Bill Text: FL S1192 | 2019 | Regular Session | Comm Sub
Bill Title: Electronic Prescribing
Spectrum:
Status: (Introduced - Dead) 2019-05-01 - Laid on Table, companion bill(s) passed, see CS/HB 831 (Ch. 2019-112) [S1192 Detail]
Download: Florida-2019-S1192-Comm_Sub.html
Florida Senate - 2019 CS for CS for SB 1192
By the Committees on Appropriations; and Health Policy; and
Senators Bean, Baxley, and Rouson
576-04635-19 20191192c2
1 A bill to be entitled
2 An act relating to electronic prescribing; amending s.
3 456.42, F.S.; requiring certain health care
4 practitioners to electronically generate and transmit
5 prescriptions for medicinal drugs upon license renewal
6 or by a specified date; providing exceptions;
7 authorizing the Department of Health, in consultation
8 with the Board of Medicine, the Board of Osteopathic
9 Medicine, the Board of Podiatric Medicine, the Board
10 of Dentistry, the Board of Nursing, and the Board of
11 Optometry, to adopt rules; amending s. 456.43, F.S.;
12 revising the definitions of the terms “prescribing
13 decision” and “point of care”; revising the authority
14 for electronic prescribing software to display
15 information regarding a payor’s formulary under
16 certain circumstances; amending ss. 409.912, 456.0392,
17 458.3265, 458.331, 459.0137, and 459.015, F.S.;
18 conforming provisions to changes made by the act;
19 providing an effective date.
20
21 Be It Enacted by the Legislature of the State of Florida:
22
23 Section 1. Section 456.42, Florida Statutes, is amended to
24 read:
25 456.42 Written prescriptions for medicinal drugs.—
26 (1) A written prescription for a medicinal drug issued by a
27 health care practitioner licensed by law to prescribe such drug
28 must be legibly printed or typed so as to be capable of being
29 understood by the pharmacist filling the prescription; must
30 contain the name of the prescribing practitioner, the name and
31 strength of the drug prescribed, the quantity of the drug
32 prescribed, and the directions for use of the drug; must be
33 dated; and must be signed by the prescribing practitioner on the
34 day when issued. However, a prescription that is electronically
35 generated and transmitted must contain the name of the
36 prescribing practitioner, the name and strength of the drug
37 prescribed, the quantity of the drug prescribed in numerical
38 format, and the directions for use of the drug and must contain
39 the date and an electronic signature, as defined in s.
40 668.003(4), be dated and signed by the prescribing practitioner
41 only on the day issued, which signature may be in an electronic
42 format as defined in s. 668.003(4).
43 (2) A written prescription for a controlled substance
44 listed in chapter 893 must have the quantity of the drug
45 prescribed in both textual and numerical formats, must be dated
46 in numerical, month/day/year format, or with the abbreviated
47 month written out, or the month written out in whole, and must
48 be either written on a standardized counterfeit-proof
49 prescription pad produced by a vendor approved by the department
50 or electronically prescribed as that term is used in s.
51 408.0611. As a condition of being an approved vendor, a
52 prescription pad vendor must submit a monthly report to the
53 department that, at a minimum, documents the number of
54 prescription pads sold and identifies the purchasers. The
55 department may, by rule, require the reporting of additional
56 information.
57 (3) A health care practitioner licensed by law to prescribe
58 a medicinal drug who maintains a system of electronic health
59 records as defined in s. 408.051(2)(a), or who prescribes
60 medicinal drugs as an owner, an employee, or a contractor of a
61 licensed health care facility or practice that maintains such a
62 system and who is prescribing in his or her capacity as such an
63 owner, an employee, or a contractor, may only electronically
64 transmit prescriptions for such drugs. This requirement applies
65 to such a health care practitioner upon renewal of the health
66 care practitioner’s license or by July 1, 2021, whichever is
67 earlier, but does not apply if:
68 (a) The practitioner and the dispenser are the same entity;
69 (b) The prescription cannot be transmitted electronically
70 under the most recently implemented version of the National
71 Council for Prescription Drug Programs SCRIPT Standard;
72 (c) The practitioner has been issued a waiver by the
73 department, not to exceed 1 year in duration, from the
74 requirement to use electronic prescribing due to demonstrated
75 economic hardship, technological limitations that are not
76 reasonably within the control of the practitioner, or another
77 exceptional circumstance demonstrated by the practitioner;
78 (d) The practitioner reasonably determines that it would be
79 impractical for the patient in question to obtain a medicinal
80 drug prescribed by electronic prescription in a timely manner
81 and such delay would adversely impact the patient’s medical
82 condition;
83 (e) The practitioner is prescribing a drug under a research
84 protocol;
85 (f) The prescription is for a drug for which the federal
86 Food and Drug Administration requires the prescription to
87 contain elements that may not be included in electronic
88 prescribing; or
89 (g) The prescription is issued to an individual receiving
90 hospice care or who is a resident of a nursing home facility.
