Senate Bill sb2022
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Florida Senate - 2003 SB 2022
By Senator Clary
4-1117-03
1 A bill to be entitled
2 An act relating to physician assistants;
3 amending ss. 458.347 and 459.022, F.S.;
4 revising continuing medical education
5 requirements regarding the prescribing of
6 controlled substances by physician assistants;
7 deleting prohibitions against the prescribing
8 of controlled substances by physician
9 assistants; amending s. 893.02, F.S.; revising
10 the definition of the term "practitioner" for
11 purposes of the Florida Comprehensive Drug
12 Abuse Prevention and Control Act to include
13 physician assistant; providing an effective
14 date.
15
16 Be It Enacted by the Legislature of the State of Florida:
17
18 Section 1. Subsection (4) of section 458.347, Florida
19 Statutes, is amended to read:
20 458.347 Physician assistants.--
21 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.--
22 (a) The boards shall adopt, by rule, the general
23 principles that supervising physicians must use in developing
24 the scope of practice of a physician assistant under direct
25 supervision and under indirect supervision. These principles
26 shall recognize the diversity of both specialty and practice
27 settings in which physician assistants are used.
28 (b) This chapter does not prevent third-party payors
29 from reimbursing employers of physician assistants for covered
30 services rendered by licensed physician assistants.
31
1
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Florida Senate - 2003 SB 2022
4-1117-03
1 (c) Licensed physician assistants may not be denied
2 clinical hospital privileges, except for cause, so long as the
3 supervising physician is a staff member in good standing.
4 (d) A supervisory physician may delegate to a licensed
5 physician assistant, pursuant to a written protocol, the
6 authority to act according to s. 154.04(1)(c). Such delegated
7 authority is limited to the supervising physician's practice
8 in connection with a county health department as defined and
9 established pursuant to chapter 154. The boards shall adopt
10 rules governing the supervision of physician assistants by
11 physicians in county health departments.
12 (e) A supervisory physician may delegate to a fully
13 licensed physician assistant the authority to prescribe any
14 medication used in the supervisory physician's practice unless
15 such medication is listed on the formulary created pursuant to
16 paragraph (f). A fully licensed physician assistant may only
17 prescribe such medication under the following circumstances:
18 1. A physician assistant must clearly identify to the
19 patient that he or she is a physician assistant. Furthermore,
20 the physician assistant must inform the patient that the
21 patient has the right to see the physician prior to any
22 prescription being prescribed by the physician assistant.
23 2. The supervisory physician must notify the
24 department of his or her intent to delegate, on a
25 department-approved form, before delegating such authority and
26 notify the department of any change in prescriptive privileges
27 of the physician assistant.
28 3. The physician assistant must file with the
29 department, before commencing to prescribe, evidence that he
30 or she has completed a continuing medical education course of
31 at least 5 3 classroom hours in prescriptive practice,
2
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Florida Senate - 2003 SB 2022
4-1117-03
1 conducted by an accredited program approved by the boards,
2 which course covers the limitations, responsibilities, and
3 privileges involved in prescribing medicinal drugs and the
4 clinical and legal aspects of prescribing controlled
5 substances, or evidence that he or she has received education
6 comparable to the continuing education course as part of an
7 accredited physician assistant training program.
8 4. The physician assistant must file with the
9 department, before commencing to prescribe, evidence that the
10 physician assistant has a minimum of 3 months of clinical
11 experience in the specialty area of the supervising physician.
12 5. The physician assistant must file with the
13 department a signed affidavit that he or she has completed a
14 minimum of 10 continuing medical education hours in the
15 specialty practice in which the physician assistant has
16 prescriptive privileges and 2 hours in the clinical and legal
17 aspects of prescribing controlled substances with each
18 licensure renewal application.
19 6. The department shall issue a license and a
20 prescriber number to the physician assistant granting
21 authority for the prescribing of medicinal drugs authorized
22 within this paragraph upon completion of the foregoing
23 requirements.
