Bill Text: FL S1192 | 2019 | Regular Session | Comm Sub
NOTE: There are more recent revisions of this legislation. Read Latest Draft
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
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 SB 1192
By the Committee on Health Policy; and Senator Bean
588-04019-19 20191192c1
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 and the Board of
9 Osteopathic Medicine, to adopt rules; amending s.
10 456.43, F.S.; revising the definitions of the terms
11 “prescribing decision” and “point of care”; revising
12 the authority for electronic prescribing software to
13 display information regarding a payor’s formulary
14 under certain circumstances; amending ss. 409.912,
15 456.0392, 458.3265, 458.331, 459.0137, and 459.015,
16 F.S.; conforming provisions to changes made by the
17 act; providing an effective date.
18
19 Be It Enacted by the Legislature of the State of Florida:
20
21 Section 1. Section 456.42, Florida Statutes, is amended to
22 read:
23 456.42 Written prescriptions for medicinal drugs.—
24 (1) A written prescription for a medicinal drug issued by a
25 health care practitioner licensed by law to prescribe such drug
26 must be legibly printed or typed so as to be capable of being
27 understood by the pharmacist filling the prescription; must
28 contain the name of the prescribing practitioner, the name and
29 strength of the drug prescribed, the quantity of the drug
30 prescribed, and the directions for use of the drug; must be
31 dated; and must be signed by the prescribing practitioner on the
32 day when issued. However, a prescription that is electronically
33 generated and transmitted must contain the name of the
34 prescribing practitioner, the name and strength of the drug
35 prescribed, the quantity of the drug prescribed in numerical
36 format, and the directions for use of the drug and must contain
37 the date and an electronic signature, as defined in s.
38 668.003(4), be dated and signed by the prescribing practitioner
39 only on the day issued, which signature may be in an electronic
40 format as defined in s. 668.003(4).
41 (2) A written prescription for a controlled substance
42 listed in chapter 893 must have the quantity of the drug
43 prescribed in both textual and numerical formats, must be dated
44 in numerical, month/day/year format, or with the abbreviated
45 month written out, or the month written out in whole, and must
46 be either written on a standardized counterfeit-proof
47 prescription pad produced by a vendor approved by the department
48 or electronically prescribed as that term is used in s.
49 408.0611. As a condition of being an approved vendor, a
50 prescription pad vendor must submit a monthly report to the
51 department that, at a minimum, documents the number of
52 prescription pads sold and identifies the purchasers. The
53 department may, by rule, require the reporting of additional
54 information.
55 (3) A health care practitioner licensed by law to prescribe
56 a medicinal drug who maintains a system of electronic health
57 records as defined in s. 408.051, or who prescribes medicinal
58 drugs as an owner, an employee, or a contractor of a licensed
59 health care facility or practice that maintains such a system
60 and who is prescribing in his or her capacity as such an owner,
61 an employee, or a contractor, may only electronically transmit
62 prescriptions for such drugs. This requirement applies to such a
63 health care practitioner upon renewal of the health care
64 practitioner’s license or by July 1, 2021, whichever is earlier,
65 but does not apply if:
66 (a) The practitioner and the dispenser are the same entity;
67 (b) The prescription cannot be transmitted electronically
68 under the most recently implemented version of the National
69 Council for Prescription Drug Programs SCRIPT Standard;
70 (c) The practitioner has been issued a waiver by the
71 department, not to exceed 1 year in duration, from the
72 requirement to use electronic prescribing due to demonstrated
73 economic hardship, technological limitations that are not
74 reasonably within the control of the practitioner, or another
75 exceptional circumstance demonstrated by the practitioner;
76 (d) The practitioner reasonably determines that it would be
77 impractical for the patient in question to obtain a medicinal
78 drug prescribed by electronic prescription in a timely manner
79 and such delay would adversely impact the patient’s medical
80 condition;
81 (e) The practitioner is prescribing a drug under a research
82 protocol;
83 (f) The prescription is for a drug for which the federal
84 Food and Drug Administration requires the prescription to
85 contain elements that may not be included in electronic
86 prescribing; or
87 (g) The prescription is issued to an individual receiving
88 hospice care or who is a resident of a nursing home facility.
