OK
Oklahoma House Bill HB3004

Oklahoma 2022 Regular Session

Oklahoma House Bill HB3004 Compare Versions

Only one version of the bill is available at this time.
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2828 STATE OF OKLAHOMA
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3030 2nd Session of the 58th Legislature (2022)
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3232 HOUSE BILL 3004 By: West (Rick)
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3838 AS INTRODUCED
3939
4040 An Act relating to controlled dangerous substances;
4141 defining terms; requiring pain management clinics to
4242 register with State Board of Medical Licensure and
4343 Supervision; providing exemptions; stipulating
4444 registration procedures; requiring clinics to
4545 designate physician; providing for the denial,
4646 revocation, or suspension of registration under
4747 certain circumstances; defining term; requiring
4848 facility operations to cease when registration is
4949 revoked or suspended; requiring removal of signage;
5050 prohibiting person fr om applying to operate pain
5151 management clinic for certain period of time after
5252 revocation; limiting pe riod of suspension; requiring
5353 new registration application if clinic changes
5454 ownership; prohibiting physicians from practicing
5555 medicine in unregistered pa in management clinics;
5656 providing for disciplinary action for violations;
5757 limiting who may prescribe co ntrolled dangerous
5858 substances at registered pain management clinics;
5959 prohibiting the dispensation of controlled dangerous
6060 substances at pain management cl inics; specifying
6161 physician responsibilities; providing facility and
6262 physical operations requirements; stipulating certain
6363 infection control requirements; providing safety
6464 requirements for buildings, grounds , and equipment of
6565 clinics; providing certain qual ity assurance
6666 requirements; stipulating certain data collection and
6767 reporting requirements; providing for the
6868 accessibility of certain data and reports; providing
6969 penalties; directing promulgation of rules; providing
7070 for codification; and providing an effe ctive date.
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101101 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
102102 SECTION 1. NEW LAW A new section of law to be codified
103103 in the Oklahoma Statutes as Section 2-1111 of Title 63, unless there
104104 is created a duplication in numbering, reads as follows:
105105 As used in this act:
106106 1. "Board eligible" means successful completion of an
107107 anesthesia, physical medicine and rehabilitation, rheumatology , or
108108 neurology residency program approved by the Accreditation Council
109109 for Graduate Medical Education or the American Osteopathic
110110 Association for a period of six (6) years from successful com pletion
111111 of such residency program;
112112 2. "Chronic nonmalignant pain " means pain unrelated to cancer
113113 which persists beyond the usual course of disease or the injury that
114114 is the cause of the pain or more than ninety (90) calendar days
115115 after surgery; and
116116 3. "Pain management clinic" or "clinic" means any publicly or
117117 privately owned facility:
118118 a. that advertises in any medium for any type of pain
119119 management services, and
120120 b. where in any month a majority of patient s are
121121 prescribed opioids, benzodiazepines, barbitur ates, or
122122 carisoprodol for the treatment of chronic nonmalignant
123123 pain.
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150150 SECTION 2. NEW LAW A new section of law to be codified
151151 in the Oklahoma Statutes as Section 2-1112 of Title 63, unless there
152152 is created a duplication in numbering, reads as follows:
153153 A. Each pain management clinic shall register with the State
154154 Board of Medical Licensure and Supervision unless:
155155 1. The majority of the physicians who provide services in the
156156 clinic primarily provide surgical services;
157157 2. The clinic is affiliated with an accredited medical school
158158 at which training is provided for medical students, residents , or
159159 fellows;
160160 3. The clinic does not prescribe c ontrolled dangerous
161161 substances for the treatment of pain;
162162 4. The clinic is wholly owned and operated by one or more
163163 board-eligible or board-certified anesthesiologists, physiatrists,
164164 rheumatologists, or neurologists; or
165165 5. The clinic is wholly owned and o perated by a physician
166166 multispecialty practice where one or more board -eligible or board-
167167 certified medical specialists, who have also completed fellowships
168168 in pain medicine approved by the Accreditation Council for Graduate
169169 Medical Education or who are als o certified in pain medicine by the
170170 American Board of Pain Medicine or a board approved by the America n
171171 Board of Physician Specialties, the American Association of
172172 Physician Specialists , or the American Osteopathic Association,
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199199 perform interventional pain p rocedures of the type routinely billed
200200 using surgical codes.
