Florida Senate - 2025 SB 1540 By Senator Collins 14-01468-25 20251540__ 1 A bill to be entitled 2 An act relating to physician assistants; amending ss. 3 458.347 and 459.022, F.S.; revising the definition of 4 the term physician assistant; deleting the 5 requirement that a supervising physician notify the 6 Department of Health of his or her intent to delegate 7 prescriptive authority, or of any change in such 8 delegation, to a physician assistant; revising 9 requirements for prescriptions issued by a physician 10 assistant; providing for the registration of a 11 physician assistant to engage in practice without 12 physician supervision; providing registration 13 requirements; providing financial responsibility 14 requirements for such physician assistants; specifying 15 the scope of practice for such physician assistants; 16 requiring the Council on Physician Assistants, in 17 consultation with the Board of Medicine and the Board 18 of Osteopathic Medicine, to adopt rules establishing 19 standards of practice for such physicians; providing 20 for registration renewal; requiring the department to 21 distinguish such physician assistants licenses and 22 include the registration in their practitioner 23 profiles; requiring such physician assistants to 24 disclose specified information in writing to new 25 patients; requiring the council to adopt rules; 26 providing an effective date. 27 28 Be It Enacted by the Legislature of the State of Florida: 29 30 Section 1.Present subsections (8) through (16) of section 31 458.347, Florida Statutes, are redesignated as subsections (9) 32 through (17), respectively, a new subsection (8) is added to 33 that section, and paragraph (e) of subsection (2) and paragraph 34 (e) of subsection (4) of that section are amended, to read: 35 458.347Physician assistants. 36 (2)DEFINITIONS.As used in this section, the term: 37 (e)Physician assistant means a person who is a graduate 38 of an approved program or its equivalent or meets standards 39 approved by the council boards and is licensed to perform 40 medical services delegated by the supervising physician. 41 (4)PERFORMANCE OF PHYSICIAN ASSISTANTS. 42 (e)A supervising physician may delegate to a fully 43 licensed physician assistant the authority to prescribe or 44 dispense any medication used in the supervising physicians 45 practice unless such medication is listed on the formulary 46 created pursuant to paragraph (f). A fully licensed physician 47 assistant may only prescribe or dispense such medication under 48 the following circumstances: 49 1.A physician assistant must clearly identify to the 50 patient that he or she is a physician assistant. 51 2.The supervising physician must notify the department of 52 his or her intent to delegate, on a department-approved form, 53 before delegating such authority and of any change in 54 prescriptive privileges of the physician assistant. Authority to 55 dispense may be delegated only by a supervising physician who is 56 registered as a dispensing practitioner in compliance with s. 57 465.0276. 58 3.A fully licensed physician assistant may procure medical 59 devices and drugs unless the medication is listed on the 60 formulary created pursuant to paragraph (f). 61 4.The physician assistant must complete a minimum of 10 62 continuing medical education hours in the specialty practice in 63 which the physician assistant has prescriptive privileges with 64 each licensure renewal. Three of the 10 hours must consist of a 65 continuing education course on the safe and effective 66 prescribing of controlled substance medications which is offered 67 by a statewide professional association of physicians in this 68 state accredited to provide educational activities designated 69 for the American Medical Association Physicians Recognition 70 Award Category 1 credit, designated by the American Academy of 71 Physician Assistants as a Category 1 credit, or designated by 72 the American Osteopathic Association as a Category 1-A credit. 73 5.The prescription may be in paper or electronic form but 74 must comply with ss. 456.0392(1) and 456.42(1) and chapter 499 75 and must contain the physician assistants name, address, and 76 telephone number and the name of each of his or her supervising 77 physicians. Unless it is a drug or drug sample dispensed by the 78 physician assistant, the prescription must be filled in a 79 pharmacy permitted under chapter 465 and must be dispensed in 80 that pharmacy by a pharmacist licensed under chapter 465. 81 6.The physician assistant must note the prescription or 82 dispensing of medication in the appropriate medical record. 83 (8)PRACTICE WITHOUT PHYSICIAN SUPERVISION. 84 (a)Registration.The council must register a physician 85 assistant to practice without a supervising physician if the 86 applicant meets all of the following criteria: 87 1.Holds an active, unencumbered license to practice as a 88 physician assistant. A physician assistant holding a temporary 89 license, a temporary certificate for practice in areas of 90 critical need, a limited license, or a conditional license may 91 not register under this subsection. 