Recent regulatory decisions by the Florida Board of Medicine and state lawmakers are bringing changes to physician practice, training, and workforce entry in Florida. These developments involve prescriptive authority for physician assistants (PAs), recurring deficiencies found during office surgery inspections, licensure issues following the MOBILE Act, and the discontinuation of the Agency for Health Care Administration’s (AHCA) Graduate Medical Education (GME) Committee. The latest Physician Workforce Advisory Council meeting also addressed ongoing challenges.
At a February Board of Medicine meeting, questions were raised about whether PAs 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 PAs may be delegated prescriptive authority. The definition excludes temporary licenses such as those under Section 458.315, F.S., which was recently amended to include PAs for the first time in 2024. The Board noted that many ACN applicants came from Puerto Rico, where PAs do not receive pharmacology training or prescriptive rights.
On June 13, a proposed rule clarified that ACN-licensed PAs cannot be given prescriptive authority. Meanwhile, legislative action via HB 1299 amended requirements so that only PAs with valid licenses from U.S. states—not any U.S. jurisdiction—are eligible for ACN licensure.
The Surgical Care and Quality Assurance Committee reviewed repeated deficiencies found during office surgery inspections at its April and June meetings. Common problems included incomplete crash cart supplies that were corrected but later recurred in subsequent inspections. To address accountability concerns, one suggestion was to adopt an enforcement approach similar to the Board of Pharmacy: if an entity fails inspection repeatedly for the same issue, an administrative complaint would be filed automatically.
Licensure processes have also changed due to the Mobile Opportunity by Interstate Licensure Endorsement (MOBILE) Act, which aimed to streamline endorsement-based licensing but removed specific statutes tailored for each profession. As a result, some qualified health professionals have been unable to practice in Florida and newly licensed residents were barred from practicing in the state for three years—a development seen as harmful to physician recruitment efforts. In response, “the FMA, working with the Board of Medicine and several specialty societies, successfully amended HB 1299 to restore residency training as qualifying active practice and reduce the waiting period for licensure from three years to two.” While issues remain with the MOBILE Act, this change is viewed as progress.
The AHCA’s GME Committee was created by SB 7016 in 2024 with a mandate to assess how state investments affect Florida’s physician workforce and produce an annual report by July 1, 2025. Despite initial work on structure and drafting report sections—including attention to concerns like a projected drop in obstetricians—the Legislature eliminated the committee before it could finish its work. It is uncertain if AHCA will release any reports completed by the committee.
During its March meeting, the Physician Workforce Advisory Council held a panel discussion featuring Chris Cogle, MD—Florida Medicaid Chief Medical Officer—and representatives from the Council of Florida Medical School Deans (CFMSD). Panelists assessed GME program performance and made recommendations regarding workforce pipeline improvements. CFMSD representatives described recent growth achieved through programs like Slots for Docs and highlighted loan repayment initiatives such as FRAME as important incentives keeping trainees in-state; both programs resulted from FMA advocacy efforts.
Panelists also discussed financial barriers facing GME programs—including costs tied to faculty development and rising living expenses—which may discourage physicians from practicing or training locally.
FMA members seeking information about regulatory activities can contact legal@flmedical.org or call (850) 224-6496.
“Mary Thomas, Esq., is executive director of the Council of Florida Medical School Deans. Previously, she served for over a decade as the FMA’s assistant general counsel. Ms. Thomas continues to represent the FMA in matters before the state’s regulatory boards.”