91 (h) The practitioner determines that it is in the best
92 interest of the patient, or the patient determines that it is in
93 his or her own best interest, to compare prescription drug
94 prices among area pharmacies. The practitioner must document
95 such determination in the patient’s medical record.
96
97 The department, in consultation with the Board of Medicine, the
98 Board of Osteopathic Medicine, the Board of Podiatric Medicine,
99 the Board of Dentistry, the Board of Nursing, and the Board of
100 Optometry, may adopt rules to implement this subsection.
101 Section 2. Section 456.43, Florida Statutes, is amended to
102 read:
103 456.43 Electronic prescribing for medicinal drugs.—
104 (1) Electronic prescribing may shall not interfere with a
105 patient’s freedom to choose a pharmacy.
106 (2) Electronic prescribing software may shall not use any
107 means or permit any other person to use any means to influence
108 or attempt to influence, through economic incentives or
109 otherwise, the prescribing decision of a prescribing
110 practitioner or his or her agent at the point of care,
111 including, but not limited to, means such as advertising,
112 instant messaging, and pop-up ads, and similar means to
113 influence or attempt to influence, through economic incentives
114 or otherwise, the prescribing decision of a prescribing
115 practitioner at the point of care. Such means shall not be
116 triggered by or in specific response to the input, selection, or
117 act of a prescribing practitioner or his or her agent in
118 prescribing a certain medicinal drug pharmaceutical or directing
119 a patient to a certain pharmacy. For purposes of this
120 subsection, the term:
121 (a) The term “Prescribing decision” means a prescribing
122 practitioner’s or his or her agent’s decision to prescribe any
123 medicinal drug a certain pharmaceutical.
124 (b) The term “Point of care” means the time at which that a
125 prescribing practitioner or his or her agent prescribes any
126 medicinal drug is in the act of prescribing a certain
127 pharmaceutical.
128 (3) Electronic prescribing software may display show
129 information regarding a payor’s formulary if as long as nothing
130 is designed to preclude or make more difficult the selection of
131 the act of a prescribing practitioner or patient selecting any
132 particular pharmacy by a patient or the selection of a certain
133 medicinal drug by a prescribing practitioner or his or her agent
134 pharmaceutical.
135 Section 3. Paragraph (a) of subsection (5) of section
136 409.912, Florida Statutes, is amended to read:
137 409.912 Cost-effective purchasing of health care.—The
138 agency shall purchase goods and services for Medicaid recipients
139 in the most cost-effective manner consistent with the delivery
140 of quality medical care. To ensure that medical services are
141 effectively utilized, the agency may, in any case, require a
142 confirmation or second physician’s opinion of the correct
143 diagnosis for purposes of authorizing future services under the
144 Medicaid program. This section does not restrict access to
145 emergency services or poststabilization care services as defined
146 in 42 C.F.R. s. 438.114. Such confirmation or second opinion
147 shall be rendered in a manner approved by the agency. The agency
148 shall maximize the use of prepaid per capita and prepaid
149 aggregate fixed-sum basis services when appropriate and other
150 alternative service delivery and reimbursement methodologies,
151 including competitive bidding pursuant to s. 287.057, designed
152 to facilitate the cost-effective purchase of a case-managed
153 continuum of care. The agency shall also require providers to
154 minimize the exposure of recipients to the need for acute
155 inpatient, custodial, and other institutional care and the
156 inappropriate or unnecessary use of high-cost services. The
157 agency shall contract with a vendor to monitor and evaluate the
158 clinical practice patterns of providers in order to identify
159 trends that are outside the normal practice patterns of a
160 provider’s professional peers or the national guidelines of a
161 provider’s professional association. The vendor must be able to
162 provide information and counseling to a provider whose practice
163 patterns are outside the norms, in consultation with the agency,
164 to improve patient care and reduce inappropriate utilization.
