Req. No. 869 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 58th Legislature (2021) SENATE BILL 497 By: McCortney AS INTRODUCED An Act relating to the healing arts; defin ing terms; requiring health care provider s to use certain titles in advertisements and professional identifications ; limiting certain disclosures; prohibiting certain advertisements; requiring display of license and certain identification; prohibiting certain use of titles; amending 59 O.S. 2011, Section 492, as amended by Section 1, Chapter 40, O.S.L. 2016 (59 O.S. Supp. 2020, Section 492) , which relates to the practice of medicine; adding terms whose use constitute practice of medicine; modifying definition of practice of medicine and surgery ; amending 59 O.S. 2011, Sections 725.2, 731.2 and 731.3, which relate to use of titles of the healing arts; modifying certain provisions to include medical specialty titles; updating language; providing gender -neutral language; providing for codification; an d providing an effective date. BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 6006 of Title 59, unless there is created a duplication in numbering, reads as follows: A. As used in this section: 1. “Advertisement” means a communication, whether printed, electronic or oral, that names a health care provider and the Req. No. 869 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 practice, profession o r institution in which the provider is employed, volunteers or otherwise provides health care services. Advertisement includes business cards, letterhead, patient brochures, e-mail, Internet, audio and video communic ations and any other communication; and 2. “Deceptive or misleading terms or false representations ” includes, but is not limite d to, use of titles, terms or other words that misstates, falsely describes, falsely holds out or falsely details the health car e provider’s professional skills, train ing, expertise, education, board certi fication or licensure. B. Health care providers shall use the following license titles in advertisements and in professional identifications : 1. A medical doctor or doctor of osteopathy shall use any of the following titles: a. “physician”, “doctor of medicine”, “medical doctor”, “M.D.”, or “doctor of osteopathic medicine”, “doctor of osteopathy”, “osteopathic physician ” or “D.O.”, or b. a specialist designation, if certified by the American Board of Medical Specialti es or an American Osteopathic Associat ion certifying board or if board- eligible including “surgeon”, “dermatologist”, “anesthesiologist”, or a similar title; 2. A Registered Nurse shall only use the titles “Registered Nurse” or “R.N.”; Req. No. 869 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 3. A Licensed Practical Nurse shall only use the titles “Licensed Practical Nurse” or “L.P.N.”; 4. An Advanced Practice Registered Nurse shall only use the titles “Advanced Practice Registered Nurse ” or “APRN”, and one of the following role titles: a. for a Certified Registered Nurse Anesthetist, “Certified Registered Nurse Anesthetist” or “CRNA”, b. for a Clinical Nurse Specialist, “Clinical Nurse Specialist” or “CNS”, c. for a Certified Nurse Practitioner, “Certified Nurse Practitioner” or “CNP”, or d. for a Certified Nurse-Midwife, “Certified Nurse- Midwife” or “CNM”; 5. A physician assistant shall only use the titles “physician assistant” or “P.A.”; and 6. Any other health care practitioner shall use the appropriate title as indicated by the applicable statute. C. An advertisement by a health care provide r shall disclose only the applicable license, as provided in this section and by the applicable statute, under which the health care provider is authorized to provide services. The advertisement: 1. Shall not include deceptive or misleading terms or fals e representations; and Req. No. 869 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. Shall include the health care provider’s name and the type of license the provider holds, as provided in this section and by the applicable statute, for the provider’s profession. D. 1. A health care provider shall display a copy of the provider’s license in a prominent place in an office area visible to current and prospective patients. If the health care provider sees patients in a setting outside of a licensed health care facility, the copy must be of sufficient size to be v isible and apparent to patients, except that a copy no smaller than the original license is deemed to be sufficient . 