Florida Senate - 2021 COMMITTEE AMENDMENT
Bill No. SB 894
Ì188076EÎ188076
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
03/17/2021 .
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The Committee on Health Policy (Diaz) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete lines 48 - 1238
4 and insert:
5 Section 1. Subsections (1) through (6), paragraphs (a),
6 (d), and (e) of subsection (7), and subsection (13) of section
7 458.347, Florida Statutes, are amended to read:
8 458.347 Physician assistants.—
9 (1) LEGISLATIVE INTENT.—
10 (a) The purpose of this section is to authorize physician
11 assistants, with their education, training, and experience in
12 the field of medicine, to provide increased efficiency of and
13 access to high-quality medical services at a reasonable cost to
14 consumers encourage more effective utilization of the skills of
15 physicians or groups of physicians by enabling them to delegate
16 health care tasks to qualified assistants when such delegation
17 is consistent with the patient’s health and welfare.
18 (b) In order that maximum skills may be obtained within a
19 minimum time period of education, a physician assistant shall be
20 specialized to the extent that he or she can operate efficiently
21 and effectively in the specialty areas in which he or she has
22 been trained or is experienced.
23 (c) The purpose of this section is to encourage the
24 utilization of physician assistants by physicians and to allow
25 for innovative development of programs for the education of
26 physician assistants.
27 (2) DEFINITIONS.—As used in this section, the term:
28 (a) “Approved program” means a physician assistant program
29 in the United States or in its territories or possessions which
30 is accredited by the Accreditation Review Commission on
31 Education for the Physician Assistant or, for programs before
32 2001, accredited by its equivalent or predecessor entities the
33 Committee on Allied Health Education and Accreditation or the
34 Commission on Accreditation of Allied Health Education Programs
35 program, formally approved by the boards, for the education of
36 physician assistants.
37 (b) “Boards” means the Board of Medicine and the Board of
38 Osteopathic Medicine.
39 (d)(c) “Council” means the Council on Physician Assistants.
40 (h)(d) “Trainee” means a person who is currently enrolled
41 in an approved program.
42 (e) “Physician assistant” means a person who is a graduate
43 of an approved program or its equivalent or meets standards
44 approved by the boards and is licensed to perform medical
45 services delegated by the supervising physician.
46 (f) “Physician assistant national certifying examination”
47 means the Physician Assistant National Certifying Examination
48 administered by the National Commission on Certification of
49 Physician Assistants or its successor agency.
50 (g) “Supervision” means responsible supervision and
51 control. Except in cases of emergency, supervision requires the
52 easy availability or physical presence of the licensed physician
53 for consultation and direction of the actions of the physician
54 assistant. For the purposes of this definition, the term “easy
55 availability” includes the ability to communicate by way of
56 telecommunication. The boards shall establish rules as to what
57 constitutes responsible supervision of the physician assistant.
58 (g) “Proficiency examination” means an entry-level
59 examination approved by the boards, including, but not limited
60 to, those examinations administered by the National Commission
61 on Certification of Physician Assistants.
62 (c)(h) “Continuing medical education” means courses
63 recognized and approved by the boards, the American Academy of
64 Physician Assistants, the American Medical Association, the
65 American Osteopathic Association, or the Accreditation Council
66 on Continuing Medical Education.
67 (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
68 group of physicians supervising a licensed physician assistant
69 must be qualified in the medical areas in which the physician
70 assistant is to perform and shall be individually or
71 collectively responsible and liable for the performance and the
72 acts and omissions of the physician assistant. A physician may
73 not supervise more than four currently licensed physician
74 assistants at any one time. A physician supervising a physician
75 assistant pursuant to this section may not be required to review
76 and cosign charts or medical records prepared by such physician
77 assistant.
78 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
79 (a) The boards shall adopt, by rule, the general principles
80 that supervising physicians must use in developing the scope of
81 practice of a physician assistant under direct supervision and
82 under indirect supervision. These principles shall recognize the
83 diversity of both specialty and practice settings in which
84 physician assistants are used.
85 (b) This chapter does not prevent third-party payors from
86 reimbursing employers of physician assistants for covered
87 services rendered by licensed physician assistants.
