Florida Senate - 2012 SB 774
By Senator Hays
20-00416A-12 2012774__
1 A bill to be entitled
2 An act relating to physician assistants; amending s.
3 458.307, F.S.; revising the membership of the Board of
4 Medicine within the Department of Health to include a
5 member who is a certified physician assistant;
6 providing for the initial appointment of the certified
7 physician assistant; amending s. 458.347, F.S.;
8 deleting the department’s requirement to issue a
9 license authorizing a physician assistant to prescribe
10 or dispense certain medication; conforming provisions
11 to changes made by the act; deleting a fee to fund the
12 licensing of a physician assistant who is authorized
13 to prescribe or dispense certain medication; amending
14 s. 459.004, F.S.; revising the membership of the Board
15 of Osteopathic Medicine within the department to
16 include a member who is a certified physician
17 assistant; providing for the initial appointment of
18 the certified physician assistant; amending s.
19 459.022, F.S.; deleting the department’s requirement
20 to issue a license to a physician assistant who is
21 authorized to prescribe or dispense certain
22 medication; providing an effective date.
23
24 Be It Enacted by the Legislature of the State of Florida:
25
26 Section 1. Subsections (2) and (3) of section 458.307,
27 Florida Statutes, are amended to read:
28 458.307 Board of Medicine.—
29 (2) Twelve members of the board must be licensed physicians
30 in good standing in this state who are residents of the state
31 and who have been engaged in the active practice or teaching of
32 medicine for at least 4 years immediately preceding their
33 appointment. One of the physicians must be on the full-time
34 faculty of a medical school in this state, and one of the
35 physicians must be in private practice and on the full-time
36 staff of a statutory teaching hospital in this state as defined
37 in s. 408.07. At least one of the physicians must be a graduate
38 of a foreign medical school. One member must be a certified
39 physician assistant who has prescribing privileges and has
40 worked in this state for at least 4 years. The remaining two
41 three members must be residents of the state who are not, and
42 never have been, licensed health care practitioners. One member
43 must be a health care risk manager licensed under s. 395.10974.
44 At least one member of the board must be 60 years of age or
45 older.
46 (3)(a) As the terms of the members expire, the Governor
47 shall appoint successors for terms of 4 years, and such members
48 shall serve until their successors are appointed.
49 (b) After July 1, 2012, the Governor shall initially
50 appoint the certified physician assistant to the board when:
51 1. A member who is not a licensed health care practitioner
52 vacates his or her position on the board; or
53 2. The term of a member who is not a licensed health care
54 practitioner expires,
55
56 whichever occurs first.
57 Section 2. Paragraphs (e) and (f) of subsection (4) of
58 section 458.347, Florida Statutes, are amended to read:
59 458.347 Physician assistants.—
60 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
61 (e) A supervisory physician may delegate to a fully
62 licensed physician assistant the authority to prescribe or
63 dispense any medication used in the supervisory physician’s
64 practice unless such medication is listed on the formulary
65 created pursuant to paragraph (f). A fully licensed physician
66 assistant may only prescribe or dispense such medication only
67 under the following circumstances:
68 1. A physician assistant must clearly identify to the
69 patient that he or she is a physician assistant. Furthermore,
70 the physician assistant must inform the patient that the patient
71 has the right to see the physician before prior to any
72 prescription is being prescribed or dispensed by the physician
73 assistant.
74 2. The supervisory physician must notify the department of
75 his or her intent to delegate, on a department-approved form,
76 before delegating such authority and notify the department of
77 any change in prescriptive privileges of the physician
78 assistant. Authority to dispense may be delegated only by a
79 supervising physician who is registered as a dispensing
80 practitioner in compliance with s. 465.0276.
81 3. The physician assistant must file with the department,
82 before commencing to prescribe or dispense, evidence that he or
83 she has completed a continuing medical education course of at
84 least 3 classroom hours in prescriptive practice, conducted by
85 an accredited program approved by the boards, which course
86 covers the limitations, responsibilities, and privileges
87 involved in prescribing medicinal drugs, or evidence that he or
88 she has received education comparable to the continuing
89 education course as part of an accredited physician assistant
90 training program.
91 4. The physician assistant must file with the department a
92 signed affidavit that he or she has completed a minimum of 10
93 continuing medical education hours in the specialty practice in
94 which the physician assistant has prescriptive privileges with
95 each licensure renewal application.
96 5. The department shall issue a license and a prescriber
97 number to the physician assistant granting authority for the
98 prescribing of medicinal drugs authorized within this paragraph
99 upon completion of the foregoing requirements. The physician
100 assistant is shall not be required to independently register
101 pursuant to s. 465.0276.
102 6. The prescription must be written in a form that complies
103 with chapter 499 and must contain, in addition to the
104 supervisory physician’s name, address, and telephone number, the
105 physician assistant’s prescriber number. Unless it is a drug or
106 drug sample dispensed by the physician assistant, the
107 prescription must be filled in a pharmacy permitted under
108 chapter 465 and must be dispensed in that pharmacy by a
109 pharmacist licensed under chapter 465. The appearance of the
110 prescriber number creates a presumption that the physician
111 assistant is authorized to prescribe the medicinal drug and the
112 prescription is valid.
113 7. The physician assistant must note the prescription or
114 dispensing of medication in the appropriate medical record.
115 8. This paragraph does not prohibit a supervisory physician
116 from delegating to a physician assistant the authority to order
117 medication for a hospitalized patient of the supervisory
118 physician.
119
120 This paragraph does not apply to facilities licensed pursuant to
121 chapter 395.
