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MOVING TO FLORIDA? FAPA has received numerous emails from PAs around the country who are: planning to move to Florida; considering it; just want to do it; are in the process of doing it; their wife wants them to do it; their former boss wants them to do it; the kids want to live near Disney World; or God told them to do it. After trying to answer all these emails in the past, Past President Ron Pace decided several years ago it was time to write the definitive article to answer all these questions. We grant you that this is a long article, but by reading it in its' entirety, you may save yourself time, needless phone calls, and worry. Many PAs before those reading this now have found it to be extremely useful in their move to Florida. We update it on a regular basis with the latest one being done on October 11, 2011. Some of the many questions we repeatedly receive are:
Most, if not all, of the answers can be found on the FAPA website. We have tried to design the site information layout so that with two or three clicks you can find out whatever you need to find out. We even have a site specific search engine to assist you finding information on the FAPA website. However, since many folks are still computer-challenged, have a computerphobia, or are simply not motivated enough to do it themselves and want someone else to do it for them, we have put together a comprehensive article outlining what you need to know if you are a PA and moving to the Sunshine State to practice. If after reading this article you still have questions, please contact us. The questions found later in this document are not organized in any specific manner and that was intentional. We felt you would be more inclined to read them all that way trying to find the specific information you are looking for and learn a few other things unintentionally. It is kind of like finding out important incidental information when you order a lab test or special procedure looking for one thing and finding out another. :o) There is a link on the website homepage in left navigation bar to the Department of Health website where you can download all the needed State forms. It links directly to the state website so the forms you get are the correct and most up to date forms. We would advise you to print this article to keep for reference. We even have it available for you in PDF format. Moving
To Florida Article The first thing you have to realize is that the southern medical folks are very conservative, and no where is this more true than here in Florida. As one advertising slogan used to proclaim, "The rules are different here." The PA practice rules in most southern states are not as liberal as elsewhere in the country. Look at the history. The southern states were among the last to grant prescribing privileges in general. Mississippi PAs just had a practice act enacted in recent years. While the overwhelming majority of states now allow prescribing privileges for controlled medicines, Florida does not now nor will we in the foreseeable future. The Board of Medicine and the organized medical groups see that as an "increase in scope of practice" issue here and are not willing to grant us those privileges at this time. Also, the recent "pill mill crisis" has brought more attention to this issue and even physicians in Florida have more stringent regulations now on prescribing controlled medicinals. That is not to say the FAPA leadership does not continue to work diligently on this issue but it remains a very political issue and controversial for us here. Life is more relaxed and less hurried in the south in many respects so you have to learn to be patient. Just as many Southerners speak with a slow southern drawl, they tend to move that way too, especially in government circles, ie., licensing agencies. Lots of people want to retire to Florida so they move here and work a while before retiring. As you are all aware, credentialing has been a major issue for several years nationwide now and no where more so than here in Florida. They take the licensing issue very seriously. So be patient during the licensing process, take a deep breath, and remember that honey catches more flies than vinegar. First things first. You may get an application for a Florida license by calling the Board of Medicine, PA Council at (850) 488-0595. Follow the instructions on the automated service to have them send you an application for a license. They will include a copy of the pertinent Florida statutes on the PA practice act. Or, you may click on the link below and go to the State of Florida website and download the forms from there. There is a link now on the FAPA website homepage where one can download any state form for PAs direct from the state website to ensure you are getting the most up to date form. State of Florida Department of Health PA Applications Website The DOH website may have not been the easiest site in the world to navigate in the past few years. Simply go to the link above, scroll down to Physician Assistant Applications and Forms, download and read the entire document, following the instructions carefully. There are several other forms you will need to download and complete. This is fun, isn't it? Yeah, just keep telling yourself that. You will need to download: License application instructions There is a licensing information service available to Physician Assistants through the Federation of State Medical Boards Credentialing Verification Service (FCVS) and the Florida Board of Medicine is one of the state medical boards and licensing agencies that accepts the FCVS profile of verified credentials for Physician Assistants seeking licensure. There are over 32 states that now accept this service for PAs. This service has been available for physicians in most states for some years now. This is a fee for service. You can call for information to (817) 868-5001, or visit their website at FCVS Website. This is a legitimate service and is a not-for-profit organization. UPDATE: In July 2008, FAPA Leaders met with the Department of Health officials to discuss some of the most common mistakes being made in initial licensure applications, resulting in delays in application processing. In order to avoid some of these most common mistakes, PLEASE MAKE SURE TO DOUBLE CHECK THE FOLLOWING BEFORE SENDING IN YOUR APPLICATION:
Some personal observations and comments from our years of experience here about the Florida licensure process:
As one of the more experienced PAs in Florida and one who receives
hundreds of questions and emails about practice in Florida, Ron Pace would like
to add this one very important piece of advice. “When you apply for a license to
practice as a PA in Florida and you sign and submit that application, you are
stating to the Board of Medicine that you agree to abide by the Florida
statutes in regards to practicing as a physician assistant in this state. That
in turn implies that you have read and
understand those appropriate statutes. I would strongly advise you to do
just that - READ THE STATUTES AND THE FLORIDA ADMINISTRATIVE CODE APPLICABLE TO
PA PRACTICE IN FLORIDA. And your supervising physician should do so as well.