88 (c) Licensed physician assistants may not be denied
89 clinical hospital privileges, except for cause, so long as the
90 supervising physician is a staff member in good standing.
91 (d) A supervisory physician may delegate to a licensed
92 physician assistant, pursuant to a written protocol, the
93 authority to act according to s. 154.04(1)(c). Such delegated
94 authority is limited to the supervising physician’s practice in
95 connection with a county health department as defined and
96 established pursuant to chapter 154. The boards shall adopt
97 rules governing the supervision of physician assistants by
98 physicians in county health departments.
99 (e) A supervising physician may delegate to a fully
100 licensed physician assistant the authority to prescribe or
101 dispense any medication used in the supervising physician’s
102 practice unless such medication is listed on the formulary
103 created pursuant to paragraph (f). A fully licensed physician
104 assistant may only prescribe or dispense such medication under
105 the following circumstances:
106 1. A physician assistant must clearly identify to the
107 patient that he or she is a physician assistant and inform the
108 patient that the patient has the right to see the physician
109 before a prescription is prescribed or dispensed by the
110 physician assistant.
111 2. The supervising physician must notify the department of
112 his or her intent to delegate, on a department-approved form,
113 before delegating such authority and of any change in
114 prescriptive privileges of the physician assistant. Authority to
115 dispense may be delegated only by a supervising physician who is
116 registered as a dispensing practitioner in compliance with s.
117 465.0276.
118 3. A fully licensed physician assistant may procure medical
119 devices and drugs unless the medication is listed on the
120 formulary created pursuant to paragraph (f).
121 4. The physician assistant must complete a minimum of 10
122 continuing medical education hours in the specialty practice in
123 which the physician assistant has prescriptive privileges with
124 each licensure renewal. Three of the 10 hours must consist of a
125 continuing education course on the safe and effective
126 prescribing of controlled substance medications which is offered
127 by a statewide professional association of physicians in this
128 state accredited to provide educational activities designated
129 for the American Medical Association Physician’s Recognition
130 Award Category 1 credit or designated by the American Academy of
131 Physician Assistants as a Category 1 credit.
132 4. The department may issue a prescriber number to the
133 physician assistant granting authority for the prescribing of
134 medicinal drugs authorized within this paragraph upon completion
135 of the requirements of this paragraph. The physician assistant
136 is not required to independently register pursuant to s.
137 465.0276.
138 5. The prescription may be in paper or electronic form but
139 must comply with ss. 456.0392(1) and 456.42(1) and chapter 499
140 and must contain the physician assistant’s, in addition to the
141 supervising physician’s name, address, and telephone number, the
142 physician assistant’s prescriber number. Unless it is a drug or
143 drug sample dispensed by the physician assistant, the
144 prescription must be filled in a pharmacy permitted under
145 chapter 465 and must be dispensed in that pharmacy by a
146 pharmacist licensed under chapter 465. The inclusion of the
147 prescriber number creates a presumption that the physician
148 assistant is authorized to prescribe the medicinal drug and the
149 prescription is valid.
150 6. The physician assistant must note the prescription or
151 dispensing of medication in the appropriate medical record.
152 (f)1. The council shall establish a formulary of medicinal
153 drugs that a fully licensed physician assistant having
154 prescribing authority under this section or s. 459.022 may not
155 prescribe. The formulary must include general anesthetics and
156 radiographic contrast materials and must limit the prescription
157 of Schedule II controlled substances as listed in s. 893.03 to a
158 7-day supply. The formulary must also restrict the prescribing
159 of psychiatric mental health controlled substances for children
160 younger than 18 years of age.
161 2. In establishing the formulary, the council shall consult
162 with a pharmacist licensed under chapter 465, but not licensed
163 under this chapter or chapter 459, who shall be selected by the
164 State Surgeon General.
165 3. Only the council shall add to, delete from, or modify
166 the formulary. Any person who requests an addition, a deletion,
167 or a modification of a medicinal drug listed on such formulary
168 has the burden of proof to show cause why such addition,
169 deletion, or modification should be made.
