Okla. Stat. tit. 59, § 59-479.1

Nurse — Requirements.

A. As used in this section:

1. “Advanced Practice Registered Nurse” has the same meaning as

defined in Section 567.3a of Title 59 of the Oklahoma Statutes,

except that such term does not include a Certified Registered Nurse

Anesthetist;

2. “Board” means the State Board of Medical Licensure and

Supervision or the State Board of Osteopathic Examiners, or both, as

the context indicates; and

3. The terms “supervising physician” and “supervision” have the

same meaning as defined in Section 567.3a of Title 59 of the

Oklahoma Statutes.

B. To be eligible to serve as a supervising physician for an

Advanced Practice Registered Nurse who has not obtained independent

prescriptive authority under Section 1 of this act, the physician

shall meet the following criteria:

1. Have possession of a full and unrestricted license to

practice allopathic or osteopathic medicine issued by the State

Board of Medical Licensure and Supervision or the State Board of

Osteopathic Examiners;

2. Have possession of a valid registration to prescribe

controlled substances issued by the Drug Enforcement Administration

and the Oklahoma State Bureau of Narcotics and Dangerous Drugs

Control; and

3. Be trained and fully qualified in the field of the Advanced

Practice Registered Nurse’s specialty as determined by the

physician’s respective Board; provided, however, a supervising

physician for a Certified Nurse-Midwife may be a family practice

physician, obstetrician, or gynecologist.

Oklahoma Statutes - Title 59. Professions and Occupations Page 432

C. A supervising physician shall enter into a written

supervision agreement with each Advanced Practice Registered Nurse

he or she supervises. The supervising physician shall file the

supervision agreement with his or her respective Board in the manner

prescribed by such Board. The supervision agreement shall specify:

1. Any fees charged to the Advanced Practice Registered Nurse

for supervision services in accordance with subsection D of this

section;

2. The scope of the Advanced Practice Registered Nurse’s

prescriptive authority, subject to any limits on scope of

prescriptive authority provided by the rules of the Oklahoma Board

of Nursing;

3. A description of the extent of the supervision required;

4. The duties and responsibilities of the supervising

physician;

5. Procedures for notice to be provided by the supervising

physician to Advanced Practice Registered Nurses for periods of

absence in accordance with subsection E of this section; and

6. One or more alternate physicians designated to supervise the

Advanced Practice Registered Nurse in such periods of absence in

accordance with the rules promulgated under subsection H of this

section.

D. 1. A supervising physician may charge a reasonable fee to

the Advanced Practice Registered Nurse for his or her supervision

services. Any such fees shall be:

a. disclosed in the supervision agreement required under

subsection C of this section,

b. appropriate based on the actual duties and

responsibilities of the supervising physician as

outlined in the supervision agreement, and

c. a fair market value hourly rate in accordance with the

rules promulgated under subsection H of this section,

or by mutual agreement between the Advanced Practice

Registered Nurse and supervising physician.

2. The provisions of this subsection shall apply only to

compensation received by the supervising physician directly from the

Advanced Practice Registered Nurse. This subsection shall not be

construed to:

a. preclude a supervising physician from entering into a

payment arrangement for supervision fees to be paid by

his or her employer or health care entity in lieu of

the Advanced Practice Registered Nurse,

b. preclude an employer or health care entity of a

supervising physician from prohibiting, limiting, or

otherwise addressing such supervision fees through

policies, contracts, or bylaws, or
. preclude a supervising physician from entering into a

payment arrangement for supervision fees to be paid by

his or her employer or health care entity in lieu of

the Advanced Practice Registered Nurse,

b. preclude an employer or health care entity of a

supervising physician from prohibiting, limiting, or

otherwise addressing such supervision fees through

policies, contracts, or bylaws, or

Oklahoma Statutes - Title 59. Professions and Occupations Page 433

c. apply to or impact any compensation a supervising

physician receives from his or her employer or health

care entity for supervision services.

E. A supervising physician shall notify all Advanced Practice

Registered Nurses under his or her supervision of reasonably

anticipated periods of unavailability or incapacity on the part of

the supervising physician. Notice shall be given 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 his or her

respective Board, and shall notify all Advanced Practice Registered

Nurses under his or her supervision of, any changes to the

supervising relationship within thirty (30) calendar days including,

but not limited to, the addition or removal of an Advanced Practice

Registered Nurse under the physician’s supervision or a change to

the physician’s practice address or contact information. The

physician’s supervision agreements shall be amended as necessary to

reflect any such changes.

G. The State Board of Medical Licensure and Supervision and the

State Board of Osteopathic Examiners shall not charge any fees to

supervising physicians or Advanced Practice Registered Nurses for

the maintenance or oversight of supervision agreements or other

administrative functions related to the implementation or

enforcement of this section.

H. The State Board of Medical Licensure and Supervision and the

State Board of Osteopathic Examiners shall promulgate a uniform set

of rules establishing standards for proper supervision of Advanced

Practice Registered Nurses who have not obtained independent

prescriptive authority under Section 1 of this act, including:

1. The charging of reasonable fees to provide supervision

services. The rules shall establish a fair market value hourly rate

for such fees, which shall be redetermined biennially;

2. Continuous availability of direct communications either in

person or by electronic communications between the Advanced Practice

Registered Nurse and supervising physician;

3. Oversight and acceptance of responsibility for the ordering

and transmission of written, telephonic, electronic, or oral

prescriptions for drugs and other medical supplies, subject to the

formulary established by the Oklahoma Board of Nursing;

4. Review of prescribing patterns of the Advanced Practice

Registered Nurse;

5. The delineation of a plan for emergencies; and

6. The designation of one or more alternate physicians in the

absence of the supervising physician.

I. A supervising physician may be subject to disciplinary

action by his or her respective Board for failure to comply with the

provisions of, or the rules promulgated under, this section

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including, but not limited to, failure to provide proper

supervision.

J. If either Board imposes limits through rule on the number of

Advanced Practice Registered Nurses that a supervising physician may

supervise, such limits shall not apply when an Advanced Practice

Registered Nurse is practicing in a hospital licensed by the State

Department of Health.

K. The Executive Director of each Board shall report annually

to the respective Board the number of complaints received in

relation to this section.

L. The State Board of Medical Licensure and Supervision and the

State Board of Osteopathic Examiners shall each create and maintain
en an Advanced Practice

Registered Nurse is practicing in a hospital licensed by the State

Department of Health.

K. The Executive Director of each Board shall report annually

to the respective Board the number of complaints received in

relation to this section.

L. The State Board of Medical Licensure and Supervision and the

State Board of Osteopathic Examiners shall each create and maintain

on the respective Board’s website a list of physicians who are

available to supervise Advanced Practice Registered Nurses.