89
90 The department, in consultation with the Board of Medicine and
91 the Board of Osteopathic Medicine, may adopt rules to implement
92 this subsection.
93 Section 2. Section 456.43, Florida Statutes, is amended to
94 read:
95 456.43 Electronic prescribing for medicinal drugs.—
96 (1) Electronic prescribing may shall not interfere with a
97 patient’s freedom to choose a pharmacy.
98 (2) Electronic prescribing software may shall not use any
99 means or permit any other person to use any means to influence
100 or attempt to influence, through economic incentives or
101 otherwise, the prescribing decision of a prescribing
102 practitioner or his or her agent at the point of care,
103 including, but not limited to, means such as advertising,
104 instant messaging, and pop-up ads, and similar means to
105 influence or attempt to influence, through economic incentives
106 or otherwise, the prescribing decision of a prescribing
107 practitioner at the point of care. Such means shall not be
108 triggered by or in specific response to the input, selection, or
109 act of a prescribing practitioner or his or her agent in
110 prescribing a certain medicinal drug pharmaceutical or directing
111 a patient to a certain pharmacy. For purposes of this
112 subsection, the term:
113 (a) The term “Prescribing decision” means a prescribing
114 practitioner’s or his or her agent’s decision to prescribe any
115 medicinal drug a certain pharmaceutical.
116 (b) The term “Point of care” means the time at which that a
117 prescribing practitioner or his or her agent prescribes any
118 medicinal drug is in the act of prescribing a certain
119 pharmaceutical.
120 (3) Electronic prescribing software may display show
121 information regarding a payor’s formulary if as long as nothing
122 is designed to preclude or make more difficult the selection of
123 the act of a prescribing practitioner or patient selecting any
124 particular pharmacy by a patient or the selection of a certain
125 medicinal drug by a prescribing practitioner or his or her agent
126 pharmaceutical.
127 Section 3. Paragraph (a) of subsection (5) of section
128 409.912, Florida Statutes, is amended to read:
129 409.912 Cost-effective purchasing of health care.—The
130 agency shall purchase goods and services for Medicaid recipients
131 in the most cost-effective manner consistent with the delivery
132 of quality medical care. To ensure that medical services are
133 effectively utilized, the agency may, in any case, require a
134 confirmation or second physician’s opinion of the correct
135 diagnosis for purposes of authorizing future services under the
136 Medicaid program. This section does not restrict access to
137 emergency services or poststabilization care services as defined
138 in 42 C.F.R. s. 438.114. Such confirmation or second opinion
139 shall be rendered in a manner approved by the agency. The agency
140 shall maximize the use of prepaid per capita and prepaid
141 aggregate fixed-sum basis services when appropriate and other
142 alternative service delivery and reimbursement methodologies,
143 including competitive bidding pursuant to s. 287.057, designed
144 to facilitate the cost-effective purchase of a case-managed
145 continuum of care. The agency shall also require providers to
146 minimize the exposure of recipients to the need for acute
147 inpatient, custodial, and other institutional care and the
148 inappropriate or unnecessary use of high-cost services. The
149 agency shall contract with a vendor to monitor and evaluate the
150 clinical practice patterns of providers in order to identify
151 trends that are outside the normal practice patterns of a
152 provider’s professional peers or the national guidelines of a
153 provider’s professional association. The vendor must be able to
154 provide information and counseling to a provider whose practice
155 patterns are outside the norms, in consultation with the agency,
156 to improve patient care and reduce inappropriate utilization.
