An Act
ENROLLED HOUSE
BILL NO. 3351 By: McEntire, Deck, and Munson
of the House
and
Thompson (Kristen) of the
Senate
An Act relating to medical preceptorship training;
defining terms; providing income tax credit for
certain individuals who conduct a preceptorship
rotation; providing amount of and basis for credit;
providing limitations on credits allowed; authorizing
the carry forward of credit; directing the Health
Care Workforce Training Commission to award credi t;
limiting the amount of credit awar ded to balance of
certain revolving funds; authorizing allocation of
partial credit; authorizing credits not allowed to be
claimed in subsequent year; specifying eligibility
for credit; directing the State Board of Medi cal
Licensure and Supervision, the St ate Board of
Osteopathic Examiners, and the Oklahoma Board of
Nursing to deposit certain fees in revolving fund for
certain purpose; requiring submission of information;
authorizing promulgation of rules; creating the
Physician Preceptor Tax Credit Revolvi ng Fund, the
Physician Assistant Preceptor Tax Credit Revolving
Fund, the Osteopathic Physician Preceptor Tax Credit
Revolving Fund, and the Advanced Practice Registered
Nurses Preceptor Tax Credit Revolving Fund;
specifying sources of funds; providing for transfer
of monies to Oklahoma Tax Commission; requiring
apportionment of monies; authorizing payment of
administrative expenditures; stating purpose;
amending 70 O.S. 2021, Section 697.5, as amended by
Section 19, Chapter 407, O.S.L. 2022 (70 O.S. Supp.
2023, Section 697.5), which relates to the Health
Care Workforce Training Commission; providing
additional duties; updating statutory language; ENR. H. B. NO. 3351 Page 2
providing for codification; and declaring an
emergency.
SUBJECT: Medical preceptorship training
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2357.409 of Title 68, unless
there is created a duplication i n numbering, reads as follows:
A. As used in this section:
1. “Advanced practice registered nursing student ” means an
individual participating in a state -supported training program in
this state that is approved by the Oklahoma Board of Nursing for the
training of individuals to become A dvanced Practice Registered
Nurses as defined in Section 567.3a of Title 59 of the Oklahoma
Statutes;
2. “Faculty preceptor” means an allopathic physician,
osteopathic physician, physician assistant, or Advanced Practi ce
Registered Nurse licensed in this state and who provides primary
care services;
3. “Medical school” means a legally chartered medical school
recognized by the Oklahoma State Regents for Higher Education;
4. “Medical student” means a student currentl y enrolled in a
medical school in th is state or a school or college of osteopathic
medicine in this state;
5. “Physician assistant student ” means an individual
participating in a state -supported training program in this state
that is approved by the Stat e Board of Medical Licensure and
Supervision for the training of individuals to become physician
assistants as defined in Section 519.2 of Title 59 of the Oklahoma
Statutes;
6. “Preceptorship rotation ” means a period of preceptorship
training of one or m ore medical students, residents, phy sician ENR. H. B. NO. 3351 Page 3
assistant students, or advanced practice registered nursing students
that in aggregate totals one hundred sixty (160) hours;
7. “Preceptorship training ” means uncompensated training in
primary care services of a medical student, resident, physicia n
assistant student, or advanced practice registered nursing student
enrolled in a training program in this state;
8. “Primary care services ” means family medicine, geriatrics,
general internal medicine, general pediat rics, or the substantial
equivalent of such services when performed by a physician assistant
or Advanced Practice Registered Nurse;
9. “Resident” means an allopathic physician or osteopathic
physician pursuing postgraduate medical education at a program
supported by a medical school or a s chool or college of osteopathic
medicine in this state; and
10. “School or college of osteopathic medicine ” shall have the
same meaning as provided by Section 631 of Title 59 of the Oklahoma
Statutes.
B. 1. For tax years 2026 through 2035, there shall be allowed
a credit against the tax imposed pursuant to Section 2355 of Title
68 of the Oklahoma Statutes for a faculty preceptor who conducts a
preceptorship rotation.
