Florida Senate - 2009                             CS for SB 1868
       
       
       
       By the Committee on Health Regulation; and Senator Peaden
       
       
       
       
       588-04443-09                                          20091868c1
    1                        A bill to be entitled                      
    2         An act relating to prescribed drugs; amending ss.
    3         465.003 and 465.019, F.S.; authorizing the use of an
    4         institutional formulary system in a Class I
    5         institutional pharmacy at which, with certain
    6         exceptions, all medicinal drugs are administered from
    7         individual prescription containers to the patient and
    8         medicinal drugs are not dispensed on the premises;
    9         specifying requirements for the policies and
   10         procedures of such an institutional formulary system;
   11         amending s. 627.4239, F.S.; revising the definition of
   12         the term “standard reference compendium” for purposes
   13         of regulating the insurance coverage of drugs used in
   14         the treatment of cancer; providing an effective date.
   15  
   16  Be It Enacted by the Legislature of the State of Florida:
   17  
   18         Section 1. Subsection (7) of section 465.003, Florida
   19  Statutes, is amended to read:
   20         465.003 Definitions.—As used in this chapter, the term:
   21         (7) “Institutional formulary system” means a method whereby
   22  the medical staff evaluates, appraises, and selects those
   23  medicinal drugs or proprietary preparations which in the medical
   24  staff’s clinical judgment are most useful in patient care, and
   25  which are available for dispensing by a practicing pharmacist
   26  for in a Class I or in a Class II institutional pharmacy.
   27         Section 2. Subsection (6) of section 465.019, Florida
   28  Statutes, is amended, and subsection (7) is added to that
   29  section, to read:
   30         465.019 Institutional pharmacies; permits.—
   31         (6) In a Class I or Class II institutional pharmacy, an
   32  institutional formulary system may be adopted with approval of
   33  the medical staff for the purpose of identifying those medicinal
   34  drugs and proprietary preparations that may be dispensed by a
   35  practicing pharmacist for a Class I or in a Class II
   36  institutional pharmacy the pharmacists employed in such
   37  institution. A facility that has with a Class I or Class II
   38  institutional permit which is operating under the formulary
   39  system shall establish policies and procedures for the
   40  development of the system, in accordance with the joint
   41  standards of the American Hospital Association and American
   42  Society of Hospital Pharmacists, for the use utilization of an
   43  institutional a hospital formulary system, which formulary shall
   44  be approved by the medical staff.
   45         (7)The policies and procedures for an institutional
   46  formulary system in a Class I institutional pharmacy shall:
   47         (a)Be approved by the medical staff.
   48         (b)Openly provide detailed methods and criteria for the
   49  selection and objective evaluation of all available
   50  pharmaceuticals.
   51         (c)Include policies for the development, maintenance,
   52  approval, dissemination, and notification to prescribers of the
   53  drug formulary and for continuous and comprehensive review of
   54  formulary drugs.
   55         (d)Provide for regular monitoring of compliance with the
   56  policies and procedures and of clinical outcomes in
   57  circumstances in which a substitution of drugs has occurred.
   58         (e)Provide a mechanism to inform the prescriber prior to
   59  any substitution of drugs by using a method of communication
   60  designated by the prescriber for such purpose. The method of
   61  communication designated by the prescriber shall be noted in the
   62  patient’s chart.
   63         (f)Establish a process that allows any individual
   64  prescriber to opt out of the formulary system entirely.
   65         (g)Establish a process that allows any individual
   66  prescriber to opt out of the formulary system with respect to a
   67  particular patient.
   68         (h)Provide a mechanism to ensure that patients or
   69  guardians are informed of any change of an existing prescription
   70  to a formulary substitute.
   71         (i)Include policies stating that practitioners are not
   72  penalized for prescribing nonformulary drug products that are
   73  medically necessary.
   74         (j)Be consistent with applicable state and federal laws
   75  and with rules of the department and board.
   76         Section 3. Paragraph (b) of subsection (1) of section
   77  627.4239, Florida Statutes, is amended to read:
   78         627.4239 Coverage for use of drugs in treatment of cancer.—
   79         (1) DEFINITIONS.—As used in this section, the term:
   80         (b) “Standard reference compendium” means an authoritative
   81  compendium identified by the Secretary of the United States
   82  Department of Health and Human Services and recognized by the
   83  federal Centers for Medicare and Medicaid Services:
   84         1.The United States Pharmacopeia Drug Information;
   85         2.The American Medical Association Drug Evaluations; or
   86         3.The American Hospital Formulary Service Drug
   87  Information.
   88         Section 4. This act shall take effect July 1, 2009.