Just because that supervising physician has supervised PAs in the past does not
mean they necessarily have any knowledge of our practice act. Do not assume they
do! You know what happens when you assume things. You are the one signing your application, and you will be the one to bear the brunt of the wrath of the Board of Medicine should you do something contrary to our practice act and become the subject of disciplinary action. Ignorance of the law is NO EXCUSE in such cases, and the Board of Medicine here is not a forgiving body. When you signed the application, you agreed to abide by the law and that you know and understand the law. And you will be the one to pay the full price. You have worked long and hard to get that license and those privileges, do not risk losing it and ruining your professional career and possibly your life and that of your family as well. The four words I hate to say the most are, "I told you so." Ron Pace, B.S., PA-C, DFAAPA Now we will try to answer the routine questions we receive about practicing here in Florida. Where can I find the Florida statutes pertaining to practice as a physician assistant in Florida? It may seem complex but physician assistants come under several laws to regulate our practice. We fall under the Medical Practice Act, Florida Statute (F.S.) 458.347 or the Osteopathic Medical Practice Act, F.S. 459.022. These two statutes set forth the laws that govern physician assistant practice. Both of these statutes defer to the Council on Physician Assistants which consists of five members who represent the Board of Medicine and the Board of Osteopathic Medicine, the Department of Health, and a physician assistant to represent the PA community. The Council makes recommendations regarding licensure by the Boards, and develops rules and regulations regarding PA practice and all matters relating to physician assistants. In addition to the Florida statutes, there is the Florida Administrative Code (F.A.C.), 64B8-30, F.A.C. for the Board of Medicine, and 64B15-6, F.A.C. for the Osteopathic Board of Medicine. The statutes provide the law and the F.A.C. further defines the law through rules under which PAs practice. It details the regulations for licensure and renewal, change in employment, dispensing drugs, the formulary content, requirements for approval of training programs, physician assistant performance, disciplinary guidelines, and fees regarding physician assistants. To further muddy the issue, if a physician assistant practices in a health department setting, the regulations set forth in F.S. 154.04(1)(c) apply as well. This statute requires those physician assistants and nurse practitioners in that setting to practice under a written protocol. Physician assistants practicing in any other setting DO NOT require any written protocols. For your information only, nurse practitioners are regulated under the Nurse Practice Act here in Florida, and thus the Board of Medicine has no control over nurse practitioners. A CME COURSE FROM FAPA PA PRACTICE IN FLORIDA: ABOUT THE CME PROGRAM The course was authored by Ron Pace, B.S., PA-C, DFAAPA, a FAPA Past President. It was reviewed and edited by members of the FAPA Legislative and Government Affairs Committee. It is reviewed, updated, edited, and reaccredited on a yearly basis. Mr. Pace also presents a lecture each year at one of the FAPA conferences on this subject. PROGRAM OBJECTIVES
ACCREDITATION This program was planned in accordance with the AAPA’s CME Standards for Enduring Material Programs and for Commercial Support of Enduring Material Programs. Successful completion of the self-assessment is required to earn Category I (Preapproved) CME credit. Successful completion is defined as a cumulative score of at least 70% correct on the post test. COURSE DOCUMENTS
Below is a link to the Course Documents Package. Simply print it out the document, complete the course, and then submit the required documents to the office with the required payment. If your printer has a "draft" print available in the quality of print setting choices, that will be quicker of course. For the more computer literate folks, some may prefer to download the Course Documents Package and save it to their computer to review and complete the course on the computer, printing only those document pages needed to submit to the FAPA office for receiving CME credit. If you print it out at home or receive a hard copy from the FAPA office this is what you need to do. Complete the course and then you will need to mail in to the office, the following: · Self assessment Post Test Answer Sheet · CME Activity Evaluation Form · Payment Form with payment attached, or credit card information included on the form. If you download the Document Package and view it on your computer, you will need to print out these documents from the Documents Package to complete and mail in to the office. We strongly suggest that every PA applying for licensure, initial and renewal, download and study this material. It will be extremely beneficial to everyone. If you are going to spend the time reviewing the course, why not just submit the paperwork and get the 2.5 hours of CME credit for it? We purposely kept the cost inexpensive to encourage more folks to take the course. The cost is $30 for FAPA members and $45 for non-members. And keep the document copy handy at work, it will be a great information resource when you get questions from physicians, administrators or others about what you can and cannot do, and you will be able to quote them verbatim from the statutes and rules. At sometime in the future if the demand develops we will consider