Florida Senate - 2014                          SENATOR AMENDMENT
       Bill No. CS for CS for SB 1354
       
       
       
       
       
       
                                Ì866412ÇÎ866412                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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                 Floor: WD/2R          .                                
             04/28/2014 07:10 PM       .                                
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       Senator Hays moved the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Between lines 167 and 168
    4  insert:
    5         Section 2. Subsection (3), paragraph (e) of subsection (4),
    6  and paragraphs (a), (c), and (e) of subsection (7) of section
    7  458.347, Florida Statutes, are amended to read:
    8         458.347 Physician assistants.—
    9         (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
   10  group of physicians supervising a licensed physician assistant
   11  must be qualified in the medical areas in which the physician
   12  assistant is to perform and shall be individually or
   13  collectively responsible and liable for the performance and the
   14  acts and omissions of the physician assistant. A physician may
   15  not supervise more than five four currently licensed physician
   16  assistants at any one time. A physician supervising a physician
   17  assistant pursuant to this section may not be required to review
   18  and cosign charts or medical records prepared by such physician
   19  assistant. Notwithstanding this subsection, a physician may
   20  supervise only up to four physician assistants in medical
   21  offices other than the physician’s primary practice location
   22  pursuant to s. 458.348(4)(c).
   23         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   24         (e) A supervisory physician may delegate to a fully
   25  licensed physician assistant the authority to prescribe or
   26  dispense any medication used in the supervisory physician’s
   27  practice unless such medication is listed on the formulary
   28  created pursuant to paragraph (f). A fully licensed physician
   29  assistant may only prescribe or dispense such medication under
   30  the following circumstances:
   31         1. A physician assistant must clearly identify to the
   32  patient that he or she is a physician assistant. Furthermore,
   33  the physician assistant must inform the patient that the patient
   34  has the right to see the physician prior to any prescription
   35  being prescribed or dispensed by the physician assistant.
   36         2. The supervisory physician must notify the department of
   37  his or her intent to delegate, on a department-approved form,
   38  before delegating such authority and notify the department of
   39  any change in prescriptive privileges of the physician
   40  assistant. Authority to dispense may be delegated only by a
   41  supervising physician who is registered as a dispensing
   42  practitioner in compliance with s. 465.0276.
   43         3. The physician assistant must certify to file with the
   44  department a signed affidavit that he or she has completed a
   45  minimum of 10 continuing medical education hours in the
   46  specialty practice in which the physician assistant has
   47  prescriptive privileges with each licensure renewal application.
   48         4. The department may issue a prescriber number to the
   49  physician assistant granting authority for the prescribing of
   50  medicinal drugs authorized within this paragraph upon completion
   51  of the foregoing requirements. The physician assistant shall not
   52  be required to independently register pursuant to s. 465.0276.
   53         5. The prescription may must be written or electronic, but
   54  must be in a form that complies with ss. 456.0392(1) and
   55  456.42(1) chapter 499 and must contain, in addition to the
   56  supervisory physician’s name, address, and telephone number, the
   57  physician assistant’s prescriber number. Unless it is a drug or
   58  drug sample dispensed by the physician assistant, the
   59  prescription must be filled in a pharmacy permitted under
   60  chapter 465 and must be dispensed in that pharmacy by a
   61  pharmacist licensed under chapter 465. The appearance of the
   62  prescriber number creates a presumption that the physician
   63  assistant is authorized to prescribe the medicinal drug and the
   64  prescription is valid.
   65         6. The physician assistant must note the prescription or
   66  dispensing of medication in the appropriate medical record.
   67         (7) PHYSICIAN ASSISTANT LICENSURE.—
   68         (a) Any person desiring to be licensed as a physician
   69  assistant must apply to the department. The department shall
   70  issue a license to any person certified by the council as having
   71  met the following requirements:
   72         1. Is at least 18 years of age.