170 4. The boards shall adopt the formulary required by this
171 paragraph, and each addition, deletion, or modification to the
172 formulary, by rule. Notwithstanding any provision of chapter 120
173 to the contrary, the formulary rule shall be effective 60 days
174 after the date it is filed with the Secretary of State. Upon
175 adoption of the formulary, the department shall mail a copy of
176 such formulary to each fully licensed physician assistant having
177 prescribing authority under this section or s. 459.022, and to
178 each pharmacy licensed by the state. The boards shall establish,
179 by rule, a fee not to exceed $200 to fund the provisions of this
180 paragraph and paragraph (e).
181 (g) A supervisory physician may delegate to a licensed
182 physician assistant the authority to, and the licensed physician
183 assistant acting under the direction of the supervisory
184 physician may, order any medication for administration to the
185 supervisory physician’s patient in a facility licensed under
186 chapter 395 or part II of chapter 400, notwithstanding any
187 provisions in chapter 465 or chapter 893 which may prohibit this
188 delegation.
189 (h) A licensed physician assistant may perform services
190 delegated by the supervising physician in the physician
191 assistant’s practice in accordance with his or her education and
192 training unless expressly prohibited under this chapter, chapter
193 459, or rules adopted under this chapter or chapter 459.
194 (i) A physician assistant may authenticate any document
195 with his or her signature, certification, stamp, verification,
196 affidavit, or endorsement if such document may be so
197 authenticated by the signature, certification, stamp,
198 verification, affidavit, or endorsement of a physician. Such
199 documents include, but are not limited to, any of the following:
200 1. Initiation of an involuntary examination pursuant to s.
201 394.463.
202 2. Do-not-resuscitate orders or physician orders for the
203 administration of life-sustaining treatment.
204 3. Death certificates.
205 4. School physical examinations.
206 5. Medical evaluations for workers’ compensation claims,
207 including date of maximum medical improvement as defined in s.
208 440.02.
209 6. Orders for physical therapy, occupational therapy,
210 speech-language therapy, home health services, or durable
211 medical equipment.
212 (j) A physician assistant may supervise medical assistants
213 as defined in this chapter and chapter 459.
214 (k) This chapter authorizes third-party payors to reimburse
215 employers of physician assistants for covered services rendered
216 by licensed physician assistants. Payment for services within
217 the physician assistant’s scope of practice must be made when
218 ordered or performed by a physician assistant if the same
219 service would have been covered if ordered or performed by a
220 physician. Physician assistants are authorized to bill for and
221 receive direct payment for the services they deliver.
222 (5) PERFORMANCE BY TRAINEES.—Notwithstanding any other law,
223 a trainee may perform medical services when such services are
224 rendered within the scope of an approved program.
225 (6) PROGRAM APPROVAL.—
226 (a) The boards shall approve programs, based on
227 recommendations by the council, for the education and training
228 of physician assistants which meet standards established by rule
229 of the boards. The council may recommend only those physician
230 assistant programs that hold full accreditation or provisional
231 accreditation from the Accreditation Review Commission on
232 Education for the Physician Assistant or its successor entity
233 or, before 2001, from the Committee on Allied Health Education
234 and Accreditation or the Commission on Accreditation of Allied
235 Health Programs or its successor organization. Any educational
236 institution offering a physician assistant program approved by
237 the boards pursuant to this paragraph may also offer the
238 physician assistant program authorized in paragraph (c) for
239 unlicensed physicians.
240 (b) Notwithstanding any other law, a trainee may perform
241 medical services when such services are rendered within the
242 scope of an approved program The boards shall adopt and publish
243 standards to ensure that such programs operate in a manner that
244 does not endanger the health or welfare of the patients who
245 receive services within the scope of the programs. The boards
246 shall review the quality of the curricula, faculties, and
247 facilities of such programs and take whatever other action is
248 necessary to determine that the purposes of this section are
249 being met.