utilizing a CD ROM format, or even possibly an interactive online format. We hope you will find this course helpful to you in understanding PA practice statutes and rules here in Florida. We plan to update the course yearly as statutes and rules change. Between yearly updates notice of changes will be posted to the website and available from the FAPA office as well. It would be wise to consider taking the course with each license renewal cycle to make sure that one stays abreast of these changes. Remember, ignorance of the law is no excuse if you get in trouble down the line. This is just one more effort by the Florida Academy to assist our members in safely and legally providing quality care to Florida citizens. Thank You. Ron Pace, B.S., PA-C, DFAAPA When should I call the Board of Medicine or PA Council? If you need to get application forms for a license, prescribing privileges, a change in supervising physicians, or in practice locations you can get these sent to you by calling the PA Council at (850) 488-0595,and following the directions on their automated system. You do not really need to speak to anyone there at this time. You can also get a copy of the state regulations pertaining to the PA practice act through this system. If you are having problems I strongly recommend you consult with any of the FAPA officers, Regional Directors, or the Executive Director to get advice on how best to handle the situation. Check the Who's Who section of the FAPA website for phone, fax, and email information for the FAPA leader you are looking for on your issue. Usually one of these people will know the answer, or at the least know where to refer you for assistance. More importantly, most of the time maintaining a "low profile" is the best action, especially in dealing with any regulatory or legal entity. The less attention you draw to yourself and the PA profession in general, the better off we all will be. This means do not call or write the PA Council or Board of Medicine unless you have exhausted all other possible sources of information to resolve your situation. The fewer official people involved, the better things turn out usually. FAPA has people in leadership positions that can get things done without raising red flags, stirring up the hornet’s nest, or opening a Pandora’s box. Give us the opportunity to help you first. Can the personnel at FAPA HQ answer my questions about working in Florida as a PA? The staff personnel at the FAPA office can answer many of your questions about practicing as a PA in Florida. Most of your questions can probably be found in the various sections of the website, especially in one of the FAQ sections, or this document. Make use of the FAPA Website. In the "Who's Who" section are the names and contact information for the Board, committee chairs, etc., who may be able to help you. In addition, there is a link to the Board of Medicine website where a lot of information can be obtained. What relation does the FAPA HQ staff have with the Board of Medicine? Officially there is no special relationship. FAPA is a professional organization for the PA profession in Florida. We are subject to state regulations regarding regulated professional organizations as would be any other medical or non-medical organization. The staff has to send occasional reports to the Board of Medicine regarding attendance at state mandated CME courses like HIV, Domestic Violence, and Prescriptive Privileges. But the FAPA office has nothing to do with licensing or other matters. We do not keep state application forms in the office or other documents like that. You must get those from the state. Where can I find a list of jobs available in Florida? There is a Job Listing on the FAPA website and it is available to members as a benefit of membership. Non-members looking for a PA job in Florida can use the site for a nominal fee. We generally average 75 or more jobs being advertised as available in Florida on a daily basis. And there are links at the end of our online job listings to several other web related job sites and recruiting companies. Also, for FAPA members, job listings are contained in the PAper, our Newsletter which comes out about every 6 weeks. Look in the PA journals and throw-away medical journals/magazines, or you can check the AAPA website if you are an AAPA member for their job listing service. However, please note the FAPA website has more and more current job listings usually for Florida than the AAPA website. What are the specific requirements for CME for PAs in Florida? On June 20, 2006 Governor Bush signed HB 699 into law. It took effect on July 1, 2006. Below is a summary of the bill regarding CME requirements. The law provides that physician assistants (PAs) will now only be required to complete one (1) hour credit in HIV/AIDS – this must be done prior to the first renewal of the license, but once the physician assistant has taken one (1) credit, he or she does not ever have to take it again. Most Florida physician assistants have already met this requirement and will not need to take the course again. The law provides that physician assistants (PAs) will now only be required to complete two (2) credits in Domestic Violence every six (6) years. The HIV/AIDS and Domestic Violence courses will no longer be required prior to initial licensure. For initial licensure, the only requirement will be two (2) credits in Prevention of Medical Errors. The biennial requirement for Prevention of Medical Errors also remains the same – PAs must complete two (2) hours during each two-year licensure cycle. Below is a summary of Florida CME requirements: Initial licensure: Two (2) credits in Prevention of Medical Errors Every renewal thereafter: If you ARE currently certified by NCCPA: 1. NCCPA certificate 2. Proof of completing a 2-hour course of category 1 or 2, Preventing Medical Errors If you ARE NOT currently certified by NCCPA: Proof of completing no less than ninety-six (98) category 1, general CME,
