Req. No. 1706 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 1st Session of the 59th Legislature (2023) COMMITTEE SUBSTITUTE FOR SENATE BILL 834 By: Daniels COMMITTEE SUBSTITUTE An Act relating to abortion; amending 21 O.S. 2021, Section 861, which relates to crimes and punishments; adding and modifying circumstances under which certain acts are not criminal offenses; listing additional acts that are not cri minal offenses; requiring certain reporting of abortion; defining terms; amending 59 O.S. 2021, Section s 509 and 637, which relate to unprofessional conduct by physicians ; modifying and adding certain exceptions; requiring certain reporting of abortion; defining terms; amending 63 O.S. 2021, Section 1 -731.3, which relates to abortion; modifying and adding certain exceptions; requiring certain reporting of abortion; defining terms; amending Section 1, Chapter 11, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-731.4), which relates to abortion; adding and modifying definitions; clarifying applicability of certain provisi on; adding and modifying exceptions to certain prohibition; removing duplicative language; requiring certain reporting of abortion; amending 63 O.S. 2021, Section 1-732, which relates to abortion; modifying and adding certain exceptions; removing duplicative language; modifying applicability of certain provisions; making language gender neutral; requiring certain reporting of abortion; defining terms; amending 63 O.S. 2021, Section 1 -745.2, which relates to definitions used in the Pain-Capable Unborn Child Protection Act; modifying definitions; amending 63 O.S. 2021, Section 1 -745.4, which relates to a bortion requirements; modifying applicability of certain provision; modifying and adding certain exceptions; requiring certain reporting of abortion; amending 63 O.S. 2021, Section 1-745.5, which relates to Req. No. 1706 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 abortion; modifying applicability of certain provision; amending Section 2, Chapter 190, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-745.32), which relates to definitions used in the Oklahoma Heartbeat Act; updating statutory reference; defining terms; amending Section 3, Chapter 190, O.S.L. 2022 (63 O .S. Supp. 2022, Section 1-745.33), which relates to determining presence of fetal heartbeat; clarifying applicability of certain provisi on; adding and updating statutory refer ences; amending Section 4, Chapter 190, O.S.L. 202 2 (63 O.S. Supp. 2022, Section 1-745.34), which relates to abortion prohibition if heartbeat detected; clarifying applicability of certain provision; adding and updating statutory references; amending Section 5, Chapter 190, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-745.35), which relates to medical emergency; modifying exception; updating statutory references; adding certain exception; requiring certain reporting of abortion; amending Section 1, Chapter 321, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-745.51), which relates to definitions; adding and modifying definitions; amending Section 2, Chapter 3 21, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-745.52), which relates to abortion prohibition; clarifying applicability of certain provision; modifying exceptions; updating statutory references; requiring certain reporting of abortion; requiring abortion performed under certain exceptions to be reported to State Department of Health on certain form; restricting type of information requested; requiring abortion provider to state proper exception and include other required information; requiring Department to compile reported information into annual statistical report ; directing certain publication and submission of report; requiring promulgati on of certain rules; repealing 63 O.S. 2021, Sections 1-733 and 1-745.6, which relate to abortion; updating statutory language; providing for codification; and declaring an emergency. BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: SECTION 1. AMENDATORY 21 O.S. 2021, Section 861, is amended to read as follows: Req. No. 1706 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Section 861. A. Every person who administers to any woman, or who prescribes for any woman, or advises or procures an y woman to take any medicine, drug or substance, or uses or employs any instrument, or other means wh atever, with intent thereby to procure the miscarriage of such woman an abortion, unless the same: 1. The abortion is necessary to preserve her life due to a medical emergency as defined in subsection D of this section; or 2. The pregnancy is the result of: a. rape or sexual assault that has been reported to law enforcement, or b. incest of a minor that has been reported to law enforcement, shall be guilty of a fe lony punishable by impriso nment in the State Penitentiary for not less than two (2) years nor more than five (5) years. B. 1. The use, prescription, administration, procuring, or selling of any type of contraception shall not be a violation of subsection A of this section if the contraception is administered before the time when a pregnancy coul d be determined through conventional medical testing . 2. An act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider acting Req. No. 1706 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 lawfully and within the scope of his or her practice shall not be a violation of subsection A of this section. 3. An act is not a violation of subsection A of this section if performed with the purpose to: a. save the life or preserve the health of the unborn child, b. remove a dead unborn child whose death was caused by miscarriage or spontaneous abortion, or c. remove an ectopic pregnancy. C. Any abortion performed or induced under an exception provided by subsection A of this section or performed or induced to remove an ectopic pregnancy shall be reported by the abortion provider to the State Department of Health in accordance with Section 18 of this act. D. As used in this section: 1. “Medical emergency” means a condition that, in reasonable medical judgment: a. cannot be remedied by delivery of the child , and b. so complicates the medical c ondition of the preg nant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irrever sible physical impairment of a major b odily function, not including psychological or emotional c onditions. A Req. No. 1706 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 condition is not a medical e mergency if it is based o n a claim, diagnosis, or determination that the woman may engage in conduct which she intends to result in her death or in the subs tantial and irreversible physical impairment of a major bo dily function; and 2. “Reasonable medical judgment ” means a medical judgment that would be made by a reasonably prud ent physician who is knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved . SECTION 2. AMENDATORY 59 O.S. 2021, Section 509, is amended to read as follows: Section 509. The words “unprofessional conduct” as used in Sections 481 through 518.1 of this title are hereby declared to include, but shall not be limited to, the following: 1. Procuring, aiding or abetting a criminal operation; 2. The obtaining of any fee or offering to accept any fee, present or other form of remuneration whatsoever, on the assurance or promise that a manifestly incurable disease can or will be cured; 3. Willfully betraying a professional secret to the detriment of the patient; 4. Habitual intemperance or the habitual use of habit-forming drugs; Req. No. 1706 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 5. Conviction or confession of, or plea of guilty, nolo contendere, no contest or Alford plea to a felony or any offense involving moral turpitude; 6. All advertising of medical business in which statements are made which are grossly untrue or impro bable and calculated to mislead the public; 7. Conviction or confession of, or plea of guilty, nolo contendere, no contest or Alford plea to a crime involving v iolation of: a. the antinarcotic or prohibition laws and regul ations of the federal government, b. the laws of this state, c. State Commissioner of Health rules, or d. a