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House Bill 1527

Florida House of Representatives - 1997 HB 1527 By Representative Morroni 1 A bill to be entitled 2 An act relating to pharmacy practice; amending 3 s. 465.003, F.S.; revising and providing 4 definitions; amending s. 465.014, F.S.; 5 providing additional duties of pharmacy 6 technicians; increasing the number of pharmacy 7 technicians who may be supervised by a licensed 8 pharmacist; correcting a cross reference; 9 amending ss. 465.015, 465.0196, and 499.003, 10 F.S.; correcting cross references; amending s. 11 465.017, F.S.; providing additional persons and 12 entities to whom records relating to the 13 filling of prescriptions and the dispensing of 14 medicinal drugs that are maintained by a 15 pharmacy may be furnished; providing 16 restrictions on such records when transmitted 17 through a data communication device; amending 18 s. 465.026, F.S.; revising provisions relating 19 to the filling of prescriptions transferred by 20 electronic or other means; amending s. 465.035, 21 F.S.; authorizing the dispensing of certain 22 controlled substances pursuant to facsimile 23 receipt of the original prescription; providing 24 an effective date. 25 26 Be It Enacted by the Legislature of the State of Florida: 27 28 Section 1. Section 465.003, Florida Statutes, is 29 amended to read: 30 465.003 Definitions.--As used in this chapter, the 31 term: 1 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 (1) "Administration" means the obtaining and giving of 2 a single dose of medicinal drugs by a legally authorized 3 person to a patient for his consumption. 4 (2) "Board" means the Board of Pharmacy. 5 (3) "Consultant pharmacist" means a pharmacist 6 licensed by the department and certified as a consultant 7 pharmacist pursuant to s. 465.0125. 8 (4) "Data communication device" means an electronic 9 device that receives electronic information from one source 10 and transmits or routes it to another, including, but not 11 limited to, any such bridge, router, switch, or gateway. 12 (5)(4) "Department" means the Department of Health 13 Business and Professional Regulation. 14 (6)(5) "Dispense" means the transfer of possession of 15 one or more doses of a medicinal drug by a pharmacist to the 16 ultimate consumer or his agent. As an element of dispensing, 17 the pharmacist shall, prior to the actual physical transfer, 18 interpret and assess the prescription order for potential 19 adverse reactions, interactions, and dosage regimen he deems 20 appropriate in the exercise of his professional judgment, and 21 he shall certify that the medicinal drug called for by the 22 prescription is ready for transfer. The pharmacist shall also 23 provide counseling on proper drug usage, either orally or in 24 writing, if in the exercise of his professional judgment 25 counseling is necessary. The actual sales transaction and 26 delivery of such drug shall not be considered dispensing. The 27 administration shall not be considered dispensing. 28 (7)(6) "Institutional formulary system" means a method 29 whereby the medical staff evaluates, appraises, and selects 30 those medicinal drugs or proprietary preparations which in the 31 medical staff's clinical judgment are most useful in patient 2 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 care, and which are available for dispensing by a practicing 2 pharmacist in a Class II institutional pharmacy. 3 (8)(7) "Medicinal drugs" or "drugs" means those 4 substances or preparations commonly known as "prescription" or 5 "legend" drugs which are required by federal or state law to 6 be dispensed only on a prescription, but shall not include 7 patents or proprietary preparations as hereafter defined. 8 (9)(8) "Patent or proprietary preparation" means a 9 medicine in its unbroken, original package which is sold to 10 the public by, or under the authority of, the manufacturer or 11 primary distributor thereof and which is not misbranded under 12 the provisions of the Florida Drug and Cosmetic Act. 13 (10)(9) "Pharmacist" means any person licensed 14 pursuant to this chapter to practice the profession of 15 pharmacy. 16 (11)(a)(10) "Pharmacy" includes a community pharmacy, 17 an institutional pharmacy, a nuclear pharmacy, and a special 18 pharmacy. 19 1.(a) The term "community pharmacy" includes every 20 location where medicinal drugs are compounded, dispensed, 21 stored, or sold or where prescriptions are filled or dispensed 22 on an outpatient basis. 23 2.(b) The term "institutional pharmacy" includes every 24 location in a hospital, clinic, nursing home, dispensary, 25 sanitarium, extended care facility, or other facility, 26 hereinafter referred to as "health care institutions," where 27 medicinal drugs are compounded, dispensed, stored, or sold. 28 3.(c) The term "nuclear pharmacy" includes every 29 location where radioactive drugs and chemicals within the 30 classification of medicinal drugs are compounded, dispensed, 31 stored, or sold. The term "nuclear pharmacy" does not include 3 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 hospitals licensed under chapter 395 or the nuclear medicine 2 facilities of such hospitals. 3 4.(d) The term "special pharmacy" includes every 4 location where medicinal drugs are compounded, dispensed, 5 stored, or sold if such locations are not otherwise defined in 6 this subsection. 