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STATE OF OKLAHOMA
1st Session of the 59th Legislature (2023)
SENATE BILL 573 By: Standridge
AS INTRODUCED
An Act relating to controlled dangerous s ubstances;
defining terms; requiring pain management clinics to
register with the Oklahoma State Bureau of Narcotics
and Dangerous Drugs Control ; providing exemptions;
stipulating registration procedures; requiring
clinics to designate owner or administrat or
responsible for certain compliance ; directing denial
of registration for specified reason s; limiting
period of suspension; requiri ng new registration
application if clinic changes ownership; specifying
responsibilities of licensed prescriber and
designated administrator ; providing facility and
physical operations requirements; stipulating certain
infection control requirements; providing certain
quality assurance requirements; stipulating certain
data collection and reporting requirements; requiring
establishment of certain written policy; dire cting
certain investigation by Bureau; providing penalties;
directing promulgation of rules; providing for
codification; and providing an effective date .
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 2 -1111 of Title 63, unless there
is created a duplication in numbering, reads as follows:
As used in this act:
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1. “Chronic nonmalignant pain” means pain unrelated to cancer
which persists beyond the usual course of disease or t he injury that
is the cause of the pain or more than ninety (90) calendar days
after surgery;
2. “Licensed prescriber” means a prescriber as defined in
Section 353.1 of Title 59 of the Oklahoma Statutes other than a
veterinarian, who has the authority to prescribe any controlled
dangerous substance under Section 2 -312 of Title 63 of the Oklahoma
Statutes; and
3. “Pain management clinic” or “clinic” means any publicly or
privately owned facility:
a. that engages in significant paid advertising in any
medium for any type of pain management services, and
b. where in any month over sixty percent (60%) of
patients who are not being seen for hospice or
palliative care are prescribed opioids,
benzodiazepines, bar biturates, or carisoprodol for the
treatment of chronic nonmalignant pain.
SECTION 2. NEW LAW A ne w section of law to be codified
in the Oklahoma Statutes as Section 2-1112 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. Each pain management cl inic shall register with the Oklahoma
State Bureau of Narcotics and Dangerous Drugs Control unless:
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1. The clinic is affiliated wi th an accredited medical school
at which training is provided for medical students, residents, or
fellows;
2. The clinic does not prescribe controlled dangerous
substances for the treatment of pain;
3. The clinic primarily treats hospice or palliative ca re
patients; or
4. A majority of the patients treated by the clinic are t reated
for acute pain.
B. Each clinic location shall be registered separately
regardless of whether the clinic is operated under the same business
name or management as another cl inic and each clinic location shall
be a permanent, fixed, physical address of operation.
C. As a part of registration, a clin ic shall designate an owner
or administrator who is responsible for ensuring compliance with all
requirements related to registrati on and operation of the clinic
under this act. Within ten (10) calendar d ays after termination of
a designated administrator, the clinic shall notify the Bureau of
the identity of another designated administrator for that clinic.
Failing to have a designated administrator at the location of the
registered clinic may be the bas is for a summary suspension of the
clinic registration certificate as described in this section.
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D. The Bureau shall deny registration to any pain management
clinic owned by or with any contractual or employment relationship
with a licensed prescriber:
1. Whose Drug Enforcement Administration number has ever been
revoked;
2. Whose application for a license to prescribe, dispense , or
administer a controlled substance has been denied for disciplinary
action by the appropriate licensing board; or
3. Who has been convicted of or pleaded guilty or nolo
contendere to, regardless of adjudication, an offense that
constitutes a felony for receipt of illicit or diverted drugs
including a controlled substance listed in Sc hedule I, II, III, IV,
or V of the Uniform Controlled Dangerous Substances Act, in this
state, any other state, or the United States.