201201 B. Each clinic location shall be registe red separately
202202 regardless of whether the clinic is operated under the same business
203203 name or management as another clinic.
204204 C. As a part of registration, a clinic shall designate a
205205 physician who is responsible for complying with all requirements
206206 related to registration and operation of the clinic in compliance
207207 with this act. Within ten (10) calendar days after termination of a
208208 designated physician, the clin ic shall notify the State Board of
209209 Medical Licensure and Supervision of the identity of another
210210 designated physician for that clinic. The designated physician
211211 shall have a full, active , and unencumbered license pursuant to
212212 Section 480 et seq. or Section 62 0 et seq. of Title 59 of the
213213 Oklahoma Statutes and shall practice at the clinic location for
214214 which the physician has assumed responsibility. Failing to have a
215215 licensed designated physician practicing at the location of the
216216 registered clinic may be the bas is for a summary suspension of the
217217 clinic registration certificate as described in this section.
218218 D. The State Board of Medical Licensure and Supervision shall
219219 deny registration to any pain management clinic owned by or with any
220220 contractual or employment r elationship with a physician:
221221 1. Whose Drug Enforcement Administration number has ever been
222222 revoked;
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249249 2. Whose application for a license to prescribe, dispense , or
250250 administer a controlled substance has been denied for disciplinary
251251 action by the appropriate medical regulatory board of the physician;
252252 or
253253 3. Who has been convicted of or pleaded guilty or nolo
254254 contendere to, regardless of adjudication, an offense that
255255 constitutes a felony for receipt of illicit or diverted drugs,
256256 including a controlled substanc e listed in Schedule I, II, III, IV ,
257257 or V of the Uniform Controlled Dangerous Substances Act, in this
258258 state, any other state or the United States.
259259 E. If the State Board of Medical Licensure and Supervision
260260 finds that a pain management clinic is owned, dire ctly or
261261 indirectly, by a person meeting any criteria listed in subsection D
262262 of this section, the State Board of Medical Licensure and
263263 Supervision shall revoke the certificate of registration previously
264264 issued by the State Board of Medical Licensure and Sup ervision. As
265265 determined by rule, the State Board of Medical Licensure and
266266 Supervision may grant an ex emption to denying a registration or
267267 revoking a previously issued registration if more than five (5)
268268 years have elapsed since adjudication. As used in th is section, the
269269 term "convicted" includes an adjudication of guilt following a plea
270270 of guilty or nolo contendere or the forfeiture of a bond when
271271 charged with a crime.
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298298 F. If the registration of a pain management clinic is revoked
299299 or suspended, the designa ted physician of the pain management
300300 clinic, the owner or lessor of the pain management clinic propert y,
301301 the manager, and the proprietor shall cease to operate the facility
302302 as a pain management clinic as of the effective date of the
303303 suspension or revocation .
304304 G. If a pain management clinic registration is revoked or
305305 suspended, the designated physician of th e pain management clinic,
306306 the owner or lessor of the clinic property, the manager or the
307307 proprietor shall be responsible for removing all signs and symbols
308308 identifying the premises as a pain management clinic.
309309 H. If the clinic's registration is revoked, any per son named in
310310 the registration documents of the pain management clinic, including
311311 persons owning or operating the pain management clinic, shall not,
312312 as an individual or as a part of a group, apply to operate a pain
313313 management clinic for one (1) year after t he date the registration
314314 is revoked.
315315 I. The period of suspension for the registration of a pain
316316 management clinic shall be prescribed by the State Board of Medical
317317 Licensure and Supervision but shall not exceed one (1) year.
318318 J. A change of ownership of a registered pain management clinic
319319 requires submission of a new registration application.
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346346 SECTION 3. NEW LAW A new section of law to be codified
347347 in the Oklahoma Statutes as Section 2-1113 of Title 63, unless there
348348 is created a duplication in numbering, reads as follows:
349349 A. A physician shall not practice medicine in a pain management
350350 clinic if the clinic is not registered with the State Board of
351351 Medical Licensure and Supervision as required by this act. Any
352352 physician who qualifies t o practice medicine in a pain management
353353 clinic pursuant to rules adopted by the appropriate medical
354354 regulatory board of the physician may continue to practice medicine
355355 in a pain management clinic as long as the physician continues to
356356 meet the qualificatio ns prescribed in the rules. A physician who
357357 violates this subsection is subject to disciplinary action by the
358358 appropriate medical regulatory board of the physician.
