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An Act
ENROLLED HOUSE
BILL NO. 4336 By: Moore of the House
and
Gollihare of the Senate
An Act relating to professions and occupations;
amending 59 O.S. 2021, Section 650, which relates to
interventional pain management license; adding
definition; modifying definitions; requiring
penalties for violations; and providing an effective
date.
SUBJECT: Professions and occupations
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 59 O.S. 2021, Section 650, is
amended to read as follows:
Section 650. A. This act shall be known and may be cited as
the "Oklahoma Interventional Pain Management and Treatment Act".
B. As used in this section:
1. "Acute pain" as defined in the Uniform Controlled Dangerous
Substances Act, Section 2-101 et seq. of Title 63 of the Oklahoma
Statutes;
2. "Chronic pain" means a pain state which is subacute,
persistent and intractable as defined in the Uniform Controlled
Dangerous Substances Act, Section 2-101 et seq. of Title 63 of the
Oklahoma Statutes;
2. 3. "Fluoroscope" means a radiologic instrument equipped with
a fluorescent screen on which opaque internal structures can be
ENR. H. B. NO. 4336 Page 2
viewed as moving shadow images formed by the differential
transmission of X-rays throughout the body; and
3. 4. "Interventional pain management" means the practice of
medicine devoted to the diagnosis and treatment of chronic pain,
through the use of such techniques as:
a. ablation of targeted nerves,
b. percutaneous precision needle placement within the
spinal column with placement of drugs such as local
anesthetics, steroids, analgesics in targeted areas of
the spinal column, or
c. surgical techniques, such as laser or endoscopic
diskectomy, intrathecal infusion pumps and spinal cord
stimulators.
C. It shall be unlawful to practice or offer to practice
interventional pain management in this state unless such person has
been duly licensed under the provisions of the Oklahoma Allopathic
Medical and Surgical Licensure and Supervision Act or the Oklahoma
Osteopathic Medicine Act.
D. Nothing in this section shall be construed to forbid the
administration of lumbar intra-laminar epidural steroid injections
or peripheral nerve blocks by a certified registered nurse
anesthetist when requested to do so by a physician and under the
supervision of an allopathic or osteopathic physician licensed in
this state and under conditions in which timely on-site consultation
by such allopathic or osteopathic physician is available.
E. A certified registered nurse anesthetist shall not operate a
freestanding pain management facility without direct supervision of
a physician who is board-certified in interventional pain management
or its equivalent. Any violation of this section by a registered
nurse shall be considered unprofessional conduct under the Oklahoma
Nursing Practice Act. Such violation may be subject to the full
range of penalties available under the Nursing Practice Act
including but not limited to administrative fines or discipline up
to revocation of a license as decided by the respective Board.
F. Except subsection E of this section, any violation of this
section by a physician shall be considered unprofessional conduct
under the Oklahoma Allopathic and Surgical Licensure and Supervision
ENR. H. B. NO. 4336 Page 3
Act or the Oklahoma Osteopathic Medicine Act. Such violation can be
subject to the full range of penalties available under the acts
including but not limited to administrative fines or discipline up
to revocation of a license as decided by the respective Board.
SECTION 2. This act shall become effective November 1, 2026.
ENR. H. B. NO. 4336 Page 4
Passed the House of Representatives the 11th day of March, 2026.
Presiding Officer of the House
of Representatives
Passed the Senate the 5th day of May, 2026.
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: _________________________________