1 STATE OF OKLAHOMA
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2 2nd Session of the 59th Legislature (2024)
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3 SENATE BILL 1613 By: Garvin
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6 AS INTRODUCED
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7 An Act relating to the practice of medicine; defining
7 terms; providing for scope of practice of
8 provisionally licensed physicians; directing the
8 State Board of Medical Licensure and Supervision and
9 the State Board of Osteopathic Examiners to
9 promulgate certain rules; specifying professional
10 terms; making collaborating physician responsible for
10 provisionally licensed physicians; requiring
11 collaborative practice arrangement; specifying
11 certain protections for rural health clinics;
12 stipulating requirements for collaborative practice
12 arrangements; providing for promulgation of certain
13 rules and approval of rules; prohibiting certain
13 disciplinary action under certain circumstances;
14 requiring certain notice by collaborating physician;
14 imposing certain limit on collaborative practice
15 arrangements; requiring certain documentation;
15 providing certain construction; requiring
16 identification badges; setting forth provisions
16 related to prescriptive authority for certain
17 controlled substances; amending 59 O.S. 2021, Section
17 725.2, as amended by Section 2, Chapter 149, O.S.L.
18 2022 (59 O.S. Supp. 2023, Section 725.2), which
18 relates to use of professional terms; modifying
19 applicability of certain provisions; providing for
19 codification; and providing an effective date.
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22 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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 1 SECTION 1. NEW LAW A new section of law to be codified
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2 in the Oklahoma Statutes as Section 479.1 of Title 59, unless there
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3 is created a duplication in numbering, reads as follows:
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4 As used in this act:
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5 1. “Graduate of an Oklahoma school or college of osteopathic
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6 medicine” means any person who has graduated from an Oklahoma school
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7 or college of osteopathic medicine as defined in this section;
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8 2. “Medical school graduate” means any person who has graduated
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9 from an Oklahoma medical school or Oklahoma school or college of
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10 osteopathic medicine as defined in this section;
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11 3. “Oklahoma medical school” means a legally chartered
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12 allopathic medical school located in this state recognized by the
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13 Oklahoma State Regents for Higher Education or the Liaison Committee
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14 on Medical Education;
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15 4. “Oklahoma school or college of osteopathic medicine” means a
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16 legally chartered and accredited school or college of osteopathic
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17 medicine located in this state requiring:
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18 a. for admission to its courses of study, a preliminary
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19 education equal to the requirements established by the
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20 Bureau of Professional Education of the American
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21 Osteopathic Association, and
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22 b. for granting the D.O. degree, Doctor of Osteopathy or
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23 Doctor of Osteopathic Medicine, actual attendance at
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24 such osteopathic school or college and demonstration
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Req. No. 3094 Page 2
 1 of successful completion of the curriculum and
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2 recommendation for graduation;
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3 5. “Provisionally licensed physician” means a graduate of an
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4 Oklahoma medical school or an Oklahoma school or college of
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5 osteopathic medicine who:
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6 a. is a resident and citizen of the United States or is a
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7 legal resident alien,
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8 b. (1) has successfully completed Step 1 and Step 2 of
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9 the United States Medical Licensing Examination
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10 or the equivalent of such steps of any other
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11 medical licensing examination approved by the
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12 State Board of Medical Licensure and Supervision
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13 within the two-year period immediately preceding
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14 application for licensure as a provisionally
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15 licensed physician, but in no event more than
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16 three (3) years after graduation from a medical
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17 school, or
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18 (2) has successfully completed Level 1 and Level 2 of
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19 the Comprehensive Osteopathic Medical Licensing
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20 Examination of the United States or the
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21 equivalent of such steps of any other medical
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22 licensing examination approved by the State Board
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23 of Osteopathic Examiners within the two-year
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24 period immediately preceding application for
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 1 licensure as a provisionally licensed physician,
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2 but in no event more than three (3) years after
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3 graduation from a school or college of
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4 osteopathic medicine,
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5 c. (1) has not completed an approved postgraduate
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6 residency and has successfully completed Step 2
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7 of the United States Medical Licensing
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8 Examination or the equivalent of such step of any
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9 other medical licensing examination approved by
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10 the State Board of Medical Licensure and
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11 Supervision within the immediately preceding two-
