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ENGROSSED HOUSE
BILL NO. 3214 By: West (Kevin) and McCall of
the House
and
Bullard and Jett of the
Senate
An Act relating to health care; defining terms;
granting certain protections to health care
institutions and health care payors; requiring
certain disclosure; providing certain immunity from
civil actions; providing certain construction;
providing exception; conferring certain rights on
medical practitioners, health care institutions, and
health care payors; authorizing certain requirement
by health care institution; prohibiting certain
discrimination against medical practitioner s and
health care institutions; granting certain immunities
to medical practitioners and health care
institutions; granting additional protections;
prohibiting certain disciplinary actions by
professional licensing board or state agency;
requiring certain provision of complaint; providing
remedy for failure to notify; making certain
interference unlawful; providing remedies for
unlawful interference; directing promulgation of
certain rules; providing certain construction;
providing for codification; and providing an
effective date.
BE IT ENACTED BY THE PEOP LE OF THE STATE OF OKLAHOMA:
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SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728g of Title 63, unless there
is created a duplication in numbering, reads as follows:
As used in this act, unless the context requires otherwise:
1. “Conscience” means the ethical, moral, or religious beliefs
or principles held by a me dical practitioner, health care
institution, or health care payor. With respect to institut ional or
corporate persons, as oppos ed to individual persons, the term is
determined by reference to that en tity’s or body’s governing
documents, including but not limited to published ethical, moral, or
religious guidelines or directives, mission statements,
constitutions, articles of incor poration, bylaws, policies, or
regulations;
2. a. “Discrimination” means an adverse action taken
against, or a threat of adverse acti on communicated
to, a medical practitioner, health care ins titution,
or health care payor as a result of the medical
practitioner, health care institution, or health care
payor’s refusal to participate in a health care
service on the basis of conscience, including but not
limited to termination of employment ; transfer from
current position; demotion from current position ;
adverse administrative action; reassignment to a
different shift or job titl e; increased administrative
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duties; denial of staff privilege s; denial of board
certification; loss of career specialty ; reduction of
wages, benefits, or privileges; refusal to award a
grant, contract, or other program; refusal to provide
residency training opportunities; denial, deprivation,
or disqualification of licensure ; withholding or
disqualifying from financial aid and other assistance ;
impediment of the creation or improvement of a health
care institution or health care payor; impediment of
the acquisition or merger of a health care institution
or health care payor; the threat of any of the
preceding actions; or any other penalty, disciplinar y,
or retaliatory action, whether exe cuted or threatened.
b. The term does not include the negotiation or purchase
of insurance by a nongovernment entity;
3. “Health care institution ” means a public or private
hospital, outpatient center for primary care, medical center,
physician organizati on, professional association, outpatient center
for surgical services, p rivate physician’s office, pharmacy, long-
term care facility, medical school, nursing school, medical training
facility, or any other entity or loc ation in which health care
services are performed. The term includes but is not limited to
organizations, corporations, partnerships, associations, agencies,
networks, sole proprietorships, or joint ventures ;
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4. “Health care payor” means an employer, health plan, health
maintenance organiza tion, insurance company, management services
organization, or another en tity that pays for or arranges for
payment for a health care service, in whole or i n part;
5. “Health care service” means medical research or medi cal care
provided to a patient or client at any time during the patient’s or
client’s course of treatment, in cluding but not limited to initial
examination; testing; diagnosis; referral; dispensing or
administration of a drug, medication, or device ; psychological
therapy or counseling ; research; prognosis; therapy; record-making
procedures; notes related to treatment, set up, or performance of a
surgery or procedure; or any other care or servic e performed or
provided by a medical practitioner;
6. “Medical practitioner ” means a person who is or may be asked
to participate in a health care service. The term includes but is
not limited to physicians; physician assistants ; nurses including
but not limited to Advanced Practice Registered Nurses; nurse aides;
allied health professionals ; medical assistants; hospital employees;
employees of an outpatient center for primary care, outpatient
center for surgical services, or long -term care facility;
pharmacists; pharmacy technicians; pharmacy employees; medical
school faculty and students; nursing school faculty and students;
psychology and counseling faculty and students ; medical researchers;
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laboratory technicians; counselors; social workers; or any other
person who facilitates or participates in a he alth care service;
7. “Participate in a health care service” means to provide,
perform, assist with, facilitate, refer for, counsel for, advise
with regard to, admit for the purposes of providing, or take p art in
any way in providing a health care service ; and
8. “Person” means one or more individuals, partnerships,
associations, or corporations.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728h of Title 63, unless there
is created a duplication i n numbering, reads as follows:
A. 1. A health care institution or health care payor may not
be required to participate in or pay for a health care service that
violates the health care institu tion’s or health care payor’s
conscience, including by permitting the use of its facil ities.
2. A health care payor, other than an employer or other entity
whose health plan is not subject to the jurisdiction of the
Insurance Commissioner, shall list any health care service that it
may refuse to pay for on the basis of conscience in the applicable
policy.
B. Except as provided in subsection D of this section, refusal
to participate in or pay for a health care service under this
section may not give rise to liability o f the health care
institution or health care payor for damages allegedly arising from
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the refusal or be the basis for any discriminat ion, discipline, or
other recriminatory action against the health care institution,
health care payor, or any personnel, agent, or governing board.
C. Nothing in this section may be construed to relieve a healt h
care institution of the requirement to provide emergency medical
treatment to all patients set forth in the federal Emergency Medical
Treatment and Labor Act, 42 U.S.C., Section 1395dd.
