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1 STATE OF OKLAHOMA
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2 2nd Session of the 60th Legislature (2026)
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3 SENATE BILL 1567 By: Stanley
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6 AS INTRODUCED
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7 An Act relating to the practice of nursing; amending
7 Section 4, Chapter 340, O.S.L. 2025 (59 O.S. Supp.
8 2025, Section 479.1), which relates to supervising
8 physician of Advanced Practice Registered Nurse;
9 modifying certain restriction on supervision fees;
9 amending Section 1, Chapter 340, O.S.L. 2025 (59 O.S.
10 Supp. 2025, Section 567.4c), which relates to
10 independent prescriptive authority for Advanced
11 Practice Registered Nurse; excluding certain
11 application from specified provisions of law;
12 prohibiting certain requirements by the Oklahoma
12 Board of Nursing; updating statutory language;
13 updating statutory references; and providing an
13 effective date.
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16 BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA:
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17 SECTION 1. AMENDATORY Section 4, Chapter 340, O.S.L.
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18 2025 (59 O.S. Supp. 2025, Section 479.1), is amended to read as
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19 follows:
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20 Section 479.1. A. As used in this section:
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21 1. "Advanced Practice Registered Nurse" has the same meaning as
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22 defined in Section 567.3a of Title 59 of the Oklahoma Statutes this
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23 title, except that such term does not include a Certified Registered
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24 Nurse Anesthetist;
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1 2. "Board" means the State Board of Medical Licensure and
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2 Supervision or the State Board of Osteopathic Examiners, or both, as
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3 the context indicates; and
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4 3. The terms "supervising physician" and "supervision" have the
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5 same meaning as defined in Section 567.3a of Title 59 of the
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6 Oklahoma Statutes this title.
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7 B. To be eligible to serve as a supervising physician for an
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8 Advanced Practice Registered Nurse who has not obtained independent
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9 prescriptive authority under Section 1 of this act Section 567.4c of
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10 this title, the physician shall meet the following criteria:
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11 1. Have possession of a full and unrestricted license to
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12 practice allopathic or osteopathic medicine issued by the State
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13 Board of Medical Licensure and Supervision or the State Board of
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14 Osteopathic Examiners;
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15 2. Have possession of a valid registration to prescribe
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16 controlled substances issued by the Drug Enforcement Administration
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17 and the Oklahoma State Bureau of Narcotics and Dangerous Drugs
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18 Control; and
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19 3. Be trained and fully qualified in the field of the Advanced
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20 Practice Registered Nurse's specialty as determined by the
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21 physician's respective Board; provided, however, a supervising
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22 physician for a Certified Nurse-Midwife may be a family practice
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23 physician, obstetrician, or gynecologist.
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1 C. A supervising physician shall enter into a written
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2 supervision agreement with each Advanced Practice Registered Nurse
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3 he or she supervises. The supervising physician shall file the
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4 supervision agreement with his or her respective Board in the manner
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5 prescribed by such Board. The supervision agreement shall specify:
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6 1. Any fees charged to the Advanced Practice Registered Nurse
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7 for supervision services in accordance with subsection D of this
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8 section;
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9 2. The scope of the Advanced Practice Registered Nurse's
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10 prescriptive authority, subject to any limits on scope of
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11 prescriptive authority provided by the rules of the Oklahoma Board
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12 of Nursing;
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13 3. A description of the extent of the supervision required;
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14 4. The duties and responsibilities of the supervising
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15 physician;
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16 5. Procedures for notice to be provided by the supervising
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17 physician to Advanced Practice Registered Nurses for periods of
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18 absence in accordance with subsection E of this section; and
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19 6. One or more alternate physicians designated to supervise the
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20 Advanced Practice Registered Nurse in such periods of absence in
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21 accordance with the rules promulgated under subsection H of this
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22 section.
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1 D. 1. A supervising physician may charge a reasonable fee to
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2 the Advanced Practice Registered Nurse for his or her supervision
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3 services. Any such fees shall be:
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4 a. disclosed in the supervision agreement required under
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5 subsection C of this section,
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6 b. appropriate based on the actual duties and
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7 responsibilities of the supervising physician as
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8 outlined in the supervision agreement, and
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9 c. a fair market value hourly rate in accordance with the
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10 rules promulgated under subsection H of this section,
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11 or by mutual agreement between the Advanced Practice
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12 Registered Nurse and supervising physician.
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13 2. The provisions of this subsection shall apply only to
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14 compensation received by the supervising physician directly from the
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15 Advanced Practice Registered Nurse. This subsection shall not be
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16 construed to:
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17 a. preclude a supervising physician from entering into a
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18 payment arrangement for supervision fees to be paid by
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19 his or her employer or health care entity in lieu of
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20 the Advanced Practice Registered Nurse,
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21 b. preclude an employer or health care entity of a
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22 supervising physician from prohibiting, limiting, or
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23 otherwise addressing such supervision fees through
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24 policies, contracts, or bylaws, or
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1 c. apply to or impact any compensation a supervising
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2 physician receives from his or her employer or health
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3 care entity for supervision services.
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4 E. A supervising physician shall notify all Advanced Practice
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5 Registered Nurses under his or her supervision of reasonably
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6 anticipated periods of unavailability or incapacity on the part of
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7 the supervising physician. Notice shall be given by the method
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8 agreed to by the supervising physician and the Advanced Practice
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9 Registered Nurse within the written supervision agreement.
