CS/HB 225

1
A bill to be entitled
2An act relating to controlled substances; creating s.
3408.0513, F.S.; requiring the Agency for Health Care
4Administration to contract with a multistate electronic
5prescribing network to provide certain agencies with
6access to certain controlled substance information;
7requiring the Agency for Health Care Administration to
8adopt rules and seek grants and donations; amending ss.
9458.309 and 459.005, F.S.; revising requirements for the
10registration of pain-management clinics; requiring the
11Department of Health to refuse to register pain-management
12clinics under certain circumstances; amending ss. 458.331
13and 459.015, F.S.; specifying additional grounds for
14disciplinary action against practitioners licensed under
15ch. 458 or ch. 459, F.S.; amending s. 465.018, F.S.;
16requiring community pharmacy permit applicants to
17demonstrate the ability to participate in and transmit
18dispensing information through a multistate electronic
19prescribing network; requiring community pharmacy
20permittees to transmit dispensing information through such
21a network for prescriptions of certain controlled
22substances; amending s. 465.023, F.S.; specifying an
23additional ground for disciplinary action against
24community pharmacy permittees; amending s. 465.0276, F.S.;
25prohibiting registered dispensing practitioners from
26dispensing more than a specified amount of certain
27controlled substances; providing penalties; providing
28exceptions; reenacting ss. 458.303, 458.311(1)(d) and (5),
29458.313(6), 458.3135(2)(d), 458.3137(2)(e),
30458.3145(1)(g), and 458.345(1)(b) and (2), F.S., relating
31to provisions not applicable to certain practitioners,
32licensure of physicians by examination, licensure of
33physicians by endorsement, temporary certificates for
34visiting physicians practicing in approved cancer centers,
35temporary certificates for visiting physicians in
36conjunction with certain plastic surgery training programs
37and educational symposiums, medical faculty certificates,
38and registration of resident physicians, interns, and
39fellows, respectively, to incorporate the amendment made
40by this act to s. 458.331, F.S., in references thereto;
41reenacting s. 459.021(8), F.S., relating to the
42registration of resident osteopathic physicians, interns,
43and fellows, to incorporate the amendment made by this act
44to s. 459.015, F.S., in a reference thereto; providing an
45effective date.
46
47Be It Enacted by the Legislature of the State of Florida:
48
49     Section 1.  Section 408.0513, Florida Statutes, is created
50to read:
51     408.0513  Access to prescription drug medication history.-
52     (1)  By December 1, 2010, the agency shall contract with an
53entity that operates a multistate electronic prescribing network
54to provide the following agencies with access to the controlled
55substance information available on such network for the
56controlled substances listed in Schedules II and III of s.
57893.03:
58     (a)  A criminal justice agency as defined in s. 119.011
59that enforces the laws of this state or the United States and
60that initiates an active investigation involving a specific
61violation of law.
62     (b)  The Department of Health or the relevant health
63regulatory board responsible for the licensure, regulation, or
64discipline of practitioners, pharmacists, or other persons who
65are authorized to prescribe, administer, or dispense controlled
66substances and who are involved in a specific investigation
67involving a designated person.
68     (2)  The agency shall adopt rules under ss. 120.536(1) and
69120.54 to administer this section, including the method and
70terms of access to the information provided under subsection
71(1).
72     (3)  The agency shall seek federal grants and donations
73from private entities to implement this section.
74     Section 2.  Subsection (4) of section 458.309, Florida
75Statutes, is amended to read:
76     458.309  Rulemaking authority.-
77     (4)  All privately owned pain-management clinics,
78facilities, or offices, hereinafter referred to as "clinics,"
79primarily engaged in the treatment of pain by prescribing or
80dispensing controlled substances, which advertise in any medium
81for any type of pain-management services, or employ a physician
82who is primarily engaged in the treatment of pain by prescribing
83or dispensing controlled substance medications, must register
84with the department by January 4, 2010, unless that clinic is
85licensed as a facility pursuant to chapter 395. The department
86shall refuse to register any clinic not wholly owned by a
87physician or group of physicians; any clinic owned by or having
88any contractual or employment relationship with a physician
89whose federal Drug Enforcement Administration registration
90number has ever been suspended or revoked or against whom the
91board has taken final administrative action relating to the
92physician's impairment due to the misuse or abuse of alcohol or
93drugs; or any clinic the ownership or any controlling interest
94of which is held by any person who has been convicted of, or has
95entered a plea of guilty or nolo contendere to, regardless of
96adjudication, a felony under chapter 893. A physician may not
97practice medicine in a pain-management clinic that is required
98to register but has not registered with the department. Each
99clinic location shall be registered separately regardless of
100whether the clinic is operated under the same business name or
101management as another clinic. If the clinic is licensed as a
102health care clinic under chapter 400, the medical director is
103responsible for registering the facility with the department. If
104the clinic is not registered pursuant to chapter 395 or chapter
105400, the clinic shall, upon registration with the department,
106designate a physician who is responsible for complying with all
107requirements related to registration of the clinic. The
108designated physician shall be licensed under this chapter or
109chapter 459 and shall practice at the office location for which
110the physician has assumed responsibility. The department shall
111inspect the clinic annually to ensure that it complies with
112rules of the Board of Medicine adopted pursuant to this
113subsection and subsection (5) unless the office is accredited by
114a nationally recognized accrediting agency approved by the Board
115of Medicine. The actual costs for registration and inspection or
116accreditation shall be paid by the physician seeking to register
117the clinic.
