HB 2051: Practice of medicine; creating the Supervised Physicians Act; limiting scope of supervised practice; directing specified Boards to promulgate certain rules; requiring collaborative practice arrangements; creating certain exemptions; effective date. - Oklahoma

Floor (House) → Floor (Senate) · 4 edits

MODERATE

The bill was moved from the House to the Senate floor, where it was amended to add a new definition for 'supervised physician' that requires graduates to have completed specific medical licensing exams (USMLE Steps 1 and 2) within the same calendar year as their graduation. The Senate version also clarifies that a supervised physician is considered an agent of the supervising physician and defines delegation through practice arrangements without requiring physical presence, as long as telecommunication contact is possible.

Scope change

The bill's scope remains focused on establishing a supervised physician practice framework in Oklahoma, but the Senate amendments tighten eligibility criteria for supervised physicians by adding specific examination requirements.

DEFINITION

Added specific requirements for supervised physicians to have completed Step 1 and Step 2 of the USMLE or equivalent exams within the same calendar year as graduation from medical school.

Clarified that a supervised physician is considered an agent of the supervising physician, establishing legal responsibility relationships.

REQUIREMENT

Modified delegation requirements to allow practice arrangements without physical presence, provided the supervising and supervised physicians can easily contact each other via telecommunication.

TECHNICAL

Added Senate-specific formatting and committee substitute designations indicating the bill has been amended by the Senate committee.

Senate Committee Substitute for House Bill → Floor (House) · 4 edits

MODERATE

The bill was revised from a Senate Committee Substitute to a House Floor version, with significant changes to the definitions of 'medical school graduate' and 'supervised physician.' The House version removed references to 'legally chartered' schools and 'State Regents for Higher Education' recognition, replacing them with broader references to schools described in existing Oklahoma statutes. The definition of 'supervised physician' was expanded to include alternative medical licensing examinations approved by state boards, and the definition of 'supervised physician collaborative practice arrangement' was clarified to allow delegation without physical presence as long as telecommunication contact is possible. These changes broaden eligibility for supervised physician practice and modify how supervision is structured.

Scope change

The bill's scope was broadened to include graduates of medical schools not specifically 'legally chartered' by the State Regents for Higher Education, and to recognize alternative medical licensing examinations beyond the USMLE Steps 1 and 2.

DEFINITION

Changed 'medical school graduate' definition to remove 'legally chartered' and 'State Regents for Higher Education' recognition requirements, instead referencing schools described in existing Title 59 statutes.

Expanded 'supervised physician' eligibility to include graduates who completed alternative medical licensing examinations approved by state boards, not just USMLE Steps 1 and 2.

REQUIREMENT

Modified 'supervised physician collaborative practice arrangement' definition to clarify that physical presence of the supervising physician is not required if telecommunication contact is possible.

TECHNICAL

Changed document header from 'Senate Committee Substitute for Engrossed House Bill' to 'Committee Substitute for House Bill' with House Floor version designation.

House Committee Substitute → Senate Committee Substitute for House Bill · 3 edits

MINOR

The bill was amended from a House Committee Substitute to a Senate Committee Substitute, primarily adding a co-sponsor from the Senate and updating the bill title to include 'Engrossed'. The substantive legislative content and policy provisions remain unchanged, with only minor formatting adjustments and page number updates.

TECHNICAL

Added Senate co-sponsor (Archer of the House and Thompson of the Senate) to the bill header.

Updated bill title from 'Committee Substitute for House Bill' to 'Committee Substitute for Engrossed House Bill'.

Minor formatting adjustments to page headers and line spacing throughout the document.

Proposed Policy Committee Substitute 1 → House Committee Substitute · 4 edits

MODERATE

The House Committee Substitute replaced the entire Proposed Policy Committee Substitute version of HB 2051 with revised language. The main substantive change is that rule-making authority for supervised physician collaborative practice arrangements is now split between two separate state boards (Medical Licensure and Supervision and Osteopathic Examiners) rather than being consolidated under one board. This affects which agency oversees the implementation and enforcement of the Supervised Physicians Act.

Scope change

The bill's scope remains focused on creating a Supervised Physicians Act, but the administrative oversight structure changed from a single board to dual-board oversight.

REQUIREMENT

Rule-making authority was split: the original version assigned all rule-making to the State Board of Medical Licensure and Supervision, while the new version requires both the State Board of Medical Licensure and Supervision and the State Board of Osteopathic Examiners to independently promulgate rules.

