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Florida Senate
-
2026
SB 668
By
Senator Truenow
13-00692-26 2026668__
1 A bill to be entitled
2 An act relating to physician assistants; amending ss.
3 458.347 and 459.022, F.S.; revising legislative
4 intent; revising the definition of the term “physician
5 assistant”; providing for the registration of
6 physician assistants to engage in practice without
7 physician supervision; requiring the Council on
8 Physician Assistants to register physician assistants
9 meeting specified criteria; providing financial
10 responsibility requirements for registered physician
11 assistants; providing exceptions; specifying
12 activities registered physician assistants may engage
13 in without physician supervision; limiting the types
14 of surgical procedures registered physician assistants
15 may perform; requiring the council, in consultation
16 with the Board of Medicine and the Board of
17 Osteopathic Medicine, to adopt rules establishing
18 standards of practice for registered physician
19 assistants; requiring biennial registration renewal;
20 requiring the department to distinguish registered
21 physician assistants’ licenses and include the
22 registration in their practitioner profiles; requiring
23 registered physician assistants to provide new
24 patients with specified information either before or
25 during the initial patient encounter; requiring the
26 council to adopt rules; providing construction;
27 providing an effective date.
28
29 Be It Enacted by the Legislature of the State of Florida:
30
31 Section 1. Present subsections (7) through (16) of section
32 458.347, Florida Statutes, are redesignated as subsections (8)
33 through (17), respectively, a new subsection (7) is added to
34 that section, and subsection (1) and paragraph (e) of subsection
35 (2) of that section are amended, to read:
36 458.347 Physician assistants.—
37 (1) LEGISLATIVE INTENT.—The purpose of this section is to
38
provide means by which physician assistants may practice
39
medicine in collaboration with physicians and other health care
40
p
ractitioners
to ensure high-quality medical care is available
41
at a reasonable cost
to consumers
.
authorize
Physician
42 assistants, with their education, training, and experience in
43 the field of medicine,
are well suited to provide these
to
44
provide increased efficiency of and access to high-quality
45 medical services
at a reasonable cost to consumers
.
46 (2) DEFINITIONS.—As used in this section, the term:
47 (e) “Physician assistant” means a person who is a graduate
48 of an approved program
or its equivalent
or meets standards
49 approved by the
council
boards
and is licensed to perform
50 medical services
delegated by the supervising physician
.
51
(7)
PRACTICING WITHOUT PHYSICIAN SUPERVISION.—
52
(a)
Registration
.—
To practice without physician
53
supervision, a physician assistant must register with the
54
council on a form prescribed by the council. The council must
55
register a physician assistant to practice without physician
56
supervision if the applicant demonstrates to the satisfaction of
57
the council that he or she meets all of the following criteria
:
58
1.
Holds an active, unencumbered license to practice
as a
59
physician assistant under this chapter. A physician assistant
60
practicing under a temporary license, a temporary certificate
61
for practice in areas of critical need, or any other type of
62
conditional license is not eligible for registration under this
63
subsection.
64
2.
Has not been subject to disciplinary action as specified
65
in s. 456.072 or s. 458.331 or any similar disciplinary action
66
in another state or other territory or jurisdiction within the 5
67
years immediately preceding the registration application
.
68
3
. Has completed, in any state, jurisdiction, or territory
69
of the United States, at least 3,000 clinical practice hours,
70
which may include clinical instructional hours provided by the
71
applicant, within the 5 years immediately preceding the
72
registration
application
. For purposes of this paragraph,
the
73
term
“clinical instruction” means education provided by faculty
74
in a clinical setting in a graduate program leading to a
75
master’s or doctoral degree in a clinical
p
hysician
a
ssistant
76
practice
area
.
77
4.
Has fulfilled any other condition of registration
78
prescribed by council rule.
79
(b)
Financial responsibility.