157 The agency may mandate prior authorization, drug therapy
158 management, or disease management participation for certain
159 populations of Medicaid beneficiaries, certain drug classes, or
160 particular drugs to prevent fraud, abuse, overuse, and possible
161 dangerous drug interactions. The Pharmaceutical and Therapeutics
162 Committee shall make recommendations to the agency on drugs for
163 which prior authorization is required. The agency shall inform
164 the Pharmaceutical and Therapeutics Committee of its decisions
165 regarding drugs subject to prior authorization. The agency is
166 authorized to limit the entities it contracts with or enrolls as
167 Medicaid providers by developing a provider network through
168 provider credentialing. The agency may competitively bid single
169 source-provider contracts if procurement of goods or services
170 results in demonstrated cost savings to the state without
171 limiting access to care. The agency may limit its network based
172 on the assessment of beneficiary access to care, provider
173 availability, provider quality standards, time and distance
174 standards for access to care, the cultural competence of the
175 provider network, demographic characteristics of Medicaid
176 beneficiaries, practice and provider-to-beneficiary standards,
177 appointment wait times, beneficiary use of services, provider
178 turnover, provider profiling, provider licensure history,
179 previous program integrity investigations and findings, peer
180 review, provider Medicaid policy and billing compliance records,
181 clinical and medical record audits, and other factors. Providers
182 are not entitled to enrollment in the Medicaid provider network.
183 The agency shall determine instances in which allowing Medicaid
184 beneficiaries to purchase durable medical equipment and other
185 goods is less expensive to the Medicaid program than long-term
186 rental of the equipment or goods. The agency may establish rules
187 to facilitate purchases in lieu of long-term rentals in order to
188 protect against fraud and abuse in the Medicaid program as
189 defined in s. 409.913. The agency may seek federal waivers
190 necessary to administer these policies.
191 (5)(a) The agency shall implement a Medicaid prescribed
192 drug spending-control program that includes the following
193 components:
194 1. A Medicaid preferred drug list, which shall be a listing
195 of cost-effective therapeutic options recommended by the
196 Medicaid Pharmacy and Therapeutics Committee established
197 pursuant to s. 409.91195 and adopted by the agency for each
198 therapeutic class on the preferred drug list. At the discretion
199 of the committee, and when feasible, the preferred drug list
200 should include at least two products in a therapeutic class. The
201 agency may post the preferred drug list and updates to the list
202 on an Internet website without following the rulemaking
203 procedures of chapter 120. Antiretroviral agents are excluded
204 from the preferred drug list. The agency shall also limit the
205 amount of a prescribed drug dispensed to no more than a 34-day
206 supply unless the drug products’ smallest marketed package is
207 greater than a 34-day supply, or the drug is determined by the
208 agency to be a maintenance drug in which case a 100-day maximum
209 supply may be authorized. The agency may seek any federal
210 waivers necessary to implement these cost-control programs and
211 to continue participation in the federal Medicaid rebate
212 program, or alternatively to negotiate state-only manufacturer
213 rebates. The agency may adopt rules to administer this
214 subparagraph. The agency shall continue to provide unlimited
215 contraceptive drugs and items. The agency must establish
216 procedures to ensure that:
217 a. There is a response to a request for prior consultation
218 by telephone or other telecommunication device within 24 hours
219 after receipt of a request for prior consultation; and
220 b. A 72-hour supply of the drug prescribed is provided in
221 an emergency or when the agency does not provide a response
222 within 24 hours as required by sub-subparagraph a.
223 2. Reimbursement to pharmacies for Medicaid prescribed
224 drugs shall be set at the lowest of: the average wholesale price
225 (AWP) minus 16.4 percent, the wholesaler acquisition cost (WAC)
226 plus 1.5 percent, the federal upper limit (FUL), the state
227 maximum allowable cost (SMAC), or the usual and customary (UAC)
228 charge billed by the provider.
229 3. The agency shall develop and implement a process for
230 managing the drug therapies of Medicaid recipients who are using
231 significant numbers of prescribed drugs each month. The
232 management process may include, but is not limited to,
233 comprehensive, physician-directed medical-record reviews, claims
234 analyses, and case evaluations to determine the medical
235 necessity and appropriateness of a patient’s treatment plan and
236 drug therapies. The agency may contract with a private
237 organization to provide drug-program-management services. The
238 Medicaid drug benefit management program shall include
239 initiatives to manage drug therapies for HIV/AIDS patients,
240 patients using 20 or more unique prescriptions in a 180-day
241 period, and the top 1,000 patients in annual spending. The
242 agency shall enroll any Medicaid recipient in the drug benefit
243 management program if he or she meets the specifications of this
244 provision and is not enrolled in a Medicaid health maintenance
245 organization.
