HB 2298: 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. - Oklahoma

Floor (House) → Floor (Senate) · 5 edits

MODERATE

The bill was moved from the House to the Senate floor, where it underwent significant substantive changes. The Senate version reorganizes the bill's structure, modifies eligibility requirements for independent prescriptive authority, and adjusts fee and insurance provisions. These changes reflect Senate committee amendments aimed at refining how Advanced Practice Registered Nurses can exercise independent prescribing rights in Oklahoma.

Scope change

The bill's scope remains focused on nursing practice and prescriptive authority, but the Senate version adds new sections and modifies existing ones to clarify supervision requirements and fee structures.

ELIGIBILITY

Changed the practice hour requirement from three years of supervised practice to 6,240 clinical practice hours with prescriptive authority supervised by a physician.

REQUIREMENT

Added new provisions requiring supervision agreements and certain notices for nurses exercising independent prescriptive authority.

Added new section requiring certain reporting and online publication of certain lists related to the nursing practice.

FISCAL

Reorganized fee provisions, allowing the Board to assess reasonable fees for application review and adding provisions about supervision fees subject to certain conditions.

ENFORCEMENT

Modified disciplinary action provisions to include suspension or revocation of independent prescriptive authority in accordance with the Administrative Procedures Act.

HB2298 (5-07-25) (ROSINO) FA1.PDF → Floor (House) · 5 edits

MODERATE

This bill grants independent prescriptive authority to Advanced Practice Registered Nurses (APRNs) in Oklahoma who meet specific experience requirements. The House version clarifies the application process, establishes renewal procedures, sets malpractice insurance requirements, and defines the scope of authority for Certified Nurse Practitioners, Clinical Nurse Specialists, and Certified Nurse-Midwives.

Scope change

The bill now explicitly allows APRNs to prescribe medications independently after meeting experience requirements, removing the need for ongoing physician supervision for these specific practitioners.

ELIGIBILITY

Added requirement that APRNs must complete a minimum of three years of practice with prescriptive authority under physician supervision before applying for independent authority.

REQUIREMENT

Established malpractice insurance requirements of $1 million per occurrence and $3 million in aggregate per year for APRNs exercising independent prescriptive authority.

Created a formal application process requiring proof of valid APRN license, good standing, and completion of required supervised practice hours.

ENFORCEMENT

Added provisions allowing the Board of Nursing to suspend or revoke independent prescriptive authority for good cause at any time.

TIMELINE

Established that independent prescriptive authority is tied to the APRN's current license renewal cycle and can be renewed simultaneously with the nursing license.

Senate Committee Substitute for House Bill → HB2298 (5-07-25) (ROSINO) FA1.PDF · 2 edits

MINOR

The bill was amended to clarify that a supervising physician for a Certified Nurse-Midwife may be a family practice physician, obstetrician, or gynecologist, expanding the range of eligible supervising physicians for nurse-midwives seeking independent prescriptive authority. The document also shows formatting changes from a committee substitute to a floor amendment version.

Scope change

The bill's scope was expanded to include family practice physicians, obstetricians, and gynecologists as eligible supervising physicians for Certified Nurse-Midwives, whereas the original text did not specify these specialties.

ELIGIBILITY

Added language specifying that a supervising physician for a Certified Nurse-Midwife may be a family practice physician, obstetrician, or gynecologist, broadening the pool of eligible supervisors for nurse-midwives.

TECHNICAL

Changed document header from 'COMMITTEE SUBSTITUTE FOR ENGROSSED' to 'SENATE CHAMBER FLOOR AMENDMENT' and included amendment submission details.

House Committee Substitute → Senate Committee Substitute for House Bill · 4 edits

MODERATE

The bill was amended to update the sponsor list, change the codification section number from 567.4c to 567.4c (no change), and modify the eligibility requirements for Advanced Practice Registered Nurses seeking independent prescriptive authority. The most significant substantive change is increasing the required clinical practice hours from 3 years to 6,240 hours, while also adjusting related administrative and fee provisions.

Scope change

The bill's scope remains focused on nursing practice, but eligibility criteria for independent prescriptive authority were tightened through increased practice hour requirements.

ELIGIBILITY

Increased required clinical practice hours from 3 years to 6,240 hours for APRNs seeking independent prescriptive authority

REQUIREMENT

Adjusted application requirements and Board review procedures to align with new practice hour standards

TECHNICAL

Updated bill sponsor list to include additional Senate sponsors and corrected formatting

Changed codification section reference from 567.4c to 567.4c (no substantive change)

Proposed Policy Committee Substitute 1 → House Committee Substitute · 5 edits

MODERATE

The House Committee Substitute replaces the Proposed Policy Committee Substitute version of HB 2298, significantly revising the bill's scope and content. The new version adds definitions, eligibility requirements for physicians, and limits while removing references to the Proposed Policy Committee. The title and header information were updated to reflect the House Committee's version of the bill.

Scope change

The bill's scope was substantially modified by the House Committee, with the addition of physician eligibility requirements and limits that were not present in the original version. The document type changed from 'Proposed Policy Committee Substitute' to 'Committee Substitute'.

TECHNICAL

The bill title and header were changed from 'Proposed Policy Committee Substitute' to 'Committee Substitute', indicating the House Committee's version of the bill.

References to the Proposed Policy Committee were removed, as this version represents the House Committee's amendments.

REQUIREMENT

New eligibility requirements for physicians were added to the bill, which were not present in the original version.

New limits were established in the bill, likely related to the scope of practice or prescribing authority.

DEFINITION

New definitions were provided in the bill, expanding the scope of terms used throughout the legislation.

