HB 1311 2003
1	A bill to be entitled
2	An act relating to physician assistants; amending ss.
3	458.347 and 459.022, F.S.; requiring additional continuing
4	medical education in the clinical and legal aspects of
5	prescribing controlled substances; removing controlled
6	substances from the formulary of medicinal drugs a
7	physician assistant may not prescribe; amending s. 893.02,
8	F.S.; including physician assistants in the definition of
9	"practitioner" under ch. 893, F.S., to authorize them to
10	prescribe controlled substances; providing an effective
11	date.
12
13	Be It Enacted by the Legislature of the State of Florida:
14
15	Section 1. Paragraphs (e) and (f) of subsection (4) of
16	section 458.347, Florida Statutes, are amended to read:
17	458.347 Physician assistants.--
18	(4) PERFORMANCE OF PHYSICIAN ASSISTANTS.--
19	(e) A supervisory physician may delegate to a fully
20	licensed physician assistant the authority to prescribe any
21	medication used in the supervisory physician's practice unless
22	such medication is listed on the formulary created pursuant to
23	paragraph (f). A fully licensed physician assistant may only
24	prescribe such medication under 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 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.
35	3. The physician assistant must file with the department,
36	before commencing to prescribe, evidence that he or she has
37	completed a continuing medical education course of at least 53
38	classroom hours in prescriptive practice, conducted by an
39	accredited program approved by the boards, which course covers
40	the limitations, responsibilities, and privileges involved in
41	prescribing medicinal drugs and the clinical and legal aspects
42	of prescribing controlled substances, or evidence that he or she
43	has received education comparable to the continuing education
44	course as part of an accredited physician assistant training
45	program.
46	4. The physician assistant must file with the department,
47	before commencing to prescribe, evidence that the physician
48	assistant has a minimum of 3 months of clinical experience in
49	the specialty area of the supervising physician.
50	5. The physician assistant must file with the department a
51	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 and 2
54	continuing medical education hours in the clinical and legal
55	aspects of prescribing controlled substanceswith each licensure
56	renewal application.
57	6. The department shall issue a license and a prescriber
58	number to the physician assistant granting authority for the
59	prescribing of medicinal drugs authorized within this paragraph
60	upon completion of the foregoing requirements.
61	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
65	sample dispensed by the physician assistant, the prescription
66	must be filled in a pharmacy permitted under chapter 465 and
67	must be dispensed in that pharmacy by a pharmacist licensed
68	under chapter 465. The appearance of the prescriber number
69	creates a presumption that the physician assistant is authorized
70	to prescribe the medicinal drug and the prescription is valid.
71	8. The physician assistant must note the prescription in
72	the appropriate medical record, and the supervisory physician
73	must review and sign each notation. For dispensing purposes
74	only, the failure of the supervisory physician to comply with
75	these requirements does not affect the validity of the
76	prescription.
77	9. This paragraph does not prohibit a supervisory
78	physician from delegating to a physician assistant the authority
79	to order medication for a hospitalized patient of the
80	supervisory physician.
81
82	This paragraph does not apply to facilities licensed pursuant to
83	chapter 395.
84	(f)1. The council shall establish a formulary of medicinal
85	drugs that a fully licensed physician assistant, licensed under
86	this section or s. 459.022, may not prescribe. The formulary
87	must include controlled substances as defined in chapter 893,
88	antipsychotics, general anesthetics and radiographic contrast
89	materials, and all parenteral preparations except insulin and
90	epinephrine.
91	2. In establishing the formulary, the council shall
92	consult with a pharmacist licensed under chapter 465, but not
93	licensed under this chapter or chapter 459, who shall be
94	selected by the Secretary of Health.
95	3. Only the council shall add to, delete from, or modify
96	the formulary. Any person who requests an addition, deletion, or
97	modification of a medicinal drug listed on such formulary has
98	the burden of proof to show cause why such addition, deletion,
99	or modification should be made.
100	4. The boards shall adopt the formulary required by this
101	paragraph, and each addition, deletion, or modification to the
102	formulary, by rule. Notwithstanding any provision of chapter 120
103	to the contrary, the formulary rule shall be effective 60 days
104	after the date it is filed with the Secretary of State. Upon
105	adoption of the formulary, the department shall mail a copy of
106	such formulary to each fully licensed physician assistant,
107	licensed under this section or s. 459.022, and to each pharmacy
108	licensed by the state. The boards shall establish, by rule, a
109	fee not to exceed $200 to fund the provisions of this paragraph
110	and paragraph (e).
