State Overview: Florida

Prior authorization requirements are up to the discretion of the state Medicaid program or insurance company.

Florida credentials two types of addiction counselors. A Certified Addiction Counselor (CAC) requires a high school diploma and requires 6,000 hours of experience. A higher-level degree can substitute the number of hours (i.e. a person with an associate degree needs 4,000 hours). A CAC also requires 250 hours of addictions education. A Certified Addiction Professional (CAP) requires a bachelor's degree and 6,000 hours of experience. A higher-level degree can substitute the number of hours (i.e. a person with a master's degree needs 4,000 hours). A CAP also requires 350 hours of addictions education. Florida Certification Board

Licensed mental health counselors are trained in methods of a psychological nature used to evaluate, assess, diagnose, and treat emotional and mental dysfunctions or disorders (e.g., cognitive, affective or behavioral), interpersonal relationships, sexual dysfunction, alcoholism, and substance abuse. Fla. Stat. §491.003(9)

The standards and requirements for the certification of a recovery support specialist and a recovery peer specialist are developed and administered by a third-party, non-profit certification provider.

Transition to independent practice and prescribing period required.

Prior to independent practice, the NM must practice and prescribe within an established protocol that has been approved by the medical staff of the health care facility in which the midwifery services are performed or approved by the NM's physician backup when the delivery is performed in a patient's home. Fla. Stat. §464.012

An APRN, including NMs, may engage in autonomous advanced practice if: they hold an active license, have not been subject to any disciplinary action within the last five years, and has completed, in any state, jurisdiction or territory of the United States, at least 3,000 hours of clinical practice hours and has completed, within the past five years, three graduate-level semester hours in differential diagnosis and three graduate-level semester hours in pharmacology. They may also prescribe, dispense, administer or order any drug including controlled substances within their specialty area. Fla. Stat. §464.0123

Transition to independent practice and prescribing period required.

Prior to independent practice, an NP must practice and prescribe within the framework of an established protocol that must be maintained on site at the location or locations at which an advanced practice registered nurse practices.  Fla. Stat. §464.012

An APRN, including NPs, may engage in autonomous advanced practice if: they hold an active license, have not been subject to any disciplinary action within the last five years, and has completed, in any state, jurisdiction or territory of the United States, at least 3,000 hours of clinical practice hours and has completed, within the past five years, three graduate-level semester hours in differential diagnosis and three graduate-level semester hours in pharmacology. An NP may prescribe any drug and Schedules II-V controlled substances if the NP is practicing autonomously. Fla. Stat. §464.0123

Florida has not codified language around POLST. Only physicians may sign advance directive forms. Please see the Florida POLST website for more information.

NPs are recognized in state policy as primary care providers. Primary care provider means a health care provider licensed under chapter 458, chapter 459, or chapter 464 who provides medical services to patients which are commonly provided without referral from another health care provider, including family and general practice, general pediatrics, and general internal medicine. Fla. Stat. §381.026

Optometrists may only examine, diagnose and treat conditions of the visual system. Fla. Stat. Ann. §463.002(7) and Fla. Stat. Ann. §463.0140(4)

Optometrists may only administer an epinephrine autoinjector for treatment of anaphylaxis. Fla. Stat. Ann. §463.001(6) and Fla. Stat. Ann. §463.0140(3)

Optometrists may prescribe Schedules III-V only for an oral analgesic placed on the formulary for the relief of pain due to ocular conditions of the eye and its appendages. Fla. Stat. Ann. §463.0055

A dental hygienist with proper insurance coverage may provide services in health access settings (e.g., a state agency program, nonprofit community health center, Head Start center, federally qualified health center, school-based prevention program, or clinic operated by an accredited dental or dental hygiene program) without the physical presence, prior examination or authorization of a dentist. Fla. Stat. §466.003 Fla. Stat. §466.024

Statute does not identify dental therapists as an oral health provider.

Florida dentists may utilize live video and store-and-forward telehealth technologies. Fl. Stat. §456.47

Florida has not enacted legislation allowing pharmacists to administer the COVID-19 vaccine. However, the federal PREP Act allowed pharmacists to administer the COVID-19 vaccine through the duration of the public health emergency.

Florida does not allow pharmacists to modify prescriptions.

Florida does not allow pharmacists to prescribe hormonal contraceptives.

Florida does not allow pharmacists to prescribe tobacco cessation aids.

Supervision by a physician required for practice and prescriptive authority.

A supervisory physician may delegate to a licensed PA, pursuant to a written protocol, the authority to act. Such delegated authority is limited to the supervising physician's practice in connection with a county health department. The boards shall adopt rules governing the supervision of PAs by physicians in county health departments. Fla. Stat. Ann. §458.347(4)(d)

"Supervision" means responsible supervision and control. Except in cases of emergency, supervision requires the easy availability or physical presence of the licensed physician for consultation and direction of the actions of the PA. For the purposes of this definition, the term "easy availability" includes the ability to communicate by way of telecommunication. Fla. Stat. Ann. §458.347(2)(g)

A supervising physician may delegate to a PA with prescribing authority the ability to procure, prescribe, or dispense only those medicinal drugs as are used in the supervising physician's practice. This includes controlled substances but a PA may only prescribe a 14-day supply of Schedule II psychiatric mental health controlled substances for children younger than 18 years of age provided the PA is under the supervision of a pediatrician, a family practice physician, an internal medicine physician, or a psychiatrist. PAs may only prescribe a 7-day supply of all other Schedule II controlled substances. Fla. Admin. Rules Ann. §64B8-30.008

Statute limits the number of PAs a physician may supervise.

A physician may not supervise more than 10 currently licensed PAs at any one time. Fla. Stat. Ann. §459.022(3)

Chart co-signatures may be determined at the practice level.

A physician supervising a PA pursuant to this section may not be required to review and cosign charts or medical records prepared by such PA. Fla. Stat. Ann. §459.022(3)

Florida does not currently have any provisions surrounding adaptable proximity requirements.

The duties delegated to the physician assistant must be within the supervising physician's scope of practice. The PA may work in any setting that is within the scope of practice of the supervising physician's practice. Fla. Admin. Rules §64B8-30.012