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Oklahoma Legislature· HB 1630Second Reading referred to Health and Human Services

An act relating to medical facilities, the official text

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1                   STATE OF OKLAHOMA

2   1st Session of the 60th Legislature (2025)

3 HOUSE BILL 1630   By: Sneed

4

5

6

7                   AS INTRODUCED

8   An Act relating to medical facilities; defining

    terms; prohibiting operation of certain facility

9   without a license; providing certain interpretation;

    requiring separate license for each location;

10  prohibiting transfer or assignment of certain

    license; providing penalty for noncompliance;

11  requiring the establishment of certain

    classification; providing certain exceptions; setting

12  requirements for certain application; requiring

    licensing fee; requiring Oklahoma Commissioner of

13  Health to adopt certain rules and set certain fees;

    authorizing facility inspections; requiring licensing

14  fees to be deposited in certain revolving fund;

    requiring Oklahoma Commissioner of Health to adopt

15  certain rules; requiring consultation; requiring

    facility to provide examination for determination of

16  emergency medical condition; requiring facility to

    meet certain standards; requiring agreement;

17  prohibiting certain reimbursement; authorizing

    complaints against certain facilities to be filed

18  with the State Department of Health; authorizing

    State Department of Health to take certain action for

19  certain violations; authorizing emergency order of

    license suspension; providing procedure for hearing;

20  authorizing petition for temporary restraining order;

    authorizing district courts to issue injunctions;

21  directing the Attorney General to file suit at

    request of Department; establishing venue;

22  authorizing administrative penalties; limiting amount

    of penalties; providing bases for calculating amount

23  of penalty; requiring certain written notice;

    specifying information to be included in written

24  notice; providing for judicial review of certain

    Req. No. 11735                                         Page 1
1   order; creating revolving fund; providing for

    codification; and providing an effective date.

2

3

4 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:

5   SECTION 1.         NEW LAW  A new section of law to be codified

6 in the Oklahoma Statutes as Section 2667 of Title 63, unless there

7 is created a duplication in numbering, reads as follows:

8   As used in this act:

9   1. "Commissioner" means the Oklahoma Commissioner of Health;

10  2. "Department" means the State Department of Health;

11  3. "Emergency care" means health care services provided to

12 achieve stabilization as needed for conditions that reasonably

13 appear to constitute a life- or limb-threatening emergency based on

14 the presenting symptoms of the patient;

15  4. "Facility" means a short-term emergency and nonemergency

16 hybrid medical facility;

17  5. "Maximum emergency stay period" means any patient who is

18 treated for an emergency situation and is prohibited from being

19 treated or held any longer than twenty-four (24) hours so long as

20 the necessary treatment required is deemed an emergency. Maximum

21 emergency stay period shall not apply to patients that are

22 stabilized and needing further treatment from being provided

23 nonemergency care;

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    Req. No. 11735                                                  Page 2
1   6. "Nonemergency care" means all health care that is not for

2 life-threatening conditions or covered as emergency care under an

3 existing health care policy, including, but not limited to, the

4 following services:

5   a. diagnostic testing,

6   b. lab testing,

7   c. outpatient services,

8   d. primary care, and

9   e. X-rays, magnetic resonance imaging (MRI), and other

10              types of imaging; and

11  7. "Short-term emergency and nonemergency hybrid medical

12 facility" means a dual-sided facility, structurally separate and

13 distinct from a hospital that is open twenty-four (24) hours per day

14 and seven (7) days a week, with one side of the facility providing

15 emergency care and the other side of the facility providing

16 nonemergency care.

17  SECTION 2.         NEW LAW  A new section of law to be codified

18 in the Oklahoma Statutes as Section 2668 of Title 63, unless there

19 is created a duplication in numbering, reads as follows:

20  A. Except as provided by Section 3 of this act, a person shall

21 not establish or operate a short-term emergency and nonemergency

22 hybrid medical facility in this state without a license issued under

23 this act.

