The proposed amendments are intended to update the rule’s language and the incorporated applications to implement statutory changes from Chapters 2021-190, 2021-199, and 2021-204, Laws of Florida.

 

DEPARTMENT OF HEALTH

Board of Medicine

RULE NOS.:RULE TITLES:

64B8-30.003Physician Assistant Licensure

64B8-30.004Change in Employment Status

64B8-30.008Formulary

64B8-30.009Requirements for Approval of Training Programs

64B8-30.013Notice of Noncompliance

64B8-30.014Citation Authority

64B8-30.015Disciplinary Guidelines

PURPOSE AND EFFECT: The proposed amendments are intended to update the rule’s language and the incorporated applications to implement statutory changes from Chapters 2021-190, 2021-199, and 2021-204, Laws of Florida.

SUMMARY: The proposed rule amendments updates the rule’s language and incorporated applications.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION:

The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: During discussion of the economic impact of this rule at its Board meeting, the Board concluded that this rule change will not have any impact on licensees and their businesses or the businesses that employ them. The rule will not increase any fees, business costs, personnel costs, will not decrease profit opportunities, and will not require any specialized knowledge to comply. This change will not increase any direct or indirect regulatory costs. Hence, the Board determined that a Statement of Estimated Regulatory Costs (SERC) was not necessary and that the rule will not require ratification by the Legislature. No person or interested party submitted additional information regarding the economic impact at that time.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 456.013, 456.031(2), 456.033, 456.073(3), 456.077, 456.079, 458.309, 458.331(5), 458.347, 458.347(4)(f)1., 458.347(7)(e), (f), (g), (12), (13) FS.

LAW IMPLEMENTED: 456.44, 456.47(7), 456.013, 456.0135, 456.017, 456.031, 456.033, 456.0635, 456.072, 456.073(3), 456.077, 456.079, 458.3265, 458.331, 458.331(5), 458.347, 458.347(4)(e), (f), 458.347(4)(e)1., (7)(f) 458.347(7)(f), (g), (12), (13), 459.022 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE SCHEDULED AND ANNOUNCED IN THE FAR.

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Paul Vazquez, J.D., Executive Director, Board of Medicine/MQA, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 32399-3253, [e-mail]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

64B8-30.003 Physician Assistant Licensure.

(1) Requirements for Licensure.

(a) All applicants for licensure as physician assistants shall apply on Form DH-MQA 2000, entitled “Physician Assistant Application for Licensure,” (revised 08/2112/20), hereby adopted and incorporated by reference, and can be obtained from the website at http://www.flrules.org/Gateway/reference.asp?No=Ref-     13152, or http://flboardofmedicine.gov/licensing/physician-assistant-licensure/.

(b) In addition, upon employment, a licensed physician assistant must notify the Board of Medicine, in writing, utilizing Form DH-MQA 2004, entitled “Supervision Data Form,” (revised 12/20), hereby adopted and incorporated by reference, and can be obtained from the website at http://www.flrules.org/Gateway/reference.asp?No=Ref-13155 or http://flboardofmedicine.gov/licensing/physician-assistant-licensure/, within 30 days of such employment. Any subsequent changes to the physician assistant’s employment must also be made, in writing, within 30 days of such change, utilizing this same form.

(b)(c) Applicants who have been granted a temporary license pursuant to Section 458.347(7)(d)(e) or 459.022(7)(d)(e), F.S., are eligible to seek an extension of the temporary license by submitting Form DH-MQA 1076, entitled “Application for Extension of Temporary Physician Assistant Licensure Application,” (Rev. 06/21 4/16), hereby adopted and incorporated by reference, and can be obtained from the website at http://www.flrules.org/Gateway/reference.asp?No=Ref-   07167, or http://flboardofmedicine.gov/licensing/physician-assistant-licensure/.

(2)  through (3) No change. 

(4) Notification to the Department Registration as a dispensing physician assistant shall be made  by the supervising physician on the form set forth in subsection 64B8-4.029(4), F.A.C.

Rulemaking Authority 456.013, 456.031(2), 456.033, 458.309, 458.347 FS. Law Implemented 456.013, 456.0135, 456.017, 456.031, 456.033, 456.0635, 458.347, 459.022 FS. History–New 4-28-76, Amended 11-15-78, 10-23-80, 12-4-85, Formerly 21M-17.03, Amended 5-13-87, 11-15-88, 11-15-90, 1-9-92, 5-6-93, Formerly 21M-17.003, Amended 9-21-93, Formerly 61F6-17.003, Amended 9-8-94, 11-30-94, 10-25-95, 3-25-96, Formerly 59R-30.003, Amended 6-7-98, 8-19-99, 5-28-00, 3-3-02, 5-19-03, 10-19-03, 11-17-03, 9-5-05, 12-12-05, 10-30-06, 2-25-07, 5-20-09, 2-2-10, 12-6-10, 1-27-13, 2-22-15, 7-27-16, 9-26-16, 12-4-16, 9-23-20, 6-23-21,                    .