2. A health care provider seeing patients on a face -to-face basis shall wear a name badge or some ot her form of identification that clearly discloses: a. the health care provider ’s name, b. the type of license, registration or certification the health care provider holds, as provided in this section and by the applicable statute, for the health care provider’s profession, and c. the health care provider’s medical staff position, if applicable. E. Except as provided in Section 725.2 of Title 59 of the Oklahoma Statutes, a person shall not u se, imply the use of, or publicly display a title in connection wi th a person’s name including “physician”, “doctor” or “surgeon” or any similar title or Req. No. 869 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 description of services, or any other words, letters or abbreviations or any co mbination thereof with the intent to represent, or that imply, that the per son practices medicine. Unless authorized to practi ce medicine by the State Board of Medical Licensure and Supervision or the State Board of Os teopathic Examiners, a person shall not u se, imply the use of, or publicly display a title in connection with a person ’s name including “doctor of medicine”, “medical doctor”, “M.D.”, “osteopath”, “doctor of osteopathic medicine”, “doctor of osteopathy”, “osteopathic physician”, “D.O.”, “anesthesiologist”, “cardiologist”, “dermatologist”, “endocrinologist”, “gastroenterologist”, “general practitioner”, “gynecologist”, “hematologist”, “internist”, “laryngologist”, “nephrologist”, “neurologist”, “obstetrician”, “oncologist”, “ophthalmologist”, “orthopedic surgeon”, “orthopedist”, “otologist”, “otolaryngologist”, “otorhinolaryngologist”, “pathologist”, “pediatrician”, “primary care physician”, “proctologist”, “psychiatrist”, “radiologist”, “rheumatologist”, “rhinologist”, “urologist” or any similar title or description of services, or any other words, letters or abbreviations or any c ombination thereof with the intent to represent, or that imply, that the per son practices medicine. SECTION 2. AMENDATORY 59 O.S. 2011, Section 492, as amended by Section 1, Chapter 40, O.S.L. 2016 (59 O.S. Supp. 2020, Section 492), is amended to read as follows: Req. No. 869 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Section 492. A. Every person shall be regarded as practicing allopathic medicine within the meaning and provisions of this act the Oklahoma Allopathic Medical and Surgical Licensure an d Supervision Act, who shall append to his or h er name the letters “M.D.”, “Physician”, “Surgeon”, “Doctor”, “doctor of medicine”, “medical doctor”, “anesthesiologist”, “cardiologist”, “dermatologist”, “endocrinologist”, “gastroenterologist”, “general practitioner”, “gynecologist”, “hematologist”, “internist”, “laryngologist”, “nephrologist”, “neurologist”, “obstetrician”, “oncologist”, “ophthalmologist”, “orthopedic surgeon”, “orthopedist”, “otologist”, “otolaryngologist”, “otorhinolaryngologist ”, “pathologist”, “pediatrician”, “primary care physician”, “proctologist”, “psychiatrist”, “radiologist”, “rheumatologist”, “rhinologist”, “urologist” or any other title, letters, description of ser vices or designation, either alone or in connection with other wor ds, which represent that such person is a physician, or who shall for a fee o r any form of compensation diagnose and/or or treat disease, injury or def ormity of persons in this state by any allopathic legend drugs, surgery, manual, or mechanical treatment unless otherwise authorized by law. B. A hospital or related institution as such terms are defined in Section 1-701 of Title 63 of the Oklahoma Statut es, which has the principal purpose or function of providing hospital or medical care , including but not limited to any corporation, association, trust, or Req. No. 869 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 other organization organiz ed and operated for such purpose, m ay employ one or more persons who are d uly licensed to practice medicine in this state without being regarded as itself practicing medicine within the meaning and provisions of this section. Th e employment by the hospita l or related institution of any per son who is duly licensed to practice me dicine in this state shall not, in and of itself, be considered as an act of unprofessional conduct by the person so employed. Nothing provided herein sha ll eliminate, limit, or restrict the liability for any act or failure to act of any hospital, any hos pital’s employees, or persons duly lice nsed to practice medicine. C. The definition of the practice of medicine and surgery shall include, but is not limi ted to: 1. Advertising, holding out to the public, or represe nting in any manner that one is authori zed to practice medicine and surgery in this state; 2. Any offer or attempt to prescribe, order, give, or administer any drug or medicine and surgery for the use of any other person, except as otherwise authorized by law; 3. a. any offer or attempt, excep t as otherwise authorized by law, to prevent, diagnose, correct, or treat in any manner or by any means, methods, devises, or instrumentalities except for manual manipulation any disease, illness, pain, wound, fractur e, infirmity, Req. No. 869 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 defect, or abnormal physi cal or mental condition of any person, including the management of pregnancy and parturition, except as otherwise authorized by law, b. except as provided in subsection D of this sec tion, performance by a person withi n