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    Req. No. 11735                                              Page 3
1   B. Except as provided by Section 3 of this act, a facility

2 shall not hold itself out to the public as a short-term emergency

3 and nonemergency hybrid medical facility or use any similar term, as

4 defined by State Department of Health rule, that would give the

5 impression that the facility or person is providing emergency care

6 unless the facility or person holds a license issued under this act.

7   C. Nothing in this act shall be interpreted to prohibit a

8 licensed short-term emergency and nonemergency hybrid medical

9 facility from providing other health care services including, but

10 not limited to, imaging, primary care, nonemergency care, and other

11 ancillary services.

12  D. Each separate facility location shall have a separate

13 license.

14  E. A license issued under this act is not transferable or

15 assignable.

16  F. Any person who is convicted of violating a provision of this

17 section shall be guilty of a misdemeanor. Each day of a continuing

18 violation constitutes a separate offense.

19  G. The Oklahoma Commissioner of Health by rule shall establish

20 a classification for a facility that is in continuous operation

21 twenty-four (24) hours per day and seven (7) days per week.

22  H. No license shall be issued to a facility located in a city

23 with an established hospital and a population of less than thirty

24 thousand (30,000) people unless written permission is obtained from

    Req. No. 11735                                                  Page 4
1 the hospital to operate a short-term emergency and nonemergency

2 hybrid medical facility.

3   SECTION 3.      NEW LAW  A new section of law to be codified

4 in the Oklahoma Statutes as Section 2669 of Title 63, unless there

5 is created a duplication in numbering, reads as follows:

6   The following facilities shall not be required to be licensed

7 under this act:

8   1. An office or clinic owned and operated by a manufacturing

9 facility solely for the purposes of treating its employees and

10 contractors;

11  2. Temporary emergency clinics in disaster areas;

12  3. An office or clinic of a licensed dentist, optometrist, or

13 podiatrist;

14  4. A licensed nursing home;

15  5. A licensed hospital;

16  6. A hospital that is owned and operated by this state;

17  7. A facility located within or connected to a hospital

18 described by paragraph 5 or 6 of this section;

19  8. A facility that is owned or operated by a hospital described

20 by paragraph 5 or 6 of this section and is:

21  a. surveyed as a service of the hospital by an

22               organization that has been granted deeming authority

23               as a national accreditation program for hospitals by

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    Req. No. 11735                                                 Page 5
1                the federal Centers for Medicare and Medicaid

2                Services, or

3        b. granted provider-based status by the Centers for

4                Medicare and Medicaid Services; or

5   9. A licensed ambulatory surgical center.

6   SECTION 4.         NEW LAW  A new section of law to be codified

7 in the Oklahoma Statutes as Section 2670 of Title 63, unless there

8 is created a duplication in numbering, reads as follows:

9   A. An applicant for a license under this act shall submit an

10 application to the State Department of Health on a form prescribed

11 by the Department.

12  B. Each application shall be accompanied by a nonrefundable

13 license fee in an amount set by the Oklahoma Commissioner of Health.

14  C. The application shall require that an emergency room is

15 staffed by board-certified emergency room physicians licensed by the

16 State Board of Medical Licensure and Supervision.

17  D. The application shall contain evidence that the facility

18 meets the minimum standards and requirements specified in Section 9

19 of this act.

20  E. The Department shall issue a license if, after inspection

21 and investigation, it finds that the applicant and the facility meet

22 the requirements of this act and the standards adopted under this

23 act.

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    Req. No. 11735                                              Page 6
1   F. The license fee shall be paid annually on renewal of the

2 license.

3   SECTION 5.      NEW LAW  A new section of law to be codified

4 in the Oklahoma Statutes as Section 2671 of Title 63, unless there

5 is created a duplication in numbering, reads as follows:

6   The Oklahoma Commissioner of Health shall adopt rules necessary

7 to implement this act, including requirements for the issuance,

8 renewal, denial, suspension, and revocation of a license to operate

9 a facility.

