Florida Senate - 2011                                     SB 742
       
       
       
       By Senator Sobel
       
       
       
       
       31-00583-11                                            2011742__
    1                        A bill to be entitled                      
    2         An act relating to surgical first assistants;
    3         providing definitions; providing requirements for the
    4         performance of supervising physicians; providing the
    5         duties and scope and location of practice for
    6         certified surgical first assistants; providing
    7         contracting and employment guidelines for physicians,
    8         hospitals, clinics, or ambulatory surgical centers
    9         employing certified surgical first assistants;
   10         providing licensure criteria for certified surgical
   11         first assistants; providing for application fees and
   12         licensure renewal fees; providing for licensure
   13         renewal; providing continuing education requirements;
   14         authorizing the Board of Medicine to impose penalties;
   15         providing the scope of a certified surgical first
   16         assistant’s license; providing for reciprocity of
   17         licenses among states; providing for inactive and
   18         delinquent status; providing that an unlicensed person
   19         who holds himself or herself out as, or indicates or
   20         implies that he or she is, licensed commits a third
   21         degree felony and is subject to applicable penalties;
   22         providing for denial, suspension, or revocation of
   23         licensure; authorizing the board to adopt rules;
   24         providing that supervising physicians may be liable
   25         for certain acts or omissions of certified surgical
   26         first assistants; providing guidelines for the use of
   27         fees collected by the board; amending s. 627.419,
   28         F.S.; providing for payments to a physician assistant
   29         under contracts providing for payment for surgical
   30         first assisting benefits or services; including
   31         certified surgical first assistants, as defined,
   32         within certain benefits or services payment
   33         provisions; limiting such application; providing an
   34         effective date.
   35  
   36  Be It Enacted by the Legislature of the State of Florida:
   37  
   38  Section 1. (1) DEFINITIONS.—As used in this section, the term:
   39         (a) “Board” means the Board of Medicine.
   40         (b) “Certified surgical first assistant” means a person who
   41  provides primary surgical assistance to the primary surgeon
   42  during a surgical procedure, is listed on the operative record
   43  as the first assistant, and meets the qualifications for
   44  licensure under this section.
   45         (c) “Continuing medical education” means courses recognized
   46  and approved by the board, the Liaison Council on Certification
   47  for the Surgical Technologist, the National Surgical Assistant
   48  Association, the American Board of Surgical Assistants, the
   49  American Medical Association, the American Osteopathic
   50  Association, or the Accreditation Council on Continuing Medical
   51  Education.
   52         (d) “Direct supervision” means supervision by a delegating
   53  physician who is physically present and who personally directs
   54  delegated acts and remains immediately available to personally
   55  respond to any emergency until the patient is released from the
   56  operating room or the physician’s care and has been transferred
   57  to the care and responsibility of another physician.
   58         (e) “Surgical assisting” means providing aid under direct
   59  supervision in exposure, hemostasis, closures, and other
   60  intraoperative technical functions that assist a physician in
   61  performing a safe operation with optimal results for the
   62  patient.
   63         (2) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
   64  group of physicians supervising a certified surgical first
   65  assistant must be qualified in the medical areas in which the
   66  certified surgical first assistant is to perform and may be
   67  individually or collectively responsible and liable for the
   68  performance and the acts and omissions of the certified surgical
   69  first assistant.
   70         (3) PERFORMANCE OF CERTIFIED SURGICAL FIRST ASSISTANTS.—
   71         (a) A certified surgical first assistant may perform duties
   72  limited to the scope of certification in surgical assisting
   73  functions while under the direct supervision of a physician.
   74         (b) The scope of practice of a certified surgical first
   75  assistant is limited to surgical assisting and tasks delegated
   76  by the supervising physician.
   77         (c) A certified surgical first assistant may perform his or
   78  her duties only in a medical clinic, hospital, ambulatory
   79  surgical center, or similar medical institution.
   80         (4) EMPLOYMENT OF CERTIFIED SURGICAL FIRST ASSISTANTS.—
   81         (a) A physician or hospital is not required to contract
   82  with a certified surgical first assistant.
   83         (b) A health maintenance organization, preferred provider
   84  organization, or health benefit plan may not require a
   85  physician, hospital, clinic, or ambulatory surgery center to
   86  contract with a certified surgical first assistant as a
   87  condition of payment to a certified surgical first assistant.
   88         (c) The board may not limit in any way by rule the
   89  employment arrangement of a certified surgical first assistant.
   90         (5) CERTIFIED SURGICAL FIRST ASSISTANT LICENSURE.—
   91         (a) A person desiring to be licensed as a certified
   92  surgical first assistant shall apply to the board. The board
   93  shall issue a license to any person determined by the board as
   94  having met the following requirements:
   95         1. Is at least 18 years of age.
   96         2. Holds and maintains certification from one of the
   97  following recognized certifying agencies:
   98         a. The Liaison Council on Certification for the Surgical
   99  Technologist.
  100         b. The National Surgical Assistant Association.
  101         c. The American Board of Surgical Assistants.
  102         3. Has completed the application form and remitted an