plus Prescribing Physician Assistants: 1. In addition to the above, proof of completing 10 hours of CME in the specialty area of your supervising physician(s). The 10 hours is inclusive of the 98 general CME hours listed above. 2. 98 credit hours of CME including two (2) credits in Prevention of Medical Errors In addition to the above, every third renewal must include: Two (2) credits in Domestic Violence. PAs renewing on January 31, 2008 will be required to complete two (2) credits of Domestic Violence before renewing on 2012. Just a clarification point here, what we have known for years as Category I CME, and is now termed by the NCCPA as "Category (Preapproved) CME", and Category II CME is now "Category II (Elective) CME" for NCCPA certification purposes. The state regulations and rules still use the old Category I and Category II nomenclature. Sometime in the future we will have to get the state regulations updated with the new nomenclature but then that opens up the state practice act and that is something we do not want to do because then anyone can throw in an amendment to change things and we can get into some nasty political fights that we do not want or need. Every two years Physician Assistants licensed in Florida must earn 100 total hours of CME. Florida law allows the NCCPA hours to count for the Florida required CME hours (just 100 total satisfies both entities). CME can be a combination of Category I and II. Full details of the requirements and logging are available from NCCPA at www.nccpa.net.
If you maintain NCCPA certification, your NCCPA certificate is all the proof you need of the 100 general education hours provided you have proof of the specific hours required by the state as outlined below. But if audited by the state or NCCPA, you will need to be able to document all the hours. As you hopefully know there are no specific required courses for the NCCPA certification or recertification; however, Florida does have some required courses that must be part of those 100 hours. In Florida, the first-time licensee applicants and new graduate PAs must certify with their license application that they have completed 1 hour of Domestic Violence, 1 hour of HIV/AIDS, and 2 hours of Medical Error Prevention. You certify that you have received these hours when you sign the application and must be able to provide documentation of course attendance if so requested. Graduates of Florida PA programs get these required hours in their education process here. Included in the 100 total hours required, prescribing physician assistants must have 10 hours of Category I (Preapproved) CME in the area of specialty of your supervising physician for license renewal. Category I (Preapproved) CME must be documented with a certificate of course completion/ attendance and remain on file in your personal records for SEVEN years and be available for audit review if so requested by the state. Fifty hours of Category I (Preapproved) are needed with at least 40 of them being clinically related. The remaining 10 can be non-clinical professional related. Category II (Elective) CME is in optional categories and hours are obtained from medically related programs not otherwise eligible for Category I (Preapproved) CME credit. Some examples of CAT II (Elective) CME include the study of journals, pharmaceutical dinner presentations, reading medical textbooks, and reading medically related postgraduate course material that is NOT part of your PA program. As always, the regulatory source for what is to be considered Category I (Preapproved) or Category II (Elective) are the NCCPA guidelines. The NCCPA makes it very easy to log your hours online now and if you log them as you earn them when renewal time comes around it is much easier to complete the process if you have done so. Remember the AAPA no longer logs hours for us due to changes in the NCCPA regulations regarding logging of CME. They even have a special feature to log hours obtained at AAPA National Conferences. Logging your hours with CE Broker as an agent of the state is a voluntary action and PAs are not required to do so to maintain licensure. Do not be misled by the literature you may receive from CE Broker. Logging with them for a fee is still voluntary for physicians and PAs at this time. However providers of CME are required to file specified forms with the state contracted firm, CE Broker. This is an ongoing issue at this time and the final rules and regulations are under debate at this time. Watch the FAPA website for information on how this affects the PA profession. Reference: FAC 64B8-30.003 (4)(a); 64B8-30.005(2)(c-g) and (3) FAPA offers the HIV, Medical Errors course and Domestic Violence courses at each of our semi-annual conferences.. The Prescriptive Practice three hour course is available at each of the conferences as well, and can be obtained by mail from the FAPA office also. There is no charge for it at the conference, but if done by mail there is a fee. Contact the FAPA office for more definitive information. And check the website link for CME Opportunities on the Knowledge Café tab at the top of any page. Where can I get CME if I cannot wait for the next FAPA conference? In the Knowledge Café section of this website is a section providing links to various