10  SECTION 6.      NEW LAW  A new section of law to be codified

11 in the Oklahoma Statutes as Section 2672 of Title 63, unless there

12 is created a duplication in numbering, reads as follows:

13  The Oklahoma Commissioner of Health shall set fees imposed by

14 this act in amounts reasonable and necessary to defray the cost of

15 administering this act.

16  SECTION 7.      NEW LAW  A new section of law to be codified

17 in the Oklahoma Statutes as Section 2673 of Title 63, unless there

18 is created a duplication in numbering, reads as follows:

19  The State Department of Health may inspect a facility at

20 reasonable times as necessary to ensure compliance with this act.

21  SECTION 8.      NEW LAW  A new section of law to be codified

22 in the Oklahoma Statutes as Section 2674 of Title 63, unless there

23 is created a duplication in numbering, reads as follows:

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    Req. No. 11735                                                 Page 7
1   All fees collected under this act shall be deposited in the

2 State Treasury to the credit of the Short-term Emergency and

3 Nonemergency Hybrid Medical Facility Licensing Fund created by

4 Section 17 of this act for the administration and enforcement of

5 this act and for no other purposes.

6   SECTION 9.      NEW LAW        A new section of law to be codified

7 in the Oklahoma Statutes as Section 2675 of Title 63, unless there

8 is created a duplication in numbering, reads as follows:

9   A. The Oklahoma Commissioner of Health shall adopt rules

10 necessary to implement this act, including standards for:

11  1. The construction and design of the facility including

12 plumbing, heating, lighting, ventilation, proper air transportation

13 accommodations, and other design standards necessary to ensure the

14 health and safety of patients;

15  2. Any transportation accommodations which shall be required

16 unless a facility is located where air transportation is expressly

17 prohibited by Title 14 of the Code of Federal Regulations;

18  3. The number, qualifications, and organization of the

19 professional staff and other personnel, including the requirement

20 that each facility staff board-certified emergency room physicians

21 when providing emergency care;

22  4. The administration of the facility;

23  5. The equipment essential to the health and welfare of the

24 patients;

    Req. No. 11735                                                Page 8
1   6. The sanitary and hygienic conditions within the facility and

2 its surroundings;

3   7. The requirements for the contents, maintenance, and release

4 of medical records;

5   8. The minimal level of care and standards for denial of care;

6   9. The provision of laboratory and radiological services;

7   10. The distribution and administration of drugs and controlled

8 substances;

9   11. A quality assurance program for patient care;

10  12. Disclosure, if applicable, of the following:

11  a. the name and Social Security number of the sole

12             proprietor, if the facility is a sole proprietor,

13  b. the name and Social Security number of each general

14             partner who is an individual, if the facility is a

15             partnership,

16  c. the name and Social Security number of any individual

17             who has an ownership interest of more than twenty-five

18             percent (25%) in the corporation, if the facility is a

19             corporation, and

20  d. the names and license numbers of any physicians

21             licensed by the State Board of Medical Licensure and

22             Supervision or the State Board of Osteopathic

23             Examiners who have a financial interest in the

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    Req. No. 11735                                                Page 9
1              facility or any entity which has an ownership interest

2              in the facility;

3   13. Transfer protocols for patients requiring advanced medical

4 care at a hospital and who require emergency medical treatment

5 extending past the twenty-four-hour maximum stay period;

6   14. Proper air transportation accommodations; and

7   15. Any other aspect of the operation of a facility that the

8 Commissioner considers necessary to protect the facility's patients

9 and the public.

10  B. In adopting the rules required under subsection A of this

11 section concerning transfer protocols, the Commissioner shall

12 consult with physicians who provide emergency care and medical

13 consultant organizations.

