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STATE OF OKLAHOMA
2nd Session of the 58th Legislature (2022)
CONFERENCE COMMITTEE SUBSTITUTE
FOR ENGROSSED
SENATE BILL 888 By: Standridge of the Senate
and
Marti of the House
CONFERENCE COMMITTEE SUBSTITUTE
An Act relating to controlled dangerous substances;
amending 63 O.S. 2021, Section 2 -309, as last amended
by Section 1, Chapter 259, O.S .L. 2021, which relates
to electronic prescriptions; clarifying certain
exception; amending 63 O.S. 2021, Section 2-309D, as
last amended by Section 2 of Enrolled Senate Bill No.
1151 of the 2nd Session of the 58th Oklahoma
Legislature, which relates to the central repository;
requiring Oklahoma State Bureau of Narcotics and
Dangerous Drugs Control to make certain determination
upon certain notification; authorizing Bureau to
report certain information to practitioner licensing
boards; requiring certain health care providers and
employers to carry specified malpractice insurance;
defining terms; requiring pain management clinics to
register with the Bureau; providing exemptions;
stipulating registration procedures; requiring
clinics to designate owner or administrat or
responsible for certain compliance ; directing denial
of registration for specified reasons ; limiting
period of suspension; requiri ng new registration
application if clinic changes ownership; specifying
responsibilities of licensed prescriber and
designated administrator ; providing facility and
physical operations requirements; stipulating certain
infection control requirements; providing certain
quality assurance requirements; stipulating certain
data collection and reporting requirements; requiring
establishment of certain written policy; directing
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certain investigation by Bureau; providing penalties;
directing promulgation of rules; providing certain
construction; amending 63 O.S. 2021, Section 942 ,
which relates to medical examiner reports; requiring
Chief Medical Examiner to furnish certain reports to
the Bureau; providing for codification; and providing
an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 63 O.S . 2021, Section 2-309, as
last amended by Section 1, Chapter 259, O. S.L. 2021, is amended to
read as follows:
Section 2-309. A. 1. Except for dosages medically require d
for a period not to exceed forty -eight (48) hours which are
administered by or on di rection of a practitioner, other than a
pharmacist, or medication dispensed directly by a pract itioner,
other than a pharmacist, to an ultimate u ser, no controlled
dangerous substance included in Schedule II, which is a prescription
drug as determined unde r regulation promulgated by the Board o f
Pharmacy, shall be dispensed without an electronic pre scription of a
practitioner; provided, that in eme rgency situations, as pre scribed
by the Board of Pharmacy by regulation, such drug may be dispensed
upon oral prescription reduced promptly to writing and filed by the
pharmacist in a manner to be prescribe d by rules and regulations of
the Director of the Oklahoma State Bureau of Narcotics and Dangerous
Drugs Control.
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2. Electronic prescrib ing shall be utilized fo r Schedules II,
III, IV and V, subject to the requirements set forth in 21 CFR,
Section 1311 et seq.
3. An electronic prescription with electron ic signature may
serve as an original prescription, subject to the requirements set
forth in 21 CFR, Section 13 11 et seq.
4. Prescriptions shall be r etained in conformity with the
requirements of this sect ion and Section 2-307 of this title. No
prescription for a Schedule II sub stance may be refilled.
5. The electronic prescription requir ement provided for in th is
section shall not apply to prescript ions for controlled dangerous
substances issued by any o f the following:
a. a person licensed to practice veterinary medicine,
b. a practitioner who experiences temporary technological
or electrical failure or other e xtenuating
circumstance that prevents t he prescription from being
transmitted electronically; p rovided, however, that
the practitioner documents the reason for this
exception in the medical record of the patient,
c. a practitioner, other than a pharmacist, who dispenses
directly to an ultimate user,
d. a practitioner who orders a controlled dangerou s
substance to be administered through an on -site
pharmacy in:
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(1) a hospital as defined in Section 1-701 of this
title,
(2) a nursing facility as defined in Sec tion 1-1902
of this title,
(3) a hospice inpatient facility as defined in
Section 1-860.2 of this title,
(4) an outpatient dialysis facility,
(5) a continuum of care faci lity as defined in
Section 1-890.2 of this title, or
(6) a penal institution listed in Section 509 of
Title 57 of the Oklahom a Statutes,
e. a practitioner who orders a controlled da ngerous
substance to be administered through a hos pice program
as defined in Section 1-860.2 of this title including
but not limited to a hospice program tha t provides
outpatient services,
f. a practitioner who writes a prescription to be
dispensed by a pharmacy located on federal property,
provided the practitioner documents the reason for
this exception in the medical record of the patient,
or
g. a practitioner that has received a waiver or extension
from his or her licensing board.