250 (c) Any community college with the approval of the State
251 Board of Education may conduct a physician assistant program
252 which shall apply for national accreditation through the
253 American Medical Association’s Committee on Allied Health,
254 Education, and Accreditation, or its successor organization, and
255 which may admit unlicensed physicians, as authorized in
256 subsection (7), who are graduates of foreign medical schools
257 listed with the World Health Organization. The unlicensed
258 physician must have been a resident of this state for a minimum
259 of 12 months immediately prior to admission to the program. An
260 evaluation of knowledge base by examination shall be required to
261 grant advanced academic credit and to fulfill the necessary
262 requirements to graduate. A minimum of one 16-week semester of
263 supervised clinical and didactic education, which may be
264 completed simultaneously, shall be required before graduation
265 from the program. All other provisions of this section shall
266 remain in effect.
267 (6)(7) PHYSICIAN ASSISTANT LICENSURE.—
268 (a) Any person desiring to be licensed as a physician
269 assistant must apply to the department. The department shall
270 issue a license to any person certified by the council as having
271 met all of the following requirements:
272 1. Is at least 18 years of age.
273 2. Has graduated from an approved program.
274 a. For an applicant who graduated after December 31, 2020,
275 has received a master’s degree in accordance with the
276 Accreditation Review Commission on Education for the Physician
277 Assistant or, before 2001, its equivalent or predecessor
278 organization.
279 b. For an applicant who graduated on or before December 31,
280 2020, has received a bachelor’s or master’s degree from an
281 approved program.
282 c. For an applicant who graduated before July 1, 1994, has
283 graduated from an approved program of instruction in primary
284 health care or surgery.
285 d. For an applicant who graduated before July 1, 1983, has
286 received a certification as a physician assistant from the
287 boards.
288 e. The board may also grant a license to an applicant who
289 does not meet the educational requirement specified in this
290 subparagraph but who has passed the Physician Assistant National
291 Certifying Examination administered by the National Commission
292 on Certification of Physician Assistants before 1986.
293 3. Has obtained a passing score as satisfactorily passed a
294 proficiency examination by an acceptable score established by
295 the National Commission on Certification of Physician Assistants
296 or its equivalent or successor organization and has been
297 nationally certified. If an applicant does not hold a current
298 certificate issued by the National Commission on Certification
299 of Physician Assistants or its equivalent or successor
300 organization and has not actively practiced as a physician
301 assistant within the immediately preceding 4 years, the
302 applicant must retake and successfully complete the entry-level
303 examination of the National Commission on Certification of
304 Physician Assistants or its equivalent or successor organization
305 to be eligible for licensure.
306 4.3. Has completed the application form and remitted an
307 application fee not to exceed $300 as set by the boards. An
308 application for licensure as made by a physician assistant must
309 include:
310 a. A diploma from an approved certificate of completion of
311 a physician assistant training program specified in subsection
312 (6).
313 b. Acknowledgment of any prior felony convictions.
314 c. Acknowledgment of any previous revocation or denial of
315 licensure or certification in any state.
316 d. A copy of course transcripts and a copy of the course
317 description from a physician assistant training program
318 describing course content in pharmacotherapy, if the applicant
319 wishes to apply for prescribing authority. These documents must
320 meet the evidence requirements for prescribing authority.
321 (d) Upon employment as a physician assistant, a licensed
322 physician assistant must notify the department in writing within
323 30 days after such employment or after any subsequent changes in
324 the supervising physician. The notification must include the
325 full name, Florida medical license number, specialty, and
326 address of the supervising physician.
327 (e) Notwithstanding subparagraph (a)2., the department may
328 grant to a recent graduate of an approved program, as specified
329 in subsection (5) (6), who expects to take the first examination
330 administered by the National Commission on Certification of
331 Physician Assistants available for registration after the
332 applicant’s graduation, a temporary license. The temporary
333 license shall expire 30 days after receipt of scores of the
334 proficiency examination administered by the National Commission
335 on Certification of Physician Assistants. Between meetings of
336 the council, the department may grant a temporary license to
337 practice based on the completion of all temporary licensure
338 requirements. All such administratively issued licenses shall be
339 reviewed and acted on at the next regular meeting of the
340 council. The recent graduate may be licensed before employment
341 but must comply with paragraph (d). An applicant who has passed
342 the proficiency examination may be granted permanent licensure.