—
80
1. A
physician assistant
registered under this
sub
section
81
must, by one of the following methods, demonstrate to the
82
satisfaction of the council and the department financial
83
responsibility to pay claims and costs ancillary thereto arising
84
out of the rendering of, or the failure to render, medical care,
85
treatment, or services:
86
a. Obtaining and maintaining professional liability
87
coverage in an amount not less than $100,000 per claim, with a
88
minimum annual aggregate of not less than $300,000, from an
89
authorized insurer as defined in s. 624.09, from a surplus lines
90
insurer as defined in s. 626.914(2), from a risk retention group
91
as defined in s. 627.942, from the Joint Underwriting
92
Association established under s. 627.351(4), or through a plan
93
of self-insurance as provided in s. 627.357; or
94
b. Obtaining and maintaining an unexpired, irrevocable
95
letter of credit, established pursuant to chapter 675, in an
96
amount of not less than $100,000 per claim, with a minimum
97
aggregate availability of credit of not less than $300,000. The
98
letter of credit must be payable to the physician assistant as
99
beneficiary upon presentment of a final judgment indicating
100
liability and awarding damages to be paid by the physician
101
assistant or upon presentment of a settlement agreement signed
102
by all parties to such agreement when such final judgment or
103
settlement is a result of a claim arising out of the rendering
104
of, or the failure to render, medical care and services.
105
2
. The requirements of
sub
paragraph
1.
do not apply to
any
106
of the following
:
107
a
. A physician assistant registered under this s
ubs
ection
108
who practices exclusively as an officer, employee, or agent of
109
the Federal Government or of the state or its agencies or its
110
subdivisions.
111
b
. A physician assistant whose registration under this
112
sub
section has become inactive and who is not practicing as a
113
physician assistant registered under
this subsection
in this
114
state.
115
c
. A physician assistant registered under this
sub
section
116
who practices only in conjunction with his or her teaching
117
duties at an accredited school or its main teaching hospitals.
118
Such practice is limited to that which is incidental to and a
119
necessary part of duties in connection with the teaching
120
position.
121
d
. A physician assistant who holds an active registration
122
under this
sub
section and who is not engaged in practice without
123
physician
supervision
as authorized under this
sub
section in
124
this state. If such person initiates or resumes any practice as
125
a physician assistant
without physician supervision
, he or she
126
must notify the department of such activity and fulfill the
127
professional liability coverage requirements of
sub
paragraph
1
.
128
(c)
Practice requirements.
—
129
1. A physician assistant registered under this s
ubs
ection
130
may
engage in any of the following activities without physician
131
supervision
:
132
a. Practice in primary care, family medicine, pediatrics,
133
internal medicine, women’s health
,
and psychiatry as defined by
134
council
rule
.
135
b. Perform the general functions of a
p
hysician
a
ssistant.
136
c. For a patient who requires the services of a health care
137
facility as defined in s. 408.032(8):
138
(I)
Admit the patient to the facility.
139
(II)
Manage the care received by the patient in the
140
facility.
141
(III)
Discharge the patient from the facility, unless
142
prohibited by federal law or rule.
143
d. Provide a signature,
a
certification,
a
stamp,
a
144
verification,
an
affidavit, or
an
endorsement that is otherwise
145
required by law to be provided by a physician, except
that
a
146
physician assistant registered under this
sub
section may not
147
issue a physician certification under s. 381.986.
148
2. A
p
hysician
a
ssistant engaging in practice under this
149
s
ubs
ection may not perform any surgical procedure
that goes
150
deeper than
the
subcutaneous tissue.
151
3. The council shall
, in consultation with the boards,
152
adopt rules
establishing standards of practice for
p
hysician
153
a
ssistants registered under this
sub
section.
154
(d)
Registration renewal.
—A physician assistant must
155
biennially renew registration under this
sub
section. The
156
biennial renewal for registration
must
coincide with the
157
physician assistant’s biennial renewal period for licensure.
158
(e)
Practitioner profile.
—The department
must
conspicuously
159
distinguish a physician assistant
’s
license if he or she is
160
registered with the
c
ouncil under
this subsection
and include
161
the registration in the physician assistant practitioner profile
162
created under s. 456.041.
