Florida Senate - 2014                          SENATOR AMENDMENT
       Bill No. CS/CS/CS/HB 573, 2nd Eng.
       
       
       
       
       
       
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                              LEGISLATIVE ACTION                        
                    Senate             .             House              
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       Senator Sobel moved the following:
       
    1         Senate Substitute for Amendment (764744) (with title
    2  amendment)
    3  
    4         Between lines 2694 and 2695
    5  insert:
    6         Section 48. Subsection (3), paragraph (e) of subsection
    7  (4), and paragraphs (a), (c), and (e) of subsection (7) of
    8  section 458.347, Florida Statutes, are amended to read:
    9         458.347 Physician assistants.—
   10         (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
   11  group of physicians supervising a licensed physician assistant
   12  must be qualified in the medical areas in which the physician
   13  assistant is to perform and shall be individually or
   14  collectively responsible and liable for the performance and the
   15  acts and omissions of the physician assistant. A physician may
   16  not supervise more than five four currently licensed physician
   17  assistants at any one time. A physician supervising a physician
   18  assistant pursuant to this section may not be required to review
   19  and cosign charts or medical records prepared by such physician
   20  assistant. Notwithstanding this subsection, a physician may only
   21  supervise up to four physician assistants in medical offices
   22  other than the physician’s primary practice location pursuant to
   23  s. 458.348(4)(c).
   24         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   25         (e) A supervisory physician may delegate to a fully
   26  licensed physician assistant the authority to prescribe or
   27  dispense any medication used in the supervisory physician’s
   28  practice unless such medication is listed on the formulary
   29  created pursuant to paragraph (f). A fully licensed physician
   30  assistant may only prescribe or dispense such medication under
   31  the following circumstances:
   32         1. A physician assistant must clearly identify to the
   33  patient that he or she is a physician assistant. Furthermore,
   34  the physician assistant must inform the patient that the patient
   35  has the right to see the physician prior to any prescription
   36  being prescribed or dispensed by the physician assistant.
   37         2. The supervisory physician must notify the department of
   38  his or her intent to delegate, on a department-approved form,
   39  before delegating such authority and notify the department of
   40  any change in prescriptive privileges of the physician
   41  assistant. Authority to dispense may be delegated only by a
   42  supervising physician who is registered as a dispensing
   43  practitioner in compliance with s. 465.0276.
   44         3. The physician assistant must certify to file with the
   45  department a signed affidavit that he or she has completed a
   46  minimum of 10 continuing medical education hours in the
   47  specialty practice in which the physician assistant has
   48  prescriptive privileges with each licensure renewal application.
   49         4. The department may issue a prescriber number to the
   50  physician assistant granting authority for the prescribing of
   51  medicinal drugs authorized within this paragraph upon completion
   52  of the foregoing requirements. The physician assistant shall not
   53  be required to independently register pursuant to s. 465.0276.
   54         5. The prescription may must be written or electronic, but
   55  must be in a form that complies with ss. 456.0392(1) and
   56  456.42(1) chapter 499 and must contain, in addition to the
   57  supervisory physician’s name, address, and telephone number, the
   58  physician assistant’s prescriber number. Unless it is a drug or
   59  drug sample dispensed by the physician assistant, the
   60  prescription must be filled in a pharmacy permitted under
   61  chapter 465 and must be dispensed in that pharmacy by a
   62  pharmacist licensed under chapter 465. The appearance of the
   63  prescriber number creates a presumption that the physician
   64  assistant is authorized to prescribe the medicinal drug and the
   65  prescription is valid.
   66         6. The physician assistant must note the prescription or
   67  dispensing of medication in the appropriate medical record.
   68         (7) PHYSICIAN ASSISTANT LICENSURE.—
   69         (a) Any person desiring to be licensed as a physician
   70  assistant must apply to the department. The department shall
   71  issue a license to any person certified by the council as having
   72  met the following requirements:
   73         1. Is at least 18 years of age.
