Oklahoma 2022 Regular Session

Oklahoma Senate Bill SB888 Compare Versions

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Version 2 (New)

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	3	+	ENGR. H. A. to ENGR. S. B. NO. 888 Page 1 1
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28		-	STATE OF OKLAHOMA
29		-
30		-	2nd Session of the 58th Legislature (2022)
31		-
32		-	CONFERENCE COMMITTEE SUBSTITUTE
33		-	FOR ENGROSSED
34		-	SENATE BILL 888 By: Standridge of the Senate
	28	+	ENGROSSED HOUSE AMENDME NT
	29	+	TO
	30	+	ENGROSSED SENATE BILL NO . 888 By: Standridge of the Senate
35	31
36	32		and
37	33
38		-	~~Marti~~ of the House
	34	+	Echols of the House
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44		-	CONFERENCE COMMITTEE SUBSTITUTE
45		-
46	40		An Act relating to controlled dangerous substances;
47		-	amending 63 O.S. 2021, Section 2 -309, as last amended
48		-	by Section 1, Chapter 259, O.S .L. 2021, which relates
49		-	to electronic prescriptions; clarifying certain
50		-	exception; amending 63 O.S. 2021, Section 2-309D, as
51		-	last amended by Section 2 of Enrolled Senate Bill No.
52		-	1151 of the 2nd Session of the 58th Oklahoma
53		-	Legislature, which relates to the central repository;
54		-	requiring Oklahoma State Bureau of Narcotics and
55		-	Dangerous Drugs Control to make certain determination
56		-	upon certain notification; authorizing Bureau to
57		-	report certain information to practitioner licensing
58		-	boards; requiring certain health care providers and
59		-	employers to carry specified malpractice insurance;
60	41		defining terms; requiring pain management clinics to
61		-	register with ~~the Bureau;~~ ~~providing exemptions;~~
62		-	stipulating ~~registration procedures; requiring~~
63		-	clinics to ~~designate owner or administrat or~~
64		-	~~responsible~~ for ~~certain compliance ; directing denial~~
65		-	of registration ~~for specified reasons~~ ; limiting
	42	+	register with State Board of Medical Licensure and
	43	+	Supervision; providing exemptions; stipulating
	44	+	registration procedures; requiring clinics to
	45	+	designate physician; stipulating procedures for
	46	+	revocation and suspension of registration; limiting
66	47		period of suspension; requiring new r egistration
67	48		application if clinic changes ownership; specifying
68		-	responsibilities of licensed prescriber and
69		-	designated administrator ; providing facility and
	49	+	physician responsibilities; providing facility and
70	50		physical operations requiremen ts; stipulating certain
71		-	infection control requirements; providing certain
72		-	quality assurance requirements; stipulating certain
73		-	data collection and reporting requirements; requiring
74		-	establishment of certain written policy; directing
	51	+	infection control requirements; providing health and
	52	+	safety requirements; providing certain quality
	53	+	assurance requirements; stipulating certain data
	54	+	collection and reporting requirements; providing that
	55	+	designated physician is respo nsible for ensuring
	56	+	compliance with all requirements; providing
	57	+	penalties; directing promulgation of rules; amending
	58	+	59 O.S. 2011, Section 355.1, as amended by Section
	59	+	21, Chapter 230, O.S.L. 2015 (59 O.S. Supp. 2020,
	60	+	Section 355.1), which relates to dispe nsation of
	61	+	dangerous drugs; provi ding certain limitations on
	62	+	dispensation of controlled dangerous substances;
	63	+	providing exception; providing for codification; and
	64	+	providing an effective date.
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76		-	Req. No. 3952 Page 2 1
	66	+	AUTHORS: Remove Echols as principal House author and
	67	+	substitute with Marti
	68	+
	69	+
	70	+	AMENDMENT NO. 1. Strike the title, enacting clause, and entire bill
	71	+	and insert:
	72	+
	73	+
	74	+
	75	+
	76	+	ENGR. H. A. to ENGR. S. B. NO. 888 Page 2 1
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101		-	certain investigation by Bureau; providing penalties;
102		-	directing promulgation of rules; providing certain
103		-	construction; amending 63 O.S. 2021, Section 942 ,
104		-	which relates to medical examiner reports; requiring
105		-	Chief Medical Examiner to furnish certain reports to
106		-	the Bureau; providing for codification; and providing
107		-	an effective date.
	101	+	"[ controlled dangerous substances - requiring pain
	102	+	management clinics to register wit h State Board of
	103	+	Medical Licensure and Supervision - requiring
	104	+	facility operations to cease when registration is
	105	+	revoked or suspended - prohibiting physicians from
	106	+	practicing medicine in unregistered pain
	107	+	management clinics - effective date ]
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111	112		BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
112		-	SECTION 1. AMENDATORY 63 O.S . 2021, Section 2-309, as
113		-	last amended by Section 1, Chapter 259, O. S.L. 2021, is amended to
114		-	read as follows:
115		-	Section 2-309. A. 1. Except for dosages medically require d
116		-	for a period not to exceed forty -eight (48) hours which are
117		-	administered by or on di rection of a practitioner, other than a
118		-	pharmacist, or medication dispensed directly by a pract itioner,
119		-	other than a pharmacist, to an ultimate u ser, no controlled
120		-	dangerous substance included in Schedule II, which is a prescription
121		-	drug as determined unde r regulation promulgated by the Board o f
122		-	Pharmacy, shall be dispensed without an electronic pre scription of a
123		-	practitioner; provided, that in eme rgency situations, as pre scribed
124		-	by the Board of Pharmacy by regulation, such drug may be dispensed
125		-	upon oral prescription reduced promptly to writing and filed by the
126		-	pharmacist in a manner to be prescribe d by rules and regulations of
127		-	the Director of the Oklahoma State Bureau of Narcotics and Dangerous
128		-	Drugs Control.
	113	+	SECTION 1. NEW LAW A new section of law to be codified
	114	+	in the Oklahoma Statutes as Section 2 -1101 of Title 63, un less there
	115	+	is created a duplication in numbering, reads as follows:
	116	+	As used in this act:
	117	+	1. "Board eligible" means successful completion of an
	118	+	anesthesia, physical medicine and rehabilitation, rheumatology or
	119	+	neurology residency program approved by the Ac creditation Council
	120	+	for Graduate Medical Education or the American O steopathic
	121	+	Association for a period of six (6) years from successful completion
	122	+	of such residency program;
	123	+	2. "Chronic nonmalignant pain" means pain unrelated to cancer
	124	+	which persists beyond the usual course of disease or the injury that
	125	+	is the cause of the pain or more than ninety (90) calendar days
	126	+	after surgery; and
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155		-	2. Electronic prescrib ing shall be utilized fo r Schedules II,
156		-	III, IV and V, subject to the requirements set forth in 21 CFR,
157		-	Section 1311 et seq.
158		-	3. An electronic prescription with electron ic signature may
159		-	serve as an original prescription, subject to the requirements set
160		-	forth in 21 CFR, Section 13 11 et seq.
161		-	4. Prescriptions shall be r etained in conformity with the
162		-	requirements of this sect ion and Section 2-307 of this title. No
163		-	prescription for a Schedule II sub stance may be refilled.
164		-	5. The electronic prescription requir ement provided for in th is
165		-	section shall not apply to prescript ions for controlled dangerous
166		-	substances issued by any o f the following:
167		-	a. a person licensed to practice veterinary medicine,
168		-	b. a practitioner who experiences temporary technological
169		-	or electrical failure or other e xtenuating
170		-	circumstance that prevents t he prescription from being
171		-	transmitted electronically; p rovided, however, that
172		-	the practitioner documents the reason for this
173		-	exception in the medical record of the patient,
174		-	c. a practitioner, other than a pharmacist, who dispenses
175		-	directly to an ultimate user,
176		-	d. a practitioner who orders a controlled dangerou s
177		-	substance to be administered through an on -site
178		-	pharmacy in:
	153	+	3. "Pain management clinic" or "clinic" means any publicly or
	154	+	privately owned facility:
	155	+	a. that advertises in any medium for any type of pain
	156	+	management services, and
	157	+	b. where in any month a majority of patients are
	158	+	prescribed opioids, benzodiazepines, barbiturates or
	159	+	carisoprodol for the treatment of chronic nonmalignant
	160	+	pain.
	161	+	SECTION 2. NEW LAW A ne w section of law to be codified
	162	+	in the Oklahoma Statutes as Section 2-1102 of Title 63, unless there
	163	+	is created a duplication in numbering, reads as follows:
	164	+	A. Each pain management clinic shall register with the State
	165	+	Board of Medical Licensure and Super vision unless:
	166	+	1. The majority of the physicians who provide servic es in the
	167	+	clinic primarily provide surgical services;
	168	+	2. The clinic is affiliated with an accredited medical school
	169	+	at which training is provided for medical students, residents or
	170	+	fellows;
	171	+	3. The clinic does not prescribe controlled dangerous
	172	+	substances for the treatment of pain;
	173	+	4. The clinic is wholly owned and operated by one or more
	174	+	board-eligible or board-certified anesthesiologists, physiatrists,
	175	+	rheumatologists or neurologists; o r
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205		-	(1) a hospital as defined in Section 1-701 of this
206		-	title,
207		-	(2) a nursing facility as defined in Sec tion 1-1902
208		-	of this title,
209		-	(3) a hospice inpatient facility as defined in
210		-	Section 1-860.2 of this title,
211		-	(4) an outpatient dialysis facility,
212		-	(5) a continuum of care faci lity as defined in
213		-	Section 1-890.2 of this title, or
214		-	(6) a penal institution listed in Section 509 of
215		-	Title 57 of the Oklahom a Statutes,
216		-	e. a practitioner who orders a controlled da ngerous
217		-	substance to be administered through a hos pice program
218		-	as defined in Section 1-860.2 of this title including
219		-	but not limited to a hospice program tha t provides
220		-	outpatient services,
221		-	f. a practitioner who writes a prescription to be
222		-	dispensed by a pharmacy located on federal property,
223		-	provided the practitioner documents the reason for
224		-	this exception in the medical record of the patient,
225		-	or
226		-	g. a practitioner that has received a waiver or extension
227		-	from his or her licensing board.
	202	+	5. The clinic is wholly owned and operated by a physician
	203	+	multispecialty practice where one or more board -eligible or board-
	204	+	certified medical specialists, who have also completed fellowships
	205	+	in pain medicine approved by the Accreditation Council for Gra duate
	206	+	Medical Education or who are also certified in pain medicine b y the
	207	+	American Board of Pain Medicine or a board approved by the American
	208	+	Board of Physician Specialties, the American Association of
	209	+	Physician Specialists or the American Osteopathic Asso ciation,
	210	+	perform interventional pain procedures of the type routinel y billed
	211	+	using surgical codes.
	212	+	B. Each clinic location shall be registered separately
	213	+	regardless of whether the clinic is operated under the same business
	214	+	name or management as another cl inic.