343 An applicant failing the proficiency examination is no longer
344 temporarily licensed but may reapply for a 1-year extension of
345 temporary licensure. An applicant may not be granted more than
346 two temporary licenses and may not be licensed as a physician
347 assistant until he or she passes the examination administered by
348 the National Commission on Certification of Physician
349 Assistants. As prescribed by board rule, the council may require
350 an applicant who does not pass the licensing examination after
351 five or more attempts to complete additional remedial education
352 or training. The council shall prescribe the additional
353 requirements in a manner that permits the applicant to complete
354 the requirements and be reexamined within 2 years after the date
355 the applicant petitions the council to retake the examination a
356 sixth or subsequent time.
357 (13) RULES.—The boards shall adopt rules to implement this
358 section, including rules detailing the contents of the
359 application for licensure and notification pursuant to
360 subsection (6) (7) and rules to ensure both the continued
361 competency of physician assistants and the proper utilization of
362 them by physicians or groups of physicians.
363 Section 2. Subsections (1) through (6), paragraphs (a),
364 (d), and (e) of subsection (7), and subsection (13) of section
365 459.022, Florida Statutes, are amended to read:
366 459.022 Physician assistants.—
367 (1) LEGISLATIVE INTENT.—
368 (a) The purpose of this section is to authorize physician
369 assistants, with their education, training, and experience in
370 the field of medicine, to provide increased efficiency of and
371 access to high-quality medical services at a reasonable cost to
372 consumers encourage more effective utilization of the skills of
373 osteopathic physicians or groups of osteopathic physicians by
374 enabling them to delegate health care tasks to qualified
375 assistants when such delegation is consistent with the patient’s
376 health and welfare.
377 (b) In order that maximum skills may be obtained within a
378 minimum time period of education, a physician assistant shall be
379 specialized to the extent that she or he can operate efficiently
380 and effectively in the specialty areas in which she or he has
381 been trained or is experienced.
382 (c) The purpose of this section is to encourage the
383 utilization of physician assistants by osteopathic physicians
384 and to allow for innovative development of programs for the
385 education of physician assistants.
386 (2) DEFINITIONS.—As used in this section, the term:
387 (a) “Approved program” means a physician assistant program
388 in the United States or in its territories or possessions which
389 is accredited by the Accreditation Review Commission on
390 Education for the Physician Assistant or, for programs before
391 2001, accredited by its equivalent or predecessor entities the
392 Committee on Allied Health Education and Accreditation or the
393 Commission on Accreditation of Allied Health Education Programs
394 program, formally approved by the boards, for the education of
395 physician assistants.
396 (b) “Boards” means the Board of Medicine and the Board of
397 Osteopathic Medicine.
398 (d)(c) “Council” means the Council on Physician Assistants.
399 (h)(d) “Trainee” means a person who is currently enrolled
400 in an approved program.
401 (e) “Physician assistant” means a person who is a graduate
402 of an approved program or its equivalent or meets standards
403 approved by the boards and is licensed to perform medical
404 services delegated by the supervising physician.
405 (f) “Physician assistant national certifying examination”
406 means the Physician Assistant National Certifying Examination
407 administered by the National Commission on Certification of
408 Physician Assistants or its successor agency.
409 (g) “Supervision” means responsible supervision and
410 control. Except in cases of emergency, supervision requires the
411 easy availability or physical presence of the licensed physician
412 for consultation and direction of the actions of the physician
413 assistant. For the purposes of this definition, the term “easy
414 availability” includes the ability to communicate by way of
415 telecommunication. The boards shall establish rules as to what
416 constitutes responsible supervision of the physician assistant.
417 (g) “Proficiency examination” means an entry-level
418 examination approved by the boards, including, but not limited
419 to, those examinations administered by the National Commission
420 on Certification of Physician Assistants.
421 (c)(h) “Continuing medical education” means courses
422 recognized and approved by the boards, the American Academy of
423 Physician Assistants, the American Medical Association, the
424 American Osteopathic Association, or the Accreditation Council
425 on Continuing Medical Education.
