Florida Senate - 2014                        COMMITTEE AMENDMENT
       Bill No. SB 1230
       
       
       
       
       
       
                                Ì568886jÎ568886                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RE            .                                
                  04/02/2014           .                                
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       following:
       
    1         Senate Amendment to Amendment (730402) (with title
    2  amendment)
    3  
    4         Between lines 115 and 116
    5  insert:
    6         Section 2. Paragraph (c) of subsection (4) of section
    7  458.348, Florida Statutes, is amended to read:
    8         458.348 Formal supervisory relationships, standing orders,
    9  and established protocols; notice; standards.—
   10         (4) SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.—A
   11  physician who supervises an advanced registered nurse
   12  practitioner or physician assistant at a medical office other
   13  than the physician’s primary practice location, where the
   14  advanced registered nurse practitioner or physician assistant is
   15  not under the onsite supervision of a supervising physician,
   16  must comply with the standards set forth in this subsection. For
   17  the purpose of this subsection, a physician’s “primary practice
   18  location” means the address reflected on the physician’s profile
   19  published pursuant to s. 456.041.
   20         (c) A physician who supervises an advanced registered nurse
   21  practitioner or physician assistant at a medical office other
   22  than the physician’s primary practice location, where the
   23  advanced registered nurse practitioner or physician assistant is
   24  not under the onsite supervision of a supervising physician and
   25  the services offered at the office are primarily dermatologic or
   26  skin care services, which include aesthetic skin care services
   27  other than plastic surgery, must comply with the standards
   28  listed in subparagraphs 1.-4. Notwithstanding s.
   29  458.347(4)(e)6., a physician supervising a physician assistant
   30  pursuant to this paragraph may not be required to review and
   31  cosign charts or medical records prepared by such physician
   32  assistant.
   33         1. The physician shall submit to the board the addresses of
   34  all offices where he or she is supervising an advanced
   35  registered nurse practitioner or a physician’s assistant which
   36  are not the physician’s primary practice location.
   37         2. The physician must be board certified or board eligible
   38  in dermatology or plastic surgery as recognized by the board
   39  pursuant to s. 458.3312.
   40         3. All such offices that are not the physician’s primary
   41  place of practice must be within 25 miles of the physician’s
   42  primary place of practice or in a county that is contiguous to
   43  the county of the physician’s primary place of practice.
   44  However, the distance between any of the offices may not exceed
   45  75 miles.
   46         4. The physician may supervise only one office other than
   47  the physician’s primary place of practice except that until July
   48  1, 2011, the physician may supervise up to two medical offices
   49  other than the physician’s primary place of practice if the
   50  addresses of the offices are submitted to the board before July
   51  1, 2006. Effective July 1, 2011, the physician may supervise
   52  only one office other than the physician’s primary place of
   53  practice, regardless of when the addresses of the offices were
   54  submitted to the board.
   55         5.a. Subparagraphs 2. and 4. do not apply to an office
   56  where nonablative aesthetic skin care services are being
   57  performed by a physician assistant under the supervision of a
   58  physician if the physician assistant has successfully completed
   59  at least:
   60         (I) Eighty hours of education and clinical training on
   61  physiology of the skin, skin conditions, skin disorders, skin
   62  diseases, pre- and post-skin procedure care, and infection
   63  control;
   64         (II) Ten hours of education and clinical training on laser
   65  and light technologies and skin applications; and
   66         (III) Thirty-two hours of education and clinical training
   67  on injectables and fillers.
   68         b. As used in this paragraph, the term nonablative
   69  aesthetic services includes, but is not limited to, services
   70  provided using intense pulsed light, lasers, radio frequency,
   71  ultrasound, injectables, and fillers. The supervising physician
   72  shall submit to the board documentation evidencing successful
   73  completion of the education and training required by this
   74  paragraph for the physician assistants that he or she is
   75  supervising. A physician may not supervise more than two offices
   76  in addition to the physician’s primary practice location.
   77  
   78  ================= T I T L E  A M E N D M E N T ================
   79  And the title is amended as follows:
   80         Delete lines 234 - 235
   81  and insert:
   82  
   83