THE BILL ITSELF
CS/HB 683
Performance of Physician Assistants and Advanced Practice Registered Nurses
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A bill to be entitled
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An act relating to the performance of physician
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assistants and advanced practice registered nurses;
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amending ss. 458.347 and 459.022, F.S.; deleting the
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requirement that a supervising physician notify the
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Department of Health in writing of any delegation of
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prescribing authority to a physician assistant;
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deleting the requirement that a supervising
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physician's name be included in the prescription
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issued by a physician assistant; revising requirements
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for the drug formulary for physician assistants;
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amending s. 464.012, F.S.; revising the drug formulary
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requirements for advanced practice registered nurses
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authorized to prescribe medications; providing an
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exception for psychiatric nurses; providing an
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effective date.
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Be It Enacted by the Legislature of the State of Florida:
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Section 1. Paragraphs (e) and (f) of subsection (4) of
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section 458.347, Florida Statutes, are amended to read:
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458.347 Physician assistants.—
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(4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
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(e) A supervising physician may delegate to a fully
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licensed physician assistant the authority to prescribe or
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dispense any medication used in the supervising physician's
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practice unless such medication is listed on the formulary
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created pursuant to paragraph (f). A fully licensed physician
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assistant may only prescribe or dispense such medication only
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under the following conditions circumstances:
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1. A physician assistant must clearly identify to the
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patient that he or she is a physician assistant.
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2. The supervising physician must notify the department of
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his or her intent to delegate, on a department-approved form,
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before delegating such authority and of any change in
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prescriptive privileges of the physician assistant. Authority to
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dispense may be delegated only by a supervising physician who is
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registered as a dispensing practitioner in compliance with s.
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465.0276.
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3. A fully licensed physician assistant may procure
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medical devices and drugs unless the medication is listed on the
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formulary created pursuant to paragraph (f).
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4. The physician assistant must complete a minimum of 10
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continuing medical education hours in the specialty practice in
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which the physician assistant has prescriptive privileges with
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each licensure renewal. Three of the 10 hours must consist of a
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continuing education course on the safe and effective
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prescribing of controlled substance medications which is offered
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by a statewide professional association of physicians in this
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state accredited to provide educational activities designated
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for the American Medical Association Physician's Recognition
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Award Category 1 credit, designated by the American Academy of
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Physician Assistants as a Category 1 credit, or designated by
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the American Osteopathic Association as a Category 1-A credit.
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5. The prescription may be in paper or electronic form but
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must comply with ss. 456.0392(1) and 456.42(1) and chapter 499
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and must contain the physician assistant's name, address, and
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telephone number and the name of each of his or her supervising
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physicians. Unless it is a drug or drug sample dispensed by the
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physician assistant, the prescription must be filled in a
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pharmacy permitted under chapter 465 and must be dispensed in
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that pharmacy by a pharmacist licensed under chapter 465.
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6. The physician assistant must note the prescription or
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dispensing of medication in the appropriate medical record.
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(f)1. The council shall establish a formulary of medicinal
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drugs that a fully licensed physician assistant having
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prescribing authority under this section or s. 459.022 may not
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prescribe. The formulary must include general anesthetics and
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radiographic contrast materials and must limit the prescription
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of Schedule II controlled substances as listed in s. 893.03 to a
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7-day supply or, in the case of Schedule II psychiatric mental
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health controlled substances, a 30-day supply if. the
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prescription is formulary must also restrict the prescribing of
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Schedule II psychiatric mental health controlled substances for
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a child children younger than 18 years of age to a 14-day
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supply, provided the physician assistant is under the
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supervision of a pediatrician, a family practice physician, an
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internal medicine physician, or a psychiatrist.
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2. In establishing the formulary, the council shall
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consult with a pharmacist licensed under chapter 465, but not
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licensed under this chapter or chapter 459, who shall be
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selected by the State Surgeon General.
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3. Only the council shall add to, delete from, or modify
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the formulary. Any person who requests an addition, a deletion,
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or a modification of a medicinal drug listed on such formulary
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has the burden of proof to show cause why such addition,
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deletion, or modification should be made.