118     Section 3.  Paragraph (nn) of subsection (1) of section
119458.331, Florida Statutes, is redesignated as paragraph (pp),
120and new paragraphs (nn) and (oo) are added to that subsection to
121read:
122     458.331  Grounds for disciplinary action; action by the
123board and department.-
124     (1)  The following acts constitute grounds for denial of a
125license or disciplinary action, as specified in s. 456.072(2):
126     (nn)  Practicing medicine in a clinic that is required to
127register but has not registered with the department pursuant to
128s. 458.309.
129     (oo)  Promoting or advertising through any communication
130media the use, sale, or dispensing of any controlled substance
131appearing on any schedule in chapter 893.
132     Section 4.  Subsection (3) of section 459.005, Florida
133Statutes, is amended to read:
134     459.005  Rulemaking authority.-
135     (3)  All privately owned pain-management clinics,
136facilities, or offices, hereinafter referred to as "clinics,"
137primarily engaged in the treatment of pain by prescribing or
138dispensing controlled substances, which advertise in any medium
139for any type of pain-management services, or employ a physician
140who is licensed under this chapter and who is primarily engaged
141in the treatment of pain by prescribing or dispensing controlled
142substance medications, must register with the department by
143January 4, 2010, unless that clinic is licensed as a facility
144under chapter 395. The department shall refuse to register any
145clinic not wholly owned by a physician or group of physicians;
146any clinic owned by or having any contractual or employment
147relationship with a physician whose federal Drug Enforcement
148Administration registration number has ever been suspended or
149revoked or against whom the board has taken final administrative
150action relating to the physician's impairment due to the misuse
151or abuse of alcohol or drugs; or any clinic the ownership or any
152controlling interest of which is held by any person who has been
153convicted of, or has entered a plea of guilty or nolo contendere
154to, regardless of adjudication, a felony under chapter 893. A
155physician may not practice osteopathic medicine in a pain-
156management clinic that is required to register but has not
157registered with the department. Each clinic location shall be
158registered separately regardless of whether the clinic is
159operated under the same business name or management as another
160clinic. If the clinic is licensed as a health care clinic under
161chapter 400, the medical director is responsible for registering
162the facility with the department. If the clinic is not
163registered under chapter 395 or chapter 400, the clinic shall,
164upon registration with the department, designate a physician who
165is responsible for complying with all requirements related to
166registration of the clinic. The designated physician shall be
167licensed under chapter 458 or this chapter and shall practice at
168the office location for which the physician has assumed
169responsibility. The department shall inspect the clinic annually
170to ensure that it complies with rules of the Board of
171Osteopathic Medicine adopted pursuant to this subsection and
172subsection (4) unless the office is accredited by a nationally
173recognized accrediting agency approved by the Board of
174Osteopathic Medicine. The actual costs for registration and
175inspection or accreditation shall be paid by the physician
176seeking to register the clinic.
177     Section 5.  Paragraph (pp) of subsection (1) of section
178459.015, Florida Statutes, is redesignated as paragraph (rr),
179and new paragraphs (pp) and (qq) are added to that subsection to
180read:
181     459.015  Grounds for disciplinary action; action by the
182board and department.-
183     (1)  The following acts constitute grounds for denial of a
184license or disciplinary action, as specified in s. 456.072(2):
185     (pp)  Practicing osteopathic medicine in a clinic that is
186required to register but has not registered with the department
187pursuant to s. 459.005.