14  SECTION 10.     NEW LAW      A new section of law to be codified

15 in the Oklahoma Statutes as Section 2676 of Title 63, unless there

16 is created a duplication in numbering, reads as follows:

17  A. A facility shall provide to each facility emergency patient,

18 without regard to the individual's ability to pay, an appropriate

19 medical screening, examination, and stabilization within the

20 facility's capability, including ancillary services routinely

21 available to the facility, to determine whether an emergency medical

22 condition exists and to determine any necessary stabilizing

23 treatment.

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    Req. No. 11735                                                 Page 10
1   B. Each facility shall meet those standards set forth by

2 Section 1395dd of 42 U.S.C. of the Emergency Medical Treatment and

3 Labor Act.

4   C. Before a facility accepts any patient for treatment or

5 diagnosis, the facility shall enter into a referral, transmission,

6 or admission agreement with a hospital licensed in this state.

7   D. An insurer or third-party administrator shall be prohibited

8 from reimbursing a facility licensed under this act on a discounted

9 fee basis for covered services that are provided to an insured

10 unless:

11  1. The insurer or third-party administrator has contracted with

12 either:

13          a. the physician or other practitioner, institutional

14            provider, or organization of physicians and health

15            care providers, or

16          b. the health maintenance organization, exclusive

17            provider organization, or preferred provider

18            organization that has a network of preferred providers

19            and that has contracted with the physician or other

20            practitioner, institutional provider, or organization

21            of physicians and health care providers;

22  2. The physician or other practitioner, institutional provider,

23 or organization of physicians and health care providers has agreed

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    Req. No. 11735                                                Page 11
1 to the contract and to provide health care services under the terms

2 of the contract; and

3   3. The insurer or third-party administrator has agreed to

4 provide coverage for those health care services under the health

5 insurance policy.

6   SECTION 11.      NEW LAW  A new section of law to be codified

7 in the Oklahoma Statutes as Section 2677 of Title 63, unless there

8 is created a duplication in numbering, reads as follows:

9   A person may file a complaint with the State Department of

10 Health against a facility licensed under this act.

11  SECTION 12.      NEW LAW  A new section of law to be codified

12 in the Oklahoma Statutes as Section 2678 of Title 63, unless there

13 is created a duplication in numbering, reads as follows:

14  A. The State Department of Health may deny, suspend, or revoke

15 a license for a violation of this act or a rule adopted under this

16 act.

17  B. If the Department finds that a facility is in repeated

18 noncompliance with this act or rules adopted under this act but the

19 noncompliance does not endanger public health and safety, the

20 Department may schedule the facility for probation rather than

21 suspending or revoking the facility's license. The Department shall

22 provide notice to the facility of the probation and of the items of

23 noncompliance not later than the tenth day before the date the

24 probation period begins. The Department shall designate a period of

    Req. No. 11735                                                 Page 12
1 not less than thirty (30) calendar days during which the facility

2 remains under probation. During the probation period, the facility

3 must correct the items that were in noncompliance and report the

4 corrections to the Department for approval.

5   C. The Department may suspend or revoke the license of a

6 facility that does not correct items that were in noncompliance or

7 that does not comply with this act or the rules adopted under this

8 act within the applicable probation period.

9   SECTION 13.     NEW LAW  A new section of law to be codified

10 in the Oklahoma Statutes as Section 2679 of Title 63, unless there

11 is created a duplication in numbering, reads as follows:

12  A. The State Department of Health may issue an emergency order

13 to suspend a license issued under this act if the Department has

14 reasonable cause to believe that the conduct of a license holder

15 creates an immediate danger to the public health or safety.

16  B. An emergency suspension under this section is effective

17 immediately without a hearing or notice to the license holder.

18  C. On written request of the license holder, the Department

19 shall conduct a hearing not earlier than the tenth day or later than

20 the thirtieth day after the date the hearing request is received to

21 determine if the emergency suspension is to be continued, modified,

22 or rescinded.

23  D. A hearing and any appeal under this section are governed by

24 the Department's rules.

