Florida Senate - 2015                              CS for SB 532
       
       
        
       By the Committee on Health Policy; and Senator Grimsley
       
       
       
       
       
       588-03209-15                                           2015532c1
    1                        A bill to be entitled                      
    2         An act relating to the ordering of medication;
    3         amending s. 212.08, F.S.; providing that an order for
    4         administration is included in the medical exemption
    5         from sales tax; revising the term “prescription” to
    6         exclude an order for administration; amending ss.
    7         458.347 and 459.022, F.S.; revising the authority of a
    8         licensed physician assistant to order medication under
    9         the direction of a supervisory physician for a
   10         specified patient; amending s. 464.012, F.S.;
   11         authorizing an advanced registered nurse practitioner
   12         to order medication for administration to a specified
   13         patient; amending s. 465.003, F.S.; revising the term
   14         “prescription” to exclude an order for drugs or
   15         medicinal supplies by a licensed practitioner that is
   16         dispensed for certain administration; amending s.
   17         893.02, F.S.; revising the term “administer” to
   18         include the term “administration”; revising the term
   19         “prescription” to exclude an order for drugs or
   20         medicinal supplies by a licensed practitioner that is
   21         dispensed for certain administration; amending s.
   22         893.04, F.S.; conforming provisions to changes made by
   23         act; amending s. 893.05, F.S.; authorizing a licensed
   24         practitioner to authorize a licensed physician
   25         assistant or advanced registered nurse practitioner to
   26         order controlled substances for a specified patient
   27         under certain circumstances; reenacting ss.
   28         400.462(26), 401.445(1), 409.906(18), and 766.103(3),
   29         F.S., to incorporate the amendments made to ss.
   30         458.347 and 459.022, F.S., in references thereto;
   31         reenacting ss. 401.445(1) and 766.103(3), F.S., to
   32         incorporate the amendment made to s. 464.012, F.S., in
   33         references thereto; reenacting ss. 409.9201(1)(a),
   34         458.331(1)(pp), 459.015(1)(rr), 465.014(1),
   35         465.015(2)(c), 465.016(1)(s), 465.022(5)(j),
   36         465.023(1)(h), 465.1901, 499.003(43), and 831.30(1),
   37         F.S., to incorporate the amendment made to s. 465.003,
   38         F.S., in references thereto; reenacting ss.
   39         112.0455(5)(i), 381.986(7)(b), 440.102(1)(l),
   40         458.331(1)(pp), 459.015(1)(rr), 465.015(3),
   41         465.016(1)(s), 465.022(5)(j), 465.023(1)(h),
   42         499.0121(14), 768.36(1)(b), 810.02(3)(f),
   43         812.014(2)(c), 856.015(1)(c), 944.47(1)(a), 951.22(1),
   44         985.711(1)(a), 1003.57(1)(i), and 1006.09(8), F.S., to
   45         incorporate the amendment made to s. 893.02, F.S., in
   46         references thereto; reenacting s. 893.0551(3)(e),
   47         F.S., to incorporate the amendment made to s. 893.04,
   48         F.S., in a reference thereto; reenacting s.
   49         893.0551(3)(d), F.S., to incorporate the amendment
   50         made to s. 893.05, F.S., in a reference thereto;
   51         providing an effective date.
   52          
   53  Be It Enacted by the Legislature of the State of Florida:
   54  
   55         Section 1. Paragraphs (a) and (b) of subsection (2) of
   56  section 212.08, Florida Statutes, are amended to read:
   57         212.08 Sales, rental, use, consumption, distribution, and
   58  storage tax; specified exemptions.—The sale at retail, the
   59  rental, the use, the consumption, the distribution, and the
   60  storage to be used or consumed in this state of the following
   61  are hereby specifically exempt from the tax imposed by this
   62  chapter.
   63         (2) EXEMPTIONS; MEDICAL.—
   64         (a) There shall be exempt from the tax imposed by this
   65  chapter any medical products and supplies or medicine dispensed
   66  according to an individual prescription or prescriptions or an
   67  order for administration, written by a prescriber authorized by
   68  law to prescribe medicinal drugs; hypodermic needles; hypodermic
   69  syringes; chemical compounds and test kits used for the
   70  diagnosis or treatment of human disease, illness, or injury; and
   71  common household remedies recommended and generally sold for
   72  internal or external use in the cure, mitigation, treatment, or
   73  prevention of illness or disease in human beings, but not
   74  including cosmetics or toilet articles, notwithstanding the
   75  presence of medicinal ingredients therein, according to a list
   76  prescribed and approved by the Department of Business and
   77  Professional Regulation, which list shall be certified to the
   78  Department of Revenue from time to time and included in the
   79  rules promulgated by the Department of Revenue. There shall also
   80  be exempt from the tax imposed by this chapter artificial eyes
   81  and limbs; orthopedic shoes; prescription eyeglasses and items
   82  incidental thereto or which become a part thereof; dentures;
   83  hearing aids; crutches; prosthetic and orthopedic appliances;
   84  and funerals. In addition, any items intended for one-time use
   85  which transfer essential optical characteristics to contact
   86  lenses shall be exempt from the tax imposed by this chapter;