	215	+	C. As a part of registration, a clinic shall designate a
	216	+	physician who is responsible for complying with all requirements
	217	+	related to registration and operation of the clinic in compliance
	218	+	with this act. Within ten (10) calendar days after terminati on of a
	219	+	designated physician, the clinic shall notify the State Boar d of
	220	+	Medical Licensure and Supervision of the identity of another
	221	+	designated physician for that clinic. The designated physician
	222	+	shall have a full, active and unencumbered license pursuan t to
	223	+	Section 480 et seq. or Section 620 et seq. of Title 59 of the
	224	+	Oklahoma Statutes and shall practice at the clinic location for
	225	+	which the physician has assumed responsibility. Failing to have a
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254		-	~~6. Electronic prescri ptions shall not be utilized under~~ the
255		-	~~following circumstances:~~
256		-	a. ~~compound prescriptions containing two or more~~
257		-	~~commercially available products or two or more a ctive~~
258		-	~~pharmaceutical ingredients,~~
259		-	~~b. compounded infusion prescriptions containing two~~ or
260		-	~~more commercially available products or two or more~~
261		-	~~active pharmaceutical ingredi ents,~~
262		-	c. ~~prescriptions issued under approved research~~
263		-	~~protocols, or~~
264		-	~~d. if~~ the ~~practitioner determines that an electronic~~
265		-	~~prescription cannot be issued in a timely manner and~~
266		-	~~the condition~~ of ~~the patient is at risk.~~
267		-	~~7. A pharmacist who receives a written~~, ~~oral or facsimile~~
268		-	~~prescription shall not be required to verify that the prescription~~
269		-	~~falls under one of the exceptions provid ed for~~ in ~~paragraph 6 of~~
270		-	this ~~subsection. Pharmacists m ay continue to dispense medications~~
271		-	~~from otherwise valid written~~, ~~oral~~ or ~~f acsimile prescriptions that~~
272		-	~~are consistent with~~ the ~~provisions~~ of ~~this section.~~
273		-	~~8. Practitioners shall indicate in the healt h record of~~ a
274		-	~~patient that an exception to the electroni c prescription requirement~~
275		-	~~was utilized.~~
276		-	~~9. All prescriptions issued pursu ant to paragraphs 5 and 6~~ of
277		-	~~this subsection shall be~~ issued ~~on an official prescripti on form~~
	252	+	licensed designated physician practicing at the location o f the
	253	+	registered clinic may be the basis for a summary suspension of the
	254	+	clinic registration certificate as described in this section.
	255	+	D. The State Board of Medical Licensure and Supervision shall
	256	+	deny registration to any pain management clinic owned by o r with any
	257	+	contractual or employment relationship with a physician:
	258	+	1. Whose Drug Enforcement Administration number has ever been
	259	+	revoked;
	260	+	2. Whose application for a license to prescribe, dispense or
	261	+	administer a controlled substance has been denied for disciplinary
	262	+	action by the appropriate medical regulatory board of t he physician;
	263	+	or
	264	+	3. Who has been convicted of or pleaded guilty or nolo
	265	+	contendere to, regardless of adjudication, an offense that
	266	+	constitutes a felony for receipt of illicit or diverted drugs,
	267	+	including a controlled substance listed in Schedule I, II, II I, IV
	268	+	or V of the Uniform Controlled Dangerous Substances Act, in this
	269	+	state, any other state or the United States.
	270	+	E. If the State Board of Medical Licensure and Supervision
	271	+	finds that a pain management clinic is owned, directly or
	272	+	indirectly, by a perso n meeting any criteria listed in subsection D
	273	+	of this section, the State Board of Medical Licensure and
	274	+	Supervision shall revoke the certificate of registration previously
	275	+	issued by the State Board of Medical Licensure and Supervision. As
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304		-	~~provided~~ by the ~~Oklahoma~~ State ~~Bureau~~ of ~~Narcotics~~ and ~~Dangerous~~
305		-	~~Drugs Control.~~
306		-	~~10.~~ a~~. Effective January 1,~~ ~~2020, practitioners shall~~
307		-	~~register with~~ the ~~Oklahoma S tate Bureau of Narcotics~~
308		-	~~and Dangerous Drugs Control in order to be issued~~
309		-	~~official prescription forms.~~ ~~Such registration sh all~~
310		-	~~include, but not be limited to, the primary address~~
311		-	~~and~~ the ~~address~~ of ~~each place of business to be~~
312		-	~~imprinted on official presc ription forms.~~ ~~Any change~~
313		-	~~to a registered practitioner 's~~ ~~registered address~~
314		-	shall ~~be promptly reported~~ to the ~~practitioner 's~~
315		-	~~licensing board and~~ the ~~Bureau by~~ the ~~practitioner in~~
316		-	~~a manner approved by the Bureau~~.
317		-	b. A ~~practitioner's~~ registration ~~shall be w ithout fee and~~
318		-	~~subject to approval by~~ the ~~Bureau. Such registration~~
319		-	~~shall be valid for a period~~ of ~~two (2) years and may~~
320		-	~~be denied,~~ ~~suspended~~ or ~~revoked by the Bureau upon a~~
321		-	~~finding by~~ the ~~Bureau or licensing board that the~~
322		-	~~registered practitioner has had~~ any ~~license to~~
323		-	~~practice a medical profession revoked or suspended by~~
324		-	~~any state~~ or ~~federal agency.~~
325		-	~~c. Where the Bureau has re voked the registration~~ of a
326		-	~~registered practitioner,~~ the ~~Bureau may revoke or~~
327		-	~~cancel any official prescrip tion forms in the~~
	302	+	determined by rule, the State Board of Medical Licensure and
	303	+	Supervision may grant an exemption to denying a registration or
	304	+	revoking a previously issued registration if more than five (5)
	305	+	years have elapsed since adjudication. As used in this section, the
	306	+	term "convicted" includes an adjudication of guilt following a plea
	307	+	of guilty or nolo contendere or the forfeiture of a bond when
	308	+	charged with a crime.
	309	+	F. If the registration of a pain management clini c is revoked
	310	+	or suspended, the designated physician of the pain mana gement
	311	+	clinic, the owner or lessor of the pain management clinic property,
	312	+	the manager and the proprietor shall cease to operate the facility
	313	+	as a pain management clinic as of the effectiv e date of the
	314	+	suspension or revocation.
	315	+	G. If a pain management cli nic registration is revoked or
	316	+	suspended, the designated physician of the pain management clinic,
	317	+	the owner or lessor of the clinic property, the manager or the
	318	+	proprietor is responsible f or removing all signs and symbols
	319	+	identifying the premises as a pain management clinic.
	320	+	H. If the clinic’s registration is revoked, any person named in
	321	+	the registration documents of the pain management clinic, including
	322	+	persons owning or operating the pai n management clinic, shall not,
	323	+	as an individual or as a part of a g roup, apply to operate a pain
	324	+	management clinic for one (1) year after the date the registration
	325	+	is revoked.
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354		-	~~possession~~ of the ~~registered practitioner.~~ ~~Any~~
355		-	~~revocation or any suspension~~ shall ~~require th e~~
356		-	~~registered practitioner to return all unused official~~
357		-	~~prescription forms to the Bureau within fifteen (15)~~
358		-	~~calendar days after the date~~ of ~~the written~~
359		-	~~notification~~.
360		-	~~d. A practitioner that has had any license to practice~~
361		-	~~terminated, revoked or suspended b y~~ a ~~state or federal~~
362		-	~~agency may,~~ ~~upon restoration of such license or~~
363		-	~~certificate, register to b e issued official~~
364		-	~~prescription forms~~.
365		-	~~11. a.~~ ~~Except as provided~~ in ~~subparag raph f of this~~
366		-	~~paragraph,~~ the ~~Bureau shall issue official~~
367		-	~~prescription forms free~~ of ~~c harge only~~ to ~~registered~~
368		-	~~practitioners~~ in ~~this state.~~ ~~Such forms shall not be~~
369		-	~~transferable~~. ~~The number of official prescription~~
370		-	~~forms issued~~ to ~~a registered practitione r at any time~~
371		-	~~shall be at the discretion~~ of the ~~Bureau~~.
372		-	b. ~~Official prescription forms issued~~ to ~~a registered~~
373		-	~~practitioner shall be imprinted only with~~ the ~~primary~~
374		-	~~address and other addresses listed~~ on the ~~registration~~
375		-	~~of the practitioner~~. ~~Such prescripti ons~~ shall ~~be sent~~
376		-	~~only to~~ the ~~primary address~~ of ~~the registered~~
377		-	~~practitioner~~.
	352	+	I. The period of suspension for the registration of a pain
	353	+	management clinic shall be prescribed by the State Board of Medical
	354	+	Licensure and Supervision but shall not exceed one (1) year.
	355	+	J. A change of ownership of a registered pain management clinic
	356	+	requires submission of a new registration application.
	357	+	SECTION 3. NEW LAW A new section of law to be codified
	358	+	in the Oklahoma Statutes as Section 2-1103 of Title 63, unless there
	359	+	is created a duplication in numbering, reads as follows:
	360	+	A. A physician shall not practice medicine in a pain management
	361	+	clinic if the clinic is not registered with the State Board of
	362	+	Medical Licensure and Supervision as required by this act. Any
	363	+	physician who qualifies to practice medicine in a pain management
	364	+	clinic pursuant to rules adopted by the appropriate medical
	365	+	regulatory board of the physician may continue to practice medicine
	366	+	in a pain management clinic as long as the physician continues to
	367	+	meet the qualifications prescribed in the rules. A physician who
	368	+	violates this subsection is subject to disciplinary action by the
	369	+	appropriate medical regulatory board of the physician.
	370	+	B. Only a physician licensed pursuant to Section 480 et seq. or
	371	+	Section 620 et seq. of Title 59 of the Oklahoma Statutes may
	372	+	prescribe a controlled dangerous substance on the premises of a
	373	+	registered pain management clinic. No person shall dispense any
	374	+	controlled dangerous substance on the premises of a pain management
	375	+	clinic.
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404		-	c. ~~Official prescription forms issued to~~ a ~~regi stered~~
405		-	~~practitioner~~ shall ~~be used only by the practition er to~~
406		-	~~whom they are issued.~~
407		-	d. ~~The Bureau may revoke or cancel official pre scription~~
408		-	~~forms in possession of registered practitioners when~~
409		-	~~the license of such pra ctitioner~~ is ~~suspended,~~
410		-	~~terminated~~ or ~~revoked.~~
411		-	~~e. Official prescription forms of registered~~
412		-	~~practitioners who are deceased or who no longer~~
413		-	~~prescribe shall be returned to~~ the ~~Bureau at a~~
414		-	~~designated address.~~ ~~If the registered practitioner is~~
415		-	~~deceased, it is the responsibility~~ of ~~the registered~~
416		-	~~practitioner's estate or lawful designee to return~~
417		-	~~such forms.~~
418		-	~~f. The Bureau may issue official prescripti on forms to~~
419		-	~~employees or agents of the Bureau and other government~~
420		-	~~agencies for the purpose of preventing,~~ ~~iden tifying,~~
421		-	~~investigating and prosecuting unacceptable or illegal~~
422		-	~~practices by providers~~ and ~~other persons and assisting~~
423		-	~~in the recovery of overpaym ents under any program~~
424		-	~~operated by the state or paid for with state funds~~.
425		-	~~Such prescription forms shall be~~ is ~~sued for this~~
426		-	~~purpose only to individua ls who are authorized to~~
427		-	~~conduct investigations on behal f of the Bureau or~~
	402	+	C. A physician, a physician assistant or an Advanced Practice
	403	+	Registered Nurse shall perform a physical examination of a patient
	404	+	on the same day that the physician prescribes a controlled substance
	405	+	to a patient at a pain management clinic.
	406	+	D. A physician authorized to prescribe controlled dangerous
	407	+	substances who practices at a pain management clinic is responsible
	408	+	for maintaining the control and security of his or her prescription
	409	+	blanks and any other method used for prescribing controlled
	410	+	dangerous substance pain medication. The physician shall notify, in
	411	+	writing, the State Board of Medical Licensure and Supervision within
	412	+	twenty-four (24) hours following any theft or loss of a prescription
	413	+	blank or breach of any other method for prescribing pain medication.