426 (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
427 group of physicians supervising a licensed physician assistant
428 must be qualified in the medical areas in which the physician
429 assistant is to perform and shall be individually or
430 collectively responsible and liable for the performance and the
431 acts and omissions of the physician assistant. A physician may
432 not supervise more than four currently licensed physician
433 assistants at any one time. A physician supervising a physician
434 assistant pursuant to this section may not be required to review
435 and cosign charts or medical records prepared by such physician
436 assistant.
437 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
438 (a) The boards shall adopt, by rule, the general principles
439 that supervising physicians must use in developing the scope of
440 practice of a physician assistant under direct supervision and
441 under indirect supervision. These principles shall recognize the
442 diversity of both specialty and practice settings in which
443 physician assistants are used.
444 (b) This chapter does not prevent third-party payors from
445 reimbursing employers of physician assistants for covered
446 services rendered by licensed physician assistants.
447 (c) Licensed physician assistants may not be denied
448 clinical hospital privileges, except for cause, so long as the
449 supervising physician is a staff member in good standing.
450 (d) A supervisory physician may delegate to a licensed
451 physician assistant, pursuant to a written protocol, the
452 authority to act according to s. 154.04(1)(c). Such delegated
453 authority is limited to the supervising physician’s practice in
454 connection with a county health department as defined and
455 established pursuant to chapter 154. The boards shall adopt
456 rules governing the supervision of physician assistants by
457 physicians in county health departments.
458 (e) A supervising physician may delegate to a fully
459 licensed physician assistant the authority to prescribe or
460 dispense any medication used in the supervising physician’s
461 practice unless such medication is listed on the formulary
462 created pursuant to s. 458.347. A fully licensed physician
463 assistant may only prescribe or dispense such medication under
464 the following circumstances:
465 1. A physician assistant must clearly identify to the
466 patient that she or he is a physician assistant and must inform
467 the patient that the patient has the right to see the physician
468 before a prescription is prescribed or dispensed by the
469 physician assistant.
470 2. The supervising physician must notify the department of
471 her or his intent to delegate, on a department-approved form,
472 before delegating such authority and of any change in
473 prescriptive privileges of the physician assistant. Authority to
474 dispense may be delegated only by a supervising physician who is
475 registered as a dispensing practitioner in compliance with s.
476 465.0276.
477 3. A fully licensed physician assistant may procure medical
478 devices and drugs unless the medication is listed on the
479 formulary created pursuant to s. 458.347(4)(f).
480 4. The physician assistant must complete a minimum of 10
481 continuing medical education hours in the specialty practice in
482 which the physician assistant has prescriptive privileges with
483 each licensure renewal. Three of the 10 hours must consist of a
484 continuing education course on the safe and effective
485 prescribing of controlled substance medications which is offered
486 by a provider that has been approved by the American Academy of
487 Physician Assistants and which is designated for the American
488 Medical Association Physician’s Recognition Award Category 1
489 credit or designated by the American Academy of Physician
490 Assistants as a Category 1 credit.
491 4. The department may issue a prescriber number to the
492 physician assistant granting authority for the prescribing of
493 medicinal drugs authorized within this paragraph upon completion
494 of the requirements of this paragraph. The physician assistant
495 is not required to independently register pursuant to s.
496 465.0276.
497 5. The prescription may be in paper or electronic form but
498 must comply with ss. 456.0392(1) and 456.42(1) and chapter 499
499 and must contain the physician assistant’s, in addition to the
500 supervising physician’s name, address, and telephone number, the
501 physician assistant’s prescriber number. Unless it is a drug or
502 drug sample dispensed by the physician assistant, the
503 prescription must be filled in a pharmacy permitted under
504 chapter 465, and must be dispensed in that pharmacy by a
505 pharmacist licensed under chapter 465. The inclusion of the
506 prescriber number creates a presumption that the physician
507 assistant is authorized to prescribe the medicinal drug and the
508 prescription is valid.
509 6. The physician assistant must note the prescription or
510 dispensing of medication in the appropriate medical record.