111	Section 2. Paragraph (e) of subsection (4) of section
112	459.022, Florida Statutes, is amended to read:
113	459.022 Physician assistants.--
114	(4) PERFORMANCE OF PHYSICIAN ASSISTANTS.--
115	(e) A supervisory physician may delegate to a fully
116	licensed physician assistant the authority to prescribe any
117	medication used in the supervisory physician's practice unless
118	such medication is listed on the formulary created pursuant to
119	s. 458.347. A fully licensed physician assistant may only
120	prescribe such medication under the following circumstances:
121	1. A physician assistant must clearly identify to the
122	patient that she or he is a physician assistant. Furthermore,
123	the physician assistant must inform the patient that the patient
124	has the right to see the physician prior to any prescription
125	being prescribed by the physician assistant.
126	2. The supervisory physician must notify the department of
127	her or his intent to delegate, on a department-approved form,
128	before delegating such authority and notify the department of
129	any change in prescriptive privileges of the physician
130	assistant.
131	3. The physician assistant must file with the department,
132	before commencing to prescribe, evidence that she or he has
133	completed a continuing medical education course of at least 53
134	classroom hours in prescriptive practice, conducted by an
135	accredited program approved by the boards, which course covers
136	the limitations, responsibilities, and privileges involved in
137	prescribing medicinal drugs and the clinical and legal aspects
138	of prescribing controlled substances, or evidence that she or he
139	has received education comparable to the continuing education
140	course as part of an accredited physician assistant training
141	program.
142	4. The physician assistant must file with the department,
143	before commencing to prescribe, evidence that the physician
144	assistant has a minimum of 3 months of clinical experience in
145	the specialty area of the supervising physician.
146	5. The physician assistant must file with the department a
147	signed affidavit that she or he has completed a minimum of 10
148	continuing medical education hours in the specialty practice in
149	which the physician assistant has prescriptive privileges and 2
150	continuing medical education hours in the clinical and legal
151	aspects of prescribing controlled substanceswith each licensure
152	renewal application.
153	6. The department shall issue a license and a prescriber
154	number to the physician assistant granting authority for the
155	prescribing of medicinal drugs authorized within this paragraph
156	upon completion of the foregoing requirements.
157	7. The prescription must be written in a form that
158	complies with chapter 499 and must contain, in addition to the
159	supervisory physician's name, address, and telephone number, the
160	physician assistant's prescriber number. Unless it is a drug
161	sample dispensed by the physician assistant, the prescription
162	must be filled in a pharmacy permitted under chapter 465, and
163	must be dispensed in that pharmacy by a pharmacist licensed
164	under chapter 465. The appearance of the prescriber number
165	creates a presumption that the physician assistant is authorized
166	to prescribe the medicinal drug and the prescription is valid.
167	8. The physician assistant must note the prescription in
168	the appropriate medical record, and the supervisory physician
169	must review and sign each notation. For dispensing purposes
170	only, the failure of the supervisory physician to comply with
171	these requirements does not affect the validity of the
172	prescription.
173	9. This paragraph does not prohibit a supervisory
174	physician from delegating to a physician assistant the authority
175	to order medication for a hospitalized patient of the
176	supervisory physician.
177
178	This paragraph does not apply to facilities licensed pursuant to
179	chapter 395.
180	Section 3. Subsection (19) of section 893.02, Florida
181	Statutes, is amended to read:
182	893.02 Definitions.--The following words and phrases as
183	used in this chapter shall have the following meanings, unless
184	the context otherwise requires:
185	(19) "Practitioner" means a physician or physician
186	assistantlicensed pursuant to chapter 458, a dentist licensed
187	pursuant to chapter 466, a veterinarian licensed pursuant to
188	chapter 474, an osteopathic physician or physician assistant
189	licensed pursuant to chapter 459, a naturopath licensed pursuant
190	to chapter 462, or a podiatric physician licensed pursuant to
191	chapter 461, provided such practitioner holds a valid federal
192	controlled substance registry number.
193	Section 4. This act shall take effect July 1, 2003.