	414	+	E. The designated physician of a pain management clinic shall
	415	+	notify the applicable board in writing of the date of termin ation of
	416	+	employment within ten (10) calendar days after terminating his or
	417	+	her employment with a pain management clinic that is required to be
	418	+	registered pursuant to this act. Each physician practicing in a
	419	+	pain management clinic shall advise the State Bo ard of Medical
	420	+	Licensure and Supervision, in writing, within ten (10 ) calendar days
	421	+	after beginning or ending his or her practice at a pain management
	422	+	clinic.
	423	+	F. Each physician practicing in a pain management clinic is
	424	+	responsible for ensuring compliance with the following facility and
	425	+	physical operations requirements:
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454		-	other government agencies as pa rt of their official
455		-	duties. Individuals and agencies receiving such
456		-	prescription forms for this purpose shall provide
457		-	appropriate assurances to the Bureau that adequate
458		-	safeguards and security measures ar e in place to
459		-	prevent the use of such prescription forms for
460		-	anything other than official government purposes.
461		-	12. a. Adequate safeguards and security measures s hall be
462		-	undertaken by registered practi tioners holding
463		-	official prescription forms to assure ag ainst the
464		-	loss, destruction, theft or unauthorized use of the
465		-	forms. Registered practitioners shall maintain a
466		-	sufficient but not excessive supply of such forms in
467		-	reserve.
468		-	b. Registered practitioner s shall immediately notify the
469		-	Bureau, in a manner desig nated by the Bureau, upon
470		-	their knowledge of the l oss, destruction, theft o r
471		-	unauthorized use of any official prescription forms
472		-	issued to them, as well as the f ailure to receive
473		-	official prescription forms within a reasonable time
474		-	after ordering them from the Bureau.
475		-	c. Registered practitioners shall imm ediately notify the
476		-	Bureau upon their knowledge of any diversion or
	452	+	1. A pain management clinic shall be located and operated at a
	453	+	publicly accessible fixed location and shall:
	454	+	a. display a sign that can be viewed by the public that
	455	+	contains the clinic name , hours of operations and a
	456	+	street address,
	457	+	b. have a publicly liste d telephone number and a
	458	+	dedicated phone number to send and receive facsimiles,
	459	+	c. have a reception and waiting area,
	460	+	d. provide a restroom,
	461	+	e. have private patient examination rooms,
	462	+	f. have treatment rooms, if treatment is being provided
	463	+	to the patients, and
	464	+	g. display a printed sign located in a conspicuous place
	465	+	in the waiting room viewable by the public with the
	466	+	name and contact information of the clinic’s
	467	+	designated physician and the names of all physicians
	468	+	practicing in the clinic; and
	469	+	2. This section does not excuse a physician from providing any
	470	+	treatment or performing any medical duty without the proper
	471	+	equipment and materials as required by the standard of care. This
	472	+	section does not supersede the level of care, skill or treatment
	473	+	recognized in general law related to health care licensure.
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503		-	suspected diversion of drugs pursuant to th e loss,
504		-	theft or unauthorized use of pr escriptions.
505		-	B. 1. Except for dosages medically requir ed for a period not
506		-	to exceed seventy-two (72) hours which are administered by or on
507		-	direction of a practitioner, other than a pharmacist, or medication
508		-	dispensed directly by a practitioner, other tha n a pharmacist, to an
509		-	ultimate user, no controlled dange rous substance included in
510		-	Schedule III or IV, whi ch is a prescription drug as determined under
511		-	regulation promulgated by the Board of Pharmacy, shall be dispens ed
512		-	without an electronic prescription.
513		-	2. Any prescription for a controlled dangerous substanc e in
514		-	Schedule III, IV or V may not be filled or re filled more than six
515		-	(6) months after the date thereof or be refilled more than five
516		-	times after the date of th e prescription, unless renewed by the
517		-	practitioner.
518		-	C. Whenever it appears to the Director of the Oklahoma State
519		-	Bureau of Narcotics and Dangero us Drugs Control that a d rug not
520		-	considered to be a prescription drug under existing state law or
521		-	regulation of the Board of Pharmacy should be so con sidered because
522		-	of its abuse potential, the Director sha ll so advise the Board of
523		-	Pharmacy and furnish to the Board all available d ata relevant
524		-	thereto.
525		-	D. 1. "Prescription", as used in this section, means a
526		-	written, oral or electronic order by a practit ioner to a pharmacist
	500	+	G. Each physician practicing in a pain management clinic is
	501	+	responsible for ensuring compliance with the following infection
	502	+	control requirements:
	503	+	1. The clinic shall maintain equipment and supplies to suppor t
	504	+	infection prevention and control activities;
	505	+	2. The clinic shall identify infection risks based on the
	506	+	following:
	507	+	a. geographic location, community and population served,
	508	+	b. the care, treatment and services it provides, and
	509	+	c. an analysis of its infecti on surveillance and control
	510	+	data; and
	511	+	3. The clinic shall maintain written infection prevention
	512	+	policies and procedures that address the following:
	513	+	a. prioritized risks,
	514	+	b. limiting unprotected exposure to pathogens,
	515	+	c. limiting the transmission of infect ions associated
	516	+	with procedures performed in the clinic, and
	517	+	d. limiting the transmission of infections associated
	518	+	with the clinic’s use of medical equipment, devices
	519	+	and supplies.
	520	+	H. Each physician practicing in a pain management clinic is
	521	+	responsible for ensuring that the clinic, including its grounds,
	522	+	buildings, furniture, appliances and equipment is structurally
527	523
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553		-	~~for a controlled dangerous substan ce for a particular patient~~, ~~which~~
554		-	~~specifies the date of its issue, and the full name and address of~~
555		-	~~the patient and, if~~ the ~~controlled dangerous substance~~ is ~~pr escribed~~
556		-	~~for an animal,~~ the ~~species of the animal,~~ ~~the name and quantity of~~
557		-	~~the controlled dangerous substance prescribed,~~ ~~the directions for~~
558		-	~~use, the name~~ and ~~address of the owner of the animal and, if~~
559		-	~~written,~~ the ~~signature of the practitioner.~~
560		-	~~2. "Registered practitioner"~~, ~~as used in this section, means a~~
561		-	~~licensed practitioner duly registered wi th the Oklahoma State Bureau~~
562		-	~~of Narcotics~~ and ~~Dang erous Drugs Control to be issued official~~
563		-	~~prescription forms.~~
564		-	E. ~~No person shall solicit,~~ ~~dispense, receive or deliver any~~
565		-	~~controlled dangerous subst ance through the mail~~, ~~unless the ultimate~~
566		-	~~user is personally known~~ to the ~~practitioner and circumstances~~
567		-	~~clearly indicate such met hod~~ of ~~delivery is in the best interest of~~
568		-	the ~~health~~ and ~~welfare of the ultimate user .~~
569		-	~~SECTION~~ 2. ~~AMENDATORY 63 O.S. 2021, Section 2 -309D, as~~
570		-	~~last amended by Section 2 of Enrolled Senate Bill No. 1151 of~~ the
571		-	~~2nd Session~~ of the ~~58th Oklahoma Legislature , is amended to read as~~
572		-	~~follows:~~
573		-	~~Section 2-309D~~. A. The ~~information collected at the central~~
574		-	~~repository pursuant~~ to ~~the Anti -Drug Diversion Act shall be~~
575		-	~~confidential and shall not be open~~ to ~~the public. Ac cess to the~~
576		-	~~information shall be limited to:~~
	549	+	sound, in good repair, clean and free from health and safety
	550	+	hazards.
	551	+	I. The designated physician is responsible for ensuring
	552	+	compliance with the following quality assurance requirements:
	553	+	1. Each pain management clinic shall have an ongoing quality
	554	+	assurance program that objectively and systematically:
	555	+	a. monitors and evaluate s the quality and appropriateness
	556	+	of patient care,
	557	+	b. evaluates methods to improve patient care,
	558	+	c. identifies and corrects deficiencies within the
	559	+	facility,
	560	+	d. alerts the designated physician to identify and
	561	+	resolve recurring problems, and
	562	+	e. provides for opportunities to improve the facility’s
	563	+	performance and to enhance and improve the quality of
	564	+	care provided to the public; and
	565	+	2. The designated physician shall establish a quality assurance
	566	+	program that includes the following components:
	567	+	a. the identification, investigation and analysis of the
	568	+	frequency and causes of ad verse incidents to patients,
	569	+	b. the identification of trends or patterns of incidents,
	570	+	c. the development of measures to correct, reduce,
	571	+	minimize or eliminate the risk of adverse incident s to
	572	+	patients, and
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603		-	1. ~~Peace officers certified pursuant to Section 3311~~ of ~~Title~~
604		-	70 of ~~the Oklahoma Statutes who are employed as investigative agents~~
605		-	of the ~~Oklahoma State Bureau of Narcotics and Dangerous Drugs~~
606		-	~~Control;~~
607		-	2. The ~~United States Drug Enforcement Administration Diversion~~
608		-	~~Group Supervisor;~~
609		-	3. The ~~executive director or chief investigator, as~~ designated
610		-	~~by each~~ board, of ~~the following state boards:~~
611		-	~~a. Board of Podiatric Medical Examiners,~~
612		-	b. ~~Board of Dentistry,~~
613		-	c. Board of ~~Pharmacy~~,
614		-	~~d. State Board of Medical Licensure and Supervision,~~
615		-	e. ~~State Board~~ of ~~Osteopathic Examiners,~~
616		-	~~f. State Board of Veterinary Medical Examiners,~~
617		-	~~g. Oklahoma Health Care Authority~~ ,
618		-	~~h. Department of Mental Health and Substance Abuse~~
619		-	~~Services~~,
620		-	i. ~~Board~~ of ~~Examiners in Optometry,~~
621		-	~~j. Oklahoma Board of Nursing~~,
622		-	k. ~~Office~~ of the ~~Chief Medical Examiner, and~~
623		-	~~l. State Board of Health;~~
624		-	4. A ~~multicounty grand jury properly convened pursuant to~~ the
625		-	~~Multicounty Grand Jury Act;~~
	599	+	d. the documentation of these functions and perio dic
	600	+	review no less than quarterly of such information by
	601	+	the designated physician.
	602	+	J. The designated physician is responsible for ensuring
	603	+	compliance with the following data collection an d reporting
	604	+	requirements:
	605	+	1. The designated physician for each pain management clinic
	606	+	shall report all adverse incidents to the State Board of Medical
	607	+	Licensure and Supervision; and
	608	+	2. The designated physician shall also report to the State
	609	+	Board of Medical Licensure and Supervision, in writing, on a
	610	+	quarterly basis the following data:
	611	+	a. the number of new and repeat patients seen and treated
	612	+	at the clinic who are prescribed controlled dangerous
	613	+	substance medications for the treatment of chronic,
	614	+	nonmalignant pain,
	615	+	b. the number of patients discharged due to drug abuse,
	616	+	c. the number of patients discharged due to drug
	617	+	diversion, and
	618	+	d. the number of patients treated at the clinic whose
	619	+	domicile is located somewhere other than in this
	620	+	state. A patient’s do micile is the patient’s fixed or
	621	+	permanent home to which he or she i ntends to return
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652		-	5. Medical practitioners employ ed by the United States
653		-	Department of Veterans Affairs, the United States Military, or other
654		-	federal agencies treating patients in this state;
655		-	6. At the discretion of the Director of the Oklahoma State
656		-	Bureau of Narcotics and Dangerous Drugs Control, medi cal
657		-	practitioners and their staff including those employed by the
658		-	federal government in this state; and
659		-	7. The members of the Opioid Overdose Fatality Review Board for
660		-	the purpose of carrying out the duties prescribed by Section 2 -1001
661		-	of this title.
