Florida Senate - 2012 COMMITTEE AMENDMENT
Bill No. SB 774
Barcode 803746
LEGISLATIVE ACTION
Senate . House
Comm: RCS .
01/19/2012 .
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The Committee on Health Regulation (Fasano) recommended the
following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Subsection (2) of section 458.307, Florida
6 Statutes, is amended to read:
7 458.307 Board of Medicine.—
8 (2) Twelve members of the board must be licensed physicians
9 in good standing in this state who are residents of the state
10 and who have been engaged in the active practice or teaching of
11 medicine for at least 4 years immediately preceding their
12 appointment. One of the physicians must be on the full-time
13 faculty of a medical school in this state, and one of the
14 physicians must be in private practice and on the full-time
15 staff of a statutory teaching hospital in this state as defined
16 in s. 408.07. At least one of the physicians must be a graduate
17 of a foreign medical school. One member must be a physician
18 assistant licensed under this chapter who has prescribing
19 authority and who has worked in the state for at least 4 years.
20 The remaining two three members must be residents of the state
21 who are not, and never have been, licensed health care
22 practitioners. One member must be a health care risk manager
23 licensed under s. 395.10974. At least one member of the board
24 must be 60 years of age or older.
25 Section 2. Paragraphs (e) and (f) of subsection (4) and
26 paragraphs (a) and (c) of subsection (7) of section 458.347,
27 Florida Statutes, are amended to read:
28 458.347 Physician assistants.—
29 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
30 (e) A supervisory physician may delegate to a fully
31 licensed physician assistant the authority to prescribe or
32 dispense any medication used in the supervisory physician’s
33 practice unless such medication is listed on the formulary
34 created pursuant to paragraph (f). A fully licensed physician
35 assistant may only prescribe or dispense such medication under
36 the following circumstances:
37 1. A physician assistant must clearly identify to the
38 patient that he or she is a physician assistant. Furthermore,
39 the physician assistant must inform the patient that the patient
40 has the right to see the physician prior to any prescription
41 being prescribed or dispensed by the physician assistant.
42 2. The supervisory physician must notify the department of
43 his or her intent to delegate, on a department-approved form,
44 before delegating such authority and notify the department of
45 any change in prescriptive privileges of the physician
46 assistant. Authority to dispense may be delegated only by a
47 supervising physician who is registered as a dispensing
48 practitioner in compliance with s. 465.0276.
49 3. The physician assistant must file with the department,
50 at the time of initial application before commencing to
51 prescribe or dispense, evidence that he or she has completed a
52 continuing medical education course in pharmacotherapeutics, to
53 include the initiation, selection, and modification of selected
54 medications, and the limitations, responsibilities, and
55 privileges involved in prescribing medicinal drugs. The course
56 must have been of at least 3 classroom hours in prescriptive
57 practice, conducted by a an accredited program accredited by the
58 Commission on Accreditation of Allied Health Programs or its
59 successor organization. The department shall issue a prescriber
60 number if the evidence submitted meets the requirements. The
61 physician assistant must receive a prescriber number before
62 commencing to prescribe or dispense medicinal drugs approved by
63 the boards, which course covers the limitations,
64 responsibilities, and privileges involved in prescribing
65 medicinal drugs, or evidence that he or she has received
66 education comparable to the continuing education course as part
67 of an accredited physician assistant training program.
68 4. The physician assistant must file with the department a
69 signed affidavit that he or she has completed a minimum of 10
70 continuing medical education hours in the specialty practice in
71 which the physician assistant has prescriptive privileges with
72 each licensure renewal application.
73 5. The department shall issue a license and a prescriber
74 number to the physician assistant granting authority for the
75 prescribing of medicinal drugs authorized within this paragraph
76 upon completion of the foregoing requirements. The physician
77 assistant shall not be required to independently register
78 pursuant to s. 465.0276.