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6. Electronic prescri ptions shall not be utilized under the
following circumstances:
a. compound prescriptions containing two or more
commercially available products or two or more a ctive
pharmaceutical ingredients,
b. compounded infusion prescriptions containing two or
more commercially available products or two or more
active pharmaceutical ingredi ents,
c. prescriptions issued under approved research
protocols, or
d. if the practitioner determines that an electronic
prescription cannot be issued in a timely manner and
the condition of the patient is at risk.
7. A pharmacist who receives a written, oral or facsimile
prescription shall not be required to verify that the prescription
falls under one of the exceptions provid ed for in paragraph 6 of
this subsection. Pharmacists m ay continue to dispense medications
from otherwise valid written, oral or f acsimile prescriptions that
are consistent with the provisions of this section.
8. Practitioners shall indicate in the healt h record of a
patient that an exception to the electroni c prescription requirement
was utilized.
9. All prescriptions issued pursu ant to paragraphs 5 and 6 of
this subsection shall be issued on an official prescripti on form
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provided by the Oklahoma State Bureau of Narcotics and Dangerous
Drugs Control.
10. a. Effective January 1, 2020, practitioners shall
register with the Oklahoma S tate Bureau of Narcotics
and Dangerous Drugs Control in order to be issued
official prescription forms. Such registration sh all
include, but not be limited to, the primary address
and the address of each place of business to be
imprinted on official presc ription forms. Any change
to a registered practitioner 's registered address
shall be promptly reported to the practitioner 's
licensing board and the Bureau by the practitioner in
a manner approved by the Bureau.
b. A practitioner's registration shall be w ithout fee and
subject to approval by the Bureau. Such registration
shall be valid for a period of two (2) years and may
be denied, suspended or revoked by the Bureau upon a
finding by the Bureau or licensing board that the
registered practitioner has had any license to
practice a medical profession revoked or suspended by
any state or federal agency.
c. Where the Bureau has re voked the registration of a
registered practitioner, the Bureau may revoke or
cancel any official prescrip tion forms in the
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possession of the registered practitioner. Any
revocation or any suspension shall require th e
registered practitioner to return all unused official
prescription forms to the Bureau within fifteen (15)
calendar days after the date of the written
notification.
d. A practitioner that has had any license to practice
terminated, revoked or suspended b y a state or federal
agency may, upon restoration of such license or
certificate, register to b e issued official
prescription forms.
11. a. Except as provided in subparag raph f of this
paragraph, the Bureau shall issue official
prescription forms free of c harge only to registered
practitioners in this state. Such forms shall not be
transferable. The number of official prescription
forms issued to a registered practitione r at any time
shall be at the discretion of the Bureau.
b. Official prescription forms issued to a registered
practitioner shall be imprinted only with the primary
address and other addresses listed on the registration
of the practitioner. Such prescripti ons shall be sent
only to the primary address of the registered
practitioner.
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c. Official prescription forms issued to a regi stered
practitioner shall be used only by the practition er to
whom they are issued.
d. The Bureau may revoke or cancel official pre scription
forms in possession of registered practitioners when
the license of such pra ctitioner is suspended,
terminated or revoked.
e. Official prescription forms of registered
practitioners who are deceased or who no longer
prescribe shall be returned to the Bureau at a
designated address. If the registered practitioner is
deceased, it is the responsibility of the registered
practitioner's estate or lawful designee to return
such forms.
f. The Bureau may issue official prescripti on forms to
employees or agents of the Bureau and other government
agencies for the purpose of preventing, iden tifying,
investigating and prosecuting unacceptable or illegal
practices by providers and other persons and assisting
in the recovery of overpaym ents under any program
operated by the state or paid for with state funds.