CME Opportunities. You can do correspondence courses, lectures, other meetings. FAPA is only one source of hundreds of hours of available CME. Just make sure it is accredited CME acceptable to the NCCPA and you will be okay for the state requirements as well. The state required courses have to be approved by the state so before you take the course make sure it has been approved by the state as meeting their requirements. Where can I obtain the 3 hour state required prescriptive practice course? The prescriptive practice course is required to get your prescribing privileges license through the state. Students at Florida PA programs get the course in school prior to graduation. You are required to view the entire video and take a short written test. The test will be graded and then a certificate of completion will be mailed to you. The course is also available on-demand via our website. First, you will need to purchase access to the course which you can do via this link. Your transaction is processed in real-time via our secure website and you will have instant access to the course content. You will also receive an e-mail with a link to the course so that you can return to the site and complete at your own pace. The final step is to take a post course quiz. Upon successful completion, your certificate will be mailed to you. The fee for this course is $25 for members and $50 for non-members. Here is a quick link to the state website page containing the application forms for PA licensure and renewal. What forms can I duplicate on a copier? The application, the licensure verification form, and the PA program verification form can be copied, and Part B of the Prescriber license What constitutes a separate employment location? A separate business practice. (Example): A medical group name "pediatric consultants" with ten offices would be considered one employment setting with ten satellite offices. Two medical groups with five offices each would be considered two separate employment locations. Can a notarized copy of my license from another state be used as verification of licensure? No. Verification of licensure must come directly to the board office from the source. What if I can't find my original documents? Obtain a duplicate from the source and submit a notarized statement explaining why you are unable to comply with this request. Can supporting documentation be sent separately from the application to insure I have made the deadline date? Yes. The application and application fee must be received by the deadline dates. The supporting documents can be mailed under separate cover. (And remember the verification service now offered by the FCVS.) What happens to the application if it's received a day or two after the deadline? All applications are processed in date order as they are received in the board office. Upon completion, the application will be presented to the next available Council meeting. Will the state accept a fax? Yes, they can proceed with a fax copy as long as the fax is followed up with the original. How long will it take to process my application? All applications are processed within 30 days. If your application is totally complete and there are no, repeat NO, questions, the Physician Assistant council staff will issue a license at that time. The application will then be ratified by the Physician Assistant Council at the next regularly scheduled meeting. However if there are any questions you will be contacted by letter and asked to explain in writing. The Physician Assistant Council may upon review of your application in cases where there are questions, request that the applicant appear before the Council in person. If you apply and receive a license you will not be notified further by the council staff when the application is ratified and accepted by the Council. What happens if my application is not complete? No application will be acted upon for approval until all requested information and documentation has been received. You ask for a certificate from my P.A. program. Do you mean the diploma? Yes. What is the application deadline? The P.A. council meets six times a year. The application should be in the board office two months prior to the meeting. What are the requirements to become a licensed physician assistant? All physician assistants must graduate from an accredited P.A. program in the U.S. If I am convicted of a felony, is it still possible to become licensed as a physician assistant? The Council on Physician Assistants makes the determination on who will be licensed, however legislation passed in 2009 provides that no health care provider licensed by the state can be issued a licensed or have a licensed renewed if they have been convicted of a felony. The most recent interpretation of this law by the Department of Health provides: 1) A physician assistant applying for an initial license and did not receive it prior by July 1, 2009 will be governed by the provisions of the new law i.e. they will be denied a license if they have been convicted or pleaded nolo contendere to certain 3rd degree felonies in the past 15 years. These include Medicaid fraud, credit card fraud or drug convictions. 