Bill Text: FL S0774 | 2012 | Regular Session | Comm Sub
Bill Title: Physician Assistants
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2012-03-09 - Laid on Table, refer to CS/CS/CS/HB 363 -SJ 1670 [S0774 Detail]
Download: Florida-2012-S0774-Comm_Sub.html
Florida Senate - 2012 CS for SB 774 By the Committee on Health Regulation; and Senator Hays 588-02038-12 2012774c1 1 A bill to be entitled 2 An act relating to physician assistants; amending ss. 3 458.307 and 459.004, F.S.; revising the composition of 4 the membership on the Board of Medicine and the Board 5 of Osteopathic Medicine; providing for the appointment 6 of new members as vacancies occur and allow; amending 7 ss. 458.347 and 459.022, F.S.; deleting the 8 requirement that the Department of Health issue a 9 license to a physician assistant to prescribe 10 medicinal drugs and requiring only a prescription 11 number; requiring that a physician assistant seeking 12 to prescribe medicinal drugs submit certain evidence 13 at the time of initial licensure of completion of a 14 course in pharmacotherapeutics from an accredited 15 program; providing that a physician assistant wishing 16 to apply for a prescriber number must submit course 17 transcripts and a copy of the course description in 18 addition to other licensure application requirements; 19 requiring that a physician assistant seeking to apply 20 for a prescriber number upon biennial licensure 21 renewal submit evidence of completion of at least a 22 certain number of classroom hours in an approved 23 program that covers prescribing limitations, 24 responsibilities, and privileges involved in 25 prescribing medicinal drugs; conforming provisions to 26 changes made by the act; providing an effective date. 27 28 Be It Enacted by the Legislature of the State of Florida: 29 30 Section 1. Subsection (2) of section 458.307, Florida 31 Statutes, is amended to read: 32 458.307 Board of Medicine.— 33 (2) Twelve members of the board must be licensed physicians 34 in good standing in this state who are residents of the state 35 and who have been engaged in the active practice or teaching of 36 medicine for at least 4 years immediately preceding their 37 appointment. One of the physicians must be on the full-time 38 faculty of a medical school in this state, and one of the 39 physicians must be in private practice and on the full-time 40 staff of a statutory teaching hospital in this state as defined 41 in s. 408.07. At least one of the physicians must be a graduate 42 of a foreign medical school. One member must be a physician 43 assistant licensed under this chapter who has prescribing 44 authority and who has worked in the state for at least 4 years. 45 The remaining twothreemembers must be residents of the state 46 who are not, and never have been, licensed health care 47 practitioners. One member must be a health care risk manager 48 licensed under s. 395.10974. At least one member of the board 49 must be 60 years of age or older. 50 Section 2. Paragraphs (e) and (f) of subsection (4) and 51 paragraphs (a) and (c) of subsection (7) of section 458.347, 52 Florida Statutes, are amended to read: 53 458.347 Physician assistants.— 54 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.— 55 (e) A supervisory physician may delegate to a fully 56 licensed physician assistant the authority to prescribe or 57 dispense any medication used in the supervisory physician’s 58 practice unless such medication is listed on the formulary 59 created pursuant to paragraph (f). A fully licensed physician 60 assistant may only prescribe or dispense such medication under 61 the following circumstances: 62 1. A physician assistant must clearly identify to the 63 patient that he or she is a physician assistant. Furthermore, 64 the physician assistant must inform the patient that the patient 65 has the right to see the physician prior to any prescription 66 being prescribed or dispensed by the physician assistant. 67 2. The supervisory physician must notify the department of 68 his or her intent to delegate, on a department-approved form, 69 before delegating such authority and notify the department of 70 any change in prescriptive privileges of the physician 71 assistant. Authority to dispense may be delegated only by a 72 supervising physician who is registered as a dispensing 73 practitioner in compliance with s. 465.0276. 