Req. No. 10618 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 60th Legislature (2025) HOUSE BILL 1812 By: Newton AS INTRODUCED An Act relating to supervision of Advanced Practice Registered Nurses; providing definitions; providing eligibility requirements for phys icians; providing limits; providing for exceptions; providing certain responsibilities; providing for disciplinary action; authorizing penalties; providing for codification; and providing an effective date . BE IT ENACTED BY THE PEOPLE OF THE ST ATE OF OKLAHOMA: SECTION 1. NEW LAW A new section of l aw to be codified in the Oklahoma Statutes as Section 479 of Title 59, unless there is created a duplication in numbering, reads as follows: A. As used in this section: 1. "Advanced Practice Registered Nurse " or "(APRN)" means a registered nurse who has obtained a license from the Oklahoma Board of Nursing to practice advanced registered nursing; 2. "Board" means the State Board of Osteopathic Examiners or State Board of Medica l Licensure and Supervision; 3. "Mid-level provider" means a licensed Advance d Practice Registered Nurse by the Oklahoma Board of Nursing or a Physician 's Req. No. 10618 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 Assistant licensed by the Oklahoma Board of Medical Licensure and Supervision; 4. "Proper physician supervision" means that the supervising physician routinely reviews the prescribing patterns of an Advanced Practice Registered Nurse under his or her supervision and that the supervising physician is available to the Advanced Practice Registered Nurse for consultation in-person or by telemedicine within a reasonable timeframe not exceeding forty-eight (48) hours; 5. "Supervising physician " means a licensed allopathic or osteopathic physician in good standing who is responsible for supervising and oversee ing the prescribing practices of an Advanced Practice Registered Nurse ; and 6. "Verified complaint" means the formal allegation of at least one violation of statutes or administrative rules against a physician filed by the board. B. To be eligible to ser ve as a supervising physician for an Advanced Practice Registered Nurse, an al lopathic or osteopathic physician shall meet the following criteria: 1. Have possession of a full and unrestricted Oklahoma license to practice allopathic or osteopathic medicin e; 2. Have possession of a valid permit to prescribe controlled drugs with the Drug Enforcement Agency (DEA) and Oklahoma Bureau of Narcotics and Dangerous Drugs Control (OBNDD); and Req. No. 10618 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 3. Be fully trained and qualified in the field of the APRN 's specialty or in the services and procedures the APRN is to provide. C. A supervising physician may charge a reasonable fee to the APRN for his or her supervision services, which shall be disclosed in a written agreement. Any fees charged by a supervising physician shall be appropriate based on the actual duties and responsibilities of the supervising physician as outlined in a written agreement. The fees charged shall be a fair -market-value hourly rate as defined by the respective board biannually. A supervising physician who charges an Advanced Practice Registered Nurse for supervision services and fails to provided proper physician supervision may be subject to discipline by the physician 's respective board. This subsection does not relate to or impact any comp ensation a supervising physician receives from his or her employer or health care entity for supervision services. It only pertains to compensation received directly from the APRN. D. All supervising physicians shall have a written agreement with each APRN he or she supervises. The written agreement shall outline any fees charged for supervision services, the scope of the Advanced Practice Registered Nurse 's practice, including any limitations on prescribing controlled drugs, and the extent of the supervision required. The physician shall file t he written agreement with the respective licensing board. Req. No. 10618 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 E. A supervising physician shall notify Advance Practice Registered Nurses under his or her supervision of reasonably anticipated periods of unavailabilit y or incapacity on the part of the supervising physicians. Notice shall be gi ven by the method agreed to by the supervising physician and the Advanced Practice Registered Nurse within the written supervision agreement. F. The supervising physician shall report to the Board and Advanced Practice Registered Nurse any changes to the supervising relationship within fourteen (14) days, including the addition or removal of an Advanced Practice Registered Nurse or changes to the practice address, cell phone numb ers, the scope of the supervision relationship, or prescriptive authority. G. The Board shall not charge any fees to supervising physicians or Advanced Practice Registered Nurses for the maintenance and tracking of the supervision relationship. H. The Board shall promulgate rules establishing the expectations for providing proper supervision to Advanced Practice Registered Nurses, including: 1. The charging of reasonable fees to provide supervision services; 2. Continuous availability of direct communic ations either in person or by electronic communications between the APRN and supervising physician; Req. No. 10618 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 3. Oversight and acceptance of responsibility for the ordering and transmission of written, telephonic electronic, or oral prescriptions for drugs and othe r medical supplies, subject to a defined formulary in Section 567.3a of Title 59 of the Oklahoma Statutes; 4. Regular chart review; 5. The delineation of a plan for emergencies; and 6. The designation of an alternate physician in the absence of the supervising physician. I. Failure to comply with these rules may result in disciplinary action by the board. J. The Executive Director of the respective board shall report annually to the Board the number of complaints received in relation to this section of law. K. The Executive Director of the respective board shall create and maintain a list of physicians on the agency 's official website who are willing to serve as a supervising physician to an Advanced Practice Registered Nurse licensed in Oklahoma. SECTION 2. This act shall become effective November 1, 2025. 60-1-10618 TJ 01/14/25