Florida Senate - 2014                        COMMITTEE AMENDMENT
       Bill No. SB 1230
       
       
       
       
       
       
                                Ì730402eÎ730402                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RE            .                                
                  04/02/2014           .                                
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       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (3), paragraph (e) of subsection (4),
    6  and paragraphs (a), (c), and (e) of subsection (7) of section
    7  458.347, Florida Statutes, are amended to read:
    8         458.347 Physician assistants.—
    9         (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
   10  group of physicians supervising a licensed physician assistant
   11  must be qualified in the medical areas in which the physician
   12  assistant is to perform and shall be individually or
   13  collectively responsible and liable for the performance and the
   14  acts and omissions of the physician assistant. A physician may
   15  not supervise more than five four currently licensed physician
   16  assistants at any one time. A physician supervising a physician
   17  assistant pursuant to this section may not be required to review
   18  and cosign charts or medical records prepared by such physician
   19  assistant. Notwithstanding this subsection, a physician may only
   20  supervise up to four physician assistants in an office regulated
   21  under s. 458.348(4)(c) or s. 459.025(3)(c).
   22         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   23         (e) A supervisory physician may delegate to a fully
   24  licensed physician assistant the authority to prescribe or
   25  dispense any medication used in the supervisory physician’s
   26  practice unless such medication is listed on the formulary
   27  created pursuant to paragraph (f). A fully licensed physician
   28  assistant may only prescribe or dispense such medication under
   29  the following circumstances:
   30         1. A physician assistant must clearly identify to the
   31  patient that he or she is a physician assistant. Furthermore,
   32  the physician assistant must inform the patient that the patient
   33  has the right to see the physician prior to any prescription
   34  being prescribed or dispensed by the physician assistant.
   35         2. The supervisory physician must notify the department of
   36  his or her intent to delegate, on a department-approved form,
   37  before delegating such authority and notify the department of
   38  any change in prescriptive privileges of the physician
   39  assistant. Authority to dispense may be delegated only by a
   40  supervising physician who is registered as a dispensing
   41  practitioner in compliance with s. 465.0276.
   42         3. The physician assistant must certify to file with the
   43  department a signed affidavit that he or she has completed a
   44  minimum of 10 continuing medical education hours in the
   45  specialty practice in which the physician assistant has
   46  prescriptive privileges with each licensure renewal application.
   47         4. The department may issue a prescriber number to the
   48  physician assistant granting authority for the prescribing of
   49  medicinal drugs authorized within this paragraph upon completion
   50  of the foregoing requirements. The physician assistant shall not
   51  be required to independently register pursuant to s. 465.0276.
   52         5. The prescription may must be written or electronic, but
   53  must be in a form that complies with ss. 456.0392(1) and
   54  456.42(1), chapter 499 and must contain, in addition to the
   55  supervisory physician’s name, address, and telephone number, the
   56  physician assistant’s prescriber number. Unless it is a drug or
   57  drug sample dispensed by the physician assistant, the
   58  prescription must be filled in a pharmacy permitted under
   59  chapter 465 and must be dispensed in that pharmacy by a
   60  pharmacist licensed under chapter 465. The appearance of the
   61  prescriber number creates a presumption that the physician
   62  assistant is authorized to prescribe the medicinal drug and the
   63  prescription is valid.
   64         6. The physician assistant must note the prescription or
   65  dispensing of medication in the appropriate medical record.
   66         (7) PHYSICIAN ASSISTANT LICENSURE.—
   67         (a) Any person desiring to be licensed as a physician
   68  assistant must apply to the department. The department shall
   69  issue a license to any person certified by the council as having
   70  met the following requirements:
   71         1. Is at least 18 years of age.
   72         2. Has satisfactorily passed a proficiency examination by
   73  an acceptable score established by the National Commission on
   74  Certification of Physician Assistants. If an applicant does not
   75  hold a current certificate issued by the National Commission on
   76  Certification of Physician Assistants and has not actively
   77  practiced as a physician assistant within the immediately
   78  preceding 4 years, the applicant must retake and successfully
   79  complete the entry-level examination of the National Commission
   80  on Certification of Physician Assistants to be eligible for
   81  licensure.