    Req. No. 11735                                                 Page 13
1   SECTION 14.     NEW LAW  A new section of law to be codified

2 in the Oklahoma Statutes as Section 2680 of Title 63, unless there

3 is created a duplication in numbering, reads as follows:

4   A. The State Department of Health may petition a district court

5 for a temporary restraining order to restrain a continuing violation

6 of the standards or licensing requirements provided under this act

7 if the Department finds that the violation creates an immediate

8 threat to the health or safety of the patients of a facility.

9   B. A district court, on petition of the Department and on a

10 finding by the court that a person is violating the standards or

11 licensing requirements provided under this act, may by injunction:

12  1. Prohibit a person from continuing a violation of the

13 standards or licensing requirements provided under this act;

14  2. Restrain or prevent the establishment or operation of a

15 facility without a license issued under this act; or

16  3. Grant any other injunctive relief warranted by the facts.

17  C. The Attorney General shall institute and conduct a suit

18 authorized by this section at the request of the Department.

19  D. Venue for a suit brought under this section is in the county

20 in which the facility is located or in Oklahoma County.

21  SECTION 15.     NEW LAW  A new section of law to be codified

22 in the Oklahoma Statutes as Section 2681 of Title 63, unless there

23 is created a duplication in numbering, reads as follows:

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    Req. No. 11735                                               Page 14
1   A. The State Department of Health may impose an administrative

2 penalty on a person licensed under this act who violates this act or

3 a rule or order adopted under this act. A penalty collected under

4 this section or Section 16 of this act shall be deposited in the

5 State Treasury in the General Revenue Fund.

6   B. A proceeding to impose the penalty is considered to be a

7 contested case.

8   C. The amount of the penalty may not exceed One Thousand

9 Dollars ($1,000.00) for each violation, and each day a violation

10 continues or occurs is a separate violation for purposes of imposing

11 a penalty. The total amount of the penalty assessed for a violation

12 continuing or occurring on separate days under this subsection may

13 not exceed Five Thousand Dollars ($5,000.00).

14  D. The amount shall be based on:

15  1. The seriousness of the violation, including the nature,

16 circumstances, extent, and gravity of the violation;

17  2. The threat to health or safety caused by the violation;

18  3. The history of previous violations;

19  4. The amount necessary to deter a future violation;

20  5. Whether the violator demonstrated good faith, including when

21 applicable whether the violator made good-faith efforts to correct

22 the violation; and

23  6. Any other matter that the Department may require.

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    Req. No. 11735                                            Page 15
1   E. If the Department initially determines that a violation

2 occurred, the Department shall give written notice of the report by

3 certified mail to the person.

4   F. The notice under subsection E of this section shall:

5   1. Include a brief summary of the alleged violation;

6   2. State the amount of the recommended penalty; and

7   3. Inform the person of the person's right to a hearing on the

8 occurrence of the violation, the amount of the penalty, or both.

9   G. Within twenty (20) calendar days after the date the person

10 receives the notice under subsection E of this section, the person

11 in writing may:

12  1. Accept the determination and recommended penalty of the

13 Department; or

14  2. Make a request for a hearing on the occurrence of the

15 violation, the amount of the penalty, or both.

16  H. If the person accepts the determination and recommended

17 penalty or if the person fails to respond to the notice, the

18 Oklahoma Commissioner of Health by order shall approve the

19 determination and impose the recommended penalty.

20  I. The notice of the order shall include a statement of the

21 right of the person to a judicial review of the order.

22  SECTION 16.     NEW LAW      A new section of law to be codified

23 in the Oklahoma Statutes as Section 2682 of Title 63, unless there

24 is created a duplication in numbering, reads as follows:

    Req. No. 11735                                               Page 16
1   A. Within thirty (30) calendar days after the date an order of

2 the Oklahoma Commissioner of Health that imposes an administrative

3 penalty becomes final, the person shall:

4   1. Pay the penalty; or

5   2. File a petition for judicial review of the Commissioner's

6 order contesting the occurrence of the violation, the amount of the

7 penalty, or both.

