HB 249

1	A bill to be entitled
2	An act relating to physician assistants; amending ss.
3	458.347 and 459.022, F.S.; providing that a supervising
4	physician may not be required to review and cosign a
5	physician assistant's charts or medical records; deleting
6	certain supervisory physician requirements related to
7	prescribing and dispensing medications noted in
8	appropriate medical records; providing an effective date.
9
10	Be It Enacted by the Legislature of the State of Florida:
11
12	Section 1.  Subsection (3) and paragraph (e) of subsection
13	(4) of section 458.347, Florida Statutes, are amended to read:
14	458.347  Physician assistants.--
15	(3)  PERFORMANCE OF SUPERVISING PHYSICIAN.--Each physician
16	or group of physicians supervising a licensed physician
17	assistant must be qualified in the medical areas in which the
18	physician assistant is to perform and shall be individually or
19	collectively responsible and liable for the performance and the
20	acts and omissions of the physician assistant. A physician may
21	not supervise more than four currently licensed physician
22	assistants at any one time. A physician supervising a physician
23	assistant pursuant to this section may not be required to review
24	and cosign charts or medical records prepared by such physician
25	assistant.
26	(4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.--
27	(e)  A supervisory physician may delegate to a fully
28	licensed physician assistant the authority to prescribe or
29	dispense any medication used in the supervisory physician's
30	practice unless such medication is listed on the formulary
31	created pursuant to paragraph (f). A fully licensed physician
32	assistant may only prescribe or dispense such medication under
33	the following circumstances:
34	1.  A physician assistant must clearly identify to the
35	patient that he or she is a physician assistant. Furthermore,
36	the physician assistant must inform the patient that the patient
37	has the right to see the physician prior to any prescription
38	being prescribed or dispensed by the physician assistant.
39	2.  The supervisory physician must notify the department of
40	his or her intent to delegate, on a department-approved form,
41	before delegating such authority and notify the department of
42	any change in prescriptive privileges of the physician
43	assistant. Authority to dispense may be delegated only by a
44	supervising physician who is registered as a dispensing
45	practitioner in compliance with s. 465.0276.
46	3.  The physician assistant must file with the department,
47	before commencing to prescribe or dispense, evidence that he or
48	she has completed a continuing medical education course of at
49	least 3 classroom hours in prescriptive practice, conducted by
50	an accredited program approved by the boards, which course
51	covers the limitations, responsibilities, and privileges
52	involved in prescribing medicinal drugs, or evidence that he or
53	she has received education comparable to the continuing
54	education course as part of an accredited physician assistant
55	training program.
56	4.  The physician assistant must file with the department,
57	before commencing to prescribe or dispense, evidence that the
58	physician assistant has a minimum of 3 months of clinical
59	experience in the specialty area of the supervising physician.
60	5.  The physician assistant must file with the department a
61	signed affidavit that he or she has completed a minimum of 10
62	continuing medical education hours in the specialty practice in
63	which the physician assistant has prescriptive privileges with
64	each licensure renewal application.
65	6.  The department shall issue a license and a prescriber
66	number to the physician assistant granting authority for the
67	prescribing of medicinal drugs authorized within this paragraph
68	upon completion of the foregoing requirements. The physician
69	assistant shall not be required to independently register
70	pursuant to s. 465.0276.
71	7.  The prescription must be written in a form that
72	complies with chapter 499 and must contain, in addition to the
73	supervisory physician's name, address, and telephone number, the
74	physician assistant's prescriber number. Unless it is a drug or
75	drug sample dispensed by the physician assistant, the
76	prescription must be filled in a pharmacy permitted under
77	chapter 465 and must be dispensed in that pharmacy by a
78	pharmacist licensed under chapter 465. The appearance of the
79	prescriber number creates a presumption that the physician
80	assistant is authorized to prescribe the medicinal drug and the
81	prescription is valid.
82	8.  The physician assistant must note the prescription or
83	dispensing of medication in the appropriate medical record, and
84	the supervisory physician must review and sign each notation.
85	For dispensing purposes only, the failure of the supervisory
86	physician to comply with these requirements does not affect the
87	validity of the prescription.