or outside of this state, through an ongoing regular arrangement, of diagnostic or treatment services , including but not limited to, stroke prevention and treatment, through electronic communications for any patient who se condition is being diagnosed or treated within this state by a physician duly licensed and practicing in this state. A person who performs any of the functions covered by this subparagraph submits himself or herself to the ju risdiction of the courts of this state for the purposes of any cause of action resulting from the fun ctions performed, and c. nothing in the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act shall be construed to affect or give jurisdi ction to the Board over any person other than medical doctors or persons holding themselves out as me dical doctors; 4. Any offer or attempt to perform any surgical operation upon any person, except as otherwise authorized by law; and Req. No. 869 Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 5. The use of the ti tle Doctor, Doctor of Medicine, Physician, Surgeon, Physician and Surg eon, Dr., M.D. or any of the medical specialty titles listed in subsec tion A of this section, or any combination thereof, in the conduct of any occupation or profession pertaining to the prevent ion, diagnosis, or treatment of human disease or condition unless, where appropriate, such a designation additionally contains the d escription of another branch of the healing arts for which on e holds a valid license in this state or as otherwise provided by law . D. The practice of medicine and surgery, as defined in this section, shall not inclu de: 1. A student while engaged in trai ning in a medical school approved by the Board or while engaged in graduate medical training under the supervision of the medical st aff of a hospital or other health care facility approved by th e state medical board f or such training, except that a student engaged in graduate medical training shall hold a license issued by the Board for such train ing; 2. Any person who provides medica l treatment in cases of emergency where no fee or other consid eration is contemplated , charged or received; 3. A commissioned medical officer of the armed forces of the United States or medical officer of the United States Public Health Service or the Department of Veterans Affairs of the United States in the discharge of official duties and/or or within federally Req. No. 869 Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 controlled facilities; and provided that such person shal l be fully licensed to practice medicine and sur gery in one or more jurisdictions of the United States; provided further that such person who holds a medical license in thi s state shall be subject to the provisions of the Oklahoma Allopathic Medical and Su rgical Licensure and Supervision Act; 4. Any person licensed under any other act when properly practicing in the healing art for which that person i s duly licensed; 5. The practice of those who endeavor to pre vent or cure disease or suffering by spiritua l means or prayer; 6. Any person administering a domestic or family remedy to a member of such person’s own family; 7. Any person licensed to pract ice medicine and surger y in another state or territory of the United States who renders emergency medical treatment or briefly provides critical medical service at the specific lawful direction of a medical institution or federal agency that assumes full r esponsibility for that treatment or service and is approved by the Board; 8. Any person who is licensed to practice medicine and surgery in another state or territory of the United States whose sole purpose and activity is limited to brief actual consulta tion with a specific physician who is licensed to practice med icine and surgery Req. No. 869 Page 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 by the Board, other than a person with a special or restricted license; or 9. The practice of any other person as licensed by appropriate agencies of this state, provided that such duties are consis tent with the accepted standards of the person’s profession and the person does not represent himself or herself as a Doctor, Doctor of Medicine, Physician, Surgeon, Physician and Surgeon, Dr., M.D. or any of the medical special ties listed in subsection A of this section, or any combination the reof, except as otherwise provided by law. E. Nothing in the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act shall prohibit: 1. The service rendered by a physician’s unlicensed trained assistant, if such service is rendered under t he supervision and control of a licensed physician pursuant to Board rules, provided such rules are not in conflict with the provisions of any other healing arts licensure act or rules promulgated pursuant to such act; or 2. The service of any other perso n duly licensed or certified by the state to practice the healing arts. F. Nothing in the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act s hall