E. If the Bureau finds that a pain management clinic is owned,
directly or indirectly, by a person meeting any criteria listed in
subsection D of this section, the Bureau shall revoke the
certificate of registration previously issued by the Bureau. As
determined by rule, the Bureau may grant an exemption to denying a
registration or revoking a previously issued registration if more
than five (5) years have elapsed since adjudication. As used in
this section, the term “convicted” includes an adjudication of guilt
following a plea of guilty or nolo contendere or the forfeiture of a
bond when charged with a crime.
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F. If the registration of a pain man agement clinic is revoked
or suspended, the designated administrator of the pain management
clinic, the owner or lessor of the pain management clinic property,
the manager, and the proprietor shall cea se to operate the facility
as a pain management clinic as of the effective date of the
suspension or revocation.
G. If a pain management clinic registration is revoked or
suspended, the designated administrator of the pain management
clinic, the owner or lessor of the clinic property, the manager , or
the proprietor is responsible for removing all signs and symbols
identifying the premises as a pain management clinic.
H. If the clinic’s registration is revoked, any person named in
the registration document s of the pain management clinic including
persons owning or oper ating the pain management clinic shall not, as
an individual or as a part of a group, apply to operate a pain
management clinic for one (1) year after the date the registration
is revoked.
I. The period of suspension for the registration of a pain
management clinic shall be prescribed by the Bureau but shall not
exceed one (1) year.
J. A change of ownership of a registered pain management clinic
shall require submission of a new registration application.
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SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2-1113 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. A licensed prescriber shall not be employed or contracted by
or otherwise practice i n a pain management clinic if the clinic is
not licensed by the Oklahoma State Bureau of Narcotics and Dangerous
Drugs Control under this act and registered with the Bureau under
Section 2-301 et seq. of Title 63 of the Oklahoma Statutes. A
licensed prescriber who qualifies to practice in a pain management
clinic pursuant to rul es adopted by the appropriate licensing board
may continue to practice in a pain management clinic as long as the
licensed prescriber continues to meet the qualifications prescribed
in the rules. A licensed prescriber who violates this subsection is
subject to disciplinary action by the appropriate licensing board.
B. Only a licensed prescriber licensed in this state and
authorized to prescribe controlled dangerous substances under
Section 2-312 of Title 63 of the Oklahoma Statutes may prescribe a
controlled dangerous substance on the premises of a reg istered pain
management clinic and only to the extent allowed by Section 2-312 of
Title 63 of the Oklahoma Statutes . No person shall dispense any
controlled dangerous substance on the premises of a pain m anagement
clinic. The provisions of this subsection shall not be construed to
expand or otherwise modify the prescriptive authority of any
licensed prescriber.
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C. A licensed prescriber shall perform a phys ical examination
of a patient on the same day that t he licensed prescriber prescribes
a controlled substance to a patient at a pain management clin ic.
D. A licensed prescriber authorized to prescribe controlled
dangerous substances who practices at a pain management clinic is
responsible for maintaining the control and security of his or her
prescription blanks and an y other method used for prescribing
controlled dangerous substance pain medication. The licensed
prescriber shall notify, in writing, the Bureau within twenty-four
(24) hours following any theft or loss of a prescription bl ank or
breach of any other method for prescribing pain medication. The
provisions of this subsection shall not be construed to exempt a
licensed prescriber from any electronic prescription requirements
stipulated in Section 2-309 of Title 63 of the Oklahoma Statutes.
E. The designated administrator of a pain management clinic
shall notify the Bureau in writing of the date of termination of
employment within ten (10) calendar days after terminating his or
her employment with a pain management clinic that is required to be
registered pursuant to this act .
F. The owners of a pain management clinic are jointly
responsible for ensuring compliance with the following faci lity and
physical operations requirements:
1. A pain management clinic shall be located and operated at a
publicly accessible fixed location and shall:
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a. display a sign that can be viewed b y the public that
contains the clinic name, hours of operation , and a
street address,
b. have a publicly listed telephone number and a
dedicated phone number to send and receive facsimiles,
c. have a reception and waiting area,
d. provide a restroom,
e. have private patient examination rooms,
f. have treatment rooms, i f treatment is being provided
to the patients, and
g. display a printed sign located in a conspicuous place
in the waiting room viewable by the public with the
name and contact information of the clinic’s
designated administrator and the names of all licensed
prescribers practicing in the clinic; and
2. This section does not excuse a licensed prescriber from
providing any treatment or performing any medical duty without the
proper equipment and materials as required by the standard of care.
