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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
HOUSE BILL 2168 By: Roe
AS INTRODUCED
An Act relating to health care; amending 59 O.S.
2021, Section 650, which relates to interventional
pain management; modifying, adding, and deleting
definitions; authorizing certified registered nurse
anesthetist to provide certain services and operate
certain facilities under specified condition s;
providing certain construction; and providin g an
effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE O F OKLAHOMA:
SECTION 1. AMENDATORY 59 O.S. 2021, Section 650, is
amended to read as follows:
Section 650. A. This act section shall be known and may be
cited as the “Oklahoma Interventional Pain Management and Treatment
Act”.
B. As used in this section:
1. "Chronic pain" means a pain state which is subacute,
persistent and intractable;
2. “Fluoroscope” means a radiologic instrument equipped with a
fluorescent screen on which opa que internal structures ca n be viewed
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as moving shadow images formed by the differential transmission of
X-rays throughout the body
"Fluoroscopy" means a medical imaging procedure that uses an X-
ray beam to take real-time footage of moving internal body parts
such as bones, muscles, joints, organs, and tissue to display a
consistent radiographic picture progressively onto a screen ; and
3. "Interventional pain management " means the practice of
medicine delivery of health care servic es devoted to the diagnos is
and treatment of chroni c pain, through the use of such techniques
as:
a. ablation of targeted nerves,
b. percutaneous precision needle place ment within the
spinal column with placement of drugs such as local
anesthetics, steroid s, and analgesics in targeted
areas of the spinal c olumn, or
c. surgical techniques, such as laser or endoscopic
diskectomy, intrathecal infusion pumps and spinal cord
stimulators, or
d. fluoroscopy.
C. It shall be unlawful to practice or offer to practic e
interventional pain man agement in this state unle ss such person has:
1. Has been duly licensed under the provisions of the Oklahoma
Allopathic Medical and Surgical L icensure and Supervision Act or the
Oklahoma Osteopathic Medicine Act; or
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2. Is a certified registered nurse ane sthetist licensed in
accordance with the Oklahoma Nurs ing Practice Act who holds a valid
certification in Non surgical Pain Management from the National Board
of Certification and Recertification for Nurse Anesthetists and
practices in accordance with the certification.
D. Nothing in this section shall be construed to forbid the
administration of lumbar intra -laminar epidural steroid injections
or peripheral nerve blocks by a certified registered nurse
anesthetist when requested to do so by a physician and under the
supervision of A certified registered nurse anesthetist who meets
the criteria of subsection C of this section may:
1. Practice interventional pain management , except for surgical
techniques, in collaboration with an allopathic or osteopathic
physician licensed in this s tate and under conditions in which
timely on-site consultation by such allopathic or osteopathic
physician is availab le.
E. A certified registered nurse anesthetist shall no t operate;
2. Operate a freestanding pain management fa cility without
direct supervision of a in collaboration with an allopathic or
osteopathic physician who is board -certified in interventional pa in
management or its equivalent ; and
3. Perform procedural sedation.
E. Nothing in this section shall authorize a Certified
Registered Nurse Anesthetist to prescribe or dispense any opioid or
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any other controlled dangerous substance to be taken by the pa tient
off-site for the management of chronic pain .
SECTION 2. This act shall become effective November 1, 2023.
59-1-6159 LRB 01/18/23