D. The immunity provisions of this section do not apply to a
health care institution or health care payor owned or operated by
this state or a political subdivision of the state.
E. Notwithstanding any other provision of this act to the
contrary, a religious medical practitioner, health care institution,
or health care payor that holds itself out to the public as
religious, states in its gov erning documents that it has a religious
purpose or mission, and has internal o perating policies or
procedures that implement its religious beliefs, shall have the
right to make employ ment, staffing, contracting, and admitting
privilege decisions c onsistent with its religious beliefs.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728i of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. A medical practitioner has the right not to participate in a
health care service that violates t he medical practitioner ’s
conscience. A health care institution may not be held liable for
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the exercise of conscience not to participate in a health care
service by a medical practitioner employed, contracted, or granted
admitting privileges by the health care institution.
B. A health care institution may require the exercise of
conscience as a basis for no t participating in a health care service
to be made in writing and signe d by the medical practitioner
objecting. A writing made under this subsection may refer only
generally to the grounds of conscience.
C. A medical practitioner ’s refusal to particip ate in a health
care service based on an exercise of conscience may not be a basis
for discrimination, discipline, or other recrimina tory action
against the medical practitioner.
D. A medical practitioner may not be held liable for damages
allegedly arising from the exercise of conscience not to participate
in a health care service.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728j of Title 63, unless there
is created a duplication in numbering, reads as follows:
The exercise of conscience not to p articipate in a health care
service by a medical practitioner, health care institution, or
health care payor may not be grounds for loss of any privileges or
immunities or for the loss of any public benefits.
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SECTION 5. NEW LAW A new sect ion of law to be codified
in the Oklahoma Statutes as Section 1-728k of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. A medical practitioner or heal th care institution may not be
discriminated against because the medical practitioner or health
care institution:
1. Provides, causes to be provided, or intends to provide or
cause to be provided information relating to a suspected violation
of this act to the medical practitioner or health care institution ’s
employer, the Attorney General, the United States Department of
Health and Human Services, or any state or federal agency charged
with protecting health care rights of conscience ; or
2. Testifies, assists, participates, or intends to testify ,
assist, or participa te in a proceeding concerning a violation of
this act.
B. Except as provided in subsection C of this section, it is
unlawful to discriminate against a medical practitioner because the
medical practitioner discloses information that the medical
practitioner reasonably believes evidences:
1. A violation of any law, rule, or regulation;
2. A violation of any standard of care or ethical guideli nes
for the provision of any health care service; or
3. Gross mismanagement, a gross waste of funds, an abuse of
authority, practices or methods of treatment that may put patient
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health at risk, or a substantial and specific danger t o public
health or safety.
C. Nothing in this section may be construed to exempt a person
from any applicable state or federal confidentiality and patient
privacy requirements including but not limited to the federal Health
Insurance Portability and Accountability Act of 1996, 42 U.S.C.,
Section 1320d et seq.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728l of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. A professional licensing board or other state agency that
grants licensure or certification may not reprimand, sanction, or
revoke or threaten to revoke a license, certificate, or registration
of a medical practition er who is licensed or certified by the board
or agency for engaging in speech or expressive activity prot ected
under the First Amendment to the United States Constitution, unless
the board or agency demonstrates by clear and convincing ev idence
that the medical practitioner ’s speech was the direct cau se of
physical harm to a person with whom the medical pract itioner had a
practitioner-patient relationship within the two (2) years
immediately preceding the incident of physical harm.
B. 1. Within fourteen (14) calendar days of receiving a
complaint that may result in revocation of a medic al practitioner’s
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license, certificate, or registration, the board or agency shall
provide the medical practitioner with a copy of the complaint.
2. If the board or agency fails to provide the complaint within
fourteen (14) calendar days of receipt, the board or agency shall
pay the medical practitioner an administrative penalty of Five
Hundred Dollars ($500.00) for each week of noncompliance.
SECTION 7. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728m of Title 63, unless there
is created a duplication in numbering, reads as foll ows:
A. It is unlawful to interfere or attempt to interfere with the
right not to participate in a health care service or the
whistleblower and free speech rights and protections authorized b y
this act, whether by duress, coercion, or any other means.
B. A medical practitioner, health care institution, or health
care payor injured by unlawful interference is entitled to:
1. Injunctive relief, wh en appropriate, including but not
limited to reinstatement of a medical practitioner to the medical
practitioner’s previous position, reinstatement of board
certification, and reli censure of a health care institution or
health care payor;
2. Monetary damages for injuries suffered; and
3. Reasonable costs and attorney fees.
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SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728n of Title 63, unless there
is created a duplication in numbering , reads as follows:
The Insurance Commissioner shall promulgate reasonable and
necessary rules concerning the i mplementation of this act relating
to those insurers under its jurisdiction.
SECTION 9. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 1-728o of Title 63, unless there
is created a duplication in numbe ring, reads as follows:
This act is supplemental to and may not be construed as
modifying or limiting the rights and remedies provided in the
Freedom of Conscience Ac t, Section 1-728a et seq. of Title 63 of the
Oklahoma Statutes.
SECTION 10. This act shall become effective November 1, 2024.
Passed the House of Representatives the 14th day of March, 2024.
Presiding Officer of the House
of Representatives
Passed the Senate the ___ day of __________, 2024.
Presiding Officer of the Senate