Florida Senate - 2026 SB 374
By Senator Trumbull
2-00199A-26 2026374__
1 A bill to be entitled
2 An act relating to prescribing authority; amending ss.
3 458.347 and 459.022, F.S.; deleting the requirement
4 that a supervising physician notify the Department of
5 Health in writing of any delegation of prescribing
6 authority to a physician assistant; deleting the
7 requirement that a supervising physician’s name be
8 included in the prescription issued by a physician
9 assistant; revising requirements for the drug
10 formulary for physician assistants; authorizing
11 certain physician assistants to render medical
12 services without physician supervision during a
13 declared state of emergency in counties covered by the
14 declaration; providing applicability; requiring that
15 such services rendered otherwise comply with laws and
16 rules applicable to physician assistants; amending s.
17 464.012, F.S.; revising the drug formulary
18 requirements for advanced practice registered nurses
19 authorized to prescribe medications; authorizing
20 certain advanced practice registered nurses to render
21 medical services without physician supervision during
22 a declared state of emergency in counties covered by
23 the declaration; providing applicability; requiring
24 that such services rendered otherwise comply with laws
25 and rules applicable to advanced practice registered
26 nurses; providing an effective date.
27
28 Be It Enacted by the Legislature of the State of Florida:
29
30 Section 1. Paragraphs (e) and (f) of subsection (4) of
31 section 458.347, Florida Statutes, are amended, and paragraph
32 (l) is added to that subsection, to read:
33 458.347 Physician assistants.—
34 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
35 (e) A supervising physician may delegate to a fully
36 licensed physician assistant the authority to prescribe or
37 dispense any medication used in the supervising physician’s
38 practice unless such medication is listed on the formulary
39 created pursuant to paragraph (f). A fully licensed physician
40 assistant may only prescribe or dispense such medication only
41 under the following conditions circumstances:
42 1. A physician assistant must clearly identify to the
43 patient that he or she is a physician assistant.
44 2. The supervising physician must notify the department of
45 his or her intent to delegate, on a department-approved form,
46 before delegating such authority and of any change in
47 prescriptive privileges of the physician assistant. Authority to
48 dispense may be delegated only by a supervising physician who is
49 registered as a dispensing practitioner in compliance with s.
50 465.0276.
51 3. A fully licensed physician assistant may procure medical
52 devices and drugs unless the medication is listed on the
53 formulary created pursuant to paragraph (f).
54 4. The physician assistant must complete a minimum of 10
55 continuing medical education hours in the specialty practice in
56 which the physician assistant has prescriptive privileges with
57 each licensure renewal. Three of the 10 hours must consist of a
58 continuing education course on the safe and effective
59 prescribing of controlled substance medications which is offered
60 by a statewide professional association of physicians in this
61 state accredited to provide educational activities designated
62 for the American Medical Association Physician’s Recognition
63 Award Category 1 credit, designated by the American Academy of
64 Physician Assistants as a Category 1 credit, or designated by
65 the American Osteopathic Association as a Category 1-A credit.
66 5. The prescription may be in paper or electronic form but
67 must comply with ss. 456.0392(1) and 456.42(1) and chapter 499
68 and must contain the physician assistant’s name, address, and
69 telephone number and the name of each of his or her supervising
70 physicians. Unless it is a drug or drug sample dispensed by the
71 physician assistant, the prescription must be filled in a
72 pharmacy permitted under chapter 465 and must be dispensed in
73 that pharmacy by a pharmacist licensed under chapter 465.
74 6. The physician assistant must note the prescription or
75 dispensing of medication in the appropriate medical record.
76 (f)1. The council shall establish a formulary of medicinal
77 drugs that a fully licensed physician assistant having
78 prescribing authority under this section or s. 459.022 may not
79 prescribe. The formulary must include general anesthetics and
80 radiographic contrast materials and must limit the prescription
81 of Schedule II controlled substances as listed in s. 893.03 to a
82 7-day supply or, in the case of Schedule II psychiatric mental
83 health controlled substances, a 30-day supply. If the
84 prescription is for a formulary must also restrict the
85 prescribing of Schedule II psychiatric mental health controlled
86 substance substances for a child children younger than 18 years
87 of age to a 14-day supply, provided the physician assistant must
88 be is under the supervision of a pediatrician, a family practice
89 physician, an internal medicine physician, or a psychiatrist.
90 2. In establishing the formulary, the council shall consult
91 with a pharmacist licensed under chapter 465, but not licensed
92 under this chapter or chapter 459, who shall be selected by the
93 State Surgeon General.
94 3. Only the council shall add to, delete from, or modify
95 the formulary. Any person who requests an addition, a deletion,
96 or a modification of a medicinal drug listed on such formulary
97 has the burden of proof to show cause why such addition,
98 deletion, or modification should be made.
99 4. The boards shall adopt the formulary required by this
100 paragraph, and each addition, deletion, or modification to the
101 formulary, by rule. Notwithstanding any provision of chapter 120
102 to the contrary, the formulary rule shall be effective 60 days
103 after the date it is filed with the Secretary of State. Upon
104 adoption of the formulary, the department shall mail a copy of
105 such formulary to each fully licensed physician assistant having
106 prescribing authority under this section or s. 459.022, and to
107 each pharmacy licensed by the state. The boards shall establish,
108 by rule, a fee not to exceed $200 to fund the provisions of
109 paragraph (e) and this paragraph.
110 (l) If the Governor issues an executive order or a
111 proclamation declaring a state of emergency pursuant to s.
