HB 4430: Medical malpractice; Physician Assistant Act requirements; Advanced Practice Registered Nurse malpractice insurance requirements; compliance; effective date. - Oklahoma

Floor (House) → Floor (Senate) · 3 edits

MINOR

The bill was amended to transition from a House version to a Senate version, which includes significant formatting updates and the addition of a new provision allowing physician assistants to prescribe medications if they are not practicing under a formal practice agreement. This change expands the scope of practice for physician assistants in specific circumstances while maintaining existing supervision requirements.

Scope change

The bill's scope was expanded to explicitly authorize physician assistants to write prescriptions when they are not operating under a practice agreement with a physician.

REQUIREMENT

Added a new subsection (D) granting physician assistants the authority to prescribe written and oral prescriptions and orders if they are not practicing under a practice agreement.

TECHNICAL

Updated the document header and introductory text to reflect the Senate Floor Version, including the date April 13, 2026, and adjusted sponsor attribution formatting.

Adjusted the spacing and indentation of the legislative text throughout the document to align with Senate formatting standards.

House Committee Substitute → Floor (House) · 3 edits

MINOR

The bill text was reformatted to reflect the House Floor version, removing the 'Committee Substitute' header and adding a 'Floor Version' designation. While the formatting and page numbering were updated, the substantive legal text regarding physician assistant supervision, licensing, and practice agreements remains unchanged.

TECHNICAL

The document header was changed from 'Committee Substitute' to 'Floor Version' to indicate the bill has moved from committee review to the full House floor for debate.

Page numbers and internal reference codes (e.g., 'Req. No. 17048') were replaced with standard House Floor formatting.

Line breaks and spacing were adjusted to fit the new floor version layout, but the actual legal content and wording of the amendments to the Physician Assistant Act were not altered.

Proposed Committee Substitute (full committee) 1 → House Committee Substitute · 4 edits

MODERATE

The bill was amended to streamline requirements for physician assistants (PAs) who have completed over 6,240 hours of postgraduate clinical experience. The key change removes the mandatory requirement for these experienced PAs to practice under a supervising physician, allowing them to work independently while still permitting them to maintain practice agreements if they choose. Additionally, the amendment clarifies that PAs not under a practice agreement can prescribe controlled medications in Schedules III through V.

Scope change

The bill's scope shifted from requiring all PAs with significant experience to have a supervising physician to allowing those same PAs to practice independently, effectively creating an exemption from supervision for experienced practitioners.

ELIGIBILITY

Physician assistants with 6,240 or more hours of postgraduate clinical experience are no longer required to practice under the supervision of a delegating physician, though they may still choose to do so.

REQUIREMENT

The Board of Medical Licensure and Supervision is explicitly directed to maintain an online list of physician assistants who have reported their completion of the 6,240-hour experience requirement.

Clarified that physician assistants not practicing under a formal agreement can prescribe controlled medications in Schedules III through V, whereas those under an agreement retain full prescription authority.

TECHNICAL

Added provisions stating that the Board will not charge fees for reporting clinical experience hours or for filing practice agreements.

Enrolled (final version) → Proposed Committee Substitute (full committee) 1 · 3 edits

MINOR

The bill was completely rewritten from scratch during committee review, replacing the original text with a new version that retains the core requirement for physician assistants to report 6,240 hours of clinical experience to practice independently. The primary change is the addition of a new header section titled 'PROPOSED OVERSIGHT COMMITTEE SUBSTITUTE,' which indicates this is a working draft version rather than the final enrolled law.

Scope change

The bill's substantive scope and legal requirements remain unchanged; the text describes the same eligibility criteria and supervision rules for physician assistants as the original version.

TECHNICAL

Added a new header section labeled 'PROPOSED OVERSIGHT COMMITTEE SUBSTITUTE' and committee amendment metadata, indicating this is a draft version for review.

Replaced the original 'ENROLLED HOUSE' title page with a new committee amendment header, effectively resetting the document from a final version to a proposed substitute.

Removed the original 'ENROLLED HOUSE' title page and the specific legislative history notes regarding the bill's final passage.

Engrossed → Enrolled (final version) · 1 edit · Apr 29, 2026

MINOR

The bill was finalized from its 'Engrossed' version to the 'Enrolled' version with no substantive changes to the law's content. The only differences are formatting corrections, such as fixing broken line breaks and adding a subject line, which do not alter the legal requirements for physician assistants.

TECHNICAL

Fixed formatting errors where text was split across lines incorrectly in the Engrossed version, ensuring the final Enrolled version is readable and consistent.

Introduced → Engrossed · 3 edits · Apr 29, 2026

MINOR

The bill was amended to expand its scope from solely regulating physician assistants to also including advanced practice registered nurses regarding malpractice insurance requirements. Additionally, the text was reorganized to clarify that the new nurse provisions are part of the same legislative act.

Scope change

The bill's scope was expanded to include advanced practice registered nurses in addition to physician assistants.

SCOPE

Added a new provision amending the malpractice insurance requirements for advanced practice registered nurses, which was not present in the original version.

TECHNICAL

Reorganized the title and introductory sections to reflect the expanded scope and corrected the effective date reference from 2026 to 2025.

Adjusted page numbering and formatting headers to align with the engrossed version of the bill.

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

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