165 The agency may mandate prior authorization, drug therapy
166 management, or disease management participation for certain
167 populations of Medicaid beneficiaries, certain drug classes, or
168 particular drugs to prevent fraud, abuse, overuse, and possible
169 dangerous drug interactions. The Pharmaceutical and Therapeutics
170 Committee shall make recommendations to the agency on drugs for
171 which prior authorization is required. The agency shall inform
172 the Pharmaceutical and Therapeutics Committee of its decisions
173 regarding drugs subject to prior authorization. The agency is
174 authorized to limit the entities it contracts with or enrolls as
175 Medicaid providers by developing a provider network through
176 provider credentialing. The agency may competitively bid single
177 source-provider contracts if procurement of goods or services
178 results in demonstrated cost savings to the state without
179 limiting access to care. The agency may limit its network based
180 on the assessment of beneficiary access to care, provider
181 availability, provider quality standards, time and distance
182 standards for access to care, the cultural competence of the
183 provider network, demographic characteristics of Medicaid
184 beneficiaries, practice and provider-to-beneficiary standards,
185 appointment wait times, beneficiary use of services, provider
186 turnover, provider profiling, provider licensure history,
187 previous program integrity investigations and findings, peer
188 review, provider Medicaid policy and billing compliance records,
189 clinical and medical record audits, and other factors. Providers
190 are not entitled to enrollment in the Medicaid provider network.
191 The agency shall determine instances in which allowing Medicaid
192 beneficiaries to purchase durable medical equipment and other
193 goods is less expensive to the Medicaid program than long-term
194 rental of the equipment or goods. The agency may establish rules
195 to facilitate purchases in lieu of long-term rentals in order to
196 protect against fraud and abuse in the Medicaid program as
197 defined in s. 409.913. The agency may seek federal waivers
198 necessary to administer these policies.
199 (5)(a) The agency shall implement a Medicaid prescribed
200 drug spending-control program that includes the following
201 components:
202 1. A Medicaid preferred drug list, which shall be a listing
203 of cost-effective therapeutic options recommended by the
204 Medicaid Pharmacy and Therapeutics Committee established
205 pursuant to s. 409.91195 and adopted by the agency for each
206 therapeutic class on the preferred drug list. At the discretion
207 of the committee, and when feasible, the preferred drug list
208 should include at least two products in a therapeutic class. The
209 agency may post the preferred drug list and updates to the list
210 on an Internet website without following the rulemaking
211 procedures of chapter 120. Antiretroviral agents are excluded
212 from the preferred drug list. The agency shall also limit the
213 amount of a prescribed drug dispensed to no more than a 34-day
214 supply unless the drug products’ smallest marketed package is
215 greater than a 34-day supply, or the drug is determined by the
216 agency to be a maintenance drug in which case a 100-day maximum
217 supply may be authorized. The agency may seek any federal
218 waivers necessary to implement these cost-control programs and
219 to continue participation in the federal Medicaid rebate
220 program, or alternatively to negotiate state-only manufacturer
221 rebates. The agency may adopt rules to administer this
222 subparagraph. The agency shall continue to provide unlimited
223 contraceptive drugs and items. The agency must establish
224 procedures to ensure that:
225 a. There is a response to a request for prior consultation
226 by telephone or other telecommunication device within 24 hours
227 after receipt of a request for prior consultation; and
228 b. A 72-hour supply of the drug prescribed is provided in
229 an emergency or when the agency does not provide a response
230 within 24 hours as required by sub-subparagraph a.
231 2. Reimbursement to pharmacies for Medicaid prescribed
232 drugs shall be set at the lowest of: the average wholesale price
233 (AWP) minus 16.4 percent, the wholesaler acquisition cost (WAC)
234 plus 1.5 percent, the federal upper limit (FUL), the state
235 maximum allowable cost (SMAC), or the usual and customary (UAC)
236 charge billed by the provider.