   82         3. Has completed the application form and remitted an
   83  application fee not to exceed $300 as set by the boards. An
   84  application for licensure made by a physician assistant must
   85  include:
   86         a. A certificate of completion of a physician assistant
   87  training program specified in subsection (6).
   88         b. A sworn statement of any prior felony convictions.
   89         c. A sworn statement of any previous revocation or denial
   90  of licensure or certification in any state.
   91         d. Two letters of recommendation.
   92         d.e. A copy of course transcripts and a copy of the course
   93  description from a physician assistant training program
   94  describing course content in pharmacotherapy, if the applicant
   95  wishes to apply for prescribing authority. These documents must
   96  meet the evidence requirements for prescribing authority.
   97         e. As of January 1, 2015, for physician assistants seeking
   98  initial licensure, fingerprints pursuant to the procedures
   99  established in s. 456.0135.
  100         (c) The license must be renewed biennially. Each renewal
  101  must include:
  102         1. A renewal fee not to exceed $500 as set by the boards.
  103         2. A sworn statement of no felony convictions in the
  104  previous 2 years.
  105         (e) Upon employment as a physician assistant, a licensed
  106  physician assistant must notify the department in writing within
  107  30 days after such employment and provide or after any
  108  subsequent changes in the supervising physician. The
  109  notification must include the full name, Florida medical license
  110  number, specialty, and address of a designated the supervising
  111  physician. Any subsequent change in the designated supervising
  112  physician shall be reported by the physician assistant to the
  113  department within 30 days after the change. The assignment of a
  114  designated supervising physician does not preclude a physician
  115  assistant from practicing under multiple supervising physicians.
  116         Section 2. Subsection (3), paragraph (e) of subsection (4),
  117  and paragraphs (a), (b), and (d) of subsection (7) of section
  118  459.022, Florida Statutes, are amended to read:
  119         459.022 Physician assistants.—
  120         (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
  121  group of physicians supervising a licensed physician assistant
  122  must be qualified in the medical areas in which the physician
  123  assistant is to perform and shall be individually or
  124  collectively responsible and liable for the performance and the
  125  acts and omissions of the physician assistant. A physician may
  126  not supervise more than five four currently licensed physician
  127  assistants at any one time. A physician supervising a physician
  128  assistant pursuant to this section may not be required to review
  129  and cosign charts or medical records prepared by such physician
  130  assistant. Notwithstanding this subsection, a physician may only
  131  supervise up to four physician assistants in an office regulated
  132  under s. 458.348(4)(c) or s. 459.025(3)(c).
  133         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
  134         (e) A supervisory physician may delegate to a fully
  135  licensed physician assistant the authority to prescribe or
  136  dispense any medication used in the supervisory physician’s
  137  practice unless such medication is listed on the formulary
  138  created pursuant to s. 458.347. A fully licensed physician
  139  assistant may only prescribe or dispense such medication under
  140  the following circumstances:
  141         1. A physician assistant must clearly identify to the
  142  patient that she or he is a physician assistant. Furthermore,
  143  the physician assistant must inform the patient that the patient
  144  has the right to see the physician prior to any prescription
  145  being prescribed or dispensed by the physician assistant.
  146         2. The supervisory physician must notify the department of
  147  her or his intent to delegate, on a department-approved form,
  148  before delegating such authority and notify the department of
  149  any change in prescriptive privileges of the physician
  150  assistant. Authority to dispense may be delegated only by a
  151  supervisory physician who is registered as a dispensing
  152  practitioner in compliance with s. 465.0276.
  153         3. The physician assistant must certify to file with the
  154  department a signed affidavit that she or he has completed a
  155  minimum of 10 continuing medical education hours in the
  156  specialty practice in which the physician assistant has
  157  prescriptive privileges with each licensure renewal application.
  158         4. The department may issue a prescriber number to the
  159  physician assistant granting authority for the prescribing of
  160  medicinal drugs authorized within this paragraph upon completion
  161  of the foregoing requirements. The physician assistant shall not
  162  be required to independently register pursuant to s. 465.0276.
