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ENGROSSED HOUSE
BILL NO. 1630 By: Sneed of the House
and
Bullard of the Senate
An Act relating to medical facilities; defining
terms; prohibiting operation of certain facility
without a license; providing certain interpretation;
requiring separate license for each location;
prohibiting transfer or assignment of certain
license; providing penalty for noncompliance;
requiring the establishment of certain
classification; providing certain exceptions; setting
requirements for certain application; requiring
licensing fee; requiring Oklahoma Commissioner of
Health to adopt certain rules and set certain fees;
authorizing facility inspections; requiring licensing
fees to be deposited in certain revolving fund;
requiring Oklahoma Commissioner of Health to adopt
certain rules; requiring consultation; requiring
facility to provide examination for determination of
emergency medical condition; requiring facility to
meet certain standards; requiring agreement;
prohibiting certain reimbursement; authorizing
complaints against certain facilities to be filed
with the State Department of Health; authoriz ing
State Department of Health to take certain action for
certain violations; authorizing emergency order of
license suspension; providing procedure for hearing;
authorizing petition for temporary restraining order;
authorizing district courts to issue injunctions;
directing the Attorney General to file suit at
request of Department; establishing venue;
authorizing administrative penalties; limiting amount
of penalties; providing basis for calculating amount
of penalty; requiring certain written notice;
specifying information to be included in written
notice; providing for judicial review of certain
order; creating revolving fund; providing for
codification; and prov iding an effective date.
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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 2667 of Title 63, unless there
is created a duplication in num bering, reads as follows:
As used in this act:
1. "Commissioner" means the Oklahoma Commissioner of Health;
2. "Department" means the State Department of Health;
3. "Emergency care" means health care services provided to
achieve stabilization as needed for conditions that reas onably
appear to constitute a life - or limb-threatening emergency based on
the presenting symptoms of the patient;
4. "Facility" means a short -term emergency and nonemergency
hybrid medical facility;
5. "Maximum emergency stay per iod" means any patient who is
treated for an emergency situation and is prohibited from being
treated or held any longer than twenty -four (24) hours so long as
the necessary treatment required is deemed an emergency. Maximum
emergency stay period shall no t apply to patients that are
stabilized and needing further treatment from being provided
nonemergency care;
6. "Nonemergency care" means all health care that is not for
life-threatening conditions or covered as emergency care under an
existing health care policy, including, but not limited to, the
following services:
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a. diagnostic testing,
b. lab testing,
c. outpatient services,
d. primary care, and
e. X-rays, magnetic resonance imaging (MRI), and other
types of imaging; and
7. "Short-term emergency and nonemergency hybrid medi cal
facility" means a dual -sided facility, structurally separate and
distinct from a hospital that is open twenty -four (24) hours per day
and seven (7) days a week, with one side of the facility providing
emergency care and the othe r side of the facility providing
nonemergency care.
SECTION 2. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2668 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. Except as provided by Section 3 of this act, a person shall
not establish or operate a short -term emergency and nonemergency
hybrid medical facility in this state without a license issued under
this act.
B. Except as provided by Section 3 of this act, a facility
shall not hold itself out to the public as a short -term emergency
and nonemergency hybrid medical facility or use any similar term, as
defined by State Department of Health rule, that would give the
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impression that the facility or person is prov iding emergency care
unless the facility or person holds a license issued under this act.
C. Nothing in this act shall be interpreted to prohibit a
licensed short-term emergency and nonemergency hybrid medical
facility from providing other health care ser vices including, but
not limited to, imaging, primary care, nonemergency care, and other
ancillary services.
D. Each separate facility location shall have a separate
license.
E. A license issued under this act is not transferable or
assignable.
F. Any person who is convicted o f violating a provision of this
section shall be guilty of a misdemeanor. Each day of a continuing
violation constitutes a separate offense.
G. The Oklahoma Commissioner of Health by rule shall establish
a classification for a fac ility that is in continuous operation
twenty-four (24) hours per day and seven (7) days per week.
H. No license shall be issued to a facility located in a city
with an established hospital within twenty (20) miles or twenty (20)
minutes (whichever is grea ter) from a rural hospit al and a
population of less than thirty thousand (30,000) people unless
written permission is obtained from the hospital to operate a short -
term emergency and nonemergency hybrid medical facility.