163
(f)
Disclosures.
—When engaging in practice under
this
164
subsection
,
a
physician assistant
shall
provide each new patient
165
information in writing
detailing the physician assistant’s
166
qualifications and the fact that he or she is practicing without
167
physician
supervision. The information must be provided to the
168
patient either
before or during the initial patient encounter.
169
(g)
Rules.
—The
c
ouncil shall adopt rules to implement
this
170
subsection
.
171
(h)
Construction.
—
This
subsection
may not be construed to
172
limit a physician assistant from practicing under a supervisory
173
agreement with a physician.
174 Section 2. Present subsections (7) through (16) of section
175 459.022, Florida Statutes, are redesignated as subsections (8)
176 through (17), respectively, a new subsection (7) is added to
177 that section, and subsection (1) and paragraph (e) of subsection
178 (2) of that section are amended, to read:
179 459.022 Physician assistants.—
180 (1) LEGISLATIVE INTENT.—The purpose of this section is to
181
provide means by which physician assistants may practice
182
medicine in collaboration with physicians and other health care
183
p
ractitioners
to ensure high-quality medical care is available
184
at a reasonable cost
to consumers
.
authorize
Physician
185 assistants, with their education, training, and experience in
186 the field of medicine,
are well suited to provide these
to
187
provide increased efficiency of and access to high-quality
188 medical services
at a reasonable cost to consumers
.
189 (2) DEFINITIONS.—As used in this section, the term:
190 (e) “Physician assistant” means a person who is a graduate
191 of an approved program
or its equivalent
or meets standards
192 approved by the
council
boards
and is licensed to perform
193 medical services
delegated by the supervising physician
.
194
(7)
PRACTICING WITHOUT PHYSICIAN SUPERVISION.—
195
(a)
Registration
.—
To practice without physician
196
supervision, a physician assistant must register with the
197
council on a form prescribed by the council. The council must
198
register a physician assistant to practice without physician
199
supervision if the applicant demonstrates to the satisfaction of
200
the council that he or she meets all of the following criteria
:
201
1.
Holds an active, unencumbered license to practice
as a
202
physician assistant under this chapter. A physician assistant
203
practicing under a temporary license, a temporary certificate
204
for practice in areas of critical need, or any other type of
205
conditional license is not eligible for registration under this
206
subsection.
207
2.
Has not been subject to disciplinary action as specified
208
in s. 456.072 or s. 45
9.015
or any similar disciplinary action
209
in another state or other territory or jurisdiction within the 5
210
years immediately preceding the registration application
.
211
3
. Has completed, in any state, jurisdiction, or territory
212
of the United States, at least 3,000 clinical practice hours,
213
which may include clinical instructional hours provided by the
214
applicant, within the 5 years immediately preceding the
215
registration
application
. For purposes of this paragraph,
the
216
term
“clinical instruction” means education provided by faculty
217
in a clinical setting in a graduate program leading to a
218
master’s or doctoral degree in a clinical
p
hysician
a
ssistant
219
practice
area
.
220
4.
Has fulfilled any other condition of registration
221
prescribed by council rule.
222
(b)
Financial responsibility.
—
223
1. A
physician assistant
registered under this
sub
section
224
must, by one of the following methods, demonstrate to the
225
satisfaction of the council and the department financial
226
responsibility to pay claims and costs ancillary thereto arising
227
out of the rendering of, or the failure to render, medical care,
228
treatment, or services:
229
a. Obtaining and maintaining professional liability
230
coverage in an amount not less than $100,000 per claim, with a
231
minimum annual aggregate of not less than $300,000, from an
232
authorized insurer as defined in s. 624.09, from a surplus lines
233
insurer as defined in s. 626.914(2), from a risk retention group
234
as defined in s. 627.942, from the Joint Underwriting
235
Association established under s. 627.351(4), or through a plan
236
of self-insurance as provided in s. 627.357; or
237
b. Obtaining and maintaining an unexpired, irrevocable
238
letter of credit, established pursuant to chapter 675, in an
239
amount of not less than $100,000 per claim, with a minimum
240
aggregate availability of credit of not less than $300,000. The
241
letter of credit must be payable to the physician assistant as
242
beneficiary upon presentment of a final judgment indicating
243
liability and awarding damages to be paid by the physician
244
assistant or upon presentment of a settlement agreement signed
245
by all parties to such agreement when such final judgment or
246
settlement is a result of a claim arising out of the rendering
247
of, or the failure to render, medical care and services.