determination by a judge or jury; 8. Dishonorable or immoral conduct which is likely to deceive, defraud, or harm the public; 9. The commission of any act which is a violation of the criminal laws of any state when such act is connected with the physician’s practice of medicine. A complaint, indictment or confession of a criminal violati on shall not be necessary for the enforcement of this provisio n. Proof of the commission of th e act while in the practice of medicine or under the guise of the practice of medicine shall be unprofessional conduct; Req. No. 1706 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 10. Failure to keep complete and accurat e records of purchase and disposal of controlled drugs or of n arcotic drugs; 11. The writing of false or fictitious prescriptions for any drugs or narcotics declared by the laws of this state to be controlled or narcotic drugs; 12. Prescribing or adminis tering a drug or treatment without sufficient examination and the establishment of a valid phys ician- patient relationship and not prescribing in a safe, medically accepted manner; 13. The violation, or attempted violation, direct or indirect, of any of the provisions of the Oklahoma Allopathic Medical and Surgical Licensure and Supervision Act, eit her as a principal, accessory or accomplice; 14. Aiding or abetting, directly or indirectly, the practice of medicine by any person not duly authorized under th e laws of this state; 15. The inability to practice medicine with reasonable skill and safety to patients by reason of age, illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material or as a result of any mental or p hysical condition. In enforcing this section the State Board of Medical Licensure and Supervision may, upon probable cause, request a physician to submit to a mental or physical examination by physicians designated by it. If the physician refuses to subm it to the examination, the Board Req. No. 1706 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 shall issue an order requirin g the physician to show cause why the physician will not submit to the examination and shall schedule a hearing on the order within thirty (30) days after notice is served on the physician, excl usive of the day of service. The physician shall be notified by either personal service or by certified mail with return receipt requested. At the hearing, the physician and the physician’s attorney are entitled to present any testimony and other evidence to show why the physician should not be required to submit to the examination. After a compl ete hearing, the Board shall issue an order either requiring the physician to submit to the examination or withdrawing the request for examination. The medical license of a physician ordered to submit for examination may b e suspended until the results of the examination are received and reviewed by the Board; 16. a. Prescribing, dispensing or administering of controlled substances or narcotic drugs in excess of t he amount considered good medical practice, b. Prescribing, dispensing or administering control led substances or narcotic drugs without medical need in accordance with pertinent licensing board standards, or c. Prescribing, dispensing or administering opio id drugs in excess of the maximum limits authorized in Section 2-309I of Title 63 of the Oklaho ma Statutes; Req. No. 1706 Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 17. Engaging in physical conduct with a patient which is sexual in nature, or in any verbal behavior which is seductive or sexually demeaning to a patient; 18. Failure to maintain an office record for each pa tient which accurately reflects t he evaluation, treatment, and medical necessity of treatment of the patient; 19. Failure to provide necessary ongoing medical treatment when a doctor-patient relationship has been established, which relationship can be sev ered by either party providing a reasonable period of time is granted; 20. a. Performance of an abortion as defined by Section 1 -730 of Title 63 of the Oklahoma Statutes, except for an abortion necessary to prevent the death of the mother or to prevent substantial or irreversible physi cal impairment of the mother that substantially increases the risk of death. The performance of an abortion on the basis of the mental or emotional health of the mother shall be a violation of this paragraph, notwithstanding a claim or diagnosis that the woman may engage in conduct which she intends to result in her death, unless: (1) the abortion is necessary due to a medical emergency as defined in subparagraph d of this paragraph, or Req. No. 1706 Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 (2) the pregnancy is the result of: (a) rape or sexual assault that ha s been reported to law enforcement, or (b) incest of a minor that has been reported to law enforcement. b. The Board shall impose a penalty as provided in Section 509.1 of this title on a licensee who violates this paragraph. The penalty shall include, bu t not be limited to, suspension of the license for a period of not less than one (1) year . c. Any abortion performed or induced under an exception provided by subparagraph a of this paragraph or performed or induced to remove an ectopic pregnancy shall be reported by the physician to the State Department of Health in accordance with Section 18 of this act. d. As used in this paragraph: (1) “abortion” means the act of using, prescribing, administering, procuring, or selling of any instrument, medicine, drug, or any other substance, device, or means with the purpose to terminate the pregnancy of a wom an, with knowledge that the termination by any of those means will with reasonable likelihood cause the Req. No. 1706 Page 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 death of an unborn child. It does not include the use, prescription, administration, procuring, or selling of any type of contraception if the contraception is administered before the time when a pregnancy could be determined through conventional medical testing . It does not include any act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider acting lawfully and within the scope of his or her practice. An act is not an abortion if the act is performed with the purpose to: (a) save the life or preserve the h ealth of the unborn child, (b) remove a dead unborn child whose death was caused by miscarriage or spontaneous abortion, or (c) remove an ectopic pregnancy, (2) “medical emergency” means a condition that, in reasonable medical judgment : (a) cannot be remedied by delivery of the child , and Req. No. 1706 Page 12 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 (b) so complicates the medical c ondition of the pregnant woman as to neces sitate the immediate abortion of her pregnancy to avert her death or for which a delay wi ll create serious risk of substantial and irreversible physical impairment of a major b odily function, not including psycholo gical or emotional conditions. A conditio n is not a medical emergency if it is based on a claim, diagnosis, or determination that the woman may engage in conduct which she intends to result in her death or in the subs tantial and irreversible physical impa irment of a major bodily function, and (3) “reasonable medical judgment ” means a medical judgment that would be made by a reasonably prudent physician who is knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved ; or 21. Failure to provide a p roper and safe medical facility setting and qualified assis tive personnel for a recognized medical act, including but not limited to an initial in -person patient examination, office surgery, diagnostic service or any other medical procedure or treatment. Adequate medical records to support Req. No. 1706 Page 13 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 diagnosis, procedure, t reatment or prescribed medications must be produced and maintained. SECTION 3. AMENDATORY 59 O.S. 2021, Section 637, is amended to read as follows: Section 637. A. The State Board of Osteopathic Examiners may refuse to admit a person to an examination or may refuse to issue or reinstate or may suspend or revoke any license