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CS/HB 683 2026
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
A bill to be entitled 1
An act relating to the performance of physician 2
assistants and advanced practice registered nurses; 3
amending ss. 458.347 and 459.022, F.S.; deleting the 4
requirement that a supervising physician notify the 5
Department of Health in writing of any delegation of 6
prescribing authority to a physician assistant; 7
deleting the requirement that a supervising 8
physician's name be included in the prescription 9
issued by a physician assistant; revising requirements 10
for the drug formulary for physician assistants; 11
amending s. 464.012, F.S.; revising the drug formulary 12
requirements for advanced practice registered nurses 13
authorized to prescribe medications; providing an 14
exception for psychiatric nurses; providing an 15
effective date. 16
17
Be It Enacted by the Legislature of the State of Florida: 18
19
Section 1. Paragraphs (e) and (f) of subsection (4) of 20
section 458.347, Florida Statutes, are amended to read: 21
458.347 Physician assistants.— 22
(4) PERFORMANCE OF PHYSICIAN ASSISTANTS.— 23
(e) A supervising physician may delegate to a fully 24
licensed physician assistant the authority to prescribe or 25
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
dispense any medication used in the supervising physician's 26
practice unless such medication is listed on the formulary 27
created pursuant to paragraph (f). A fully licensed physician 28
assistant may only prescribe or dispense such medication only 29
under the following conditions circumstances: 30
1. A physician assistant must clearly identify to the 31
patient that he or she is a physician assistant. 32
2. The supervising physician must notify the department of 33
his or her intent to delegate, on a department-approved form, 34
before delegating such authority and of any change in 35
prescriptive privileges of the physician assistant. Authority to 36
dispense may be delegated only by a supervising physician who is 37
registered as a dispensing practitioner in compliance with s. 38
465.0276. 39
3. A fully licensed physician assistant may procure 40
medical devices and drugs unless the medication is listed on the 41
formulary created pursuant to paragraph (f). 42
4. The physician assistant must complete a minimum of 10 43
continuing medical education hours in the specialty practice in 44
which the physician assistant has prescriptive privileges with 45
each licensure renewal. Three of the 10 hours must consist of a 46
continuing education course on the safe and effective 47
prescribing of controlled substance medications which is offered 48
by a statewide professional association of physicians in this 49
state accredited to provide educational activities designated 50
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
for the American Medical Association Physician's Recognition 51
Award Category 1 credit, designated by the American Academy of 52
Physician Assistants as a Category 1 credit, or designated by 53
the American Osteopathic Association as a Category 1-A credit. 54
5. The prescription may be in paper or electronic form but 55
must comply with ss. 456.0392(1) and 456.42(1) and chapter 499 56
and must contain the physician assistant's name, address, and 57
telephone number and the name of each of his or her supervising 58
physicians. Unless it is a drug or drug sample dispensed by the 59
physician assistant, the prescription must be filled in a 60
pharmacy permitted under chapter 465 and must be dispensed in 61
that pharmacy by a pharmacist licensed under chapter 465. 62
6. The physician assistant must note the prescription or 63
dispensing of medication in the appropriate medical record. 64
(f)1. The council shall establish a formulary of medicinal 65
drugs that a fully licensed physician assistant having 66
prescribing authority under this section or s. 459.022 may not 67
prescribe. The formulary must include general anesthetics and 68
radiographic contrast materials and must limit the prescription 69
of Schedule II controlled substances as listed in s. 893.03 to a 70
7-day supply or, in the case of Schedule II psychiatric mental 71
health controlled substances, a 30-day supply if. the 72
prescription is formulary must also restrict the prescribing of 73
Schedule II psychiatric mental health controlled substances for 74
a child children younger than 18 years of age to a 14-day 75
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
supply, provided the physician assistant is under the 76
supervision of a pediatrician, a family practice physician, an 77
internal medicine physician, or a psychiatrist. 78
2. In establishing the formulary, the council shall 79
consult with a pharmacist licensed under chapter 465, but not 80
licensed under this chapter or chapter 459, who shall be 81
selected by the State Surgeon General. 82
3. Only the council shall add to, delete from, or modify 83
the formulary. Any person who requests an addition, a deletion, 84
or a modification of a medicinal drug listed on such formulary 85
has the burden of proof to show cause why such addition, 86
deletion, or modification should be made. 87
4. The boards shall adopt the formulary required by this 88
paragraph, and each addition, deletion, or modification to the 89
formulary, by rule. Notwithstanding any provision of chapter 120 90
