Senate Bill 0812c1

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    Florida Senate - 1999                            CS for SB 812

    By the Committee on Health, Aging and Long-Term Care; and
    Senator Lee




    317-2054-99

  1                      A bill to be entitled

  2         An act relating to pharmacy practice; amending

  3         s. 465.003, F.S.; revising the definition of

  4         the term "practice of the profession of

  5         pharmacy"; amending s. 465.016, F.S.;

  6         authorizing the redispensing of unused or

  7         returned unit-dose medication by correctional

  8         facilities under certain conditions; amending

  9         s. 499.012, F.S.; redefining the term

10         "wholesale distribution," relating to the

11         distribution of prescription drugs, to provide

12         for the exclusion of certain activities;

13         providing effective dates.

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

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17         Section 1.  Subsection (12) of section 465.003, Florida

18  Statutes, is amended to read:

19         465.003  Definitions.--As used in this chapter, the

20  term:

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

22  compounding, dispensing, and consulting concerning contents,

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

24  consulting concerning therapeutic values and interactions of

25  patent or proprietary preparations, whether pursuant to

26  prescriptions or in the absence and entirely independent of

27  such prescriptions or orders; and other pharmaceutical

28  services. For purposes of this subsection, "other

29  pharmaceutical services" means the monitoring of the patient's

30  drug therapy and assisting the patient in the management of

31  his or her drug therapy, and includes review of the patient's

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    Florida Senate - 1999                            CS for SB 812
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  1  drug therapy and communication with the patient's prescribing

  2  health care provider as licensed under chapter 458, chapter

  3  459, chapter 461, or chapter 466, or similar statutory

  4  provision in another jurisdiction, or such provider's agent or

  5  such other persons as specifically authorized by the patient,

  6  regarding the drug therapy. However, nothing in this

  7  subsection may be interpreted to permit an alteration of a

  8  prescriber's directions, the diagnosis or treatment of any

  9  disease, the initiation of any drug therapy, the practice of

10  medicine, or the practice of osteopathic medicine, unless

11  otherwise permitted by law. "Practice of the profession of

12  pharmacy" The phrase also includes any other act, service,

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

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

15  employing the science or art of any branch of the

16  pharmaceutical profession, study, or training, and shall

17  expressly permit a pharmacist to transmit information from

18  persons authorized to prescribe medicinal drugs to their

19  patients.

20         Section 2.  Effective upon this act becoming a law,

21  paragraph (l) of subsection (1) of section 465.016, Florida

22  Statutes, is amended to read:

23         465.016  Disciplinary actions.--

24         (1)  The following acts shall be grounds for

25  disciplinary action set forth in this section:

26         (l)  Placing in the stock of any pharmacy any part of

27  any prescription compounded or dispensed which is returned by

28  a patient; however, in a hospital, nursing home, correctional

29  facility, or extended care facility in which unit-dose

30  medication is dispensed to inpatients, each dose being

31  individually sealed and the individual unit dose or unit-dose

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    Florida Senate - 1999                            CS for SB 812
    317-2054-99




  1  system labeled with the name of the drug, dosage strength,

  2  manufacturer's control number, and expiration date, if any,

  3  the unused unit dose of medication may be returned to the

  4  pharmacy for redispensing.  Each pharmacist shall maintain

  5  appropriate records for any unused or returned medicinal

  6  drugs.

  7         Section 3.  Paragraph (a) of subsection (1) and

  8  subsection (5) of section 499.012, Florida Statutes, 1998

  9  Supplement, are amended to read:

10         499.012  Wholesale distribution; definitions; permits;

11  general requirements.--

12         (1)  As used in this section, the term:

13         (a)  "Wholesale distribution" means distribution of

14  prescription drugs to persons other than a consumer or

15  patient, but does not include:

16         1.  Any of the following activities, which is not a

17  violation of s. 499.005(21) if such activity is conducted in

18  accordance with s. 499.014:

19         a.  The purchase or other acquisition by a hospital or

20  other health care entity that is a member of a group

21  purchasing organization of a prescription drug for its own use

22  from the group purchasing organization or from other hospitals

23  or health care entities that are members of that organization.

24         b.  The sale, purchase, or trade of a prescription drug

25  or an offer to sell, purchase, or trade a prescription drug by

26  a charitable organization described in s. 501(c)(3) of the

27  Internal Revenue Code of 1986, as amended and revised, to a

28  nonprofit affiliate of the organization to the extent

29  otherwise permitted by law.

30         c.  The sale, purchase, or trade of a prescription drug

31  or an offer to sell, purchase, or trade a prescription drug

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    Florida Senate - 1999                            CS for SB 812
    317-2054-99




  1  among hospitals or other health care entities that are under

  2  common control. For purposes of this section, "common control"

  3  means the power to direct or cause the direction of the

  4  management and policies of a person or an organization,

  5  whether by ownership of stock, by voting rights, by contract,

  6  or otherwise.

  7         d.  The sale, purchase, trade, or other transfer of a

  8  prescription drug from or for any federal, state, or local

  9  government agency or any entity eligible to purchase

10  prescription drugs at public health services prices pursuant

11  to s. 602 of Pub. L. No. 102-585 to a contract provider or its

12  subcontractor for eligible patients of the agency or entity

13  under the following conditions:

14         (I)  The agency or entity must obtain written

15  authorization for the sale, purchase, trade, or other transfer

16  of a prescription drug under this sub-subparagraph from the

17  Secretary of Health or his or her designee.

18         (II)  The contract provider or subcontractor must be

19  authorized by law to administer or dispense prescription

20  drugs.

21         (III)  In the case of a subcontractor, the agency or

22  entity must be a party to and execute the subcontract.

