House Bill 3973

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    Florida House of Representatives - 1998                HB 3973

        By Representative Gay






  1                      A bill to be entitled

  2         An act relating to pharmacy practice; amending

  3         s. 409.908, F.S., relating to reimbursement of

  4         Medicaid providers; deleting a requirement that

  5         the Agency for Health Care Administration

  6         implement a variable dispensing fee for

  7         payments for prescribed medicines for Medicaid

  8         recipients; amending s. 465.003, F.S.; revising

  9         the definition of the term "practice of the

10         profession of pharmacy"; creating s. 465.0123,

11         F.S.; providing requirements for licensure as a

12         pharmacist practitioner; providing fees;

13         providing the scope of practice of such a

14         licensee; providing rulemaking authority for

15         such licensure to the Board of Pharmacy;

16         amending s. 465.022, F.S.; requiring the board

17         to adopt rules relating to pharmacist duties

18         and pharmacy responsibilities; providing an

19         effective date.

20

21  Be It Enacted by the Legislature of the State of Florida:

22

23         Section 1.  Subsection (14) of section 409.908, Florida

24  Statutes, is amended to read:

25         409.908  Reimbursement of Medicaid providers.--Subject

26  to specific appropriations, the agency shall reimburse

27  Medicaid providers, in accordance with state and federal law,

28  according to methodologies set forth in the rules of the

29  agency and in policy manuals and handbooks incorporated by

30  reference therein. These methodologies may include fee

31  schedules, reimbursement methods based on cost reporting,

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    Florida House of Representatives - 1998                HB 3973

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  1  negotiated fees, competitive bidding pursuant to s. 287.057,

  2  and other mechanisms the agency considers efficient and

  3  effective for purchasing services or goods on behalf of

  4  recipients. Payment for Medicaid compensable services made on

  5  behalf of Medicaid eligible persons is subject to the

  6  availability of moneys and any limitations or directions

  7  provided for in the General Appropriations Act or chapter 216.

  8  Further, nothing in this section shall be construed to prevent

  9  or limit the agency from adjusting fees, reimbursement rates,

10  lengths of stay, number of visits, or number of services, or

11  making any other adjustments necessary to comply with the

12  availability of moneys and any limitations or directions

13  provided for in the General Appropriations Act, provided the

14  adjustment is consistent with legislative intent.

15         (14)  A provider of prescribed drugs shall be

16  reimbursed the least of the amount billed by the provider, the

17  provider's usual and customary charge, or the Medicaid maximum

18  allowable fee established by the agency, plus a dispensing

19  fee. The agency is directed to implement a variable dispensing

20  fee for payments for prescribed medicines while ensuring

21  continued access for Medicaid recipients. The variable

22  dispensing fee may be based upon, but not limited to, either

23  or both the volume of prescriptions dispensed by a specific

24  pharmacy provider and the volume of prescriptions dispensed to

25  an individual recipient. The agency is authorized to limit

26  reimbursement for prescribed medicine in order to comply with

27  any limitations or directions provided for in the General

28  Appropriations Act, which may include implementing a

29  prospective or concurrent utilization review program.

30         Section 2.  Subsection (12) of section 465.003, Florida

31  Statutes, is amended to read:

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    Florida House of Representatives - 1998                HB 3973

    540-175-98






  1         465.003  Definitions.--As used in this chapter, the

  2  term:

  3         (12)  "Practice of the profession of pharmacy" includes

  4  compounding, dispensing, and consulting concerning contents,

  5  therapeutic values, and uses of any medicinal drug; and

  6  consulting concerning therapeutic values and interactions of

  7  patent or proprietary preparations, whether pursuant to

  8  prescriptions or in the absence and entirely independent of

  9  such prescriptions or orders; and other pharmaceutical care

10  services. The phrase also includes any other act, service,

11  operation, research, or transaction incidental to, or forming

12  a part of, any of the foregoing acts, requiring, involving, or

13  employing the science or art of any branch of the

14  pharmaceutical profession, study, or training, and shall

15  expressly permit a pharmacist to transmit information from

16  persons authorized to prescribe medicinal drugs to their

17  patients. In addition to the authority to order and dispense

18  medicinal drugs independently of an established protocol as

19  set forth in s. 465.186, a pharmacist may also administer

20  immunizations, either within the framework of an established

21  protocol under a supervisory practitioner who is a physician

22  licensed under chapter 458 or chapter 459 or by written

23  agreement with a county health department.

24         Section 3.  Section 465.0123, Florida Statutes, is

25  created to read:

26         465.0123  Pharmacist practitioner; licensure; scope of

27  practice; rules.--The department shall issue or renew a

28  pharmacist practitioner license upon receipt of both an

29  initial or renewal application that conforms to the

30  requirements prescribed by board rule and a fee established by

31  the board, not to exceed $250. A pharmacist practitioner must

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    Florida House of Representatives - 1998                HB 3973

    540-175-98






  1  have completed specific instruction in evaluation and testing

  2  of blood pressure and cholesterol levels, diabetes,

  3  anticoagulation therapy monitoring, and asthma. Upon

  4  completion of the instruction and issuance of the required

  5  license, a pharmacist practitioner may provide primary care,

  6  professional referral, and consulting services for these

  7  health conditions. The board shall adopt rules necessary to

  8  administer this section.

  9         Section 4.  Paragraph (i) is added to subsection (1) of

10  section 465.022, Florida Statutes, to read:

11         465.022  Pharmacies; general requirements; fees.--

12         (1)  The board shall adopt such rules relating to

13  pharmacies as are necessary to protect the public health,

14  safety, and welfare. Such rules shall include, but shall not

15  be limited to, rules relating to:

16         (i)  Duties of a pharmacist and responsibilities of a

17  pharmacy, consistent with the size, scope, and type of the

18  pharmacy in order to ensure the highest level of patient care

19  and safety.

20         Section 5.  This act shall take effect July 1 of the

21  year in which enacted.

22

23            *****************************************

24                          HOUSE SUMMARY

25
      Deletes a requirement that the Agency for Health Care
26    Administration implement a variable dispensing fee for
      payments for prescribed medicines for Medicaid
27    recipients. Revises the definition of the term "practice
      of the profession of pharmacy" to include certain
28    research and pharmacist practitioner and other
      pharmaceutical care services. Provides requirements for
29    licensure as a pharmacist practitioner, including fees,
      and prescribes the scope of practice of one so licensed.
30    Provides general rulemaking authority with respect
      thereto to the Board of Pharmacy, and requires the board
31    to adopt rules specifically relating to pharmacist duties
      and pharmacy responsibilities. See bill for details.
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