determined hospice eligibility is necessary and
in the best interest of the patient,
(2) two physicians licensed in the State of Oklahoma
who have reviewed the patient's medical history
and determined it is in the patient's best
interest to elect for hospice benefits, or
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(3) the patient's primary care physician who has
managed the care of the patient for no less than
six (6) months.
b. The hospice program shall have admission criteria and
procedures that reflect:
(1) the patient and family's desire and need for
service,
(2) the participation of the attending physician, and
(3) the diagnosis and prognosis of the patient.
c. (1) Any hospice or employee or agent thereof who
knowingly or intentionally solicits patients or
pays to or offers a benefit to any person, firm,
association, partnership, corporation or other
legal entity for securing or soliciting patients
for the hospice or hospice services in this
state, upon conviction thereof, shall be guilty
of a misdemeanor and shall be punished by a fine
of not less than Five Hundred Dollars ($500.00)
and not more than Two Thousand Dollars
($2,000.00).
(2) In addition to any other penalties or remedies
provided by law:
(a) a violation of this section by a hospice or
employee or agent thereof shall be grounds
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for disciplinary action by the State
Department of Health, and
(b) the State Department of Health may institute
an action to enjoin violation or potential
violation of this section. The action for
an injunction shall be in addition to any
other action, proceeding or remedy
authorized by law.
(3) This subparagraph shall not be construed to
prohibit:
(a) advertising, except that advertising which:
(i) is false, misleading or deceptive,
(ii) advertises professional superiority or
the performance of a professional
service in a superior manner, and
(iii) is not readily subject to verification,
and
(b) remuneration for advertising, marketing or
other services that are provided for the
purpose of securing or soliciting patients,
provided the remuneration is:
(i) set in advance,
(ii) consistent with the fair market value
of the services, and
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(iii) not based on the volume or value of any
patient referrals or business otherwise
generated between the parties, and
(c) any payment, business arrangements or
payments practice not prohibited by 42
U.S.C., Section 1320a-7b(b), or any
regulations promulgated pursuant thereto.
(4) This paragraph shall not apply to licensed
insurers, including but not limited to group
hospital service corporations or health
maintenance organizations which reimburse,
provide, offer to provide or administer hospice
services under a health benefits plan for which
it is the payor when it is providing those
services under a health benefits plan;
12. A hospice program shall develop and maintain a quality
assurance program that includes:
a. evaluation of services,
b. regular chart audits, and
c. organizational review; and
13. A hospice program shall be managed by an administrator
meeting the requirements as set forth in Section 1-862 of this
title.
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B. A hospice team shall consist of, as a minimum, a physician,
a registered nurse, and a social worker or counselor, each of whom
shall be licensed as required by the laws of this state. The team
may also include clergy and such volunteers as are necessary to
provide hospice services. A registered nurse licensed pursuant to
the laws of this state shall be employed by the hospice as a patient
care coordinator to supervise and coordinate the palliative and
supportive care for patients and families provided by a hospice
team. Nothing in this section shall be construed as to require a
hospice to employ a certified home health aide in the provision of
hospice services so long as the hospice employs a certified nurse
aide.
C. 1. An up-to-date record of the services given to the
patient and family shall be kept by the hospice team. Records shall
contain pertinent past and current medical, nursing, social, and
such other information that is necessary for the safe and adequate
care of the patient and the family. Notations regarding all aspects
of care for the patient and family shall be made in the record.
When services are terminated, the record shall show the date and
reason for termination.
2. Information received by persons employed by or providing
services to a hospice, or information received by the State
Department of Health through reports or inspection shall be deemed
privileged and confidential information and shall not be disclosed
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to any person other than the patient or the family without the
written consent of that patient, the patient's guardian or the
patient's family.
D. 1. A hospice program shall have a clearly defined and
organized governing body, which has autonomous authority for the
conduct of the hospice program.
2. The hospice program shall have an administrator who shall be
responsible for the overall coordination and administration of the
hospice program.
SECTION 2. This act shall become effective November 1, 2026.
Passed the House of Representatives the 10th day of March, 2026.
Presiding Officer of the House
of Representatives
Passed the Senate the _____ day of __________, 2026.
Presiding Officer of the Senate