Text of OK SB 1883 (2024)

Req. No. 2710 Page 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 STATE OF OKLAHOMA 2nd Session of the 59th Legislature (2024) SENATE BILL 1883 By: Rosino AS INTRODUCED An Act relating to health care; defining terms; granting certain protections to health care institutions and health care payors; providing certain immunity from civil actions; providing certain construction; providing exception; conferring certain right on medical practitioners; authorizing certain requirement by health care institution; excluding certain refusal from staff privilege consideration; granting certain immunities to health care institutions and medical practitioners; granting additional protections; prohibiting discrimination against health care institution or medical practitioner on certain grounds; providing certain construction; prohibiting certain disciplinary actions by professional licensing board or state agency; requiring certain provision of complaint; providing remedy for failure to notify; making certain interference unlawful; providing remedies for unlawful interference; directing promulgation of certain rules; providing certain construction; providing for codification; and providing an effective date. BE IT ENACTED BY THE PEOPLE OF THE STATE OF OKLAHOMA: Req. No. 2710 Page 2 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 1. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728g of Title 63, unless there is created a duplication in numbering, reads as follows: As used in this act, unless the context requires otherwise: 1. “Conscience” means the ethical, moral, or religious beliefs or principles held by a medical practitioner, health care institution, or health care payor. With respect to institutional or corporate persons, as opposed to individual persons, the term is determined by reference to that entity’s or body’s governing documents, including but not limited to published ethical, moral, or religious guidelines or directives, mission statements, constitutions, articles of incorporation, bylaws, policies, or regulations; 2. a. “Discrimination” means an adverse action taken against, or a threat of adverse action communicated to, a medical practitioner, health care institution, or health care payor as a result of the medical practitioner, health care institution, or health care payor’s refusal to participate in a health care service on the basis of conscience, including but not limited to termination of employment, transfer from current position, demotion from current position, adverse administrative action, reassignment to a different shift or job title, increased administrative Req. No. 2710 Page 3 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 duties, denial of staff privileges, denial of board certification, loss of career specialty, reduction of wages, benefits, or privileges, refusal to award a grant, contract, or other program, refusal to provide residency training opportunities, denial, deprivation, or disqualification of licensure, withholding or disqualifying from financial aid and other assistance, impediment of the creation or improvement of a health care institution or health care payor, impediment of the acquisition or merger of a health care institution or health care payor, the threat of any of the preceding actions, or any other penalty, disciplinary, or retaliatory action, whether executed or threatened. b. The term does not include the negotiation or purchase of insurance by a nongovernment entity; 3. “Health care institution” means a public or private hospital, outpatient center for primary care, medical center, physician organization, professional association, outpatient center for surgical services, private physician’s office, pharmacy, long- term care facility, medical school, nursing school, medical training facility, or any other entity or location in which health care services are performed. The term includes but is not limited to organizations, corporations, partnerships, associations, agencies, networks, sole proprietorships, or joint ventures; Req. No. 2710 Page 4 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 4. “Health care payor” means an employer, health plan, health maintenance organization, insurance company, management services organization, or another entity that pays for or arranges for payment for a health care service, in whole or in part; 5. “Health care service” means medical research or medical care provided to a patient at any time during the patient’s course of treatment, including but not limited to initial examination, testing, diagnosis, referral, dispensing or administration of a drug, medication, or device, psychological therapy or counseling, research, prognosis, therapy, record-making procedures, notes related to treatment, set up, or performance of a surgery or procedure, or any other care or service performed or provided by a medical practitioner; 6. “Medical practitioner” means a person who is or may be asked to participate in a health care service. The term includes but is not limited to physicians, physician assistants, nurses including but not limited to Advanced Practice Registered Nurses, nurse aides, allied health professionals, medical assistants, hospital employees, employees of an outpatient center for primary care, outpatient center for surgical services, or long-term care facility, pharmacists, pharmacy technicians, pharmacy employees, medical school faculty and students, nursing school faculty and students, psychology and counseling faculty and students, medical researchers, Req. No. 2710 Page 5 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 laboratory technicians, counselors, social workers, or any other person who facilitates or participates in a health care service; 7. “Participate in a health care service” means to provide, perform, assist with, facilitate, refer for, counsel for, advise with regard to, admit for the purposes of providing, or take part in any way in providing a health care service; and 8. “Person” means one or more individuals, partnerships, associations, or corporations. SECTION 2. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728h of Title 63, unless there is created a duplication in numbering, reads as follows: A. 1. A health care institution or health care payor may not be required to participate in or pay for a health care service that violates the health care institution’s or health care payor’s conscience, including by permitting the use of its facilities. 2. A health care payor shall list any health care service that it may refuse to pay for on the basis of conscience in the applicable policy. B. Except as provided in subsection D of this section, refusal to participate in or pay for a health care service under this section may not give rise to liability of the health care institution or health care payor for damages allegedly arising from the refusal or be the basis for any discrimination, discipline, or Req. No. 2710 Page 6 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 other recriminatory action against the health care institution, health care payor, or any personnel, agent, or governing board. C. Nothing in this section may be construed to relieve a health care institution of the requirement to provide emergency medical treatment to all patients set forth in the federal Emergency Medical Treatment and Active Labor Act, 42 U.S.C., Section 1395dd. D. The immunity provisions of this section do not apply to a health care institution or health care payor owned or operated by the state or a political subdivision of the state. SECTION 3. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728i of Title 63, unless there is created a duplication in numbering, reads as follows: A. A medical practitioner has the right not to participate in a health care service that violates the medical practitioner’s conscience. A health care institution may not be held liable for the exercise of conscience not to participate in a health care service by a medical practitioner employed, contracted, or granted admitting privileges by the health care institution. B. A health care institution may require the exercise of conscience as a basis for not participating in a health care service to be made in writing and signed by the medical practitioner objecting. A writing made under this subsection may refer only generally to the grounds of “conscience”. Req. No. 2710 Page 7 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 C. A medical practitioner’s refusal to participate in a health care service based on an exercise of conscience may not be a consideration with respect to staff privileges of a health care institution or a basis for discrimination, discipline, or other recriminatory action against the medical practitioner. D. A medical practitioner may not be held liable for damages allegedly arising from the exercise of conscience not to participate in a health care service. SECTION 4. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728j of Title 63, unless there is created a duplication in numbering, reads as follows: The exercise of conscience not to participate in a health care service by a medical practitioner, health care institution, or health care payor may not be grounds for loss of any privileges or immunities or for the loss of any public benefits. SECTION 5. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728k of Title 63, unless there is created a duplication in numbering, reads as follows: A. A medical practitioner or health care institution may not be discriminated against because the medical practitioner or health care institution: 1. Provides, causes to be provided, or intends to provide or cause to be provided information relating to a suspected violation of this act to the medical practitioner or health care institution’s Req. No. 2710 Page 8 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 employer, the Attorney General, the United States Department of Health and Human Services, or any state or federal agency charged with protecting health care rights of conscience; or 2. Testifies, assists, participates, or intends to testify, assist, or participate in a proceeding concerning a violation of this act. B. Except as provided in subsection C of this section, it is unlawful to discriminate against a medical practitioner because the medical practitioner discloses information that the medical practitioner reasonably believes evidences: 1. A violation of any law, rule, or regulation; 2. A violation of any standard of care or ethical guidelines for the provision of any health care service; or 3. Gross mismanagement, a gross waste of funds, an abuse of authority, practices or methods of treatment that may put patient health at risk, or a substantial and specific danger to public health or safety. C. Nothing in this section may be construed to exempt a person from any applicable state or federal confidentiality and patient privacy requirements including but not limited to the federal Health Insurance Portability and Accountability Act of 1996, 42 U.S.C., Section 1320d et seq. Req. No. 2710 Page 9 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 6. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728l of Title 63, unless there is created a duplication in numbering, reads as follows: A. A professional licensing board or other state agency that grants licensure or certification may not reprimand, sanction, or revoke or threaten to revoke a license, certificate, or registration of a medical practitioner who is licensed or certified by the board or agency for engaging in speech or expressive activity protected under the First Amendment to the United States Constitution, unless the board or agency demonstrates beyond a reasonable doubt that the medical practitioner’s speech was the direct cause of physical harm to a person with whom the medical practitioner had a practitioner- patient relationship within the three (3) years immediately preceding the incident of physical harm. B. 1. Within fourteen (14) calendar days of receiving a complaint that may result in revocation of a medical practitioner’s license, certificate, or registration, the board or agency shall provide the medical practitioner with a copy of the complaint. 2. If the board or agency fails to provide the complaint within fourteen (14) calendar days of receipt, the board or agency shall pay the medical practitioner an administrative penalty of Five Hundred Dollars ($500.00) for each week of noncompliance. Req. No. 2710 Page 10 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 7. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728m of Title 63, unless there is created a duplication in numbering, reads as follows: A. It is unlawful to interfere or attempt to interfere with the right not to participate in a health care service or the whistleblower and free speech rights and protections authorized by this act, whether by duress, coercion, or any other means. B. A medical practitioner, health care institution, or health care payor injured by unlawful interference is entitled to: 1. Injunctive relief, when appropriate, including but not limited to reinstatement of a medical practitioner to the medical practitioner’s previous position, reinstatement of board certification, and relicensure of a health care institution or health care payor; 2. Monetary damages for injuries suffered; and 3. Reasonable costs and attorney fees. SECTION 8. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728n of Title 63, unless there is created a duplication in numbering, reads as follows: The Insurance Commissioner shall promulgate reasonable and necessary rules concerning the implementation of this act relating to those insurers under its jurisdiction. Req. No. 2710 Page 11 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 SECTION 9. NEW LAW A new section of law to be codified in the Oklahoma Statutes as Section 1-728o of Title 63, unless there is created a duplication in numbering, reads as follows: This act is supplemental to and may not be construed as modifying or limiting the rights and remedies provided in the Freedom of Conscience Act, Section 1-728a et seq. of Title 63 of the Oklahoma Statutes. SECTION 10. This act shall become effective November 1, 2024. 59-2-2710 DC 1/18/2024 8:49:10 AM