Such prescription forms shall be is sued for this
purpose only to individua ls who are authorized to
conduct investigations on behal f of the Bureau or
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other government agencies as pa rt of their official
duties. Individuals and agencies receiving such
prescription forms for this purpose shall provide
appropriate assurances to the Bureau that adequate
safeguards and security measures ar e in place to
prevent the use of such prescription forms for
anything other than official government purposes.
12. a. Adequate safeguards and security measures s hall be
undertaken by registered practi tioners holding
official prescription forms to assure ag ainst the
loss, destruction, theft or unauthorized use of the
forms. Registered practitioners shall maintain a
sufficient but not excessive supply of such forms in
reserve.
b. Registered practitioner s shall immediately notify the
Bureau, in a manner desig nated by the Bureau, upon
their knowledge of the l oss, destruction, theft o r
unauthorized use of any official prescription forms
issued to them, as well as the f ailure to receive
official prescription forms within a reasonable time
after ordering them from the Bureau.
c. Registered practitioners shall imm ediately notify the
Bureau upon their knowledge of any diversion or
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suspected diversion of drugs pursuant to th e loss,
theft or unauthorized use of pr escriptions.
B. 1. Except for dosages medically requir ed for a period not
to exceed seventy-two (72) hours which are administered by or on
direction of a practitioner, other than a pharmacist, or medication
dispensed directly by a practitioner, other tha n a pharmacist, to an
ultimate user, no controlled dange rous substance included in
Schedule III or IV, whi ch is a prescription drug as determined under
regulation promulgated by the Board of Pharmacy, shall be dispens ed
without an electronic prescription.
2. Any prescription for a controlled dangerous substanc e in
Schedule III, IV or V may not be filled or re filled more than six
(6) months after the date thereof or be refilled more than five
times after the date of th e prescription, unless renewed by the
practitioner.
C. Whenever it appears to the Director of the Oklahoma State
Bureau of Narcotics and Dangero us Drugs Control that a d rug not
considered to be a prescription drug under existing state law or
regulation of the Board of Pharmacy should be so con sidered because
of its abuse potential, the Director sha ll so advise the Board of
Pharmacy and furnish to the Board all available d ata relevant
thereto.
D. 1. "Prescription", as used in this section, means a
written, oral or electronic order by a practit ioner to a pharmacist
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for a controlled dangerous substan ce for a particular patient, which
specifies the date of its issue, and the full name and address of
the patient and, if the controlled dangerous substance is pr escribed
for an animal, the species of the animal, the name and quantity of
the controlled dangerous substance prescribed, the directions for
use, the name and address of the owner of the animal and, if
written, the signature of the practitioner.
2. "Registered practitioner", as used in this section, means a
licensed practitioner duly registered wi th the Oklahoma State Bureau
of Narcotics and Dang erous Drugs Control to be issued official
prescription forms.
E. No person shall solicit, dispense, receive or deliver any
controlled dangerous subst ance through the mail, unless the ultimate
user is personally known to the practitioner and circumstances
clearly indicate such met hod of delivery is in the best interest of
the health and welfare of the ultimate user .
SECTION 2. AMENDATORY 63 O.S. 2021, Section 2 -309D, as
last amended by Section 2 of Enrolled Senate Bill No. 1151 of the
2nd Session of the 58th Oklahoma Legislature , is amended to read as
follows:
Section 2-309D. A. The information collected at the central
repository pursuant to the Anti -Drug Diversion Act shall be
confidential and shall not be open to the public. Ac cess to the
information shall be limited to:
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1. Peace officers certified pursuant to Section 3311 of Title
70 of the Oklahoma Statutes who are employed as investigative agents
of the Oklahoma State Bureau of Narcotics and Dangerous Drugs
Control;
2. The United States Drug Enforcement Administration Diversion
Group Supervisor;
3. The executive director or chief investigator, as designated
by each board, of the following state boards:
a. Board of Podiatric Medical Examiners,
b. Board of Dentistry,
c. Board of Pharmacy,
d. State Board of Medical Licensure and Supervision,
e. State Board of Osteopathic Examiners,
f. State Board of Veterinary Medical Examiners,
g. Oklahoma Health Care Authority ,
h. Department of Mental Health and Substance Abuse
Services,
i. Board of Examiners in Optometry,
j. Oklahoma Board of Nursing,
k. Office of the Chief Medical Examiner, and
l. State Board of Health;
4. A multicounty grand jury properly convened pursuant to the
Multicounty Grand Jury Act;
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5. Medical practitioners employ ed by the United States
Department of Veterans Affairs, the United States Military, or other
federal agencies treating patients in this state;
6. At the discretion of the Director of the Oklahoma State
Bureau of Narcotics and Dangerous Drugs Control, medi cal
practitioners and their staff including those employed by the
federal government in this state; and
7. The members of the Opioid Overdose Fatality Review Board for
the purpose of carrying out the duties prescribed by Section 2 -1001
of this title.