248
2
. The requirements of
sub
paragraph
1.
do not apply to
any
249
of the following
:
250
a
. A physician assistant registered under this s
ubs
ection
251
who practices exclusively as an officer, employee, or agent of
252
the Federal Government or of the state or its agencies or its
253
subdivisions.
254
b
. A physician assistant whose registration under this
255
sub
section has become inactive and who is not practicing as a
256
physician assistant registered under
this subsection
in this
257
state.
258
c
. A physician assistant registered under this
sub
section
259
who practices only in conjunction with his or her teaching
260
duties at an accredited school or its main teaching hospitals.
261
Such practice is limited to that which is incidental to and a
262
necessary part of duties in connection with the teaching
263
position.
264
d
. A physician assistant who holds an active registration
265
under this
sub
section and who is not engaged in practice without
266
physician
supervision
as authorized under this
sub
section in
267
this state. If such person initiates or resumes any practice as
268
a physician assistant
without physician supervision
, he or she
269
must notify the department of such activity and fulfill the
270
professional liability coverage requirements of
sub
paragraph
1
.
271
(c)
Practice requirements.
—
272
1. A physician assistant registered under this s
ubs
ection
273
may
engage in any of the following activities without physician
274
supervision
:
275
a. Practice in primary care, family medicine, pediatrics,
276
internal medicine, women’s health
,
and psychiatry as defined by
277
council
rule
.
278
b. Perform the general functions of a
p
hysician
a
ssistant.
279
c. For a patient who requires the services of a health care
280
facility as defined in s. 408.032(8):
281
(I)
Admit the patient to the facility.
282
(II)
Manage the care received by the patient in the
283
facility.
284
(III)
Discharge the patient from the facility, unless
285
prohibited by federal law or rule.
286
d. Provide a signature,
a
certification,
a
stamp,
a
287
verification,
an
affidavit, or
an
endorsement that is otherwise
288
required by law to be provided by a physician, except
that
a
289
physician assistant registered under this
sub
section may not
290
issue a physician certification under s. 381.986.
291
2. A
p
hysician
a
ssistant engaging in practice under this
292
s
ubs
ection may not perform any surgical procedure
that goes
293
deeper than
the
subcutaneous tissue.
294
3. The council shall
, in consultation with the boards,
295
adopt rules
establishing standards of practice for
p
hysician
296
a
ssistants registered under this
sub
section.
297
(d)
Registration renewal.
—A physician assistant must
298
biennially renew registration under this
sub
section. The
299
biennial renewal for registration
must
coincide with the
300
physician assistant’s biennial renewal period for licensure.
301
(e)
Practitioner profile.
—The department
must
conspicuously
302
distinguish a physician assistant
’s
license if he or she is
303
registered with the
c
ouncil under
this subsection
and include
304
the registration in the physician assistant practitioner profile
305
created under s. 456.041.
306
(f)
Disclosures.
—When engaging in practice under
this
307
subsection
,
a
physician assistant
shall
provide each new patient
308
information in writing
detailing the physician assistant’s
309
qualifications and the fact that he or she is practicing without
310
physician
supervision. The information must be provided to the
311
patient either
before or during the initial patient encounter.
312
(g)
Rules.
—The
c
ouncil shall adopt rules to implement
this
313
subsection
.
314
(h)
Construction.
—
This
subsection
may not be construed to
315
limit a physician assistant from practicing under a supervisory
316
agreement with a physician.
317 Section 3. This act shall take effect July 1, 2026.