511 (f) A supervisory physician may delegate to a licensed
512 physician assistant the authority to, and the licensed physician
513 assistant acting under the direction of the supervisory
514 physician may, order any medication for administration to the
515 supervisory physician’s patient in a facility licensed under
516 chapter 395 or part II of chapter 400, notwithstanding any
517 provisions in chapter 465 or chapter 893 which may prohibit this
518 delegation.
519 (g) A licensed physician assistant may perform services
520 delegated by the supervising physician in the physician
521 assistant’s practice in accordance with his or her education and
522 training unless expressly prohibited under this chapter, chapter
523 458, or rules adopted under this chapter or chapter 458.
524 (h) A physician assistant may authenticate any document
525 with his or her signature, certification, stamp, verification,
526 affidavit, or endorsement if such document may be so
527 authenticated by the signature, certification, stamp,
528 verification, affidavit, or endorsement of a physician. Such
529 documents include, but are not limited to, any of the following:
530 1. Initiation of an involuntary examination pursuant to s.
531 394.463.
532 2. Do-not-resuscitate orders or physician orders for the
533 administration of life-sustaining treatment.
534 3. Death certificates.
535 4. School physical examinations.
536 5. Medical evaluations for workers’ compensation claims,
537 including date of maximum medical improvement as defined in s.
538 440.02.
539 6. Orders for physical therapy, occupational therapy,
540 speech-language therapy, home health services, or durable
541 medical equipment.
542 (i) A physician assistant may supervise medical assistants
543 as defined in this chapter and chapter 459.
544 (j) This chapter authorizes third-party payors to reimburse
545 employers of physician assistants for covered services rendered
546 by licensed physician assistants. Payment for services within
547 the physician assistant’s scope of practice must be made when
548 ordered or performed by a physician assistant if the same
549 service would have been covered if ordered or performed by a
550 physician. Physician assistants are authorized to bill for and
551 receive direct payment for the services they deliver.
552 (5) PERFORMANCE BY TRAINEES.—Notwithstanding any other law,
553 a trainee may perform medical services when such services are
554 rendered within the scope of an approved program.
555 (6) PROGRAM APPROVAL.—
556 (a) The boards shall approve programs, based on
557 recommendations by the council, for the education and training
558 of physician assistants which meet standards established by rule
559 of the boards. The council may recommend only those physician
560 assistant programs that hold full accreditation or provisional
561 accreditation from the Accreditation Review Commission on
562 Education for the Physician Assistant or its successor entity
563 or, before 2001, from the Committee on Allied Health Education
564 and Accreditation or the Commission on Accreditation of Allied
565 Health Programs or its successor organization.
566 (b) Notwithstanding any other law, a trainee may perform
567 medical services when such services are rendered within the
568 scope of an approved program The boards shall adopt and publish
569 standards to ensure that such programs operate in a manner that
570 does not endanger the health or welfare of the patients who
571 receive services within the scope of the programs. The boards
572 shall review the quality of the curricula, faculties, and
573 facilities of such programs and take whatever other action is
574 necessary to determine that the purposes of this section are
575 being met.
576 (6)(7) PHYSICIAN ASSISTANT LICENSURE.—
577 (a) Any person desiring to be licensed as a physician
578 assistant must apply to the department. The department shall
579 issue a license to any person certified by the council as having
580 met all of the following requirements:
581 1. Is at least 18 years of age.
582 2. Has graduated from an approved program.
583 a. For an applicant who graduated after December 31, 2020,
584 has received a master’s degree in accordance with the
585 Accreditation Review Commission on Education for the Physician
586 Assistant or, before 2001, its equivalent or predecessor
587 organization.
588 b. For an applicant who graduated on or before December 31,
589 2020, has received a bachelor’s or master’s degree from an
590 approved program.
591 c. For an applicant who graduated before July 1, 1994, has
592 graduated from an approved program of instruction in primary
593 health care or surgery.
594 d. For an applicant who graduated before July 1, 1983, has
595 received a certification as a physician assistant from the
596 boards.
597 e. The board may also grant a license to an applicant who
598 does not meet the educational requirement specified in this
599 subparagraph but who has passed the Physician Assistant National
600 Certifying Examination administered by the National Commission
601 on Certification of Physician Assistants before 1986.