2) A physician assistant who currently has a license in Florida and is renewing will not be subject to this new law i.e. their license can be renewed. However, just as in the past, each professional board may discipline the individual for criminal convictions. Can I be licensed as a temporary physician assistant even though I have taken the NCCPA exam? Only those eligible to take the exam, but who have not yet taken and passed the NCCPA exam can obtain a temporary physician assistant license. Is there an age limit to become a licensed physician assistant? Yes. You must be 18 and older. Can I work as a PA in Florida if I do not yet have a Florida license? No, you must be licensed as a physician assistant or a temporary physician assistant prior to practicing as a PA in Florida. What should I do if I have let my PA license lapse? Apply for a license renewal as soon as possible. Make sure that you are working under direct supervision at all times until you have received your new license. Do I need current NCCPA certification to work as a PA in Florida? No, however you need to have passed the initial certification examination. But please note that most hospitals, managed care organizations, and insurance companies now require current NCCPA certification, and so it is usually wise to maintain current certification. Which drugs are on the PA formulary? Prescribing physician assistants are able to prescribe any medication except those specifically prohibited by the Formulary Committee of the PA Council and the Boards of Medicine. This is termed an Exclusionary Formulary. Which drugs are excluded? At present the medications that physician assistants are excluded from prescribing are controlled substances, general anesthetics, and radiographic contrast materials. Are prescribing physician assistants required to keep a list of drugs that their supervising physician authorizes them to prescribe? Yes. Even though we have an exclusionary formulary, other sections of the law and administrative code require each prescribing PA to have a list of medications the PA and the supervising physician agree that the PA may prescribe under the supervising physicians authority. It must be signed, dated, and maintained in the office for five years and available to DOH representatives upon request. Can I join FAPA online? Yes, you can join or renew your membership online and pay your annual dues as well. Click on the Membership tab on the homepage for forms and online When is the membership period from? FAPA membership is on an annual basis from January 1st to December 31st of each calendar year. The FAPA office staff sends out renewals thru the mail in the last quarter of the calendar year. New members who join on or after October 1st of a calendar year receive full membership benefits for the rest of that year and the following calendar year as well, thus getting up to 15 months of membership benefits. If you sign up for the summer conference and join FAPA at the same time you get membership for the rest of that year PLUS the following calendar year. What are the dues? It depends on your membership category. Fellow, Associate, Affiliate dues are $185. Physician dues are $100. Military and Friendship dues are $50. Corporate dues are $500, and student dues are $50(covers the 2 yr. training period). Retired PAs dues are $50 but you cannot be working full time or part time in a paid PA position to be eligible for this category. The membership application has an explanation of each category of membership and can also be found in the Membership section on the website. Why should I join FAPA?
Which drugs can a prescribing PA write prescriptions for at this time? Only a PA with a current license with approved prescribing privileges can write prescriptions in Florida. Prescribing PAs can prescribe any medication except those specifically excluded by law under the provisions of our Exclusionary formulary. Also, the only medications you should write for are those medications authorized by your supervising physician within the scope of his/her practice since you are also limited to practice within the scope of your supervising physicians' practice. Prescribing PAs are required to maintain a list of medications that their supervising physician authorizes them to prescribe. It must be signed, dated and maintained in the office and available to DOH representatives upon request. How does a change in employment affect my prescribing privileges? Prescribing privileges are granted to a PA working with a specific physician or physicians after you submit the properly completed application form and it is approved and returned to you by the state. You may prescribe under their delegated authority while under their supervision. If you change supervising physicians you may not prescribe under your new supervising physician until you have submitted the proper forms to the state and received them back as annotated received and approved. Submitting the Change of Supervising Physician Data Form alone is NOT sufficient to prescribe under the new physician(s). You must submit a new application for change in prescribing privileges and a supervision physician data form with the new physician(s) within thirty days of the change. How does changing a practice specialty affect prescribing privileges? As of July 1, 2010, there is no longer a statutory requirement to have completed three months of supervision in a specialty after such a change in order to be granted privileges in that specialty. Again, you must still submit the properly completed application for change in prescribing privileges to that new specialty position. If you had prescribing privileges in Florida before, you do not have to pay the fee again. If you work in two different specialties, you have to complete an application for each setting, but there is no fee for the second application. Such as if you work in a Family Practice office and then work night or weekends in the Emergency Room. How do I get prescribing rights? You may apply for prescribing privileges at the time you apply for your license, or