79 6. The prescription must be written in a form that complies
80 with chapter 499 and must contain, in addition to the
81 supervisory physician’s name, address, and telephone number, the
82 physician assistant’s prescriber number. Unless it is a drug or
83 drug sample dispensed by the physician assistant, the
84 prescription must be filled in a pharmacy permitted under
85 chapter 465 and must be dispensed in that pharmacy by a
86 pharmacist licensed under chapter 465. The appearance of the
87 prescriber number creates a presumption that the physician
88 assistant is authorized to prescribe the medicinal drug and the
89 prescription is valid.
90 7. The physician assistant must note the prescription or
91 dispensing of medication in the appropriate medical record.
92 8. This paragraph does not prohibit a supervisory physician
93 from delegating to a physician assistant the authority to order
94 medication for a hospitalized patient of the supervisory
95 physician.
96
97 This paragraph does not apply to facilities licensed pursuant to
98 chapter 395.
99 (f)1. The council shall establish a formulary of medicinal
100 drugs that a fully licensed physician assistant having
101 prescribing authority, licensed under this section or s.
102 459.022, may not prescribe. The formulary must include
103 controlled substances as defined in chapter 893, general
104 anesthetics, and radiographic contrast materials.
105 2. In establishing the formulary, the council shall consult
106 with a pharmacist licensed under chapter 465, but not licensed
107 under this chapter or chapter 459, who shall be selected by the
108 State Surgeon General.
109 3. Only the council shall add to, delete from, or modify
110 the formulary. Any person who requests an addition, deletion, or
111 modification of a medicinal drug listed on such formulary has
112 the burden of proof to show cause why such addition, deletion,
113 or modification should be made.
114 4. The boards shall adopt the formulary required by this
115 paragraph, and each addition, deletion, or modification to the
116 formulary, by rule. Notwithstanding any provision of chapter 120
117 to the contrary, the formulary rule shall be effective 60 days
118 after the date it is filed with the Secretary of State. Upon
119 adoption of the formulary, the department shall mail a copy of
120 such formulary to each fully licensed physician assistant having
121 prescribing authority, licensed under this section or s.
122 459.022, and to each pharmacy licensed by the state. The boards
123 shall establish, by rule, a fee not to exceed $200 to fund the
124 provisions of this paragraph and paragraph (e).
125 (7) PHYSICIAN ASSISTANT LICENSURE.—
126 (a) Any person desiring to be licensed as a physician
127 assistant must apply to the department. The department shall
128 issue a license to any person certified by the council as having
129 met the following requirements:
130 1. Is at least 18 years of age.
131 2. Has satisfactorily passed a proficiency examination by
132 an acceptable score established by the National Commission on
133 Certification of Physician Assistants. If an applicant does not
134 hold a current certificate issued by the National Commission on
135 Certification of Physician Assistants and has not actively
136 practiced as a physician assistant within the immediately
137 preceding 4 years, the applicant must retake and successfully
138 complete the entry-level examination of the National Commission
139 on Certification of Physician Assistants to be eligible for
140 licensure.
141 3. Has completed the application form and remitted an
142 application fee not to exceed $300 as set by the boards. An
143 application for licensure made by a physician assistant must
144 include:
145 a. A certificate of completion of a physician assistant
146 training program specified in subsection (6).
147 b. A sworn statement of any prior felony convictions.
148 c. A sworn statement of any previous revocation or denial
149 of licensure or certification in any state.
150 d. Two letters of recommendation.
151 e. A copy of course transcripts and a copy of the course
152 description from a physician assistant training program
153 describing a pharmacotherapy course pursuant to subparagraph
154 (4)(e)3., if the applicant wishes to apply for a prescriber
155 number. These documents must meet the evidence requirements for
156 prescribing authority.
157 (c) The license must be renewed biennially. Each renewal
158 must include:
159 1. A renewal fee not to exceed $500 as set by the boards.
160 2. A sworn statement of no felony convictions in the
161 previous 2 years.
162
163 A licensed physician assistant without prescribing authority may
164 request a prescriber number upon biennial licensure renewal
165 under this paragraph by submitting evidence that he or she has
166 completed a continuing medical education course of at least 3
167 classroom hours in prescriptive practice, covering the
168 limitations, responsibilities, and privileges involved in
169 prescribing medicinal drugs. The course must be conducted by an
170 accredited program approved by the boards. The physician
171 assistant must receive a prescriber number before commencing to
172 prescribe or dispense medicinal drugs.