88	9.  This paragraph does not prohibit a supervisory
89	physician from delegating to a physician assistant the authority
90	to order medication for a hospitalized patient of the
91	supervisory physician.
92
93	This paragraph does not apply to facilities licensed pursuant to
94	chapter 395.
95	Section 2.  Subsection (3) and paragraph (e) of subsection
96	(4) and of section 459.022, Florida Statutes, are amended to
97	read:
98	459.022  Physician assistants.--
99	(3)  PERFORMANCE OF SUPERVISING PHYSICIAN.--Each physician
100	or group of physicians supervising a licensed physician
101	assistant must be qualified in the medical areas in which the
102	physician assistant is to perform and shall be individually or
103	collectively responsible and liable for the performance and the
104	acts and omissions of the physician assistant. A physician may
105	not supervise more than four currently licensed physician
106	assistants at any one time. A physician supervising a physician
107	assistant pursuant to this section may not be required to review
108	and cosign charts or medical records prepared by such physician
109	assistant.
110	(4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.--
111	(e)  A supervisory physician may delegate to a fully
112	licensed physician assistant the authority to prescribe or
113	dispense any medication used in the supervisory physician's
114	practice unless such medication is listed on the formulary
115	created pursuant to s. 458.347. A fully licensed physician
116	assistant may only prescribe or dispense such medication under
117	the following circumstances:
118	1.  A physician assistant must clearly identify to the
119	patient that she or he is a physician assistant. Furthermore,
120	the physician assistant must inform the patient that the patient
121	has the right to see the physician prior to any prescription
122	being prescribed or dispensed by the physician assistant.
123	2.  The supervisory physician must notify the department of
124	her or his intent to delegate, on a department-approved form,
125	before delegating such authority and notify the department of
126	any change in prescriptive privileges of the physician
127	assistant. Authority to dispense may be delegated only by a
128	supervisory physician who is registered as a dispensing
129	practitioner in compliance with s. 465.0276.
130	3.  The physician assistant must file with the department,
131	before commencing to prescribe or dispense, evidence that she or
132	he has completed a continuing medical education course of at
133	least 3 classroom hours in prescriptive practice, conducted by
134	an accredited program approved by the boards, which course
135	covers the limitations, responsibilities, and privileges
136	involved in prescribing medicinal drugs, or evidence that she or
137	he has received education comparable to the continuing education
138	course as part of an accredited physician assistant training
139	program.
140	4.  The physician assistant must file with the department,
141	before commencing to prescribe or dispense, evidence that the
142	physician assistant has a minimum of 3 months of clinical
143	experience in the specialty area of the supervising physician.
144	5.  The physician assistant must file with the department a
145	signed affidavit that she or he has completed a minimum of 10
146	continuing medical education hours in the specialty practice in
147	which the physician assistant has prescriptive privileges with
148	each licensure renewal application.
149	6.  The department shall issue a license and a prescriber
150	number to the physician assistant granting authority for the
151	prescribing of medicinal drugs authorized within this paragraph
152	upon completion of the foregoing requirements. The physician
153	assistant shall not be required to independently register
154	pursuant to s. 465.0276.
155	7.  The prescription must be written in a form that
156	complies with chapter 499 and must contain, in addition to the
157	supervisory physician's name, address, and telephone number, the
158	physician assistant's prescriber number. Unless it is a drug or
159	drug sample dispensed by the physician assistant, the
160	prescription must be filled in a pharmacy permitted under
161	chapter 465, and must be dispensed in that pharmacy by a
162	pharmacist licensed under chapter 465. The appearance of the
163	prescriber number creates a presumption that the physician
164	assistant is authorized to prescribe the medicinal drug and the
165	prescription is valid.
166	8.  The physician assistant must note the prescription or
167	dispensing of medication in the appropriate medical record, and
168	the supervisory physician must review and sign each notation.
169	For dispensing purposes only, the failure of the supervisory
170	physician to comply with these requirements does not affect the
171	validity of the prescription.
172	9.  This paragraph does not prohibit a supervisory
173	physician from delegating to a physician assistant the authority
174	to order medication for a hospitalized patient of the
175	supervisory physician.
176
177	This paragraph does not apply to facilities licensed pursuant to
178	chapter 395.
179	Section 3.  This act shall take effect July 1, 2009.

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