Recent decisions by the Florida Board of Medicine and state lawmakers are changing how physicians and physician assistants operate in the state. These developments affect prescriptive authority for physician assistants, repeated deficiencies in office surgery inspections, licensing rules under the MOBILE Act, and the sudden removal of the Agency for Health Care Administration’s (AHCA) Graduate Medical Education (GME) Committee. The update also includes details from a recent Physician Workforce Advisory Council meeting.
At its February meeting, the Board of Medicine considered whether physician assistants with an area of critical need (ACN) license can prescribe medication under Florida law. According to Section 458.347(4)(e), F.S., only fully licensed physician assistants may be delegated prescriptive authority by supervising physicians. Board Rule 64B8-30.001(7), F.A.C., defines a “fully licensed physician assistant” as one who has passed the required exams and holds a license other than certain temporary licenses. The rule does not mention Section 458.315, F.S., which now includes physician assistants due to a legislative change in 2024.
The Board and its PA Council expressed concerns that many ACN applicants were from Puerto Rico, where prescriptive authority is not granted to PAs and pharmacology training is lacking. On June 13, the Board proposed a rule clarifying that ACN-licensed PAs cannot be given prescriptive authority. At the same time, lawmakers passed HB 1299 to specify that ACN licenses may only go to PAs with valid licenses from any U.S. state, narrowing eligibility from all U.S. jurisdictions.
During April and June meetings, the Surgical Care and Quality Assurance Committee reviewed ongoing problems with repeat deficiencies found during office surgery inspections—such as incomplete crash cart supplies—that continued even after registrants had addressed previous citations. The Committee suggested working with the Board of Osteopathic Medicine to align regulations between allopathic and osteopathic practices. One idea is to adopt an enforcement policy similar to that used by the Board of Pharmacy: if an entity fails inspection for the same issue more than once, an administrative complaint would be filed automatically.
Licensing changes were also discussed following issues caused by the Mobile Opportunity by Interstate Licensure Endorsement (MOBILE) Act, which aimed to simplify endorsement licensure but ended up preventing some qualified health professionals from practicing in Florida by removing tailored statutes for each profession. The MOBILE Act also prevented newly licensed residents from practicing in Florida for three years—a concern for recruiting new physicians into the state workforce. In response, amendments made through HB 1299 now allow residency training as qualifying active practice and reduce this waiting period from three years to two.
The AHCA’s GME Committee was established by legislation in 2024 to evaluate how state investments impact Florida’s physician workforce and was tasked with delivering an annual report on July 1, 2025. Despite making progress on these tasks—including discussions about program structures and concerns over reductions in obstetrician numbers—the Legislature eliminated this committee within months of its creation. It remains uncertain if AHCA will release any reports produced during this brief period.
On March 13, at a meeting of the Physician Workforce Advisory Council (PWAC), panelists including Chris Cogle, MD (Florida Medicaid Chief Medical Officer), and representatives from the Council of Florida Medical School Deans (CFMSD), assessed GME programs’ performance and made recommendations for strengthening Florida’s pipeline of new doctors. CFMSD highlighted successful expansions like Slots for Docs—funded through FMA advocacy—and emphasized loan repayment programs such as FRAME as important tools for retaining trainees within Florida.
Panelists also discussed financial barriers facing GME programs: faculty development costs, oversight expenses, salaries, and rising living costs that could discourage physicians from training or staying in certain areas across Florida.
Members seeking more information about regulatory changes affecting medical practice can contact legal@flmedical.org or call (850) 224-6496.
“Both the Slots for Docs and FRAME programs were created and funded through successful FMA legislative advocacy.”
Mary Thomas serves as executive director of CFMSD; she previously spent over ten years as assistant general counsel at FMA and continues representing FMA before regulatory boards.
