1| STATE OF OKLAHOMA | | | 2| 1st Session of the 60th Legislature (2025) | | | 3|HOUSE BILL 2148 By: Kannady | | | 4| | | | 5| | | | 6| AS INTRODUCED | | | 7| An Act relating to controlled dangerous substances; | | defining terms; requiring pain management clinics to | 8| register with the Oklahoma Bureau of Narcotics and | | Dangerous Drugs Control; providing exemptions; | 9| stipulating registration procedures; requiring | | clinics to designate owner or administrator | 10| responsible for certain compliance; directing denial | | of registration for specified reasons; limiting | 11| period of suspension; requiring new registration | | application if clinic changes ownership; specifying | 12| responsibilities of licensed prescriber and | | designated administrator; providing facility and | 13| physical operations requirements; stipulating certain | | infection control requirements; stipulating certain | 14| data collection and reporting requirements; requiring | | establishment of certain written policy; directing | 15| certain investigation by Bureau; providing penalties; | | directing promulgation of rules; providing for | 16| codification; and providing an effective date. | | | 17| | | | 18| | | | 19|BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: | | | 20| SECTION 1. NEW LAW A new section of law to be codified | | | 21|in the Oklahoma Statutes as Section 2-1111 of Title 63, unless there | | | 22|is created a duplication in numbering, reads as follows: | | | 23| As used in this act: | | | 24| | | | Req. No. 10243 Page 1 ___________________________________________________________________________
1| 1. "Chronic nonmalignant pain" means pain unrelated to cancer | | | 2|which persists beyond the usual course of disease or the injury that | | | 3|is the cause of the pain for more than ninety (90) calendar days | | | 4|after surgery; | | | 5| 2. "Licensed prescriber" means a prescriber as defined in | | | 6|Section 353.1 of Title 59 of the Oklahoma Statutes other than a | | | 7|veterinarian, who has the authority to prescribe any controlled | | | 8|dangerous substance under Section 2-312 of Title 63 of the Oklahoma | | | 9|Statutes; and | | | 10| 3. "Pain management clinic" or "clinic" means any publicly or | | | 11|privately owned facility: | | | 12| a. that engages in advertising in any medium for any | | | 13| type of pain management services, and | | | 14| b. where in any month over fifty percent (50%) of | | | 15| patients who are not being seen for hospice or | | | 16| palliative care are prescribed opioids, | | | 17| benzodiazepines, barbiturates, or carisoprodol for the | | | 18| treatment of chronic nonmalignant pain. | | | 19| SECTION 2. NEW LAW A new section of law to be codified | | | 20|in the Oklahoma Statutes as Section 2-1112 of Title 63, unless there | | | 21|is created a duplication in numbering, reads as follows: | | | 22| A. A pain management clinic shall be either: | | | 23| | | | 24| | | | Req. No. 10243 Page 2 ___________________________________________________________________________
1| 1. At least fifty-one percent (51%) owned by a physician or | | | 2|physicians licensed by the State Board of Medical Licensure and | | | 3|Supervision or the State Board of Osteopathic Examiners; or | | | 4| 2. Owned by a hospital licensed by the State Department of | | | 5|Health. | | | 6| B. Each pain management clinic shall register with the Oklahoma | | | 7|Bureau of Narcotics and Dangerous Drugs Control unless: | | | 8| 1. The clinic is affiliated with an accredited medical school | | | 9|at which training is provided for medical students, residents, or | | | 10|fellows; | | | 11| 2. The clinic does not prescribe controlled dangerous | | | 12|substances for the treatment of pain; | | | 13| 3. The clinic primarily treats hospice or palliative care | | | 14|patients; or | | | 15| 4. A majority of the patients treated by the clinic are treated | | | 16|for acute pain. | | | 17| C. Each clinic location shall be registered separately | | | 18|regardless of whether the clinic is operated under the same business | | | 19|name or management as another clinic and each clinic location shall | | | 20|be a permanent, fixed, physical address of operation. | | | 21| D. As a part of registration, a clinic shall designate an owner | | | 22|or administrator who is responsible for ensuring compliance with all | | | 23|requirements related to registration and operation of the clinic | | | 24|under this act. Within ten (10) calendar days after termination of | | | Req. No. 10243 Page 3 ___________________________________________________________________________