B. This section shall not prevent access, at the discretion of
the Director of the Oklahoma State Bureau of Narcotics and Dangerous
Drugs Control, to investigative information by peace of ficers and
investigative agents of federal, state, tribal, county or mun icipal
law enforcement agencies, district attorneys and the Attorney
General in furtherance of criminal, civil or administrative
investigations or prosecutions within their respective
jurisdictions, designat ed legal, communications, and analytical
employees of the Bureau, and to registrants in furtherance of
efforts to guard against the diversion of controlled dangerous
substances.
C. This section shall not prevent the disclosure, at t he
discretion of the Di rector of the Oklahoma State Bureau of Narcotics
and Dangerous Drugs Control, of statistical information gathered
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from the central repository to the general public for statistical,
research, substance abuse prevention, or educational purposes,
provided that consumer confidentiality is not compromised.
D. This section shall not prevent the disclosure, at the
discretion of the Director of the Oklahoma State Bureau of Narcotics
and Dangerous Drugs Control, of prescription -monitoring-program
information to prescription-monitoring programs of other states
provided a reciprocal data-sharing agreement is in place.
E. The Department of Mental Health and Substance Abuse Services
and the State Department of Health may utilize the information i n
the central repositor y for statistical, research, substance abuse
prevention, or educational purposes, provided that consumer
confidentiality is not compromised.
F. Any unauthorized disclosure of any information collected at
the central repository provi ded by the Anti-Drug Diversion Act shall
be a misdemeanor. Violation of the provisions of this section shall
be deemed willful neglect of duty and shall be grounds for removal
from office.
G. 1. Registrants shall have access to the central repository
for the purposes of patie nt treatment and to aid in the
determination in prescribing or screening new patients. The
physician or designee shall provide, upon request by the patient,
the history of the patient or the query history of the patient.
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2. a. Prior to prescribing or auth orizing for refill, if one
hundred eighty (180) d ays have elapsed prior to the
previous access and check, of opiates, synthetic
opiates, semisynthetic opiates, benzodiazepine or
carisoprodol to a patient of record, registrants or
members of their medical o r administrative staff shall
be required to acces s the information in the central
repository to assess medical necessity and the
possibility that the patient may be unlawfully
obtaining prescription drugs in violation of the
Uniform Controlled Dangerous Su bstances Act. The duty
to access and check shall not alter or otherwise amend
appropriate medical standards of care. The registrant
or medical provider shall note in the patient file
that the central repository has been checked and may
maintain a copy of the information.
b. The requirements set forth i n subparagraph a of this
paragraph shall not apply:
(1) to medical practitioners who prescribe the
controlled substances set forth in subparagraph a
of this paragraph for hospice or en d-of-life
care, or
(2) for a prescription of a controlled substance set
forth in subparagraph a of this paragraph that is
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issued by a practitioner for a patient residing
in a nursing facility as defined by Section 1 -
1902 of this title, provided that the
prescription is issued to a resident of such
facility.
3. Registrants shall not be liable to any person for any claim
of damages as a result of accessing or failing to access the
information in the central repository and no lawsuit may be
predicated thereon.
4. The failure of a registrant to access and check the central
repository as required under state or federal law or regulation may,
after investigation, be grounds for the licensing board of the
registrant to take disciplinary action against the registr ant.
H. The Board of Podiatric Medical Examiners, the Board of
Dentistry, the State Board of Medical Licensure and Supervision, the
Board of Examiners in Optometry, the Oklahoma Board of Nursing, the
State Board of Osteopathic Examiners and the State Boar d of
Veterinary Medical Examiners shall have the sole responsibility for
enforcement of the provisions of subsection G of this section.