   87  however, this exemption shall apply only after $100,000 of the
   88  tax imposed by this chapter on such items has been paid in any
   89  calendar year by a taxpayer who claims the exemption in such
   90  year. Funeral directors shall pay tax on all tangible personal
   91  property used by them in their business.
   92         (b) For the purposes of this subsection:
   93         1. “Prosthetic and orthopedic appliances” means any
   94  apparatus, instrument, device, or equipment used to replace or
   95  substitute for any missing part of the body, to alleviate the
   96  malfunction of any part of the body, or to assist any disabled
   97  person in leading a normal life by facilitating such person’s
   98  mobility. Such apparatus, instrument, device, or equipment shall
   99  be exempted according to an individual prescription or
  100  prescriptions written by a physician licensed under chapter 458,
  101  chapter 459, chapter 460, chapter 461, or chapter 466, or
  102  according to a list prescribed and approved by the Department of
  103  Health, which list shall be certified to the Department of
  104  Revenue from time to time and included in the rules promulgated
  105  by the Department of Revenue.
  106         2. “Cosmetics” means articles intended to be rubbed,
  107  poured, sprinkled, or sprayed on, introduced into, or otherwise
  108  applied to the human body for cleansing, beautifying, promoting
  109  attractiveness, or altering the appearance and also means
  110  articles intended for use as a compound of any such articles,
  111  including, but not limited to, cold creams, suntan lotions,
  112  makeup, and body lotions.
  113         3. “Toilet articles” means any article advertised or held
  114  out for sale for grooming purposes and those articles that are
  115  customarily used for grooming purposes, regardless of the name
  116  by which they may be known, including, but not limited to, soap,
  117  toothpaste, hair spray, shaving products, colognes, perfumes,
  118  shampoo, deodorant, and mouthwash.
  119         4. “Prescription” includes any order for drugs or medicinal
  120  supplies written or transmitted by any means of communication by
  121  a duly licensed practitioner authorized by the laws of this the
  122  state to prescribe such drugs or medicinal supplies and intended
  123  to be dispensed by a pharmacist, except for an order that is
  124  dispensed for administration. The term also includes an orally
  125  transmitted order by the lawfully designated agent of such
  126  practitioner;. The term also includes an order written or
  127  transmitted by a practitioner licensed to practice in a
  128  jurisdiction other than this state, but only if the pharmacist
  129  called upon to dispense such order determines, in the exercise
  130  of his or her professional judgment, that the order is valid and
  131  necessary for the treatment of a chronic or recurrent illness;
  132  and. The term also includes a pharmacist’s order for a product
  133  selected from the formulary created pursuant to s. 465.186. A
  134  prescription may be retained in written form, or the pharmacist
  135  may cause it to be recorded in a data processing system,
  136  provided that such order can be produced in printed form upon
  137  lawful request.
  138         Section 2. Paragraph (g) of subsection (4) of section
  139  458.347, Florida Statutes, is amended to read:
  140         458.347 Physician assistants.—
  141         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
  142         (g) A supervisory physician may delegate to a licensed
  143  physician assistant the authority to, and the licensed physician
  144  assistant acting under the direction of the supervisory
  145  physician may, order any medication medications for
  146  administration to the supervisory physician’s patient during his
  147  or her care in a facility licensed under chapter 395,
  148  notwithstanding any provisions in chapter 465 or chapter 893
  149  which may prohibit this delegation. For the purpose of this
  150  paragraph, an order is not considered a prescription. A licensed
  151  physician assistant working in a facility that is licensed under
  152  chapter 395 may order any medication under the direction of the
  153  supervisory physician.
  154         Section 3. Paragraph (f) of subsection (4) of section
  155  459.022, Florida Statutes, is amended to read:
  156         459.022 Physician assistants.—
  157         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
  158         (f) A supervisory physician may delegate to a licensed
  159  physician assistant the authority to, and the licensed physician
  160  assistant acting under the direction of the supervisory
  161  physician may, order any medication medications for
  162  administration to the supervisory physician’s patient during his
  163  or her care in a facility licensed under chapter 395,
  164  notwithstanding any provisions in chapter 465 or chapter 893
  165  which may prohibit this delegation. For the purpose of this
  166  paragraph, an order is not considered a prescription. A licensed
  167  physician assistant working in a facility that is licensed under
  168  chapter 395 may order any medication under the direction of the
  169  supervisory physician.
  170         Section 4. Paragraph (a) of subsection (3) of section
  171  464.012, Florida Statutes, is amended to read:
  172         464.012 Certification of advanced registered nurse
  173  practitioners; fees.—
  174         (3) An advanced registered nurse practitioner shall perform
  175  those functions authorized in this section within the framework
  176  of an established protocol that is filed with the board upon
