State by State Requirements
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      3. State by State Requirements

      Collaborating in Oklahoma

      Review the requirements to successfully and compliantly collaborate in Oklahoma.

      State Regulations for Nurse Practitioners


      General

      In Oklahoma, a collaboration is required for NP prescribing. Supervision required for general practice.

      Delegation authority/process:

      • Is an agreement required?
        • Yes, for prescriptive authority. No agreement required for general practice.
      • What form of agreement is required and what are the requirements for the substance of the agreement (is use of state template required?)
        • The Oklahoma Board of Nursing provides a specific form – the Agreement for Physician Supervising Advanced Practice Prescriptive Authority – to satisfy the agreement requirement. No separate agreement or document is required.
      • Where must the agreement be stored?
        • No requirement, however it will be maintained in your Zivian platform. 
      • Does the agreement need to be filed with the state?
        • Yes. Must use the state form.
      • Are there requirements to file the agreement after the initial filing? (e.g., for updates or on a specified frequency)
        • Changes to the written statement previously filed shall be filed with the Board within thirty (30) days of the change and shall be effective on filing.
      • Who must sign the agreement?
        • Supervising physician.
      • How often must the agreement be reviewed/reauthorized?
        • No requirement.
      • What are the qualifications for the collaborating provider (licensure, same scope, active practice in state, etc.)?
        • “Supervising physician” means an individual holding a current Oklahoma license to practice as a physician and who is not in training as an intern, resident, or fellow.
        • To be eligible to serve as supervising physician for NPs with prescriptive authority, an allopathic physician shall meet the following criteria:
          • (1) Have possession of a full and unrestricted Oklahoma medical license with Drug Enforcement Agency (DEA) and Oklahoma Bureau of Narcotics (OBN) permits for any drug on the formulary as defined in the Physician Assistant Practice Act and the Oklahoma Nursing Practice Act.
          • (2) The physician shall be in an active clinical practice in which no less than twenty (20) hours per week shall involve direct patient contact.
          • (3) The supervising physician shall be trained and fully qualified in the field of the NP’s specialty.
        • To be eligible to serve as a supervising physician for mid-level practitioners, an osteopathic physician shall meet the following criteria:
          • (1) Have possession of a full and unrestricted Oklahoma license to practice osteopathic medicine; with Drug Enforcement Agency (DEA) and Oklahoma Bureau of Narcotics and Dangerous Drugs Control (OBNDD) permits.
          • (2) The supervising physician shall be trained and fully qualified in the field of the mid-level practitioners specialty.
      • What are the qualifications for the NP?
      • Is an alternate collaborating physician required?
        • No requirement.

      Collaboration requirements

      • Are there ratios/limits on the number of NPs that a collaborator may supervise or enter into collaboration agreements?
        • No physician shall supervise more than a total of six (6) physician assistants and/or advanced practice nurses regarding their prescriptive authority. The Board may make an exception to any limit set herein upon request by the physician.
        • No limit exists for allopathic physicians supervising general practice. The limit appears to apply for general practice to osteopathic physicians.
      • Is there an express requirement to review a certain number/percentage of charts?
        • For prescriptive practice: “The supervising physician should regularly and routinely review the prescriptive practices and patterns of the advanced practice nurse with prescriptive authority. Supervision implies that there is appropriate referral, consultation, and collaboration between the advanced practice nurse and the supervising physician.” There is no explicit number of charts to review.
      • Is there a requirement to meet and, if so, how often and how?
        • No requirement.
      • Are there proximity requirements? (e.g., between the NP/collaborator or practice site)
        • No requirement.
      • Are there location-specific requirements? (e.g., that collaborator must go to practice site at some frequency)
        • No requirement.
      • Is remote supervision allowed/are there limitations on remote supervision?
        • Remote supervision is permitted. The supervising physician must be available for consultation, collaboration, assistance with medical emergencies and patient referral through direct contact, telecommunications or other appropriate electronic means.
      • Physician and NP filing requirements – outside of filing the collab agreement, must the physician and/or NP file any separate forms? (e.g., notice of delegation of prescriptive authority, notice of collaboration, notice to PDMP, etc.) NOTE: timing/frequency should be noted because the state may have requirements for initial filing and/or filing for updates, terminations, etc.
        • No requirement.
      • What are the prescription requirements? (identifying collaborators on rxs, restrictions on certain categories of drugs that may or may not be scheduled [one area of concern right now is abortion-inducing medications], etc.)
        • Oklahoma has an exclusionary formulary available here
      • What are the requirements for controlled substance prescribing?
        • An NP with prescriptive authority who prescribes Schedule III-V drugs will comply with state and DEA and Oklahoma Bureau of Narcotics and Dangerous Drug (OBNDD) requirements prior to prescribing controlled substances. Even after receiving DEA and OBNDD registration, the NP may not prescribe Schedule I or II drugs.  Schedule III-V drugs may be prescribed for no more than a 30 day supply.

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