issued or reinstated by the Board upon proof that the applicant or holder of such a license: 1. Has obtained a license, license renewal or authorization to sit for an examination, as the c ase may be, through fraud, deception, misrepresentation or bribery; or has been granted a license, license renewal or authorization to sit for an examination based upon a material mistake of fact; 2. Has engaged in the use or employment of dishonesty, fra ud, misrepresentation, fals e promise, false pretense, unethical conduct or unprofessional conduct, as may be determined by the Board, in the performance of the functio ns or duties of an osteopathic physician, including but not limited to the following: a. obtaining or attempting to obtain any fee, charge, tuition or other compensation by fraud, deception or misrepresentation; willfully and continually overcharging or overtreating patients; or charging for Req. No. 1706 Page 14 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 visits to the physicia n’s office which did not occur or for services which were not rendered, b. using intimidation, coercion or deception to obtain or retain a patient or discourage the use of a second opinion or consultation, c. willfully performing inappropriate or unnecessa ry treatment, diagnostic tests or osteopathic medical or surgical services, d. delegating professional responsibilities to a person who is not qualified by training, skill, competency, age, experience or licensure to perform them, noting that delegation may only occur within an appropr iate doctor-patient relationship, wherein a proper patient record is maintained including, but not limited to, at the minimum, a current history and physical, e. misrepresenting that any disease, ailment, or infirmity can be cured by a method, procedure, treatment, medicine or devic e, f. acting in a manner which results in final disciplinary action by any professional society or association or hospital or medical staff of such hospital in this or any other state, whether agreed to voluntarily or not, if the action was in any way rela ted to professional conduct, professional competence, malpractice or any Req. No. 1706 Page 15 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 other violation of the Oklahoma Osteopathic Medicine Act, g. signing a blank prescription form; or dispensing, prescribing, administering or otherwise distr ibuting any drug, controlled substance or other treatment without sufficient examination or the establishment of a physician-patient relationship, or for other than medically accepted therapeutic or experimental or investigational purpose duly authorized b y a state or federal agency, or not in good faith to relieve pain and suffering, or not to treat an ailment, physical infirmity or disease, or violating any state or federal law on controlled dangerous substances including, but not limited to, prescribing, dispensing or administering opioid drugs in excess of the maximum limits authorized in Section 2 -309I of Title 63 of the Oklahoma Statutes, h. engaging in any sexual activity within a physician - patient relationship, i. terminating the care of a patient wi thout adequate notice or without making other arrangements for the continued care of the patient, j. failing to furnish a copy of a patient ’s medical records upon a proper request from the patient or Req. No. 1706 Page 16 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 legal agent of the patient or another physician; or failing to comply with any othe r law relating to medical records, k. failing to comply with any subpoena issued by the Board, l. violating a probation agreement or order w ith this Board or any other agency, and m. failing to keep complete and accurate records of purchase and disposal of controlled drugs or narcotic drugs; 3. Has engaged in gross negligence, gross malpractice or gross incompetence; 4. Has engaged in repeat ed acts of negligence, malpractice or incompetence; 5. Has been finally adjudicated and found guilty, or entered a plea of guilty or nolo contendere in a criminal prosecution, for any offense reasonably related to the qualifications, functions or duties of an osteopathic physician, whether or not sentence is imposed, and regardless of the pen dency of an appeal; 6. Has had the authority to engage in the activities regulated by the Board revoked, suspended, restricted, modified or limited, or has been reprimanded, warned or censured, probated or otherwise disciplined by any other state or feder al agency whether or not voluntarily agreed to by the physician including, but not limited Req. No. 1706 Page 17 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 to, the denial of licensure, surrender of the license, permit or authority, allowing the license, permit or authority to expire or lapse, or discontinuing or limitin g the practice of osteopath ic medicine pending disposition of a complaint or completion of an investigation; 7. Has violated or failed to comply with provisions of an y act or regulation administered by the Board; 8. Is incapable, for medical or psychiatr ic or any other good cause, of discharging the functions of an osteopathic physician in a manner consistent with the public ’s health, safety and welfare; 9. Has been guilty of advertising by means of knowingly false or deceptive statements; 10. Has been guilty of advertising, prac ticing, or attempting to practice under a name other than one ’s own; 11. Has violated or refused to comply with a lawful order of the Board; 12. Has been guilty of habitual drunkenness, or habitual addiction to the use of morphine, cocaine or other habit -forming drugs; 13. Has been guilty of personal offensive behavior, which would include, but not be limited to, obscenity, lewdness, and molestation; 14. a. Has performed an abortion as defined by Section 1-730 of Title 63 of the Oklahoma Statutes, except for an Req. No. 1706 Page 18 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 abortion necessary to prevent the death of the mother or to prevent substantial or irreversible physical impairment of the mother th at substantially increases the risk of death. The performa nce of an abortion on the basis of the mental or emotional health of the mother shall be a violation of this paragraph, notwithstanding a claim or diagnosis that the woman may engage in conduct whi ch she intends to result in her death, unless: (1) the abortion is necessary due to a medical emergency as defined in subparagraph d of this paragraph, or (2) the pregnancy is the result of: (a) rape or sexual assault that has been reported to law enforcem ent, or (b) incest of a minor that has been reported to law enforcement. b. The Board shall impose a penalty as provided in this section and in Section 6 37.1 of this title on a licensee who violates this paragraph. The penalty shall include, but not be li mited to, suspension of the license for a period of not less than one (1) year. Req. No. 1706 Page 19 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 c. Any abortion performed or induced under an exception provided by subparagraph a of this paragraph or performed or induced to remove an ectopic pregnancy shall be reported by the physician to the State Department of Health in accorda nce with Section 18 of this act. d. As used in this paragraph: (1) “abortion” means the act of using, prescribing, administering, procuring, or selling of any instrument, medicine, drug, or any other substance, device, or means with the purpose to terminate the pregnancy of a woman, with knowledge that the termination by any of those means will with reasonable likelihood cause the death of an unborn child. It does not include the use, prescription, administration, procuring, or selling of any type of contraception if the contraception is administered before the time when a pregnancy could be determined through conventional medical testing . It does not include any act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider Req. No. 1706 Page 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 acting lawfully and within the scope of his or her practice. An act is not an abortion if the act is performed with the