662		-	B. This section shall not prevent access, at the discretion of
663		-	the Director of the Oklahoma State Bureau of Narcotics and Dangerous
664		-	Drugs Control, to investigative information by peace of ficers and
665		-	investigative agents of federal, state, tribal, county or mun icipal
666		-	law enforcement agencies, district attorneys and the Attorney
667		-	General in furtherance of criminal, civil or administrative
668		-	investigations or prosecutions within their respective
669		-	jurisdictions, designat ed legal, communications, and analytical
670		-	employees of the Bureau, and to registrants in furtherance of
671		-	efforts to guard against the diversion of controlled dangerous
672		-	substances.
673		-	C. This section shall not prevent the disclosure, at t he
674		-	discretion of the Di rector of the Oklahoma State Bureau of Narcotics
675		-	and Dangerous Drugs Control, of statistical information gathered
	648	+	even though he or she may temporarily reside
	649	+	elsewhere.
	650	+	K. The data and reports specified in subsection J of this
	651	+	section shall be accessible to the Oklahoma State Bureau of
	652	+	Narcotics and Dangerous Drugs Control.
	653	+	SECTION 4. NEW LAW A new section of law to be codified
	654	+	in the Oklahoma Statutes as Section 2 -1104 of Title 63, unless there
	655	+	is created a duplication in numbering, reads as follows:
	656	+	A. The State Board of Medical Licensure and Supervision may
	657	+	impose an administrative fine on a clinic of up to Five Thousand
	658	+	Dollars ($5,000.00) per violation for violating the requirements of
	659	+	this act or the rules of the State Board of Medical Licensure and
	660	+	Supervision. In determining whether a penalty is to be imposed, and
	661	+	in fixing the amount of the fine, the State Board of Medical
	662	+	Licensure and Supervision shall consider the following factors:
	663	+	1. The gravity of the violation, including the probability that
	664	+	death or serious physical or emotional harm to a patient has
	665	+	resulted, or could have resulted, from the pain management clinic’s
	666	+	actions or the actions of the physician, the severity of the action
	667	+	or potential harm and the extent to which the provisions of the
	668	+	applicable laws or rules were violated;
	669	+	2. What actions, if any , the owner or designated physician took
	670	+	to correct the violations;
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702		-	from the central repository to the general public for statistical,
703		-	research, substance abuse prevention, or educational purposes,
704		-	provided that consumer confidentiality is not compromised.
705		-	D. This section shall not prevent the disclosure, at the
706		-	discretion of the Director of the Oklahoma State Bureau of Narcotics
707		-	and Dangerous Drugs Control, of prescription -monitoring-program
708		-	information to prescription-monitoring programs of other states
709		-	provided a reciprocal data-sharing agreement is in place.
710		-	E. The Department of Mental Health and Substance Abuse Services
711		-	and the State Department of Health may utilize the information i n
712		-	the central repositor y for statistical, research, substance abuse
713		-	prevention, or educational purposes, provided that consumer
714		-	confidentiality is not compromised.
715		-	F. Any unauthorized disclosure of any information collected at
716		-	the central repository provi ded by the Anti-Drug Diversion Act shall
717		-	be a misdemeanor. Violation of the provisions of this section shall
718		-	be deemed willful neglect of duty and shall be grounds for removal
719		-	from office.
720		-	G. 1. Registrants shall have access to the central repository
721		-	for the purposes of patie nt treatment and to aid in the
722		-	determination in prescribing or screening new patients. The
723		-	physician or designee shall provide, upon request by the patient,
724		-	the history of the patient or the query history of the patient.
	697	+	3. Whether there were any previous violations at the pain
	698	+	management clinic; and
	699	+	4. The financial benefits that the pa in management clinic
	700	+	derived from committing or continuing to commit the violation.
	701	+	B. Each day a violation continues after the date fixed for
	702	+	termination of the violation as ordered by the State Board of
	703	+	Medical Licensure and Supervision constitutes an a dditional,
	704	+	separate and distinct violation.
	705	+	C. The State Board of M edical Licensure and Supervision may
	706	+	impose a fine and, in the case of an owner -operated pain management
	707	+	clinic, revoke or deny a pain management clinic’s registration if
	708	+	the clinic’s designated physician knowingly and intentionally
	709	+	misrepresents actions t aken to correct a violation.
	710	+	D. An owner or designated physician of a pain management clinic
	711	+	who concurrently operates an unregistered pain management clinic is
	712	+	subject to an administrati ve fine of Five Thousand Dollars
	713	+	($5,000.00) per day.
	714	+	E. If the owner of a pain management clinic that requires
	715	+	registration fails to apply to register the clinic upon a change of
	716	+	ownership and operates the clinic under the new ownership, the owner
	717	+	is subject to a fine of Five Thousand Dollars ($5,000.00).
	718	+	SECTION 5. NEW LAW A new section of law to be codified
	719	+	in the Oklahoma Statutes as Section 2 -1105 of Title 63, unless there
	720	+	is created a duplication in numbering, reads as follows :
725	721
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751		-	2. a. Prior to prescribing or auth orizing for refill, if one
752		-	hundred eighty (180) d ays have elapsed prior to the
753		-	previous access and check, of opiates, synthetic
754		-	opiates, semisynthetic opiates, benzodiazepine or
755		-	carisoprodol to a patient of record, registrants or
756		-	members of their medical o r administrative staff shall
757		-	be required to acces s the information in the central
758		-	repository to assess medical necessity and the
759		-	possibility that the patient may be unlawfully
760		-	obtaining prescription drugs in violation of the
761		-	Uniform Controlled Dangerous Su bstances Act. The duty
762		-	to access and check shall not alter or otherwise amend
763		-	appropriate medical standards of care. The registrant
764		-	or medical provider shall note in the patient file
765		-	that the central repository has been checked and may
766		-	maintain a copy of the information.
767		-	b. The requirements set forth i n subparagraph a of this
768		-	paragraph shall not apply:
769		-	(1) to medical practitioners who prescribe the
770		-	controlled substances set forth in subparagraph a
771		-	of this paragraph for hospice or en d-of-life
772		-	care, or
773		-	(2) for a prescription of a controlled substance set
774		-	forth in subparagraph a of this paragraph that is
	747	+	All affected agencies and boards shall promulgate such rules as
	748	+	are necessary to implement the provisions of this act.
	749	+	SECTION 6. This act shall become effective November 1, 2021. "
	750	+	Passed the House of Representatives the 28th day of April, 2022.
775	751
776		-	Req. No. 3952 Page 16 1
	752	+
	753	+
	754	+
	755	+
	756	+	Presiding Officer of the House of
	757	+	Representatives
	758	+
	759	+
	760	+	Passed the Senate the ____ day of _______ ___, 2022.
	761	+
	762	+
	763	+
	764	+
	765	+
	766	+	Presiding Officer of the Senate
	767	+
	768	+
	769	+	ENGR. S. B. NO. 888 Page 1 1
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801		-	issued by a practitioner for a patient residing
802		-	in a nursing facility as defined by Section 1 -
803		-	1902 of this title, provided that the
804		-	prescription is issued to a resident of such
805		-	facility.
806		-	3. Registrants shall not be liable to any person for any claim
807		-	of damages as a result of accessing or failing to access the
808		-	information in the central repository and no lawsuit may be
809		-	predicated thereon.
810		-	4. The failure of a registrant to access and check the central
811		-	repository as required under state or federal law or regulation may,
812		-	after investigation, be grounds for the licensing board of the
813		-	registrant to take disciplinary action against the registr ant.
814		-	H. The Board of Podiatric Medical Examiners, the Board of
815		-	Dentistry, the State Board of Medical Licensure and Supervision, the
816		-	Board of Examiners in Optometry, the Oklahoma Board of Nursing, the
817		-	State Board of Osteopathic Examiners and the State Boar d of
818		-	Veterinary Medical Examiners shall have the sole responsibility for
819		-	enforcement of the provisions of subsection G of this section.
820		-	Nothing in this section shall be construed so as to permit the
821		-	Director of the State Bureau of Narcotics and Dangerous Drugs
822		-	Control to assess administrative fines provided for in Section 2 -304
823		-	of this title.
	794	+	ENGROSSED SENATE
	795	+	BILL NO. 888 By: Standridge of the Senate
824	796
825		-	Req. No. 3952 Page 17 1
	797	+	and
	798	+
	799	+	Echols of the House
	800	+
	801	+
	802	+
	803	+
	804	+	An Act relating to controlled dangerous substances;
	805	+	defining terms; requiring pain management clinics to
	806	+	register with State Board of Medical Licensure and
	807	+	Supervision; providing exemptions; stipulating
	808	+	registration procedures; requiring clinics to
	809	+	designate physician; stipulating procedures for
	810	+	revocation and suspension of registration; limiting
	811	+	period of suspension; requiring new registration
	812	+	application if clinic changes ownership; specifying
	813	+	physician responsibilities; providing facility and
	814	+	physical operations requirements; stipulating certain
	815	+	infection control requirements; providing health and
	816	+	safety requirements; providing certain quality
	817	+	assurance requirements; stipulating certain data
	818	+	collection and reporting requirements; providing that
	819	+	designated physician is responsible for ensuring
	820	+	compliance with all requirements; providing
	821	+	penalties; directing promulgation of rules; amending
	822	+	59 O.S. 2011, Section 355.1, as amended by Section
	823	+	21, Chapter 230, O.S.L. 2015 (59 O.S. Supp. 2020,
	824	+	Section 355.1), which relates to dispensation of
	825	+	dangerous drugs; provi ding certain limitations on
	826	+	dispensation of controlled dangerous substances;
	827	+	providing exception; providing for codification; and
	828	+	providing an effective date .