to the contrary, the formulary rule shall be effective 60 days 91
after the date it is filed with the Secretary of State. Upon 92
adoption of the formulary, the department shall mail a copy of 93
such formulary to each fully licensed physician assistant having 94
prescribing authority under this section or s. 459.022, and to 95
each pharmacy licensed by the state. The boards shall establish, 96
by rule, a fee not to exceed $200 to fund the provisions of 97
paragraph (e) and this paragraph. 98
Section 2. Paragraph (e) of subsection (4) of section 99
459.022, Florida Statutes, is amended to read: 100
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
459.022 Physician assistants.— 101
(4) PERFORMANCE OF PHYSICIAN ASSISTANTS.— 102
(e) A supervising physician may delegate to a fully 103
licensed physician assistant the authority to prescribe or 104
dispense any medication used in the supervising physician's 105
practice unless such medication is listed on the formulary 106
created pursuant to s. 458.347. A fully licensed physician 107
assistant may only prescribe or dispense such medication only 108
under the following conditions circumstances: 109
1. A physician assistant must clearly identify to the 110
patient that she or he is a physician assistant. 111
2. The supervising physician must notify the department of 112
her or his intent to delegate, on a department-approved form, 113
before delegating such authority and of any change in 114
prescriptive privileges of the physician assistant. Authority to 115
dispense may be delegated only by a supervising physician who is 116
registered as a dispensing practitioner in compliance with s. 117
465.0276. 118
3. A fully licensed physician assistant may procure 119
medical devices and drugs unless the medication is listed on the 120
formulary created pursuant to s. 458.347(4)(f). 121
4. The physician assistant must complete a minimum of 10 122
continuing medical education hours in the specialty practice in 123
which the physician assistant has prescriptive privileges with 124
each licensure renewal. Three of the 10 hours must consist of a 125
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F L O R I D A H O U S E O F R E P R E S E N T A T I V E S
continuing education course on the safe and effective 126
prescribing of controlled substance medications which is offered 127
by a provider that has been approved by the American Academy of 128
Physician Assistants and which is designated for the American 129
Medical Association Physician's Recognition Award Category 1 130
credit, designated by the American Academy of Physician 131
Assistants as a Category 1 credit, or designated by the American 132
Osteopathic Association as a Category 1-A credit. 133
5. The prescription may be in paper or electronic form but 134
must comply with ss. 456.0392(1) and 456.42(1) and chapter 499 135
and must contain the physician assistant's name, address, and 136
telephone number and the name of each of his or her supervising 137
physicians. Unless it is a drug or drug sample dispensed by the 138
physician assistant, the prescription must be filled in a 139
pharmacy permitted under chapter 465, and must be dispensed in 140
that pharmacy by a pharmacist licensed under chapter 465. 141
6. The physician assistant must note the prescription or 142
dispensing of medication in the appropriate medical record. 143
Section 3. Paragraph (a) of subsection (6) of section 144
464.012, Florida Statutes, is amended to read: 145
464.012 Licensure of advanced practice registered nurses; 146
fees; controlled substance prescribing.— 147
(6)(a) The board shall establish a committee to recommend 148
a formulary of controlled substances that an advanced practice 149
registered nurse may not prescribe or may prescribe only for 150
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specific uses or in limited quantities. The committee must be 151
composed consist of three advanced practice registered nurses 152
licensed under this section, recommended by the board; three 153
physicians licensed under chapter 458 or chapter 459 who have 154
work experience with advanced practice registered nurses, 155
recommended by the Board of Medicine; and a pharmacist licensed 156
under chapter 465 who is a doctor of pharmacy, recommended by 157
the Board of Pharmacy. The committee may recommend an evidence-158
based formulary applicable to all advanced practice registered 159
nurses which is limited by specialty certification, is limited 160
to approved uses of controlled substances, or is subject to 161
other similar restrictions the committee finds are necessary to 162
protect the health, safety, and welfare of the public. The 163
formulary must restrict the prescribing of psychiatric mental 164
health controlled substances for children younger than 18 years 165
of age to a 30-day supply, except that such restriction does not 166
apply to controlled substances that are prescribed by advanced 167
practice registered nurses who also are psychiatric nurses as 168
defined in s. 394.455. The formulary must also limit the 169
prescribing of Schedule II controlled substances as listed in s. 170
893.03 to a 7-day supply, except that such restriction does not 171
apply to controlled substances that are psychiatric medications 172
prescribed by psychiatric nurses as defined in s. 394.455. 173
Section 4. This act shall take effect July 1, 2026. 174