112 252.36, fully licensed physician assistants holding an active,
113 unrestricted license to practice in this state may render
114 medical services without physician supervision in any county
115 covered by the executive order or proclamation for the duration
116 of the declared state of emergency. However, out-of-state
117 physician assistants registered to provide telehealth services
118 in this state and physician assistants holding a temporary
119 certificate to practice in an area of critical need are not
120 authorized to practice without physician supervision under this
121 paragraph. All services rendered under this paragraph must
122 otherwise comply with the requirements of this section and the
123 rules adopted pursuant hereto.
124 Section 2. Paragraph (e) of subsection (4) of section
125 459.022, Florida Statutes, is amended, and paragraph (k) is
126 added to that subsection, to read:
127 459.022 Physician assistants.—
128 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
129 (e) A supervising physician may delegate to a fully
130 licensed physician assistant the authority to prescribe or
131 dispense any medication used in the supervising physician’s
132 practice unless such medication is listed on the formulary
133 created pursuant to s. 458.347. A fully licensed physician
134 assistant may only prescribe or dispense such medication only
135 under the following conditions circumstances:
136 1. A physician assistant must clearly identify to the
137 patient that she or he is a physician assistant.
138 2. The supervising physician must notify the department of
139 her or his intent to delegate, on a department-approved form,
140 before delegating such authority and of any change in
141 prescriptive privileges of the physician assistant. Authority to
142 dispense may be delegated only by a supervising physician who is
143 registered as a dispensing practitioner in compliance with s.
144 465.0276.
145 3. A fully licensed physician assistant may procure medical
146 devices and drugs unless the medication is listed on the
147 formulary created pursuant to s. 458.347(4)(f).
148 4. The physician assistant must complete a minimum of 10
149 continuing medical education hours in the specialty practice in
150 which the physician assistant has prescriptive privileges with
151 each licensure renewal. Three of the 10 hours must consist of a
152 continuing education course on the safe and effective
153 prescribing of controlled substance medications which is offered
154 by a provider that has been approved by the American Academy of
155 Physician Assistants and which is designated for the American
156 Medical Association Physician’s Recognition Award Category 1
157 credit, designated by the American Academy of Physician
158 Assistants as a Category 1 credit, or designated by the American
159 Osteopathic Association as a Category 1-A credit.
160 5. The prescription may be in paper or electronic form but
161 must comply with ss. 456.0392(1) and 456.42(1) and chapter 499
162 and must contain the physician assistant’s name, address, and
163 telephone number and the name of each of his or her supervising
164 physicians. Unless it is a drug or drug sample dispensed by the
165 physician assistant, the prescription must be filled in a
166 pharmacy permitted under chapter 465, and must be dispensed in
167 that pharmacy by a pharmacist licensed under chapter 465.
168 6. The physician assistant must note the prescription or
169 dispensing of medication in the appropriate medical record.
170 (k) If the Governor issues an executive order or a
171 proclamation declaring a state of emergency pursuant to s.
172 252.36, a fully licensed physician assistant holding an active,
173 unrestricted license to practice in this state may render
174 medical services without physician supervision in any county
175 covered by the executive order or proclamation for the duration
176 of the declared state of emergency. However, out-of-state
177 physician assistants registered to provide telehealth services
178 in this state and physician assistants holding a temporary
179 certificate to practice in an area of critical need are not
180 authorized to practice without physician supervision under this
181 paragraph. All services rendered under this paragraph must
182 otherwise comply with the requirements of this section and the
183 rules adopted pursuant hereto.
184 Section 3. Present subsection (7) of section 464.012,
185 Florida Statutes, is redesignated as subsection (8), a new
186 subsection (7) is added to that section, and paragraph (a) of
187 subsection (6) of that section is amended, to read:
188 464.012 Licensure of advanced practice registered nurses;
189 fees; controlled substance prescribing.—
190 (6)(a) The board shall establish a committee to recommend a
191 formulary of controlled substances that an advanced practice
192 registered nurse may not prescribe or may prescribe only for
193 specific uses or in limited quantities. The committee must be
194 composed consist of three advanced practice registered nurses
195 licensed under this section, recommended by the board; three
196 physicians licensed under chapter 458 or chapter 459 who have
197 work experience with advanced practice registered nurses,
198 recommended by the Board of Medicine; and a pharmacist licensed
199 under chapter 465 who is a doctor of pharmacy, recommended by
200 the Board of Pharmacy. The committee may recommend an evidence
201 based formulary applicable to all advanced practice registered
202 nurses which is limited by specialty certification, is limited
203 to approved uses of controlled substances, or is subject to
204 other similar restrictions the committee finds are necessary to
205 protect the health, safety, and welfare of the public. The
206 formulary must restrict the prescribing of psychiatric mental
207 health controlled substances for children younger than 18 years
208 of age to a 30-day supply advanced practice registered nurses
209 who also are psychiatric nurses as defined in s. 394.455. The
210 formulary must also limit the prescribing of Schedule II
211 controlled substances as listed in s. 893.03 to a 7-day supply,
212 except that such restriction does not apply to controlled
213 substances that are psychiatric medications prescribed by
214 psychiatric nurses as defined in s. 394.455.
215 (7) If the Governor issues an executive order or a
216 proclamation declaring a state of emergency pursuant to s.
217 252.36, fully licensed advanced practice registered nurses
218 holding an active, unrestricted license to practice in this
219 state may render medical services without physician supervision
220 in any county covered by the executive order or proclamation for
221 the duration of the declared state of emergency. However, out
222 of-state advanced practice registered nurses registered to
223 provide telehealth services in this state and advanced practice
224 registered nurses holding a temporary certificate to practice in
225 an area of critical need are not authorized to practice without
226 physician supervision under this paragraph. All services
227 rendered under this paragraph must otherwise comply with the
228 requirements of this part and the rules adopted pursuant hereto.
229 Section 4. This act shall take effect July 1, 2026.