74 3. The physician assistant must file with the department, 75 at the time of initial applicationbefore commencing to76prescribe or dispense, evidence that he or she has completed a 77continuing medical educationcourse in pharmacotherapeutics, to 78 include the initiation, selection, and modification of selected 79 medications, and the limitations, responsibilities, and 80 privileges involved in prescribing medicinal drugs. The course 81 must have beenof at least 3 classroom hours in prescriptive82practice,conducted by aan accreditedprogram accredited by the 83 Commission on Accreditation of Allied Health Programs or its 84 successor organization. The department shall issue a prescriber 85 number if the evidence submitted meets the requirements. The 86 physician assistant must receive a prescriber number before 87 commencing to prescribe or dispense medicinal drugsapproved by88the boards, which course covers the limitations,89responsibilities, and privileges involved in prescribing90medicinal drugs, or evidence that he or she has received91education comparable to the continuing education course as part92of an accredited physician assistant training program. 93 4. The physician assistant must file with the department a 94 signed affidavit that he or she has completed a minimum of 10 95 continuing medical education hours in the specialty practice in 96 which the physician assistant has prescriptive privileges with 97 each licensure renewal application. 98 5. The department shall issuea license anda prescriber 99 number to the physician assistant granting authority for the 100 prescribing of medicinal drugs authorized within this paragraph 101 upon completion of the foregoing requirements. The physician 102 assistant shall not be required to independently register 103 pursuant to s. 465.0276. 104 6. The prescription must be written in a form that complies 105 with chapter 499 and must contain, in addition to the 106 supervisory physician’s name, address, and telephone number, the 107 physician assistant’s prescriber number. Unless it is a drug or 108 drug sample dispensed by the physician assistant, the 109 prescription must be filled in a pharmacy permitted under 110 chapter 465 and must be dispensed in that pharmacy by a 111 pharmacist licensed under chapter 465. The appearance of the 112 prescriber number creates a presumption that the physician 113 assistant is authorized to prescribe the medicinal drug and the 114 prescription is valid. 115 7. The physician assistant must note the prescription or 116 dispensing of medication in the appropriate medical record. 117 8. This paragraph does not prohibit a supervisory physician 118 from delegating to a physician assistant the authority to order 119 medication for a hospitalized patient of the supervisory 120 physician. 121 122 This paragraph does not apply to facilities licensed pursuant to 123 chapter 395. 124 (f)1. The council shall establish a formulary of medicinal 125 drugs that a fully licensed physician assistant having 126 prescribing authority, licensedunder this section or s. 127 459.022,may not prescribe. The formulary must include 128 controlled substances as defined in chapter 893, general 129 anesthetics, and radiographic contrast materials. 130 2. In establishing the formulary, the council shall consult 131 with a pharmacist licensed under chapter 465, but not licensed 132 under this chapter or chapter 459, who shall be selected by the 133 State Surgeon General. 134 3. Only the council shall add to, delete from, or modify 135 the formulary. Any person who requests an addition, deletion, or 136 modification of a medicinal drug listed on such formulary has 137 the burden of proof to show cause why such addition, deletion, 138 or modification should be made. 139 4. The boards shall adopt the formulary required by this 140 paragraph, and each addition, deletion, or modification to the 141 formulary, by rule. Notwithstanding any provision of chapter 120 142 to the contrary, the formulary rule shall be effective 60 days 143 after the date it is filed with the Secretary of State. Upon 144 adoption of the formulary, the department shall mail a copy of 145 such formulary to each fully licensed physician assistant having 146 prescribing authority, licensedunder this section or s. 147 459.022, and to each pharmacy licensed by the state.The boards148shall establish, by rule, a fee not to exceed $200 to fund the149provisions of this paragraph and paragraph (e).150 (7) PHYSICIAN ASSISTANT LICENSURE.— 151 (a) Any person desiring to be licensed as a physician 152 assistant must apply to the department. The department shall 153 issue a license to any person certified by the council as having 154 met the following requirements: 155 1. Is at least 18 years of age. 156 2. Has satisfactorily passed a proficiency examination by 157 an acceptable score established by the National Commission on 158 Certification of Physician Assistants. If an applicant does not 159 hold a current certificate issued by the National Commission on 160 Certification of Physician Assistants and has not actively 161 practiced as a physician assistant within the immediately 162 preceding 4 years, the applicant must retake and successfully 163 complete the entry-level examination of the National Commission 164 on Certification of Physician Assistants to be eligible for 165 licensure. 