188     (qq)  Promoting or advertising through any communication
189media the use, sale, or dispensing of any controlled substance
190appearing on any schedule in chapter 893.
191     Section 6.  Section 465.018, Florida Statutes, is amended
192to read:
193     465.018  Community pharmacies; permits.-Any person desiring
194a permit to operate a community pharmacy shall apply to the
195department. If the board office certifies that the application
196complies with the laws of the state and the rules of the board
197governing pharmacies, the department shall issue the permit. A
198No permit may not shall be issued unless a licensed pharmacist
199is designated as the prescription department manager responsible
200for maintaining all drug records, providing for the security of
201the prescription department, and following such other rules as
202relate to the practice of the profession of pharmacy. The
203permittee and the newly designated prescription department
204manager shall notify the department within 10 days of any change
205in prescription department manager. Effective July 1, 2012, a
206permit may not be issued unless the applicant demonstrates the
207ability to participate in and transmit dispensing information
208through a multistate electronic prescribing network. Effective
209January 1, 2013, a permittee must transmit dispensing
210information through a multistate electronic prescribing network
211for each prescription of a controlled substance listed in
212Schedule II or Schedule III of s. 893.03.
213     Section 7.  Subsection (1) of section 465.023, Florida
214Statutes, is amended to read:
215     465.023  Pharmacy permittee; disciplinary action.-
216     (1)  The department or the board may revoke or suspend the
217permit of any pharmacy permittee, and may fine, place on
218probation, or otherwise discipline any pharmacy permittee if the
219permittee, or any affiliated person, partner, officer, director,
220or agent of the permittee, including a person fingerprinted
221under s. 465.022(3), has:
222     (a)  Obtained a permit by misrepresentation or fraud or
223through an error of the department or the board;
224     (b)  Attempted to procure, or has procured, a permit for
225any other person by making, or causing to be made, any false
226representation;
227     (c)  Violated any of the requirements of this chapter or
228any of the rules of the Board of Pharmacy; of chapter 499, known
229as the "Florida Drug and Cosmetic Act"; of 21 U.S.C. ss. 301-
230392, known as the "Federal Food, Drug, and Cosmetic Act"; of 21
231U.S.C. ss. 821 et seq., known as the Comprehensive Drug Abuse
232Prevention and Control Act; or of chapter 893;
233     (d)  Been convicted or found guilty, regardless of
234adjudication, of a felony or any other crime involving moral
235turpitude in any of the courts of this state, of any other
236state, or of the United States;
237     (e)  Been convicted or disciplined by a regulatory agency
238of the Federal Government or a regulatory agency of another
239state for any offense that would constitute a violation of this
240chapter;
241     (f)  Been convicted of, or entered a plea of guilty or nolo
242contendere to, regardless of adjudication, a crime in any
243jurisdiction which relates to the practice of, or the ability to
244practice, the profession of pharmacy;
245     (g)  Been convicted of, or entered a plea of guilty or nolo
246contendere to, regardless of adjudication, a crime in any
247jurisdiction which relates to health care fraud; or
248     (h)  Dispensed any medicinal drug based upon a
249communication that purports to be a prescription as defined by
250s. 465.003(14) or s. 893.02 when the pharmacist knows or has
251reason to believe that the purported prescription is not based
252upon a valid practitioner-patient relationship that includes a
253documented patient evaluation, including history and a physical
254examination adequate to establish the diagnosis for which any
255drug is prescribed and any other requirement established by
256board rule under chapter 458, chapter 459, chapter 461, chapter
257463, chapter 464, or chapter 466; or
258     (i)  Failed to transmit dispensing information through a
259multistate electronic prescribing network pursuant to s. 465.018
260for any prescription of a controlled substance listed in
261
262     Section 8.  Subsection (1) of section 465.0276, Florida
263Statutes, is amended to read:
264     465.0276  Dispensing practitioner.-
265     (1)(a)  A person may not dispense medicinal drugs unless
266licensed as a pharmacist or otherwise authorized under this
267chapter to do so, except that a practitioner authorized by law
268to prescribe drugs may dispense such drugs to her or his
269patients in the regular course of her or his practice in
270compliance with this section.