64B8-30.004 Change in Employment Status.

Rulemaking Authority 458.309, 458.347 FS. Law Implemented 458.347 FS. History–New 5-13-87, Formerly 21M-17.0031, 61F6-17.0031, Amended 9-8-94, 7-25-95, 3-25-96, Formerly 59R-30.004, Amended 6-7-98,    Repealed.

Substantial rewording of Rule 64B8-30.008 follows.  See Florida Administrative Code for present text.

64B8-30.008 Formulary.

(1)  Subject to the requirements of this rule, Sections 456.44, 458.347, 458.3265, 459.022 and 459.0137, F.S., and the rules enacted thereunder, drugs not appearing on this formulary may be delegated by a supervising physician to a prescribing physician assistant to prescribe.  A supervising physician may delegate to a prescribing physician assistant only such authorized medicinal drugs as are used in the supervising physician’s practice, except those listed in subsection (2).

(2)  Physician assistants prescribing medicinal drugs under the provisions of Section 458.347(4)(e) or 459.022(4)(e), F.S., are not authorized to prescribe the following medicinal drugs, in pure form or combination:

(a) General, spinal or epidural anesthetics.

(b) Radiographic contrast materials.

(3) Controlled Substances.  Physician assistants may prescribe controlled substances, as defined in Chapter 893, F.S., with the following restrictions:

(a) Physician assistants may only prescribe a 14-day supply of Schedule II psychiatric mental health controlled substances for children younger than 18 years of age provided the physician assistant is under the supervision of a pediatrician, a family practice physician, an internal medicine physician, or a psychiatrist.

(b) Physician assistants may only prescribe a 7-day supply of all other Schedule II controlled substances as listed in Section 893.03, F.S.

(4) Nothing herein prohibits a supervising physician from delegating to a physician assistant the authority to order medicinal drugs for a hospitalized patient of the supervising physician, nor does anything herein prohibit a supervising physician from delegating to a physician assistant the administration of a medicinal drug under the direction and supervision of the physician.

 

Rulemaking Authority 458.309, 458.347(4)(f)1. FS. Law Implemented 458.347(4)(e), (f), 458.3265, 456.44 FS. History–New 3-12-94, Formerly 61F6-17.0038, Amended 11-30-94, 2-22-95, 1-24-96, 11-13-96, 3-26-97, Formerly 59R-30.008, Amended 11-26-97, 1-11-99, 12-28-99, 6-20-00, 11-13-00, 2-15-02, 7-30-03, 8-2-09, 10-26-16, __________.

 

64B8-30.009 Requirements for Approval of Training Programs.

(1) Any Physician Assistant program wishing to be approved and recognized by the State of Florida must have been accredited by the Accreditation Review Commission on Education for the Physician Assistant or its successor entity or, for programs before 2001, from the Committee on Allied Health, Education, and Accreditation. For those allopathic Physician Assistant training programs graduating Physician Assistants prior to February 1973, any graduate is deemed eligible to be licensed as a Physician Assistant in the State of Florida, provided the graduate has been recognized by the National Commission on Certification of Physician Assistants as a formally trained Physician Assistant. For those osteopathic Physician Assistant training programs graduating Physician Assistants prior to 1974, any graduate is deemed eligible to be licensed as a Physician Assistant in the State of Florida, provided the graduate has been recognized by the National Commission on Certification of Physician Assistants as a formally trained Physician Assistant.

(2) No change.  

 

Rulemaking Authority 458.309, 458.347 FS. Law Implemented 458.347 FS. History–New 4-28-76, Amended 11-15-78, 12-5-79, 7-1-80, 10-23-80, 5-26-85, 12-4-85, Formerly 21M-17.05, Amended 5-13-87, 5-22-88, Formerly 21M-17.005, 61F6-17.005, 59R-30.009, Amended 6-7-98,

3-28-99,                               .

 

64B8-30.013 Notice of Noncompliance.

(1) through (2) No change.  

(3) The following violations are those for which the board authorizes the Department to issue a notice of noncompliance:

(a) No change.

(b) Violating any of the following provisions of Chapter 458, F.S., as prohibited by Sections 458.347(7)(g) and 458.331(1)(x), F.S.:

1.  through 2.   No change.

3. Failure to timely notify the Department of a change of supervision (addition or deletion of a supervisor) (Section 458.347(7)(e), (g), F.S.).

(c) No change.  

