HB 7125

CS

CHAMBER ACTION

1	The Health & Families Council recommends the following:
2
3	Council/Committee Substitute
4	Remove the entire bill and insert:
5	A bill to be entitled
6	An act relating to medical records; amending s. 456.057,
7	F.S.; providing definitions; requiring a health care
8	practitioner's employer who is a records owner and a
9	records custodian to comply with specified requirements
10	for confidentiality and disclosure; amending s. 456.42,
11	F.S.; providing requirements for prescriptions of
12	medicinal drugs by health care practitioners that are
13	electronically generated and transmitted; creating s.
14	456.43, F.S.; regulating electronic prescribing for
15	medicinal drugs; providing restrictions for electronic
16	prescribing software; providing definitions; authorizing
17	electronic prescribing software to show information
18	regarding a payor's formulary under certain circumstances;
19	providing that payors or providers are not limited from
20	implementing utilization management tools; amending s.
21	465.025, F.S.; specifying requirements for a prescriber to
22	prevent generic substitution for brand name drugs when a
23	prescription is electronically transmitted and generated;
24	amending s. 381.028, F.S.; correcting a cross-reference;
25	providing an effective date.
26
27	Be It Enacted by the Legislature of the State of Florida:
28
29	Section 1.  Present subsections (3) through (19) of section
30	456.057, Florida Statutes, are renumbered as subsections (5)
31	through (21), respectively, and new subsections (3) and (4) are
32	added to that section to read:
33	456.057  Ownership and control of patient records; report
34	or copies of records to be furnished.--
35	(3)  As used in this section, the term "records custodian"
36	means any person or entity that:
37	(a)  Maintains documents that are authorized in subsection
38	(2); or
39	(b)  Obtains medical records from a records owner.
40	(4)  Any health care practitioner's employer who is a
41	records owner and any records custodian shall maintain records
42	or documents as provided under the confidentiality and
43	disclosure requirements of this section.
44	Section 2.  Section 456.42, Florida Statutes, is amended to
45	read:
46	456.42  Written prescriptions for medicinal drugs.--A
47	written prescription for a medicinal drug issued by a health
48	care practitioner licensed by law to prescribe such drug must be
49	legibly printed or typed so as to be capable of being understood
50	by the pharmacist filling the prescription; must contain the
51	name of the prescribing practitioner, the name and strength of
52	the drug prescribed, the quantity of the drug prescribed in both
53	textual and numerical formats, and the directions for use of the
54	drug; must be dated with the month written out in textual
55	letters; and must be signed by the prescribing practitioner on
56	the day when issued. However, a prescription that is
57	electronically generated and transmitted must contain the name
58	of the prescribing practitioner, the name and strength of the
59	drug prescribed, the quantity of the drug prescribed in
60	numerical format, and the directions for use of the drug and
61	must be dated and signed by the prescribing practitioner only on
62	the day issued, which signature may be in an electronic format
63	as defined by s. 668.003(4).
64	Section 3.  Section 456.43, Florida Statutes, is created to
65	read:
66	456.43  Electronic prescribing for medicinal drugs.--
67	(1)  Electronic prescribing shall not interfere with a
68	patient's freedom to choose a pharmacy.
69	(2)  Electronic prescribing software shall not use any
70	means or permit any other person to use any means, including,
71	but not limited to, advertising, instant messaging, and pop-up
72	ads, to influence or attempt to influence, through economic
73	incentives or otherwise, the prescribing decision of a
74	prescribing practitioner at the point of care. Such means shall
75	not be triggered or in specific response to the input,
76	selection, or act of a prescribing practitioner or his or her
77	agent in prescribing a certain pharmaceutical or directing a
78	patient to a certain pharmacy.
79	(a)  The term "prescribing decision" means a prescribing
80	practitioner's decision to prescribe a certain pharmaceutical.
81	(b)  The term "point of care" means the time that a
82	prescribing practitioner or his or her agent is in the act of
83	prescribing a certain pharmaceutical.
84	(3)  Electronic prescribing software may show information
85	regarding a payor's formulary as long as nothing is designed to
86	preclude or make more difficult the acts of a practitioner in
87	prescribing any particular pharmaceutical or a patient in
88	selecting a particular pharmacy.
89	(4)  This section does not limit a payor or provider from
90	implementing utilization management tools, including, but not
91	limited to, utilization review, a quality assurance program, a
92	continuity of care system, a disease management system, step
93	therapy, or prior authorization system.
94	Section 4.  Subsection (2) of section 465.025, Florida
95	Statutes, is amended to read:
96	465.025  Substitution of drugs.--
97	(2)  A pharmacist who receives a prescription for a brand
98	name drug shall, unless requested otherwise by the purchaser,
99	substitute a less expensive, generically equivalent drug product
100	that is:
101	(a)  Distributed by a business entity doing business, and
102	subject to suit and service of legal process, in the United
103	States; and
104	(b)  Listed in the formulary of generic and brand name drug
105	products as provided in subsection (5) for the brand name drug
106	prescribed,
107
108	unless the prescriber writes the words "MEDICALLY NECESSARY," in
109	her or his own handwriting, on the face of a written
110	prescription; or unless, in the case of an oral prescription,
111	the prescriber expressly indicates to the pharmacist that the
112	brand name drug prescribed is medically necessary; or unless, in
113	the case of a prescription that is electronically generated and
114	transmitted, the prescriber makes an overt act when transmitting
115	the prescription to indicate that the brand name drug prescribed
116	is medically necessary. When done in conjunction with the
117	electronic transmission of the prescription, the prescriber's
118	overt act indicates to the pharmacist that the brand name drug
119	prescribed is medically necessary.
120	Section 5.  Paragraph (c) of subsection (7) of section
121	381.028, Florida Statutes, is amended to read:
122	381.028  Adverse medical incidents.--
123	(7)  PRODUCTION OF RECORDS.--
124	(c)1.  Fees charged by a health care facility for copies of
125	records requested by a patient under s. 25, Art. X of the State
126	Constitution may not exceed the reasonable and actual cost of
127	complying with the request, including a reasonable charge for
128	the staff time necessary to search for records and prevent the
129	disclosure of the identity of any patient involved in the
130	adverse medical incident through redaction or other means as
131	required by the Health Insurance Portability and Accountability
132	Act of 1996 or its implementing regulations. The health care
133	facility may require payment, in full or in part, before acting
134	on the records request.
135	2.  Fees charged by a health care provider for copies of
136	records requested by a patient under s. 25, Art. X of the State
137	Constitution may not exceed the amount established under s.
138	456.057(18)(16), which may include a reasonable charge for the
139	staff time necessary to prevent the disclosure of the identity
140	of any patient involved in the adverse medical incident through
141	redaction or other means as required by the Health Insurance
142	Portability and Accountability Act of 1996 or its implementing
143	regulations. The health care provider may require payment, in
144	full or in part, before acting on the records request.
145	Section 6.  This act shall take effect July 1, 2006.

CODING: Words stricken are deletions; words underlined are additions.