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4. The boards shall adopt the formulary required by this
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paragraph, and each addition, deletion, or modification to the
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formulary, by rule. Notwithstanding any provision of chapter 120
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to the contrary, the formulary rule shall be effective 60 days
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after the date it is filed with the Secretary of State. Upon
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adoption of the formulary, the department shall mail a copy of
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such formulary to each fully licensed physician assistant having
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prescribing authority under this section or s. 459.022, and to
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each pharmacy licensed by the state. The boards shall establish,
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by rule, a fee not to exceed $200 to fund the provisions of
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paragraph (e) and this paragraph.
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Section 2. Paragraph (e) of subsection (4) of section
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459.022, Florida Statutes, is amended to read:
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459.022 Physician assistants.—
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(4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
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(e) A supervising physician may delegate to a fully
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licensed physician assistant the authority to prescribe or
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dispense any medication used in the supervising physician's
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practice unless such medication is listed on the formulary
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created pursuant to s. 458.347. A fully licensed physician
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assistant may only prescribe or dispense such medication only
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under the following conditions circumstances:
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1. A physician assistant must clearly identify to the
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patient that she or he is a physician assistant.
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2. The supervising physician must notify the department of
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her or his intent to delegate, on a department-approved form,
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before delegating such authority and of any change in
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prescriptive privileges of the physician assistant. Authority to
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dispense may be delegated only by a supervising physician who is
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registered as a dispensing practitioner in compliance with s.
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465.0276.
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3. A fully licensed physician assistant may procure
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medical devices and drugs unless the medication is listed on the
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formulary created pursuant to s. 458.347(4)(f).
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4. The physician assistant must complete a minimum of 10
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continuing medical education hours in the specialty practice in
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which the physician assistant has prescriptive privileges with
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each licensure renewal. Three of the 10 hours must consist of a
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continuing education course on the safe and effective
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prescribing of controlled substance medications which is offered
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by a provider that has been approved by the American Academy of
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Physician Assistants and which is designated for the American
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Medical Association Physician's Recognition Award Category 1
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credit, designated by the American Academy of Physician
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Assistants as a Category 1 credit, or designated by the American
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Osteopathic Association as a Category 1-A credit.
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5. The prescription may be in paper or electronic form but
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must comply with ss. 456.0392(1) and 456.42(1) and chapter 499
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and must contain the physician assistant's name, address, and
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telephone number and the name of each of his or her supervising
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physicians. Unless it is a drug or drug sample dispensed by the
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physician assistant, the prescription must be filled in a
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pharmacy permitted under chapter 465, and must be dispensed in
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that pharmacy by a pharmacist licensed under chapter 465.
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6. The physician assistant must note the prescription or
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dispensing of medication in the appropriate medical record.
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Section 3. Paragraph (a) of subsection (6) of section
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464.012, Florida Statutes, is amended to read:
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464.012 Licensure of advanced practice registered nurses;
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fees; controlled substance prescribing.—
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(6)(a) The board shall establish a committee to recommend
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a formulary of controlled substances that an advanced practice
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registered nurse may not prescribe or may prescribe only for
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specific uses or in limited quantities. The committee must be
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composed consist of three advanced practice registered nurses
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licensed under this section, recommended by the board; three
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physicians licensed under chapter 458 or chapter 459 who have
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work experience with advanced practice registered nurses,
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recommended by the Board of Medicine; and a pharmacist licensed
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under chapter 465 who is a doctor of pharmacy, recommended by
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the Board of Pharmacy. The committee may recommend an evidence-
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based formulary applicable to all advanced practice registered
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nurses which is limited by specialty certification, is limited
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to approved uses of controlled substances, or is subject to
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other similar restrictions the committee finds are necessary to
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protect the health, safety, and welfare of the public. The
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formulary must restrict the prescribing of psychiatric mental
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health controlled substances for children younger than 18 years
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of age to a 30-day supply, except that such restriction does not
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apply to controlled substances that are prescribed by advanced
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practice registered nurses who also are psychiatric nurses as
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defined in s. 394.455. The formulary must also limit the
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prescribing of Schedule II controlled substances as listed in s.
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893.03 to a 7-day supply, except that such restriction does not
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apply to controlled substances that are psychiatric medications
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prescribed by psychiatric nurses as defined in s. 394.455.
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Section 4. This act shall take effect July 1, 2026.