246 4. The agency may limit the size of its pharmacy network
247 based on need, competitive bidding, price negotiations,
248 credentialing, or similar criteria. The agency shall give
249 special consideration to rural areas in determining the size and
250 location of pharmacies included in the Medicaid pharmacy
251 network. A pharmacy credentialing process may include criteria
252 such as a pharmacy’s full-service status, location, size,
253 patient educational programs, patient consultation, disease
254 management services, and other characteristics. The agency may
255 impose a moratorium on Medicaid pharmacy enrollment if it is
256 determined that it has a sufficient number of Medicaid
257 participating providers. The agency must allow dispensing
258 practitioners to participate as a part of the Medicaid pharmacy
259 network regardless of the practitioner’s proximity to any other
260 entity that is dispensing prescription drugs under the Medicaid
261 program. A dispensing practitioner must meet all credentialing
262 requirements applicable to his or her practice, as determined by
263 the agency.
264 5. The agency shall develop and implement a program that
265 requires Medicaid practitioners who issue written prescriptions
266 for medicinal prescribe drugs to use a counterfeit-proof
267 prescription pad for Medicaid prescriptions. The agency shall
268 require the use of standardized counterfeit-proof prescription
269 pads by Medicaid-participating prescribers or prescribers who
270 issue written write prescriptions for Medicaid recipients. The
271 agency may implement the program in targeted geographic areas or
272 statewide.
273 6. The agency may enter into arrangements that require
274 manufacturers of generic drugs prescribed to Medicaid recipients
275 to provide rebates of at least 15.1 percent of the average
276 manufacturer price for the manufacturer’s generic products.
277 These arrangements shall require that if a generic-drug
278 manufacturer pays federal rebates for Medicaid-reimbursed drugs
279 at a level below 15.1 percent, the manufacturer must provide a
280 supplemental rebate to the state in an amount necessary to
281 achieve a 15.1-percent rebate level.
282 7. The agency may establish a preferred drug list as
283 described in this subsection, and, pursuant to the establishment
284 of such preferred drug list, negotiate supplemental rebates from
285 manufacturers that are in addition to those required by Title
286 XIX of the Social Security Act and at no less than 14 percent of
287 the average manufacturer price as defined in 42 U.S.C. s. 1936
288 on the last day of a quarter unless the federal or supplemental
289 rebate, or both, equals or exceeds 29 percent. There is no upper
290 limit on the supplemental rebates the agency may negotiate. The
291 agency may determine that specific products, brand-name or
292 generic, are competitive at lower rebate percentages. Agreement
293 to pay the minimum supplemental rebate percentage guarantees a
294 manufacturer that the Medicaid Pharmaceutical and Therapeutics
295 Committee will consider a product for inclusion on the preferred
296 drug list. However, a pharmaceutical manufacturer is not
297 guaranteed placement on the preferred drug list by simply paying
298 the minimum supplemental rebate. Agency decisions will be made
299 on the clinical efficacy of a drug and recommendations of the
300 Medicaid Pharmaceutical and Therapeutics Committee, as well as
301 the price of competing products minus federal and state rebates.
302 The agency may contract with an outside agency or contractor to
303 conduct negotiations for supplemental rebates. For the purposes
304 of this section, the term “supplemental rebates” means cash
305 rebates. Value-added programs as a substitution for supplemental
306 rebates are prohibited. The agency may seek any federal waivers
307 to implement this initiative.
308 8. The agency shall expand home delivery of pharmacy
309 products. The agency may amend the state plan and issue a
310 procurement, as necessary, in order to implement this program.
311 The procurements must include agreements with a pharmacy or
312 pharmacies located in the state to provide mail order delivery
313 services at no cost to the recipients who elect to receive home
314 delivery of pharmacy products. The procurement must focus on
315 serving recipients with chronic diseases for which pharmacy
316 expenditures represent a significant portion of Medicaid
317 pharmacy expenditures or which impact a significant portion of
318 the Medicaid population. The agency may seek and implement any
319 federal waivers necessary to implement this subparagraph.
