Florida Senate - 2014                        COMMITTEE AMENDMENT
       Bill No. SB 1230
       
       
       
       
       
       
                                Ì582424"Î582424                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: WD            .                                
                  04/01/2014           .                                
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       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Between lines 106 and 107
    4  insert:
    5         Section 2. Paragraph (c) of subsection (4) of section
    6  458.348, Florida Statutes, is amended to read:
    7         458.348 Formal supervisory relationships, standing orders,
    8  and established protocols; notice; standards.—
    9         (4) SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.—A
   10  physician who supervises an advanced registered nurse
   11  practitioner or physician assistant at a medical office other
   12  than the physician’s primary practice location, where the
   13  advanced registered nurse practitioner or physician assistant is
   14  not under the onsite supervision of a supervising physician,
   15  must comply with the standards set forth in this subsection. For
   16  the purpose of this subsection, a physician’s “primary practice
   17  location” means the address reflected on the physician’s profile
   18  published pursuant to s. 456.041.
   19         (c) A physician who supervises an advanced registered nurse
   20  practitioner or physician assistant at a medical office other
   21  than the physician’s primary practice location, where the
   22  advanced registered nurse practitioner or physician assistant is
   23  not under the onsite supervision of a supervising physician and
   24  the services offered at the office are primarily dermatologic or
   25  skin care services, which include aesthetic skin care services
   26  other than plastic surgery, must comply with the standards
   27  listed in subparagraphs 1.-4. Notwithstanding s.
   28  458.347(4)(e)6., a physician supervising a physician assistant
   29  pursuant to this paragraph may not be required to review and
   30  cosign charts or medical records prepared by such physician
   31  assistant.
   32         1. The physician shall submit to the board the addresses of
   33  all offices where he or she is supervising an advanced
   34  registered nurse practitioner or a physician’s assistant which
   35  are not the physician’s primary practice location.
   36         2. The physician must be board certified or board eligible
   37  in dermatology or plastic surgery as recognized by the board
   38  pursuant to s. 458.3312.
   39         3. All such offices that are not the physician’s primary
   40  place of practice must be within 25 miles of the physician’s
   41  primary place of practice or in a county that is contiguous to
   42  the county of the physician’s primary place of practice.
   43  However, the distance between any of the offices may not exceed
   44  75 miles.
   45         4. The physician may supervise only one office other than
   46  the physician’s primary place of practice except that until July
   47  1, 2011, the physician may supervise up to two medical offices
   48  other than the physician’s primary place of practice if the
   49  addresses of the offices are submitted to the board before July
   50  1, 2006. Effective July 1, 2011, the physician may supervise
   51  only one office other than the physician’s primary place of
   52  practice, regardless of when the addresses of the offices were
   53  submitted to the board.
   54         5.a. Subparagraphs 2. and 4. do not apply to an office
   55  where nonablative aesthetic skin care services are being
   56  performed by a physician assistant under the supervision of a
   57  physician if the physician assistant has successfully completed
   58  at least:
   59         (I) Eighty hours of education and clinical training on
   60  physiology of the skin, skin conditions, skin disorders, skin
   61  diseases, pre- and post- skin procedure care, and infection
   62  control;
   63         (II) Ten hours of education and clinical training on laser
   64  and light technologies and skin applications; and
   65         (III) Thirty-two hours of education and clinical training
   66  on injectables and fillers.
   67         b. As used in this paragraph, the term nonablative
   68  aesthetic services includes, but is not limited to, services
   69  provided using intense pulsed light, lasers, radio frequency,
   70  ultrasound, injectables, and fillers. The supervising physician
   71  shall submit to the board documentation evidencing successful
   72  completion of the education and training required by this
   73  paragraph for the physician assistants that he or she is
   74  supervising. A physician may not supervise more than two offices
   75  in addition to the physician’s primary practice location.
   76  
   77  ================= T I T L E  A M E N D M E N T ================
   78  And the title is amended as follows:
   79         Delete lines 2 - 3
   80  and insert:
   81  
   82