later after you get your permanent state license. There is a separate application form for prescribing privileges which you must get from the state. Due to legislation passed in July 2010, you no longer require three months of supervised experience in the specialty for which you are applying for prescription privileges. (When completing the forms for new privileges or changes to privileges, in the space where it asks for one to document the experience, just write "No longer required by law as of July 1, 2010." New forms should be prepared soon by the PA Council.) Don't forget to notify the state when you pass the NCCPA certification exam and provide proof to them to get your permanent license. Can I sign for sample medications received from pharmaceutical representatives? Yes, if you have a prescribing license, but only for those medications you are authorized to prescribe. Am I required to maintain a list of drugs that I prescribe? F.A.C. 64B-300.007 and 64B15-6.0037 require that each supervising physician and prescribing physician assistant shall enter into and keep on file a written agreement outlining which of the medicinal drugs in the formulary that the supervising physician has specifically authorized the prescribing physician assistant to prescribe. It must be signed and dated by all parties and maintained on file for at least five years, and be available to responsible Department of Health personnel upon request. Can I dispense medications? PAs are allowed to dispense medications for a fee if they are Licensed Prescribing PAs who are being supervised by a physician who has dispensing privileges. Formulary laws still apply, so PAs may not dispense medications outside of their negative formulary. Does my supervising physician have to countersign my prescriptions? No, as long as it is an approved drug on the formulary and included on your agreed upon list. Do I have to keep duplicate copies of the prescriptions on file? No. You must include notations in the medical record regarding the medications given the patient by you. It is recommended that you include in the note the name of the drug, strength, amount prescribed, specific directions, and refill instructions. What information must be on the prescription form? The prescription form may be preprinted. It must have the supervising physicians name, practice address, and phone number. It must have the physician assistant’s name and prescriber number on it also. If you work in a satellite office, or another practice setting, you will need to have a prescription form for each office or setting including all the required information. Can PAs perform Florida Department of Law Enforcement physical examinations? Yes. PAs can also perform the sports physicals for schools as well. Can PAs sign the Application for Disabled Person Parking Permit Placard? Yes. PAs are authorized to sign these application forms. Are PAs required by law to have their notes cosigned by physicians? Florida law states that a physician is not required to cosign PA notations in medical records. The decision of how to best supervise a PA, however, lies with the supervising physician(s). Therefore they still have the right to require cosigning in their clinic or setting if that is their prerogative. Are PAs required to have written protocols in order to practice? If a physician assistant practices in a health department setting, the regulations set forth in F.S. 154.04(1)(c) apply to physician assistants and nurse practitioners in these specific settings. This statute requires written protocols for PAs and ARNPs in that setting. If you practice in any other setting you DO NOT need written protocols by state law. However, please be aware that some insurance companies, hospitals, physicians or other supervisory party may include protocols at their discretion. While restrictive, it is not illegal. Remember that responsible parties, credentialing agencies, and other supervisory parties cannot do LESS than the law requires, but they may place other restrictions as part of the job limitations or requirements. Most employers will not want to put any more limitations on your practice than are required by law. Is there a state law regarding reimbursement for PAs in surgical first assisting? Yes. Chapter 627.419, paragraph (6) of Title XXXVII relating to Insurance Rates and Contracts provides for reimbursement of physician assistants who are assisting in surgery. On the homepage of the FAPA website is a link to "Reimbursement Information" and if you have questions in that area you may find the answers there. If you have questions that were not answered above, please contact us.
What are the state laws in regards to notifying patients of my credentials as a Physician Assistant? All health care licensees must provide notice to patients of what type of license the health care provider has (e.g., Medical Doctor, ARNP, Physician Assistant, Dentist, etc):
What are the supervision requirements for PAs? Supervisory relationships with Physician Assistants (PA) and Advanced Registered Nurse Practitioners (ARNP) in medical office settings are now subject to new requirements/limitations:
The following apply only to satellite offices offering primarily dermatologic or skin care services, which include, aesthetic skin care services other than plastic surgery:
We believe that this article should answer about 99% of your questions, but if you still have questions, just call us and we will do our best to assist you. We sincerely want your move to Florida and the licensure process to be as painless as possible.
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