320 9. The agency shall limit to one dose per month any drug
321 prescribed to treat erectile dysfunction.
322 10.a. The agency may implement a Medicaid behavioral drug
323 management system. The agency may contract with a vendor that
324 has experience in operating behavioral drug management systems
325 to implement this program. The agency may seek federal waivers
326 to implement this program.
327 b. The agency, in conjunction with the Department of
328 Children and Families, may implement the Medicaid behavioral
329 drug management system that is designed to improve the quality
330 of care and behavioral health prescribing practices based on
331 best practice guidelines, improve patient adherence to
332 medication plans, reduce clinical risk, and lower prescribed
333 drug costs and the rate of inappropriate spending on Medicaid
334 behavioral drugs. The program may include the following
335 elements:
336 (I) Provide for the development and adoption of best
337 practice guidelines for behavioral health-related drugs such as
338 antipsychotics, antidepressants, and medications for treating
339 bipolar disorders and other behavioral conditions; translate
340 them into practice; review behavioral health prescribers and
341 compare their prescribing patterns to a number of indicators
342 that are based on national standards; and determine deviations
343 from best practice guidelines.
344 (II) Implement processes for providing feedback to and
345 educating prescribers using best practice educational materials
346 and peer-to-peer consultation.
347 (III) Assess Medicaid beneficiaries who are outliers in
348 their use of behavioral health drugs with regard to the numbers
349 and types of drugs taken, drug dosages, combination drug
350 therapies, and other indicators of improper use of behavioral
351 health drugs.
352 (IV) Alert prescribers to patients who fail to refill
353 prescriptions in a timely fashion, are prescribed multiple same
354 class behavioral health drugs, and may have other potential
355 medication problems.
356 (V) Track spending trends for behavioral health drugs and
357 deviation from best practice guidelines.
358 (VI) Use educational and technological approaches to
359 promote best practices, educate consumers, and train prescribers
360 in the use of practice guidelines.
361 (VII) Disseminate electronic and published materials.
362 (VIII) Hold statewide and regional conferences.
363 (IX) Implement a disease management program with a model
364 quality-based medication component for severely mentally ill
365 individuals and emotionally disturbed children who are high
366 users of care.
367 11. The agency shall implement a Medicaid prescription drug
368 management system.
369 a. The agency may contract with a vendor that has
370 experience in operating prescription drug management systems in
371 order to implement this system. Any management system that is
372 implemented in accordance with this subparagraph must rely on
373 cooperation between physicians and pharmacists to determine
374 appropriate practice patterns and clinical guidelines to improve
375 the prescribing, dispensing, and use of drugs in the Medicaid
376 program. The agency may seek federal waivers to implement this
377 program.
378 b. The drug management system must be designed to improve
379 the quality of care and prescribing practices based on best
380 practice guidelines, improve patient adherence to medication
381 plans, reduce clinical risk, and lower prescribed drug costs and
382 the rate of inappropriate spending on Medicaid prescription
383 drugs. The program must:
384 (I) Provide for the adoption of best practice guidelines
385 for the prescribing and use of drugs in the Medicaid program,
386 including translating best practice guidelines into practice;
387 reviewing prescriber patterns and comparing them to indicators
388 that are based on national standards and practice patterns of
389 clinical peers in their community, statewide, and nationally;
390 and determine deviations from best practice guidelines.
391 (II) Implement processes for providing feedback to and
392 educating prescribers using best practice educational materials
393 and peer-to-peer consultation.
394 (III) Assess Medicaid recipients who are outliers in their
395 use of a single or multiple prescription drugs with regard to
396 the numbers and types of drugs taken, drug dosages, combination
397 drug therapies, and other indicators of improper use of
398 prescription drugs.
399 (IV) Alert prescribers to recipients who fail to refill
400 prescriptions in a timely fashion, are prescribed multiple drugs
401 that may be redundant or contraindicated, or may have other
402 potential medication problems.