	829	+
	830	+
	831	+
	832	+
	833	+
	834	+	BE IT ENACTED BY THE PEOPLE OF THE STATE O F OKLAHOMA:
	835	+	SECTION 7. NEW LAW A new section of law to be codi fied
	836	+	in the Oklahoma Statutes as Section 2 -1101 of Title 63, unless there
	837	+	is created a duplication in numbering, reads as follows:
	838	+
	839	+	ENGR. S. B. NO. 888 Page 2 1
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850		-	~~I. The Director of the Oklahoma State Bureau of Narcotics and~~
851		-	~~Dangerous Drugs Control,~~ ~~or a designee thereof,~~ ~~shall provide a~~
852		-	~~monthly list to the Directors of the Board of Podiatric Medica l~~
853		-	~~Examiners,~~ the ~~Board of Dentistry, the State Bo ard of Medical~~
854		-	~~Licensure and Supervision,~~ the ~~Board of Examiners in Optometry, the~~
855		-	~~Oklahoma Board~~ of ~~Nursing, the State Board of Osteopathic Examiners~~
856		-	~~and the State Board~~ of ~~Veterinary Medical Examiners of t he top~~
857		-	~~twenty prescribers of controlled dangerous substances within their~~
858		-	~~respective areas~~ of ~~jurisdiction. Upon discovering~~ that a
859		-	~~registrant~~ is ~~prescribing outside~~ the ~~limitations~~ of ~~his~~ or ~~her~~
860		-	~~licensure or outside of drug registr ation rules or applicab le state~~
861		-	~~laws, the respective licensing board sha ll be notified by the Bureau~~
862		-	~~in writing.~~ ~~Such notifications may be considered complaints for the~~
863		-	~~purpose~~ of ~~investigations or other actions by the respective~~
864		-	~~licensing board.~~ ~~Licensi ng boards shall have ex clusive jurisdiction~~
865		-	~~to take action against~~ a ~~lic ensee for a violation~~ of ~~subsection G of~~
866		-	~~this section.~~
867		-	~~J. Information regarding fatal and nonfatal overdoses,~~ ~~other~~
868		-	~~than statistical information as required by Section 2 -106 of this~~
869		-	~~title, shall~~ be ~~complete ly confidential. Access to this information~~
870		-	~~shall be strictly limited to the Director of~~ the Oklahoma ~~State~~
871		-	~~Bureau of Narcotics and Dangerous Drugs Control or designee~~, ~~the~~
872		-	~~Chief Medical Examiner,~~ state ~~agencies and boards provided in~~
873		-	~~subsection A~~ of ~~this section,~~ and ~~the registrant that enters the~~
	864	+	As used in this act:
	865	+	1. “Board eligible” means successful completion of an
	866	+	anesthesia, physical medicine and rehabilitation, rheumatology or
	867	+	neurology residency program approved by the Accreditation Council
	868	+	for Graduate Medical Education or the American Osteopathic
	869	+	Association for a period of six (6) years from successful completion
	870	+	of such residency program;
	871	+	2. “Chronic nonmalignant pain” means pain unrelated to cancer
	872	+	which persists beyond the usual course of disease or the injury that
	873	+	is the cause of the pain or more than ninety (90) calend ar days
	874	+	after surgery; and
	875	+	3. “Pain management clinic” or “clinic” means any publicly or
	876	+	privately owned facility:
	877	+	a. that advertises in any m edium for any type of pain
	878	+	management services, or
	879	+	b. where in any month a majority of patients are
	880	+	prescribed opioids, benzodiazepines, barbiturates or
	881	+	carisoprodol for the treatment of chronic nonm alignant
	882	+	pain.
	883	+	SECTION 8. NEW LAW A new section of law to be codified
	884	+	in the Oklahoma Statutes as Section 2 -1102 of Title 63, unless there
	885	+	is created a duplication in numbering, reads as f ollows:
	886	+	A. Each pain management clinic shall register with the State
	887	+	Board of Medical Licensure and Supervision unless:
874	888
875		-	~~Req~~. No. ~~3952~~ Page 18 1
	889	+	ENGR. S. B. NO. 888 Page 3 1
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900		-	~~information~~. ~~Registrants shall not be liable to any person for a~~
901		-	~~claim of damages for information reported pursuant to the provisions~~
902		-	~~of Section~~ 2~~-105 of this title~~.
903		-	K. The ~~Director of t he Oklahoma State Burea u of Narcotics and~~
904		-	~~Dangerous Drugs Control shall provide adequate means~~ and ~~procedures~~
905		-	~~allowing access to central repository information for registrants~~
906		-	~~lacking direct computer access.~~
907		-	L. ~~Upon completion of~~ an ~~investigation in which it is~~
908		-	~~determined that a death was caused by an overdose~~, ~~either~~
909		-	~~intentionally or unintentionally, of a controlled dangerous~~
910		-	~~substance,~~ the ~~medical examiner shall be required to report the~~
911		-	~~decedent’s name and date~~ of ~~birth to the Oklahoma State Bureau of~~
912		-	~~Narcotics and Dangerous Drugs Control~~. The ~~Oklahoma State Bureau of~~
913		-	~~Narcotics and Dangerous Drugs Control shall be required to maintain~~
914		-	~~a database containing~~ the ~~classification of medical practitioners~~
915		-	~~who prescribed~~ or ~~authorized controlled dangerous subs tances~~
916		-	~~pursuant to this subsection.~~
917		-	M. The ~~Oklahoma State Bureau of Nar cotics~~ and ~~Dangerous Drugs~~
918		-	~~Control is authorized to provide unsolicited notification to the~~
919		-	~~licensing board of a pharmacist or practitioner if a patient has~~
920		-	~~received one or more prescriptions~~ for ~~controlled substances in~~
921		-	~~quantities~~ or ~~with a frequency inco nsistent with generally~~
922		-	~~recognized standards~~ of ~~safe practice.~~ ~~An unsolicited notification~~
923		-	~~to the licensing~~ board of the ~~practitioner pursuant to this section:~~
	914	+	1. The majority of the physicians who provide services in the
	915	+	clinic primarily provide s urgical services;
	916	+	2. The clinic is owned by a publicly held corporation whose
	917	+	shares are traded on a national exchange or on the over -the-counter
	918	+	market and whose total assets at the end of the corporation ’s most
	919	+	recent fiscal quarter exceeded Fifty Milli on Dollars
	920	+	($50,000,000.00);
	921	+	3. The clinic is affiliated with an accredited medical schoo l
	922	+	at which training is provided for medical students, res idents or
	923	+	fellows;
	924	+	4. The clinic does not prescribe controlled dangerous
	925	+	substances for the treatment of pai n;
	926	+	5. The clinic is owned by a corporate enti ty exempt from
	927	+	federal taxation under 26 U.S .C., Section 501(c)(3) (1954);
	928	+	6. The clinic is wholly o wned and operated by one or more
	929	+	board-eligible or board-certified anesthesiologists, physiatrists,
	930	+	rheumatologists or neurologists; or
	931	+	7. The clinic is wholly owned and operated by a physician
	932	+	multispecialty practice where one or more board -eligible or board-
	933	+	certified medical specialists, who have also completed fellowships
	934	+	in pain medicine approved by the Accr editation Council for Graduate
	935	+	Medical Education or who are also certified in pain medicin e by the
	936	+	American Board of Pain Medicine or a board appro ved by the American
	937	+	Board of Medical Specialties, the American Association of Physician
924	938
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950		-	~~1. Is confidential;~~
951		-	~~2. May not disclose info rmation that is confidential pursuant~~
952		-	~~to this section; and~~
953		-	3. ~~May~~ be ~~in a summary form sufficient to provide notice of the~~
954		-	~~basis for~~ the ~~unsolicited notification.~~
955		-	~~N. Except~~ as ~~otherwise provided for in subsections A and B of~~
956		-	~~this section~~, ~~any information collected at the central repository,~~
957		-	~~as outlined in Section 2-309C~~ ~~of this title,~~ ~~shall:~~
958		-	~~1. Be confidential by law~~ and ~~privileged;~~
959		-	2. ~~Not be subject to the Oklahoma Open Records Act;~~
960		-	~~3. Not be subject to subpoena;~~ ~~and~~
961		-	~~4. Not be subject to discovery or admissible in evidence in any~~
962		-	~~private civil action~~.
963		-	~~O. Beginning January 1, 2024, upon receipt of~~ a ~~report from the~~
964		-	~~Chief Medical Examiner in which~~ the ~~cause of death or a contributing~~
965		-	~~factor to~~ the ~~death was determined to be one or more opioid drugs as~~
966		-	~~described in subsection B of Section 9 42 of this title,~~ the ~~Oklahoma~~
967		-	~~State Bureau~~ of ~~Narcotics and Dangerous Drugs Control shall search~~
968		-	~~the decedent in~~ the ~~central repository to determine if~~ the ~~decedent~~
969		-	~~had been prescribed one or more opioid drugs at any point~~ in ~~the~~
970		-	~~year prior to~~ the ~~death. Beginning January 1,~~ ~~2024, if the Bureau~~
971		-	~~determines that the decedent had been prescribed one or more opioid~~
972		-	~~drugs at any point in the year prior~~ to ~~the death,~~ ~~the Bureau may~~
973		-	~~report the name~~ of the ~~prescribing practit ioner to the~~
	964	+	Specialists or the Am erican Osteopathic Association, perform
	965	+	interventional pain procedures of the type routine ly billed using
	966	+	surgical codes.
	967	+	B. Each clinic location shall be registered separately
	968	+	regardless of whether the clinic is operated under the same business
	969	+	name or management as another clinic.
	970	+	C. As a part of registration, a clinic shall designate a
	971	+	physician who is responsible for complying with all requirem ents
	972	+	related to registration and operation of the clinic in compliance
	973	+	with this act. Within ten (10) calend ar days after termination of a
	974	+	designated physician, the clinic shall notify the State Board of
	975	+	Medical Licensure and Supervision of the identity o f another
	976	+	designated physician for that clinic. The designated physician
	977	+	shall have a full, active and unenc umbered license pursuant to
	978	+	Section 480 et seq. or Section 620 et seq. of Title 59 of the
	979	+	Oklahoma Statutes and shall practice at the clinic locati on for
	980	+	which the physician has assumed responsibility. Failing to have a
	981	+	licensed designated physician pract icing at the location of the
	982	+	registered clinic may be the basis for a summary suspension o f the
	983	+	clinic registration certificate as described in thi s section.
	984	+	D. The State Board of Medical Licensure and Supervision shall
	985	+	deny registration to any clinic tha t is not fully owned by a
	986	+	physician licensed p ursuant to Section 480 et seq. or Section 62 0 et
	987	+	seq. of Title 59 of the Oklahoma Statutes or group o f physicians,
974	988
975		-	~~Req~~. No. ~~3952~~ Page 20 1
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1000		-	practitioner’s licensing board an d may report any other information
1001		-	from the central repository requested by the licensing board
1002		-	pertaining to the death for the purposes of investigation by the
1003		-	licensing board.
1004		-	SECTION 3. NEW LAW A new section of law to be codified
1005		-	in the Oklahoma Statutes as Section 2-312.3 of Title 63, unless
1006		-	there is created a duplica tion in numbering, reads as follows:
1007		-	Any licensed practitioner as defined in Section 353.1 of Title
1008		-	59 of the Oklahoma Statutes other than a veterinarian , or any health
1009		-	care provider other than a licensed practitioner, who has the
1010		-	authority to prescribe , dispense, or administer any controlled
1011		-	dangerous substance under Section 2-312 of Title 63 of the Oklahoma
1012		-	Statutes, or his or her employer on his or her behalf, shall carry
1013		-	malpractice insurance or demonstrate proof of financial
1014		-	responsibility in a minimum amount of One Million Dollars
1015		-	($1,000,000.00) per occurrence and Three Millio n Dollars
1016		-	($3,000,000.00) in the aggregate per year.
1017		-	SECTION 4. NEW LAW A new section of law to be codified
1018		-	in the Oklahoma Statutes as Section 2 -1102 of Title 63, unless there
1019		-	is created a duplication in numbering, reads as follows:
1020		-	As used in this act:
1021		-	1. "Chronic nonmalignant pain" means pain unrelated to cancer
1022		-	which persists beyond the usual course of disease or the injury that
	1014	+	each of whom is licensed pursuant to Section 480 et seq. or Section
	1015	+	620 et seq. of Title 59 of the Oklahoma Statutes.
	1016	+	E. The State Board of Medical Licensure and Supervision shall
	1017	+	deny registration to any pain management clinic owned by or w ith any
	1018	+	contractual or employment relationship with a physician:
	1019	+	1. Whose Drug Enforcement Administration nu mber has ever been
	1020	+	revoked;
	1021	+	2. Whose application for a license to prescribe, dispense or
	1022	+	administer a controlled substance has been denied by any
	1023	+	jurisdiction;
	1024	+	3. Who has been convicted of or pleaded guilty or nolo
	1025	+	contendere to, regardless of adjudicati on, an offense that
	1026	+	constitutes a felony for r eceipt of illicit or diverted drugs,
	1027	+	including a controlled substance listed in Schedule I, II, III, IV
	1028	+	or V of the Uniform Controlled Dangerous Substances Act, in this
	1029	+	state, any other state or the United Stat es.