237 3. The agency shall develop and implement a process for
238 managing the drug therapies of Medicaid recipients who are using
239 significant numbers of prescribed drugs each month. The
240 management process may include, but is not limited to,
241 comprehensive, physician-directed medical-record reviews, claims
242 analyses, and case evaluations to determine the medical
243 necessity and appropriateness of a patient’s treatment plan and
244 drug therapies. The agency may contract with a private
245 organization to provide drug-program-management services. The
246 Medicaid drug benefit management program shall include
247 initiatives to manage drug therapies for HIV/AIDS patients,
248 patients using 20 or more unique prescriptions in a 180-day
249 period, and the top 1,000 patients in annual spending. The
250 agency shall enroll any Medicaid recipient in the drug benefit
251 management program if he or she meets the specifications of this
252 provision and is not enrolled in a Medicaid health maintenance
253 organization.
254 4. The agency may limit the size of its pharmacy network
255 based on need, competitive bidding, price negotiations,
256 credentialing, or similar criteria. The agency shall give
257 special consideration to rural areas in determining the size and
258 location of pharmacies included in the Medicaid pharmacy
259 network. A pharmacy credentialing process may include criteria
260 such as a pharmacy’s full-service status, location, size,
261 patient educational programs, patient consultation, disease
262 management services, and other characteristics. The agency may
263 impose a moratorium on Medicaid pharmacy enrollment if it is
264 determined that it has a sufficient number of Medicaid
265 participating providers. The agency must allow dispensing
266 practitioners to participate as a part of the Medicaid pharmacy
267 network regardless of the practitioner’s proximity to any other
268 entity that is dispensing prescription drugs under the Medicaid
269 program. A dispensing practitioner must meet all credentialing
270 requirements applicable to his or her practice, as determined by
271 the agency.
272 5. The agency shall develop and implement a program that
273 requires Medicaid practitioners who issue written prescriptions
274 for medicinal prescribe drugs to use a counterfeit-proof
275 prescription pad for Medicaid prescriptions. The agency shall
276 require the use of standardized counterfeit-proof prescription
277 pads by Medicaid-participating prescribers or prescribers who
278 issue written write prescriptions for Medicaid recipients. The
279 agency may implement the program in targeted geographic areas or
280 statewide.
281 6. The agency may enter into arrangements that require
282 manufacturers of generic drugs prescribed to Medicaid recipients
283 to provide rebates of at least 15.1 percent of the average
284 manufacturer price for the manufacturer’s generic products.
285 These arrangements shall require that if a generic-drug
286 manufacturer pays federal rebates for Medicaid-reimbursed drugs
287 at a level below 15.1 percent, the manufacturer must provide a
288 supplemental rebate to the state in an amount necessary to
289 achieve a 15.1-percent rebate level.
290 7. The agency may establish a preferred drug list as
291 described in this subsection, and, pursuant to the establishment
292 of such preferred drug list, negotiate supplemental rebates from
293 manufacturers that are in addition to those required by Title
294 XIX of the Social Security Act and at no less than 14 percent of
295 the average manufacturer price as defined in 42 U.S.C. s. 1936
296 on the last day of a quarter unless the federal or supplemental
297 rebate, or both, equals or exceeds 29 percent. There is no upper
298 limit on the supplemental rebates the agency may negotiate. The
299 agency may determine that specific products, brand-name or
300 generic, are competitive at lower rebate percentages. Agreement
301 to pay the minimum supplemental rebate percentage guarantees a
302 manufacturer that the Medicaid Pharmaceutical and Therapeutics
303 Committee will consider a product for inclusion on the preferred
304 drug list. However, a pharmaceutical manufacturer is not
305 guaranteed placement on the preferred drug list by simply paying
306 the minimum supplemental rebate. Agency decisions will be made
307 on the clinical efficacy of a drug and recommendations of the
308 Medicaid Pharmaceutical and Therapeutics Committee, as well as
309 the price of competing products minus federal and state rebates.
310 The agency may contract with an outside agency or contractor to
311 conduct negotiations for supplemental rebates. For the purposes
312 of this section, the term “supplemental rebates” means cash
313 rebates. Value-added programs as a substitution for supplemental
314 rebates are prohibited. The agency may seek any federal waivers
315 to implement this initiative.