92 2.Is providing primary care services in an area designated 93 as a rural area of opportunity as defined in s. 288.0656. 94 3.Has not been subject to disciplinary action under s. 95 456.072 or s. 458.331 or any similar disciplinary action in 96 another state or other territory or jurisdiction within the 5 97 years immediately preceding the registration application. 98 4.Has completed, in any state, jurisdiction, or territory 99 of the United States, at least 3,000 clinical practice hours, 100 which may include clinical instructional hours provided by the 101 applicant, within the 5 years immediately preceding the 102 registration application. For purposes of this paragraph, the 103 term clinical instruction means education provided by faculty 104 in a clinical setting in a graduate program leading to a 105 masters or doctoral degree in a clinical physician assistant 106 studies area. 107 (b)Financial responsibility. 108 1.A person registered under this subsection must, by one 109 of the following methods, demonstrate to the satisfaction of the 110 council and the department financial responsibility to pay 111 claims and costs ancillary thereto arising out of the rendering 112 of, or the failure to render, medical care, treatment, or 113 services: 114 a.Obtaining and maintaining professional liability 115 coverage in an amount not less than $100,000 per claim, with a 116 minimum annual aggregate of not less than $300,000, from an 117 authorized insurer as defined in s. 624.09, from an eligible 118 surplus lines insurer as defined in s. 626.914(2), from a risk 119 retention group as defined in s. 627.942, from the Joint 120 Underwriting Association established under s. 627.351(4), or 121 through a plan of self-insurance as provided in s. 627.357; or 122 b.Obtaining and maintaining an unexpired, irrevocable 123 letter of credit, established pursuant to chapter 675, in an 124 amount of not less than $100,000 per claim, with a minimum 125 aggregate availability of credit of not less than $300,000. The 126 letter of credit must be payable to the physician assistant as 127 beneficiary upon presentment of a final judgment indicating 128 liability and awarding damages to be paid by the physician 129 assistant or upon presentment of a settlement agreement signed 130 by all parties to such agreement when such final judgment or 131 settlement is a result of a claim arising out of the rendering 132 of, or the failure to render, medical care, treatment, or 133 services. 134 2.The requirements of subparagraph 1. do not apply to: 135 a.A physician assistant registered under this subsection 136 who practices exclusively as an officer, employee, or agent of 137 the Federal Government or of the state or its agencies or 138 subdivisions. 139 b.A physician assistant whose registration under this 140 subsection has become inactive and who is not practicing as a 141 physician assistant registered under this subsection in this 142 state. 143 c.A physician assistant registered under this subsection 144 who practices only in conjunction with his or her teaching 145 duties at an accredited school or its main teaching hospitals. 146 Such practice is limited to that which is incidental to and a 147 necessary part of duties in connection with the teaching 148 position. 149 d.A physician assistant who holds an active registration 150 under this subsection but is not engaged in practice without a 151 supervising physician as authorized under this subsection in 152 this state. If such person initiates or resumes practice as a 153 physician assistant without physician supervision, he or she 154 must notify the department of such activity and fulfill the 155 professional liability coverage requirements of subparagraph 1. 156 (c)Practice requirements. 157 1.A physician assistant who is registered under this 158 subsection may do all of the following: 159 a.Practice in primary care, family medicine, pediatrics, 160 internal medicine, womens health, and psychiatry, as defined by 161 council rule. 162 b.Perform the general functions of a physician assistant. 163 c.For a patient who requires the services of a health care 164 facility as defined in s. 408.032: 165 (I)Admit the patient to the facility. 166 (II)Manage the care received by the patient in the 167 facility. 168 (III)Discharge the patient from the facility, unless 169 prohibited by federal law or rule. 170 d.Provide a signature, certification, stamp, verification, 171 affidavit, or endorsement that is otherwise required by law to 172 be provided by a physician, except a physician assistant 173 registered under this subsection may not issue a physician 174 certification under s. 381.986. 175 2.A physician assistant engaging in practice under this 176 subsection may not perform any surgical procedure deeper than 177 subcutaneous tissues. 178 3.The council, in consultation with the boards, shall 179 adopt rules establishing standards of practice for physician 180 assistants registered under this subsection. 181 (d)Registration renewal.A physician assistant must 182 biennially renew registration under this subsection. The 183 biennial renewal for registration shall coincide with the 184 physician assistants biennial renewal period for licensure. 