prohibit services rendered by any person not licensed by the Board and practicing any nonallopathic healing practice. Req. No. 869 Page 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 G. Nothing in the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act shall be construed as to require a physician to secure a Maintenance of Certification (MOC) as a condition of licensure, reimbursement, employment or admitting privileges at a hospital in this state. For the purposes of this subsection, “Maintenance of Certification (MOC) ” shall mean a continuing education program measuring core competencies in the practice of medicine and surgery and app roved by a nationally - recognized accrediting organization. SECTION 3. AMENDATORY 59 O.S. 2011, Section 725.2, is amended to read as follows: Section 725.2. A. The following nine classes of persons may use the word “Doctor”, or an abbreviation thereof, and sha ll have the right to use, whether or not in conjunction with the word “Doctor”, or any abbreviation th ereof, the following designations: 1. The letters “D.P.M.” or the words podiatrist, doctor of podiatry, podiatric surgeon, or doctor of podiatric medicin e by a person licensed to practice podiatry under the Podiatric Medicine Practice Act; 2. The letters “D.C.” or the words chiropractor or doctor of chiropractic by a person licensed to practice chiropractic under the Oklahoma Chiropractic Practice Act ; 3. The letters “D.D.S.” or “D.M.D.”, as appropriate, or the words dentist, doctor of dental surgery, or doctor of dental Req. No. 869 Page 13 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 medicine, as appropriate, by a person licensed to practice dentistry under the State Dental Act ; 4. The letters “M.D.” or the words surgeon, medical doctor, or doctor of medicine, or medical specialty titles, by a person licensed to practice medic ine and surgery unde r the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act ; 5. The letters “O.D.” or the words optometris t or doctor of optometry by a person licensed to practice optometry under Sections 581 through 606 of this title; 6. The letters “D.O.” or the words surgeon, oste opathic surgeon, osteopath, doctor of osteopathy, or doctor of osteopathic medicine by a person licensed to practice osteopathy under the Oklahoma Osteopathic Medicine Act ; 7. The letters “Ph.D.”, “Ed.D.”, or “Psy.D.” or the words psychologist, therapist, or counselor by a person licensed as a health service psychologist pursuant to the Psycholog ists Licensing Act; 8. The letters “Ph.D.”, “Ed.D.”, or other letters representing a doctoral degree or the words language patholog ist, speech pathologist, or speech and language pathologist by a person licensed as a speech and language pathologist pursua nt to the Speech-Language Pathology and Audiology Licensing Act and who has earned a doctoral degree from a regionally accredited in stitution of higher learning in the field of speech and language pathology; and Req. No. 869 Page 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 9. The letters “Ph.D.”, “Ed.D.”, or other letters representing a doctoral degree or the word audiologist by a person licensed as an audiologist pursuant to the Speech-Language Pathology and Audiology Licensing Act and who has earned a doctoral degree from a regionally accredited institution of high er learning in the field of audiology. B. Unless otherwise specifically provided in a particular section or chapter of the Oklahoma Statutes, the word “doctor” or “doctors” shall mean and include each of the nine classes of persons listed in subsection A and the word “physician” or “physicians”, as provided in subsection C of this section. Any other person using the term doctor, or a ny abbreviation thereof, shall designate the authority under which the title is used or the college or honorary degree that gives rise to use of the title. C. Unless otherwise specifically provided in a particular section or chapter of the Oklahoma Statutes, the word “physician” or “physicians” shall mean and include each of the classes of persons listed in paragraphs 1 throug h 6 of subsection A and the word “doctor” or “doctors” as provided in subsection B of this section. The term “physician” shall not include any person specified in paragraphs 7 through 9 of subsection A of this section unless such person is otherwise autho rized to use such designation pursuant to this section. D. For purposes of this section, “provider” means and includes: Req. No. 869 Page 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 l. Each of the nine classes of persons li sted in subsection A of this section and referred to in subsectio ns B and C of this section; and 2. Any other person using the term doctor or any abbreviation thereof. E. Persons in each of the nine clas ses listed in subsec tion A, and referred to in subs ections B and C, of this section shall identify through written notice, which may include the wearing of a name tag, the type of license under which the doctor is