24 7. The prescription must be written in a form that
25 complies with chapter 499 and must contain, in addition to the
26 supervisory physician's name, address, and telephone number,
27 the physician assistant's prescriber number. Unless it is a
28 drug sample dispensed by the physician assistant, the
29 prescription must be filled in a pharmacy permitted under
30 chapter 465 and must be dispensed in that pharmacy by a
31 pharmacist licensed under chapter 465. The appearance of the
3
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Florida Senate - 2003 SB 2022
4-1117-03
1 prescriber number creates a presumption that the physician
2 assistant is authorized to prescribe the medicinal drug and
3 the prescription is valid.
4 8. The physician assistant must note the prescription
5 in the appropriate medical record, and the supervisory
6 physician must review and sign each notation. For dispensing
7 purposes only, the failure of the supervisory physician to
8 comply with these requirements does not affect the validity of
9 the prescription.
10 9. This paragraph does not prohibit a supervisory
11 physician from delegating to a physician assistant the
12 authority to order medication for a hospitalized patient of
13 the supervisory physician.
14
15 This paragraph does not apply to facilities licensed pursuant
16 to chapter 395.
17 (f)1. The council shall establish a formulary of
18 medicinal drugs that a fully licensed physician assistant,
19 licensed under this section or s. 459.022, may not prescribe.
20 The formulary must include controlled substances as defined in
21 chapter 893, antipsychotics, general anesthetics and
22 radiographic contrast materials, and all parenteral
23 preparations except insulin and epinephrine.
24 2. In establishing the formulary, the council shall
25 consult with a pharmacist licensed under chapter 465, but not
26 licensed under this chapter or chapter 459, who shall be
27 selected by the Secretary of Health.
28 3. Only the council shall add to, delete from, or
29 modify the formulary. Any person who requests an addition,
30 deletion, or modification of a medicinal drug listed on such
31
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Florida Senate - 2003 SB 2022
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1 formulary has the burden of proof to show cause why such
2 addition, deletion, or modification should be made.
3 4. The boards shall adopt the formulary required by
4 this paragraph, and each addition, deletion, or modification
5 to the formulary, by rule. Notwithstanding any provision of
6 chapter 120 to the contrary, the formulary rule shall be
7 effective 60 days after the date it is filed with the
8 Secretary of State. Upon adoption of the formulary, the
9 department shall mail a copy of such formulary to each fully
10 licensed physician assistant, licensed under this section or
11 s. 459.022, and to each pharmacy licensed by the state. The
12 boards shall establish, by rule, a fee not to exceed $200 to
13 fund the provisions of this paragraph and paragraph (e).
14 Section 2. Subsection (4) of section 459.022, Florida
15 Statutes, is amended to read:
16 459.022 Physician assistants.--
17 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.--
18 (a) The boards shall adopt, by rule, the general
19 principles that supervising physicians must use in developing
20 the scope of practice of a physician assistant under direct
21 supervision and under indirect supervision. These principles
22 shall recognize the diversity of both specialty and practice
23 settings in which physician assistants are used.
24 (b) This chapter does not prevent third-party payors
25 from reimbursing employers of physician assistants for covered
26 services rendered by licensed physician assistants.
27 (c) Licensed physician assistants may not be denied
28 clinical hospital privileges, except for cause, so long as the
29 supervising physician is a staff member in good standing.
30 (d) A supervisory physician may delegate to a licensed
31 physician assistant, pursuant to a written protocol, the
5
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2003 SB 2022
4-1117-03
1 authority to act according to s. 154.04(1)(c). Such delegated
2 authority is limited to the supervising physician's practice
3 in connection with a county health department as defined and
4 established pursuant to chapter 154. The boards shall adopt
5 rules governing the supervision of physician assistants by
6 physicians in county health departments.