This section does not supersede the level of care, skill, or
treatment recognized in general law related to health care
licensure.
G. Each owner or designated administrator of a pain management
clinic is responsible for ensuring compliance with infection
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prevention and control requirements stipulated by the Occupational
Safety and Health Administration.
H. The designated administrator shall establish a quality
assurance program that includes the identification, investigation,
and analysis of the frequency and causes of adverse incidents to
patients. The designated administrator is responsible for ensuring
compliance with the quality assurance requirements.
I. The designated administrator is responsible for ensuring
compliance with the following d ata collection and reporting
requirements:
1. The designated administrator for each pain management clinic
shall report all significant adverse incidents to the Bureau; and
2. The designated administrator shall also report to the
Bureau, in writing, on a quarterly basis the following data:
a. the number of new and repeat patients seen a nd treated
at the clinic who are p rescribed controlled dangerous
substance medications for the treatment of chro nic,
nonmalignant pain,
b. the number of patients diagnosed with substance use
disorder,
c. the number of patients discharged due to drug
diversion, and
d. the number of patients treated at the clinic whose
domicile is located somewhere other than in this
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state. A patient’s domicile is the patient’s fixed or
permanent home to which he or she intends to return
even though he or she may temporarily reside
elsewhere.
J. The data and reports specified in subsection I of this
section shall be accessible to each appropriate licensing board.
K. Each pain management clin ic shall establish a written po licy
and administrative process for transferring care of patients
diagnosed with a substance use disorder where appropriate for their
continued treatment. Each appropriate licensing board shall issue
guidance on best practices to ensure appropriate referr al and
treatment of patients with a substance use disorder.
L. Upon referral by the ap propriate licensing board, the Bureau
shall investigate suspected instances of drug diversion involving a
pain management clinic. Nothing in this act shall be construed to
restrict the appropriate licensing board from con ducting its own
investigation into instances of suspected drug diversion.
SECTION 4. NEW LAW A new sectio n of law to be codified
in the Oklahoma Statutes as Section 2-1114 of Title 63, unless there
is created a duplication in number ing, reads as follows:
A. The Oklahoma State Bureau of Narcotics and Dangerous Drugs
Control may impose an administrative fine on a clinic of up to One
Thousand Dollars ($1,000.00) per violation for vio lating the
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requirements of this act or the rules promulgated by the Bureau to
enforce this act.
B. Each day a violation continues after the date fixed for
termination of the violati on as ordered by the Bureau constitutes an
additional, separate, and distinct violation.
C. The Bureau may impose a fine and, in the case of an owner -
operated pain management clinic, revoke or deny a pain management
clinic’s registration if the clinic’s owner or designated
administrator knowingly and intentionally misrepresents actions
taken to correct a violation.
D. An owner or designated administrator of a pain management
clinic who concurren tly operates an unregistered pain management
clinic is subject to an administrative fine of One Thousand Dollars
($1,000.00) per day.
E. If the owner of a pain management clinic that requires
registration fails to apply t o register the clinic upon a chan ge of
ownership and operates the clinic under the new ownershi p, the owner
is subject to a fine of One Thousand Dollars ($1,000.00).
SECTION 5. NEW LAW A n ew section of law to be codified
in the Oklahoma Statutes as Section 2 -1115 of Title 63, unless there
is created a duplication in numbering , reads as follows:
The Oklahoma State Bureau of Narcotics and Dangerous Drugs
Control and all appropriate licensing boards shall promulgate such
rules as are necessary to implement the pr ovisions of this act.
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SECTION 6. This act shall become effective November 1, 2023.
59-1-1437 DC 1/17/2023 6:12:47 PM