  163         5. The prescription may must be written or electronic, but
  164  must be in a form that complies with ss. 456.0392(1) and
  165  456.42(1) chapter 499 and must contain, in addition to the
  166  supervisory physician’s name, address, and telephone number, the
  167  physician assistant’s prescriber number. Unless it is a drug or
  168  drug sample dispensed by the physician assistant, the
  169  prescription must be filled in a pharmacy permitted under
  170  chapter 465, and must be dispensed in that pharmacy by a
  171  pharmacist licensed under chapter 465. The appearance of the
  172  prescriber number creates a presumption that the physician
  173  assistant is authorized to prescribe the medicinal drug and the
  174  prescription is valid.
  175         6. The physician assistant must note the prescription or
  176  dispensing of medication in the appropriate medical record.
  177         (7) PHYSICIAN ASSISTANT LICENSURE.—
  178         (a) Any person desiring to be licensed as a physician
  179  assistant must apply to the department. The department shall
  180  issue a license to any person certified by the council as having
  181  met the following requirements:
  182         1. Is at least 18 years of age.
  183         2. Has satisfactorily passed a proficiency examination by
  184  an acceptable score established by the National Commission on
  185  Certification of Physician Assistants. If an applicant does not
  186  hold a current certificate issued by the National Commission on
  187  Certification of Physician Assistants and has not actively
  188  practiced as a physician assistant within the immediately
  189  preceding 4 years, the applicant must retake and successfully
  190  complete the entry-level examination of the National Commission
  191  on Certification of Physician Assistants to be eligible for
  192  licensure.
  193         3. Has completed the application form and remitted an
  194  application fee not to exceed $300 as set by the boards. An
  195  application for licensure made by a physician assistant must
  196  include:
  197         a. A certificate of completion of a physician assistant
  198  training program specified in subsection (6).
  199         b. A sworn statement of any prior felony convictions.
  200         c. A sworn statement of any previous revocation or denial
  201  of licensure or certification in any state.
  202         d. Two letters of recommendation.
  203         d.e. A copy of course transcripts and a copy of the course
  204  description from a physician assistant training program
  205  describing course content in pharmacotherapy, if the applicant
  206  wishes to apply for prescribing authority. These documents must
  207  meet the evidence requirements for prescribing authority.
  208         e. As of January 1, 2015, for physician assistants seeking
  209  initial licensure, fingerprints pursuant to the procedures
  210  established in s. 456.0135.
  211         (b) The licensure must be renewed biennially. Each renewal
  212  must include:
  213         1. A renewal fee not to exceed $500 as set by the boards.
  214         2. A sworn statement of no felony convictions in the
  215  previous 2 years.
  216         (d) Upon employment as a physician assistant, a licensed
  217  physician assistant must notify the department in writing within
  218  30 days after such employment and provide or after any
  219  subsequent changes in the supervising physician. The
  220  notification must include the full name, Florida medical license
  221  number, specialty, and address of a designated the supervising
  222  physician. Any subsequent change in the designated supervising
  223  physician shall be reported by the physician assistant to the
  224  department within 30 days after the change. The assignment of a
  225  designated supervising physician does not preclude a physician
  226  assistant from practicing under multiple supervising physicians.
  227         Section 3. This act shall take effect July 1, 2014.
  228  
  229  ================= T I T L E  A M E N D M E N T ================
  230  And the title is amended as follows:
  231         Delete everything before the enacting clause
  232  and insert:
  233                        A bill to be entitled                      
  234         An act relating to physician assistants; amending ss.
  235         458.347 and 459.022, F.S.; increasing the number of
  236         licensed physician assistants that a physician may
  237         supervise at any one time; providing an exception;
  238         revising circumstances under which a physician
  239         assistant is authorized to prescribe or dispense
  240         medication; specifying that a prescription may be in
  241         written or electronic form and must meet certain
  242         requirements; revising application requirements for
  243         licensure as a physician assistant and license
  244         renewal; revising the notification requirements for a
  245         physician assistant to the Department of Health upon
  246         employment as a physician assistant; providing an
  247         effective date.