23         (IV)  A contract provider or subcontractor must

24  maintain separate and apart from other prescription drug

25  inventory any prescription drugs of the agency or entity in

26  its possession.

27         (V)  The contract provider and subcontractor must

28  maintain and produce immediately for inspection all records of

29  movement or transfer of all the prescription drugs belonging

30  to the agency or entity, including, but not limited to, the

31  records of receipt and disposition of prescription drugs.

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    Florida Senate - 1999                            CS for SB 812
    317-2054-99




  1  Each contractor and subcontractor dispensing or administering

  2  these drugs must maintain and produce records documenting the

  3  dispensing or administration.  Records that are required to be

  4  maintained include, but are not limited to, a perpetual

  5  inventory itemizing drugs received and drugs dispensed by

  6  prescription number or administered by patient identifier,

  7  which must be submitted to the agency or entity quarterly.

  8         (VI)  The contract provider or subcontractor may

  9  administer or dispense the prescription drugs only to the

10  eligible patients of the agency or entity or must return the

11  prescription drugs for or to the agency or entity.  The

12  contract provider or subcontractor must require proof from

13  each person seeking to fill a prescription or obtain treatment

14  that the person is an eligible patient of the agency or entity

15  and must, at a minimum, maintain a copy of this proof as part

16  of the records of the contractor or subcontractor required

17  under sub-sub-subparagraph (V).

18         (VII)  The prescription drugs transferred pursuant to

19  this sub-subparagraph may not be billed to Medicaid.

20         (VIII)  In addition to the departmental inspection

21  authority set forth in s. 499.051, the establishment of the

22  contract provider and subcontractor and all records pertaining

23  to prescription drugs subject to this sub-subparagraph shall

24  be subject to inspection by the agency or entity.  All records

25  relating to prescription drugs of a manufacturer under this

26  sub-subparagraph shall be subject to audit by the manufacturer

27  of those drugs, without identifying individual patient

28  information.

29         2.  Any of the following activities, which is not a

30  violation of s. 499.005(21) if such activity is conducted in

31  accordance with rules established by the department:

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    Florida Senate - 1999                            CS for SB 812
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  1         a.  The sale, purchase, or trade of a prescription drug

  2  among federal, state, or local government health care entities

  3  that are under common control and are authorized to purchase

  4  such prescription drug.

  5         b.  The sale, purchase, or trade of a prescription drug

  6  or an offer to sell, purchase, or trade a prescription drug

  7  for emergency medical reasons.; For purposes of this

  8  sub-subparagraph subparagraph, the term "emergency medical

  9  reasons" includes transfers of prescription drugs by a retail

10  pharmacy to another retail pharmacy to alleviate a temporary

11  shortage.

12         c.  The transfer purchase or acquisition of a

13  prescription drug acquired by a medical director on behalf of

14  a licensed an emergency medical services provider to that

15  medical director for use by emergency medical services

16  provider and its transport vehicles for use in accordance with

17  the provider's license under providers acting within the scope

18  of their professional practice pursuant to chapter 401.

19         d.  The revocation of a sale or the return of a

20  prescription drug to the person's prescription drug wholesale

21  supplier.

22         e.  The donation of a prescription drug by a health

23  care entity to a charitable organization that has been granted

24  an exemption under s. 501(c)(3) of the Internal Revenue Code

25  of 1986, as amended, and that is authorized to possess

26  prescription drugs.

27         f.  The transfer of a prescription drug by a person

28  authorized to purchase or receive prescription drugs to a

29  person licensed or permitted to handle reverse distributions

30  or destruction under the laws of the jurisdiction in which the

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    Florida Senate - 1999                            CS for SB 812
    317-2054-99




  1  person handling the reverse distribution or destruction

  2  receives the drug.

  3         3.  The dispensing of a prescription drug pursuant to a

  4  prescription;

  5         3.4.  The distribution of prescription drug samples by

  6  manufacturers' representatives or distributors'

  7  representatives conducted in accordance with s. 499.028.; or

  8         4.5.  The sale, purchase, or trade of blood and blood

  9  components intended for transfusion. As used in this

10  subparagraph section, the term "blood" means whole blood

11  collected from a single donor and processed either for

12  transfusion or further manufacturing, and the term "blood

13  components" means that part of the blood separated by physical

14  or mechanical means.

15         5.  The lawful dispensing of a prescription drug in

16  accordance with chapter 465.

17         (5)  The department may adopt rules governing the

18  recordkeeping, storage, and handling with respect to each of

19  the distributions of prescription drugs specified in

20  subparagraphs (1)(a)1.-4.1., 2., 4., and 5.

21         Section 4.  Except as otherwise provided in this act,

22  this act shall take effect July 1, 1999.

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    Florida Senate - 1999                            CS for SB 812
    317-2054-99




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                         Senate Bill 812

  3

  4  The Committee Substitute for SB 812 no longer authorizes
    pharmacists to administer immunizations under a protocol;
  5  deletes provisions expanding the parties to whom
    pharmaceutical records may be released; revises the definition
  6  of "other pharmaceutical services" to mean the monitoring of
    the patient's drug therapy and assisting the patient in the
  7  management of his or her drug therapy, and includes review of
    the patient's drug therapy and communication with the
  8  patient's prescribing health care provider as licensed under
    the medical practice act, the osteopathic practice act, the
  9  podiatric practice act, or the dental practice act, or similar
    law in another jurisdiction, or such provider's agent or other
10  persons specifically authorized by the patient, regarding the
    drug therapy. The committee substitute provides that a
11  pharmacist may not alter a prescriber's directions, the
    diagnosis or treatment of any disease, the initiation of any
12  drug therapy, the practice of medicine, or the practice of
    osteopathic medicine, unless otherwise permitted by law.
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