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12 year period unless when such two-year anniversary
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13 occurred he or she was serving as a resident
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14 physician in an accredited residency in the
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15 United States and continued to do so within
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16 thirty (30) calendar days prior to application
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17 for licensure as a provisionally licensed
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18 physician, or
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19 (2) has not completed an approved postgraduate
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20 residency and has successfully completed Level 2
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21 of the Comprehensive Osteopathic Medical
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22 Licensing Examination of the United States or the
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23 equivalent of such step of any other medical
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24 licensing examination approved by the State Board
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 1 of Osteopathic Examiners within the immediately
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2 preceding two-year period unless when such two-
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3 year anniversary occurred he or she was serving
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4 as a resident physician in an accredited
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5 residency in the United States and continued to
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6 do so within thirty (30) calendar days prior to
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7 application for licensure as a provisionally
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8 licensed physician, and
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9 d. has proficiency in the English language; and
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10 6. “Provisionally licensed physician collaborative practice
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11 arrangement” means an agreement between a physician and a
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12 provisionally licensed physician that meets the requirements of this
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13 act.
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14 SECTION 2. NEW LAW A new section of law to be codified
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15 in the Oklahoma Statutes as Section 479.2 of Title 59, unless there
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16 is created a duplication in numbering, reads as follows:
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17 A. A provisionally licensed physician collaborative practice
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18 arrangement shall limit the provisionally licensed physician to
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19 providing only primary care services.
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20 B. The licensure of provisionally licensed physicians shall
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21 take place within processes established by rules of the State Board
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22 of Medical Licensure and Supervision or of the State Board of
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23 Osteopathic Examiners. The State Board of Medical Licensure and
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24 Supervision and the State Board of Osteopathic Examiners shall
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 1 promulgate rules establishing licensure and renewal procedures,
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2 supervision, collaborative practice arrangements, and fees and
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3 addressing such other matters as are necessary to protect the public
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4 and discipline the profession. An application for licensure may be
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5 denied or the licensure of a provisionally licensed physician may be
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6 suspended or revoked by the State Board of Medical Licensure and
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7 Supervision or by the State Board of Osteopathic Examiners in the
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8 same manner and for violation of the standards as set forth by the
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9 Oklahoma Allopathic Medical and Surgical Licensure and Supervision
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10 Act or the Oklahoma Osteopathic Medicine Act, or such other
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11 standards of conduct set by the State Board of Medical Licensure and
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12 Supervision or the State Board of Osteopathic Examiners by rule.
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13 C. A provisionally licensed physician shall clearly identify
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14 himself or herself as a provisionally licensed physician and shall
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15 be permitted to use the terms “doctor”, “Dr.”, or “doc”. No
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16 provisionally licensed physician shall practice or attempt to
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17 practice without a provisionally licensed physician collaborative
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18 practice arrangement, except as otherwise provided in this section
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19 and in an emergency situation.
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20 D. The collaborating physician is responsible at all times for
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21 the oversight of the activities of and accepts responsibility for
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22 primary care services rendered by the provisionally licensed
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23 physician.
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 1 E. The provisions of Section 3 of this act shall apply to all
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2 provisionally licensed physician collaborative practice
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3 arrangements. To be eligible to practice as a provisionally
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4 licensed physician, a provisionally licensed physician shall enter
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5 into a provisionally licensed physician collaborative practice
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6 arrangement within six (6) months of his or her initial licensure
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7 and shall not have more than a six-month time period between
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8 collaborative practice arrangements during his or her licensure
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9 period. Any renewal of licensure pursuant to this section shall
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10 include verification of actual practice under a collaborative
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11 practice arrangement in accordance with this subsection during the
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12 immediately preceding licensure period.