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10 F. The supervising physician shall report to his or her
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11 respective Board, and shall notify all Advanced Practice Registered
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12 Nurses under his or her supervision of, any changes to the
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13 supervising relationship within thirty (30) calendar days including,
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14 but not limited to, the addition or removal of an Advanced Practice
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15 Registered Nurse under the physician's supervision or a change to
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16 the physician's practice address or contact information. The
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17 physician's supervision agreements shall be amended as necessary to
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18 reflect any such changes.
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19 G. The State Board of Medical Licensure and Supervision and the
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20 State Board of Osteopathic Examiners shall not charge any fees to
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21 supervising physicians or Advanced Practice Registered Nurses for
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22 the maintenance or oversight of supervision agreements or other
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23 administrative functions related to the implementation or
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24 enforcement of this section.
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1 H. The State Board of Medical Licensure and Supervision and the
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2 State Board of Osteopathic Examiners shall promulgate a uniform set
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3 of rules establishing standards for proper supervision of Advanced
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4 Practice Registered Nurses who have not obtained independent
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5 prescriptive authority under Section 1 of this act Section 567.4c of
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6 this title, including:
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7 1. The charging of reasonable fees to provide supervision
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8 services. The rules shall establish a fair market value hourly rate
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9 for such fees, which shall be redetermined biennially;
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10 2. Continuous availability of direct communications either in
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11 person or by electronic communications between the Advanced Practice
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12 Registered Nurse and supervising physician;
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13 3. Oversight and acceptance of responsibility for the ordering
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14 and transmission of written, telephonic, electronic, or oral
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15 prescriptions for drugs and other medical supplies, subject to the
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16 formulary established by the Oklahoma Board of Nursing;
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17 4. Review of prescribing patterns of the Advanced Practice
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18 Registered Nurse;
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19 5. The delineation of a plan for emergencies; and
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20 6. The designation of one or more alternate physicians in the
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21 absence of the supervising physician.
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22 I. A supervising physician may be subject to disciplinary
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23 action by his or her respective Board for failure to comply with the
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24 provisions of, or the rules promulgated under, this section
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1 including, but not limited to, failure to provide proper
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2 supervision.
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3 J. If either Board imposes limits through rule on the number of
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4 Advanced Practice Registered Nurses that a supervising physician may
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5 supervise, such limits shall not apply when an Advanced Practice
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6 Registered Nurse is practicing in a hospital licensed by the State
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7 Department of Health.
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8 K. The Executive Director of each Board shall report annually
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9 to the respective Board the number of complaints received in
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10 relation to this section.
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11 L. The State Board of Medical Licensure and Supervision and the
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12 State Board of Osteopathic Examiners shall each create and maintain
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13 on the respective Board's website a list of physicians who are
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14 available to supervise Advanced Practice Registered Nurses.
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15 SECTION 2. AMENDATORY Section 1, Chapter 340, O.S.L.
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16 2025 (59 O.S. Supp. 2025, Section 567.4c), is amended to read as
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17 follows:
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18 Section 567.4c. A. An Advanced Practice Registered Nurse
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19 recognized by the Oklahoma Board of Nursing as a Certified Nurse
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20 Practitioner, Clinical Nurse Specialist, or Certified Nurse-Midwife
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21 who has completed a minimum of six thousand two hundred forty
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22 (6,240) clinical practice hours with prescriptive authority
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23 supervised by a physician may apply to the Oklahoma Board of Nursing
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24 for authority to prescribe and order independent of supervision.
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1 B. The application for independent prescriptive authority shall
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2 include proof that the Certified Nurse Practitioner, Clinical Nurse
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3 Specialist, or Certified Nurse-Midwife:
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4 1. Holds a valid, current license in the appropriate Advanced
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5 Practice Registered Nurse role issued by the Board and is in good
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6 standing with the Board; and
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7 2. Has completed a minimum of six thousand two hundred forty
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8 (6,240) clinical practice hours with prescriptive authority
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9 supervised by a physician. This paragraph shall not be construed to
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10 exclude practice hours with supervised prescriptive authority
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11 obtained prior to the effective date of this act November 1, 2025,
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12 from being counted toward the hours required in this paragraph.
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13 C. An application for independent prescriptive authority made
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14 under this section shall not be considered an initial application
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15 for prescriptive authority as described in paragraph 3 of Section
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16 567.4a of this title. The Board shall not require an Advanced
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17 Practice Registered Nurse applying for independent prescriptive
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18 authority under this section to recomplete any minimal requirements
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19 for initial application for prescriptive authority as described in
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20 paragraph 3 of Section 567.4a of this title.
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21 D. Independent prescriptive authority granted under this
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22 section shall be valid until the expiration of the current license
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23 to practice and may be renewed upon application to the Board at the
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1 same time and for the same period as the renewal of the license to
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2 practice.
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3 D. E. The Board may suspend or revoke independent prescriptive
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4 authority granted under this section in accordance with the
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5 Administrative Procedures Act for violation of the provisions of, or
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6 the rules promulgated under, the Oklahoma Nursing Practice Act.
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7 E. F. The Board may assess a reasonable fee for the review of
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8 initial and renewal applications under the provisions of this
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9 section.
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10 SECTION 3. This act shall become effective November 1, 2026.
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12 60-2-2632 DC 1/12/2026 7:41:44 PM
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Req. No. 2632 Page 9Every fact on this page links to its source, starting with the official bill record.