602 3. Has obtained a passing score as satisfactorily passed a
603 proficiency examination by an acceptable score established by
604 the National Commission on Certification of Physician Assistants
605 or its equivalent or successor organization and has been
606 nationally certified. If an applicant does not hold a current
607 certificate issued by the National Commission on Certification
608 of Physician Assistants or its equivalent or successor
609 organization and has not actively practiced as a physician
610 assistant within the immediately preceding 4 years, the
611 applicant must retake and successfully complete the entry-level
612 examination of the National Commission on Certification of
613 Physician Assistants or its equivalent or successor organization
614 to be eligible for licensure.
615 4.3. Has completed the application form and remitted an
616 application fee not to exceed $300 as set by the boards. An
617 application for licensure as made by a physician assistant must
618 include:
619 a. A diploma from an approved certificate of completion of
620 a physician assistant training program specified in subsection
621 (6).
622 b. Acknowledgment of any prior felony convictions.
623 c. Acknowledgment of any previous revocation or denial of
624 licensure or certification in any state.
625 d. A copy of course transcripts and a copy of the course
626 description from a physician assistant training program
627 describing course content in pharmacotherapy, if the applicant
628 wishes to apply for prescribing authority. These documents must
629 meet the evidence requirements for prescribing authority.
630 (d) Upon employment as a physician assistant, a licensed
631 physician assistant must notify the department in writing within
632 30 days after such employment or after any subsequent changes in
633 the supervising physician. The notification must include the
634 full name, Florida medical license number, specialty, and
635 address of the supervising physician.
636 (e) Notwithstanding subparagraph (a)2., the department may
637 grant to a recent graduate of an approved program, as specified
638 in subsection (5) (6), a temporary license to expire upon
639 receipt of scores of the proficiency examination administered by
640 the National Commission on Certification of Physician
641 Assistants. Between meetings of the council, the department may
642 grant a temporary license to practice to physician assistant
643 applicants based on the completion of all temporary licensure
644 requirements. All such administratively issued licenses shall be
645 reviewed and acted on at the next regular meeting of the
646 council. The recent graduate may be licensed before prior to
647 employment, but must comply with paragraph (d). An applicant who
648 has passed the proficiency examination may be granted permanent
649 licensure. An applicant failing the proficiency examination is
650 no longer temporarily licensed, but may reapply for a 1-year
651 extension of temporary licensure. An applicant may not be
652 granted more than two temporary licenses and may not be licensed
653 as a physician assistant until she or he passes the examination
654 administered by the National Commission on Certification of
655 Physician Assistants. As prescribed by board rule, the council
656 may require an applicant who does not pass the licensing
657 examination after five or more attempts to complete additional
658 remedial education or training. The council shall prescribe the
659 additional requirements in a manner that permits the applicant
660 to complete the requirements and be reexamined within 2 years
661 after the date the applicant petitions the council to retake the
662 examination a sixth or subsequent time.
663 (13) RULES.—The boards shall adopt rules to implement this
664 section, including rules detailing the contents of the
665 application for licensure and notification pursuant to
666 subsection (6) (7) and rules to ensure both the continued
667 competency of physician assistants and the proper utilization of
668 them by physicians or groups of physicians.
669
670 ================= T I T L E A M E N D M E N T ================
671 And the title is amended as follows:
672 Delete lines 10 - 39
673 and insert:
674 supervision; deleting a requirement that a physician
675 assistant inform his or her patients that they have
676 the right to see a physician before the physician
677 assistant prescribes or dispenses a prescription;
678 authorizing physician assistants to procure drugs and
679 medical devices; providing an exception; conforming
680 provisions to changes made by the act; revising
681 requirements for a certain formulary; authorizing
682 physician assistants to authenticate documents that
683 may be authenticated by a physician; authorizing
684 physician assistants to supervise medical assistants;
685 authorizing third-party payors to reimburse employers
686 of physician assistants for services rendered;
687 providing requirements for such payment for services;
688 authorizing physician assistants to bill for and
689 receive direct payment for services they deliver;
690 revising provisions relating to approved programs for
691 physician assistants; revising provisions relating to
692 physician assistant licensure requirements; amending
693 ss.