2. Except as provided for by subsection F of thi s section,
credit shall be allowed f or no greater than ten preceptorship
rotations completed in a calendar year, and shall be equal to the
following amounts:
a. for a medical student or resident, Two Hundred Ninety
Dollars ($290.00) each for the first, se cond, or third
preceptorship rotatio ns and Five Hundred Ninety
Dollars ($590.00) each for up to seven subsequent
rotations, and
b. for a physician assistant student or advanced practice
registered nursing student, One Hundred Sixty -five
Dollars ($165.00) each for the first, second, or third
preceptorship rotations and Three Hundred Forty
Dollars ($340.00) each for up to seven subsequent
rotations.
ENR. H. B. NO. 3351 Page 4
C. The credit authorized by this section shall not be used to
reduce the tax liability of the taxpayer to le ss than zero (0).
D. To the extent not used, the credit s authorized by this
section may be carried over, in order, to each of the five (5)
subsequent tax years.
E. The Health Care Workforce Training Commission shall award
the credit authorized by subse ction B of this section to faculty
preceptors for precepto rship rotations of:
1. Medical students enrolled in a medical school in this state;
2. Residents who are allopathic physicians pursuing
postgraduate medical education at a program supported by a medical
school in this state;
3. Physician assistant stude nts;
4. Medical students enrolled in a school or college of
osteopathic medicine in this state;
5. Residents who are osteopathic physicians pursuing
postgraduate medical education at a progra m supported by a school or
college of osteopathic medicine in t his state; and
6. Advanced practice registered nursing students.
F. 1. The credits awarded by the Health Care Workforce
Training Commission under paragraphs 1 and 2 of subsection E of this
section for the tax year shall not exceed the amount deposited to
the Physician Preceptor Tax Credit Revolving Fund created in Section
2 of this act during the fiscal year ending on the June 30 date
immediately preceding the date upon which the applicable in come tax
year begins.
2. The credits awarded by the Health Care Workforce Training
Commission under paragraph 3 of subsection E of this section for the
tax year shall not exceed the amount deposited to the Physician
Assistant Preceptor Tax Credit Revolvi ng Fund created in Section 3
of this act during the fiscal year en ding on the June 30 date
immediately preceding the date upon which the applicable income tax
year begins.
ENR. H. B. NO. 3351 Page 5
3. The credits awarded by the Health Care Workforce Training
Commission under para graphs 4 and 5 of subsection E of this section
for the tax year sha ll not exceed the amount deposited to the
Osteopathic Physician Preceptor Tax Credit Revolving Fund created in
Section 4 of this act during the preceding fiscal year ending on the
June 30 date immediately preceding the dat e upon which the
applicable income tax year begins.
4. The credits awarded by the Health Care Workforce Training
Commission under paragraph 6 of subsection E of this section for the
tax year shall not exceed the amount de posited to the Advanced
Practice Registered Nurses Preceptor Tax Cre dit Revolving Fund
created in Section 5 of this act during the preceding fiscal year
ending on the June 30 date immediately preceding the date upon which
the applicable income tax year beg ins.
G. Partial claims for cred it may be awarded. Credits earned
but not allowed due to the application of the limitation provided in
this section shall be considered suspended and authorized to be used
in the subsequent tax year and applied to the next tax year’s
limitation.
H. In order to receive the credit provided p ursuant to this
section, a faculty preceptor shall:
1. Claim the credit for the tax year in which the preceptorship
rotation was completed;
2. Certify that he or she did not receive payment during the
tax year from any source for providing the training; and
3. Supply supporting documentation as may be required by the
Health Care Workforce Training Commission.
I. 1. The State Board of Medical Licensure and Supervision
shall reserve Seven Dollars ($7.00) of every annual licensure fee
received from allopa thic physicians and shall deposit the sum to the
Physician Preceptor Tax Credit Revolving Fund created in Section 2
of this act for the purpose of providing funding for the credit
authorized by this section.