166 3. Has completed the application form and remitted an 167 application fee not to exceed $300 as set by the boards. An 168 application for licensure made by a physician assistant must 169 include: 170 a. A certificate of completion of a physician assistant 171 training program specified in subsection (6). 172 b. A sworn statement of any prior felony convictions. 173 c. A sworn statement of any previous revocation or denial 174 of licensure or certification in any state. 175 d. Two letters of recommendation. 176 e. A copy of course transcripts and a copy of the course 177 description from a physician assistant training program 178 describing a pharmacotherapy course pursuant to subparagraph 179 (4)(e)3., if the applicant wishes to apply for a prescriber 180 number. These documents must meet the evidence requirements for 181 prescribing authority. 182 (c) The license must be renewed biennially. Each renewal 183 must include: 184 1. A renewal fee not to exceed $500 as set by the boards. 185 2. A sworn statement of no felony convictions in the 186 previous 2 years. 187 188 A licensed physician assistant without prescribing authority may 189 request a prescriber number upon biennial licensure renewal 190 under this paragraph by submitting evidence that he or she has 191 completed a continuing medical education course of at least 3 192 classroom hours in prescriptive practice, covering the 193 limitations, responsibilities, and privileges involved in 194 prescribing medicinal drugs. The course must be conducted by an 195 accredited program approved by the boards. The physician 196 assistant must receive a prescriber number before commencing to 197 prescribe or dispense medicinal drugs. 198 Section 3. Subsection (2) of section 459.004, Florida 199 Statutes, is amended to read: 200 459.004 Board of Osteopathic Medicine.— 201 (2) Five members of the board must be licensed osteopathic 202 physicians in good standing in this state who are residents of 203 this state and who have been engaged in the practice of 204 osteopathic medicine for at least 4 years immediately prior to 205 their appointment. One member must be a physician assistant 206 licensed under this chapter who has prescribing authority and 207 who has worked in the state for at least 4 years. The remaining 208 membertwo membersmust be a citizencitizensof the state who 209 isarenot, and hashavenever been, a licensed health care 210 practitionerpractitioners. At least one member of the board 211 must be 60 years of age or older. 212 Section 4. Paragraph (e) of subsection (4) and paragraphs 213 (a) and (b) of subsection (7) of section 459.022, Florida 214 Statutes, are amended to read: 215 459.022 Physician assistants.— 216 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.— 217 (e) A supervisory physician may delegate to a fully 218 licensed physician assistant the authority to prescribe or 219 dispense any medication used in the supervisory physician’s 220 practice unless such medication is listed on the formulary 221 created pursuant to s. 458.347. A fully licensed physician 222 assistant may only prescribe or dispense such medication under 223 the following circumstances: 224 1. A physician assistant must clearly identify to the 225 patient that she or he is a physician assistant. Furthermore, 226 the physician assistant must inform the patient that the patient 227 has the right to see the physician prior to any prescription 228 being prescribed or dispensed by the physician assistant. 229 2. The supervisory physician must notify the department of 230 her or his intent to delegate, on a department-approved form, 231 before delegating such authority and notify the department of 232 any change in prescriptive privileges of the physician 233 assistant. Authority to dispense may be delegated only by a 234 supervisory physician who is registered as a dispensing 235 practitioner in compliance with s. 465.0276. 236 3. The physician assistant must file with the department, 237 at the time of the initial applicationbefore commencing to238prescribe or dispense, evidence that she or he has completed a 239continuing medical educationcourse in pharmacotherapeutics, to 240 include the initiation, selection, and modification of selected 241 medications, and the limitations, responsibilities, and 242 privileges involved in prescribing medicinal drugs. The course 243 must have beenof at least 3 classroom hours in prescriptive244practice,conducted by aan accreditedprogram accredited by the 245 Commission on Accreditation of Allied Health Programs or its 246 successor organization. The department shall issue a prescriber 247 number if the evidence submitted meets the requirements. The 248 physician assistant must receive a prescriber number before 249 commencing to prescribe or dispense medicinal drugsapproved by250the boards, which course covers the limitations,251responsibilities, and privileges involved in prescribing252medicinal drugs, or evidence that she or he has received253education comparable to the continuing education course as part254of an accredited physician assistant training program. 