MOVING TO FLORIDA?
(Updated February 15th, 2007)
By
Ron Pace, PA-C
Edited by Eric Smith, PA-C
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 I decided several years ago it was time to write the definitive article to answer all these questions. I 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. And I update it on a regular basis with the latest one being done on July 1st, 2006.
Some of the many questions we repeatedly receive are:
How do I get my license?
Why does it take so long to get my license?
Why is the prescribing license separate from the regular license?
What drugs can I prescribe?
What is this "prescribing privileges course" I have to take and where can I get it?
What CME courses are required to get licensed in Florida?
Why can't I prescribe controlled drugs?
Why do my charts have to be countersigned and the NPs do not?
Most, if not all, of the answers can be found on the FAPA website. I 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 not motivated enough to do it themselves and want someone else to do it for them, I felt it was time to 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. I 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. 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.
I would advise you to print this article to keep for reference. We have it available for you in PDF format.
Moving To Florida Article
Print for Reference
The first thing you have to realize is that the southern medical folks are very conservative, and no where is this more true than 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 vast 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. The FAPA leadership continues to work to that end but as of July 2006, it is not in our near future to get these privileges.
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 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. To get an application for a Florida license call 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, 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 Website
The DOH website is not the easiest site in the world to navigate but it is possible. So here is the pathway you need to follow: (Print it out so you can have it to read as you navigate the site.)
Scroll down to Information on Becoming a Practitioner
Click on Information on Regulated Professions
Click on Physician Assistants
Click on Information on Becoming a Practitioner
Click on License Requirement, Application Deadlines, and Fees, or
Click on Information on How To Apply
Click on Application
Click on Physician Assistant and other forms
There are several 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 14 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.
1. It will take two to six months to get your license. You cannot speed it up so don't waste your time trying.
As one of the more experienced PAs in Florida and one who receives hundreds of questions and emails about practice in Florida I 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
have 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."
Now I 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 NEW CME COURSE FROM FAPA
PA PRACTICE IN FLORIDA:
ABOUT THE CME PROGRAM
The course was authored by Ron Pace, PA-C, a FAPA Past President. It was reviewed and edited by members
of the FAPA Legislative and Government Affairs Committee.
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, 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:
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.
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, PA-C
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 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.
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 Search Program. 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 anyone looking for a PA job in Florida. 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 new 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 new 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.
End of life and palliative care courses can no longer be used in lieu of the HIV/AIDS course or Domestic Violence course.
Below is a summary of Florida CME requirements, effective July 1, 2006:
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, 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 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. You can also get them via correspondence courses thru a company called MESA that works with FAPA in this area. Their phone number
is 800-597-6372. They also have a website you can visit, ARCMESA.
The Prescriptive Practice three hour video 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.
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. FAPA offers the course via a video presentation at each of the
conferences at no cost to conference attendees. 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 video/DVD is also
available from the FAPA office. It will be mailed to you along with the test. Once the office receives the test
and video/DVD back in the office, your certificate will be mailed to you if you passed the test. Call the FAPA office at 407-774-7880 to
arrange to have the video/DVD sent to you. There is a fee for this service. It is $25 for members, and $50 for
non-members. To order online, Click Here For the Online Order Form to order the video using a credit card (the FAPA site is a secure site.)
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, the NCCPA 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. This procedure is new as of May 2006: 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.
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. The rule approving this went into effect
in February 2002. This is termed an Exclusionary Formulary.
Which drugs are excluded?
At present the medications that physician assistants are excluded from prescribing are controlled substances,
anti-psychotics, general anesthetics, radiographic contrast materiels, and parenteral injectables except for
insulin and epinephrine.
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 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. We do not pro-rate membership,
but 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 memberhship
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 $150. 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 an 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?
If you change from one specialty to another you must have completed three months
of supervision in that specialty within the last four years before you can be granted privileges in that specialty. Again, you must
submit the properly completed application for change in prescribing privileges in that specialty after completion of the three
months supervision in that new specialty if you have not worked for three months in that specialty within the preceding four years.
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. You must have three months supervised experience
in the specialty for which you are applying for prescription privileges. You cannot count any time
for experience while working with a temporary license. The three months begin after you get your permanent
license. Don't forget to notify the state when you pass the NCCPA certification exam and provide
proof to them to get you 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?
Effective July 1, 2007, 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. Florida statute 465.0276 and
the PA Statutes (458.347 and 459.022) will be adjusted accordingly to reflect
this new law, which was signed into effect by Governor Charlie Crist in June
2007.
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. He does
have to countersign your medical notes in accordance with current regulations within seven days for the first six months of practice
under their supervision, and within thirty days after the first six months.