2. The State Board of Medical Licensure and Sup ervision shall
reserve Four Dollars ($4.00) of every annual licensure fee received
from physician assistants and shall deposit the sum to the Physician
Assistant Preceptor Tax Credi t Revolving Fund created in Secti on 3 ENR. H. B. NO. 3351 Page 6
of this act for the purpose of provid ing funding for the credit
authorized by this section.
3. The State Board of Osteopathic Examiners shall reserve Seven
Dollars ($7.00) of every annual licensure fee received from
osteopathic physicians and shall deposit the sum to the Osteopathic
Physician Preceptor Tax Credit Revolving Fund created in Section 4
of this act for the purpose of providing funding for the credit
authorized by this section.
4. The Oklahoma Board of Nu rsing shall reserve Four Dollars
($4.00) of every annual licensure fee receiv ed from Advanced
Practice Registered Nurses and shall deposit the sum to the Advanced
Practice Registered Nurses Preceptor Tax Credit Revolving Fund
created in Section 5 of this a ct for the purpose of providing
funding for the credit authorized by this sec tion.
J. 1. With respect to each tax year for which any tax credit
authorized by this section is awarded, the Health Care Workforce
Training Commission shall electronically sub mit information to the
Oklahoma Tax Commission, which shall include the number and amount
of tax credits awarded and the name of the taxpayers that were
awarded credits.
2. With respect to each fiscal year the State Board of Medical
Licensure and Supervi sion, the State Board of Osteopat hic Examiners,
and the Oklahoma Board of Nursi ng shall electronically submit to the
Health Care Workforce Training Commission and the Oklahoma Tax
Commission the amount deposited in the Physician Preceptor Tax
Credit Revolving Fund created in Section 2 of this act, the
Physician Assistant Preceptor Ta x Credit Revolving Fund created in
Section 3 of this act, the Osteopathic Physician Preceptor Tax
Credit Revolving Fund created in Section 4 of this act, and the
Advanced Practice Registered Nurses Preceptor Ta x Credit Revolving
Fund created in Section 5 o f this act.
K. The Oklahoma Tax Commission, the Health Care Workforce
Training Commission, the State Board of Medical Licensure and
Supervision, the State Board of Osteopathic Examiners, and the
Oklahoma Board of Nursing may promulgate rules to effectuate the
provisions of this act.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 495i of Title 59, unless there
is created a duplication in numbe ring, reads as follows: ENR. H. B. NO. 3351 Page 7
There is hereby created in the State Treasury a revolving fund
for the State Board of Medical Licensure and Supervision to be
designated the “Physician Preceptor Tax Credit Revolving Fund ”. The
fund shall be a continuing fund, not subject to fiscal year
limitations, and shall co nsist of the monies received by the Board
from a portion of licensure fees received from allopathic physicians
under subsection I of Section 1 of this act. All monies accrui ng to
the credit of the fund are hereby appropriated and the fund shall be
used to make a transfer payment to the Oklahoma Tax Commission in an
amount equal to the amount of tax credits awarded pursuant to this
act. The Oklahoma Tax Commission shall appor tion monies transferred
from the fund in the same manner as provided by Section 23 52 of
Title 68 of the Oklahoma Statutes. Monies in the fund which are not
required for payment of administrative expenses to the Health Care
Workforce Training Commission, w hich shall not exceed five percen t
(5%) of monies apportioned to the fund, or whic h are not required to
be transferred to the Oklahoma Tax Commission as otherwise required
by this act to offset the revenue impacted by the use of the income
tax credits awarded pursuant to Section 1 of this act may be used to
implement programs required o r authorized by law.
SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 519.8a of Title 59, unless there
is created a duplication in numbering , reads as follows:
There is hereby created in the State Treasury a revolving fund
for the State Board of Medical Licensure and Supervision to be
designated the “Physician Assistant Preceptor Tax Credit Revolving
Fund”. The fund shall be a continuing fun d, not subject to fiscal
year limitations, and shal l consist of the monies received by the
Board from a portion of licensure fees received from physician
assistants under subsection I of Section 1 of this act. All monies
accruing to the credit of the fund are hereby appropriated and the
fund shall be used to make a transfer payment to the Oklahoma Tax
Commission in an amount equal to the amount of tax credits awarded
pursuant to this act. The Oklahoma Tax Commission shall apportion
monies transferred from the fund in the same manner as provided by
Section 2352 of Title 68 of the Oklahoma Statutes. Monies in the
fund which are not required for payment of administrative expenses
to the Health Care Workforce Training Commissi on, which shall not
exceed five percent (5%) of monies apportioned to the fund, or w hich
are not required to be transferred to the Oklahoma Tax Commission as
otherwise required by this act to offset the revenue impacted by the ENR. H. B. NO. 3351 Page 8
use of the income tax credits awarded pursuant to Section 1 of this
act may be used to implement programs require d or authorized by law.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 645.1 of Title 59, unless there
is created a duplication in numbe ring, reads as follows:
There is hereby created in t he State Treasury a revolving fund
for the State Board of Osteopathic Examiners to be designated the
“Osteopathic Physician Preceptor Tax Credit Revolving Fund ”. The
fund shall be a continuing fund, not subject to fiscal year
limitations, and shall consis t of the monies received by the Board
from a portion of licensure fees received from osteopathic
physicians under subsection I of Section 1 of this act. All monies
accruing to the credit of the fund are hereby appropriated and the
fund shall be used to ma ke a transfer payment to the Oklahoma Tax
Commission in an amount equal to the amount of tax credits awarded
pursuant to this act. The Oklahoma Tax Commission shall appo rtion
monies transferred from the fund in the same manner as provided by
Section 2352 of Title 68 of the Oklahoma Statutes. Monies in the
fund which are not required for payment of administrative expenses
to the Health Care Workforce Training Commission, which shall not
exceed five percent (5%) of monies apportioned to the fund, or which
are not required to be transferred to the Oklahoma Tax Commission as
otherwise required by this act to offset the revenue impacted by the
use of the income tax credits awa rded pursuant to Section 1 of thi s
act may be used to implement programs required or a uthorized by law.
SECTION 5. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 567.31 of Title 59, unless there
is created a duplication in numberin g, reads as follows:
There is hereby created in the St ate Treasury a revolving fund
for the Oklahoma Board of Nursing to be designated the “Advanced
Practice Registered Nurses Preceptor Tax Credit Revolving Fund ”.
The fund shall be a continuing fund, not subject to fiscal year
limitations, and shall consist of the monies received by the Board
from a portion of licensure fees received from Advanced Practice
Registered Nurses under subsection I of Section 1 of this act. All
monies accruing to the credit of the fund are hereby appropriated
and the fund shall be used to make a transfer payment to the
Oklahoma Tax Commission in an amount equal to the amount of tax
credits awarded pursuant to this act. The Oklahoma Tax Commissi on
shall apportion monies transfe rred from the fund in the same manner
as provided by Section 2352 of Title 68 of the Oklahoma Statutes. ENR. H. B. NO. 3351 Page 9
Monies in the fund which are not required for payment of
administrative expenses to the Health Care Workforce Training
Commission, which shall not exce ed five percent (5%) of monies
apportioned to the fund, or which are not required to be transferred
to the Oklahoma Tax Commission as otherwise required by this act to
offset the revenue impacted by the use of the income ta x credits
awarded pursuant to Sec tion 1 of this act may be used to implement
programs required or authorized by law.