7 (e) A supervisory physician may delegate to a fully
8 licensed physician assistant the authority to prescribe any
9 medication used in the supervisory physician's practice unless
10 such medication is listed on the formulary created pursuant to
11 s. 458.347. A fully licensed physician assistant may only
12 prescribe such medication under the following circumstances:
13 1. A physician assistant must clearly identify to the
14 patient that she or he is a physician assistant. Furthermore,
15 the physician assistant must inform the patient that the
16 patient has the right to see the physician prior to any
17 prescription being prescribed by the physician assistant.
18 2. The supervisory physician must notify the
19 department of her or his intent to delegate, on a
20 department-approved form, before delegating such authority and
21 notify the department of any change in prescriptive privileges
22 of the physician assistant.
23 3. The physician assistant must file with the
24 department, before commencing to prescribe, evidence that she
25 or he has completed a continuing medical education course of
26 at least 5 3 classroom hours in prescriptive practice,
27 conducted by an accredited program approved by the boards,
28 which course covers the limitations, responsibilities, and
29 privileges involved in prescribing medicinal drugs and the
30 clinical and legal aspects of prescribing controlled
31 substances, or evidence that she or he has received education
6
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Florida Senate - 2003 SB 2022
4-1117-03
1 comparable to the continuing education course as part of an
2 accredited physician assistant training program.
3 4. The physician assistant must file with the
4 department, before commencing to prescribe, evidence that the
5 physician assistant has a minimum of 3 months of clinical
6 experience in the specialty area of the supervising physician.
7 5. The physician assistant must file with the
8 department a signed affidavit that she or he has completed a
9 minimum of 10 continuing medical education hours in the
10 specialty practice in which the physician assistant has
11 prescriptive privileges and 2 hours in the clinical and legal
12 aspects of prescribing controlled substances with each
13 licensure renewal application.
14 6. The department shall issue a license and a
15 prescriber number to the physician assistant granting
16 authority for the prescribing of medicinal drugs authorized
17 within this paragraph upon completion of the foregoing
18 requirements.
19 7. The prescription must be written in a form that
20 complies with chapter 499 and must contain, in addition to the
21 supervisory physician's name, address, and telephone number,
22 the physician assistant's prescriber number. Unless it is a
23 drug sample dispensed by the physician assistant, the
24 prescription must be filled in a pharmacy permitted under
25 chapter 465, and must be dispensed in that pharmacy by a
26 pharmacist licensed under chapter 465. The appearance of the
27 prescriber number creates a presumption that the physician
28 assistant is authorized to prescribe the medicinal drug and
29 the prescription is valid.
30 8. The physician assistant must note the prescription
31 in the appropriate medical record, and the supervisory
7
CODING: Words stricken are deletions; words underlined are additions.
Florida Senate - 2003 SB 2022
4-1117-03
1 physician must review and sign each notation. For dispensing
2 purposes only, the failure of the supervisory physician to
3 comply with these requirements does not affect the validity of
4 the prescription.
5 9. This paragraph does not prohibit a supervisory
6 physician from delegating to a physician assistant the
7 authority to order medication for a hospitalized patient of
8 the supervisory physician.
9
10 This paragraph does not apply to facilities licensed pursuant
11 to chapter 395.
12 Section 3. Subsection (19) of section 893.02, Florida
13 Statutes, is amended to read:
14 893.02 Definitions.--The following words and phrases
15 as used in this chapter shall have the following meanings,
16 unless the context otherwise requires:
17 (19) "Practitioner" means a physician or physician
18 assistant licensed pursuant to chapter 458, a dentist licensed
19 pursuant to chapter 466, a veterinarian licensed pursuant to
20 chapter 474, an osteopathic physician or physician assistant
21 licensed pursuant to chapter 459, a naturopath licensed
22 pursuant to chapter 462, or a podiatric physician licensed
23 pursuant to chapter 461, provided such practitioner holds a
24 valid federal controlled substance registry number.
25 Section 4. This act shall take effect July 1, 2003.
26
27 *****************************************
28 SENATE SUMMARY
29 Revises provisions to allow physician assistants to
prescribe controlled substances. Revises a definition to
30 conform. Revises continuing medical education
requirements to include education in the prescribing of
31 controlled substances.
8
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