7 (b) The pharmacy department of any permittee shall be 8 considered closed whenever a Florida-licensed pharmacist is 9 not present and on duty. The term "not present and on duty" 10 may not be construed to prevent a pharmacist from exiting the 11 prescription department for the purposes of consulting or 12 responding to inquiries or providing assistance to patients or 13 customers, attending to personal hygiene needs, or performing 14 any other function for which the pharmacist is responsible, 15 provided that such activities are conducted in a manner 16 consistent with the pharmacist's responsibility to provide 17 pharmacy services. 18 (12)(11) "Pharmacy intern" means a person who is 19 currently registered in, and attending, a duly accredited 20 college or school of pharmacy, or who is a graduate of such a 21 school or college of pharmacy, and who is duly and properly 22 registered with the department as provided for under its 23 rules. 24 (13)(12) "Practice of the profession of pharmacy" 25 includes compounding, dispensing, and consulting concerning 26 contents, therapeutic values, and uses of any medicinal drug 27 and consulting concerning therapeutic values and interactions 28 of patent or proprietary preparations, whether pursuant to 29 prescriptions or in the absence and entirely independent of 30 such prescriptions or orders, and other related cognitive 31 services. The phrase also includes any other act, service, 4 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 operation, or transaction incidental to, or forming a part of, 2 any of the foregoing acts, requiring, involving, or employing 3 the science or art of any branch of the pharmaceutical 4 profession, study, or training, and shall expressly permit a 5 pharmacist to transmit information from persons authorized to 6 prescribe medicinal drugs to their patients. 7 (14)(13) "Prescription" includes any order for drugs 8 or medicinal supplies written or transmitted by any means of 9 communication by a duly licensed practitioner authorized by 10 the laws of the state to prescribe such drugs or medicinal 11 supplies and intended to be dispensed by a pharmacist. The 12 term also includes an orally transmitted order by the lawfully 13 designated agent of such practitioner. The term also includes 14 an order written or transmitted by a practitioner licensed to 15 practice in a jurisdiction other than this state, but only if 16 the pharmacist called upon to dispense such order determines, 17 in the exercise of his professional judgment, that the order 18 is valid and necessary for the treatment of a chronic or 19 recurrent illness. The term "prescription" also includes a 20 pharmacist's order for a product selected from the formulary 21 created pursuant to s. 465.186. Prescriptions may be retained 22 in written form or the pharmacist may cause it to be recorded 23 in a data processing system, provided that such order can be 24 produced in printed form upon lawful request. 25 (15)(14) "Nuclear pharmacist" means a pharmacist 26 licensed by the department and certified as a nuclear 27 pharmacist pursuant to s. 465.0126. 28 Section 2. Section 465.014, Florida Statutes, is 29 amended to read: 30 465.014 Pharmacy technician.--No person other than a 31 licensed pharmacist or pharmacy intern may engage in the 5 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 practice of the profession of pharmacy, except that a licensed 2 pharmacist may delegate to nonlicensed pharmacy technicians 3 those duties, tasks, and functions which do not fall within 4 the purview of s. 465.003(13)(12). All such delegated acts 5 shall be performed under the direct supervision of a licensed 6 pharmacist who shall be responsible for all such acts 7 performed by persons under his supervision. A pharmacy 8 technician, under the direct supervision of a licensed 9 pharmacist, may initiate or receive communications with a 10 practitioner, on behalf of the patient, regarding refill 11 authorization requests and related information. No licensed 12 pharmacist shall supervise more than one pharmacy technician 13 unless otherwise permitted by the guidelines adopted by the 14 board. The board shall establish guidelines to be followed by 15 licensees or permittees in determining the circumstances under 16 which a licensed pharmacist may supervise more than one but 17 not more than three two pharmacy technicians. 18 Section 3. Paragraph (c) of subsection (2) of section 19 465.015, Florida Statutes, is amended to read: 20 465.015 Violations and penalties.-- 21 (2) It is unlawful for any person: 22 (c) To sell or dispense drugs as defined in s. 23 465.003(8)(7) without first being furnished with a 24 prescription. 25 Section 4. Subsection (2) of section 465.017, Florida 26 Statutes, is amended to read: 27 465.017 Authority to inspect.