271     (b)  A practitioner registered under this section may not
272dispense more than a 72-hour supply of a controlled substance
273listed in Schedule II or Schedule III of s. 893.03. A
274practitioner who violates this paragraph commits a felony of the
275third degree, punishable as provided in s. 775.082, s. 775.083,
276or s. 775.084. This paragraph does not apply to the dispensing
277of complimentary packages of medicinal drugs to the
278practitioner's own patients in the regular course of her or his
279practice without the payment of a fee or remuneration of any
280kind, whether direct or indirect, as provided in subsection (5).
281This paragraph does not apply to a controlled substance
282dispensed in the health care system of the Department of
283Corrections.
284     Section 9.  For the purpose of incorporating the amendment
285made by this act to section 458.331, Florida Statutes, in
286references thereto, section 458.303, Florida Statutes, is
287reenacted to read:
288     458.303  Provisions not applicable to other practitioners;
289exceptions, etc.-
290     (1)  The provisions of ss. 458.301, 458.303, 458.305,
291458.307, 458.309, 458.311, 458.313, 458.315, 458.317, 458.319,
292458.321, 458.327, 458.329, 458.331, 458.337, 458.339, 458.341,
293458.343, 458.345, and 458.347 shall have no application to:
294     (a)  Other duly licensed health care practitioners acting
295within their scope of practice authorized by statute.
296     (b)  Any physician lawfully licensed in another state or
297territory or foreign country, when meeting duly licensed
298physicians of this state in consultation.
299     (c)  Commissioned medical officers of the Armed Forces of
300the United States and of the Public Health Service of the United
301States while on active duty and while acting within the scope of
302their military or public health responsibilities.
303     (d)  Any person while actually serving without salary or
304professional fees on the resident medical staff of a hospital in
305this state, subject to the provisions of s. 458.321.
306     (e)  Any person furnishing medical assistance in case of an
307emergency.
308     (f)  The domestic administration of recognized family
309remedies.
310     (g)  The practice of the religious tenets of any church in
311this state.
312     (h)  Any person or manufacturer who, without the use of
313drugs or medicine, mechanically fits or sells lenses, artificial
314eyes or limbs, or other apparatus or appliances or is engaged in
315the mechanical examination of eyes for the purpose of
316constructing or adjusting spectacles, eyeglasses, or lenses.
317     (2)  Nothing in s. 458.301, s. 458.303, s. 458.305, s.
318458.307, s. 458.309, s. 458.311, s. 458.313, s. 458.319, s.
319458.321, s. 458.327, s. 458.329, s. 458.331, s. 458.337, s.
320458.339, s. 458.341, s. 458.343, s. 458.345, or s. 458.347 shall
321be construed to prohibit any service rendered by a registered
322nurse or a licensed practical nurse, if such service is rendered
323under the direct supervision and control of a licensed physician
324who provides specific direction for any service to be performed
325and gives final approval to all services performed. Further,
326nothing in this or any other chapter shall be construed to
327prohibit any service rendered by a medical assistant in
328accordance with the provisions of s. 458.3485.
329     Section 10.  For the purpose of incorporating the amendment
330made by this act to section 458.331, Florida Statutes, in
331references thereto, paragraph (d) of subsection (1) and
332subsection (5) of section 458.311, Florida Statutes, are
333reenacted to read:
334     458.311  Licensure by examination; requirements; fees.-
335     (1)  Any person desiring to be licensed as a physician, who
336does not hold a valid license in any state, shall apply to the
337department on forms furnished by the department. The department
338shall license each applicant who the board certifies:
339     (d)  Has not committed any act or offense in this or any
340other jurisdiction which would constitute the basis for
341disciplining a physician pursuant to s. 458.331.
342     (5)  The board may not certify to the department for
343licensure any applicant who is under investigation in another
344jurisdiction for an offense which would constitute a violation
345of this chapter until such investigation is completed. Upon
346completion of the investigation, the provisions of s. 458.331
347shall apply. Furthermore, the department may not issue an
348unrestricted license to any individual who has committed any act
349or offense in any jurisdiction which would constitute the basis
350for disciplining a physician pursuant to s. 458.331. When the
351board finds that an individual has committed an act or offense
352in any jurisdiction which would constitute the basis for
353disciplining a physician pursuant to s. 458.331, then the board
354may enter an order imposing one or more of the terms set forth
355in subsection (8).