8   B. Within the thirty-day period prescribed by subsection A of

9 this section, a person who files a petition for judicial review may:

10  1. Stay enforcement of the penalty by:

11  a. paying the penalty to the court for placement in an

12  escrow account, or

13  b. giving the court a supersedeas bond approved by the

14  court that:

15  (1) is for the amount of the penalty, and

16  (2) is effective until all judicial review of the

17                   Commissioner's order is final;

18  2. Request the court to stay enforcement of the penalty by

19 filing with the court a sworn affidavit of the person stating that

20 the person is financially unable to pay the penalty and is

21 financially unable to give the supersedeas bond and by sending a

22 copy of the affidavit to the Commissioner by certified mail.

23  C. If the Commissioner receives a copy of an affidavit under

24 subsection B of this section, the Commissioner may file with the

    Req. No. 11735                                               Page 17
1 court, within five (5) calendar days after the date the copy is

2 received, a contest to the affidavit. The court shall hold a

3 hearing on the facts alleged in the affidavit as soon as practicable

4 and shall stay the enforcement of the penalty on finding that the

5 alleged facts are true. The person who files an affidavit has the

6 burden of proving that the person is financially unable to pay the

7 penalty or to give a supersedeas bond.

8   D. If the person does not pay the penalty and the enforcement

9 of the penalty is not stayed, the penalty may be collected. The

10 Attorney General may sue to collect the penalty.

11  E. If the court sustains the finding that a violation occurred,

12 the court may uphold or reduce the amount of the penalty and order

13 the person to pay the full or reduced amount of the penalty.

14  F. If the court does not sustain the finding that a violation

15 occurred, the court shall order that a penalty is not owed.

16  G. If the person paid the penalty and if the amount of the

17 penalty is reduced or the penalty is not upheld by the court, the

18 court shall order, when the court's judgment becomes final, that the

19 appropriate amount plus accrued interest be remitted to the person

20 within thirty (30) calendar days after the date that the judgment of

21 the court becomes final. The interest accrues at the rate charged

22 on loans to depository institutions by the Federal Reserve Bank of

23 New York. The interest shall be paid for the period beginning on

24

    Req. No. 11735                                               Page 18
1 the date the penalty is paid and ending on the date the penalty is

2 remitted.

3   H. If the person gave a supersedeas bond and the penalty is not

4 upheld by the court, the court shall order, when the court's

5 judgment becomes final, the release of the bond. If the person gave

6 a supersedeas bond and the amount of the penalty is reduced, the

7 court shall order the release of the bond after the person pays the

8 reduced amount.

9   SECTION 17.     NEW LAW  A new section of law to be codified

10 in the Oklahoma Statutes as Section 2683 of Title 63, unless there

11 is created a duplication in numbering, reads as follows:

12  There is hereby created in the State Treasury a revolving fund

13 for the State Department of Health to be designated the "Short-term

14 Emergency and Nonemergency Hybrid Medical Facility Licensing Fund".

15 The fund shall be a continuing fund, not subject to fiscal year

16 limitations, and shall consist of all monies received by the State

17 Department of Health from short-term emergency and nonemergency

18 hybrid medical facilities. All monies accruing to the credit of the

19 fund are hereby appropriated and may be budgeted and expended by the

20 State Department of Health for the purpose of administering and

21 enforcing licensing provisions for short-term emergency and

22 nonemergency hybrid medical facilities. Expenditures from the fund

23 shall be made upon warrants issued by the State Treasurer against

24

    Req. No. 11735                                              Page 19
1 claims filed as prescribed by law with the Director of the Office of

2 Management and Enterprise Services for approval and payment.

3   SECTION 18. This act shall become effective November 1, 2025.

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5   60-1-11735      TJ  01/09/25

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    Req. No. 11735                                              Page 20
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