122 (f)1. The council shall establish a formulary of medicinal
123 drugs that a fully licensed physician assistant who has
124 prescribing authority, licensed under this section or s.
125 459.022, may not prescribe. The formulary must include
126 controlled substances as defined in chapter 893, general
127 anesthetics, and radiographic contrast materials.
128 2. In establishing the formulary, the council shall consult
129 with a pharmacist licensed under chapter 465, but not licensed
130 under this chapter or chapter 459, who shall be selected by the
131 State Surgeon General.
132 3. Only the council shall add to, delete from, or modify
133 the formulary. Any person who requests an addition, deletion, or
134 modification of a medicinal drug listed on such formulary has
135 the burden of proof to show cause why such addition, deletion,
136 or modification should be made.
137 4. The boards shall adopt the formulary required by this
138 paragraph, and each addition, deletion, or modification to the
139 formulary, by rule. Notwithstanding any provision of chapter 120
140 to the contrary, the formulary rule shall be effective 60 days
141 after the date it is filed with the Secretary of State. Upon
142 adoption of the formulary, the department shall mail a copy of
143 such formulary to each fully licensed physician assistant who
144 has prescribing authority, licensed under this section or s.
145 459.022, and to each pharmacy licensed by the state. The boards
146 shall establish, by rule, a fee not to exceed $200 to fund the
147 provisions of this paragraph and paragraph (e).
148 Section 3. Subsections (2) and (3) of section 459.004,
149 Florida Statutes, are amended to read:
150 459.004 Board of Osteopathic Medicine.—
151 (2) Five members of the board must be licensed osteopathic
152 physicians in good standing in this state who are residents of
153 this state and who have been engaged in the practice of
154 osteopathic medicine for at least 4 years immediately before
155 prior to their appointment. One member must be a certified
156 physician assistant who has prescribing privileges and has
157 worked in this state for at least 4 years. The remaining member
158 two members must be a citizen citizens of the state who is are
159 not, and have never has been, a licensed health care
160 practitioner practitioners. At least one member of the board
161 must be 60 years of age or older.
162 (3)(a) As the terms of the members expire, the Governor
163 shall appoint successors for terms of 4 years, and such members
164 shall serve until their successors are appointed.
165 (b) After July 1, 2012, the Governor shall initially
166 appoint the certified physician assistant to the board when:
167 1. A member who is not a licensed health care practitioner
168 vacates his or her position on the board; or
169 2. The term of a member who is not a licensed health care
170 practitioner expires,
171
172 whichever occurs first.
173 Section 4. Paragraph (e) of subsection (4) of section
174 459.022, Florida Statutes, is amended to read:
175 459.022 Physician assistants.—
176 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
177 (e) A supervisory physician may delegate to a fully
178 licensed physician assistant the authority to prescribe or
179 dispense any medication used in the supervisory physician’s
180 practice unless such medication is listed on the formulary
181 created pursuant to s. 458.347. A fully licensed physician
182 assistant may only prescribe or dispense such medication only
183 under the following circumstances:
184 1. A physician assistant must clearly identify to the
185 patient that she or he is a physician assistant. Furthermore,
186 the physician assistant must inform the patient that the patient
187 has the right to see the physician before prior to any
188 prescription is being prescribed or dispensed by the physician
189 assistant.
190 2. The supervisory physician must notify the department of
191 her or his intent to delegate, on a department-approved form,
192 before delegating such authority and notify the department of
193 any change in prescriptive privileges of the physician
194 assistant. Authority to dispense may be delegated only by a
195 supervisory physician who is registered as a dispensing
196 practitioner in compliance with s. 465.0276.
197 3. The physician assistant must file with the department,
198 before commencing to prescribe or dispense, evidence that she or
199 he has completed a continuing medical education course of at
200 least 3 classroom hours in prescriptive practice, conducted by
201 an accredited program approved by the boards, which course
202 covers the limitations, responsibilities, and privileges
203 involved in prescribing medicinal drugs, or evidence that she or
204 he has received education comparable to the continuing education
205 course as part of an accredited physician assistant training
206 program.
207 4. The physician assistant must file with the department a
208 signed affidavit that she or he has completed a minimum of 10
209 continuing medical education hours in the specialty practice in
210 which the physician assistant has prescriptive privileges with
211 each licensure renewal application.
212 5. The department shall issue a license and a prescriber
213 number to the physician assistant granting authority for the
214 prescribing of medicinal drugs authorized within this paragraph
215 upon completion of the foregoing requirements. The physician
216 assistant is shall not be required to independently register
217 pursuant to s. 465.0276.
218 6. The prescription must be written in a form that complies
219 with chapter 499 and must contain, in addition to the
220 supervisory physician’s name, address, and telephone number, the
221 physician assistant’s prescriber number. Unless it is a drug or
222 drug sample dispensed by the physician assistant, the
223 prescription must be filled in a pharmacy permitted under
224 chapter 465, and must be dispensed in that pharmacy by a
225 pharmacist licensed under chapter 465. The appearance of the
226 prescriber number creates a presumption that the physician
227 assistant is authorized to prescribe the medicinal drug and the
228 prescription is valid.
229 7. The physician assistant must note the prescription or
230 dispensing of medication in the appropriate medical record.
231 8. This paragraph does not prohibit a supervisory physician
232 from delegating to a physician assistant the authority to order
233 medication for a hospitalized patient of the supervisory
234 physician.
235
236 This paragraph does not apply to facilities licensed under
237 pursuant to chapter 395.
238 Section 5. This act shall take effect July 1, 2012.