173 Section 3. Subsection (2) of section 459.004, Florida
174 Statutes, is amended to read:
175 459.004 Board of Osteopathic Medicine.—
176 (2) Five members of the board must be licensed osteopathic
177 physicians in good standing in this state who are residents of
178 this state and who have been engaged in the practice of
179 osteopathic medicine for at least 4 years immediately prior to
180 their appointment. One member must be a physician assistant
181 licensed under this chapter who has prescribing authority and
182 who has worked in the state for at least 4 years. The remaining
183 member two members must be a citizen citizens of the state who
184 is are not, and has have never been, a licensed health care
185 practitioner practitioners. At least one member of the board
186 must be 60 years of age or older.
187 Section 4. Paragraph (e) of subsection (4) and paragraphs
188 (a) and (b) of subsection (7) of section 459.022, Florida
189 Statutes, are amended to read:
190 459.022 Physician assistants.—
191 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
192 (e) A supervisory physician may delegate to a fully
193 licensed physician assistant the authority to prescribe or
194 dispense any medication used in the supervisory physician’s
195 practice unless such medication is listed on the formulary
196 created pursuant to s. 458.347. A fully licensed physician
197 assistant may only prescribe or dispense such medication under
198 the following circumstances:
199 1. A physician assistant must clearly identify to the
200 patient that she or he is a physician assistant. Furthermore,
201 the physician assistant must inform the patient that the patient
202 has the right to see the physician prior to any prescription
203 being prescribed or dispensed by the physician assistant.
204 2. The supervisory physician must notify the department of
205 her or his intent to delegate, on a department-approved form,
206 before delegating such authority and notify the department of
207 any change in prescriptive privileges of the physician
208 assistant. Authority to dispense may be delegated only by a
209 supervisory physician who is registered as a dispensing
210 practitioner in compliance with s. 465.0276.
211 3. The physician assistant must file with the department,
212 at the time of the initial application before commencing to
213 prescribe or dispense, evidence that she or he has completed a
214 continuing medical education course in pharmacotherapeutics, to
215 include the initiation, selection, and modification of selected
216 medications, and the limitations, responsibilities, and
217 privileges involved in prescribing medicinal drugs. The course
218 must have been of at least 3 classroom hours in prescriptive
219 practice, conducted by a an accredited program accredited by the
220 Commission on Accreditation of Allied Health Programs or its
221 successor organization. The department shall issue a prescriber
222 number if the evidence submitted meets the requirements. The
223 physician assistant must receive a prescriber number before
224 commencing to prescribe or dispense medicinal drugs approved by
225 the boards, which course covers the limitations,
226 responsibilities, and privileges involved in prescribing
227 medicinal drugs, or evidence that she or he has received
228 education comparable to the continuing education course as part
229 of an accredited physician assistant training program.
230 4. The physician assistant must file with the department a
231 signed affidavit that she or he has completed a minimum of 10
232 continuing medical education hours in the specialty practice in
233 which the physician assistant has prescriptive privileges with
234 each licensure renewal application.
235 5. The department shall issue a license and a prescriber
236 number to the physician assistant granting authority for the
237 prescribing of medicinal drugs authorized within this paragraph
238 upon completion of the foregoing requirements. The physician
239 assistant shall not be required to independently register
240 pursuant to s. 465.0276.
241 6. The prescription must be written in a form that complies
242 with chapter 499 and must contain, in addition to the
243 supervisory physician’s name, address, and telephone number, the
244 physician assistant’s prescriber number. Unless it is a drug or
245 drug sample dispensed by the physician assistant, the
246 prescription must be filled in a pharmacy permitted under
247 chapter 465, and must be dispensed in that pharmacy by a
248 pharmacist licensed under chapter 465. The appearance of the
249 prescriber number creates a presumption that the physician
250 assistant is authorized to prescribe the medicinal drug and the
251 prescription is valid.
252 7. The physician assistant must note the prescription or
253 dispensing of medication in the appropriate medical record.
