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STATE OF OKLAHOMA
1st Session of the 60th Legislature (2025)
SENATE BILL 442 By: Bergstrom
AS INTRODUCED
An Act relating to health care; amending 59 O.S.
2021, Section 650, which relates to interventional
pain management; modifying, adding , and deleting
definitions; authorizing Certified Registered Nurse
Anesthetist to provide certain services and operate
certain facilities under specified conditions;
providing certain construction; updating statutory
reference; updating statutory language; and providing
an effective date.
BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
SECTION 1. AMENDATORY 59 O.S. 2021, Section 650, is
amended to read as follows:
Section 650. A. This act section shall be known and may be
cited as the “Oklahoma Interventional Pain Management and Treatment
Act”.
B. As used in this section:
1. “Chronic pain” means a pain state which is subacute,
persistent and intractable;
2. “Fluoroscope” means a radiologic instrument equipped with a
fluorescent screen on which opaque internal structures can be viewed
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as moving shadow images formed by the differential transmission of
X-rays throughout the body “Fluoroscopy” means a medical imaging
procedure that uses an X -ray beam to take real -time footage of
moving internal body parts such as bones, muscles, joints, organs,
and tissue to display a consistent radiographic picture
progressively onto a screen ; and
3. “Interventional pain management ” means the practice of
medicine delivery of health care services devoted to the diagnosis
and treatment of chronic pain, throu gh the use of such techniques
as:
a. ablation of targeted nerves,
b. percutaneous precision needle placement within the
spinal column with placement of drugs such as local
anesthetics, steroids, and analgesics in targeted
areas of the spinal column , or
c. surgical techniques, such as laser or endoscopic
diskectomy discectomy, intrathecal infusion pumps and
spinal cord stimulators , or
d. fluoroscopy.
C. It shall be unlawful to pra ctice or offer to practice
interventional pain management in this state unless such person has:
1. Has been duly licensed under the provisions of the Oklahoma
Allopathic Medical and Surgical Licensure and Supervision Act or the
Oklahoma Osteopathic Medici ne Act; or
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2. Is a Certified Registered Nurse Anesthetist licensed in
accordance with the Oklahoma Nursing Practice Act who holds a valid
certification in Nonsurgical Pain Management from the National Board
of Certification and Recertification for Nurse A nesthetists and
practices in accordance with the certification .
D. Nothing in this section shall be construed to forbid the
administration of lumbar intra -laminar epidural steroid injections
or peripheral nerve blocks by a certified registered nurse
anesthetist when requested to do so by a physician and under the
supervision of A Certified Registered Nurse Anesthetist who meets
the criteria of subsection C of this section may:
1. Practice interventional pain management, except for surgical
techniques, in collaboration with an allopathic or osteopathic
physician licensed in this sta te and under conditions in which
timely on-site consultation by such allopathic or osteopathic
physician is available .
E. A certified registered nurse anesthetist shall not oper ate;
2. Operate a freestanding pain management facility without
direct supervision of a in collaboration with an allopathic or
osteopathic physician who is board -certified in interventional pain
management or its equivalent ; and
3. Perform procedural sed ation.
E. Nothing in this section shall authorize a Certified
Registered Nurse Anesthetist to prescribe or dispense any opioid or
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any other controlled dangerous substance to be taken by the patient
offsite for the management of chronic pain .
SECTION 2. This act shall become effective November 1, 2025.
60-1-432 DC 1/7/2025 7:04:42 PM