	1030	+	F. If the State Board of Medical Licensur e and Supervision
	1031	+	finds that a pain management clinic does not meet the requirement of
	1032	+	subsection D of this section or is owned, directly or indirectly, by
	1033	+	a person meeting any criteria listed in subsection E o f this
	1034	+	section, the State Board of Medical Lic ensure and Supervision shall
	1035	+	revoke the certificate of registration previously issued by the
	1036	+	State Board of Medical Licensure and Supervision. As determined by
	1037	+	rule, the State Board of Medical Licensure and Supervision may grant
1023	1038
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1049		-	~~is the cause of the pain~~ or ~~more than ninety (90) calendar days~~
1050		-	~~after surgery;~~
1051		-	2. ~~“Licensed prescriber” means a licensed practitioner~~ as
1052		-	~~defined in Section 353.1~~ of ~~Title 59~~ of ~~the Oklahoma Statutes other~~
1053		-	~~than~~ a ~~veterinarian, or any health care provider other than~~ a
1054		-	~~licensed practitioner,~~ ~~who has~~ the ~~authority to prescribe any~~
1055		-	~~controlled dangerous s ubstance under Section 2 -312~~ of ~~Title 63 of~~
1056		-	the ~~Oklahoma Statutes;~~ ~~and~~
1057		-	~~3. "Pain~~ ~~management clinic"~~ ~~or "clinic" means any publicly or~~
1058		-	~~privately owned facility:~~
1059		-	a. ~~that engages in significant paid advertising in any~~
1060		-	~~medium for any type of~~ pain management ~~services, and~~
1061		-	~~b. where in any month over sixty percent (60%)~~ of
1062		-	~~patients who are not being seen for hospice~~ or
1063		-	~~palliative care are prescribed opioids,~~
1064		-	~~benzodiazepines, barbiturates , or carisoprodol for~~ the
1065		-	~~treatment of chronic nonmalignant pain~~.
1066		-	~~SECTION 5.~~ ~~NEW LAW A ne w section~~ of ~~law to be codified~~
1067		-	in the ~~Oklahoma Statutes as Section 2-1103 of Title 63~~, ~~unless there~~
1068		-	~~is created~~ a ~~duplication in numbering~~, ~~reads as follows:~~
1069		-	~~A. Each pain~~ management clinic ~~shall register with~~ the ~~Oklahoma~~
1070		-	~~State Bureau of Narcotics and Dangerous Drugs Control unless:~~
	1064	+	an exemption to denying a registration or revoking a previously
	1065	+	issued registration if more than ten (10) years have elapsed si nce
	1066	+	adjudication. As used in this section, the term “convicted”
	1067	+	includes an adjudication of guilt following a plea of guilty or nolo
	1068	+	contendere or the for feiture of a bond when charged with a crime.
	1069	+	G. If the registration of a pain management clinic is revoked
	1070	+	or suspended, the designated physician of the pain management
	1071	+	clinic, the owner or lessor of the pain management clinic property,
	1072	+	the manager and the proprietor shall cease to operate the faci lity
	1073	+	as a pain management clinic as of the effective date of the
	1074	+	suspension or revocation.
	1075	+	H. If a pain management clinic registration is revoked or
	1076	+	suspended, the designated physician of the pain management clinic,
	1077	+	the owner or lessor of the clinic prope rty, the manager or the
	1078	+	proprietor is responsible for rem oving all signs and symbols
	1079	+	identifying the premises as a pain management clinic.
	1080	+	I. If the clinic’s registration is revoked, any person named in
	1081	+	the registration documents of the pain management clinic, including
	1082	+	persons owning or operating the pain management clinic, shall not,
	1083	+	as an individual or as a part of a group, apply to operate a pain
	1084	+	management clinic for five (5) years after the date the registr ation
	1085	+	is revoked.
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1097		-	1. The clinic is affiliated wi th an accredited medical school
1098		-	at which training is provided for medical students, residents , or
1099		-	fellows;
1100		-	2. The clinic does not prescribe controlled dangerous
1101		-	substances for the treatment of pain;
1102		-	3. The clinic primarily treats hospice or palliative ca re
1103		-	patients; or
1104		-	4. A majority of the patients treated by the clinic are treated
1105		-	for acute pain.
1106		-	B. Each clinic location shall be registered separately
1107		-	regardless of whether the clinic is operated under the same business
1108		-	name or management as another cl inic and each clinic location shall
1109		-	be a permanent, fixed, physical address of operation .
1110		-	C. As a part of registration, a clinic shall designate a n owner
1111		-	or administrator who is responsible for ensuring compliance with all
1112		-	requirements related to registrati on and operation of the clinic
1113		-	under this act. Within ten (10) calendar days after terminati on of
1114		-	a designated administrator, the clinic shall notify the Bureau of
1115		-	the identity of another designated administrator for that clinic.
1116		-	Failing to have a designated administrator at the location of the
1117		-	registered clinic may be the basis for a summary suspension o f the
1118		-	clinic registration certificate as d escribed in this section.
	1112	+	J. The period of suspensi on for the registration of a pain
	1113	+	management clinic shall be prescribed by the State Board of Medical
	1114	+	Licensure and Supervision but shall not exceed one (1) year.
	1115	+	K. A change of ownership of a registered pain management clinic
	1116	+	requires submission of a new registration application.
	1117	+	SECTION 9. NEW LAW A new section of law to be codified
	1118	+	in the Oklahoma Statutes as Section 2 -1103 of Title 63, unl ess there
	1119	+	is created a duplication in numberin g, reads as follows:
	1120	+	A. A physician shall no t practice medicine in a pain management
	1121	+	clinic if the clinic is not registered with the State Board of
	1122	+	Medical Licensure and Supervision as required by this act. Any
	1123	+	physician who qualifies to practice medicin e in a pain management
	1124	+	clinic pursuant to rul es adopted by the State Board of Medical
	1125	+	Licensure and Supervision may continue to practice medicine in a
	1126	+	pain management clinic as long as the physician continues to mee t
	1127	+	the qualifications prescribed in the rules. A physician who
	1128	+	violates this subsectio n is subject to disciplinary action by his or
	1129	+	her appropriate medical regulatory board.
	1130	+	B. Only a physician licensed pur suant to Section 480 et seq. or
	1131	+	Section 620 et seq. of Title 59 of the Oklahoma Statutes m ay
	1132	+	prescribe a controlled dangerous substance on the premises of a
	1133	+	registered pain management clinic. No person shall dispense any
	1134	+	controlled dangerous substance on the premises of a pain management
	1135	+	clinic.
1119	1136
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1145		-	D. The Bureau shall deny registration to any pain management
1146		-	clinic owned by or with any contractual or employment relationship
1147		-	with a licensed prescriber:
1148		-	1. Whose Drug Enforcement Administration number has ever been
1149		-	revoked;
1150		-	2. Whose application for a license to prescribe, dispense , or
1151		-	administer a controlled substance has been denied for disciplinary
1152		-	action by the appropriate licensing board; or
1153		-	3. Who has been convicted of or pleaded guilty or nolo
1154		-	contendere to, regardless of adjudication, an offense that
1155		-	constitutes a felony for receipt of illicit or diverted drugs
1156		-	including a controlled substance listed in Sc hedule I, II, III, IV,
1157		-	or V of the Uniform Controlled Dangerous Substances Act, in this
1158		-	state, any other state , or the United States.
1159		-	E. If the Bureau finds that a pain management clinic is owned,
1160		-	directly or indirectly, by a person meeting any criteria listed in
1161		-	subsection D of this section, the Bureau shall revoke the
1162		-	certificate of registration previously iss ued by the Bureau. As
1163		-	determined by rule, the Bureau may grant an exemption to denying a
1164		-	registration or revoking a previously issued registration if more
1165		-	than five (5) years have elapsed since adjudication. As used in
1166		-	this section, the term "convicted" includes an adjudication of guilt
1167		-	following a plea of guilty or nolo contendere or the forfeiture of a
1168		-	bond when charged with a crime.
	1162	+	C. A physician, a physician assistant or an Advanced Practice
	1163	+	Registered Nurse shall perform a physical examination of a patient
	1164	+	on the same day that the physician prescribes a controlled substance
	1165	+	to a patient at a pain management clinic. If the physician
	1166	+	prescribes more than a seventy -two-hour dose of controlled dangerous
	1167	+	substances for the treatment of chronic nonmalignant pain, the
	1168	+	physician shall document in the patient’s record the reason for
	1169	+	prescribing that quantity.
	1170	+	D. A physician authorized to prescri be controlled dangerous
	1171	+	substances who practices at a pain management clinic is responsible
	1172	+	for maintaining the control and security of his or her prescription
	1173	+	blanks and any other method used for prescribing controlled
	1174	+	dangerous substance pain medication. The physician shall notify, in
	1175	+	writing, the State Board of Medical Licensure and Supervision within
	1176	+	twenty-four (24) hours following any thef t or loss of a prescription
	1177	+	blank or breach of any other method for prescribing pain medication.
	1178	+	E. The designated physician of a pain management clinic shall
	1179	+	notify the applicable board in writing of the date of termination of
	1180	+	employment within ten (10) calendar days after terminating his or
	1181	+	her employment with a pain management clinic that is required to be
	1182	+	registered pursuant to this act. Each physicia n practicing in a
	1183	+	pain management clinic shall advise the State Board of Medical
	1184	+	Licensure and Supervision, in writing, within ten (10) calendar days
1169	1185
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1195		-	F. If the registration of a pain man agement clinic is revoked
1196		-	or suspended, the designated administrator of the pain management
1197		-	clinic, the owner or lessor of the pain management clinic property,
1198		-	the manager, and the proprietor shall cea se to operate the facility
1199		-	as a pain management clinic as of the effective date of the
1200		-	suspension or revocation.
1201		-	G. If a pain management clinic registration is revoked or
1202		-	suspended, the designated administrator of the pain management
1203		-	clinic, the owner or lessor of the clinic property, the manager , or
1204		-	the proprietor is responsible for removing all signs and symbols
1205		-	identifying the premises as a pain management clinic.
1206		-	H. If the clinic's registration is revoked, any person named in
1207		-	the registration document s of the pain management clinic including
1208		-	persons owning or oper ating the pain management clinic, s hall not,
1209		-	as an individual or as a part of a group, apply to operate a pain
1210		-	management clinic for one (1) year after the date the registration
1211		-	is revoked.
1212		-	I. The period of suspension for the registration of a pain
1213		-	management clinic shall be prescribed by the Bureau but shall not
1214		-	exceed one (1) year.
1215		-	J. A change of ownership of a registered pain management clinic
1216		-	shall require submission of a new registration application.
	1211	+	after beginning or ending his or her practice at a pain management
	1212	+	clinic.
