At a glance
EPT is potentially allowable in Oklahoma as of December 3, 2013.
Findings
[+] supports the use of EPT
[-] negatively affects the use of EPT
I. Statutes/regs on health care providers’ authority to prescribe for STDs to a patient’s partner(s) w/out prior evaluation
[+] “Providers ordering appropriate medications for persons with laboratory-proven, sexually transmitted diseases” may provide medications to “persons who have been in contact with certain infectious diseases” without a face-to-face encounter. Okla. Admin. Code § 435:10-7-12. (effective 12/2/2013)
[-] Physicians prohibited from prescribing to a patient without sufficient examination or establishing physician/patient relationship. Okla. Stat. tit. 59 § 637*. See Okla. Admin. Code § 435:10-7-12* (“The physician/patient relationship shall include a medically appropriate, timely-scheduled, face-to-face encounter with the patient… except that the following providers are not subject to the face-to-face encounter: … (3) Providers ordering appropriate medications for persons with laboratory-proven, sexually diseases”)
[-] It is unlawful for any person not a physician to treat anyone for an STD, unless that person is under direct control of a physician. Okla. Stat. tit. 63 § 1-521.
II. Specific judicial decisions concerning EPT (or like practices)
[-] Physician misconduct found when physician prescribed to patients without establishing physician-patient relationship or prior examination. State v. Litchfield, 103 P.3d 111 (Okla. Civ. App. 2004)*. State v. Ray, 848 P.2d 46 (Okla. Civ. App. 1992)*.
III. Specific administrative opinions by the Attorney General or medical or pharmacy boards concerning EPT (or like practices)
[-] The Oklahoma State Board of Medical Licensure and Supervision determined that “Unprofessional conduct includes “prescribing or administering a drug or treatment without sufficient examination and the establishment of a valid physician/ patient relationship” pursuant to Title 59 O.S. 509-12. Also, a “sufficient examination” and “establishment of a valid physician/patient relationship” can NOT take place without an initial face to face encounter with the patient. In other words, it requires at a minimum: . . .
2. Establishing a diagnosis through the use of accepted medical practices such as a patient history, mental status exam, physical examination and appropriate diagnostic and laboratory testing by the prescribing physician;
3. Discussing with the patient, the diagnosis and the evidence for it, the risks and benefits of various treatment options; and
3. Discussing with the patient, the diagnosis and the evidence for it, the risks and benefits of various treatment options; and
4. Insuring availability of the physician or coverage for the patient for appropriate follow-up care.”*
IV. Laws that incorporate via reference guidelines as acceptable practices (including EPT)
V. Prescription requirements
[-] Prescription label must bear name of patient. 59 Okl. St § 353.20.1.*
[-] If the name of patient is stated in the prescription, the label must bear the patient’s name. Okla. Stat. tit. 63, § 1-1409.*
[-] “The pharmacy or pharmacist shall not dispense a prescription drug if the pharmacist knows or should have known that the prescription was issued without a valid preexisting patient-practitioner relationship.” Okla. Admin. Code § 535:15-3-13(d)*
VI. Assessment of EPT’s legal status with brief comments
EPT is potentially allowable. Administrative regulations authorize the practice of EPT. Other statutory authority, case law, medical board opinions, and administrative regulations pose potential legal barriers to the practice of EPT.
* This legal authority predates the effective date of the state’s law that authorizes EPT.