185 (e)Practitioner profile.The department shall 186 conspicuously distinguish a physician assistants license if he 187 or she is registered with the council under this subsection and 188 include the registration in the physician assistants 189 practitioner profile created under s. 456.041. 190 (f)Disclosures.When engaging in practice under this 191 subsection, the physician assistant must provide information in 192 writing to a new patient about his or her qualifications and the 193 fact that he or she is practicing without a supervising 194 physician before or during the initial patient encounter. 195 (g)Rules.The council shall adopt rules to implement this 196 subsection. 197 Section 2.Present subsections (8) through (16) of section 198 459.022, Florida Statutes, are redesignated as subsections (9) 199 through (17), respectively, a new subsection (8) is added to 200 that section, and paragraph (e) of subsection (2) and paragraph 201 (e) of subsection (4) of that section are amended, to read: 202 459.022Physician assistants. 203 (2)DEFINITIONS.As used in this section, the term: 204 (e)Physician assistant means a person who is a graduate 205 of an approved program or its equivalent or meets standards 206 approved by the council boards and is licensed to perform 207 medical services delegated by the supervising physician. 208 (4)PERFORMANCE OF PHYSICIAN ASSISTANTS. 209 (e)A supervising physician may delegate to a fully 210 licensed physician assistant the authority to prescribe or 211 dispense any medication used in the supervising physicians 212 practice unless such medication is listed on the formulary 213 created pursuant to s. 458.347. A fully licensed physician 214 assistant may only prescribe or dispense such medication under 215 the following circumstances: 216 1.A physician assistant must clearly identify to the 217 patient that she or he is a physician assistant. 218 2.The supervising physician must notify the department of 219 her or his intent to delegate, on a department-approved form, 220 before delegating such authority and of any change in 221 prescriptive privileges of the physician assistant. Authority to 222 dispense may be delegated only by a supervising physician who is 223 registered as a dispensing practitioner in compliance with s. 224 465.0276. 225 3.A fully licensed physician assistant may procure medical 226 devices and drugs unless the medication is listed on the 227 formulary created pursuant to s. 458.347(4)(f). 228 4.The physician assistant must complete a minimum of 10 229 continuing medical education hours in the specialty practice in 230 which the physician assistant has prescriptive privileges with 231 each licensure renewal. Three of the 10 hours must consist of a 232 continuing education course on the safe and effective 233 prescribing of controlled substance medications which is offered 234 by a provider that has been approved by the American Academy of 235 Physician Assistants and which is designated for the American 236 Medical Association Physicians Recognition Award Category 1 237 credit, designated by the American Academy of Physician 238 Assistants as a Category 1 credit, or designated by the American 239 Osteopathic Association as a Category 1-A credit. 240 5.The prescription may be in paper or electronic form but 241 must comply with ss. 456.0392(1) and 456.42(1) and chapter 499 242 and must contain the physician assistants name, address, and 243 telephone number and the name of each of his or her supervising 244 physicians. Unless it is a drug or drug sample dispensed by the 245 physician assistant, the prescription must be filled in a 246 pharmacy permitted under chapter 465, and must be dispensed in 247 that pharmacy by a pharmacist licensed under chapter 465. 248 6.The physician assistant must note the prescription or 249 dispensing of medication in the appropriate medical record. 250 (8)PRACTICE WITHOUT PHYSICIAN SUPERVISION. 251 (a)Registration.The council must register a physician 252 assistant to practice without a supervising physician if the 253 applicant meets all of the following criteria: 254 1.Holds an active, unencumbered license to practice as a 255 physician assistant. A physician assistant holding a temporary 256 license, a temporary certificate for practice in areas of 257 critical need, a limited license, or a conditional license may 258 not register under this subsection. 259 2.Is providing primary care services in an area designated 260 as a rural area of opportunity as defined in s. 288.0656. 261 3.Has not been subject to disciplinary action under s. 262 456.072 or s. 458.331 or any similar disciplinary action in 263 another state or other territory or jurisdiction within the 5 264 years immediately preceding the registration application. 265 4.Has completed, in any state, jurisdiction, or territory 266 of the United States, at least 3,000 clinical practice hours, 267 which may include clinical instructional hours provided by the 268 applicant, within the 5 years immediately preceding the 269 registration application. For purposes of this paragraph, the 270 term clinical instruction means education provided by faculty 271 in a clinical setting in a graduate program leading to a 272 masters or doctoral degree in a clinical physician assistant 273 studies area. 274 (b)Financial responsibility. 