HB 0699

CS

CHAMBER ACTION

1	The Health Care Regulation Committee recommends the following:
2
3	Council/Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to health care; amending ss. 458.331 and
7	459.015, F.S.; authorizing the Board of Medicine and the
8	Board of Osteopathic Medicine to establish by rule certain
9	standards of practice and standards of care for physicians
10	and osteopathic physicians who supervise licensed health
11	care practitioners who are not under direct, onsite
12	supervision by the supervising physician; providing
13	exemptions; providing for such rules to apply equally to
14	physician assistants and advanced registered nurse
15	practitioners; providing an effective date.
16
17	Be It Enacted by the Legislature of the State of Florida:
18
19	Section 1.  Paragraph (dd) of subsection (1) of section
20	458.331, Florida Statutes, is amended to read:
21	458.331  Grounds for disciplinary action; action by the
22	board and department.--
23	(1)  The following acts constitute grounds for denial of a
24	license or disciplinary action, as specified in s. 456.072(2):
25	(dd)1.  Failing to supervise adequately the activities of
26	those physician assistants, paramedics, emergency medical
27	technicians, advanced registered nurse practitioners, or
28	anesthesiologist assistants acting under the supervision of the
29	physician.
30	2.  Notwithstanding any other provision of this chapter,
31	the board may establish by rule standards of practice and
32	standards of care for physicians who supervise licensed health
33	care practitioners in a facility that is not licensed under
34	chapter 395, and who are not under direct, onsite supervision of
35	a supervising physician, which may include:
36	a.  The percentage of time a supervising physician spends
37	directly supervising the licensed health care practitioners.
38	b.  Standards for adequate supervision, including the
39	standards for review of medical records and the allowable
40	distance of the licensed health care practitioners from the
41	supervising physician.
42	c.  The number of each type of licensed health care
43	practitioner that a supervising physician may supervise.
44	3.  The standards established in the rules under
45	subparagraph 2. may vary depending on the specialty of the
46	physician, the type of licensed health care practitioner under
47	supervision, and the practice setting.
48	4.  The requirements of subparagraph 2. shall not apply to
49	health care practitioners providing services in conjunction with
50	a college of medicine; to health care practitioners providing
51	services in a nursing home licensed under part II of chapter
52	400, an assisted living facility licensed under part III of
53	chapter 400, a continuing care facility licensed under chapter
54	651, or a retirement community consisting of independent living
55	units and either a licensed nursing home or assisted living
56	facility; or to health care practitioners providing services to
57	a rural health network as defined in s. 381.0406 or to persons
58	enrolled in a program designed to maintain elders and persons
59	with disabilities in a home and community-based setting.
60	5.  Any rule adopted pursuant to the authority granted
61	under subparagraph 2. shall apply equally to physician
62	assistants and advanced registered nurse practitioners.
63	Section 2.  Paragraph (hh) of subsection (1) of section
64	459.015, Florida Statutes, is amended to read:
65	459.015  Grounds for disciplinary action; action by the
66	board and department.--
67	(1)  The following acts constitute grounds for denial of a
68	license or disciplinary action, as specified in s. 456.072(2):
69	(hh)1.  Failing to supervise adequately the activities of
70	those physician assistants, paramedics, emergency medical
71	technicians, advanced registered nurse practitioners,
72	anesthesiologist assistants, or other persons acting under the
73	supervision of the osteopathic physician.
74	2.  Notwithstanding any other provision of this chapter,
75	the board may establish by rule standards of practice and
76	standards of care for osteopathic physicians who supervise
77	licensed health care practitioners in a facility that is not
78	licensed under chapter 395, and who are not under direct, onsite
79	supervision of a supervising osteopathic physician, which may
80	include:
81	a.  The percentage of time a supervising osteopathic
82	physician spends directly supervising the licensed health care
83	practitioners.
84	b.  Standards for adequate supervision, including the
85	standards for review of medical records and the allowable
86	distance of the licensed health care practitioners from the
87	supervising osteopathic physician.
88	c.  The number of each type of licensed health care
89	practitioner that a supervising osteopathic physician may
90	supervise.
91	3.  The standards established in the rules under
92	subparagraph 2. may vary depending on the specialty of the
93	osteopathic physician, the type of licensed health care
94	practitioner under supervision, and the practice setting.
95	4.  The requirements of subparagraph 2. shall not apply to
96	health care practitioners providing services in conjunction with
97	a college of medicine; to health care practitioners providing
98	services in a nursing home licensed under part II of chapter
99	400, an assisted living facility licensed under part III of
100	chapter 400, a continuing care facility licensed under chapter
101	651, or a retirement community consisting of independent living
102	units and either a licensed nursing home or assisted living
103	facility; or to health care practitioners providing services to
104	a rural health network as defined in s. 381.0406 or to persons
105	enrolled in a program designed to maintain elders and persons
106	with disabilities in a home and community-based setting.
107	5.  Any rule adopted pursuant to the authority granted
108	under subparagraph 2. shall apply equally to physician
109	assistants and advanced registered nurse practitioners.
110	Section 3.  This act shall take effect upon becoming a law.

CODING: Words stricken are deletions; words underlined are additions.