Nothing in this section shall be construed so as to permit the
Director of the State Bureau of Narcotics and Dangerous Drugs
Control to assess administrative fines provided for in Section 2 -304
of this title.
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I. The Director of the Oklahoma State Bureau of Narcotics and
Dangerous Drugs Control, or a designee thereof, shall provide a
monthly list to the Directors of the Board of Podiatric Medica l
Examiners, the Board of Dentistry, the State Bo ard of Medical
Licensure and Supervision, the Board of Examiners in Optometry, the
Oklahoma Board of Nursing, the State Board of Osteopathic Examiners
and the State Board of Veterinary Medical Examiners of t he top
twenty prescribers of controlled dangerous substances within their
respective areas of jurisdiction. Upon discovering that a
registrant is prescribing outside the limitations of his or her
licensure or outside of drug registr ation rules or applicab le state
laws, the respective licensing board sha ll be notified by the Bureau
in writing. Such notifications may be considered complaints for the
purpose of investigations or other actions by the respective
licensing board. Licensi ng boards shall have ex clusive jurisdiction
to take action against a lic ensee for a violation of subsection G of
this section.
J. Information regarding fatal and nonfatal overdoses, other
than statistical information as required by Section 2 -106 of this
title, shall be complete ly confidential. Access to this information
shall be strictly limited to the Director of the Oklahoma State
Bureau of Narcotics and Dangerous Drugs Control or designee, the
Chief Medical Examiner, state agencies and boards provided in
subsection A of this section, and the registrant that enters the
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information. Registrants shall not be liable to any person for a
claim of damages for information reported pursuant to the provisions
of Section 2-105 of this title.
K. The Director of t he Oklahoma State Burea u of Narcotics and
Dangerous Drugs Control shall provide adequate means and procedures
allowing access to central repository information for registrants
lacking direct computer access.
L. Upon completion of an investigation in which it is
determined that a death was caused by an overdose, either
intentionally or unintentionally, of a controlled dangerous
substance, the medical examiner shall be required to report the
decedent’s name and date of birth to the Oklahoma State Bureau of
Narcotics and Dangerous Drugs Control. The Oklahoma State Bureau of
Narcotics and Dangerous Drugs Control shall be required to maintain
a database containing the classification of medical practitioners
who prescribed or authorized controlled dangerous subs tances
pursuant to this subsection.
M. The Oklahoma State Bureau of Nar cotics and Dangerous Drugs
Control is authorized to provide unsolicited notification to the
licensing board of a pharmacist or practitioner if a patient has
received one or more prescriptions for controlled substances in
quantities or with a frequency inco nsistent with generally
recognized standards of safe practice. An unsolicited notification
to the licensing board of the practitioner pursuant to this section:
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1. Is confidential;
2. May not disclose info rmation that is confidential pursuant
to this section; and
3. May be in a summary form sufficient to provide notice of the
basis for the unsolicited notification.
N. Except as otherwise provided for in subsections A and B of
this section, any information collected at the central repository,
as outlined in Section 2-309C of this title, shall:
1. Be confidential by law and privileged;
2. Not be subject to the Oklahoma Open Records Act;
3. Not be subject to subpoena; and
4. Not be subject to discovery or admissible in evidence in any
private civil action.
