How does Oklahoma’s new law for nurse practitioners compare to other states?

With the passage of House Bill 2298, Oklahoma joins a growing list of states granting nurse practitioners full practice authority, meaning they can prescribe medications and manage patient care without physician oversight. Supporters argue the change will expand access to healthcare, particularly in rural and underserved communities.

To understand how Oklahoma’s law fits into the national landscape, it’s helpful to look at where other states stand.

What is a Certified Nurse Practitioner (CNP)?

A Certified Nurse Practitioner (CNP) is a highly trained advanced practice registered nurse (APRN) who has completed graduate-level education in a specialty area such as family health, women’s health, or psychiatric care. According to the Oklahoma Board of Nursing, CNPs are licensed to diagnose, treat, and manage a wide range of health conditions, and are nationally certified in their specialty. This makes them an essential part of expanding access to care, especially in underserved areas.

Breaking Down the New Law

The new law allows qualified nurse practitioners in Oklahoma to apply for independent prescriptive authority, which includes:

1. The ability to prescribe medications like antibiotics and blood pressure medications without needing a physician’s signature
2. A requirement for applicants to have at least 6,240 hours (about three years) of supervised clinical practice with prescriptive authority under a collaborating physician, according to House Bill 2298.
3. Submission of an application to the Oklahoma Board of Nursing, including proof of experience and malpractice insurance coverage of at least $1 million per occurrence and $3 million aggregate annually.
4. Removal of the need for a physician’s name on paperwork for prescriptions, which Shelby Pope, a nurse practitioner in Skiatook, told News On 6 was “red tape” that complicated patient care.

What are the qualifications required for nurse practitioners to obtain independent prescriptive authority in Oklahoma?

Where Does Oklahoma Stand?

According to the Oklahoma Legislature, this new law aligns Oklahoma with 27 other states and Washington, D.C., that already grant nurse practitioners full practice authority.

Those states are:

Alaska, Arizona, Colorado, Connecticut, Delaware, District of Columbia, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, and Wyoming.

How Do Other States Compare?

According to the American Association of Nurse Practitioners (AANP), states such as Arizona, Colorado, and New Mexico grant nurse practitioners full practice authority, meaning they can evaluate patients, diagnose conditions, interpret diagnostic tests, and prescribe medications without physician oversight. This autonomy allows nurse practitioners to operate independently and even establish their own clinics.

In contrast, Texas requires nurse practitioners to enter into a prescriptive authority agreement with a supervising physician, outlining the scope of their practice and prescribing capabilities, according to the Texas Medical Board. Similarly, Missouri mandates that nurse practitioners work under a collaborative practice agreement with a physician, including protocols and limitations on prescribing certain medications, as detailed by the Missouri Revised Statutes.

Why Did Governor Stitt Veto the Bill?

Governor Kevin Stitt vetoed the bill, arguing that nurse practitioners should be supervised by licensed physicians. After the veto override, Stitt warned voters.

"You gotta know how these people vote – and are they voting for bigger government and to override the governor’s vetoes..."

What Changed After the Veto?

Despite Governor Stitt’s objections, the House and Senate overrode his veto, enacting the bill into law. The new provisions will take effect in November.

What Does This Mean for Patients?

Shelby Pope told News On 6 the new law will help keep patient-focused clinics open, particularly in rural and underserved areas:

“I am extremely passionate about accessible and equitable healthcare... If I had to close tomorrow, 600 patients would have to figure out healthcare again.”

Read this related story: What Oklahoma’s new nurse practitioner law means for patients and providers

How Will It Affect Healthcare Delivery?

Pope believes this law will expand access, reduce costs, and maintain safety standards for nurse practitioner care:

“If we get into a bind and we don’t have prescriptive authority, then we get desperate,” she said. “That just doesn’t work long term.”

Oklahoma Board of Nursing – Advanced Practice Registered Nurse (APRN) Guidelines

https://oklahoma.gov/content/dam/ok/en/nursing/documents/pa-4.pdf

House Bill 2298 (HB 2298) – Oklahoma Legislature Bill Information

https://www.oklegislature.gov/BillInfo.aspx?Bill=hb2298&Session=2500

American Association of Nurse Practitioners (AANP) – State Practice Environment

https://www.aanp.org/advocacy/state/state-practice-environment

Texas Medical Board – Prescriptive Authority Agreement FAQs

https://www.tmb.state.tx.us/page/renewal-prescriptive-Authority-Agreement-FAQs

Missouri Revised Statutes – Section 334.104 (Collaborative Practice Arrangements)

https://revisor.mo.gov/main/OneSection.aspx?section=334.104