purpose to: (a) save the life or preserve the h ealth of the unborn child, (b) remove a dead unborn child whose death was caused by miscarriage or spontaneous abortion, or (c) remove an ectopic pregnancy, (2) “medical emergency” means a condition that, in reasonable medical judgment : (a) cannot be remedied by delivery of the child, and (b) so complicates the medical c ondition of the pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irreversible physical impairment of a major bodily function, not including psycholo gical or emotional conditions. A condition is not a medical emergency if it is based on a claim, diagnosis, or determination that the woman may engage in conduct which she intends to Req. No. 1706 Page 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 result in her death or in the substantial and irreversible physical impa irment of a major bodily function, and (3) “reasonable medical judgment ” means a medical judgment that would be made by a reasonably prudent physician who is knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved ; or 15. Has been adjudicated to be insane, or incompetent, or admitted to an institution for the treatment of psychiatric disorders. B. The State Board of Osteopathic Examiners shall neith er refuse to renew, nor suspend, nor revoke any license, however, for any of these causes, unless the person accused has been given at least twenty (20) days’ notice in writing of the charge agains t him or her and a public hearing by the Board; provided, t hree-fourths (3/4) of a quorum present at a meeting may vote to suspend a license in an emergency situation if the licensee affected is prov ided a public hearing within thirty (30) days of the emer gency suspension. C. The State Board of Osteopathic Examin ers shall have the power to order or subpoena the attendance of witnesses, the inspection of records and premises and the production of rele vant books and papers for the investigation of matters th at may come before them. The presiding officer of the Boar d shall have the Req. No. 1706 Page 22 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 authority to compel the giving of testimony as is conferred on courts of justice. D. Any osteopathic physician in the State of Oklahoma this state whose license to practice osteop athic medicine is revoked or suspended under this section s hall have the right to seek judicial review of a ruling of the Board pursuant to the Administrative Procedures Act. E. The Board may enact rules and r egulations pursuant to the Administrative Procedures Act setting out additional acts of unprofessional conduct, which acts shall be grounds for refusal to issue or reinstate, or for action to condition, suspend or revoke a license. SECTION 4. AMENDATORY 63 O.S. 2021, Section 1-731.3, is amended to read as follows: Section 1-731.3. A. No person shall perform or induce an abortion upon a pregnant woman without first detecting whether or not her unborn child has a heartbeat. No person shall perform or induce an abortion upon a pregnant woman after such time as her unborn child has been determined to have a detectable heartbeat except if, in reasonable medical judgment, she has a condition that so complicates her medical condition that it necessitates the abortion of her pregna ncy to avert her death or to avert s erious risk of substantial and irreversible physical impairment of a major bodily function, not including psychological or emotional Req. No. 1706 Page 23 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 conditions. No such condition may be determined to exist if it is based on a claim or diagnosis that the woman will engage in conduct which she intends to result in her death or in substantial and irreversible physical impairment of a major bodily function . B. A “detectable heartbeat ” shall mean Subsection A of this section shall not apply : 1. If the abortion is necessary due to a medical emerge ncy as defined in subsection D of this section; or 2. If the pregnancy is the result of : a. rape or sexual assault that has been reported to law enforcement, or b. incest of a minor that has been reported to law enforcement. C. Any abortion performed or induced under an exception provided by subsection B of this section , performed or induced to remove an ectopic pregnancy, or performed or induced in compliance with subsection A of this section shall be reported by the abortion provider to the State Department of Health in accordance with Section 18 of this act. D. As used in this section: 1. “Abortion” means the act of using, prescribing, administering, procuring, or selling of any i nstrument, medicine, drug, or any other substance, device, or means with the purpose to terminate the pregnancy of a wom an, with knowledge that the Req. No. 1706 Page 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 termination by any of those means will with reasonable likelihood cause the death of an unborn child. It does not include the use, prescription, administration, procuring, or selling of any type of contraception if the contraception is administered before the time when a pregnancy could be determined through conventional medical testing. It does not include any act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider acting lawfully and within the scope of his or her practice. An act is not an abortion if the act is performed with the purpose to: a. save the life or preserve the health of the unborn child, b. remove a dead unborn child whose death was caused by miscarriage or spontaneous abortion , or c. remove an ectopic pregnancy; 2. “Detectable heartbeat ” means embryonic or fetal cardiac activity or the steady or repetitive rhythmic contract contractions of the heart within the gestational sac .; 3. “Medical emergency” means a condition that, in reasonable medical judgment: a. cannot be remedied by delivery of the child, and b. so complicates the medical cond ition of the pregnant woman as to necessitate the immediate abortion of her Req. No. 1706 Page 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 pregnancy to avert her d eath or for which a delay will create serious risk of substantial and irreversible physical impairment of a major bodily function, not including psychologic al or emotional conditions. A condition is not a medical e mergency if it is based on a claim, diagnosis, or determination that the woman may engage in conduct which she intends to result in her death or in the substantial and irreversible physical impairment of a major bodily function; and C. 4. “Reasonable medical judgment ” means a medical judgment that would be made by a reasonably prudent physician , who is knowledgeable about the case and the treatment po ssibilities with respect to the medical conditio ns involved. D. E. Any person violating subsection A of this section shall be guilty of homicide. SECTION 5. AMENDATORY Section 1, Chapter 11, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-731.4), is amended to read as follows: Section 1-731.4. A. As used in this section: 1. The terms “abortion” and “unborn child” shall have the same meaning as provided by Section 1-730 of Title 63 of the Oklahoma Statutes “Abortion” means the act of using, prescribing, administering, procuring, or selling of any instrument, medicine, drug, or any other substance, device, or means with the purpose to Req. No. 1706 Page 26 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 terminate the pregnancy of a wom an, with knowledge that the termination by any of those means will with reasonable likelihood cause the death of an unborn child. It does not include the use, prescription, administration, procuring, or selling of any type of contraception if the contraception is administered before the time when a pregnancy could be determined through conventional medical testing. It does not include any act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider acting lawfully and within the scope of his or her practice. An act is not an abortion if the act is performed with the purpose to: a. save the life or preserve the h ealth of the unborn child, b. remove a dead unborn child whose death was caused by miscarriage