1|a designated administrator, the clinic shall notify the Bureau of | | | 2|the identity of another designated administrator for that clinic. | | | 3|Failing to have a designated administrator at the location of the | | | 4|registered clinic may be the basis for a summary suspension of the | | | 5|clinic registration certificate as described in this section. | | | 6| E. The Bureau shall deny registration to any pain management | | | 7|clinic owned by or with any contractual or employment relationship | | | 8|with a licensed prescriber: | | | 9| 1. Whose Drug Enforcement Administration number has ever been | | | 10|revoked; | | | 11| 2. Whose application for a license to prescribe, dispense, or | | | 12|administer a controlled substance has been denied for disciplinary | | | 13|action by the appropriate licensing board; or | | | 14| 3. Who has been convicted of or pleaded guilty or nolo | | | 15|contendere to, regardless of adjudication, an offense that | | | 16|constitutes a felony for receipt of illicit or diverted drugs | | | 17|including a controlled substance listed in Schedule I, II, III, IV, | | | 18|or V of the Uniform Controlled Dangerous Substances Act, in this | | | 19|state, any other state, or the United States. | | | 20| F. If the Bureau finds that a pain management clinic is owned, | | | 21|directly or indirectly, by a person meeting any criteria listed in | | | 22|subsection D of this section, the Bureau shall revoke the | | | 23|certificate of registration previously issued by the Bureau. As | | | 24|determined by rule, the Bureau may grant an exemption to denying a | | | Req. No. 10243 Page 4 ___________________________________________________________________________
1|registration or revoking a previously issued registration if more | | | 2|than five (5) years have elapsed since adjudication. As used in | | | 3|this section, the term "convicted" includes an adjudication of guilt | | | 4|following a plea of guilty or nolo contendere or the forfeiture of a | | | 5|bond when charged with a crime. | | | 6| G. If the registration of a pain management clinic is revoked | | | 7|or suspended, the designated administrator of the pain management | | | 8|clinic, the owner or lessor of the pain management clinic property, | | | 9|the manager, and the proprietor shall cease to operate the facility | | | 10|as a pain management clinic as of the effective date of the | | | 11|suspension or revocation. | | | 12| H. If a pain management clinic registration is revoked or | | | 13|suspended, the designated administrator of the pain management | | | 14|clinic, the owner or lessor of the clinic property, the manager, or | | | 15|the proprietor is responsible for removing all signs and symbols | | | 16|identifying the premises as a pain management clinic. | | | 17| I. If the clinic's registration is revoked, any person named in | | | 18|the registration documents of the pain management clinic, including | | | 19|persons owning or operating the pain management clinic shall not, as | | | 20|an individual or as a part of a group, apply to operate a pain | | | 21|management clinic for one (1) year after the date the registration | | | 22|is revoked. | | | 23| | | | 24| | | | Req. No. 10243 Page 5 ___________________________________________________________________________
1| J. The period of suspension for the registration of a pain | | | 2|management clinic shall be prescribed by the Bureau but shall not | | | 3|exceed one (1) year. | | | 4| K. A change of ownership or control of a registered pain | | | 5|management clinic shall require submission of a new registration | | | 6|application. | | | 7| SECTION 3. NEW LAW A new section of law to be codified | | | 8|in the Oklahoma Statutes as Section 2-1113 of Title 63, unless there | | | 9|is created a duplication in numbering, reads as follows: | | | 10| A. A licensed prescriber shall not be employed or contracted by | | | 11|or otherwise practice in a pain management clinic if the clinic is | | | 12|not licensed by the Oklahoma Bureau of Narcotics and Dangerous Drugs | | | 13|Control under this act and registered with the Bureau under Section | | | 14|2-301 et seq. of Title 63 of the Oklahoma Statutes. A licensed | | | 15|prescriber who qualifies to practice in a pain management clinic | | | 16|pursuant to rules adopted by the appropriate licensing board may | | | 17|continue to practice in a pain management clinic as long as the | | | 18|licensed prescriber continues to meet the qualifications prescribed | | | 19|in the rules. A licensed prescriber who violates this subsection is | | | 20|subject to disciplinary action by the appropriate licensing board, | | | 21|and the Oklahoma Bureau of Narcotics and Dangerous Drugs Control | | | 22|shall report all such violations to the appropriate licensing board | | | 23|within thirty (30) days of such violation. | | | 24| | | | Req. No. 10243 Page 6 ___________________________________________________________________________