   74         2. Has satisfactorily passed a proficiency examination by
   75  an acceptable score established by the National Commission on
   76  Certification of Physician Assistants. If an applicant does not
   77  hold a current certificate issued by the National Commission on
   78  Certification of Physician Assistants and has not actively
   79  practiced as a physician assistant within the immediately
   80  preceding 4 years, the applicant must retake and successfully
   81  complete the entry-level examination of the National Commission
   82  on Certification of Physician Assistants to be eligible for
   83  licensure.
   84         3. Has completed the application form and remitted an
   85  application fee not to exceed $300 as set by the boards. An
   86  application for licensure made by a physician assistant must
   87  include:
   88         a. A certificate of completion of a physician assistant
   89  training program specified in subsection (6).
   90         b. A sworn statement of any prior felony convictions.
   91         c. A sworn statement of any previous revocation or denial
   92  of licensure or certification in any state.
   93         d. Two letters of recommendation.
   94         d.e. A copy of course transcripts and a copy of the course
   95  description from a physician assistant training program
   96  describing course content in pharmacotherapy, if the applicant
   97  wishes to apply for prescribing authority. These documents must
   98  meet the evidence requirements for prescribing authority.
   99         e. For physician assistants seeking initial licensure on or
  100  after January 1, 2015, fingerprints pursuant to s. 456.0135.
  101         (c) The license must be renewed biennially. Each renewal
  102  must include:
  103         1. A renewal fee not to exceed $500 as set by the boards.
  104         2. A sworn statement of no felony convictions in the
  105  previous 2 years.
  106         (e) Upon employment as a physician assistant, a licensed
  107  physician assistant must notify the department in writing within
  108  30 days after such employment and provide or after any
  109  subsequent changes in the supervising physician. The
  110  notification must include the full name, Florida medical license
  111  number, specialty, and address of a designated the supervising
  112  physician. Any subsequent change in the designated supervising
  113  physician shall be reported to the department within 30 days
  114  after the change. Assignment of a designated supervising
  115  physician does not preclude a physician assistant from
  116  practicing under multiple supervising physicians.
  117         Section 49. Subsection (3), paragraph (e) of subsection
  118  (4), and paragraphs (a), (b), and (d) of subsection (7) of
  119  section 459.022, Florida Statutes, are amended to read:
  120         459.022 Physician assistants.—
  121         (3) PERFORMANCE OF SUPERVISING PHYSICIAN.—Each physician or
  122  group of physicians supervising a licensed physician assistant
  123  must be qualified in the medical areas in which the physician
  124  assistant is to perform and shall be individually or
  125  collectively responsible and liable for the performance and the
  126  acts and omissions of the physician assistant. A physician may
  127  not supervise more than five four currently licensed physician
  128  assistants at any one time. A physician supervising a physician
  129  assistant pursuant to this section may not be required to review
  130  and cosign charts or medical records prepared by such physician
  131  assistant. Notwithstanding this subsection, a physician may only
  132  supervise up to four physician assistants in medical offices
  133  other than the physician’s primary practice location pursuant to
  134  s. 459.025(3)(c).
  135         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
  136         (e) A supervisory physician may delegate to a fully
  137  licensed physician assistant the authority to prescribe or
  138  dispense any medication used in the supervisory physician’s
  139  practice unless such medication is listed on the formulary
  140  created pursuant to s. 458.347. A fully licensed physician
  141  assistant may only prescribe or dispense such medication under
  142  the following circumstances:
  143         1. A physician assistant must clearly identify to the
  144  patient that she or he is a physician assistant. Furthermore,
  145  the physician assistant must inform the patient that the patient
  146  has the right to see the physician prior to any prescription
  147  being prescribed or dispensed by the physician assistant.
  148         2. The supervisory physician must notify the department of
  149  her or his intent to delegate, on a department-approved form,
  150  before delegating such authority and notify the department of
  151  any change in prescriptive privileges of the physician
  152  assistant. Authority to dispense may be delegated only by a
  153  supervisory physician who is registered as a dispensing
  154  practitioner in compliance with s. 465.0276.
  155         3. The physician assistant must certify to file with the
  156  department a signed affidavit that she or he has completed a
  157  minimum of 10 continuing medical education hours in the
  158  specialty practice in which the physician assistant has
  159  prescriptive privileges with each licensure renewal application.