Proposed Committee Substitute (full committee) 1 → Proposed Policy Committee Substitute 1 · 4 edits

MODERATE

The bill was amended to change the committee designation from 'Oversight' to 'Policy' and updated the sponsor name from Carl Newton to Kyle Hilbert. The substantive legislative text remains largely unchanged, with only minor formatting adjustments to line numbers and page references.

TECHNICAL

Committee designation changed from 'Proposed Oversight Committee Substitute' to 'Proposed Policy Committee Substitute'.

Sponsor name changed from Carl Newton to Kyle Hilbert on the amendment form.

Request number updated from 13030 to 12346.

Page and line number formatting adjusted throughout the document to reflect the new version.

Enrolled (final version) → Proposed Committee Substitute (full committee) 1 · 5 edits

MODERATE

The bill was substantially rewritten by the House Committee, changing the eligibility requirements for Advanced Practice Registered Nurses to obtain independent prescriptive authority. The most significant change is reducing the required supervised practice experience from 6,240 clinical hours to 3 years of practice with prescriptive authority. The committee version also clarifies application procedures, fee structures, and disciplinary actions while maintaining most of the original statutory amendments.

Scope change

The bill's scope remains focused on nursing practice and prescriptive authority, but the eligibility criteria for nurses seeking independent prescriptive authority have been modified to require less clinical experience.

ELIGIBILITY

Reduced the supervised practice experience requirement from 6,240 clinical hours to 3 years of practice with prescriptive authority supervised by a physician

REQUIREMENT

Added explicit provisions for application approval, denial, reapplication processes, and fee establishment by the Board

Changed the language from 'may assess a reasonable fee' to 'may establish a fee' for application reviews

ENFORCEMENT

Modified disciplinary language to allow suspension or revocation for 'good cause at any time' rather than only for violations of the Nursing Practice Act

TECHNICAL

Updated bill title and formatting to reflect committee amendments and proper legislative markup

Engrossed → Enrolled (final version) · 7 edits · May 22, 2025

MODERATE

The bill was finalized from its engrossed version, with substantive changes to the prescriptive authority requirements for Advanced Practice Registered Nurses (APRNs). Key changes include adding 'clinical' to practice hour requirements, modifying the effective date reference, updating sponsor lists, and clarifying enforcement mechanisms.

Scope change

The bill's scope remains focused on granting independent prescriptive authority to qualified APRNs, but eligibility criteria and enforcement provisions were refined.

ELIGIBILITY

Added the word 'clinical' before 'practice hours' in eligibility requirements for independent prescriptive authority, clarifying that the hours must be clinical in nature.

Changed the practice hour requirement from 6,240 hours of 'practice' to 6,240 hours of 'clinical practice' with prescriptive authority supervised by a physician.

ENFORCEMENT

Updated disciplinary action language to reference the Administrative Procedures Act when suspending or revoking independent prescriptive authority.

Changed fee language from 'establish a fee' to 'assess a reasonable fee' for application reviews, providing more clarity on fee collection.

TECHNICAL

Updated sponsor lists to reflect final enrolled versions with additional sponsors added to both House and Senate lists.

Added 'clinical' to malpractice insurance requirement language to ensure consistency with clinical practice context.

Updated statutory references to reflect the enrolled version with corrected chapter and section citations.

Amended And Engrossed → Engrossed · 7 edits · May 8, 2025

MODERATE

The bill was amended to significantly expand its scope and clarify requirements for Advanced Practice Registered Nurses (APRNs) seeking independent prescriptive authority in Oklahoma. The changes add detailed provisions regarding application processes, fees, malpractice insurance requirements, and disciplinary actions, while updating statutory references and codification details.

Scope change

The bill's scope expanded from primarily establishing independent prescriptive authority for APRNs to include comprehensive provisions on application procedures, fees, malpractice insurance, advertising rules, online information disclosure, and specific definitions for physicians and other practitioners.

REQUIREMENT

Added detailed provisions for application approval, denial, reapplication processes, and fee structures for independent prescriptive authority.

Added specific malpractice insurance requirements and clarified that coverage extends to supervising or collaborating physicians.

Added provisions directing the Board of Nursing to make specified information available online and requiring the Formulary Advisory Council to develop guidelines.

DEFINITION

Added eligibility requirements for physicians and provisions for limits and exceptions related to prescriptive authority.

ENFORCEMENT

Added provisions for disciplinary action, penalties, and authority to suspend or revoke independent prescriptive authority for good cause.

TECHNICAL

Modified author coauthor lists and updated statutory references to reflect current legislative chapters and sections.

SCOPE

Modified the bill title and summary to reflect the expanded scope including advertising rules, online disclosures, and additional statutory amendments.

Introduced → Amended And Engrossed · 7 edits · May 8, 2025

MODERATE

The bill was amended to significantly expand its scope from primarily regulating Advanced Practice Registered Nurses (APRNs) to also include provisions for supervising physicians, advertising rules, and malpractice insurance requirements. The amendment also adds new coauthors and updates statutory references to reflect recent legislative changes.

Scope change

The bill's scope expanded from focusing solely on APRN prescriptive authority to include regulations for supervising physicians, advertising requirements, and malpractice insurance mandates.

SCOPE

Added provisions requiring supervising physicians to meet eligibility requirements and sign supervision agreements.

REQUIREMENT

Introduced new requirements for malpractice insurance coverage of one million dollars per occurrence and three million dollars in aggregate per year.

Added provisions directing the Formulary Advisory Council to develop and publish guidelines.

Added provisions prohibiting certain fees and requiring specific notices.

Added provisions requiring online publication of certain lists.

Added provisions for disciplinary action and advertising rules.

TECHNICAL

Updated statutory references to reflect 2024 legislative sessions and amended sections.

What changed between versions

How they voted

Actions timeline

Sponsors