	1213	+	F. Each physician practicing i n a pain management clinic is
	1214	+	responsible for ensuring compliance with the following facility and
	1215	+	physical operations requirements:
	1216	+	1. A pain management clinic shall be located and operated at a
	1217	+	publicly accessible fixed location and shall:
	1218	+	a. display a sign that can be viewed by t he public that
	1219	+	contains the clinic name, hours of operation s and a
	1220	+	street address,
	1221	+	b. have a publicly listed telephone number and a
	1222	+	dedicated phone number to send and receive facsimiles
	1223	+	with a facsimile machine that shall be ope rational
	1224	+	twenty-four (24) hours per day,
	1225	+	c. have emergency lighting and communications,
	1226	+	d. have a reception and waiting area,
	1227	+	e. provide a restroom,
	1228	+	f. have an administrative area, including room for
	1229	+	storage of medical records, supplies and equipment,
	1230	+	g. have private patient examina tion rooms,
	1231	+	h. have treatment rooms, if treatment is being provided
	1232	+	to the patients, and
	1233	+	i. display a printed sign located in a conspicuous place
	1234	+	in the waiting room viewable by the public with the
1217	1235
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1243		-	SECTION 6. NEW LAW A new section of law to be codified
1244		-	in the Oklahoma Statutes as Section 2-1104 of Title 63, unless there
1245		-	is created a duplication in numbering, reads as follows:
1246		-	A. A licensed prescriber shall not be employed or contracted by
1247		-	or otherwise practice i n a pain management clinic if the clinic is
1248		-	not licensed by the Oklahoma State Bureau of Narcotics and Dangerous
1249		-	Drugs Control under this act and registered with the Bureau under
1250		-	Section 2-301 et seq. of Title 63 of the Oklahoma Statutes. A
1251		-	licensed prescriber who qualifies to practice in a pain management
1252		-	clinic pursuant to rules adopted by the appropriate licensing board
1253		-	may continue to practice in a pain management clinic as long as the
1254		-	licensed prescriber continues to meet the qualifications prescribed
1255		-	in the rules. A licensed prescriber who violates this subsection is
1256		-	subject to disciplinary action by the appropriate licensing board.
1257		-	B. Only a licensed prescriber licensed in this state and
1258		-	authorized to prescribe controlled dangerous substances under
1259		-	Section 2-312 of Title 63 of the Oklahoma Statutes may prescribe a
1260		-	controlled dangerous subst ance on the premises of a reg istered pain
1261		-	management clinic and only to the extent allowed by Section 2-312 of
1262		-	Title 63 of the Oklahoma Statutes . No person shall dispense any
1263		-	controlled dangerous substance on the premises of a pain m anagement
1264		-	clinic. The provisions of this subsection shall not be construed to
1265		-	expand or otherwise modify the prescriptive authority of any
1266		-	licensed prescriber.
	1261	+	name and contact information of the clinic’s
	1262	+	designated physician and the names of all physicians
	1263	+	practicing in the clinic; and
	1264	+	2. This section does not excuse a physician from providing any
	1265	+	treatment or performing any medical duty without the pr oper
	1266	+	equipment and materials as required by the standard of care. This
	1267	+	section does not supersede the level of care, skill or treatment
	1268	+	recognized in general law related to health care licensure.
	1269	+	G. Each physician practicing in a pain management clinic is
	1270	+	responsible for ensuring compliance wi th the following infection
	1271	+	control requirements:
	1272	+	1. The clinic shall maintain equipment and supplies t o support
	1273	+	infection prevention and control activities;
	1274	+	2. The clinic shall identify infection risks based on the
	1275	+	following:
	1276	+	a. geographic location, comm unity and population served ,
	1277	+	b. the care, treatment and services it provides, and
	1278	+	c. an analysis of its infection surveillance and control
	1279	+	data; and
	1280	+	3. The clinic shall maintain written infection prevention
	1281	+	policies and procedures that address the followi ng:
	1282	+	a. prioritized risks,
	1283	+	b. limiting unprotected exposure to pathogens,
1267	1284
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1293		-	C. ~~A licensed prescriber shall perform a physical examinatio n~~
1294		-	~~of a patient on~~ the ~~same day that t he licensed prescriber prescribes~~
1295		-	~~a controlled substance to~~ a ~~patient at a pain management clin ic.~~
1296		-	~~D. A licensed prescriber authorized to prescribe controlled~~
1297		-	~~dangerous substances who practices at a pain management clinic is~~
1298		-	~~responsible for maintaining the control and securi ty of his or her~~
1299		-	~~prescription blanks~~ and ~~an y other method used for prescribing~~
1300		-	~~controlled dangerous substance pain medication. The licensed~~
1301		-	~~prescriber shall notify, in writing,~~ the ~~Bureau within twenty-four~~
1302		-	~~(24) hours following any theft or loss of a prescription bl ank or~~
1303		-	~~breach of any other method for prescribing pain medication.~~ ~~The~~
1304		-	~~provisions~~ of ~~this subsection shall not be construed to exempt a~~
1305		-	~~licensed prescriber from any electronic prescription requirements~~
1306		-	~~stipulated in Section 2-309~~ ~~of Title 63 of the Oklahoma Statutes.~~
1307		-	E. The ~~designated administrator of~~ a ~~pain management clinic~~
1308		-	~~shall notify~~ the ~~Bureau in writing~~ of ~~the date of termination of~~
1309		-	~~employment within ten (10) calendar days after terminatin g his or~~
1310		-	~~her employment with a pain manage ment clinic that is required to be~~
1311		-	~~registered pursuant to this act~~ .
1312		-	~~F. The owners of a pain management clinic are jointly~~
1313		-	~~responsible for ensuring compliance with the following faci lity~~ and
1314		-	~~physical operations requirements:~~
1315		-	1. ~~A pain management clinic shall be located and operated at a~~
1316		-	~~publicly accessible fixed location and shall~~:
	1310	+	c. limiting the transmission o f infections associated
	1311	+	with procedures performed in the clinic, and
	1312	+	d. limiting the transmission of infections a ssociated
	1313	+	with the clinic’s use of medical equipment, devices
	1314	+	and supplies.
	1315	+	H. Each physician practicing in a pain management clinic is
	1316	+	responsible for ensuring compliance with the following health and
	1317	+	safety requirements:
	1318	+	1. The clinic, including its gr ounds, buildings, furniture,
	1319	+	appliances and equipment shall be str ucturally sound, in good
	1320	+	repair, clean and free from health and safety hazard s;
	1321	+	2. The clinic shall have evacuation procedures in the event of
	1322	+	an emergency, which shall include provisions f or the evacuation of
	1323	+	disabled patients and employees;
	1324	+	3. The clinic shall have a writ ten facility-specific disaster
	1325	+	plan specifying actions that will be taken in the event of clinic
	1326	+	closure due to unforeseen disasters and shall include provisions for
	1327	+	the protection of medical records; and
	1328	+	4. Each clinic shall have at l east one employee on the premises
	1329	+	during patient care hours who is certified in basic life support and
	1330	+	is trained in reacting to accidents and medical emergencies until
	1331	+	emergency medical per sonnel arrive.
	1332	+	I. The designated physic ian is responsible for ens uring
	1333	+	compliance with the following quality assurance requirements:
1317	1334
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1343		-	a. ~~display a sign that can be viewed b y the public that~~
1344		-	~~contains the clinic name, hours of operations ,~~ and a
1345		-	~~street address,~~
1346		-	~~b. have a publicly listed telephone number and a~~
1347		-	~~dedicated phone number~~ to ~~send and receive facsimiles~~,
1348		-	c. ~~have a reception~~ and ~~waiting area,~~
1349		-	~~d. provide a restroom~~,
1350		-	e. ~~have private patient examination rooms,~~
1351		-	~~f. have treatment rooms~~, ~~i f treatment is being provided~~
1352		-	to the ~~patients, and~~
1353		-	~~g. display a printed sign loc ated in a conspicuous place~~
1354		-	~~in the waiting room viewable by~~ the public ~~with the~~
1355		-	~~name and contact information of~~ the ~~clinic's~~
1356		-	~~designated administrator and~~ the ~~names of all licensed~~
1357		-	~~prescribers practicing in~~ the ~~clinic;~~ and
1358		-	~~2. This section does not excuse~~ a ~~licensed prescriber from~~
1359		-	~~providing any treatment~~ or ~~performing any medical duty without the~~
1360		-	~~proper equipment and materials as required by~~ the ~~standard~~ of ~~care.~~
1361		-	~~This section does not supersede~~ the ~~le vel~~ of ~~care, skill,~~ or
1362		-	~~treatment recognized in general law related to health care~~
1363		-	~~licensure~~.
1364		-	~~G. Each owner or designated administrator~~ of ~~a pain management~~
1365		-	~~clinic is responsible for ensuring compliance with infection~~
	1360	+	1. Each pain management clinic shall have an ongoing quality
	1361	+	assurance program that objectively and systematically:
	1362	+	a. monitors and evaluates the quality and app ropriateness
	1363	+	of patient care,
	1364	+	b. evaluates methods to improve patient care,
	1365	+	c. identifies and corrects deficiencies within the
	1366	+	facility,
	1367	+	d. alerts the designated physician to identify and
	1368	+	resolve recurring problems, and
	1369	+	e. provides for opportunities to imp rove the facility’s
	1370	+	performance and to enhance and improve the quality of
	1371	+	care provided to the public; and
	1372	+	2. The designated physician shall establish a quality assurance
	1373	+	program that includes the following componen ts:
	1374	+	a. the identification, investigation and analysis of the
	1375	+	frequency and causes of a dverse incidents to patients,
	1376	+	b. the identification of tr ends or patterns of incidents,
	1377	+	c. the development of measures to correct, reduce,
	1378	+	minimize or eliminate the risk of adverse incidents to
	1379	+	patients, and
	1380	+	d. the documentation of thes e functions and peri odic
	1381	+	review no less than quarterly of such information by
	1382	+	the designated physician.
1366	1383
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1392		-	prevention and control requirements stipulated by the Occupational
1393		-	Safety and Health Administration.
1394		-	H. The designated administrator shall establish a quality
1395		-	assurance program that includes the identification, investigation,
1396		-	and analysis of the frequency and causes of adverse incidents to
1397		-	patients. The designated administrator is responsible for ensuring
1398		-	compliance with the quality assurance requirements.
1399		-	I. The designated administrator is responsible for ensuring
	1409	+	J. The designated physician is responsible for ensuring
1400	1410		compliance with the following data collection and reporting
1401	1411		requirements:
1402		-	1. The designated administrator for each pain management clinic
1403		-	shall report all significant adverse incidents to the Bureau; and
1404		-	2. The designated administrator shall also report to the
1405		-	Bureau, in writing, on a quarterly basis the following data:
	1412	+	1. The designated ph ysician for each pain management clinic
	1413	+	shall report all adverse incidents to the State Board of Medical
	1414	+	Licensure and Supervision; and
	1415	+	2. The designated physician shall also report to the State
	1416	+	Board of Medical Licensure and Supervision, in writing, on a
	1417	+	quarterly basis the following data:
1406	1418		a. the number of new and repeat patients seen and treated
1407	1419		at the clinic who are prescribed controlled dangerous
1408	1420		substance medications for the treatment o f chronic,
1409	1421		nonmalignant pain,
1410		-	b. the number of patients diagnosed with substance use
1411		-	disorder,
	1422	+	b. the number of patients discharged due to drug abuse,
1412	1423		c. the number of patients discharged due to drug
1413	1424		diversion, and
1414	1425		d. the number of patients treated at the clinic whose
1415	1426		domicile is located somewhere other than in this
	1427	+	state. A patient’s domicile is the patient ’s fixed or
	1428	+	permanent home to which he or she intends to return
	1429	+	even though he or she may temporarily r eside
	1430	+	elsewhere.
