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.