Florida Senate - 2009                        COMMITTEE AMENDMENT
       Bill No. SB 1868
       
       
       
       
       
       
                                Barcode 668950                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  04/06/2009           .                                
                                       .                                
                                       .                                
                                       .                                
       —————————————————————————————————————————————————————————————————




       —————————————————————————————————————————————————————————————————
       The Committee on Health Regulation (Bennett) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (7) of section 465.003, Florida
    6  Statutes, is amended to read:
    7         465.003 Definitions.—As used in this chapter, the term:
    8         (7) “Institutional formulary system” means a method whereby
    9  the medical staff evaluates, appraises, and selects those
   10  medicinal drugs or proprietary preparations which in the medical
   11  staff’s clinical judgment are most useful in patient care, and
   12  which are available for dispensing by a practicing pharmacist
   13  for in a Class I or in a Class II institutional pharmacy.
   14         Section 2. Subsection (6) of section 465.019, Florida
   15  Statutes, is amended, and subsection (7) is added to that
   16  section, to read:
   17         465.019 Institutional pharmacies; permits.—
   18         (6) In a Class I or Class II institutional pharmacy, an
   19  institutional formulary system may be adopted with approval of
   20  the medical staff for the purpose of identifying those medicinal
   21  drugs and proprietary preparations that may be dispensed by a
   22  practicing pharmacist for a Class I or in a Class II
   23  institutional pharmacy the pharmacists employed in such
   24  institution. A facility that has with a Class I or Class II
   25  institutional permit which is operating under the formulary
   26  system shall establish policies and procedures for the
   27  development of the system, in accordance with the joint
   28  standards of the American Hospital Association and American
   29  Society of Hospital Pharmacists, for the use utilization of an
   30  institutional a hospital formulary system, which formulary shall
   31  be approved by the medical staff.
   32         (7)The policies and procedures for an institutional
   33  formulary system in a Class I institutional pharmacy shall:
   34         (a)Be approved by the medical staff.
   35         (b)Openly provide detailed methods and criteria for the
   36  selection and objective evaluation of all available
   37  pharmaceuticals.
   38         (c)Include policies for the development, maintenance,
   39  approval, dissemination, and notification to prescribers of the
   40  drug formulary and for continuous and comprehensive review of
   41  formulary drugs.
   42         (d)Provide for regular monitoring of compliance with the
   43  policies and procedures and of clinical outcomes in
   44  circumstances in which a substitution of drugs has occurred.
   45         (e)Provide a mechanism to inform the prescriber prior to
   46  any substitution of drugs by using a method of communication
   47  designated by the prescriber for such purpose. The method of
   48  communication designated by the prescriber shall be noted in the
   49  patient’s chart.
   50         (f)Establish a process that allows any individual
   51  prescriber to opt out of the formulary system entirely.
   52         (g)Establish a process that allows any individual
   53  prescriber to opt out of the formulary system with respect to a
   54  particular patient.
   55         (h)Provide a mechanism to ensure that patients or
   56  guardians are informed of any change of an existing prescription
   57  to a formulary substitute.
   58         (i)Include policies stating that practitioners are not
   59  penalized for prescribing nonformulary drug products that are
   60  medically necessary.
   61         (j)Be consistent with applicable state and federal laws
   62  and with rules of the department and board.
   63         Section 3. Paragraph (b) of subsection (1) of section
   64  627.4239, Florida Statutes, is amended to read:
   65         627.4239 Coverage for use of drugs in treatment of cancer.—
   66         (1) DEFINITIONS.—As used in this section, the term:
   67         (b) “Standard reference compendium” means an authoritative
   68  compendium identified by the Secretary of the United States
   69  Department of Health and Human Services and recognized by the
   70  federal Centers for Medicare and Medicaid Services:
   71         1.The United States Pharmacopeia Drug Information;
   72         2.The American Medical Association Drug Evaluations; or
   73         3.The American Hospital Formulary Service Drug
   74  Information.
   75         Section 4. This act shall take effect July 1, 2009.
   76  
   77  ================= T I T L E  A M E N D M E N T ================
   78         And the title is amended as follows:
   79         Delete everything before the enacting clause
   80  and insert:
   81                        A bill to be entitled                      
   82         An act relating to prescribed drugs; amending ss.
   83         465.003 and 465.019, F.S.; authorizing the use of an
   84         institutional formulary system in a Class I
   85         institutional pharmacy at which, with certain
   86         exceptions, all medicinal drugs are administered from
   87         individual prescription containers to the patient and
   88         medicinal drugs are not dispensed on the premises;
   89         specifying requirements for the policies and
   90         procedures of such an institutional formulary system;
   91         amending s. 627.4239, F.S.; revising the definition of
   92         the term “standard reference compendium” for purposes
   93         of regulating the insurance coverage of drugs used in
   94         the treatment of cancer; providing an effective date.