O. Beginning January 1, 2024, upon receipt of a report from the
Chief Medical Examiner in which the cause of death or a contributing
factor to the death was determined to be one or more opioid drugs as
described in subsection B of Section 9 42 of this title, the Oklahoma
State Bureau of Narcotics and Dangerous Drugs Control shall search
the decedent in the central repository to determine if the decedent
had been prescribed one or more opioid drugs at any point in the
year prior to the death. Beginning January 1, 2024, if the Bureau
determines that the decedent had been prescribed one or more opioid
drugs at any point in the year prior to the death, the Bureau may
report the name of the prescribing practit ioner to the
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practitioner’s licensing board an d may report any other information
from the central repository requested by the licensing board
pertaining to the death for the purposes of investigation by the
licensing board.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2-312.3 of Title 63, unless
there is created a duplica tion in numbering, reads as follows:
Any licensed practitioner as defined in Section 353.1 of Title
59 of the Oklahoma Statutes other than a veterinarian , or any health
care provider other than a licensed practitioner, who has the
authority to prescribe , dispense, or administer any controlled
dangerous substance under Section 2-312 of Title 63 of the Oklahoma
Statutes, or his or her employer on his or her behalf, shall carry
malpractice insurance or demonstrate proof of financial
responsibility in a minimum amount of One Million Dollars
($1,000,000.00) per occurrence and Three Millio n Dollars
($3,000,000.00) in the aggregate per year.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2 -1102 of Title 63, unless there
is created a duplication in numbering, reads as follows:
As used in this act:
1. "Chronic nonmalignant pain" means pain unrelated to cancer
which persists beyond the usual course of disease or the injury that
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is the cause of the pain or more than ninety (90) calendar days
after surgery;
2. “Licensed prescriber” means a licensed practitioner as
defined in Section 353.1 of Title 59 of the Oklahoma Statutes other
than a veterinarian, or any health care provider other than a
licensed practitioner, who has the authority to prescribe any
controlled dangerous s ubstance under Section 2 -312 of Title 63 of
the Oklahoma Statutes; and
3. "Pain management clinic" or "clinic" means any publicly or
privately owned facility:
a. that engages in significant paid advertising in any
medium for any type of pain management services, and
b. where in any month over sixty percent (60%) of
patients who are not being seen for hospice or
palliative care are prescribed opioids,
benzodiazepines, barbiturates , or carisoprodol for the
treatment of chronic nonmalignant pain.
SECTION 5. NEW LAW A ne w section of law to be codified
in the Oklahoma Statutes as Section 2-1103 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. Each pain management clinic shall register with the Oklahoma
State Bureau of Narcotics and Dangerous Drugs Control unless:
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1. The clinic is affiliated wi th an accredited medical school
at which training is provided for medical students, residents , or
fellows;
2. The clinic does not prescribe controlled dangerous
substances for the treatment of pain;
3. The clinic primarily treats hospice or palliative ca re
patients; or
4. A majority of the patients treated by the clinic are treated
for acute pain.
B. Each clinic location shall be registered separately
regardless of whether the clinic is operated under the same business
name or management as another cl inic and each clinic location shall
be a permanent, fixed, physical address of operation .
C. As a part of registration, a clinic shall designate a n owner
or administrator who is responsible for ensuring compliance with all
requirements related to registrati on and operation of the clinic
under this act. Within ten (10) calendar days after terminati on of
a designated administrator, the clinic shall notify the Bureau of
the identity of another designated administrator for that clinic.
Failing to have a designated administrator at the location of the
registered clinic may be the basis for a summary suspension o f the
clinic registration certificate as d escribed in this section.
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D. The Bureau shall deny registration to any pain management
clinic owned by or with any contractual or employment relationship
with a licensed prescriber:
1. Whose Drug Enforcement Administration number has ever been
revoked;
2. Whose application for a license to prescribe, dispense , or
administer a controlled substance has been denied for disciplinary
action by the appropriate licensing board; or
3. Who has been convicted of or pleaded guilty or nolo
contendere to, regardless of adjudication, an offense that
constitutes a felony for receipt of illicit or diverted drugs
including a controlled substance listed in Sc hedule I, II, III, IV,
or V of the Uniform Controlled Dangerous Substances Act, in this
state, any other state , or the United States.
E. If the Bureau finds that a pain management clinic is owned,
directly or indirectly, by a person meeting any criteria listed in
subsection D of this section, the Bureau shall revoke the
certificate of registration previously iss ued by the Bureau. As
determined by rule, the Bureau may grant an exemption to denying a
registration or revoking a previously issued registration if more
than five (5) years have elapsed since adjudication. As used in
this section, the term "convicted" includes an adjudication of guilt
following a plea of guilty or nolo contendere or the forfeiture of a
bond when charged with a crime.
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F. If the registration of a pain man agement clinic is revoked
or suspended, the designated administrator of the pain management
clinic, the owner or lessor of the pain management clinic property,
the manager, and the proprietor shall cea se to operate the facility
as a pain management clinic as of the effective date of the
suspension or revocation.
G. If a pain management clinic registration is revoked or
suspended, the designated administrator of the pain management
clinic, the owner or lessor of the clinic property, the manager , or
the proprietor is responsible for removing all signs and symbols
identifying the premises as a pain management clinic.