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SECTION 3. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2669 of Title 63, unless there
is created a duplication in numbering, reads as follows:
The following facilities shall not be required to be licensed
under this act:
1. An office or clinic owned and operated by a manufacturing
facility solely for the purposes of treating its employees and
contractors;
2. Temporary emergency clinics in disaster areas;
3. An office or clinic of a licensed dentist, optometrist, or
podiatrist;
4. A licensed nursing home;
5. A licensed hospital;
6. A hospital that is owned and operated by this state;
7. A facility located within or connected to a hospital
described by paragraph 5 or 6 of this section;
8. A facility that is owned or operated by a hospital described
by paragraph 5 or 6 of this section and is:
a. surveyed as a service of the hospital by an
organization that has been granted deeming authority
as a national accreditation program for hospitals by
the federal Centers for Medicare and Medicaid
Services, or
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b. granted provider-based status by the Centers for
Medicare and Medicaid Services; or
9. A licensed ambulatory surgical center.
SECTION 4. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2670 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. An applicant for a license under this act shall submit an
application to the State Department of Health on a form prescribed
by the Department.
B. Each application shall be accompanied by a nonrefundable
license fee in an amount set by the Oklahoma Commissioner of Health.
C. The application shall require that an emergency room is
staffed by board-certified emergency room physicians licensed by the
State Board of Medical Licensu re and Supervision.
D. The application shall contain evidence that the facility
meets the minimum standards and requirements specified in Section 9
of this act.
E. The Department shall issue a license if, after inspection
and investigation, it finds that the applicant and the facility meet
the requirements of this act and the standards adopted under this
act.
F. The license fee shall be paid annually on renewal of the
license.
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SECTION 5. NEW LAW A new secti on of law to be codified
in the Oklahoma Statutes as Section 2671 of Title 63, unless there
is created a duplication in numbering, reads as follows:
The Oklahoma Commissioner of Health shall adopt rules necessary
to implement this act, including requiremen ts for the issuance,
renewal, denial, suspension, and revocation of a license to operate
a facility.
SECTION 6. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2672 of Title 63, unless there
is created a duplication in numbe ring, reads as follows:
The Oklahoma Commissioner of Health shall set fees imposed by
this act in amounts reasonable and necessary to defray the cost of
administering this act.
SECTION 7. NEW LAW A new sectio n of law to be codified
in the Oklahoma Statutes as Section 2673 of Title 63, unless there
is created a duplication in numbering, reads as follows:
The State Department of Health may inspect a facility at
reasonable times as necessary to ensure compliance with this act.
SECTION 8. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2674 of Title 63, unless there
is created a duplication in numbering, reads as follows:
All fees collected under this act shal l be deposited in the
State Treasury to the credit of the Short -term Emergency and
Nonemergency Hybrid Medical Facility Licensing Fund created by
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Section 17 of this act for the administration and enforcement of
this act and for no other purposes.
SECTION 9. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2675 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. The Oklahoma Commissioner of Health shall adopt rules
necessary to implement this act, including standards for:
1. The construction and design of the facility including
plumbing, heating, lighting, ventilation, proper air transportation
accommodations, and other design standards necessary to ensure the
health and safety of patients;
2. Any transportation accommodations which shall be required
unless a facility is located where air transportation is expressly
prohibited by Title 14 of the Code of Federal Regulations;
3. The number, qualifications, and organizati on of the
professional staff and other personnel, including the requirement
that each facility staff board -certified emergency room physicians
when providing emergency care;
4. The administration of the facility;
5. The equipment essential to the health and welfare of the
patients;
6. The sanitary and hygienic conditions within the facility and
its surroundings;
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7. The requirements for the contents, maintenance, and release
of medical records;
8. The minimal level of care and standards for denial of ca re;
9. The provision of laboratory and radiological services;
10. The distribution and administration of drugs and controlled
substances;
11. A quality assurance program for patient care;
12. Disclosure, if applicable, of the following:
a. the name and Social Security number of the sole
proprietor, if the facility is a sole proprietor,
b. the name and Social Security number of each general
partner who is an individual, if the facility is a
partnership,
c. the name and Social Security number of any indiv idual
who has an ownership interest of more than twenty -five
percent (25%) in the corporation, if the facility is a
corporation, and
d. the names and license numbers of any physicians
licensed by the State Board of Medical Licensure and
Supervision or the State Board of Osteopath ic
Examiners who have a financial interest in the
facility or any entity which has an ownership interest
in the facility;
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13. Transfer protocols for patients requiring advanced medical
care at a hospital and who require emergency m edical treatment
extending past the twenty -four-hour maximum stay period;
14. Proper air transportation accommodations; and
15. Any other aspect of the operation of a facility that the
Commissioner considers necessary to protect the facility's patients
and the public.
B. In adopting the rules required under subsection A of this
section concerning transfer protocols, the Commissioner shall
consult with physicians who provide emergency care and medical
consultant organizations.
SECTION 10. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2676 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. A facility shall provide to each facility emergency patient,
without regard to the individual's abili ty to pay, an appropriate
medical screening, examination, and stabilization within the
facility's capability, including ancillary services routinely
available to the facility, to determine whether an emergency medical
condition exists and to determine any necessary stabilizing
treatment.