1| B. Only a licensed prescriber licensed in this state and | | | 2|authorized to prescribe controlled dangerous substances under | | | 3|Section 2-312 of Title 63 of the Oklahoma Statutes may prescribe a | | | 4|controlled dangerous substance on the premises of a registered pain | | | 5|management clinic and only to the extent allowed by Section 2-312 of | | | 6|Title 63 of the Oklahoma Statutes. No person shall dispense any | | | 7|controlled dangerous substance on the premises of a pain management | | | 8|clinic. The provisions of this subsection shall not be construed to | | | 9|expand or otherwise modify the prescriptive authority of any | | | 10|licensed prescriber. | | | 11| C. A licensed prescriber or qualified designee shall perform a | | | 12|physical examination of a patient on the same day that the licensed | | | 13|prescriber prescribes a controlled substance to a patient at a pain | | | 14|management clinic. | | | 15| D. A licensed prescriber authorized to prescribe controlled | | | 16|dangerous substances who practices at a pain management clinic is | | | 17|responsible for maintaining the control and security of his or her | | | 18|prescription blanks and any other method used for prescribing | | | 19|controlled dangerous substance pain medication. The licensed | | | 20|prescriber shall notify, in writing, the Bureau within twenty-four | | | 21|(24) hours following any theft or loss of a prescription blank or | | | 22|breach of any other method for prescribing pain medication. The | | | 23|provisions of this subsection shall not be construed to exempt a | | | 24| | | | Req. No. 10243 Page 7 ___________________________________________________________________________
1|licensed prescriber from any electronic prescription requirements | | | 2|stipulated in Section 2-309 of Title 63 of the Oklahoma Statutes. | | | 3| E. The designated administrator of a pain management clinic | | | 4|shall notify the Bureau in writing of the date of termination of | | | 5|employment within ten (10) calendar days after terminating his or | | | 6|her employment with a pain management clinic that is required to be | | | 7|registered pursuant to this act. | | | 8| F. The owners of a pain management clinic are jointly | | | 9|responsible for ensuring compliance with the following facility and | | | 10|physical operations requirements: | | | 11| 1. A pain management clinic shall be located and operated at a | | | 12|publicly accessible fixed location and shall: | | | 13| a. display a sign that can be viewed by the public that | | | 14| contains the clinic name, hours of operation, and a | | | 15| street address, | | | 16| b. have a publicly listed telephone number and a | | | 17| dedicated phone number to send and receive facsimiles, | | | 18| c. have a reception and waiting area, | | | 19| d. provide a restroom, | | | 20| e. have private patient examination rooms, | | | 21| f. have treatment rooms, if treatment is being provided | | | 22| to the patients, and | | | 23| g. display a printed sign located in a conspicuous place | | | 24| in the waiting room viewable by the public with the | | | Req. No. 10243 Page 8 ___________________________________________________________________________
1| name and contact information of the clinic's | | | 2| designated administrator and the names of all licensed | | | 3| prescribers practicing in the clinic. | | | 4| 2. This section does not excuse a licensed prescriber from | | | 5|providing any treatment or performing any medical duty without the | | | 6|proper equipment and materials as required by the standard of care. | | | 7|This section does not supersede the level of care, skill, or | | | 8|treatment recognized in general law related to health care | | | 9|licensure. | | | 10| G. Each owner or designated administrator of a pain management | | | 11|clinic is responsible for ensuring compliance with infection | | | 12|prevention and control requirements stipulated by the Occupational | | | 13|Safety and Health Administration. | | | 14| H. The designated administrator shall establish a quality | | | 15|assurance program that includes the identification, investigation, | | | 16|and analysis of the frequency and causes of adverse incidents to | | | 17|patients. The designated administrator is responsible for ensuring | | | 18|compliance with the quality assurance requirements. | | | 19| I. The designated administrator is responsible for ensuring | | | 20|compliance with the following data collection and reporting | | | 21|requirements: | | | 22| 1. The designated administrator for each pain management clinic | | | 23|shall report all significant adverse incidents to the Bureau; and | | | 24| | | | Req. No. 10243 Page 9 ___________________________________________________________________________