316 8. The agency shall expand home delivery of pharmacy
317 products. The agency may amend the state plan and issue a
318 procurement, as necessary, in order to implement this program.
319 The procurements must include agreements with a pharmacy or
320 pharmacies located in the state to provide mail order delivery
321 services at no cost to the recipients who elect to receive home
322 delivery of pharmacy products. The procurement must focus on
323 serving recipients with chronic diseases for which pharmacy
324 expenditures represent a significant portion of Medicaid
325 pharmacy expenditures or which impact a significant portion of
326 the Medicaid population. The agency may seek and implement any
327 federal waivers necessary to implement this subparagraph.
328 9. The agency shall limit to one dose per month any drug
329 prescribed to treat erectile dysfunction.
330 10.a. The agency may implement a Medicaid behavioral drug
331 management system. The agency may contract with a vendor that
332 has experience in operating behavioral drug management systems
333 to implement this program. The agency may seek federal waivers
334 to implement this program.
335 b. The agency, in conjunction with the Department of
336 Children and Families, may implement the Medicaid behavioral
337 drug management system that is designed to improve the quality
338 of care and behavioral health prescribing practices based on
339 best practice guidelines, improve patient adherence to
340 medication plans, reduce clinical risk, and lower prescribed
341 drug costs and the rate of inappropriate spending on Medicaid
342 behavioral drugs. The program may include the following
343 elements:
344 (I) Provide for the development and adoption of best
345 practice guidelines for behavioral health-related drugs such as
346 antipsychotics, antidepressants, and medications for treating
347 bipolar disorders and other behavioral conditions; translate
348 them into practice; review behavioral health prescribers and
349 compare their prescribing patterns to a number of indicators
350 that are based on national standards; and determine deviations
351 from best practice guidelines.
352 (II) Implement processes for providing feedback to and
353 educating prescribers using best practice educational materials
354 and peer-to-peer consultation.
355 (III) Assess Medicaid beneficiaries who are outliers in
356 their use of behavioral health drugs with regard to the numbers
357 and types of drugs taken, drug dosages, combination drug
358 therapies, and other indicators of improper use of behavioral
359 health drugs.
360 (IV) Alert prescribers to patients who fail to refill
361 prescriptions in a timely fashion, are prescribed multiple same
362 class behavioral health drugs, and may have other potential
363 medication problems.
364 (V) Track spending trends for behavioral health drugs and
365 deviation from best practice guidelines.
366 (VI) Use educational and technological approaches to
367 promote best practices, educate consumers, and train prescribers
368 in the use of practice guidelines.
369 (VII) Disseminate electronic and published materials.
370 (VIII) Hold statewide and regional conferences.
371 (IX) Implement a disease management program with a model
372 quality-based medication component for severely mentally ill
373 individuals and emotionally disturbed children who are high
374 users of care.
375 11. The agency shall implement a Medicaid prescription drug
376 management system.
377 a. The agency may contract with a vendor that has
378 experience in operating prescription drug management systems in
379 order to implement this system. Any management system that is
380 implemented in accordance with this subparagraph must rely on
381 cooperation between physicians and pharmacists to determine
382 appropriate practice patterns and clinical guidelines to improve
383 the prescribing, dispensing, and use of drugs in the Medicaid
384 program. The agency may seek federal waivers to implement this
385 program.
386 b. The drug management system must be designed to improve
387 the quality of care and prescribing practices based on best
388 practice guidelines, improve patient adherence to medication
389 plans, reduce clinical risk, and lower prescribed drug costs and
390 the rate of inappropriate spending on Medicaid prescription
391 drugs. The program must:
392 (I) Provide for the adoption of best practice guidelines
393 for the prescribing and use of drugs in the Medicaid program,
394 including translating best practice guidelines into practice;
395 reviewing prescriber patterns and comparing them to indicators
396 that are based on national standards and practice patterns of
397 clinical peers in their community, statewide, and nationally;
398 and determine deviations from best practice guidelines.
399 (II) Implement processes for providing feedback to and
400 educating prescribers using best practice educational materials
401 and peer-to-peer consultation.
402 (III) Assess Medicaid recipients who are outliers in their
403 use of a single or multiple prescription drugs with regard to
404 the numbers and types of drugs taken, drug dosages, combination
405 drug therapies, and other indicators of improper use of
406 prescription drugs.
