HB 363

1	A bill to be entitled
2	An act relating to physician assistants; amending ss.
3	458.307 and 459.004, F.S.; revising the composition of
4	the membership on the Board of Medicine and the Board
5	of Osteopathic Medicine; providing for the appointment
6	of new members as vacancies occur and allow; amending
7	ss. 458.347 and 459.022, F.S.; deleting the
8	requirement that the Department of Health issue a
9	license to a physician assistant to prescribe
10	medicinal drugs and requiring only a prescription
11	number; conforming provisions to changes made by the
12	act; providing an effective date.
13
14	Be It Enacted by the Legislature of the State of Florida:
15
16	Section 1.  Subsection (2) of section 458.307, Florida
17	Statutes, is amended to read:
18	458.307  Board of Medicine.-
19	(2)  Twelve members of the board must be licensed
20	physicians in good standing in this state who are residents of
21	the state and who have been engaged in the active practice or
22	teaching of medicine for at least 4 years immediately preceding
23	their appointment. One of the physicians must be on the full-
24	time faculty of a medical school in this state, and one of the
25	physicians must be in private practice and on the full-time
26	staff of a statutory teaching hospital in this state as defined
27	in s. 408.07. At least one of the physicians must be a graduate
28	of a foreign medical school. One member must be a physician
29	assistant licensed under this chapter with prescribing authority
30	who has worked in the state for at least 4 years. The remaining
31	two three members must be residents of the state who are not,
32	and never have been, licensed health care practitioners. One
33	member must be a health care risk manager licensed under s.
34	395.10974. At least one member of the board must be 60 years of
35	age or older.
36	Section 2.  Paragraphs (e) and (f) of subsection (4) of
37	section 458.347, Florida Statutes, are amended to read:
38	458.347  Physician assistants.-
39	(4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.-
40	(e)  A supervisory physician may delegate to a fully
41	licensed physician assistant the authority to prescribe or
42	dispense any medication used in the supervisory physician's
43	practice unless such medication is listed on the formulary
44	created pursuant to paragraph (f). A fully licensed physician
45	assistant may only prescribe or dispense such medication under
46	the following circumstances:
47	1.  A physician assistant must clearly identify to the
48	patient that he or she is a physician assistant. Furthermore,
49	the physician assistant must inform the patient that the patient
50	has the right to see the physician prior to any prescription
51	being prescribed or dispensed by the physician assistant.
52	2.  The supervisory physician must notify the department of
53	his or her intent to delegate, on a department-approved form,
54	before delegating such authority and notify the department of
55	any change in prescriptive privileges of the physician
56	assistant. Authority to dispense may be delegated only by a
57	supervising physician who is registered as a dispensing
58	practitioner in compliance with s. 465.0276.
59	3.  The physician assistant must file with the department,
60	before commencing to prescribe or dispense, evidence that he or
61	she has completed a continuing medical education course of at
62	least 3 classroom hours in prescriptive practice, conducted by
63	an accredited program approved by the boards, which course
64	covers the limitations, responsibilities, and privileges
65	involved in prescribing medicinal drugs, or evidence that he or
66	she has received education comparable to the continuing
67	education course as part of an accredited physician assistant
68	training program.
69	4.  The physician assistant must file with the department a
70	signed affidavit that he or she has completed a minimum of 10
71	continuing medical education hours in the specialty practice in
72	which the physician assistant has prescriptive privileges with
73	each licensure renewal application.
74	5.  The department shall issue a license and a prescriber
75	number to the physician assistant granting authority for the
76	prescribing of medicinal drugs authorized within this paragraph
77	upon completion of the foregoing requirements. The physician
78	assistant shall not be required to independently register
79	pursuant to s. 465.0276.
80	6.  The prescription must be written in a form that
81	complies with chapter 499 and must contain, in addition to the
82	supervisory physician's name, address, and telephone number, the
83	physician assistant's prescriber number. Unless it is a drug or
84	drug sample dispensed by the physician assistant, the
85	prescription must be filled in a pharmacy permitted under
86	chapter 465 and must be dispensed in that pharmacy by a
87	pharmacist licensed under chapter 465. The appearance of the
88	prescriber number creates a presumption that the physician
89	assistant is authorized to prescribe the medicinal drug and the
90	prescription is valid.
91	7.  The physician assistant must note the prescription or
92	dispensing of medication in the appropriate medical record.
93	8.  This paragraph does not prohibit a supervisory
94	physician from delegating to a physician assistant the authority
95	to order medication for a hospitalized patient of the
96	supervisory physician.
97
98	This paragraph does not apply to facilities licensed pursuant to
99	chapter 395.
100	(f)1.  The council shall establish a formulary of medicinal
101	drugs that a fully licensed physician assistant having
102	prescribing authority, licensed under this section or s.
103	459.022, may not prescribe. The formulary must include
104	controlled substances as defined in chapter 893, general
105	anesthetics, and radiographic contrast materials.
106	2.  In establishing the formulary, the council shall
107	consult with a pharmacist licensed under chapter 465, but not
108	licensed under this chapter or chapter 459, who shall be
109	selected by the State Surgeon General.
