Florida Senate - 2016                          SENATOR AMENDMENT
       Bill No. CS for HB 977
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                 Floor: WD/2R          .                                
             03/09/2016 05:48 PM       .                                

       Senator Bean moved the following:
    1         Senate Amendment to Amendment (510114) (with title
    2  amendment)
    4         Delete line 109
    5  and insert:
    6         Section 4. Paragraph (e) of subsection (4) of section
    7  458.347, Florida Statutes, is amended, and paragraph (c) of
    8  subsection (9) of that section is republished, to read:
    9         458.347 Physician assistants.—
   11         (e) A supervisory physician may delegate to a fully
   12  licensed physician assistant the authority to prescribe or
   13  dispense any medication used in the supervisory physician’s
   14  practice unless such medication is listed on the formulary
   15  created pursuant to paragraph (f). A fully licensed physician
   16  assistant may only prescribe or dispense such medication under
   17  the following circumstances:
   18         1. A physician assistant must clearly identify to the
   19  patient that he or she is a physician assistant. Furthermore,
   20  the physician assistant must inform the patient that the patient
   21  has the right to see the physician prior to any prescription
   22  being prescribed or dispensed by the physician assistant.
   23         2. The supervisory physician must notify the department of
   24  his or her intent to delegate, on a department-approved form,
   25  before delegating such authority and notify the department of
   26  any change in prescriptive privileges of the physician
   27  assistant. Authority to dispense may be delegated only by a
   28  supervising physician who is registered as a dispensing
   29  practitioner in compliance with s. 465.0276.
   30         3. The physician assistant must file with the department a
   31  signed affidavit that he or she has completed a minimum of 10
   32  continuing medical education hours in the specialty practice in
   33  which the physician assistant has prescriptive privileges with
   34  each licensure renewal application. Three of the 10 hours must
   35  consist of a continuing education course on the safe and
   36  effective prescribing of controlled substance medications which
   37  is offered by a statewide professional association of physicians
   38  in this state accredited to provide educational activities
   39  designated for the American Medical Association Physician’s
   40  Recognition Award Category 1 credit or designated by the
   41  American Academy of Physician Assistants as a Category 1 credit.
   42         4. The department may issue a prescriber number to the
   43  physician assistant granting authority for the prescribing of
   44  medicinal drugs authorized within this paragraph upon completion
   45  of the foregoing requirements. The physician assistant shall not
   46  be required to independently register pursuant to s. 465.0276.
   47         5. The prescription must be written in a form that complies
   48  with chapter 499 and must contain, in addition to the
   49  supervisory physician’s name, address, and telephone number, the
   50  physician assistant’s prescriber number. Unless it is a drug or
   51  drug sample dispensed by the physician assistant, the
   52  prescription must be filled in a pharmacy permitted under
   53  chapter 465 and must be dispensed in that pharmacy by a
   54  pharmacist licensed under chapter 465. The appearance of the
   55  prescriber number creates a presumption that the physician
   56  assistant is authorized to prescribe the medicinal drug and the
   57  prescription is valid.
   58         6. The physician assistant must note the prescription or
   59  dispensing of medication in the appropriate medical record.
   60         (9) COUNCIL ON PHYSICIAN ASSISTANTS.—The Council on
   61  Physician Assistants is created within the department.
   62         (c) The council shall:
   63         1. Recommend to the department the licensure of physician
   64  assistants.
   65         2. Develop all rules regulating the use of physician
   66  assistants by physicians under this chapter and chapter 459,
   67  except for rules relating to the formulary developed under
   68  paragraph (4)(f). The council shall also develop rules to ensure
   69  that the continuity of supervision is maintained in each
   70  practice setting. The boards shall consider adopting a proposed
   71  rule developed by the council at the regularly scheduled meeting
   72  immediately following the submission of the proposed rule by the
   73  council. A proposed rule submitted by the council may not be
   74  adopted by either board unless both boards have accepted and
   75  approved the identical language contained in the proposed rule.
   76  The language of all proposed rules submitted by the council must
   77  be approved by both boards pursuant to each respective board’s
   78  guidelines and standards regarding the adoption of proposed
   79  rules. If either board rejects the council’s proposed rule, that
   80  board must specify its objection to the council with
   81  particularity and include any recommendations it may have for
   82  the modification of the proposed rule.
   83         3. Make recommendations to the boards regarding all matters
   84  relating to physician assistants.
   85         4. Address concerns and problems of practicing physician
   86  assistants in order to improve safety in the clinical practices
   87  of licensed physician assistants.
   88         Section 5. Effective January 1, 2017, paragraph (f) of
   89  subsection (4) of section 458.347, Florida Statutes, is amended
   90  to read:
   91         458.347 Physician assistants.—
   93         (f)1. The council shall establish a formulary of medicinal
   94  drugs that a fully licensed physician assistant having
   95  prescribing authority under this section or s. 459.022 may not
   96  prescribe. The formulary must include controlled substances as
   97  defined in chapter 893, general anesthetics, and radiographic
   98  contrast materials. A physician assistant, as defined in
   99  paragraph (2)(e) or s. 459.022, who possesses a Certificate of
  100  Added Qualifications (CAQ) in psychiatry obtained from the
  101  National Commission on Certification of Physician Assistants and
  102  who is working under the supervision of a psychiatrist may
  103  prescribe psychotropic controlled substances for the treatment
  104  of mental disorders.
  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 under this section or s. 459.022, and to
  122  each pharmacy licensed by the state. The boards shall establish,
  123  by rule, a fee not to exceed $200 to fund the provisions of this
  124  paragraph and paragraph (e).
  125         Section 6. Except as otherwise expressly provided in this
  126  act, this act shall take effect upon becoming a law.
  128  ================= T I T L E  A M E N D M E N T ================
  129  And the title is amended as follows:
  130         Delete line 123
  131  and insert:
  132         provider personnel; amending s. 458.347, F.S.;
  133         clarifying the continuing education course
  134         requirements for physician assistants; authorizing
  135         certain physician assistants to prescribe psychotropic
  136         controlled substances in specified circumstances;
  137         providing effective dates.