  103  application fee not to exceed $750 as set by the board. An
  104  application for licensure made by a certified surgical first
  105  assistant must include:
  106         a. A certificate from one of the recognized certifying
  107  agencies specified in subparagraph 2.
  108         b. A sworn statement of any prior felony convictions.
  109         c. A sworn statement of any previous revocation or denial
  110  of licensure or certification.
  111         (b) A license must be renewed biennially. Each renewal must
  112  include:
  113         1. A renewal fee not to exceed $1,000 as set by the board.
  114         2. A sworn statement of no felony convictions in the
  115  previous 2 years.
  116         (c) Each licensed certified surgical first assistant shall
  117  biennially complete 40 hours of continuing medical education or
  118  hold a current certificate issued by a recognized certifying
  119  agency listed in subparagraph (a)2.
  120         (d) The board may impose any of the penalties authorized
  121  under ss. 456.072 and 458.331(2), Florida Statutes, upon a
  122  certified surgical first assistant if the certified surgical
  123  first assistant or the supervising physician has been found
  124  guilty of or is being investigated for any act that constitutes
  125  a violation of chapter 456 or chapter 458, Florida Statutes.
  126         (e) A certified surgical first assistant’s license:
  127         1. Does not authorize the licensee to engage in the
  128  practice of medicine or professional nursing.
  129         2. Is not required of a registered nurse, an advanced
  130  registered nurse practitioner, a registered nurse first
  131  assistant, or a physician assistant as a condition of
  132  employment.
  133         (6) RECIPROCITY.—The Department of Health shall allow
  134  reciprocity to certified surgical first assistants who are
  135  determined by the board to:
  136         (a) Be licensed in other states and who are in good
  137  standing with their state of licensure and their certifying
  138  agency.
  139         (b) Have paid appropriate licensure fees.
  140         (c) Have complied with all other requirements of the board.
  141         (7) INACTIVE AND DELINQUENT STATUS.—A license on inactive
  142  or delinquent status may be reactivated only as provided in s.
  143  456.036, Florida Statutes.
  144         (8) PENALTY.—A person who has not been licensed by the
  145  board and approved by the Department of Health and who holds
  146  himself or herself out as a licensed certified surgical first
  147  assistant or who uses any other term in indicating or implying
  148  that he or she is a licensed certified surgical first assistant
  149  commits a felony of the third degree, punishable as provided in
  150  s. 775.082, s. 775.083, or s. 775.084, Florida Statutes.
  151         (9) DENIAL, SUSPENSION, OR REVOCATION OF LICENSURE.—The
  152  board may deny, suspend, or revoke a certified surgical first
  153  assistant license if the board determines that the certified
  154  surgical first assistant has violated chapter 456 or chapter
  155  458, Florida Statutes.
  156         (10) RULES.—The board may adopt rules to administer this
  157  section.
  158         (11) LIABILITY.—Each supervising physician using a
  159  certified surgical first assistant may be liable for acts or
  160  omissions of the certified surgical first assistant acting under
  161  the physician’s supervision and control.
  162         (12) FEES.—The fees collected by the board under this
  163  section shall be used for the licensure and regulation of
  164  certified surgical first assistants in accordance with this
  165  section.
  166         Section 2. Subsection (6) of section 627.419, Florida
  167  Statutes, is amended to read:
  168         627.419 Construction of policies.—
  169         (6)(a) Notwithstanding any other provision of law, if a
  170  when any health insurance policy, health care services plan, or
  171  other contract provides for payment for surgical first assisting
  172  benefits or services, the policy, plan, or contract shall is to
  173  be construed as providing for payment to a physician assistant
  174  or a registered nurse first assistant or employers of a
  175  physician assistant or registered nurse first assistant who
  176  performs such services that are within the scope of a physician
  177  assistant’s or a registered nurse first assistant’s professional
  178  license. This paragraph applies The provisions of this
  179  subsection apply only if reimbursement for an assisting
  180  physician, licensed under chapter 458 or chapter 459, would be
  181  covered and a physician assistant or a registered nurse first
  182  assistant who performs such services is used as a substitute.
  183         (b)1. Notwithstanding any other provision of law, if a
  184  health insurance policy, health care services plan, or other
  185  contract provides for payment for surgical first assisting
  186  benefits or services, the policy, plan, or contract shall be
  187  construed as providing for payment to a certified surgical first
  188  assistant or to the employer of a certified surgical first
  189  assistant who performs such services that are assigned by the
  190  supervising physician or osteopathic physician. This paragraph
  191  applies only if reimbursement for an assisting physician
  192  licensed under chapter 458 or chapter 459 would be covered and
  193  the certified surgical first assistant who performs such
  194  services is used as a substitute. As used in this paragraph, the
  195  term “certified surgical first assistant” means a person who is
  196  a licensed health care provider who is directly accountable to a
  197  physician licensed under chapter 458 or an osteopathic physician
  198  licensed under chapter 459 and who is certified by the National
  199  Surgical Assistant Association, the Liaison Council on
  200  Certification for the Surgical Technologist, or the American
  201  Board of Surgical Assistants.
  202         2. This paragraph does not require an insurer to directly
  203  reimburse a certified surgical first assistant if the certified
  204  surgical first assistant is paid or will be paid for a surgical
  205  procedure by the health care facility at which the surgical
  206  procedure is performed.
  207         Section 3. This act shall take effect July 1, 2011.