House Bill 3973c1

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    Florida House of Representatives - 1998             CS/HB 3973

        By the Committee on Health Care Standards & Regulatory
    Reform and Representatives Gay and Lippman





  1                      A bill to be entitled

  2         An act relating to pharmacy practice; amending

  3         s. 409.908, F.S.; deleting a requirement that

  4         the Agency for Health Care Administration

  5         implement a variable dispensing fee for

  6         payments for prescribed medicines for Medicaid

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

  8         the definition of the term "practice of the

  9         profession of pharmacy"; providing an effective

10         date.

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

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

15  Statutes, is amended to read:

16         409.908  Reimbursement of Medicaid providers.--Subject

17  to specific appropriations, the agency shall reimburse

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

19  according to methodologies set forth in the rules of the

20  agency and in policy manuals and handbooks incorporated by

21  reference therein. These methodologies may include fee

22  schedules, reimbursement methods based on cost reporting,

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

24  and other mechanisms the agency considers efficient and

25  effective for purchasing services or goods on behalf of

26  recipients. Payment for Medicaid compensable services made on

27  behalf of Medicaid eligible persons is subject to the

28  availability of moneys and any limitations or directions

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

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

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

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    Florida House of Representatives - 1998             CS/HB 3973

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

  2  making any other adjustments necessary to comply with the

  3  availability of moneys and any limitations or directions

  4  provided for in the General Appropriations Act, provided the

  5  adjustment is consistent with legislative intent.

  6         (14)  A provider of prescribed drugs shall be

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

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

  9  allowable fee established by the agency, plus a dispensing

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

11  fee for payments for prescribed medicines while ensuring

12  continued access for Medicaid recipients. The variable

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

14  or both the volume of prescriptions dispensed by a specific

15  pharmacy provider and the volume of prescriptions dispensed to

16  an individual recipient. The agency is authorized to limit

17  reimbursement for prescribed medicine in order to comply with

18  any limitations or directions provided for in the General

19  Appropriations Act, which may include implementing a

20  prospective or concurrent utilization review program.

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

22  Statutes, is amended to read:

23         465.003  Definitions.--As used in this chapter, the

24  term:

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

26  compounding, dispensing, and consulting concerning contents,

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

28  consulting concerning therapeutic values and interactions of

29  patent or proprietary preparations, whether pursuant to

30  prescriptions or in the absence and entirely independent of

31  such prescriptions or orders; and other pharmaceutical

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    Florida House of Representatives - 1998             CS/HB 3973

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  1  services. For purposes of this subsection, "other

  2  pharmaceutical services" means the evaluation and monitoring

  3  of the patient's health as it relates to drug therapy and

  4  assisting the patient in the management of his or her drug

  5  therapy, and includes the assessment of the patient's drug

  6  therapy and communication with the patient and the patient's

  7  prescribing health care provider as licensed under chapter

  8  458, chapter 459, chapter 461, or chapter 466, or similar

  9  statutory provision in another jurisdiction, or such

10  provider's agent or such other persons as specifically

11  authorized by the patient, regarding the drug therapy.

12  "Practice of the profession of pharmacy" The phrase also

13  includes any other act, service, operation, research, or

14  transaction incidental to, or forming a part of, any of the

15  foregoing acts, requiring, involving, or employing the science

16  or art of any branch of the pharmaceutical profession, study,

17  or training, and shall expressly permit a pharmacist to

18  transmit information from persons authorized to prescribe

19  medicinal drugs to their patients. In addition to the

20  authority to order and dispense medicinal drugs independently

21  of an established protocol as set forth in s. 465.186, a

22  pharmacist may also administer immunizations within the

23  framework of an established protocol under a supervisory

24  practitioner who is a physician licensed under chapter 458 or

25  chapter 459 or by written agreement with a county health

26  department. The decision by a supervisory practitioner to

27  enter into such a protocol is a professional decision of the

28  practitioner, and no person may interfere with a supervisory

29  practitioner's decision as to whether to enter into such a

30  protocol. A pharmacist may not enter into a protocol that is

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    Florida House of Representatives - 1998             CS/HB 3973

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  1  to be performed while acting as an employee without the

  2  written approval of the owner of the pharmacy.

  3         Section 3.  This act shall take effect July 1 of the

  4  year in which enacted.

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