December 07, 2019
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       Florida Senate - 2010                                    SB 1456
       
       
       
       By Senator Jones
       
       
       
       
       13-01285-10                                           20101456__
    1                        A bill to be entitled                      
    2         An act relating to physician assistants; amending ss.
    3         458.347 and 459.022, F.S.; deleting requirements that
    4         physician assistants file with the Department of
    5         Health evidence of having obtained certain clinical
    6         experience before prescribing or dispensing
    7         medication; amending ss. 458.348 and 459.025, F.S.;
    8         conforming cross-references; providing an effective
    9         date.
   10  
   11  Be It Enacted by the Legislature of the State of Florida:
   12  
   13         Section 1. Paragraph (e) of subsection (4) of section
   14  458.347, Florida Statutes, is amended to read:
   15         458.347 Physician assistants.—
   16         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   17         (e) A supervisory physician may delegate to a fully
   18  licensed physician assistant the authority to prescribe or
   19  dispense any medication used in the supervisory physician’s
   20  practice unless such medication is listed on the formulary
   21  created pursuant to paragraph (f). A fully licensed physician
   22  assistant may only prescribe or dispense such medication under
   23  the following circumstances:
   24         1. A physician assistant must clearly identify to the
   25  patient that he or she is a physician assistant. Furthermore,
   26  the physician assistant must inform the patient that the patient
   27  has the right to see the physician prior to any prescription
   28  being prescribed or dispensed by the physician assistant.
   29         2. The supervisory physician must notify the department of
   30  his or her intent to delegate, on a department-approved form,
   31  before delegating such authority and notify the department of
   32  any change in prescriptive privileges of the physician
   33  assistant. Authority to dispense may be delegated only by a
   34  supervising physician who is registered as a dispensing
   35  practitioner in compliance with s. 465.0276.
   36         3. The physician assistant must file with the department,
   37  before commencing to prescribe or dispense, evidence that he or
   38  she has completed a continuing medical education course of at
   39  least 3 classroom hours in prescriptive practice, conducted by
   40  an accredited program approved by the boards, which course
   41  covers the limitations, responsibilities, and privileges
   42  involved in prescribing medicinal drugs, or evidence that he or
   43  she has received education comparable to the continuing
   44  education course as part of an accredited physician assistant
   45  training program.
   46         4. The physician assistant must file with the department,
   47  before commencing to prescribe or dispense, evidence that the
   48  physician assistant has a minimum of 3 months of clinical
   49  experience in the specialty area of the supervising physician.
   50         4.5. The physician assistant must file with the department
   51  a signed affidavit that he or she has completed a minimum of 10
   52  continuing medical education hours in the specialty practice in
   53  which the physician assistant has prescriptive privileges with
   54  each licensure renewal application.
   55         5.6. The department shall issue a license and a prescriber
   56  number to the physician assistant granting authority for the
   57  prescribing of medicinal drugs authorized within this paragraph
   58  upon completion of the foregoing requirements. The physician
   59  assistant shall not be required to independently register
   60  pursuant to s. 465.0276.
   61         6.7. The prescription must be written in a form that
   62  complies with chapter 499 and must contain, in addition to the
   63  supervisory physician’s name, address, and telephone number, the
   64  physician assistant’s prescriber number. Unless it is a drug or
   65  drug sample dispensed by the physician assistant, the
   66  prescription must be filled in a pharmacy permitted under
   67  chapter 465 and must be dispensed in that pharmacy by a
   68  pharmacist licensed under chapter 465. The appearance of the
   69  prescriber number creates a presumption that the physician
   70  assistant is authorized to prescribe the medicinal drug and the
   71  prescription is valid.
   72         7.8. The physician assistant must note the prescription or
   73  dispensing of medication in the appropriate medical record.
   74         8.9. This paragraph does not prohibit a supervisory
   75  physician from delegating to a physician assistant the authority
   76  to order medication for a hospitalized patient of the
   77  supervisory physician.
   78  
   79  This paragraph does not apply to facilities licensed pursuant to
   80  chapter 395.
   81         Section 2. Paragraph (e) of subsection (4) of section
   82  459.022, Florida Statutes, is amended to read:
   83         459.022 Physician assistants.—
   84         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   85         (e) A supervisory physician may delegate to a fully