or spontaneous abortion, or c. remove an ectopic pregnancy; and 2. “Medical emergency” means a condition which that, in reasonable medical judgment : a. cannot be remedied by delivery of the child in which an abortion is necessary to preserve the life of a pregnant woman whose life is endangered by a physical disorder, physical illness or physical injury Req. No. 1706 Page 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 including a life-endangering physical condition caused by or arising from the pregnancy itself, and b. so complicates the me dical condition of the pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irreversible physical impairment of a major bodily function, not including psychological or emotional conditions . A condition is not a medical e mergency if it is based on a claim, diagnosis, or determination that the woman may engage in conduct which she intends to result in her death or in the substantial and irreversible physical impairment of a major bodily func tion; 3. “Reasonable medical judgment ” means a medical judgment that would be made by a re asonably prudent physi cian who is knowledgeable about the case and the treatment possibilities with respect to the medical conditions involved ; and 4. “Unborn child” means a human fetus or embryo in any stage of gestation from fertilization until birth . B. 1. Notwithstanding any other provision of law, a person shall not purposely perform, induce, or attempt to perform or induce an abortion except to save the life of a pregnant woman in: 1. If the abortion is necessary due to a medical emergency as defined in subsection A of this section ; or Req. No. 1706 Page 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. If the pregnancy is the res ult of: a. rape or sexual assault that has been reported to law enforcement, or b. incest of a minor that has been reported to law enforcement. 2. C. 1. A person convicted of performing or attempting to perform an abortion shall be guilty of a felony punishable by a fine not to exceed One Hundred Thousand Dollars ($100,000.00), or by confinement in the custody of the Department of Correcti ons for a term not to exceed ten (10) years, or by such fine and imprisonment. 3. 2. This section does not: a. authorize the charging or conviction of a woman with any criminal offense in the death of her own unborn child, or b. prohibit the sale, use, pr escription or administration of a contraceptive measure, drug or chemical if the contraceptive measure, drug or chemical is administered before the time when a pregnancy could be determined through conventi onal medical testing and if the contraceptive measure, drug or chemical is sold, used, prescribed or administered in accordance with manufacturer instructions. 4. 3. It is an affirmative defense to prosecution under this section if a licensed physician provi des medical treatment to a Req. No. 1706 Page 29 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 pregnant woman which results in the accidental or unintentional injury or death to the unbo rn child. D. Any abortion performed or induced under an exception provided by subsection B of this section or performed or induced to remove an ectopic pregnancy shall be reported by the abortion provider to the State Department of Health in accordance with Section 18 of this act. SECTION 6. AMENDATORY 63 O.S. 2021, Section 1 -732, is amended to read as f ollows: Section 1-732. A. No person shall perform or induce an abortion upon a pregnant woman after suc h time as her unborn child has become viable unless such: 1. The abortion is necessary to prevent the death of the pregnant woman or to prevent impairment to her heal th due to a medical emergency as defined in subsection I of this section; or 2. The pregnancy is the result of: a. rape or sexual assault that has been reported to law enforcement, or b. incest of a minor that has been reported to law enforcement. B. An unborn child shall be presumed to be viable if more than twenty-four (24) weeks have elap sed since the probable beginning of the last menstrual period of the pregnant woman, based upon either information provided by her or by an examination by h er attending Req. No. 1706 Page 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 physician. If it is the judgment of the attending physician th at a particular unborn child is not viable where the presumption of viability exists as to that particular unborn child, then he or she shall certify in writing the precise medical criter ia upon which he has determined that the particular unborn child is n ot viable before an abortion may be performed or induced. C. No abortion of a viable unborn child shall be performed or induced except after written certification by the attending physician that in his best medical judgment the abortion is necessary to prevent the death of the pregnant woman or to prevent an impairment to her health . The physician shall further certify in writing the medical indications for such abortion and the probable health consequences if the abortion is not performed or induced . D. C. The physician who sh all perform or induce an abortion upon a pregnant woman after such time as her unborn child has become viable shall utilize the available method or technique of abort ion most likely to preserve the life and health of the unborn chil d, unless he or she shall first certify in writing that in his or her best medical judgment such method or technique shall present a significantly greater danger t o the life or health of the pregna nt woman than another available method or technique. E. D. An abortion of a viable unborn child performed solely under the exception provided by paragraph 2 of subsection A of this section shall be performed or induced only when there is in Req. No. 1706 Page 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 attendance a physician other than the physician performing or inducing the abortion who shall tak e control of and provide immediate medical care for the child. E. During the performance or inducing of th e abortion, the physician performing it, and subsequent to it, the physician required by this section to be in attendance , if applicable under subsections D and F of this section, shall take all reasonable steps in keeping with good medical practice, consi stent with the procedure used, to preserve the life and health of the child, in the same manner as if the child had been born naturally or spontaneou sly. F. The requirement of the attendance of a second physician may be waived when in the best judgment of the attending physician a shall not apply to an abortion performe d due to a medical emergency exists and further delay would result in a serious thr eat to the life or physical health of the pregnant woman under the exception provided by paragraph 1 of sub section A of this section . Provided that, under such emergen cy circumstances and waiver, the attending physician shall have the duty to take all rea sonable steps to preserve the life and health of the chil d before, during and after the abortion procedure, unless such steps shall, in the best medical judgment of the physician, present a significantly great er danger to the life or health of the pregnant woman. F. G. Any person violating subsection A of this section shall be guilty of homicide. Req. No. 1706 Page 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 H. Any abortion performed or induced under an exception provided by subsection A of this section, performed or induced to remove an ectopic pregnancy, or performed or induced before the unborn child has become viable shall be reported by the abortion provider to the State Department of Health in accordance with Section 18 of this act. I. As used in this section: 1. “Abortion” means the act of using, prescribing, administering, procuring, or selling of any i nstrument, medicine, drug, or any other substance, device, or means with the purpose to terminate the pregnancy of a woman , with knowledge that the termination by any of t hose means will with reasonable likelihood cause the death of an unborn child. It does not include the use, prescription, administration, procuri ng, or