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1442		-	state. A patient's domicile is the patient's fixed or
1443		-	permanent home to which he or she intends to return
1444		-	even though he or she may temporarily reside
1445		-	elsewhere.
1446		-	J. The data and reports specified in subsection I of this
1447		-	section shall be accessible to each appropriate licensing board.
1448		-	K. Each pain management clin ic shall establish a written policy
1449		-	and administrative process for transferring care of patients
1450		-	diagnosed with a substance use disorder where appropriate for their
1451		-	continued treatment. Each appropriate licensing board shall issue
1452		-	guidance on best practices to ensure appropriate referral and
1453		-	treatment of patients with a substance use disorder.
1454		-	L. Upon referral by the ap propriate licensing board, the Bureau
1455		-	shall investigate suspected instances of drug diversion involving a
1456		-	pain management clinic. Nothing in this act shall be construed to
1457		-	restrict the appropriate licensing board from conducting its own
1458		-	investigation into instances of suspected drug diversion.
1459		-	SECTION 7. NEW LAW A new sectio n of law to be codified
1460		-	in the Oklahoma Statutes as Section 2-1105 of Title 63, unless there
	1457	+	SECTION 10. NEW LAW A new section of law to be codified
	1458	+	in the Oklahoma Statutes as Section 2 -1104 of Title 63, unless there
1461	1459		is created a duplication in number ing, reads as follows:
1462		-	A. The Oklahoma State Bureau of Narcotics and Dangerous Drugs
1463		-	Control may impose an administrative fine on a clinic of up to One
1464		-	Thousand Dollars ($1,000.00) per violation for violating the
	1460	+	A. The State Board of Medical Lic ensure and Supervision may
	1461	+	impose an administrative fine on a clinic of up to Five Thousand
	1462	+	Dollars ($5,000.00) p er violation for violating the requireme nts of
	1463	+	this act or the rules of the State Board of Medical Licensure and
	1464	+	Supervision. In determining w hether a penalty is to be imposed, and
	1465	+	in fixing the amount of the fine, the State Board of Medical
	1466	+	Licensure and Supervision shall consider the followin g factors:
	1467	+	1. The gravity of the violation, i ncluding the probability that
	1468	+	death or serious physical o r emotional harm to a patient has
	1469	+	resulted, or could have resulted, from the pain management clinic’s
	1470	+	actions or the actions of the physician, the severi ty of the action
	1471	+	or potential harm and the ext ent to which the provisions of the
	1472	+	applicable laws or rul es were violated;
	1473	+	2. What actions, if any, the owner or designated physician took
	1474	+	to correct the violations;
	1475	+	3. Whether there were any previous violati ons at the pain
	1476	+	management clinic; and
	1477	+	4. The financial benefits that the pain management clinic
	1478	+	derived from committing or continuing to commit the violation.
	1479	+	B. Each day a violation continues after the date fixed for
	1480	+	termination of the violation as ord ered by the State Board of
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1491		-	requirements of this act or the rules promulgated by the Bureau to
1492		-	enforce this act.
1493		-	B. Each day a violation continues after the date fixed for
1494		-	termination of the violati on as ordered by the Bureau constitutes an
1495		-	additional, separate, and distinct violation.
1496		-	C. The Bureau may impose a fine and, in the case of an owner -
1497		-	operated pain management clinic, revoke or deny a pain management
1498		-	clinic's registration if the clinic's owner or designated
1499		-	administrator knowingly and intentionally misrepresents actions
1500		-	taken to correct a violation.
1501		-	D. An owner or designated administrator of a pain management
1502		-	clinic who concurren tly operates an unregistered pain management
1503		-	clinic is subject to an administrative fine of One Thousand Dollars
1504		-	($1,000.00) per day.
	1507	+	Medical Licensure and Supervision constitutes an additional,
	1508	+	separate and distinct violation.
	1509	+	C. The State Board of Medical Licensure and Supervision may
	1510	+	impose a fine and, in the case of an owner-operated pain management
	1511	+	clinic, revoke or deny a pain management clinic’s registration if
	1512	+	the clinic’s designated physician knowingly and intentionally
	1513	+	misrepresents actions taken to correct a violation.
	1514	+	D. An owner or designated physician of a pain management clinic
	1515	+	who concurrently operates an unregistered pain management clinic is
	1516	+	subject to an administrative fine of Five Thousand D ollars
	1517	+	($5,000.00) per day.
1505	1518		E. If the owner of a pain management clinic that requires
1506	1519		registration fails to appl y to register the clinic upon a change of
1507	1520		ownership and operates the clinic under the new ownership, the owner
1508		-	is subject to a fine of ~~One Thousand~~ Dollars ($1,000.00).
1509		-	SECTION 8. NEW LAW A ~~n ew~~ section of law to be codified
1510		-	in the Oklahoma Statutes as Section 2 -~~1106~~ of Title 63, unless there
	1521	+	is subject to a fine of Five Tho usand Dollars ($5,000.00).
	1522	+	SECTION 11. NEW LAW A new section of law to be codified
	1523	+	in the Oklahoma Statutes as Section 2 -1105 of Title 63, unless there
1511	1524		is created a duplication in numbering, reads as follows:
1512		-	The Oklahoma State Bureau of Narcotics and Dangerous Drugs
1513		-	Control and all appropriate licensing boards shall promulgate such
1514		-	rules as are necessary to implement the pr ovisions of this act.
	1525	+	All affected agencies an d boards shall promulgate such rules as
	1526	+	are necessary to implement the provisions of this act .
	1527	+	SECTION 12. AMENDATORY 59 O.S. 2 011, Section 355.1, as
	1528	+	amended by Section 21, C hapter 230, O.S.L. 2015 (59 O.S. Supp. 2020,
	1529	+	Section 355.1), is amended to read as follows:
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1541		-	SECTION 9. ~~AMENDATORY 63 O.S. 2021,~~ Section ~~942, is~~
1542		-	~~amended to read as follows:~~
1543		-	~~Section 942.~~ ~~A. 1.~~ ~~Upon completion of an investigation,~~ the
1544		-	~~medical examiner shall reduce his or h er findings to writing upon~~
1545		-	~~the form supplied to~~ the ~~medical examiner which~~ shall be ~~promptly~~
1546		-	~~sent~~ to ~~the Chief Medical Examiner by mail~~.
1547		-	~~2. If~~ the ~~medical examiner finds that~~ the ~~deceased had illicit,~~
1548		-	~~prescription or nonprescription drugs in his or her s ystem at the~~
1549		-	~~time of death~~, the ~~medical examiner shall document in his~~ or ~~her~~
1550		-	~~findings if~~ the ~~death was:~~
1551		-	~~a. a natural or accidental death with drug involvement~~,
1552		-	b. a ~~homicide by drugs,~~
1553		-	c. a ~~suicide by drug overdose, or~~
1554		-	d. a ~~death with drug involvement, but the manner~~ of ~~death~~
1555		-	~~could not be determined~~.
1556		-	3. A ~~fatality shall not be considered a drug -related death~~
1557		-	~~unless~~ the ~~medical examiner dete rmines that the drug or drugs~~
1558		-	~~present in the deceased materially contributed to the death.~~
1559		-	~~B. Copies of reports shall be furnished~~ by ~~the Chief Medical~~
1560		-	~~Examiner~~ to ~~investigating agencies having official interest therein.~~
1561		-	~~Copies~~ of ~~reports shall also be f urnished to the spouse~~ of ~~the~~
1562		-	~~deceased or any person within one degree of consanguinity of the~~
1563		-	~~deceased upon request a nd within five (5) business days of~~ the
1564		-	~~request once~~ the ~~cause and manner of death have been de termined and~~
	1556	+	Section 355.1. A. Except as provided for in Section 353.1 et
	1557	+	seq. of this title, only a licensed practitioner may d ispense
	1558	+	dangerous drugs to such practitioner ’s patients, and only for the
	1559	+	expressed purpose of serving t he best interests and promoting the
	1560	+	welfare of such patients. The dangerous drugs shall be dispensed in
	1561	+	an appropriate container to which a label has b een affixed. Such
	1562	+	label shall include the name and office address of the licensed
	1563	+	practitioner, date di spensed, name of patient, directions for
	1564	+	administration, prescription number, the trade or generic name and
	1565	+	the quantity and strength, not meaning ingre dients, of the drug
	1566	+	therein contained; provided , this requirement shall not apply to
	1567	+	compounded medicines. The licensed practitioner shall keep a
	1568	+	suitable book, file or record in which shall be preserved for a
	1569	+	period of not less than five (5) years a reco rd of every dangerous
	1570	+	drug compounded or dispen sed by the licensed practitioner.
	1571	+	B. A prescriber desiring to dispense dangerous drugs pursuant
	1572	+	to this section shall register annually with the appropriate
	1573	+	licensing board as a dispenser, through a regulator y procedure
	1574	+	adopted and prescribed by such lice nsing board.
	1575	+	C. A prescriber who dispenses professional samples to patients
	1576	+	shall be exempt from the requirement of subsection B of this section
	1577	+	if:
	1578	+	1. The prescriber f urnishes the professional samples to th e
	1579	+	patient in the package provided by the manufa cturer;
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1591		-	the death certificate has been issued. Beginning January 1, 2024,
1592		-	the Chief Medical Examiner shall furnish a copy of any report in
1593		-	which the cause of death or a contributing factor to the death was
1594		-	determined to be one or more opioid drugs to the Oklahoma State
1595		-	Bureau of Narcotics and Dangerous Drugs Control for the purpose of
1596		-	implementing the provisions of subsection O of Section 2-309D of
1597		-	this title.
1598		-	SECTION 10. This act shall become effective November 1, 2022.
	1606	+	2. No charge is made to the patient; and
	1607	+	3. An appropriate record is entered in the patient ’s chart.
	1608	+	D. This section shall not apply to the services provided
	1609	+	through the State Department of Health, city/county health
	1610	+	departments, or the Department of Mental Health and Substance Abuse
	1611	+	Services.
	1612	+	E. This section shall not apply to organizations and services
	1613	+	incorporated as state or federal tax -exempt charitable no nprofit
	1614	+	entities and/or organizations a nd services receiving all or part of
	1615	+	their operating funds from a local, state or federal governmental
	1616	+	entity; provided, such organizations and services shall comply with
	1617	+	the labeling and recordkeeping requirements se t out in subsection A
	1618	+	of this section.
	1619	+	F. A prescriber who issues a prescription for a controlled
	1620	+	dangerous substance shall not dispense the controlled dangerous
	1621	+	substance pursuant to such prescription. A prescriber shall not
	1622	+	dispense a controlled danger ous substance pursuant to a prescriptio n
	1623	+	issued by another prescriber if the dispensin g prescriber has a
	1624	+	financial interest in the practice of the prescribing prescriber.
	1625	+	The restrictions on dispensing of controlled dangerous substances
	1626	+	provided by this subsection shall not apply to substance abuse
	1627	+	treatment programs or services.
	1628	+	SECTION 13. This act shall become effective Novemb er 1, 2021.
1599	1629
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	1630	+	ENGR. S. B. NO. 888 Page 18 1
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	1654	+
	1655	+	Passed the Senate the 10th day of March, 2021.
	1656	+
	1657	+
	1658	+
	1659	+	Presiding Officer of the Senate
	1660	+
	1661	+
	1662	+	Passed the House of Representatives the ____ day of __________,
	1663	+	2021.
	1664	+
	1665	+
	1666	+
	1667	+	Presiding Officer of the House
	1668	+	of Representatives
	1669	+
	1670	+