B. Each facility shall meet those standards set forth by
Section 1395dd of 42 U.S.C. of the Emergency Medical Treatment and
Labor Act.
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C. Before a facility accepts any patient for treatment or
diagnosis, the facility shal l enter into a referral, transmission,
or admission agreement with a hospital licensed in this state.
D. An insurer or third -party administrator shall be prohibited
from reimbursing a facility licensed under this act on a discounte d
fee basis for covered services that are provided to an insured
unless:
1. The insurer or third -party administrator has contracted with
either:
a. the physician or other practitioner, institutional
provider, or organization of physicians and health
care providers, or
b. the health maintenance organization, exclusive
provider organization, or preferred provider
organization that has a network of preferred providers
and that has contracted with the physician or other
practitioner, institutional provider, or organization
of physicians and health care providers;
2. The physician or other practitioner, institutional provider,
or organization of physicians and health care providers has agreed
to the contract and to provide health care services under the terms
of the contract; and
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3. The insurer or third -party administrator has agreed to
provide coverage for those health care services under the health
insurance policy.
SECTION 11. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2677 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A person may file a complaint with the State Department of
Health against a facility licensed under this act.
SECTION 12. NEW LAW A new section of l aw to be codified
in the Oklahoma Statutes as Section 2678 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. The State Department of Health may deny, suspend, or revoke
a license for a violation of this act or a rule adopted under this
act.
B. If the Department finds that a facility is in repeated
noncompliance with this act or rules adopted under this act but the
noncompliance does not endanger public health and safety, the
Department may schedu le the facility for prob ation rather than
suspending or revoking the facility's license. The Department shall
provide notice to the facility of the probation and of the items of
noncompliance not later than the tenth day before the date the
probation period begins. The Department shall designate a period of
not less than thirty (30) calendar days during which the facility
remains under probation. During the probation period, the facility
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must correct the items that were in noncompliance and report the
corrections to the Departm ent for approval.
C. The Department may suspend or revoke the license of a
facility that does not correct items that were in noncompliance or
that does not comply with this act or the rules adopted under this
act within the applica ble probation period.
SECTION 13. NEW LAW A new section of law to be codified
in the Oklahoma Statutes as Section 2679 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. The State Department of Hea lth may issue an emergen cy order
to suspend a license issued under this act if the Department has
reasonable cause to believe that the conduct of a license holder
creates an immediate danger to the public health or safety.
B. An emergency suspension under this section is effective
immediately without a hearing or notice to the license holder.
C. On written request of the license holder, the Department
shall conduct a hearing not earlier than the tenth day or later than
the thirtieth day after the date the hearing request is rece ived to
determine if the emergency suspension is to be continued, modified,
or rescinded.
D. A hearing and any appeal under this section are governed by
the Department's rules.
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SECTION 14. NEW LAW A new secti on of law to be codified
in the Oklahoma Statutes as Section 2680 of Title 63, unless there
is created a duplication in numbering, reads as follows:
A. The State Department of Health may petition a district court
for a temporary restraining order to restr ain a continuing violati on
of the standards or licensing requirements provided under this act
if the Department finds that the violation creates an immediate
threat to the health or safety of the patients of a facility.
B. A district court, on petition of the Department and on a
finding by the court that a person is violating the standards or
licensing requirements provided under this act, may by injunction:
1. Prohibit a person from continuing a violation of the
standards or licensing requirements provid ed under this act;
2. Restrain or prevent the establishment or operation of a
facility without a license issued under this act; or
3. Grant any other injunctive relief warranted by the facts.
C. The Attorney General shall institute and conduct a suit
authorized by this section at the request of the Department.
D. Venue for a suit brought under this section is in the county
in which the facility is located or in Oklahoma County.
SECTION 15. NEW LAW A new section of law to be codifi ed
in the Oklahoma Statu tes as Section 2681 of Title 63, unless there
is created a duplication in numbering, reads as follows:
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A. The State Department of Health may impose an administrative
penalty on a person licensed under this act who violates this act or
a rule or order adopted under this act. A penalty collected under
this section or Section 16 of this act shall be deposited in the
State Treasury in the General Revenue Fund.
B. A proceeding to impose the penalty is considered to be a
contested case.
C. The amount of the p enalty may not exceed One Thousand
Dollars ($1,000.00) for each violation, and each day a violation
continues or occurs is a separate violation for purposes of imposing
a penalty. The total amount of the penalty assessed for a viol ation
continuing or occurring on separate days under this subsection may
not exceed Five Thousand Dollars ($5,000.00).
D. The amount shall be based on:
1. The seriousness of the violation, including the nature,
circumstances, extent, and gravity of the v iolation;
2. The threat to health or safety caused by the violation;
3. The history of previous violations;
4. The amount necessary to deter a future violation;
5. Whether the violator demonstrated good faith, including when
applicable whether the viol ator made good-faith efforts to correct
the violation; and
6. Any other matter that the Department may require.
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E. If the Department initially determines that a violation
occurred, the Department shall give written notice of the report by
certified mail to the person.
