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An Act
ENROLLED SENATE
BILL NO. 1567 By: Stanley of the Senate
and
Fetgatter of the House
An Act relating to the practice of nursing; amending
Section 4, Chapter 340, O.S.L. 2025 (59 O.S. Supp.
2025, Section 479.1), which relates to supervising
physician of Advanced Practice Registered Nurse;
modifying certain restriction on supervision fees;
amending Section 1, Chapter 340, O.S.L. 2025 (59 O.S.
Supp. 2025, Section 567.4c), which relates to
independent prescriptive authority for Advanced
Practice Registered Nurse; excluding certain
application from specified provisions of law;
prohibiting certain requirements by the Oklahoma
Board of Nursing; updating statutory language;
updating statutory references; and providing an
effective date.
SUBJECT: Advanced Practice Registered Nurses
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY Section 4, Chapter 340, O.S.L.
2025 (59 O.S. Supp. 2025, Section 479.1), is amended to read as
follows:
Section 479.1. 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 this
title, except that such term does not include a Certified Registered
Nurse Anesthetist;
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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 this title.
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 Section 567.4c of
this title, 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
ENR. S. B. NO. 1567 Page 3
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
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,
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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
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 Section 567.4c of
this title, including:
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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
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.
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SECTION 2. AMENDATORY Section 1, Chapter 340, O.S.L.
2025 (59 O.S. Supp. 2025, Section 567.4c), is amended to read as
follows:
Section 567.4c. 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:
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 November 1, 2025,
from being counted toward the hours required in this paragraph.
C. An application for independent prescriptive authority made
under this section shall not be considered an initial application
for prescriptive authority as described in paragraph 3 of Section
567.4a of this title. The Board shall not require an Advanced
Practice Registered Nurse applying for independent prescriptive
authority under this section to recomplete any minimal requirements
for initial application for prescriptive authority as described in
paragraph 3 of Section 567.4a of this title.
D. 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.
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D. E. 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. F. The Board may assess a reasonable fee for the review of
initial and renewal applications under the provisions of this
section.
SECTION 3. This act shall become effective November 1, 2026.
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Passed the Senate the 23rd day of March, 2026.
Presiding Officer of the Senate
Passed the House of Representatives the 28th day of April, 2026.
Presiding Officer of the House
of Representatives
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: _________________________________