OklahomaHB 4430Oklahoma 2026 Regular SessionHouse

Medical malpractice; Physician Assistant Act requirements; Advanced Practice Registered Nurse malpractice insurance requirements; compliance; effective date.

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Bill Overview

Analyzed Economic Effects

4 provisions identified: 1 benefits, 0 costs, 3 mixed.

Experienced physician assistants gain practice freedom

Beginning November 1, 2026, Oklahoma physician assistants can practice without physician supervision after reporting 6,240 postgraduate clinical practice hours. Hours earned before that date count, and practice agreements are optional for qualifying assistants. The Oklahoma State Board of Medical Licensure and Supervision must provide a free reporting form. It must also keep an online list of assistants who report qualifying hours. The Board can still require supervision as discipline.

Assistants and advanced nurses need malpractice protection

Beginning November 1, 2026, Oklahoma physician assistants without practice agreements and advanced practice registered nurses must meet malpractice protection minimums. They, or employers on their behalf, must carry insurance or prove financial responsibility of $1 million per occurrence and $3 million total per year. Federal-agency coverage counts only during covered federal employment or contract work. Employment by a state agency or facility covered by or subject to the Oklahoma Governmental Tort Claims Act also satisfies the requirement, but outside practice must meet the minimums. Advanced practice registered nurses do not have to provide malpractice coverage for supervising physicians.

Physician assistants face oversight and licensing rules

Beginning November 1, 2026, Oklahoma physician assistants need supervision unless they complete and report 6,240 postgraduate clinical practice hours. Practice agreements can include multiple physicians in good standing, and supervision can use telecommunications while preserving physician responsibilities. Agreements and amendments must reach the Oklahoma State Board of Medical Licensure and Supervision within 10 business days after signing, with no filing fee. For a newly diagnosed complex illness, supervised assistants must contact the physician within 48 hours after the initial examination or treatment and arrange patient evaluation as directed. All physician assistants must have a current, Board-approved license on file before providing care, keep it available at their main workplace, and identify themselves as physician assistants during professional activities.

Physician assistants gain prescribing authority with limits

Beginning November 1, 2026, Oklahoma physician assistants without practice agreements can prescribe medical supplies, services, and drugs. This includes Schedule III through V controlled drugs, but physician assistants cannot dispense drugs. Under a practice agreement, prescribing requires the physician's delegation, including for Schedule II through V controlled drugs. Schedule II prescriptions also need a written protocol set by the physician. Assistants cannot prescribe a controlled-drug schedule for which their delegating physician is not registered.

Sponsors & Cosponsors

Sponsor

Kyle Hilbert
Republican • House

Cosponsors

Jared Deck
Democratic • House
Paul Rosino
Republican • Senate

Roll Call Votes

All Roll Calls

Yes: 164 • No: 4

Senate vote • 4/29/2026

THIRD READING

Yes: 44 • No: 0

Senate vote • 4/13/2026

Top_of_Page

Yes: 0 • No: 0

Senate vote • 4/13/2026

Committee vote: Health & Human Services

Yes: 12 • No: 0

House vote • 3/23/2026

THIRD READING

Yes: 90 • No: 4

House vote • 3/4/2026

DO PASS

Yes: 13 • No: 0

House vote • 2/11/2026