Bill Text: FL H0573 | 2010 | Regular Session | Comm Sub

---

Bill Title: Physician Assistants [SPSC]

Spectrum: Partisan Bill (Republican 2-0)

Status: (Passed) 2010-05-11 - Approved by Governor; Chapter No. 2010-55 [H0573 Detail]

Download: Florida-2010-H0573-Comm_Sub.html

---

CS/HB 573

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

CODING: Words stricken are deletions; words underlined are additions.