Bill Name: Senate Bill 458 (SB 458)

Primary Sponsor: Senator Brenda Stanley, Marcus McEntire

Status: 3/07/2023 Passed Senate and sent to House

AmSpa’s Take: Allowing advanced practitioners, such as physician assistants (PAs) and nurse practitioners (NPs), to practice to the level of their education and skill without the need to maintain cumbersome chart review and meeting requirements frees up time and resources that can be better spent seeing patients, improving their skills and developing their practices. Independence also allows these practitioners to innovate in new practice areas through owning their own practices.

Outlook: This has passed the Senate and entered the House; based on the sponsor’s past record, it has a higher likelihood of passing.

Analysis: Currently, Oklahoma nurse practitioners (NPs) practice under the supervision of a physician. This relationship is documented in a written collaborative agreement that defines the NP’s scope of practice and the level of oversight of a physician. Under SB 458, NPs could complete a period of collaboration before becoming eligible for independent practice.

SB 458 would require NPs and other advanced practice registered nurses (APRNs) with fewer than 2,000 hours of supervised practice to enter a supervised collaboration relationship. The collaborating provider could be either a physician or an NP who meets certain requirements, which will be discussed later. Under this two-year period, the NP does not necessarily require onsite supervision, provided a means of communicating with the collaborating provider has been established. This relationship must be documented in a collaborative agreement and kept up-to-date by the NP. As a “grandfathering” measure for current NPs, those with more than 6,240 hours could apply directly for independence. Independent NPs and APRNs would need to carry their own malpractice insurance with minimum coverage of $1 million per occurrence and $3 million in aggregate.

In addition to physicians, NPs who have completed 8,000 hours of independent practice and who have been registered for at least five years are eligible to serve as “supervising advanced practice registered nurses.” This means that an NP could potentially complete their initial supervision period under a more senior NP rather than a physician.

The majority of states allow nurse practitioners to practice independently, in some form. If passed, Oklahoma would join this national trend. If you would like additional information, to read the language of the bill or to contact the sponsors or committee, you can find the information you need through this link.