H. If the clinic's registration is revoked, any person named in
the registration document s of the pain management clinic including
persons owning or oper ating the pain management clinic, s hall not,
as an individual or as a part of a group, apply to operate a pain
management clinic for one (1) year after the date the registration
is revoked.
I. The period of suspension for the registration of a pain
management clinic shall be prescribed by the Bureau but shall not
exceed one (1) year.
J. A change of ownership of a registered pain management clinic
shall require submission of a new registration application.
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SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2-1104 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. A licensed prescriber shall not be employed or contracted by
or otherwise practice i n a pain management clinic if the clinic is
not licensed by the Oklahoma State Bureau of Narcotics and Dangerous
Drugs Control under this act and registered with the Bureau under
Section 2-301 et seq. of Title 63 of the Oklahoma Statutes. A
licensed prescriber who qualifies to practice in a pain management
clinic pursuant to rules adopted by the appropriate licensing board
may continue to practice in a pain management clinic as long as the
licensed prescriber continues to meet the qualifications prescribed
in the rules. A licensed prescriber who violates this subsection is
subject to disciplinary action by the appropriate licensing board.
B. Only a licensed prescriber licensed in this state and
authorized to prescribe controlled dangerous substances under
Section 2-312 of Title 63 of the Oklahoma Statutes may prescribe a
controlled dangerous subst ance on the premises of a reg istered pain
management clinic and only to the extent allowed by Section 2-312 of
Title 63 of the Oklahoma Statutes . No person shall dispense any
controlled dangerous substance on the premises of a pain m anagement
clinic. The provisions of this subsection shall not be construed to
expand or otherwise modify the prescriptive authority of any
licensed prescriber.
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C. A licensed prescriber shall perform a physical examinatio n
of a patient on the same day that t he licensed prescriber prescribes
a controlled substance to a patient at a pain management clin ic.
D. A licensed prescriber authorized to prescribe controlled
dangerous substances who practices at a pain management clinic is
responsible for maintaining the control and securi ty of his or her
prescription blanks and an y other method used for prescribing
controlled dangerous substance pain medication. The licensed
prescriber shall notify, in writing, the Bureau within twenty-four
(24) hours following any theft or loss of a prescription bl ank or
breach of any other method for prescribing pain medication. The
provisions of this subsection shall not be construed to exempt a
licensed prescriber from any electronic prescription requirements
stipulated in Section 2-309 of Title 63 of the Oklahoma Statutes.
E. The designated administrator of a pain management clinic
shall notify the Bureau in writing of the date of termination of
employment within ten (10) calendar days after terminatin g his or
her employment with a pain manage ment clinic that is required to be
registered pursuant to this act .
F. The owners of a pain management clinic are jointly
responsible for ensuring compliance with the following faci lity and
physical operations requirements:
1. A pain management clinic shall be located and operated at a
publicly accessible fixed location and shall:
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a. display a sign that can be viewed b y the public that
contains the clinic name, hours of operations , and a
street address,
b. have a publicly listed telephone number and a
dedicated phone number to send and receive facsimiles,
c. have a reception and waiting area,
d. provide a restroom,
e. have private patient examination rooms,
f. have treatment rooms, i f treatment is being provided
to the patients, and
g. display a printed sign loc ated in a conspicuous place
in the waiting room viewable by the public with the
name and contact information of the clinic's
designated administrator and the names of all licensed
prescribers practicing in the clinic; and
2. This section does not excuse a licensed prescriber from
providing any treatment or performing any medical duty without the
proper equipment and materials as required by the standard of care.
This section does not supersede the le vel of care, skill, or
treatment recognized in general law related to health care
licensure.
G. Each owner or designated administrator of a pain management
clinic is responsible for ensuring compliance with infection
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prevention and control requirements stipulated by the Occupational
Safety and Health Administration.
H. The designated administrator shall establish a quality
assurance program that includes the identification, investigation,
and analysis of the frequency and causes of adverse incidents to
patients. The designated administrator is responsible for ensuring
compliance with the quality assurance requirements.