   86  licensed physician assistant the authority to prescribe or
   87  dispense any medication used in the supervisory physician’s
   88  practice unless such medication is listed on the formulary
   89  created pursuant to s. 458.347. A fully licensed physician
   90  assistant may only prescribe or dispense such medication under
   91  the following circumstances:
   92         1. A physician assistant must clearly identify to the
   93  patient that she or he is a physician assistant. Furthermore,
   94  the physician assistant must inform the patient that the patient
   95  has the right to see the physician prior to any prescription
   96  being prescribed or dispensed by the physician assistant.
   97         2. The supervisory physician must notify the department of
   98  her or his intent to delegate, on a department-approved form,
   99  before delegating such authority and notify the department of
  100  any change in prescriptive privileges of the physician
  101  assistant. Authority to dispense may be delegated only by a
  102  supervisory physician who is registered as a dispensing
  103  practitioner in compliance with s. 465.0276.
  104         3. The physician assistant must file with the department,
  105  before commencing to prescribe or dispense, evidence that she or
  106  he has completed a continuing medical education course of at
  107  least 3 classroom hours in prescriptive practice, conducted by
  108  an accredited program approved by the boards, which course
  109  covers the limitations, responsibilities, and privileges
  110  involved in prescribing medicinal drugs, or evidence that she or
  111  he has received education comparable to the continuing education
  112  course as part of an accredited physician assistant training
  113  program.
  114         4. The physician assistant must file with the department,
  115  before commencing to prescribe or dispense, evidence that the
  116  physician assistant has a minimum of 3 months of clinical
  117  experience in the specialty area of the supervising physician.
  118         4.5. The physician assistant must file with the department
  119  a signed affidavit that she or he has completed a minimum of 10
  120  continuing medical education hours in the specialty practice in
  121  which the physician assistant has prescriptive privileges with
  122  each licensure renewal application.
  123         5.6. The department shall issue a license and a prescriber
  124  number to the physician assistant granting authority for the
  125  prescribing of medicinal drugs authorized within this paragraph
  126  upon completion of the foregoing requirements. The physician
  127  assistant shall not be required to independently register
  128  pursuant to s. 465.0276.
  129         6.7. The prescription must be written in a form that
  130  complies with chapter 499 and must contain, in addition to the
  131  supervisory physician’s name, address, and telephone number, the
  132  physician assistant’s prescriber number. Unless it is a drug or
  133  drug sample dispensed by the physician assistant, the
  134  prescription must be filled in a pharmacy permitted under
  135  chapter 465, and must be dispensed in that pharmacy by a
  136  pharmacist licensed under chapter 465. The appearance of the
  137  prescriber number creates a presumption that the physician
  138  assistant is authorized to prescribe the medicinal drug and the
  139  prescription is valid.
  140         7.8. The physician assistant must note the prescription or
  141  dispensing of medication in the appropriate medical record.
  142         8.9. This paragraph does not prohibit a supervisory
  143  physician from delegating to a physician assistant the authority
  144  to order medication for a hospitalized patient of the
  145  supervisory physician.
  146  
  147  This paragraph does not apply to facilities licensed pursuant to
  148  chapter 395.
  149         Section 3. Paragraph (c) of subsection (4) of section
  150  458.348, Florida Statutes, is amended to read:
  151         458.348 Formal supervisory relationships, standing orders,
  152  and established protocols; notice; standards.—
  153         (4) SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.—A
  154  physician who supervises an advanced registered nurse
  155  practitioner or physician assistant at a medical office other
  156  than the physician’s primary practice location, where the
  157  advanced registered nurse practitioner or physician assistant is
  158  not under the onsite supervision of a supervising physician,
  159  must comply with the standards set forth in this subsection. For
  160  the purpose of this subsection, a physician’s “primary practice
  161  location” means the address reflected on the physician’s profile
  162  published pursuant to s. 456.041.
  163         (c) A physician who supervises an advanced registered nurse
  164  practitioner or physician assistant at a medical office other
  165  than the physician’s primary practice location, where the
  166  advanced registered nurse practitioner or physician assistant is
  167  not under the onsite supervision of a supervising physician and
  168  the services offered at the office are primarily dermatologic or
  169  skin care services, which include aesthetic skin care services