  160         4. The department may issue a prescriber number to the
  161  physician assistant granting authority for the prescribing of
  162  medicinal drugs authorized within this paragraph upon completion
  163  of the foregoing requirements. The physician assistant shall not
  164  be required to independently register pursuant to s. 465.0276.
  165         5. The prescription may must be written or electronic, but
  166  must be in a form that complies with ss. 456.0392(1) and
  167  456.42(1) chapter 499 and must contain, in addition to the
  168  supervisory physician’s name, address, and telephone number, the
  169  physician assistant’s prescriber number. Unless it is a drug or
  170  drug sample dispensed by the physician assistant, the
  171  prescription must be filled in a pharmacy permitted under
  172  chapter 465, and must be dispensed in that pharmacy by a
  173  pharmacist licensed under chapter 465. The appearance of the
  174  prescriber number creates a presumption that the physician
  175  assistant is authorized to prescribe the medicinal drug and the
  176  prescription is valid.
  177         6. The physician assistant must note the prescription or
  178  dispensing of medication in the appropriate medical record.
  179         (7) PHYSICIAN ASSISTANT LICENSURE.—
  180         (a) Any person desiring to be licensed as a physician
  181  assistant must apply to the department. The department shall
  182  issue a license to any person certified by the council as having
  183  met the following requirements:
  184         1. Is at least 18 years of age.
  185         2. Has satisfactorily passed a proficiency examination by
  186  an acceptable score established by the National Commission on
  187  Certification of Physician Assistants. If an applicant does not
  188  hold a current certificate issued by the National Commission on
  189  Certification of Physician Assistants and has not actively
  190  practiced as a physician assistant within the immediately
  191  preceding 4 years, the applicant must retake and successfully
  192  complete the entry-level examination of the National Commission
  193  on Certification of Physician Assistants to be eligible for
  194  licensure.
  195         3. Has completed the application form and remitted an
  196  application fee not to exceed $300 as set by the boards. An
  197  application for licensure made by a physician assistant must
  198  include:
  199         a. A certificate of completion of a physician assistant
  200  training program specified in subsection (6).
  201         b. A sworn statement of any prior felony convictions.
  202         c. A sworn statement of any previous revocation or denial
  203  of licensure or certification in any state.
  204         d. Two letters of recommendation.
  205         d.e. A copy of course transcripts and a copy of the course
  206  description from a physician assistant training program
  207  describing course content in pharmacotherapy, if the applicant
  208  wishes to apply for prescribing authority. These documents must
  209  meet the evidence requirements for prescribing authority.
  210         e. For physician assistants seeking initial licensure on or
  211  after January 1, 2015, fingerprints pursuant to s. 456.0135.
  212         (b) The licensure must be renewed biennially. Each renewal
  213  must include:
  214         1. A renewal fee not to exceed $500 as set by the boards.
  215         2. A sworn statement of no felony convictions in the
  216  previous 2 years.
  217         (d) Upon employment as a physician assistant, a licensed
  218  physician assistant must notify the department in writing within
  219  30 days after such employment and provide or after any
  220  subsequent changes in the supervising physician. The
  221  notification must include the full name, Florida medical license
  222  number, specialty, and address of a designated the supervising
  223  physician. Any subsequent change in the designated supervising
  224  physician shall be reported to the department within 30 days
  225  after the change. Assignment of a designated supervising
  226  physician does not preclude a physician assistant from
  227  practicing under multiple supervising physicians.
  228  
  229  ================= T I T L E  A M E N D M E N T ================
  230  And the title is amended as follows:
  231         Delete line 292
  232  and insert:
  233         home health agencies; amending ss. 458.347 and
  234         459.022, F.S.; increasing the number of licensed
  235         physician assistants that a physician may supervise at
  236         any one time; providing an exception; revising
  237         circumstances under which a physician assistant is
  238         authorized to prescribe or dispense medication;
  239         revising requirements for medications prescribed or
  240         dispensed by physician assistants; revising
  241         application requirements for licensure as a physician
  242         assistant and license renewal; providing effective
  243         dates.