407 (IV) Alert prescribers to recipients who fail to refill
408 prescriptions in a timely fashion, are prescribed multiple drugs
409 that may be redundant or contraindicated, or may have other
410 potential medication problems.
411 12. The agency may contract for drug rebate administration,
412 including, but not limited to, calculating rebate amounts,
413 invoicing manufacturers, negotiating disputes with
414 manufacturers, and maintaining a database of rebate collections.
415 13. The agency may specify the preferred daily dosing form
416 or strength for the purpose of promoting best practices with
417 regard to the prescribing of certain drugs as specified in the
418 General Appropriations Act and ensuring cost-effective
419 prescribing practices.
420 14. The agency may require prior authorization for
421 Medicaid-covered prescribed drugs. The agency may prior
422 authorize the use of a product:
423 a. For an indication not approved in labeling;
424 b. To comply with certain clinical guidelines; or
425 c. If the product has the potential for overuse, misuse, or
426 abuse.
427
428 The agency may require the prescribing professional to provide
429 information about the rationale and supporting medical evidence
430 for the use of a drug. The agency shall post prior
431 authorization, step-edit criteria and protocol, and updates to
432 the list of drugs that are subject to prior authorization on the
433 agency’s Internet website within 21 days after the prior
434 authorization and step-edit criteria and protocol and updates
435 are approved by the agency. For purposes of this subparagraph,
436 the term “step-edit” means an automatic electronic review of
437 certain medications subject to prior authorization.
438 15. The agency, in conjunction with the Pharmaceutical and
439 Therapeutics Committee, may require age-related prior
440 authorizations for certain prescribed drugs. The agency may
441 preauthorize the use of a drug for a recipient who may not meet
442 the age requirement or may exceed the length of therapy for use
443 of this product as recommended by the manufacturer and approved
444 by the Food and Drug Administration. Prior authorization may
445 require the prescribing professional to provide information
446 about the rationale and supporting medical evidence for the use
447 of a drug.
448 16. The agency shall implement a step-therapy prior
449 authorization approval process for medications excluded from the
450 preferred drug list. Medications listed on the preferred drug
451 list must be used within the previous 12 months before the
452 alternative medications that are not listed. The step-therapy
453 prior authorization may require the prescriber to use the
454 medications of a similar drug class or for a similar medical
455 indication unless contraindicated in the Food and Drug
456 Administration labeling. The trial period between the specified
457 steps may vary according to the medical indication. The step
458 therapy approval process shall be developed in accordance with
459 the committee as stated in s. 409.91195(7) and (8). A drug
460 product may be approved without meeting the step-therapy prior
461 authorization criteria if the prescribing physician provides the
462 agency with additional written medical or clinical documentation
463 that the product is medically necessary because:
464 a. There is not a drug on the preferred drug list to treat
465 the disease or medical condition which is an acceptable clinical
466 alternative;
467 b. The alternatives have been ineffective in the treatment
468 of the beneficiary’s disease; or
469 c. Based on historic evidence and known characteristics of
470 the patient and the drug, the drug is likely to be ineffective,
471 or the number of doses have been ineffective.
472
473 The agency shall work with the physician to determine the best
474 alternative for the patient. The agency may adopt rules waiving
475 the requirements for written clinical documentation for specific
476 drugs in limited clinical situations.
477 17. The agency shall implement a return and reuse program
478 for drugs dispensed by pharmacies to institutional recipients,
479 which includes payment of a $5 restocking fee for the
480 implementation and operation of the program. The return and
481 reuse program shall be implemented electronically and in a
482 manner that promotes efficiency. The program must permit a
483 pharmacy to exclude drugs from the program if it is not
484 practical or cost-effective for the drug to be included and must
485 provide for the return to inventory of drugs that cannot be
486 credited or returned in a cost-effective manner. The agency
487 shall determine if the program has reduced the amount of
488 Medicaid prescription drugs which are destroyed on an annual
489 basis and if there are additional ways to ensure more
490 prescription drugs are not destroyed which could safely be
491 reused.