I. The designated administrator is responsible for ensuring
compliance with the following d ata collection and reporting
requirements:
1. The designated administrator for each pain management clinic
shall report all significant adverse incidents to the Bureau; and
2. The designated administrator shall also report to the
Bureau, in writing, on a quarterly basis the following data:
a. the number of new and repeat patients seen and treated
at the clinic who are p rescribed controlled dangerous
substance medications for the treatment of chro nic,
nonmalignant pain,
b. the number of patients diagnosed with substance use
disorder,
c. the number of patients dischar ged due to drug
diversion, and
d. the number of patients treated at the clinic whose
domicile is located somewhere other than in this
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state. A patient's domicile is the patient's fixed or
permanent home to which he or she intends to return
even though he or she may temporarily reside
elsewhere.
J. The data and reports specified in subsection I of this
section shall be accessible to each appropriate licensing board.
K. Each pain management clin ic shall establish a written policy
and administrative process for transferring care of patients
diagnosed with a substance use disorder where appropriate for their
continued treatment. Each appropriate licensing board shall issue
guidance on best practices to ensure appropriate referral and
treatment of patients with a substance use disorder.
L. Upon referral by the ap propriate licensing board, the Bureau
shall investigate suspected instances of drug diversion involving a
pain management clinic. Nothing in this act shall be construed to
restrict the appropriate licensing board from conducting its own
investigation into instances of suspected drug diversion.
SECTION 7. NEW LAW A new sectio n of law to be codified
in the Oklahoma Statutes as Section 2-1105 of Title 63, unless there
is created a duplication in numbering, reads as foll ows:
A. The Oklahoma State Bureau of Narcotics and Dangerous Drugs
Control may impose an administrative fine on a clinic of up to One
Thousand Dollars ($1,000.00) per violation for violating the
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requirements of this act or the rules promulgated by the Bureau to
enforce this act.
B. Each day a violation continues after the date fixed for
termination of the violati on as ordered by the Bureau constitutes an
additional, separate, and distinct violation.
C. The Bureau may impose a fine and, in the case of an owner -
operated pain management clinic, revoke or deny a pain management
clinic's registration if the clinic's owner or designated
administrator knowingly and intentionally misrepresents actions
taken to correct a violation.
D. An owner or designated administrator of a pain management
clinic who concurren tly operates an unregistered pain management
clinic is subject to an administrative fine of One Thousand Dollars
($1,000.00) per day.
E. If the owner of a pain management clinic that requires
registration fails to apply t o register the clinic upon a chan ge of
ownership and operates the clinic under the new ownershi p, the owner
is subject to a fine of One Thousand Dollars ($1,000.00).
SECTION 8. NEW LAW A n ew section of law to be codified
in the Oklahoma Statutes as Section 2 -1106 of Title 63, unless there
is created a duplication in numbering , reads as follows:
The Oklahoma State Bureau of Narcotics and Dangerous Drugs
Control and all appropriate licensing boards shall promulgate such
rules as are necessary to implement the pr ovisions of this act.
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SECTION 9. AMENDATORY 63 O.S. 2021, Section 942, is
amended to read as follows:
Section 942. A. 1. Upon completion of an investigation, the
medical examiner shall reduce his or h er findings to writing upon
the form supplied to the medical examiner which shall be promptly
sent to the Chief Medical Examiner by mail.
2. If the medical examiner finds that the deceased had illicit,
prescription or nonprescription drugs in his or her s ystem at the
time of death, the medical examiner shall document in his or her
findings if the death was:
a. a natural or accidental death with drug involvement,
b. a homicide by drugs,
c. a suicide by drug overdose, or
d. a death with drug involvement, but the manner of death
could not be determined.
3. A fatality shall not be considered a drug -related death
unless the medical examiner dete rmines that the drug or drugs
present in the deceased materially contributed to the death.
B. Copies of reports shall be furnished by the Chief Medical
Examiner to investigating agencies having official interest therein.
Copies of reports shall also be f urnished to the spouse of the
deceased or any person within one degree of consanguinity of the
deceased upon request a nd within five (5) business days of the
request once the cause and manner of death have been de termined and
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the death certificate has been issued. Beginning January 1, 2024,
the Chief Medical Examiner shall furnish a copy of any report in
which the cause of death or a contributing factor to the death was
determined to be one or more opioid drugs to the Oklahoma State
Bureau of Narcotics and Dangerous Drugs Control for the purpose of
implementing the provisions of subsection O of Section 2-309D of
this title.
SECTION 10. This act shall become effective November 1, 2022.
58-2-3952 DC 5/20/2022 11:06:15 AM