selling of any type of contraception if the contraception is administered before the time when a pregnancy could be determined through convent ional medical testing. It does not include any act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider acting lawfully and within the scope of his or her practice. An act is not an abortion if the act is performed with the purpose to: a. save the life or preserve the healt h of the unborn child, Req. No. 1706 Page 33 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 b. remove a dead unborn child whose death was caused by miscarriage or spontaneous abortion, or c. remove an ectopic pregnancy; 2. “Medical emergency” means a condition that, in reasonable medical judgment: a. cannot be remedied by delivery of the child , and b. so complicates the medical condition of the pr egnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial an d irreversible physical impairment of a major b odily function, not including psychological or emotional conditions. A condition is not a medical e mergency if it is based on a claim, diagnosis, or determina tion that the woman may engage in conduct which sh e intends to result in her death or in the subs tantial and irreversible physical impairment of a major bodily function; and 3. “Reasonable medical judgment” means a medical judgment that would be made by a reasonably prudent physician who is knowledgeable about the case and the treatment possibilities with respect to th e medical conditions involved . SECTION 7. AMENDATORY 63 O.S. 2021, Section 1-745.2, is amended to read as follows: Req. No. 1706 Page 34 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Section 1-745.2. As used in the Pain-Capable Unborn Child Protection Act only: 1. “Abortion” means the use or prescription act of using, prescribing, administering, procuring, or selling of any instrument, medicine, drug, or any other substance or, device, or means with the purpose to terminate the pregnancy of a woman known to be pregnant with an intention other tha n to increase the probability of a live birth, to preserve, with knowledge that the termination by any of those means will with reasonable likelihood cause the death of an unborn child. It does not include the use, prescription, administration, procuring, or selling of any type of contraception if the contraception is administered befor e the time when a pregnancy could be determined through conventional medical test ing. It does not include any act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider acting lawfully and within the scope of his or her practice. An act is not an abortion if the act is performed with the purpose to: a. save the life or preserve the health of the unborn child after live birth, or to, b. remove a dead unborn child who died as the result of natural causes in utero, accidental t rauma, or a criminal assault on the pregnant woman or her u nborn child, and which causes the premature termination of Req. No. 1706 Page 35 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 the pregnancy whose death was caused by miscarriage or spontaneous abortion, or c. remove an ectopic pregnancy; 2. “Attempt to perform or induce an abortion” means an act, or an omission of a statutorily required act, that, under the circumstances as the actor believes them to be, consti tutes a substantial step in a course of conduct planned to culminate in the performance or induction of a n abortion in this state in violation of the Pain-Capable Unborn Child Protection Act; 3. “Postfertilization age” means the age of the unborn child as calculated from the fertilization of the human ovum; 4. “Fertilization” means the fusion of a human spe rmatozoon with a human ovum; 5. “Medical emergency” means a condition that, in reasonable medical judgment,: a. cannot be remedied by delivery of the child, and b. so complicates the medical condition of the pre gnant woman that it necessitates as to necessitate the immediate abortion of her pregnancy without first determining postfertilization a ge to avert her death or for which the delay necessary to d etermine postfertilization age a delay will create serious risk of substantial and irre versible physical impairment of a major bodily function, not including psychological Req. No. 1706 Page 36 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 or emotional conditions. No condition shall be deemed A condition is not a medical emergency if it is based on a claim or, diagnosis, or determination that the woman will may engage in conduct which she intends to result in her death or in substantial and irreversible physical impairment of a major bodily function; 6. “Reasonable medical judgment” means a medical judgment that would be made by a reasonably prudent physician , who is knowledgeable about the case and the treatme nt possibilities with respect to the medical conditions involved; 7. “Physician” means any person licensed to pra ctice medicine and surgery or osteopathic medic ine and surgery in this state; 8. “Probable postfertilization age of the unborn child ” means what, in reasonable medical judgment, will with reasonab le probability be the postfertilization age of the unborn c hild at the time the abortion is planned to be performed or induced; 9. “Unborn child” or “fetus” each means an individual organism of the species homo sapiens from fertilization until live birth; and 10. “Woman” means a female human being whether or not she has reached the age of majority. SECTION 8. AMENDATORY 63 O.S. 2021, Section 1 -745.4, is amended to read as follows: Section 1-745.4. A. Except in the case of a med ical emergency as provided by subsection C of this section , no abortion shall be Req. No. 1706 Page 37 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 performed or induced or be attempted to be performed or induced unless the physician performing or inducing it has first made a determination of the probable postfertilization age of the unborn child or relied upon such a determinatio n made by another phys ician. In making such a determination, the physician shall make such inquiries of the woman and perform or cause to be perfo rmed such medical examinations and tests as a reas onably prudent physician, knowledgeable about the case and the medical conditions involved, would consider necessary to perform in making an accurate diagnosis with respect to postfertilization age. B. Knowing or reckless failure by any physician to confo rm to any requirement of this section constitutes “unprofessional conduct”. C. Subsection A of this section shall not apply : 1. If the abortion is necessary due to a medical emerge ncy as defined in subsection D of this section; or 2. If the pregnancy is the result of: a. rape or sexual assault that has been reported to law enforcement, or b. incest of a minor that has been reported to law enforcement. D. Any abortion performed or induced under an exception provided by subsection C of this section, performed or induced to remove an ectopic pregnancy, or performed or induced in compliance Req. No. 1706 Page 38 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 with subsection A of this section shall be reported by the abortion provider to the State Department of Health in accordance with Section 18 of this act. SECTION 9. AMENDATORY 63 O.S. 2021, Section 1 -745.5, is amended to read as follows: Section 1-745.5. A. No Except as provided by subsection C of Section 1-745.4 of this title, no person shall perform or induce or attempt to perform or induce an abortion upon a woman when it has been determined, by the physician performing or inducing or attempting to perform or i nduce the abortion or by another physician upon whose determination that physician relies, that the probable postfertilization age of t he woman’s unborn child is twenty (20 ) or more weeks, unless, in reasonable medical judgment, she has a condition which so complicates her medical condition as to necessitate the abortion of her pregnancy to avert her death or to avert serious risk of subs tantial and irreversible physical impairment of a major bod ily function, not including psychological or emotional conditi ons. No such condition