492 Section 4. Section 456.0392, Florida Statutes, is amended
493 to read:
494 456.0392 Prescription labeling.—
495 (1) A prescription issued written by a practitioner who is
496 authorized under the laws of this state to prescribe write
497 prescriptions for drugs that are not listed as controlled
498 substances in chapter 893 but who is not eligible for a federal
499 Drug Enforcement Administration number shall include that
500 practitioner’s name and professional license number. The
501 pharmacist or dispensing practitioner must include the
502 practitioner’s name on the container of the drug that is
503 dispensed. A pharmacist shall be permitted, upon verification by
504 the prescriber, to document any information required by this
505 section.
506 (2) A prescription for a drug that is not listed as a
507 controlled substance in chapter 893 which is issued written by
508 an advanced practice registered nurse licensed under s. 464.012
509 is presumed, subject to rebuttal, to be valid and within the
510 parameters of the prescriptive authority delegated by a
511 practitioner licensed under chapter 458, chapter 459, or chapter
512 466.
513 (3) A prescription for a drug that is not listed as a
514 controlled substance in chapter 893 which is issued written by a
515 physician assistant licensed under chapter 458 or chapter 459 is
516 presumed, subject to rebuttal, to be valid and within the
517 parameters of the prescriptive authority delegated by the
518 physician assistant’s supervising physician.
519 Section 5. Paragraph (d) of subsection (3) of section
520 458.3265, Florida Statutes, is amended to read:
521 458.3265 Pain-management clinics.—
522 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
523 apply to any physician who provides professional services in a
524 pain-management clinic that is required to be registered in
525 subsection (1).
526 (d) A physician authorized to prescribe controlled
527 substances who practices at a pain-management clinic is
528 responsible for maintaining the control and security of his or
529 her prescription blanks or electronic prescribing software and
530 any other method used for prescribing controlled substance pain
531 medication. A The physician who issues written prescriptions
532 shall comply with the requirements for counterfeit-resistant
533 prescription blanks in s. 893.065 and the rules adopted pursuant
534 to that section. A The physician shall notify, in writing, the
535 department within 24 hours after following any theft or loss of
536 a prescription blank or breach of his or her electronic
537 prescribing software used any other method for prescribing pain
538 medication.
539 Section 6. Paragraph (qq) of subsection (1) of section
540 458.331, Florida Statutes, is amended to read:
541 458.331 Grounds for disciplinary action; action by the
542 board and department.—
543 (1) The following acts constitute grounds for denial of a
544 license or disciplinary action, as specified in s. 456.072(2):
545 (qq) Failing to timely notify the department of the theft
546 of prescription blanks from a pain-management clinic or a breach
547 of a physician’s electronic prescribing software other methods
548 for prescribing within 24 hours as required by s. 458.3265(3).
549 Section 7. Paragraph (d) of subsection (3) of section
550 459.0137, Florida Statutes, is amended to read:
551 459.0137 Pain-management clinics.—
552 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
553 apply to any osteopathic physician who provides professional
554 services in a pain-management clinic that is required to be
555 registered in subsection (1).
556 (d) An osteopathic physician authorized to prescribe
557 controlled substances who practices at a pain-management clinic
558 is responsible for maintaining the control and security of his
559 or her prescription blanks or electronic prescribing software
560 and any other method used for prescribing controlled substance
561 pain medication. An The osteopathic physician who issues written
562 prescriptions shall comply with the requirements for
563 counterfeit-resistant prescription blanks in s. 893.065 and the
564 rules adopted pursuant to that section. An The osteopathic
565 physician shall notify, in writing, the department within 24
566 hours after following any theft or loss of a prescription blank
567 or breach of his or her electronic prescribing software used any
568 other method for prescribing pain medication.
569 Section 8. Paragraph (ss) of subsection (1) of section
570 459.015, Florida Statutes, is amended to read:
571 459.015 Grounds for disciplinary action; action by the
572 board and department.—
573 (1) The following acts constitute grounds for denial of a
574 license or disciplinary action, as specified in s. 456.072(2):
575 (ss) Failing to timely notify the department of the theft
576 of prescription blanks from a pain-management clinic or a breach
577 of an osteopathic physician’s electronic prescribing software
578 other methods for prescribing within 24 hours as required by s.
579 459.0137(3).
580 Section 9. This act shall take effect January 1, 2020.