   73         2. Has satisfactorily passed a proficiency examination by
   74  an acceptable score established by the National Commission on
   75  Certification of Physician Assistants. If an applicant does not
   76  hold a current certificate issued by the National Commission on
   77  Certification of Physician Assistants and has not actively
   78  practiced as a physician assistant within the immediately
   79  preceding 4 years, the applicant must retake and successfully
   80  complete the entry-level examination of the National Commission
   81  on Certification of Physician Assistants to be eligible for
   82  licensure.
   83         3. Has completed the application form and remitted an
   84  application fee not to exceed $300 as set by the boards. An
   85  application for licensure made by a physician assistant must
   86  include:
   87         a. A certificate of completion of a physician assistant
   88  training program specified in subsection (6).
   89         b. A sworn statement of any prior felony convictions.
   90         c. A sworn statement of any previous revocation or denial
   91  of licensure or certification in any state.
   92         d. Two letters of recommendation.
   93         d.e. A copy of course transcripts and a copy of the course
   94  description from a physician assistant training program
   95  describing course content in pharmacotherapy, if the applicant
   96  wishes to apply for prescribing authority. These documents must
   97  meet the evidence requirements for prescribing authority.
   98         e. For physician assistants seeking initial licensure on or
   99  after January 1, 2015, fingerprints pursuant to s. 456.0135.
  100         (c) The license must be renewed biennially. Each renewal
  101  must include:
  102         1. A renewal fee not to exceed $500 as set by the boards.
  103         2. A sworn statement of no felony convictions in the
  104  previous 2 years.
  105         (e) Upon employment as a physician assistant, a licensed
  106  physician assistant must notify the department in writing within
  107  30 days after such employment and provide or after any
  108  subsequent changes in the supervising physician. The
  109  notification must include the full name, Florida medical license
  110  number, specialty, and address of a designated the supervising
  111  physician. Any subsequent change in the designated supervising
  112  physician shall be reported to the department within 30 days
  113  after the change. Assignment of a designated supervising
  114  physician does not preclude a physician assistant from
  115  practicing under multiple supervising physicians.
  116         Section 3. Subsection (3), paragraph (e) of subsection (4),
  117  and paragraphs (a), (b), and (d) of subsection (7) of section
  118  459.022, Florida Statutes, are amended to read:
  119         459.022 Physician assistants.—
  120         (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
  121  group of physicians supervising a licensed physician assistant
  122  must be qualified in the medical areas in which the physician
  123  assistant is to perform and shall be individually or
  124  collectively responsible and liable for the performance and the
  125  acts and omissions of the physician assistant. A physician may
  126  not supervise more than five four currently licensed physician
  127  assistants at any one time. A physician supervising a physician
  128  assistant pursuant to this section may not be required to review
  129  and cosign charts or medical records prepared by such physician
  130  assistant. Notwithstanding this subsection, a physician may only
  131  supervise up to four physician assistants in medical offices
  132  other than the physician’s primary practice location pursuant to
  133  s. 459.025(3)(c).
  134         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
  135         (e) A supervisory physician may delegate to a fully
  136  licensed physician assistant the authority to prescribe or
  137  dispense any medication used in the supervisory physician’s
  138  practice unless such medication is listed on the formulary
  139  created pursuant to s. 458.347. A fully licensed physician
  140  assistant may only prescribe or dispense such medication under
  141  the following circumstances:
  142         1. A physician assistant must clearly identify to the
  143  patient that she or he is a physician assistant. Furthermore,
  144  the physician assistant must inform the patient that the patient
  145  has the right to see the physician prior to any prescription
  146  being prescribed or dispensed by the physician assistant.
  147         2. The supervisory physician must notify the department of
  148  her or his intent to delegate, on a department-approved form,
  149  before delegating such authority and notify the department of
  150  any change in prescriptive privileges of the physician
  151  assistant. Authority to dispense may be delegated only by a
  152  supervisory physician who is registered as a dispensing
  153  practitioner in compliance with s. 465.0276.
  154         3. The physician assistant must certify to file with the
  155  department a signed affidavit that she or he has completed a
  156  minimum of 10 continuing medical education hours in the
  157  specialty practice in which the physician assistant has
  158  prescriptive privileges with each licensure renewal application.