403 12. The agency may contract for drug rebate administration,
404 including, but not limited to, calculating rebate amounts,
405 invoicing manufacturers, negotiating disputes with
406 manufacturers, and maintaining a database of rebate collections.
407 13. The agency may specify the preferred daily dosing form
408 or strength for the purpose of promoting best practices with
409 regard to the prescribing of certain drugs as specified in the
410 General Appropriations Act and ensuring cost-effective
411 prescribing practices.
412 14. The agency may require prior authorization for
413 Medicaid-covered prescribed drugs. The agency may prior
414 authorize the use of a product:
415 a. For an indication not approved in labeling;
416 b. To comply with certain clinical guidelines; or
417 c. If the product has the potential for overuse, misuse, or
418 abuse.
419
420 The agency may require the prescribing professional to provide
421 information about the rationale and supporting medical evidence
422 for the use of a drug. The agency shall post prior
423 authorization, step-edit criteria and protocol, and updates to
424 the list of drugs that are subject to prior authorization on the
425 agency’s Internet website within 21 days after the prior
426 authorization and step-edit criteria and protocol and updates
427 are approved by the agency. For purposes of this subparagraph,
428 the term “step-edit” means an automatic electronic review of
429 certain medications subject to prior authorization.
430 15. The agency, in conjunction with the Pharmaceutical and
431 Therapeutics Committee, may require age-related prior
432 authorizations for certain prescribed drugs. The agency may
433 preauthorize the use of a drug for a recipient who may not meet
434 the age requirement or may exceed the length of therapy for use
435 of this product as recommended by the manufacturer and approved
436 by the Food and Drug Administration. Prior authorization may
437 require the prescribing professional to provide information
438 about the rationale and supporting medical evidence for the use
439 of a drug.
440 16. The agency shall implement a step-therapy prior
441 authorization approval process for medications excluded from the
442 preferred drug list. Medications listed on the preferred drug
443 list must be used within the previous 12 months before the
444 alternative medications that are not listed. The step-therapy
445 prior authorization may require the prescriber to use the
446 medications of a similar drug class or for a similar medical
447 indication unless contraindicated in the Food and Drug
448 Administration labeling. The trial period between the specified
449 steps may vary according to the medical indication. The step
450 therapy approval process shall be developed in accordance with
451 the committee as stated in s. 409.91195(7) and (8). A drug
452 product may be approved without meeting the step-therapy prior
453 authorization criteria if the prescribing physician provides the
454 agency with additional written medical or clinical documentation
455 that the product is medically necessary because:
456 a. There is not a drug on the preferred drug list to treat
457 the disease or medical condition which is an acceptable clinical
458 alternative;
459 b. The alternatives have been ineffective in the treatment
460 of the beneficiary’s disease; or
461 c. Based on historic evidence and known characteristics of
462 the patient and the drug, the drug is likely to be ineffective,
463 or the number of doses have been ineffective.
464
465 The agency shall work with the physician to determine the best
466 alternative for the patient. The agency may adopt rules waiving
467 the requirements for written clinical documentation for specific
468 drugs in limited clinical situations.
469 17. The agency shall implement a return and reuse program
470 for drugs dispensed by pharmacies to institutional recipients,
471 which includes payment of a $5 restocking fee for the
472 implementation and operation of the program. The return and
473 reuse program shall be implemented electronically and in a
474 manner that promotes efficiency. The program must permit a
475 pharmacy to exclude drugs from the program if it is not
476 practical or cost-effective for the drug to be included and must
477 provide for the return to inventory of drugs that cannot be
478 credited or returned in a cost-effective manner. The agency
479 shall determine if the program has reduced the amount of
480 Medicaid prescription drugs which are destroyed on an annual
481 basis and if there are additional ways to ensure more
482 prescription drugs are not destroyed which could safely be
483 reused.