DEFINITION

The definition of 'Supervised physician collaborative practice arrangement' was expanded to specify it must be between an Oklahoma licensed supervising physician and a supervised physician in good standing.

TECHNICAL

The bill header was changed from 'PROPOSED POLICY COMMITTEE SUBSTITUTE' to 'COMMITTEE SUBSTITUTE' to reflect the House Committee's amendment.

The bill's required number changed from 12315 to 13097, indicating a new version number for tracking purposes.

Proposed Committee Substitute (full committee) 1 → Proposed Policy Committee Substitute 1 · 6 edits

MODERATE

The bill was amended from a 'Proposed Oversight Committee Substitute' to a 'Proposed Policy Committee Substitute,' indicating a shift in the committee's approach to reviewing the legislation. The most significant substantive change is the reorganization of the bill's structure, with new sections added to establish a formal rulemaking process for temporary licensure and supervision requirements, and to set fees for the supervised physician collaborative practice arrangement. The bill also clarifies that supervised physicians are not subject to additional supervision requirements beyond those in the act, while maintaining that they must meet federal supervision standards.

Scope change

The bill's scope remains focused on creating a Supervised Physicians Act, but the amendment adds specific provisions for rulemaking authority, fee setting, and temporary license duration (two years from medical school graduation, non-renewable).

REQUIREMENT

Added a new section requiring the State Board of Medical Licensure and Supervision to promulgate rules for temporary licensure, supervision requirements, and fee setting for supervised physician collaborative practice arrangements.

Added a provision stating that a supervised physician's temporary license is valid for two years from medical school graduation and is not subject to renewal.

Added a provision stating that the physical presence of the delegating physician is not required as long as they can be easily contacted by telecommunication.

DEFINITION

Modified the definition of 'supervised physician collaborative practice arrangement' to include requirements of the act, and added a definition for 'supervising physician' as the physician overseeing delegated activities.

Modified the definition of 'supervised physician' to include requirements of the act and any controlling federal law supervision requirements.

TECHNICAL

Removed the requirement that the supervising physician must have a full and unrestricted Oklahoma license with DEA and OBNDD permits, replacing it with a requirement that the supervising physician be trained and qualified in the field of the supervised physician's specialty.

Engrossed → Proposed Committee Substitute (full committee) 1 · 3 edits

MINOR

The bill was completely rewritten from scratch by the committee, replacing the entire original text with a new version. The substantive policy content appears to remain largely the same, but the formatting, page numbering, and some line numbers were adjusted during the committee review process.

Scope change

No substantive change to the bill's scope or applicability; the core policy provisions remain intact.

TECHNICAL

The entire bill text was deleted and replaced with a new committee substitute version, indicating a complete rewrite rather than incremental changes.

Page numbers and line numbers were renumbered throughout the document to reflect the new formatting structure.

Header information was updated to reflect the committee substitute status with new dates and sponsor information.

Introduced → Engrossed · 5 edits · Mar 11, 2025

MODERATE

The bill was renamed from the 'Graduate Physicians Act' to the 'Supervised Physicians Act,' changing terminology throughout to reflect a shift from 'graduate physicians' to 'supervised physicians' and 'collaborating physicians' to 'supervising physicians.' This terminology change clarifies the relationship between physicians under supervision and their overseeing physicians, emphasizing the supervisory nature of the arrangement rather than the educational status of the physician.

Scope change

The scope of the bill remains focused on regulating temporary licensure and practice arrangements for medical school graduates, but the terminology shift suggests a policy emphasis on supervision and oversight rather than graduation status.

DEFINITION

The term 'Graduate physician' was replaced with 'Medical school graduate' in the definitions section, broadening the terminology to focus on educational status rather than practice status.

The term 'Graduate physician collaborative practice arrangement' was replaced with 'Supervised physician collaborative practice arrangement,' changing the focus from the graduate's arrangement to the supervised physician's arrangement.

The term 'Collaborating physician' was replaced with 'Supervising physician,' clarifying the role of the overseeing physician in the practice arrangement.

REQUIREMENT

References to 'graduate physicians' throughout the bill were changed to 'supervised physicians,' and 'collaborating physicians' were changed to 'supervising physicians,' standardizing terminology to emphasize the supervisory relationship.

TECHNICAL

The bill title and act name were changed from 'Graduate Physicians Act' to 'Supervised Physicians Act,' reflecting the terminology shift in the definitions.

Practice of medicine; creating the Supervised Physicians Act; limiting scope of supervised practice; directing specified Boards to promulgate certain rules; requiring collaborative practice arrangements; creating certain exemptions; effective date.

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