  159         4. The department may issue a prescriber number to the
  160  physician assistant granting authority for the prescribing of
  161  medicinal drugs authorized within this paragraph upon completion
  162  of the foregoing requirements. The physician assistant shall not
  163  be required to independently register pursuant to s. 465.0276.
  164         5. The prescription may must be written or electronic, but
  165  must be in a form that complies with ss. 456.0392(1) and
  166  456.42(1) chapter 499 and must contain, in addition to the
  167  supervisory physician’s name, address, and telephone number, the
  168  physician assistant’s prescriber number. Unless it is a drug or
  169  drug sample dispensed by the physician assistant, the
  170  prescription must be filled in a pharmacy permitted under
  171  chapter 465, and must be dispensed in that pharmacy by a
  172  pharmacist licensed under chapter 465. The appearance of the
  173  prescriber number creates a presumption that the physician
  174  assistant is authorized to prescribe the medicinal drug and the
  175  prescription is valid.
  176         6. The physician assistant must note the prescription or
  177  dispensing of medication in the appropriate medical record.
  178         (7) PHYSICIAN ASSISTANT LICENSURE.—
  179         (a) Any person desiring to be licensed as a physician
  180  assistant must apply to the department. The department shall
  181  issue a license to any person certified by the council as having
  182  met the following requirements:
  183         1. Is at least 18 years of age.
  184         2. Has satisfactorily passed a proficiency examination by
  185  an acceptable score established by the National Commission on
  186  Certification of Physician Assistants. If an applicant does not
  187  hold a current certificate issued by the National Commission on
  188  Certification of Physician Assistants and has not actively
  189  practiced as a physician assistant within the immediately
  190  preceding 4 years, the applicant must retake and successfully
  191  complete the entry-level examination of the National Commission
  192  on Certification of Physician Assistants to be eligible for
  193  licensure.
  194         3. Has completed the application form and remitted an
  195  application fee not to exceed $300 as set by the boards. An
  196  application for licensure made by a physician assistant must
  197  include:
  198         a. A certificate of completion of a physician assistant
  199  training program specified in subsection (6).
  200         b. A sworn statement of any prior felony convictions.
  201         c. A sworn statement of any previous revocation or denial
  202  of licensure or certification in any state.
  203         d. Two letters of recommendation.
  204         d.e. A copy of course transcripts and a copy of the course
  205  description from a physician assistant training program
  206  describing course content in pharmacotherapy, if the applicant
  207  wishes to apply for prescribing authority. These documents must
  208  meet the evidence requirements for prescribing authority.
  209         e. For physician assistants seeking initial licensure on or
  210  after January 1, 2015, fingerprints pursuant to s. 456.0135.
  211         (b) The licensure must be renewed biennially. Each renewal
  212  must include:
  213         1. A renewal fee not to exceed $500 as set by the boards.
  214         2. A sworn statement of no felony convictions in the
  215  previous 2 years.
  216         (d) Upon employment as a physician assistant, a licensed
  217  physician assistant must notify the department in writing within
  218  30 days after such employment and provide or after any
  219  subsequent changes in the supervising physician. The
  220  notification must include the full name, Florida medical license
  221  number, specialty, and address of a designated the supervising
  222  physician. Any subsequent change in the designated supervising
  223  physician shall be reported to the department within 30 days
  224  after the change. Assignment of a designated supervising
  225  physician does not preclude a physician assistant from
  226  practicing under multiple supervising physicians.
  227  
  228  ================= T I T L E  A M E N D M E N T ================
  229  And the title is amended as follows:
  230         Between lines 14 and 15
  231  insert:
  232         amending ss. 458.347 and 459.022, F.S.; increasing the
  233         number of licensed physician assistants that a
  234         physician may supervise at any one time; providing an
  235         exception; revising circumstances under which a
  236         physician assistant is authorized to prescribe or
  237         dispense medication; revising requirements for
  238         medications prescribed or dispensed by physician
  239         assistants; revising application requirements for
  240         licensure as a physician assistant and license
  241         renewal;