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Florida Statutes (Last Updated: April 21, 2021) |
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TITLE XXXII. REGULATION OF PROFESSIONS AND OCCUPATIONS |
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CHAPTER 458. MEDICAL PRACTICE |
SECTION 458.348. Formal supervisory relationships, standing orders, and established protocols; notice; standards.
Latest version.
- 1(1) 2NOTICE.3-4(a) 5When a physician enters into a formal supervisory relationship or standing orders with an emergency medical technician or paramedic licensed pursuant to s. 28401.27, 29which relationship or orders contemplate the performance of medical acts, or when a physician enters into an established protocol with an advanced practice registered nurse, which protocol contemplates the performance of medical acts set forth in s. 66464.012(3) 67and (4), the physician shall submit notice to the board. The notice shall contain a statement in substantially the following form:
88I, 89(name and professional license number of physician) , 96of 97(address of physician) 100have hereby entered into a formal supervisory relationship, standing orders, or an established protocol with 115(number of persons) 118emergency medical technician(s), 121(number of persons) 124paramedic(s), or 126(number of persons) 129advanced practice registered nurse(s).
133(b) 134Notice shall be filed within 30 days of entering into the relationship, orders, or protocol. Notice also shall be provided within 30 days after the physician has terminated any such relationship, orders, or protocol.168(2) 169PROTOCOLS REQUIRING DIRECT SUPERVISION.173-174All protocols relating to electrolysis or electrology using laser or light-based hair removal or reduction by persons other than physicians licensed under this chapter or chapter 459 shall require the person performing such service to be appropriately trained and work only under the direct supervision and responsibility of a physician licensed under this chapter or chapter 459.231(3) 232SUPERVISORY RELATIONSHIPS IN MEDICAL OFFICE SETTINGS.238-239A physician who supervises an advanced practice registered nurse or physician assistant at a medical office other than the physician’s primary practice location, where the advanced practice registered nurse or physician assistant is not under the onsite supervision of a supervising physician, must comply with the standards set forth in this subsection. For the purpose of this subsection, a physician’s “primary practice location” means the address reflected on the physician’s profile published pursuant to s. 314456.041315.316(a) 317A physician who is engaged in providing primary health care services may not supervise more than four offices in addition to the physician’s primary practice location. For the purpose of this subsection, “primary health care” means health care services that are commonly provided to patients without referral from another practitioner, including obstetrical and gynecological services, and excludes practices providing primarily dermatologic and skin care services, which include aesthetic skin care services.388(b) 389A physician who is engaged in providing specialty health care services may not supervise more than two offices in addition to the physician’s primary practice location. For the purpose of this subsection, “specialty health care” means health care services that are commonly provided to patients with a referral from another practitioner and excludes practices providing primarily dermatologic and skin care services, which include aesthetic skin care services.456(c) 457A physician who supervises an advanced practice registered nurse or physician assistant at a medical office other than the physician’s primary practice location, where the advanced practice registered nurse or physician assistant is not under the onsite supervision of a supervising physician and the services offered at the office are primarily dermatologic or skin care services, which include aesthetic skin care services other than plastic surgery, must comply with the standards listed in subparagraphs 1.-4. Notwithstanding s. 534458.347(4)(e)6535., a physician supervising a physician assistant pursuant to this paragraph may not be required to review and cosign charts or medical records prepared by such physician assistant.5631. 564The physician shall submit to the board the addresses of all offices where he or she is supervising an advanced practice registered nurse or a physician assistant which are not the physician’s primary practice location.5992. 600The physician must be board certified or board eligible in dermatology or plastic surgery as recognized by the board pursuant to s. 622458.3312623.6243. 625All such offices that are not the physician’s primary place of practice must be within 25 miles of the physician’s primary place of practice or in a county that is contiguous to the county of the physician’s primary place of practice. However, the distance between any of the offices may not exceed 75 miles.6794. 680The physician may supervise only one office other than the physician’s primary place of practice.695(d) 696A physician who supervises an office in addition to the physician’s primary practice location must conspicuously post in each of the physician’s offices a current schedule of the regular hours when the physician is present in that office and the hours when the office is open while the physician is not present.748(e) 749This subsection does not apply to health care services provided in facilities licensed under chapter 395 or in conjunction with a college of medicine, a college of nursing, an accredited graduate medical program, or a nursing education program; not-for-profit, family-planning clinics that are not licensed pursuant to chapter 390; rural and federally qualified health centers; health care services provided in a nursing home licensed under part II of chapter 400, an assisted living facility licensed under part I of chapter 429, a continuing care facility licensed under chapter 651, or a retirement community consisting of independent living units and a licensed nursing home or assisted living facility; anesthesia services provided in accordance with law; health care services provided in a designated rural health clinic; health care services provided to persons enrolled in a program designed to maintain elderly persons and persons with disabilities in a home or community-based setting; university primary care student health centers; school health clinics; or health care services provided in federal, state, or local government facilities. Subsection (2) and this subsection do not apply to offices at which the exclusive service being performed is laser hair removal by an advanced practice registered nurse or physician assistant.949(4) 950REQUIREMENTS FOR NOTICE AND REVIEW.955-956Upon initial referral of a patient by another practitioner, the physician receiving the referral must ensure that the patient is informed of the type of license held by the physician and the type of license held by any other practitioner who will be providing services to the patient. When scheduling the initial examination or consultation following such referral, the patient may decide to see the physician or any other licensed practitioner supervised by the physician and, before the initial examination or consultation, shall sign a form indicating the patient’s choice of practitioner. The supervising physician must review the medical record of the initial examination or consultation and ensure that a written report of the initial examination or consultation is furnished to the referring practitioner within 10 business days following the completion of the initial examination or consultation.1093(5) 1094LIMITATION ON RULEMAKING.1097-1098This section is self-executing and does not require or provide authority for additional rulemaking.
History.-ss. 1, 4, ch. 82-32; s. 33, ch. 83-215; s. 83, ch. 83-218; s. 65, ch. 86-220; ss. 25, 26, ch. 86-245; s. 4, ch. 88-361; s. 15, ch. 91-220; s. 4, ch. 91-429; ss. 40, 118, ch. 2000-318; s. 5, ch. 2006-251; s. 112, ch. 2007-5; s. 7, ch. 2007-167; s. 3, ch. 2009-177; s. 7, ch. 2010-37; s. 2, ch. 2010-55; s. 3, ch. 2012-170; ss. 20, 26, ch. 2016-224; s. 1, ch. 2017-134; s. 51, ch. 2018-106; s. 81, ch. 2019-3.
