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Gov. Kevin Stitt vetoes bill that would allow nurse practitioners to prescribe without supervision

 Oklahoma officials estimate 300,000 Oklahomans will lose Medicaid eligibility following the expiration of some pandemic-era expansions.
Karolina Grabowska
Oklahoma officials estimate 300,000 Oklahomans will lose Medicaid eligibility following the expiration of some pandemic-era expansions.

Oklahoma Governor Kevin Stitt vetoed a bill Friday that would have allowed providers like nurse practitioners to independently prescribe certain drugs, saying these professionals shouldn't have this power.

Senate Bill 458, authored by Sen. Brenda Stanley (R-Midwest City) and Rep. Marcus McEntire (R-Duncan), would have allowed advanced practice registered nurses (APRNs) to order and administer certain drugs. Those mid-level providers include certified nurse practitioners, clinical nurse specialists and certified nurse-midwives.

Under this measure, APRNs could have obtained 6,240 hours of practice with physician supervision, apply for licensure through the Board of Nursing and independently prescribe Schedule III-V drugs, which include things like anabolic steroids, Ambien and Xanax.

Stanley said during the bill’s hearing on the Senate floor it could help combat the state's physician shortage in rural areas.

“I know that rural Oklahoma is desperate for health care. … (APRNs) can treat a sinus infection. They can treat prescribed Lipitor for cholesterol,” Stanley said. “They have a wide scope, but (the bill is) just within their scope of practice.”

Stitt said in a news release these professionals can set up clinics in rural Oklahoma and practice in primary care settings. But he doesn’t think they should be allowed to prescribe Schedule III-V drugs without a physician’s supervision.

He said he did support the exploration of a portion of the bill that would have mandated licensure boards like the Oklahoma Board of Nursing, State Board of Medical Licensure and Supervision and State Board of Osteopathic Examiners promulgate rules.

Those rules would have included governing supervision requirements for APRNs who can’t prescribe independently and limiting the amount a supervising physician can charge for supervision.

The Oklahoma State Medical Association opposed the bill, while the Association of Oklahoma Nurse Practitioners supported it.

The Oklahoma State Medical Association Director of Government Affairs Matt Robinson told StateImpact that a main concern for physicians with this bill was misdiagnosis and mistreatment that could come from less experience. He said this could also impact costs for patients.

“That is going to cause further and enhanced health problems throughout the longevity of that patient. … That's going to also cost a lot more in the long run because you're going to be treating a lot of different ailments rather than the initial one that should have been treated in the first place,” Robinson said.

Stitt requested the Legislature explore other ways to attract health care providers to rural communities through things like tax credits.

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Jillian Taylor has been StateImpact Oklahoma's health reporter since August 2023.
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