shall be deemed to exist if it is based on a claim or diagnosis that the woman will engage in conduct which she intends to result in her death or in substantial and irreversible physical impairment of a major bodily function . B. When an abortion upon a woman whose unborn child has been determined to have a probable postfertilization age of twenty (20) or more weeks is not prohibited by this section, the physician shall Req. No. 1706 Page 39 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 terminate the pregnancy in the manner which, in reasonable medic al judgment, provides the best opportunity for the unborn child to survive, unless, in reasonable medical judgment, termination of the pregnancy in that manner would pose a greater risk either o f the death of the pregnant woman or of the substantial and ir reversible physical impairment of a major bodily function, not including psychological or emotional conditions, of the woman than would other available methods. No such gr eater risk shall be de emed to exist if it is based on a claim or diagnosis that the woman will engage in conduct which she intends to result in her death or in substantial and irreversible physical impairment of a major bodily function. SECTION 10. AMENDATORY Section 2, Chapter 190, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-745.32), is amended to read as follows: Section 1-745.32. As used in this act the Oklahoma Heartbeat Act: 1. “Abortion” means the act of using, prescribing, administering, procuring, or selling of any instrument, medicine, drug, or any other substance, device, or means with the purpose to terminate the pregnancy of a woman, with knowledge that the termination by any of t hose means will with reasonable likelihood cause the death of an unborn child. It does not include the use, prescription, administration, procuring, or selling of any type of contraception if the contraception is administered before the time Req. No. 1706 Page 40 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 when a pregnancy could be determined through conventional medical testing. It does not include any act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider acting lawfully and within the scope of his or her practice. An act is not an abortion if the act is performed with the purpose to: a. save the life or preserve the healt h of the unborn child, b. remove a dead unborn child whose death was caused by miscarriage or spontaneous abortion , or c. remove an ectopic pregnancy; 2. “Fetal heartbeat” means cardiac activity or the steady and repetitive rhythmic contraction of the fetal heart within the gestational sac; 2. 3. “Gestational age” means the amount of time that has elapsed from the first day of a woman’s last menstrual period; 3. 4. “Gestational sac” means the structure comprising the extraembryonic membranes that envelop the unborn child and that is typically visible by ultrasound after the fourth week of pregnancy; 4. 5. “Medical emergency” means a condition that, in reasonable medical judgment: a. cannot be remedied by delivery of the child , and Req. No. 1706 Page 41 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 b. so complicates the medical condition of the pr egnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of substantial and irre versible physical impairment of a major b odily function, not including psychological or emotional conditions. A condition is not a medical e mergency if it is based on a claim, diagnosis, or determination that the woman may engage in conduct which she inte nds to result in her death or in the subs tantial and irreversible physical impairment of a major bodily function; 6. “Physician” means an individual licensed to practice medicine in this state including a medical doctor and a doctor of osteopathic medicine; 5. 7. “Pregnancy” means the human female reproductive condition that: a. begins with fertiliz ation, b. occurs when the woman is carrying the deve loping human offspring, and c. is calculated from the first day of the woman’s last menstrual period; 6. 8. “Reasonable medical judgment” means a medical judgment that would be made by a reasonably prudent physician who is Req. No. 1706 Page 42 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 knowledgeable about the case and the treatm ent possibilities with respect to the medical conditions involved; 9. “Standard medical practice” means the degree of skill, care, and diligence that an obstetricia n of ordinary judgment, learning, and skill would employ in like circumstances; 7. 10. “Unborn child” means a human fetus or embryo in any stage of gestation from fertili zation until birth; and 8. 11. “Woman” and “women” include any person whose biologica l sex is female including any person with XX chromosomes and any person with a uterus, regardless of any gender identit y that the person attempts to assert or claim. SECTION 11. AMENDATORY Section 3, Chapter 190, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1 -745.33), is amended to read as follows: Section 1-745.33. A. For the purposes of determining the presence of a fetal heartbeat under this section, “standard medical practice” includes employing the appropriate means of detecting the heartbeat based on the estimated gestational age of the unborn child and the condition of the woman and her pregnancy. B. Except as provided by Sections 5 and 6 of this act Sections 1-745.35 and 1-745.36 of this title or Section 14 of this act, an abortion may not be performed or, induced, or attempted to be performed or induced on a pregnant woman unless a physician has Req. No. 1706 Page 43 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 determined, in accordance with this section, whether the woman’s unborn child has a detectable fetal heartbeat. C. In making a determination under subsection B of this section, the physician must use a test that is: 1. Consistent with the physician’s good faith and reasonable understanding of standard medical practice; and 2. Appropriate for the estimated gestational age of the unbo rn child and the condition of the pregnant woman and her pregnancy. D. A physician making a determination under subsection B of this section shall record in the pregnant woman’s medical record: 1. The estimated gestational age of the unborn child; 2. The method used to estimate the gestational age; and 3. The test used for detecting a fetal heartbeat including the date, time, and results of the test. SECTION 12. AMENDATORY Section 4, Chapter 190, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1 -745.34), is amended to read as follows: Section 1-745.34. A. Except as provided by Sections 5 and 6 of this act Sections 1-745.35 and 1-745.36 of this title or Section 14 of this act, a physician shall not knowingly perform or, induce, or attempt to perform or induce an abortion on a pregnant woman if the physician detected a fetal heartbeat for the unborn child as required by Section 3 of this act Section 1-745.33 of this title or failed to perform a test to detect a fetal heartbeat. Req. No. 1706 Page 44 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 B. A physician shall not be in violation of this section if the physician performed a test for a fetal heartbeat as required by Section 3 of this act Section 1-745.33 of this title and did not detect a fetal heartbeat. C. This section shall not affect any provision of state law that regulates or prohibits abortion including but not lim ited to any provision that restricts or regulates an ab ortion by a particular method or during a particular stage of pregnancy. SECTION 13. AMENDATORY Section 5, Chapter 190, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1 -745.35), is amended to read as follows: Section 1-745.35. A. Sections 3 and 4 of this act Sections 1- 745.33 and 1-745.34 of this title shall not apply if a physician believes an abortion is necessary due to a medical emergency exists that prevents complian ce with this act as defined in Section 1- 745.32 of this title. B. A physician who performs or induces an abortion under circumstances described by subsection A of this section shall make written notations in the pr egnant woman’s medical record of: 1. The physician’s belief that a medical emergency necessitated the abortion; and 2. The medical condition of the pregnant woman that prevented compliance with this act the Oklahoma Heartbeat Act . Req. No. 1706 Page 45 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 C. A physician performing or inducing an abortion under this section shall maintain in the physician’s practice records a copy of the notations made under subsection B of this section. SECTION 14. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-745.35a of Title 63, unless there is created a duplication in numbering, reads as fo llows: Sections 1-745.33 and 1-745.34 of Title 63 of the Oklahoma Statutes shall not apply if the pregnancy is the result of: 1. Rape or sexual assault that has been reported to law enforcement; or 2. Incest of a minor that has been reported to law enforceme nt. SECTION 15. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-745.36a of Title 63, unless there is created a du plication in numbering, reads as follows: Any abortion performed or induced under an exception provided by Section 1-745.35 or 1-745.36 of this title or Section 14 of this act, performed or induced to remove an ectopic pregnancy, or performed or induced in complian ce with Sections 1-745.33 and 1- 745.34 of Title 63 of the Oklahoma Statutes shall be reported by the abortion provider to the State Department of Health in accordance with Section 18 of this act. SECTION 16. AMENDATORY Section 1, Chapter 321, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-745.51), is amended to read as follows: Req. No. 1706 Page 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 Section 1-745.51. As used in this act Section 1-745.51 et seq. of this title: 1. “Abortion” means the act of using, prescribing, administering, procuring, or selling of any inst rument, medicine, drug, or any other substance, device, or means with the purpose to terminate the pregnancy of a woman, with knowledge that the termination by any of those means will with reasonable likelihood cause the death of an unborn child. It does not include the use, prescription, administration, proc uring, or selling of Plan B, morning-after pills, or any other type of contraception or emergency contraception if the contraception is administered before the time when a pregnancy could be determined through convent ional medical testing. It does not include any act related to in vitro fertilization or otherwise related to the diagnosis or treatment of infertility or the preservation of fertility by a licensed healthcare provider acting lawfully and within the scope of his or her practice. An act is not an abortion if the act is performed with the purpose to: a. save the life or preserve the health of the unborn child, b. remove a dead unborn child whose death was caused by miscarriage or spontaneous abortion , or c. remove an ectopic pregnancy; Req. No. 1706 Page 47 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2. “Fertilization” means the fusion of a human spermatozoon with a human ovum; 3. “Medical emergency” means a condition in which an abortion is necessary to preserve the life of a pregnant woman whose life is endangered by a physical disorder, physical illness, or physical injury, including a life-endangering physical condition caused by or arising from the pregnancy itself that, in reasonable medi cal judgment: a. cannot be remedied by delivery of the child , and b. so complicates the medical condition of the pregnant woman as to necessitate the immediate abortion of her pregnancy to avert her death or for which a delay will create serious risk of su bstantial and irreversible physical impairment of a major bodily function, not including psychological or emotional conditions. A condition is not a medical e mergency if it is based on a claim, diagnosis, or det ermination that the woman may engage in conduct which she intends to result in her death or in the substantial and irreversi ble physical impairment of a major bodily function ; 4. “Reasonable medical judgment ” means a medical judgment that would be made by a reasonably prudent physician who is knowl edgeable about the case and the treatment possibilities with respect to the medical conditions involved; Req. No. 1706 Page 48 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 4. 5. “Unborn child” means a human fetus or embryo in any stage of gestation from fertilizatio n until birth; and 5. 6. “Woman” and “women” include any person whose biological sex is female, including any person with XX chromosomes and any person with a uterus, regardless of any gender identity that the person attempts to assert or claim. SECTION 17. AMENDATORY Section 2, Chapter 321, O.S.L. 2022 (63 O.S. Supp. 2022, Section 1-745.52), is amended to read as follows: Section 1-745.52. A. Except as provided by Section 3 of this act Section 1-745.53 of this title, a person shall not knowingly perform or, induce, or attempt to perform or induce an abortion unless: 1. The abortion is necessary to save the life of a pregnant woman in due to a medical emergency as defined in Section 1-745.51 of this title; or 2. The pregnancy is the result of: a. rape, or sexual assault that has been reported to law enforcement, or b. incest of a minor that has been reported to law enforcement. B. Any abortion performed or induced under an exception provided by subsection A of this section or Section 1-745.53 of this title or performed or induced to remove an ectopic pregnancy shall Req. No. 1706 Page 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 be reported by the abortion provider to the St ate Department of Health in accordance with Section 18 of this act. SECTION 18. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-738r of Title 63, unless there is created a duplicati on in numbering, reads as follows: A. Any abortion performed or induced under an exception provided by Section 861 of Title 21 of the Oklahoma St atutes, Section 509 or 637 of Title 59 of the Ok lahoma Statutes, Section 1- 731.3, 1-731.4, or Section 1-732 of Title 63 of the Oklahoma Statutes, Section 1-745.1 et seq. of Title 63 of th e Oklahoma Statutes, Section 1-745.31 et seq. of Title 63 of the Oklahoma Statutes, or Section 1-745.51 of Title 63 of the Oklahoma Statutes shall be reported by the abortion provider to the State Department of Health on a form prescribed by the State Commissioner of Health. The form shall not request the name of the woman who obtained the abortion or any other potentia lly identifying information that could lead to the identification of the woman. B. The abortion provider shall state on the form the specific exception under which the abortion was performed and shall provide a detailed explanation of the justification for performing such abortion including any relevant supporting documentation. The completed form shall include all other infor mation as may be required by the Commissioner. Req. No. 1706 Page 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 C. The Department shall compile the informatio n received under this section into an annual statistical report which shall be published on the Department’s Internet website and submitted to the President Pro Tempore of th e Senate and the Speaker of the House of Representatives each year. D. The Commissioner shall promulgate rules to implement this section. Such rules shall include, but not be limited to: 1. The manner of reporting; 2. Information to be reported ; and 3. Patient privacy protections that ensure the anonymity of women who obtain an abortion under an exception provided by Section 861 of Title 21 of the Oklahoma Statutes, Section 731.4 of Title 63 of the Oklahoma Statutes, Section 1-745.31 et seq. of Title 63 of the Oklahoma Statutes, or Section 1-745.51 of Title 63 of the Oklahoma Statutes. SECTION 19. REPEALER 63 O.S. 2021, Sections 1-733 and 1- 745.6, are hereby repealed. SECTION 20. It being immediately necessary for the preservation of the public peace, health or safety, an emergency is hereby declared to exist, by reason whereo f this act shall take effect and be in full force from and after its passage and approval. 59-1-1706 DC 2/9/2023 12:35:14 PM