State Overview: Oklahoma

Prior authorization requirements are up to the discretion of the state Medicaid program or insurance company.

Oklahoma credentials two types of addiction counselors. A Certified Alcohol and Drug Counselor requires, at minimum, a bachelor's degree, 270 hours of relevant education courses and 4,000 hours of supervised work experience. A Licensed Alcohol and Drug Counselor requires a master's degree, relevant education courses and 2,000 hours of supervised work experience. Okla. Stat. tit. 59 §59-1870 and Oklahoma Board of Licensed Alcohol and Drug Counselors

Licensed professional counselors facilitate human development and adjustment throughout the life span. Counselors prevent, diagnose or treat mental, emotional or behavioral disorders or associated distress that interfere with mental health and conduct assessments or diagnoses for the purpose of establishing treatment goals and objectives. Okla. Stat. §59-1902(3)

The certification requirements for peer recovery support specialists are established by the state's Department of Mental Health and Substance Abuse Services. The comprehensive certification standards include minimum qualifications, training, continuing education and employment requirements. Okla. Admin. Code § 450:53-1-1, et seq

Full independent practice authority but physician relationship in order to prescribe.

"Nurse midwifery practice" means providing management of care of normal newborns and women, antepartally, intrapartally, postpartally and gynecologically, occurring within a health care system which provides for medical consultation, medical management or referral, and is in accord with the standards for nurse midwifery practice as defined by the American College of Nurse-Midwives.  Okla. Stat. §567.3a(9)

An advanced practice nurse who is recognized to prescribe by the Oklahoma Board of Nursing as an advanced registered NP and is subject to medical direction by a supervising physician may prescribe and administer Schedule III-V controlled substances. Okla. Stat. tit. 63 §2-312 

Full independent practice authority but physician relationship in order to prescribe.

Supervision by a physician is required in order for the NP to prescribe drugs and other medical supplies. Okla. Stat. tit. 59 §567.3a(6)

An advanced practice nurse who is recognized to prescribe by the Oklahoma Board of Nursing as an advanced registered NP and is subject to medical direction by a supervising physician may prescribe and administer Schedule III-V controlled substances. Okla. Stat. tit. 63 §2-312

Only physicians are authorized to sign POLST forms. Okla. Stat. tit. 63 §63-3105

NPs are recognized in state policy as primary care providers. Primary care providers are limited to physicians, NPs, PAs, and Indian Health Service Facilities and Federally Qualified Health Center provider groups. Okla. Admin. Code §317:25-7-5

Physician relationship required for practice and prescriptive authority.

Oklahoma opted out of the CRNA federal supervision requirement in 2020.

A CRNA may administer anesthesia in collaboration with a medical doctor, osteopathic physician, podiatric physician or a dentist and under conditions in which timely on-site consultation by a physician is available. Okla. Nursing Practice Act §567.3a(10)

In collaboration with a medical doctor, osteopathic physician, podiatric physician or a dentist, a CRNA may administer and apply for authorization to order, select, obtain legend drugs, Schedules II-V controlled substances, devices, and medical gases only when engaged in the pre-anesthetic preparation and evaluation; anesthesia induction, maintenance and emergence; and post-anesthesia care. Okla. Nursing Practice Act §567.3b

CRNAs are authorized to handle Schedules II-V controlled substances but only in specific settings related to their field and under supervision. These settings include pre-anesthetic preparation or evaluation, anesthesia induction, maintenance, emergence, and post-anesthesia care. A CRNA may order, select, obtain and administer such drugs only during the perioperative or periobstetrical period. Okla. Stat. §63-2-312

Optometrists may perform all procedures included in their full scope of practice, including laser surgery. Okla Stat. §59-581(a)

Optometrists may use pharmaceutical agents to treat eye abnormalities. Okla Stat. §59-581(a)

Optometrists may prescribe Schedule III-V controlled substances and Schedule II controlled substances containing hydrocodone combinations for a five-day supply. Okla Stat. §59-581(b)

A dental hygienist may provide services outside of the private dental office for a patient not examined by the dentist. The dentist must authorize care in writing and the dental hygienist must have at least two years of experience. Okla. Stat. Ann. tit. 59 §328.34

Statute does not identify dental therapists as an oral health provider.

Teledentistry means the remote delivery of dental patient care via telecommunications and other technology for the exchange of clinical information and images for dental consultation, preliminary treatment planning and patient monitoring. A dentist holding a valid dental license in Oklahoma may consult, diagnose and treat a patient of record via synchronous or asynchronous telecommunication between the patient and dentist. The dentist must record all activities relating to teledentistry in the patient record and must have an office location in Oklahoma available for follow-up treatment and maintenance of records. Okla. Stat. tit. 59 §328.3(34)

Oklahoma has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Oklahoma does not allow pharmacists to modify prescriptions.

Oklahoma does not allow pharmacists to prescribe hormonal contraceptives.

Oklahoma does not allow pharmacists to prescribe tobacco cessation aids.

Supervision by a physician required for practice and prescriptive authority.

A PA may perform health care services in patient care settings as authorized by the delegating physician. Okla. Stat. Ann. tit. 59, § 519.6(F)

"Supervision" means overseeing or delegating the activities of the medical services rendered by a PA through a practice agreement between a medical doctor or osteopathic physician performing procedures or directly or indirectly involved with the treatment of a patient, and the PA working jointly toward a common goal of providing services. Delegation shall be defined by the practice agreement. Okla. Stat. Ann. tit. 59, § 519.2(6),(7)

A PA under the direction of a delegating physician may prescribe written and oral prescriptions and orders. The PA may prescribe drugs, including controlled medications in Schedules II through V. Prescriptions and orders for Schedule II drugs written by a PA must be included on a written protocol determined by the delegating physician and approved by the medical staff committee of the facility or by direct verbal order of the delegating physician. Okla. Stat. Ann. tit. 59, § 519.6(E)

Statute limits the number of PAs a physician may supervise.

A supervising physician shall not serve as the supervising physician for more than a total of six (6) PAs and/or advanced practice nurses regarding their prescriptive authority. Okla. Admin. Code § 435:15-3-13(c)

Chart co-signatures may be determined at the practice level.

In all patient care settings, the delegating physician shall provide appropriate methods of participating in health care services provided by the PA including: … reviewing a sample of outpatient medical records. Such reviews shall take place at a site agreed upon between the delegating physician and PA in the practice agreement which may also occur using electronic or virtual conferencing […]. Okla. Stat. Ann. tit. 59, § 519.6(C)(a),(b),(d)

Statute allows adaptable proximity.

The physical presence of the delegating physician is not required as long as the delegating physician and PA are or can be easily in contact with each other by telecommunication. At all times a PA shall be considered an agent of the delegating physician; […]. Okla. Stat. Ann. tit. 59, § 519.2(6),(7)

The supervising physician delegates medical services to a physician assistant through a practice agreement. Delegated services should be based on the education, training, skills and experience of the physician assistant. Okla. Stat. tit. 59, §519.2(3)