254 8. This paragraph does not prohibit a supervisory physician
255 from delegating to a physician assistant the authority to order
256 medication for a hospitalized patient of the supervisory
257 physician.
258
259 This paragraph does not apply to facilities licensed pursuant to
260 chapter 395.
261 (7) PHYSICIAN ASSISTANT LICENSURE.—
262 (a) Any person desiring to be licensed as a physician
263 assistant must apply to the department. The department shall
264 issue a license to any person certified by the council as having
265 met the following requirements:
266 1. Is at least 18 years of age.
267 2. Has satisfactorily passed a proficiency examination by
268 an acceptable score established by the National Commission on
269 Certification of Physician Assistants. If an applicant does not
270 hold a current certificate issued by the National Commission on
271 Certification of Physician Assistants and has not actively
272 practiced as a physician assistant within the immediately
273 preceding 4 years, the applicant must retake and successfully
274 complete the entry-level examination of the National Commission
275 on Certification of Physician Assistants to be eligible for
276 licensure.
277 3. Has completed the application form and remitted an
278 application fee not to exceed $300 as set by the boards. An
279 application for licensure made by a physician assistant must
280 include:
281 a. A certificate of completion of a physician assistant
282 training program specified in subsection (6).
283 b. A sworn statement of any prior felony convictions.
284 c. A sworn statement of any previous revocation or denial
285 of licensure or certification in any state.
286 d. Two letters of recommendation.
287 e. A copy of course transcripts and a copy of the course
288 description from a physician assistant training program
289 describing a pharmacotherapy course pursuant to subparagraph
290 (4)(e)3., if the applicant wishes to apply for a prescriber
291 number. These documents must meet the evidence requirements for
292 prescribing authority.
293 (b) The licensure must be renewed biennially. Each renewal
294 must include:
295 1. A renewal fee not to exceed $500 as set by the boards.
296 2. A sworn statement of no felony convictions in the
297 previous 2 years.
298
299 A licensed physician assistant without prescribing authority may
300 request a prescriber number upon biennial licensure renewal
301 under this paragraph by submitting evidence that she or he has
302 completed a continuing medical education course of at least 3
303 classroom hours in prescriptive practice, covering the
304 limitations, responsibilities, and privileges involved in
305 prescribing medicinal drugs. The course must be conducted by an
306 accredited program approved by the boards. The physician
307 assistant must receive a prescriber number before commencing to
308 prescribe or dispense medicinal drugs.
309 Section 5. The amendment of sections 458.307 and 459.004,
310 Florida Statutes, made by this act to change the composition of
311 the membership on the Board of Medicine and the Board of
312 Osteopathic Medicine shall be implemented as vacancies on those
313 boards occur and allow.
314 Section 6. This act shall take effect July 1, 2012.
315
316 ================= T I T L E A M E N D M E N T ================
317 And the title is amended as follows:
318 Delete everything before the enacting clause
319 and insert:
320 A bill to be entitled
321 An act relating to physician assistants; amending ss.
322 458.307 and 459.004, F.S.; revising the composition of
323 the membership on the Board of Medicine and the Board
324 of Osteopathic Medicine; providing for the appointment
325 of new members as vacancies occur and allow; amending
326 ss. 458.347 and 459.022, F.S.; deleting the
327 requirement that the Department of Health issue a
328 license to a physician assistant to prescribe
329 medicinal drugs and requiring only a prescription
330 number; requiring that a physician assistant seeking
331 to prescribe medicinal drugs submit certain evidence
332 at the time of initial licensure of completion of a
333 course in pharmacotherapeutics from an accredited
334 program; providing that a physician assistant wishing
335 to apply for a prescriber number must submit course
336 transcripts and a copy of the course description in
337 addition to other licensure application requirements;
338 requiring that a physician assistant seeking to apply
339 for a prescriber number upon biennial licensure
340 renewal submit evidence of completion of at least a
341 certain number of classroom hours in an approved
342 program that covers prescribing limitations,
343 responsibilities, and privileges involved in
344 prescribing medicinal drugs; conforming provisions to
345 changes made by the act; providing an effective date.