-- 28 (2) Except as permitted by this chapter, and chapters 29 406, 409, 455, 499, and 893, records maintained by in a 30 pharmacy relating to the filling of prescriptions and the 31 dispensing of medicinal drugs shall not be furnished, except 6 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 upon the written authorization of the patient, to any person 2 other than to the patient for whom the drugs were dispensed, 3 or his legal representative, or to the department pursuant to 4 existing law, or, in the event that the patient is 5 incapacitated or unable to request said records, his spouse; 6 to the department pursuant to existing law; to treating 7 practitioners and other pharmacists when, in the professional 8 judgment of the pharmacist, such release protects or benefits 9 the patient's health, well-being, or treatment; or, to 10 insurance carriers or other payors authorized by the patient 11 to receive such records. For purposes of this section, records 12 held in a pharmacy shall be considered held by the owner of 13 the pharmacy except upon the written authorization of such 14 patient. Such records may be furnished in any civil or 15 criminal proceeding, upon the issuance of a subpoena from a 16 court of competent jurisdiction and proper notice to the 17 patient or his legal representative by the party seeking such 18 records. Such records or any part thereof, if transmitted 19 through a data communication device and not directly between a 20 pharmacy and a treating practitioner, may not be accessed, 21 used, or maintained by the operator or owner of the data 22 communication device unless specifically authorized by this 23 section. 24 Section 5. Section 465.0196, Florida Statutes, is 25 amended to read: 26 465.0196 Special pharmacy permits.--Any person 27 desiring a permit to operate a pharmacy which does not fall 28 within the definitions set forth in s. 465.003(11)(10)(a)1., 29 2.(b), and 3.(c) shall apply to the department for a special 30 pharmacy permit. If the board certifies that the application 31 complies with the applicable laws and rules of the board 7 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 governing the practice of the profession of pharmacy, the 2 department shall issue the permit. No permit shall be issued 3 unless a licensed pharmacist is designated to undertake the 4 professional supervision of the compounding and dispensing of 5 all drugs dispensed by the pharmacy. The licensed pharmacist 6 shall be responsible for maintaining all drug records and for 7 providing for the security of the area in the facility in 8 which the compounding, storing, and dispensing of medicinal 9 drugs occurs. The permittee shall notify the department within 10 10 days of any change of the licensed pharmacist responsible 11 for such duties. 12 Section 6. Section 465.026, Florida Statutes, is 13 amended to read: 14 465.026 Filling of certain prescriptions.--Nothing 15 contained in this chapter shall be construed to prohibit a 16 pharmacist licensed in this state from filling or refilling a 17 valid prescription which is on file in a pharmacy located in 18 this state or in another state and has been transferred from 19 one pharmacy to another by any means, including any electronic 20 means transfer by way of electronic data processing equipment, 21 under the following conditions: 22 (1) Prior to dispensing any transferred pursuant to 23 any such prescription, the dispensing pharmacist must, either 24 verbally or by any electronic means, do all of the following 25 shall: 26 (a) Advise the patient that the prescription on file 27 at the such other pharmacy must be canceled before it may be 28 filled or refilled he will be able to fill or refill it. 29 (b) Determine from the requested pharmacist that the 30 prescription is valid and on file at the such other pharmacy 31 and that the such prescription may be filled or refilled, as 8 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 requested, in accordance with the prescriber's intent 2 expressed on the such prescription. 3 (c) Notify the pharmacist or at the pharmacy where the 4 prescription is on file that the prescription must be 5 canceled. 6 (d) Record in writing, or by any electronic means, or 7 cause to be recorded by data processing equipment the 8 prescription order, the name of the pharmacy at which the 9 prescription was on file, the prescription number, the name of 10 the drug and the original amount dispensed, the date of 11 original dispensing, and the number of remaining authorized 12 refills. 13 (e) Obtain the consent of the prescriber to the 14 refilling of the prescription when the prescription, in the 15 dispensing pharmacist's professional judgment of the 16 dispensing pharmacist, so requires. Any interference with the 17 professional judgment of the dispensing pharmacist by any 18 pharmacist or pharmacy permittee, or its agents, or employees, 19 shall be grounds for discipline revocation or suspension of 20 the permit issued to the pharmacy. 21 (2) Upon receipt of a request for prescription 22 transfer request information set forth in paragraph (1)(d), if 23 the requested pharmacist is satisfied in his professional 24 judgment that the such request is valid, or if the request has 25 been validated by any electronic means, the requested 26 pharmacist or pharmacy must do all of the following shall: 27 (a) Transfer the information required by paragraph 28 (1)(d) Provide such information accurately and completely. 29 (b) Record on the prescription, or by any electronic 30 means, or record with data processing equipment the name of 31 9 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 the requesting pharmacy and pharmacist and the date of 2 request. 