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13 F. For a physician-provisionally licensed physician team
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14 working in a rural health clinic under the federal Rural Health
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15 Clinic Services Act, P.L. 95-210:
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16 1. A provisionally licensed physician shall be considered a
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17 physician assistant for purposes of regulations of the Centers for
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18 Medicare and Medicaid Services (CMS); and
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19 2. No supervision requirements in addition to the minimum
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20 federal law shall be required.
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21 SECTION 3. NEW LAW A new section of law to be codified
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22 in the Oklahoma Statutes as Section 479.3 of Title 59, unless there
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23 is created a duplication in numbering, reads as follows:
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 1 A. A physician may enter into collaborative practice
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2 arrangements with provisionally licensed physicians. Collaborative
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3 practice arrangements shall be in the form of written agreements,
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4 jointly agreed-upon protocols or standing orders for the delivery of
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5 health care services. Collaborative practice arrangements, which
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6 shall be in writing, may delegate to a provisionally licensed
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7 physician the authority to administer and dispense drugs and provide
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8 treatment as long as the delivery of such health care services is
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9 within the scope of practice of the provisionally licensed physician
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10 and is consistent with that provisionally licensed physician’s
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11 skill, training, and competence and the skill and training of the
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12 collaborating physician.
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13 B. The written collaborative practice arrangement shall
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14 include, but not be limited to:
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15 1. Complete names, home and business addresses, zip codes, and
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16 telephone numbers of the collaborating physician and the
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17 provisionally licensed physician;
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18 2. A list of all other offices or locations besides those
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19 listed in paragraph 1 of this subsection where the collaborating
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20 physician authorized the provisionally licensed physician to
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21 prescribe;
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22 3. A requirement that there shall be posted at every office
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23 where the provisionally licensed physician is authorized to
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24 prescribe, in collaboration with a physician, a prominently
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 1 displayed disclosure statement informing patients that they may be
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2 seen by a provisionally licensed physician and have the right to see
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3 the collaborating physician;
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4 4. All specialty or Board certifications of the collaborating
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5 physician and all certifications of the provisionally licensed
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6 physician;
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7 5. The manner of collaboration between the collaborating
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8 physician and the provisionally licensed physician, including how
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9 the collaborating physician and the provisionally licensed physician
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10 shall:
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11 a. engage in collaborative practice consistent with each
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12 professional’s skill, training, education, and
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13 competence,
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14 b. maintain geographic proximity; provided, the
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15 collaborative practice arrangement may allow for
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16 geographic proximity to be waived for a maximum of
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17 twenty-eight (28) calendar days per calendar year for
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18 rural health clinics as defined by P.L. 95-210, as
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19 long as the collaborative practice arrangement
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20 includes alternative plans as required in subparagraph
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21 c of this paragraph. Such exception to geographic
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22 proximity shall apply only to independent rural health
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23 clinics, provider-based rural health clinics if the
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24 provider is a critical access hospital as provided in
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 1 42 U.S.C. Section 1395i-4 and provider-based rural
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2 health clinics if the main location of the hospital
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3 sponsor is not less than fifty (50) miles from the
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4 clinic. The collaborating physician shall maintain
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5 documentation related to such requirement and present
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6 it to the State Board of Medical Licensure and
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7 Supervision or the State Board of Osteopathic
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8 Examiners when requested, and
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9 c. provide coverage during absence, incapacity,
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10 infirmity, or emergency by the collaborating
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11 physician;
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12 6. A description of the provisionally licensed physician’s
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13 controlled substance prescriptive authority in collaboration with
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14 the physician, including a list of the controlled substances the
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15 physician authorizes the provisionally licensed physician to
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16 prescribe and documentation that it is consistent with each
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17 professional’s education, knowledge, skill, and competence;
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18 7. A list of all other written practice agreements of the
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19 collaborating physician and the provisionally licensed physician;
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20 8. The duration of the written practice agreement between