HB 0699CS

CHAMBER ACTION




1The 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
6An act relating to health care; amending ss. 458.331 and
7459.015, F.S.; authorizing the Board of Medicine and the
8Board of Osteopathic Medicine to establish by rule certain
9standards of practice and standards of care for physicians
10and osteopathic physicians who supervise licensed health
11care practitioners who are not under direct, onsite
12supervision by the supervising physician; providing
13exemptions; providing for such rules to apply equally to
14physician assistants and advanced registered nurse
15practitioners; providing an effective date.
16
17Be It Enacted by the Legislature of the State of Florida:
18
19     Section 1.  Paragraph (dd) of subsection (1) of section
20458.331, Florida Statutes, is amended to read:
21     458.331  Grounds for disciplinary action; action by the
22board and department.--
23     (1)  The following acts constitute grounds for denial of a
24license or disciplinary action, as specified in s. 456.072(2):
25     (dd)1.  Failing to supervise adequately the activities of
26those physician assistants, paramedics, emergency medical
27technicians, advanced registered nurse practitioners, or
28anesthesiologist assistants acting under the supervision of the
29physician.
30     2.  Notwithstanding any other provision of this chapter,
31the board may establish by rule standards of practice and
32standards of care for physicians who supervise licensed health
33care practitioners in a facility that is not licensed under
34chapter 395, and who are not under direct, onsite supervision of
35a supervising physician, which may include:
36     a.  The percentage of time a supervising physician spends
37directly supervising the licensed health care practitioners.
38     b.  Standards for adequate supervision, including the
39standards for review of medical records and the allowable
40distance of the licensed health care practitioners from the
41supervising physician.
42     c.  The number of each type of licensed health care
43practitioner that a supervising physician may supervise.
44     3.  The standards established in the rules under
45subparagraph 2. may vary depending on the specialty of the
46physician, the type of licensed health care practitioner under
47supervision, and the practice setting.
48     4.  The requirements of subparagraph 2. shall not apply to
49health care practitioners providing services in conjunction with
50a college of medicine; to health care practitioners providing
51services in a nursing home licensed under part II of chapter
52400, an assisted living facility licensed under part III of
53chapter 400, a continuing care facility licensed under chapter
54651, or a retirement community consisting of independent living
55units and either a licensed nursing home or assisted living
56facility; or to health care practitioners providing services to
57a rural health network as defined in s. 381.0406 or to persons
58enrolled in a program designed to maintain elders and persons
59with disabilities in a home and community-based setting.
60     5.  Any rule adopted pursuant to the authority granted
61under subparagraph 2. shall apply equally to physician
62assistants and advanced registered nurse practitioners.
63     Section 2.  Paragraph (hh) of subsection (1) of section
64459.015, Florida Statutes, is amended to read:
65     459.015  Grounds for disciplinary action; action by the
66board and department.--
67     (1)  The following acts constitute grounds for denial of a
68license or disciplinary action, as specified in s. 456.072(2):
69     (hh)1.  Failing to supervise adequately the activities of
70those physician assistants, paramedics, emergency medical
71technicians, advanced registered nurse practitioners,
72anesthesiologist assistants, or other persons acting under the
73supervision of the osteopathic physician.
74     2.  Notwithstanding any other provision of this chapter,
75the board may establish by rule standards of practice and
76standards of care for osteopathic physicians who supervise
77licensed health care practitioners in a facility that is not
78licensed under chapter 395, and who are not under direct, onsite
79supervision of a supervising osteopathic physician, which may
80include:
81a.  The percentage of time a supervising osteopathic
82physician spends directly supervising the licensed health care
83practitioners.
84     b.  Standards for adequate supervision, including the
85standards for review of medical records and the allowable
86distance of the licensed health care practitioners from the
87supervising osteopathic physician.
88     c.  The number of each type of licensed health care
89practitioner that a supervising osteopathic physician may
90supervise.
91     3.  The standards established in the rules under
92subparagraph 2. may vary depending on the specialty of the
93osteopathic physician, the type of licensed health care
94practitioner under supervision, and the practice setting.
95     4.  The requirements of subparagraph 2. shall not apply to
96health care practitioners providing services in conjunction with
97a college of medicine; to health care practitioners providing
98services in a nursing home licensed under part II of chapter
99400, an assisted living facility licensed under part III of
100chapter 400, a continuing care facility licensed under chapter
101651, or a retirement community consisting of independent living
102units and either a licensed nursing home or assisted living
103facility; or to health care practitioners providing services to
104a rural health network as defined in s. 381.0406 or to persons
105enrolled in a program designed to maintain elders and persons
106with disabilities in a home and community-based setting.
107     5.  Any rule adopted pursuant to the authority granted
108under subparagraph 2. shall apply equally to physician
109assistants 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.