  170  other than plastic surgery, must comply with the standards
  171  listed in subparagraphs 1.-4. Notwithstanding s. 458.347(4)(e)7.
  172  s. 458.347(4)(e)8., a physician supervising a physician
  173  assistant pursuant to this paragraph may not be required to
  174  review and cosign charts or medical records prepared by such
  175  physician assistant.
  176         1. The physician shall submit to the board the addresses of
  177  all offices where he or she is supervising an advanced
  178  registered nurse practitioner or a physician’s assistant which
  179  are not the physician’s primary practice location.
  180         2. The physician must be board certified or board eligible
  181  in dermatology or plastic surgery as recognized by the board
  182  pursuant to s. 458.3312.
  183         3. All such offices that are not the physician’s primary
  184  place of practice must be within 25 miles of the physician’s
  185  primary place of practice or in a county that is contiguous to
  186  the county of the physician’s primary place of practice.
  187  However, the distance between any of the offices may not exceed
  188  75 miles.
  189         4. The physician may supervise only one office other than
  190  the physician’s primary place of practice except that until July
  191  1, 2011, the physician may supervise up to two medical offices
  192  other than the physician’s primary place of practice if the
  193  addresses of the offices are submitted to the board before July
  194  1, 2006. Effective July 1, 2011, the physician may supervise
  195  only one office other than the physician’s primary place of
  196  practice, regardless of when the addresses of the offices were
  197  submitted to the board.
  198         Section 4. Paragraph (c) of subsection (3) of section
  199  459.025, Florida Statutes, is amended to read:
  200         459.025 Formal supervisory relationships, standing orders,
  201  and established protocols; notice; standards.—
  202         (3) SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.
  203  An osteopathic physician who supervises an advanced registered
  204  nurse practitioner or physician assistant at a medical office
  205  other than the osteopathic physician’s primary practice
  206  location, where the advanced registered nurse practitioner or
  207  physician assistant is not under the onsite supervision of a
  208  supervising osteopathic physician, must comply with the
  209  standards set forth in this subsection. For the purpose of this
  210  subsection, an osteopathic physician’s “primary practice
  211  location” means the address reflected on the physician’s profile
  212  published pursuant to s. 456.041.
  213         (c) An osteopathic physician who supervises an advanced
  214  registered nurse practitioner or physician assistant at a
  215  medical office other than the osteopathic physician’s primary
  216  practice location, where the advanced registered nurse
  217  practitioner or physician assistant is not under the onsite
  218  supervision of a supervising osteopathic physician and the
  219  services offered at the office are primarily dermatologic or
  220  skin care services, which include aesthetic skin care services
  221  other than plastic surgery, must comply with the standards
  222  listed in subparagraphs 1.-4. Notwithstanding s. 459.022(4)(e)7.
  223  s. 459.022(4)(e)8., an osteopathic physician supervising a
  224  physician assistant pursuant to this paragraph may not be
  225  required to review and cosign charts or medical records prepared
  226  by such physician assistant.
  227         1. The osteopathic physician shall submit to the Board of
  228  Osteopathic Medicine the addresses of all offices where he or
  229  she is supervising or has a protocol with an advanced registered
  230  nurse practitioner or a physician’s assistant which are not the
  231  osteopathic physician’s primary practice location.
  232         2. The osteopathic physician must be board certified or
  233  board eligible in dermatology or plastic surgery as recognized
  234  by the Board of Osteopathic Medicine pursuant to s. 459.0152.
  235         3. All such offices that are not the osteopathic
  236  physician’s primary place of practice must be within 25 miles of
  237  the osteopathic physician’s primary place of practice or in a
  238  county that is contiguous to the county of the osteopathic
  239  physician’s primary place of practice. However, the distance
  240  between any of the offices may not exceed 75 miles.
  241         4. The osteopathic physician may supervise only one office
  242  other than the osteopathic physician’s primary place of practice
  243  except that until July 1, 2011, the osteopathic physician may
  244  supervise up to two medical offices other than the osteopathic
  245  physician’s primary place of practice if the addresses of the
  246  offices are submitted to the Board of Osteopathic Medicine
  247  before July 1, 2006. Effective July 1, 2011, the osteopathic
  248  physician may supervise only one office other than the
  249  osteopathic physician’s primary place of practice, regardless of
  250  when the addresses of the offices were submitted to the Board of
  251  Osteopathic Medicine.
  252         Section 5. This act shall take effect July 1, 2010.

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