484 Section 4. Section 456.0392, Florida Statutes, is amended
485 to read:
486 456.0392 Prescription labeling.—
487 (1) A prescription issued written by a practitioner who is
488 authorized under the laws of this state to prescribe write
489 prescriptions for drugs that are not listed as controlled
490 substances in chapter 893 but who is not eligible for a federal
491 Drug Enforcement Administration number shall include that
492 practitioner’s name and professional license number. The
493 pharmacist or dispensing practitioner must include the
494 practitioner’s name on the container of the drug that is
495 dispensed. A pharmacist shall be permitted, upon verification by
496 the prescriber, to document any information required by this
497 section.
498 (2) A prescription for a drug that is not listed as a
499 controlled substance in chapter 893 which is issued written by
500 an advanced practice registered nurse licensed under s. 464.012
501 is presumed, subject to rebuttal, to be valid and within the
502 parameters of the prescriptive authority delegated by a
503 practitioner licensed under chapter 458, chapter 459, or chapter
504 466.
505 (3) A prescription for a drug that is not listed as a
506 controlled substance in chapter 893 which is issued written by a
507 physician assistant licensed under chapter 458 or chapter 459 is
508 presumed, subject to rebuttal, to be valid and within the
509 parameters of the prescriptive authority delegated by the
510 physician assistant’s supervising physician.
511 Section 5. Paragraph (d) of subsection (3) of section
512 458.3265, Florida Statutes, is amended to read:
513 458.3265 Pain-management clinics.—
514 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
515 apply to any physician who provides professional services in a
516 pain-management clinic that is required to be registered in
517 subsection (1).
518 (d) A physician authorized to prescribe controlled
519 substances who practices at a pain-management clinic is
520 responsible for maintaining the control and security of his or
521 her prescription blanks or electronic prescribing software and
522 any other method used for prescribing controlled substance pain
523 medication. A The physician who issues written prescriptions
524 shall comply with the requirements for counterfeit-resistant
525 prescription blanks in s. 893.065 and the rules adopted pursuant
526 to that section. A The physician shall notify, in writing, the
527 department within 24 hours after following any theft or loss of
528 a prescription blank or breach of his or her electronic
529 prescribing software used any other method for prescribing pain
530 medication.
531 Section 6. Paragraph (qq) of subsection (1) of section
532 458.331, Florida Statutes, is amended to read:
533 458.331 Grounds for disciplinary action; action by the
534 board and department.—
535 (1) The following acts constitute grounds for denial of a
536 license or disciplinary action, as specified in s. 456.072(2):
537 (qq) Failing to timely notify the department of the theft
538 of prescription blanks from a pain-management clinic or a breach
539 of a physician’s electronic prescribing software other methods
540 for prescribing within 24 hours as required by s. 458.3265(3).
541 Section 7. Paragraph (d) of subsection (3) of section
542 459.0137, Florida Statutes, is amended to read:
543 459.0137 Pain-management clinics.—
544 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
545 apply to any osteopathic physician who provides professional
546 services in a pain-management clinic that is required to be
547 registered in subsection (1).
548 (d) An osteopathic physician authorized to prescribe
549 controlled substances who practices at a pain-management clinic
550 is responsible for maintaining the control and security of his
551 or her prescription blanks or electronic prescribing software
552 and any other method used for prescribing controlled substance
553 pain medication. An The osteopathic physician who issues written
554 prescriptions shall comply with the requirements for
555 counterfeit-resistant prescription blanks in s. 893.065 and the
556 rules adopted pursuant to that section. An The osteopathic
557 physician shall notify, in writing, the department within 24
558 hours after following any theft or loss of a prescription blank
559 or breach of his or her electronic prescribing software used any
560 other method for prescribing pain medication.
561 Section 8. Paragraph (ss) of subsection (1) of section
562 459.015, Florida Statutes, is amended to read:
563 459.015 Grounds for disciplinary action; action by the
564 board and department.—
565 (1) The following acts constitute grounds for denial of a
566 license or disciplinary action, as specified in s. 456.072(2):
567 (ss) Failing to timely notify the department of the theft
568 of prescription blanks from a pain-management clinic or a breach
569 of an osteopathic physician’s electronic prescribing software
570 other methods for prescribing within 24 hours as required by s.
571 459.0137(3).
572 Section 9. This act shall take effect July 1, 2019.