3 (c) Cancel the prescription on file by electronic 4 means or by recording the word "void" on the prescription 5 record. No further prescription information shall be given or 6 medication dispensed pursuant to the said original 7 prescription. 8 (3) If a transferred prescription is not dispensed 9 within a reasonable time, the pharmacist shall, by any means, 10 so notify the transferring pharmacy. In the event that, after 11 the information set forth in paragraph (1)(d) has been 12 provided, a prescription is not dispensed by the requesting 13 pharmacist, then such pharmacist shall provide notice of this 14 fact to the pharmacy from which said information was obtained; 15 Such notice shall serve to revalidate the canceled voided 16 prescription. The pharmacist who has served such notice shall 17 then cancel the prescription in the same manner as set forth 18 in paragraph (2)(c). 19 (4) In the case of a prescription to be transferred 20 from or to a pharmacy located in another outside of the state, 21 it shall be the responsibility of the pharmacist or pharmacy 22 located in the State of Florida to verify, whether by 23 electronic means or otherwise, assure that the person or 24 entity involved in the performing the act of transfer is a 25 licensed pharmacist or pharmacy in the other state from 26 outside the state is a practitioner licensed to practice 27 pharmacy in the jurisdiction wherein the non-Florida pharmacy 28 involved is located. 29 (5) Electronic transfers of prescriptions are 30 permitted regardless of whether the transferor or transferee 31 pharmacy is open for business. 10 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 (6)(5) The transfer of a prescription for medicinal 2 drugs listed in Schedules III, IV, and V appearing in chapter 3 893 for the purpose of refill dispensing is permissible, 4 between pharmacies on a one-time basis subject to the 5 requirements of this section and federal law. Compliance with 6 federal law shall be deemed compliance with the requirements 7 of this section. 8 Section 7. Section 465.035, Florida Statutes, is 9 amended to read: 10 465.035 Dispensing of medicinal medical drugs pursuant 11 to facsimile of prescription.-- 12 (1) Notwithstanding any other provision of this 13 chapter, it is lawful for a pharmacy to dispense medicinal 14 drugs, including controlled substances as provided in this 15 section, based on reception of an electronic facsimile of the 16 original prescription if all of the following conditions are 17 met: 18 (a) In the course of the transaction the pharmacy 19 complies with laws and administrative rules relating to 20 pharmacies and pharmacists. 21 (b) Except in the case of the transmission of a 22 prescription by a person authorized by law to prescribe 23 medicinal drugs: 24 1. The facsimile system making the transmission 25 provides the pharmacy receiving the transmission with audio 26 communication via telephonic, electronic, or similar means 27 with the person presenting the prescription. 28 2. At the time of the delivery of the medicinal drugs, 29 the pharmacy has in its possession the original prescription 30 for the medicinal drug involved. 31 11 CODING: Words stricken are deletions; words underlined are additions. Florida House of Representatives - 1997 HB 1527 536-141A-97 1 3. The recipient of the prescription shall sign a log 2 and shall indicate the name and address of both the recipient 3 and the patient for whom the medicinal drug was prescribed. 4 (2) This section does not apply to the dispensing of 5 Controlled substances listed in Schedule II as defined in s. 6 893.03(2) may be dispensed as provided in 21 C.F.R. s. 7 1306.11. 8 Section 8. Subsection (19) of section 499.003, Florida 9 Statutes, is amended to read: 10 499.003 Definitions of terms used in ss. 11 499.001-499.081.--As used in ss. 499.001-499.081, the term: 12 (19) "Legend drug," "prescription drug," or "medicinal 13 drug" means any drug, including, but not limited to, finished 14 dosage forms, or active ingredients subject to, defined by, or 15 described by s. 503(b) of the Federal Food, Drug, and Cosmetic 16 Act or s. 465.003(8)(7), s. 499.007(12), or s. 499.0122(1)(b) 17 or (c). 18 Section 9. This act shall take effect July 1, 1997. 19 20 ***************************************** 21 HOUSE SUMMARY 22 Revises and provides definitions relating to pharmacy 23 practice. Authorizes pharmacy technicians, under direct supervision of a licensed pharmacist, to initiate and 24 receive communications with a practitioner, on behalf of patients, regarding refill authorization requests and 25 related information. Increases to three the number of pharmacy technicians who may be supervised by a licensed 26 pharmacist. Provides additional persons and entities to whom records relating to the filling of prescriptions and 27 the dispensing of medicinal drugs that are maintained by a pharmacy may be furnished, and provides restrictions on 28 such records when transmitted through a data communication device. Revises provisions relating to the 29 filling of prescriptions transferred by electronic or other means. Authorizes the dispensing of certain 30 Schedule II controlled substances pursuant to facsimile receipt of the original prescription. See bill for 31 details. 12