SECTION 6. AMENDATORY 70 O.S. 2021, Section 697.5, as
amended by Section 19, Chapter 407, O.S.L. 2022 (70 O.S. S upp. 2023,
Section 697.5), is ame nded to read as follows:
Section 697.5 The Health Care Workforce Training Commission, in
order to perform its official function in establishing and
administering physician training programs, shall have the following
specific powers, duties, and responsibilities:
1. To review all available data on health care workforce in
Oklahoma in order to determine the current and projected
distribution of physicians by geographic location and by type of
practice, and, to accomplish this review, the Commission shall
obtain information from and work in conjunction with the State
Department of Health and all other agencies which gather data and
evaluate health care workforce needs;
2. To review data and information on accredited physi cian
internship and residency prog rams currently operated by Oklahoma
hospitals and other ap proved clinical situations, in order to
ascertain the number and distribution by physician specialty
training and by geographic location of available internship and
residency positions and to evalua te the impact of internship and
residency placement on the establishment of practices by physicians
in that geographic area or similar areas within the state where
their services are urgently needed;
3. To serve as an ag ent to advise hospitals, clinics, and
communities on setting up and planning internship and r esidency
programs which emphasize the provision of additional primary care
physicians to service the rural areas of Oklahoma with primary care
specialties to be de fined to include training in the a rea of
internal medicine, obstetrics and gynecology, pediat rics, emergency
trauma, and family practice;
ENR. H. B. NO. 3351 Page 10
4. To provide general counsel and advice in the development,
operation and evaluation of physician internship and re sidency
programs throughout the State of Oklahoma this state in cooperation
with the efforts of the Oklahoma State Regents for Higher Education
and the state’s physician training institutions such as the Oklahoma
University University of Oklahoma College of Medicine, Oklahoma City
and Tulsa campuses, and the Oklahoma State University College of
Osteopathic Medicine and Surgery, and subject to accreditation by
official and appropriate accrediting agencies;
5. To develop the criteria for determining the phy sician
training cost component or associated clinical and hospital training
costs which are or may be nonreimbursable by third -party payers in
programs proposed by accredited hospitals, clinical situations, or
hospital and clinical programs affiliated with and administered by
the University of Oklahoma College of Medicine, University of
Oklahoma College of Medicine – Tulsa, or Oklahoma State University
College of Osteopathic Medicine and Surgery in order to determine
the share for the state in supporting th e salary, benefits, training
and program administration costs incurred by hospitals in supporti ng
of the interns and residents;
6. To develop the criteria and procedure by which state
matching funds will be awarded to hospitals, accredited clinical
situations, in cooperation with the Uni versity of Oklahoma College
of Medicine, University of Oklahom a College of Medicine - Tulsa, and
the Oklahoma State University College of Osteopathic Medicine and
Surgery which shall administer programs in hospital and cli nical
situations in the state to b e used to underwrite the salaries,
benefits and associated tra ining and administration costs provided
for the physician interns and residents during their period of
training in such a way as to create an incentive for the development
and establishment of r esidency and internship positions by
hospitals, clinical estab lishments or by affiliation agreement with
the University of Oklahoma College of Medicine, University of
Oklahoma College of Medicine – Tulsa, and the Oklahoma State
University College of Osteopathic Medicine and Surgery by providing
funds to cover and to supplement the nonreimbursable or additional
costs incurred in hospitals for training activities or for delivery
of service in outreach and ambulatory clinical situations which are
outside but associated with the hospitals and clinical
establishments parti cipating in the program;
7. To review and to approve for inclusion in the programs
funded the applications for funds submitted by accredited hospitals ENR. H. B. NO. 3351 Page 11
and clinical situations participating in physician training programs
in cooperation with the University of Oklahoma College of Medicine,
University of Oklahoma College of Medicine – Tulsa, and the Oklahoma
State University College of Osteopathic Medicine and Surgery for the
costs of supplying res idents and interns in programs which they
administer by affilia tion agreements with hospitals and clinical
situations throughout the state in which the interns and residents
are supervised and funded by the University of O klahoma College of
Medicine, University of Oklahoma College of Medicine – Tulsa, and
the Oklahoma State University College of Osteopathic Medicine and
Surgery and the hospitals and clinical establishments pay for the