1| 2. The designated administrator shall also report to the | | | 2|Bureau, in writing, on a quarterly basis the following data: | | | 3| a. the number of new and repeat patients seen and | | | 4| treated at the clinic who are prescribed controlled | | | 5| dangerous substance medications for the treatment of | | | 6| chronic, nonmalignant pain, | | | 7| b. the number of patients diagnosed with substance use | | | 8| disorder, | | | 9| c. the number of patients discharged due to drug | | | 10| diversion, and the number of patients treated at the | | | 11| clinic whose domicile is located somewhere other than | | | 12| in this state. A patient's domicile is the patient's | | | 13| fixed or permanent home to which he or she intends to | | | 14| return even though he or she may temporarily reside | | | 15| elsewhere. | | | 16| J. The data and reports specified in subsection I of this | | | 17|section shall be accessible to each appropriate licensing board. | | | 18| K. Each pain management clinic shall establish a written policy | | | 19|and administrative process for transferring care of patients | | | 20|diagnosed with a substance use disorder where appropriate for their | | | 21|continued treatment. Each appropriate licensing board shall issue | | | 22|guidance on best practices to ensure appropriate referral and | | | 23|treatment of patients with a substance use disorder. | | | 24| | | | Req. No. 10243 Page 10 ___________________________________________________________________________
1| L. Upon referral by the appropriate licensing board, the Bureau | | | 2|shall investigate suspected instances of drug diversion involving a | | | 3|pain management clinic. Nothing in this act shall be construed to | | | 4|restrict the appropriate licensing board from conducting its own | | | 5|investigation into instances of suspected drug diversion. | | | 6| SECTION 4. NEW LAW A new section of law to be codified | | | 7|in the Oklahoma Statutes as Section 2-1114 of Title 63, unless there | | | 8|is created a duplication in numbering, reads as follows: | | | 9| A. The Oklahoma Bureau of Narcotics and Dangerous Drugs Control | | | 10|may impose an administrative fine on a clinic of up to One Thousand | | | 11|Dollars ($1,000.00) per violation for violating the requirements of | | | 12|this act or the rules promulgated by the Bureau to enforce this act. | | | 13| B. Each day a violation continues after the date fixed for | | | 14|termination of the violation as ordered by the Bureau constitutes an | | | 15|additional, separate, and distinct violation. | | | 16| C. The Bureau may impose a fine and, in the case of an | | | 17|owner-operated pain management clinic, revoke or deny a pain | | | 18|management clinic's registration if the clinic's owner or designated | | | 19|administrator knowingly and intentionally misrepresents actions | | | 20|taken to correct a violation. | | | 21| D. An owner or designated administrator of a pain management | | | 22|clinic who concurrently operates an unregistered pain management | | | 23|clinic is subject to an administrative fine of One Thousand Dollars | | | 24|($1,000.00) per day. | | | Req. No. 10243 Page 11 ___________________________________________________________________________
1| E. If the owner of a pain management clinic that requires | | | 2|registration fails to apply to register the clinic upon a change of | | | 3|ownership and operates the clinic under the new ownership, the owner | | | 4|is subject to a fine of One Thousand Dollars ($1,000.00). | | | 5| SECTION 5. NEW LAW A new section of law to be codified | | | 6|in the Oklahoma Statutes as Section 2-1115 of Title 63, unless there | | | 7|is created a duplication in numbering, reads as follows: | | | 8| The Oklahoma Bureau of Narcotics and Dangerous Drugs and all | | | 9|appropriate licensing boards shall promulgate such rules as are | | | 10|necessary to implement the provisions of this act. | | | 11| SECTION 6. This act shall become effective November 1, 2025. | | | 12| | | | 13| 60-1-10243 TJ 12/11/24 | | | 14| | | | 15| | | | 16| | | | 17| | | | 18| | | | 19| | | | 20| | | | 21| | | | 22| | | | 23| | | | 24| | | | Req. No. 10243 Page 12