Practice of nursing; providing for independent prescriptive authority of Advanced Practice Registered Nurses who meet certain requirements; modifying various provisions of the Oklahoma Pharmacy Act, the Oklahoma Nursing Practice Act, and the Uniform Controlled Dangerous Substances Act; effective date.
HB2298 expands the authority of certain Advanced Practice Registered Nurses (APRNs) in Oklahoma to prescribe medications more independently. The bill creates a pathway for Certified Nurse Practitioners, Clinical Nurse Specialists, and Certified Nurse-Midwives to obtain independent prescriptive authority after completing at least 6,240 supervised clinical practice hours with prescriptive authority. It also allows that authority to be renewed with the APRN’s license and gives the Oklahoma Board of Nursing power to suspend or revoke it for violations.
The measure also updates related nursing, pharmacy, and controlled-substances statutes to align with the new authority structure. It revises definitions in the Oklahoma Nursing Practice Act and Pharmacy Act, clarifies when APRNs may prescribe under supervision versus independently, and adjusts controlled dangerous substances rules so APRNs with the proper authority may prescribe Schedule III-V drugs, while independent authority is limited by the bill’s terms. In addition, it requires malpractice coverage or proof of financial responsibility, sets advertising and disclosure rules, and establishes supervision agreement requirements and reporting duties for physicians who supervise APRNs without independent authority.
HB2298 amends multiple sections of Title 59 and Title 63, including the Oklahoma Nursing Practice Act, the Oklahoma Pharmacy Act, and the Uniform Controlled Dangerous Substances Act. It creates new statutory sections for independent APRN prescriptive authority, malpractice insurance requirements, advertising standards, and physician supervision rules, while conforming existing definitions and cross-references to the new framework. The bill affects APRNs, supervising physicians, the Oklahoma Board of Nursing, the State Board of Medical Licensure and Supervision, the State Board of Osteopathic Examiners, pharmacists, and patients receiving prescription services.
The bill appears to have broad legislative support but not unanimous agreement. It advanced through committee and floor votes in both chambers with clear majorities, and it ultimately passed veto override votes in both the House and Senate, indicating strong enough support to enact the measure despite executive opposition. The vote margins suggest the proposal was generally favored, though a substantial minority remained opposed at several stages.
The main points of contention are the degree of autonomy granted to APRNs and the role of physician supervision. Supporters appear to favor expanding access to care and allowing experienced APRNs to prescribe independently after meeting defined clinical-hour requirements, while opponents likely object to reducing physician oversight, especially for controlled substances and prescribing authority. Additional friction points include the bill’s supervision-fee provisions, the requirement that APRNs carry significant malpractice coverage, and the detailed regulatory authority given to the nursing and medical boards over advertising, supervision agreements, and formulary-related limits.