359359 B. Only a physician licensed pursuant to Section 480 et seq. or
360360 Section 620 et seq. of Ti tle 59 of the Oklahoma Statutes may
361361 prescribe a controlled dangerous substance on the premises of a
362362 registered pain management clinic. No person shall dispense any
363363 controlled dangerous substance on the premises of a pain management
364364 clinic.
365365 C. A physician, a physician assistant, or an Advanced Practice
366366 Registered Nurse shall perform a physical examination o f a patient
367367 on the same day that the physician prescribes a controlled dangerous
368368 substance to a patient at a pain management clinic.
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395395 D. A physician author ized to prescribe controlled dangerous
396396 substances who practices at a pain management clinic is responsible
397397 for maintaining the control and security of his or her prescription
398398 blanks and any other method used for prescribing a controlled
399399 dangerous substance pain medication. The physician shall notify, in
400400 writing, the State Board of Medical Licensure and Supervision within
401401 twenty-four (24) hours following any theft or loss of a prescription
402402 blank or breach of any other method for prescribing pain medication.
403403 E. The designated physician of a pain management clinic shall
404404 notify the applicable board , in writing, of the date of termination
405405 of employment within ten (10) calendar days after terminating his or
406406 her employment with a pain management clinic that is re quired to be
407407 registered pursuant to this act. Each physician practicing in a
408408 pain management clinic shall advise the State Board of Medical
409409 Licensure and Supervision, in writing, within ten (10) calendar days
410410 after beginning or ending his or her practice at a pain management
411411 clinic.
412412 F. Each physician practicing in a pain management clinic is
413413 responsible for ensurin g compliance with the facility and physical
414414 operations requirements . A pain management clinic shall :
415415 1. Be located and operated at a publicly accessible fixed
416416 location;
417417 2. Display a sign that can be viewed by the public that
418418 contains the clinic name, hours of operation , and a street address ;
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445445 3. Have a publicly listed telephone number and a dedicated
446446 phone number to send and receive facs imiles;
447447 4. Have a reception and waiting area ;
448448 5. Provide a restroom;
449449 6. Have private patient examination rooms ;
450450 7. Have treatment rooms, if treatment is being provided to the
451451 patients; and
452452 8. Display a printed sign located in a conspicuous place in the
453453 waiting room, viewable by the public, with the name and contact
454454 information of the clinic 's designated physician and the names of
455455 all physicians practicing in the clinic .
456456 The provisions of this section do not excuse a physician from
457457 providing any treatment o r performing any medical duty without the
458458 proper equipment and materials as required by the standard of care.
459459 This section does not supersede the level of care, skill , or
460460 treatment recognized i n general law related to health care
461461 licensure.
462462 G. Each physician practicing in a pain management clinic is
463463 responsible for ensuring compliance with the following infection
464464 control requirements:
465465 1. The clinic shall maintain equipment and supplies to supp ort
466466 infection prevention and control activities;
467467 2. The clinic shall identify infection risks based on the
468468 following:
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495495 a. geographic location, community , and population served,
496496 b. the care, treatment, and services it provides, and
497497 c. an analysis of its infec tion surveillance and control
498498 data; and
499499 3. The clinic shall maintain written infection-prevention
500500 policies and procedures that address the following:
501501 a. prioritized risks,
502502 b. limiting unprotected exposure to pathogens,
503503 c. limiting the transmission of infe ctions associated
504504 with procedures performed in the clinic, a nd
505505 d. limiting the transmission of infections associated
506506 with the clinic's use of medical equipment, devices ,
507507 and supplies.
508508 H. Each physician practicing in a pain management clinic is
509509 responsible for ensuring that the clinic, including its grounds,
510510 buildings, furniture, appliances, and equipment is structurally
511511 sound, in good repair, clean , and free from health and safety
512512 hazards.