110	3.  Only the council shall add to, delete from, or modify
111	the formulary. Any person who requests an addition, deletion, or
112	modification of a medicinal drug listed on such formulary has
113	the burden of proof to show cause why such addition, deletion,
114	or modification should be made.
115	4.  The boards shall adopt the formulary required by this
116	paragraph, and each addition, deletion, or modification to the
117	formulary, by rule. Notwithstanding any provision of chapter 120
118	to the contrary, the formulary rule shall be effective 60 days
119	after the date it is filed with the Secretary of State. Upon
120	adoption of the formulary, the department shall mail a copy of
121	such formulary to each fully licensed physician assistant having
122	prescribing authority, licensed under this section or s.
123	459.022, and to each pharmacy licensed by the state. The boards
124	shall establish, by rule, a fee not to exceed $200 to fund the
125	provisions of this paragraph and paragraph (e).
126	Section 3.  Subsection (2) of section 459.004, Florida
127	Statutes, is amended to read:
128	459.004  Board of Osteopathic Medicine.-
129	(2)  Five members of the board must be licensed osteopathic
130	physicians in good standing in this state who are residents of
131	this state and who have been engaged in the practice of
132	osteopathic medicine for at least 4 years immediately prior to
133	their appointment. One member must be a physician assistant
134	licensed under this chapter with prescribing authority who has
135	worked in the state for at least 4 years. The remaining member
136	two members must be a citizen citizens of the state who is are
137	not, and has have never been, a licensed health care
138	practitioner practitioners. At least one member of the board
139	must be 60 years of age or older.
140	Section 4.  Paragraph (e) of subsection (4) of section
141	459.022, Florida Statutes, is amended to read:
142	459.022  Physician assistants.-
143	(4)  PERFORMANCE OF PHYSICIAN ASSISTANTS.-
144	(e)  A supervisory physician may delegate to a fully
145	licensed physician assistant the authority to prescribe or
146	dispense any medication used in the supervisory physician's
147	practice unless such medication is listed on the formulary
148	created pursuant to s. 458.347. A fully licensed physician
149	assistant may only prescribe or dispense such medication under
150	the following circumstances:
151	1.  A physician assistant must clearly identify to the
152	patient that she or he is a physician assistant. Furthermore,
153	the physician assistant must inform the patient that the patient
154	has the right to see the physician prior to any prescription
155	being prescribed or dispensed by the physician assistant.
156	2.  The supervisory physician must notify the department of
157	her or his intent to delegate, on a department-approved form,
158	before delegating such authority and notify the department of
159	any change in prescriptive privileges of the physician
160	assistant. Authority to dispense may be delegated only by a
161	supervisory physician who is registered as a dispensing
162	practitioner in compliance with s. 465.0276.
163	3.  The physician assistant must file with the department,
164	before commencing to prescribe or dispense, evidence that she or
165	he has completed a continuing medical education course of at
166	least 3 classroom hours in prescriptive practice, conducted by
167	an accredited program approved by the boards, which course
168	covers the limitations, responsibilities, and privileges
169	involved in prescribing medicinal drugs, or evidence that she or
170	he has received education comparable to the continuing education
171	course as part of an accredited physician assistant training
172	program.
173	4.  The physician assistant must file with the department a
174	signed affidavit that she or he has completed a minimum of 10
175	continuing medical education hours in the specialty practice in
176	which the physician assistant has prescriptive privileges with
177	each licensure renewal application.
178	5.  The department shall issue a license and a prescriber
179	number to the physician assistant granting authority for the
180	prescribing of medicinal drugs authorized within this paragraph
181	upon completion of the foregoing requirements. The physician
182	assistant shall not be required to independently register
183	pursuant to s. 465.0276.
184	6.  The prescription must be written in a form that
185	complies with chapter 499 and must contain, in addition to the
186	supervisory physician's name, address, and telephone number, the
187	physician assistant's prescriber number. Unless it is a drug or
188	drug sample dispensed by the physician assistant, the
189	prescription must be filled in a pharmacy permitted under
190	chapter 465, and must be dispensed in that pharmacy by a
191	pharmacist licensed under chapter 465. The appearance of the
192	prescriber number creates a presumption that the physician
193	assistant is authorized to prescribe the medicinal drug and the
194	prescription is valid.
195	7.  The physician assistant must note the prescription or
196	dispensing of medication in the appropriate medical record.
197	8.  This paragraph does not prohibit a supervisory
198	physician from delegating to a physician assistant the authority
199	to order medication for a hospitalized patient of the
200	supervisory physician.
201
202	This paragraph does not apply to facilities licensed pursuant to
203	chapter 395.
204	Section 5.  The amendment of sections 458.307 and 459.004,
205	Florida Statutes, by this act to change the composition of the
206	membership on the Board of Medicine and the Board of Osteopathic
207	Medicine shall be implemented as vacancies on those boards occur
208	and allow.
209	Section 6.  This act shall take effect July 1, 2012.

CODING: Words stricken are deletions; words underlined are additions.