F. The notice under subsection E of this section shall:
1. Include a brief summary of the alleged violation;
2. State the amount of the recommended penalty; and
3. Inform the person of the person's right to a hearing on the
occurrence of the violation, the amount of the penalty, or both.
G. Within twenty (20) calendar days after the date the person
receives the notice under subsection E of this section, the person
in writing may:
1. Accept the determination and recommended penalty of th e
Department; or
2. Make a request for a hearing on the occurrence of the
violation, the amount of the penalty, or both.
H. If the person accepts the determination and recommended
penalty or if the person fails to respond to the notice, the
Oklahoma Commissioner of Health by order shall approve the
determination and impose the recommended penalty.
I. The notice of the order shall include a statement of the
right of the person to a judicial review of the order.
SECTION 16. NEW LAW A new section of law to b e codified
in the Oklahoma Statutes as Section 2682 of Title 63, unless there
is created a duplication in numbering, reads as follows:
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A. Within thirty (30) calendar days after the date an order of
the Oklahoma Commissioner of Heal th that imposes an administrative
penalty becomes final, the person shall:
1. Pay the penalty; or
2. File a petition for judicial review of the Commissioner's
order contesting the occurrence of the violation, the amount of the
penalty, or both.
B. Within the thirty-day period prescribed by subsection A of
this section, a person who files a petition for judicial review may:
1. Stay enforcement of the penalty by:
a. paying the penalty to the court for placement in an
escrow account, or
b. giving the court a supersedeas bond approved by the
court that:
(1) is for the amount of the penalty, and
(2) is effective until all judicial review of the
Commissioner's order is final;
2. Request the court to stay enforcement of the penalty by
filing with the court a s worn affidavit of the pe rson stating that
the person is financially unable to pay the penalty and is
financially unable to give the supersedeas bond and by sending a
copy of the affidavit to the Commissioner by certified mail.
C. If the Commissioner recei ves a copy of an affidavit under
subsection B of this section, the Commissioner may file with the
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court, within five (5) calendar days after the date the copy is
received, a contest to the affidavit. The court shall hold a
hearing on the facts alleged in the affidavit as soon as practicable
and shall stay the enforcement of the penalty on finding that the
alleged facts are true. The person who files an affidavit has the
burden of proving that the person is financially unable to pay the
penalty or to give a supersedeas bond.
D. If the person does not pay the penalty and the enforcement
of the penalty is not stayed, the penalty may be collected. The
Attorney General may sue to collect the penalty.
E. If the court sustains the finding that a violation occu rred,
the court may uphold or reduce the amount of the penalty and order
the person to pay the full or reduced amount of the penalty.
F. If the court does not sustain the finding that a violation
occurred, the court shall order that a penalty is not owed.
G. If the person paid the penalty and if the amount of the
penalty is reduced or the penalty is not upheld by the court, the
court shall order, when the court's judgment becomes final, that the
appropriate amount plus accrued interest be remitted to the person
within thirty (30) calendar days after the date that the judgment of
the court becomes final. The interest accrues at the rate charged
on loans to depository institutions by the Federal Reserve Bank of
New York. The interest shall be paid for the period beginning on
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the date the penalty is paid and ending on the date the penalty is
remitted.
H. If the person gave a supersedeas bond and the penalty is not
upheld by the court, the court shall order, when the court's
judgment becomes final, the relea se of the bond. If the person gave
a supersedeas bond and the amount of the penalty is reduced, the
court shall order the release of the bond after the person pays the
reduced amount.
SECTION 17. NEW LAW A new section of law to be c odified
in the Oklahoma Statutes as Section 2683 of Title 63, 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 Department of Health to be designated the "Shor t-term
Emergency and Nonemergency Hybrid Medical Facility Licensing Fund".
The fund shall be a continuing fund, not subject to fiscal year
limitations, and shall consist of all monies received by the State
Department of Health from short -term emergency and nonemergency
hybrid medical facilities. All monies accruing to the credit of the
fund are hereby appropriated and may be budgeted and expended by the
State Department of Health for the purpose of administering and
enforcing licensing provisions for shor t-term emergency and
nonemergency hybrid medical facilities. Expenditures from the fund
shall be made upon warrants issued by the State Treasurer against
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claims filed as prescribed by law with the Director of the Office of
Management and Enterprise Servic es for approval and payment.
SECTION 18. This act shall become effective November 1, 2025.
Passed the House of Representatives the 25th day of March, 2025.
Presiding Officer of the House
of Representatives
Passed the Senate the ___ day of __________, 2025.
Presiding Officer of the Senate