275 1.A person registered under this subsection must, by one 276 of the following methods, demonstrate to the satisfaction of the 277 council and the department financial responsibility to pay 278 claims and costs ancillary thereto arising out of the rendering 279 of, or the failure to render, medical care, treatment, or 280 services: 281 a.Obtaining and maintaining professional liability 282 coverage in an amount not less than $100,000 per claim, with a 283 minimum annual aggregate of not less than $300,000, from an 284 authorized insurer as defined in s. 624.09, from an eligible 285 surplus lines insurer as defined in s. 626.914(2), from a risk 286 retention group as defined in s. 627.942, from the Joint 287 Underwriting Association established under s. 627.351(4), or 288 through a plan of self-insurance as provided in s. 627.357; or 289 b.Obtaining and maintaining an unexpired, irrevocable 290 letter of credit, established pursuant to chapter 675, in an 291 amount of not less than $100,000 per claim, with a minimum 292 aggregate availability of credit of not less than $300,000. The 293 letter of credit must be payable to the physician assistant as 294 beneficiary upon presentment of a final judgment indicating 295 liability and awarding damages to be paid by the physician 296 assistant or upon presentment of a settlement agreement signed 297 by all parties to such agreement when such final judgment or 298 settlement is a result of a claim arising out of the rendering 299 of, or the failure to render, medical care, treatment, or 300 services. 301 2.The requirements of subparagraph 1. do not apply to: 302 a.A physician assistant registered under this subsection 303 who practices exclusively as an officer, employee, or agent of 304 the Federal Government or of the state or its agencies or 305 subdivisions. 306 b.A physician assistant whose registration under this 307 subsection has become inactive and who is not practicing as a 308 physician assistant registered under this subsection in this 309 state. 310 c.A physician assistant registered under this subsection 311 who practices only in conjunction with her or his teaching 312 duties at an accredited school or its main teaching hospitals. 313 Such practice is limited to that which is incidental to and a 314 necessary part of duties in connection with the teaching 315 position. 316 d.A physician assistant who holds an active registration 317 under this subsection but is not engaged in practice without a 318 supervising physician as authorized under this subsection in 319 this state. If such person initiates or resumes practice as a 320 physician assistant without physician supervision, she or he 321 must notify the department of such activity and fulfill the 322 professional liability coverage requirements of subparagraph 1. 323 (c)Practice requirements. 324 1.A physician assistant who is registered under this 325 subsection may do all of the following: 326 a.Practice in primary care, family medicine, pediatrics, 327 internal medicine, womens health, and psychiatry, as defined by 328 council rule. 329 b.Perform the general functions of a physician assistant. 330 c.For a patient who requires the services of a health care 331 facility as defined in s. 408.032: 332 (I)Admit the patient to the facility. 333 (II)Manage the care received by the patient in the 334 facility. 335 (III)Discharge the patient from the facility, unless 336 prohibited by federal law or rule. 337 d.Provide a signature, certification, stamp, verification, 338 affidavit, or endorsement that is otherwise required by law to 339 be provided by a physician, except a physician assistant 340 registered under this subsection may not issue a physician 341 certification under s. 381.986. 342 2.A physician assistant engaging in practice under this 343 subsection may not perform any surgical procedure deeper than 344 subcutaneous tissues. 345 3.The council, in consultation with the boards, shall 346 adopt rules establishing standards of practice for physician 347 assistants registered under this subsection. 348 (d)Registration renewal.A physician assistant must 349 biennially renew registration under this subsection. The 350 biennial renewal for registration shall coincide with the 351 physician assistants biennial renewal period for licensure. 352 (e)Practitioner profile.The department shall 353 conspicuously distinguish a physician assistants license if she 354 or he is registered with the council under this subsection and 355 include the registration in the physician assistants 356 practitioner profile created under s. 456.041. 357 (f)Disclosures.When engaging in practice under this 358 subsection, the physician assistant must provide information in 359 writing to a new patient about her or his qualifications and the 360 fact that she or he is practicing without a supervising 361 physician before or during the initial patient encounter. 362 (g)Rules.The council shall adopt rules to implement this 363 subsection. 364 Section 3.This act shall take effect July 1, 2025.