patient care services rendered in their institutions by these
residents and interns during the period of training;
8. To determine the specific level of funding and the
priorities used for granting state support to approved hospitals and
clinical situations, in cooperation with the University of Oklahoma
College of Medicine, University of Oklahoma College of Medicine –
Tulsa, and the Oklahoma State University College of Osteopathic
Medicine and Surgery for approved hospital physician training
programs for interns and residents and to recommend to the Governor
and the Oklahoma Legislature the total funds needed to carry out the
purpose of this program;
9. To employ a director and any staff personnel required to
administer the funding of approved physician training programs and
to contract with other state agencies and institut ions to conduct
and to perform specified services, functions and aspects in
administering state funds on the specified cost -sharing basis
determined by the Commission or for developing programs and
community and institutio nal participation in these trainin g
programs;
10. To ensure that hospitals or clinical situations that can
qualify in all sections of Oklahoma be utilized, and to take all
steps necessary to assist such hospitals or clinics in obtaining
necessary recognition or status, or in meeting stan dards for
accreditation or affiliation so that they may participat e in these
physician training programs;
11. To ensure that in programs administered and operated by the
University of Oklahoma College of Medicine, Univer sity of Oklahoma
College of Medicine – Tulsa, and the Oklahoma State University
College of Osteopathi c Medicine and Surgery in hospitals and
clinical situations throughout the state that funds allocated to the ENR. H. B. NO. 3351 Page 12
colleges are paid by the hospitals and clinica l situations in which
the patient care services are rendered, the funds are expended for
such purposes in funding residents and interns in the physician
training programs that the colleges have established with the
approved hospitals and clinical situation s which programs are
designed to provide primary health care services to the rural and
medically underserved parts of the state;
12. To conduct and to administer a program of physician and
health care workforce placement services throughout the State of
Oklahoma this state. Placement services shall be made available to
communities, hospitals, health car e facilities, physician and health
professional training institutions, health professional associations
and organizations, individual physicians, health p rofessionals,
students in physicia n and health professional training institutions
and schools, and oth er interested parties in such a way so as to
further the purposes of improving the distribution of physicians and
health professionals practicing or avail able for practice in the
state and improving in the availability of health care services to
the people of the state. Said The placement service shall include
but not be limited to assisting communities in matching with,
contacting and recruiting physician s and health professionals to
practice in communities in the state. The Commission shall develop
criteria and procedures for the conduct and performance of placement
services and employ any staff, contract for services with any
private agency, nonprofit c orporation, or institution to faci litate
the performance of placement services ; and
13. For purposes of the income tax credit authorized pursuant
to Section 1 of this act and in cooperation with the Oklahoma Tax
Commission:
a. to certify preceptorship r otations for allopathic
medicine, osteopathic medicine, advanced practice
registered nursing, and physic ian assistant training
programs in this state and to register faculty
preceptors who provide certified training,
b. to charge administrative expenses t o the State Board
of Medical Licensure and Supervision, the State Board
of Osteopathic Examiners, and the Oklahoma Board of
Nursing pursuant to Sections 2 through 5 of this act,
and
ENR. H. B. NO. 3351 Page 13
c. to promulgate any additional rules necessary for the
implementation of this act.
SECTION 7. It being immediately necessary for the preservation
of the public peace, health or safety, an emergency is hereby
declared to exist, by reason whereof this act shall take effect and
be in full force from and after it s passage and approval.
ENR. H. B. NO. 3351 Page 14
Passed the House of Representatives the 13th day of May, 2024.
Presiding Officer of the House
of Representatives
Passed the Senate the 23rd day of April, 2024.
Presiding Officer of the Senat e
OFFICE OF THE GOVERNO R
Received by the Office of the Go vernor this ____________________
day of ___________________, 20_______, at _______ o'clock _______ M.
By: _________________________________
Approved by the Governor of the State of Oklahoma this _____ ____
day of ___________________, 20_______, at _______ o 'clock _______ M.
_________________________________
Governor of the State of Oklahoma
OFFICE OF THE SECRETARY OF STATE
Received by the Office of the Secretary of State this __________
day of ___________________, 20___ ____, at _______ o'clock _______ M .
By: _________________________________