practicing, utilizing the designations pro vided in subsections A, B and C of this section. Each applicable licensing board is authorized by rule to determine how its license holders may comply with this disclosure requirement. F. 1. Any advertisement for health care services naming a provider shall: a. identify the type of license of the doctor utilizing the letters or words set forth in this section if the person is one of the classes of persons listed in subsection A of this section, and referred to in subsections B and C of this section, or b. utilize appropriate, accepted, and easily underst ood words or letters, which clearly show and indicate the branch of the healing art in which the person is licensed to practice and is engaged in, if the person Req. No. 869 Page 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 is not one of the nine classes of persons li sted in subsection A of this section, or referred t o in subsections B and C of this section. 2. The term “advertisement” includes any printed d ocument including letterhead, video clip, or audio clip created by, for, or at the direction of the provider or providers and advert ised for the purpose of promoting the services of the doctor or provider. G. 1. It shall be unlawful for any medical docto r, doctor of osteopathic medicine, doctor of dental surgery, doctor of dental medicine, doctor of optometry, doc tor of podiatry, or doctor of chiropractic to make any deceptive or misleading statement, or engage in any deceptive or misleading act, that dec eives or misleads the public or a prospective or current patient, regarding the training and the license under w hich the person is a uthorized to practice. 2. The term “deceptive or misleading statement or act ” includes, but is not limited to: a. such statement or act in any advertising medium, b. making a false statement regarding the education, skills, training, or licensure of a person, or c. in any other way des cribing the profession, skills, training, expertise, education, or licensure of a person in a fashion that causes the public, a potential patient, or current patient to believe that Req. No. 869 Page 17 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 the person is a medical doctor, doctor of osteopathic medicine, doctor of dental surgery, doctor of dental medicine, doctor of optometry, doctor of podiatry, or doctor of chiropractic when that person does not hold such credentials. H. Notwithstanding any other provision of thi s section, a person licensed in this state to perfo rm speech pathology or audiology services is designated to be a practitioner of the healing art for purposes of making a referral for speech pathology or audiology services pursuant to the provisions of th e Individuals with Disabilities Education Act, Amen dment of 1997, Public Law 105- 17, and Section 504 of the Rehabilitation Act of 1973. SECTION 4. AMENDATORY 59 O.S. 2011, Section 731.2, is amended to read as follows: Section 731.2. A. Proof that any class of persons identified in Section 725.2 of thi s title appends to their name the word “Doctor”, the abbreviation “Dr.”, any medical specialty title or any other word, abbreviation or designation, which word, abbreviation or designation, indicate indicates that such person is qualified for diagnosis or treatment, as herein defined, shall constitute prima facie evidence that such person is holding himself or herself out, within the meaning of this act Sections 731.1 through 731.6 of this title, as qualified to engage in diagnosis or treatment. Req. No. 869 Page 18 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 B. Nothing in this section shall be construed to prevent a person specified in paragraphs 7 through 9 of subsection A of Section 725.2 of this title from appending to such person ’s name the word “Doctor”, so long as such person follows such na me and designation with the letters signifying the recognized doctoral degrees specified in paragraphs 7 through 9 of subsection A of Section 725.2 of this title. SECTION 5. AMENDATORY 59 O.S. 2011, Section 731.3, is amended to read as follows: Section 731.3. Except as authorized by the provisions of Sections 492 and 731.5 of this title and Section 5 of this act Section 1-116.2 of Title 70 of the Oklahoma Statutes , no person shall in any manner engage in, offer to engage in, or ho ld himself or herself out as qualified to engage in the diagnosis and/or or treatment of any huma n ill including by the use of medical titles or medical specialty titles, unless such person is the holder o f a legal and unrevoked license or certificate issu ed under the laws of Oklahoma authorizing s uch person to practice the heali ng art covered by such license and is practicing thereunder in the manner and subject to the limitations provided by the laws of the State of Oklahoma this state for the issuance of such license or certificate for the practice thereunder. SECTION 6. This act shall become effective November 1, 2021. 58-1-869 DC 1/19/2021 9:14:45 PM