255 4. The physician assistant must file with the department a 256 signed affidavit that she or he has completed a minimum of 10 257 continuing medical education hours in the specialty practice in 258 which the physician assistant has prescriptive privileges with 259 each licensure renewal application. 260 5. The department shall issuea license anda prescriber 261 number to the physician assistant granting authority for the 262 prescribing of medicinal drugs authorized within this paragraph 263 upon completion of the foregoing requirements. The physician 264 assistant shall not be required to independently register 265 pursuant to s. 465.0276. 266 6. The prescription must be written in a form that complies 267 with chapter 499 and must contain, in addition to the 268 supervisory physician’s name, address, and telephone number, the 269 physician assistant’s prescriber number. Unless it is a drug or 270 drug sample dispensed by the physician assistant, the 271 prescription must be filled in a pharmacy permitted under 272 chapter 465, and must be dispensed in that pharmacy by a 273 pharmacist licensed under chapter 465. The appearance of the 274 prescriber number creates a presumption that the physician 275 assistant is authorized to prescribe the medicinal drug and the 276 prescription is valid. 277 7. The physician assistant must note the prescription or 278 dispensing of medication in the appropriate medical record. 279 8. This paragraph does not prohibit a supervisory physician 280 from delegating to a physician assistant the authority to order 281 medication for a hospitalized patient of the supervisory 282 physician. 283 284 This paragraph does not apply to facilities licensed pursuant to 285 chapter 395. 286 (7) PHYSICIAN ASSISTANT LICENSURE.— 287 (a) Any person desiring to be licensed as a physician 288 assistant must apply to the department. The department shall 289 issue a license to any person certified by the council as having 290 met the following requirements: 291 1. Is at least 18 years of age. 292 2. Has satisfactorily passed a proficiency examination by 293 an acceptable score established by the National Commission on 294 Certification of Physician Assistants. If an applicant does not 295 hold a current certificate issued by the National Commission on 296 Certification of Physician Assistants and has not actively 297 practiced as a physician assistant within the immediately 298 preceding 4 years, the applicant must retake and successfully 299 complete the entry-level examination of the National Commission 300 on Certification of Physician Assistants to be eligible for 301 licensure. 302 3. Has completed the application form and remitted an 303 application fee not to exceed $300 as set by the boards. An 304 application for licensure made by a physician assistant must 305 include: 306 a. A certificate of completion of a physician assistant 307 training program specified in subsection (6). 308 b. A sworn statement of any prior felony convictions. 309 c. A sworn statement of any previous revocation or denial 310 of licensure or certification in any state. 311 d. Two letters of recommendation. 312 e. A copy of course transcripts and a copy of the course 313 description from a physician assistant training program 314 describing a pharmacotherapy course pursuant to subparagraph 315 (4)(e)3., if the applicant wishes to apply for a prescriber 316 number. These documents must meet the evidence requirements for 317 prescribing authority. 318 (b) The licensure must be renewed biennially. Each renewal 319 must include: 320 1. A renewal fee not to exceed $500 as set by the boards. 321 2. A sworn statement of no felony convictions in the 322 previous 2 years. 323 324 A licensed physician assistant without prescribing authority may 325 request a prescriber number upon biennial licensure renewal 326 under this paragraph by submitting evidence that she or he has 327 completed a continuing medical education course of at least 3 328 classroom hours in prescriptive practice, covering the 329 limitations, responsibilities, and privileges involved in 330 prescribing medicinal drugs. The course must be conducted by an 331 accredited program approved by the boards. The physician 332 assistant must receive a prescriber number before commencing to 333 prescribe or dispense medicinal drugs. 334 Section 5. The amendment of sections 458.307 and 459.004, 335 Florida Statutes, made by this act to change the composition of 336 the membership on the Board of Medicine and the Board of 337 Osteopathic Medicine shall be implemented as vacancies on those 338 boards occur and allow. 339 Section 6. This act shall take effect July 1, 2012.