356     Section 11.  For the purpose of incorporating the amendment
357made by this act to section 458.331, Florida Statutes, in
358references thereto, subsection (6) of section 458.313, Florida
359Statutes, is reenacted to read:
360     458.313  Licensure by endorsement; requirements; fees.-
361     (6)  The department shall not issue a license by
362endorsement to any applicant who is under investigation in any
363jurisdiction for an act or offense which would constitute a
364violation of this chapter until such time as the investigation
365is complete, at which time the provisions of s. 458.331 shall
366apply. Furthermore, the department may not issue an unrestricted
367license to any individual who has committed any act or offense
368in any jurisdiction which would constitute the basis for
369disciplining a physician pursuant to s. 458.331. When the board
370finds that an individual has committed an act or offense in any
371jurisdiction which would constitute the basis for disciplining a
372physician pursuant to s. 458.331, the board may enter an order
373imposing one or more of the terms set forth in subsection (7).
374     Section 12.  For the purpose of incorporating the amendment
375made by this act to section 458.331, Florida Statutes, in a
376reference thereto, paragraph (d) of subsection (2) of section
377458.3135, Florida Statutes, is reenacted to read:
378     458.3135  Temporary certificate for visiting physicians to
379practice in approved cancer centers.-
380     (2)  A temporary certificate for practice in an approved
381cancer center may be issued without examination to an individual
382who:
383     (d)  Has not committed any act in this or any other
384jurisdiction which would constitute the basis for disciplining a
385physician under s. 456.072 or s. 458.331;
386     Section 13.  For the purpose of incorporating the amendment
387made by this act to section 458.331, Florida Statutes, in a
388reference thereto, paragraph (e) of subsection (2) of section
389458.3137, Florida Statutes, is reenacted to read:
390     458.3137  Temporary certificate for visiting physicians to
391obtain medical privileges for instructional purposes in
392conjunction with certain plastic surgery training programs and
393plastic surgery educational symposiums.-
394     (2)  A temporary certificate to practice medicine for
395educational purposes to help teach plastic surgery residents of
396a medical school within this state in conjunction with a
397nationally sponsored educational symposium may be issued without
398examination, upon verification by the board that the individual
399meets all of the following requirements:
400     (e)  Has not committed an act in this or any other
401jurisdiction that would constitute a basis for disciplining a
402physician under s. 456.072 or s. 458.331.
403     Section 14.  For the purpose of incorporating the amendment
404made by this act to section 458.331, Florida Statutes, in a
405reference thereto, paragraph (g) of subsection (1) of section
406458.3145, Florida Statutes, is reenacted to read:
407     458.3145  Medical faculty certificate.-
408     (1)  A medical faculty certificate may be issued without
409examination to an individual who:
410     (g)  Has not committed any act in this or any other
411jurisdiction which would constitute the basis for disciplining a
412physician under s. 458.331;
413     Section 15.  For the purpose of incorporating the amendment
414made by this act to section 458.331, Florida Statutes, in
415references thereto, paragraph (b) of subsection (1) and
416subsection (2) of section 458.345, Florida Statutes, are
417reenacted to read:
418     458.345  Registration of resident physicians, interns, and
419fellows; list of hospital employees; prescribing of medicinal
420drugs; penalty.-
421     (1)  Any person desiring to practice as a resident
422physician, assistant resident physician, house physician,
423intern, or fellow in fellowship training which leads to
424subspecialty board certification in this state, or any person
425desiring to practice as a resident physician, assistant resident
426physician, house physician, intern, or fellow in fellowship
427training in a teaching hospital in this state as defined in s.
428408.07(45) or s. 395.805(2), who does not hold a valid, active
429license issued under this chapter shall apply to the department
430to be registered and shall remit a fee not to exceed $300 as set
431by the board. The department shall register any applicant the
432board certifies has met the following requirements:
433     (b)  Has not committed any act or offense within or without
434the state which would constitute the basis for refusal to
435certify an application for licensure pursuant to s. 458.331.
436     (2)  The board shall not certify to the department for
437registration any applicant who is under investigation in any
438state or jurisdiction for an act which would constitute grounds
439for disciplinary action under s. 458.331 until such time as the
440investigation is completed, at which time the provisions of s.
441458.331 shall apply.
442     Section 16.  For the purpose of incorporating the amendment
443made by this act to section 459.015, Florida Statutes, in a
444reference thereto, subsection (8) of section 459.021, Florida
445Statutes, is reenacted to read:
446     459.021  Registration of resident physicians, interns, and
447fellows; list of hospital employees; penalty.-
448     (8)  Notwithstanding any provision of this section or s.
449120.52 to the contrary, any person who is registered under this
450section is subject to the provisions of s. 459.015.
451     Section 17.  This act shall take effect July 1, 2010.


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