513513 I. The designated physician is responsible for ensuring
514514 compliance with the following quality assurance requirements:
515515 1. Each pain management clinic shall have an ongoing quality
516516 assurance program that objectively and systematically:
517517 a. monitors and evaluates the quality and appropriateness
518518 of patient care,
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545545 b. evaluates methods to improve patient care,
546546 c. identifies and corrects deficiencies within the
547547 facility,
548548 d. alerts the designated physician to identify and
549549 resolve recurring problems, and
550550 e. provides opportunities to improve the facility 's
551551 performance and to enhanc e and improve the quality of
552552 care provided to the public; and
553553 2. The designated physician shall establish a quality assurance
554554 program that includes the following components:
555555 a. the identification, investigation , and analysis of the
556556 frequency and causes of adverse incidents to patients,
557557 b. the identification of tren ds or patterns of incidents,
558558 c. the development of measures to correct, reduce,
559559 minimize, or eliminate the risk of a dverse incidents
560560 to patients, and
561561 d. the documentation of these functions and periodic
562562 review no less than quarterly of such information by
563563 the designated physician.
564564 J. The designated physician is responsible for ensuring
565565 compliance with the following dat a collection and reporting
566566 requirements:
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593593 1. The designated physician for each pain management clinic
594594 shall report all adverse incidents to the State Board of Medical
595595 Licensure and Supervision; and
596596 2. The designated physician shall also report to the Stat e
597597 Board of Medical Licensure and Supervision, in writing, on a
598598 quarterly basis the following data:
599599 a. the number of new and repeat patients seen and treated
600600 at the clinic who are prescribed controlled dangerous
601601 substance medications for the treatment of ch ronic
602602 nonmalignant pain,
603603 b. the number of patients discharged due to drug abuse,
604604 c. the number of patients discharged due to drug
605605 diversion, and
606606 d. the number of patients treated at the clinic whose
607607 domicile is located somewhere other than in this
608608 state. A patient's domicile is the patient 's fixed or
609609 permanent home to which he or she intends to return
610610 even though he or she may temporarily res ide
611611 elsewhere.
612612 K. The data and reports specified in subsection J of this
613613 section shall be accessible to the Oklaho ma State Bureau of
614614 Narcotics and Dangerous Drugs Control.
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641641 SECTION 4. NEW LAW A new section of law to be codified
642642 in the Oklahoma Statutes as Section 2-1114 of Title 63, unless there
643643 is created a duplication in numbering, reads as follows:
644644 A. The State Board of Medical Licensure and Supervision may
645645 impose an administrative fine on a clinic of up to Five Thousand
646646 Dollars ($5,000.00) per violation for violating the requirements of
647647 this act or the rules of the State Board of Medical Licensure and
648648 Supervision. In determining whether a penalty is to be imposed, and
649649 in fixing the amount of the fine, the State Board of Medical
650650 Licensure and Supervision shall consider the following factors:
651651 1. The gravity of the violation, including the probability that
652652 death or serious physical or emotional harm to a patient has
653653 resulted, or could have resulted, from the pain management clinic 's
654654 actions or the actions of the physician, the severity of the action
655655 or potential harm and the extent to which the provisions of the
656656 applicable laws or rules were violated;
657657 2. What actions, if any, the owner or designated physician took
658658 to correct the violations;
659659 3. Whether there were any previous violations at the pain
660660 management clinic; and
661661 4. The financial benefits that the pain management clinic
662662 derived from committing or continuing to commit the violation.
663663 B. Each day a violation continues after t he date fixed for
664664 termination of the violation as ordered by the State Board of
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691691 Medical Licensure and Supervision constitutes an additional,
692692 separate, and distinct violation.
693693 C. The State Board of Medical Licensure and Supervision may
694694 impose a fine and, i n the case of an owner-operated pain management
695695 clinic, revoke or deny a pain management clinic 's registration if
696696 the clinic's designated physician knowingly and intentionally
697697 misrepresents actions taken to correct a violation.
698698 D. An owner or designated p hysician of a pain management clinic
699699 who concurrently operates an unregistered pain management clinic is
700700 subject to an administrative fine of Five Thousand Dollars
701701 ($5,000.00) per day.
702702 E. If the owner of a pain management clinic that requires
703703 registration fails to apply to register the clinic upon a change of
704704 ownership and operates the clinic under the new ownership, the owner
705705 is subject to a fine of Five Thousand Dollars ($5,000.00).
706706 SECTION 5. NEW LAW A new section of law to be co dified
707707 in the Oklahoma Statutes as Section 2-1115 of Title 63, unless there
708708 is created a duplication in numbering, reads as follows:
709709 All affected agencies and boards shall promulgate such rules as
710710 are necessary to implement the provisions of this act.
711711 SECTION 6. This act shall become effective November 1, 2022.
712712
713713 58-2-8754 GRS 12/30/21