Rulemaking Authority 456.073(3), 458.309, 458.347(7)(e), (g), (12) FS. Law Implemented 456.073(3), 458.331, 458.347(7)(g), (12) FS. History–New 3-3-02, Amended 8-2-06, 11-3-09,                                    .

64B8-30.014 Citation Authority.

In lieu of the disciplinary procedures contained in Section 456.073, F.S., the offenses enumerated in this rule may be disciplined by the issuance of a citation. The citation shall include a requirement that the licensee correct the offense, if possible, within a specified period of time, impose whatever obligations will correct the offense, and impose the prescribed penalty.

(1) through (2)   No change.

(3) The following violations with accompanying penalty may be disposed of by citation with the specified penalty:

VIOLATIONS	PENALTY
(a) through (d) No change.
(e) Failure to notify Department of change of practice and/or mailing address. (Section 456.035, F.S.) (Section 458.319(3), F.S.) (Section 458.331(1)(g), F.S.) (Section 458.347(7)(f), F.S.)	$125 fine.
(f) No change.
(g) Second failure to report to the Department of $250 fine per supervising physician addition/deletion/change of supervising physician(s) within 30 days after the change is made. (Section 456.035, F.S.) (Section 458.331(1)(g), F.S.) (Section 458.347(7)(e), (g), F.S.)
(h) through (k) renumbered (g) through (j)  No change.

(4)  -  (5) No change.  

Rulemaking Authority 456.077, 458.309, 458.347(7)(f), (13) FS. Law Implemented 456.077, 458.331, 458.347(7)(f), (13) FS. History–New 3-3-02, Amended 5-19-03, 11-17-03, 5-4-04, 12-12-05, 8-2-06, 8-18-09, 5-17-17, 11-15-18,                       .

64B8-30.015 Disciplinary Guidelines.

(1) No change.  

(2) Violations and Range of Penalties. In imposing discipline upon physician assistant applicants and licensees, in proceedings pursuant to Sections 120.57(1) and (2), F.S., the Board shall act in accordance with the following disciplinary guidelines and shall impose a penalty within the range corresponding to the violations set forth below. The verbal identification of offenses are descriptive only; the full language of each statutory provision cited must be consulted in order to determine the conduct included.  In addition to the guideline penalties provided herein, if the violation is for fraud or making a false or fraudulent representation, the Board shall impose a fine of $10,000.00 per count.  In no event for the penalties set forth below shall the fine exceed $10,000.00 per count.

VIOLATIONS	RECOMMENDED PENALTIES
					FOR TELEHEALTH REGISTRANTS
	First Offense		Subsequent Offenses		First Offense	Subsequent Offenses
(a) through (ccc)  No change.
	FIRST OFFENSE		SECOND OFFENSE	THIRD OFFENSE	FIRST OFFENSE	SECOND OR SUBSEQUENT OFFENSE
(ddd)  Failure to comply with parental consent requirements of s. 1014.06, F.S.  Section 456.072(1)(rr)	(ddd) From a letter of concern to six (6) months’ probation and an administrative fine of $1,000.00 to  $2,500.00.		(ddd) From a reprimand   to one (1) year probation and an administrative fine of $2,500.00 to $5,000.00.	(ddd) From six (6) months’ probation   to revocation and an administrative fine of $5,000.00 to $10,000.00, or denial of licensure.	(ddd) From a reprimand to one (1) year suspension.	(ddd) From six (6) month suspension with a corrective action plan to revocation, or denial of registration.
	First Offense		Subsequent Offenses		First Offense	Subsequent Offenses
(eee) Being convicted or found guilty of, entering a plea, or committing or attempting, soliciting, or conspiring to commit an act that would constitute a violation of any of the offenses listed in s. 456.074(5), F.S. or similar offense in another jurisdiction. (Section 456.072(1)(ss), F.S.)		(eee) Revocation and administrative fine of $1,000.00 to $5,000.00, or denial of licensure.	(eee) Revocation and administrative fine of $5,000.00 to $10,000.00, or denial of licensure.		(eee) Revocation, or denial of registration.	(eee) Revocation, or denial of registration.

(3) through (4)  No change.  

 

Rulemaking Authority 456.079, 456.47(7), 458.309, 458.331(5) FS. Law Implemented 456.072, 456.079, 456.47(7), 458.331(5), 458.347(4)(e)1., (7)(f) FS. History–New 3-13-89, Formerly 21M-17.015, 61F6-17.015, 59R-30.015, Amended 6-7-98, 4-9-01, 5-16-10, 3-26-12, 5-17-17, 11-15-18, 4-18-21, 7-7-21,                            .

 

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Council on Physician Assistants

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Board of Medicine

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: August 27, 2021

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: September 21, 2021