Do I have to keep duplicate copies of the prescriptions on file?
This practice is no longer required. 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 must be preprinted with the prescribing physician assistant's name, practice address,
phone number, and prescriber number. It must also contain the supervising physician's name, address and phone
number as well (if different from the physician assistant's). If you work in an office setting with more
than one supervising physician, each physician must be listed on the prescription. You can get them printed
with a check box by their name so that you can check off which physician is supervising you in providing
care to that particular patient, i.e., the physician whom will be countersigning the record. If you work
in a satellite office, or another practice setting, you will need to have a prescription form preprinted
for each office or setting including all the required information.
Can PAs perform Florida Department of Law Enforcement physical examinations?
Yes. The law was changed in the 2002 legislative session that allows that now. PAs can also perform the
sports physicals for schools as well.
Can PAs sign the Application for Disabled Person Parking Permit Placard?
Yes. A law was passed in 2005 that authorizes PAs to sign these application forms.
What should I do about getting my charts co-signed if I have an alternate supervising physician
covering me while my primary supervising physician is out of town?
Make sure the alternate supervising physician signs all chart notes that were done while supervising you.
The physician's name needs to be on the prescriptions that you write as well if you have prescribing
privileges, thus his name should be listed as an alternate supervising physician on the supervision data
form, and he should have signed a Part B form for the prescribing license.
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.
There was new legislation passed in 2006 which affects several aspects of our practice act. The Board of Medicine just posted this
information on their Web Board. Please read this information carefully and make sure you understand your obligations under these new
statutory requirements.
THE BILLS: Effective July 1, the following bills are in force and may affect your license:
SUMMARY OF BILLS: The following are brief summaries and are not a substitute for reading the full bill text.
BILL #1. HB 587-Relating to Health Care Practitioners/Licensees:
BILL # 2. HB 699-Relating to Health Care Practitioners:
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:
The bill does NOT:
The bill affects ARNP protocols:
BILL # 3. SB 1408 Relating to Medical Records
BILL # 4. SB 1690 Relating to Physician Assistants (PA):
I 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.
NCCPA Verification Form
Prescribing PA Application and Instruction
Some personal observations and comments from my years of experience here about the Florida licensure process:
2. Don't make people unhappy with you on the phone. Always be polite, and cordial on the phone. Above all, do
not get upset and lose control, raise your voice and scream, yell, or otherwise be verbally abusive.
3. Remain the consummate professional that you are expected to be.
4. Dot every "I" and cross every "T" on the forms. If it is not totally complete and correct it will most
likely be bounced back to you at a later date and thus delayed in approval.
5. Make sure you account for your entire professional history and do not leave any chronological gaps.
6. Make copies of everything you send them.
7. Get names of people of you talk with on the phone, and record dates and times.
8. Speaking of talking with people on the phone, the less you call the better off you are. Maintain a low profile.
9. Be honest in everything you say on the phone and write down on the application. The Board of Medicine here takes a
very dim view of applicants who provide false information either unintentionally, and even more so if done so intentionally
and you get caught. It will cost you time and money if they suspect false information and they will probably request your
presence before the Board of Medicine to personally explain any questionable area before approving a license.
WHAT EVERY PA & SUPERVISING
PHYSICIAN
NEEDS TO KNOW
This continuing medical education activity was designed specifically to assist physician assistants
applying for initial licensure to understand the Florida statutes and the Florida Administrative Code
(FAC) and to learn what your legal responsibilities are as a licensed physician assistant in Florida.
It was also designed to assist those licensed physician assistants who are applying for license renewal
in updating their knowledge base of current statutes and laws. Finally, it was designed to assist
physicians who are currently supervising physicians of PAs, and physicians who are considering becoming
a supervising physician, to better understand the PA practice acts and rules and their responsibilities
as a supervising physician.
Upon completion of this course the participant will:
This program has been reviewed and is approved for a maximum of 2.5 hours of AAPA Category I (Preapproved) CME
credit by the AAPA Physician Assistant Review Panel. Approval is valid for one year from the issue date of
February 2007. Participants may submit the self-assessment at any time during that period.
The CME course documents package contains:
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 $20 for FAPA members
and $30 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.
FAPA Past President
CME Course Author/Administrator
When should I call the Board of Medicine or PA Council?
Proof of completing a 2-hour course of category 1 or 2, Preventing Medical Errors
HB 587
SB 1690
SB 1408
HB 699
All health care licensees must provide notice to patients of what type of license the health care provider
has (e.g., Medical Doctor, Dentist, ARNP, Physician Assistant, Dentist, etc):
Continuing education requirements for Board of Medicine Licenses are changed as follows:
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