  177  biennial license renewal and within 30 days after entering into
  178  a supervisory relationship with a physician or changes to the
  179  protocol. The board shall review the protocol to ensure
  180  compliance with applicable regulatory standards for protocols.
  181  The board shall refer to the department licensees submitting
  182  protocols that are not compliant with the regulatory standards
  183  for protocols. A practitioner currently licensed under chapter
  184  458, chapter 459, or chapter 466 shall maintain supervision for
  185  directing the specific course of medical treatment. Within the
  186  established framework, an advanced registered nurse practitioner
  187  may:
  188         (a) Monitor and alter drug therapies and order any
  189  medication for administration to a patient in a facility
  190  licensed under chapter 395.
  191         Section 5. Subsection (14) of section 465.003, Florida
  192  Statutes, is amended to read:
  193         465.003 Definitions.—As used in this chapter, the term:
  194         (14) “Prescription” includes any order for drugs or
  195  medicinal supplies written or transmitted by any means of
  196  communication by a duly licensed practitioner authorized by the
  197  laws of this the state to prescribe such drugs or medicinal
  198  supplies and intended to be dispensed by a pharmacist, except
  199  for an order that is dispensed for administration. The term also
  200  includes an orally transmitted order by the lawfully designated
  201  agent of such practitioner;. The term also includes an order
  202  written or transmitted by a practitioner licensed to practice in
  203  a jurisdiction other than this state, but only if the pharmacist
  204  called upon to dispense such order determines, in the exercise
  205  of her or his professional judgment, that the order is valid and
  206  necessary for the treatment of a chronic or recurrent illness;
  207  and. The term “prescription” also includes a pharmacist’s order
  208  for a product selected from the formulary created pursuant to s.
  209  465.186. Prescriptions may be retained in written form or the
  210  pharmacist may cause them to be recorded in a data processing
  211  system, provided that such order can be produced in printed form
  212  upon lawful request.
  213         Section 6. Subsections (1) and (22) of section 893.02,
  214  Florida Statutes, are amended to read:
  215         893.02 Definitions.—The following words and phrases as used
  216  in this chapter shall have the following meanings, unless the
  217  context otherwise requires:
  218         (1) “Administer” or “administration” means the direct
  219  application of a controlled substance, whether by injection,
  220  inhalation, ingestion, or any other means, to the body of a
  221  person or animal.
  222         (22) “Prescription” means and includes any an order for
  223  drugs or medicinal supplies which is written, signed, or
  224  transmitted by any word of mouth, telephone, telegram, or other
  225  means of communication by a duly licensed practitioner
  226  authorized licensed by the laws of this the state to prescribe
  227  such drugs or medicinal supplies, is issued in good faith and in
  228  the course of professional practice, is intended to be filled,
  229  compounded, or dispensed by a another person authorized licensed
  230  by the laws of this the state to do so, and meets meeting the
  231  requirements of s. 893.04.
  232         (a) The term also includes an order for drugs or medicinal
  233  supplies so transmitted or written by a physician, dentist,
  234  veterinarian, or other practitioner licensed to practice in a
  235  state other than Florida, but only if the pharmacist called upon
  236  to fill such an order determines, in the exercise of his or her
  237  professional judgment, that the order was issued pursuant to a
  238  valid patient-physician relationship, that it is authentic, and
  239  that the drugs or medicinal supplies so ordered are considered
  240  necessary for the continuation of treatment of a chronic or
  241  recurrent illness.
  242         (b) The term does not include an order that is dispensed
  243  for administration by a licensed practitioner authorized by the
  244  laws of this state to administer such drugs or medicinal
  245  supplies.
  246         (c)However, If the physician writing the prescription is
  247  not known to the pharmacist, the pharmacist shall obtain proof
  248  to a reasonable certainty of the validity of the said
  249  prescription.
  250         (d) A prescription order for a controlled substance may
  251  shall not be issued on the same prescription blank with another
  252  prescription order for a controlled substance that which is
  253  named or described in a different schedule or with another, nor
  254  shall any prescription order for a controlled substance be
  255  issued on the same prescription blank as a prescription order
  256  for a medicinal drug, as defined in s. 465.003(8), that is which
  257  does not fall within the definition of a controlled substance as
  258  defined in this act.
  259         Section 7. Paragraphs (a), (d), and (f) of subsection (2)
  260  of section 893.04, Florida Statutes, are amended to read:
  261         893.04 Pharmacist and practitioner.—
  262         (2)(a) A pharmacist may not dispense a controlled substance
  263  listed in Schedule II, Schedule III, or Schedule IV to any
  264  patient or patient’s agent without first determining, in the
  265  exercise of her or his professional judgment, that the
  266  prescription order is valid. The pharmacist may dispense the
  267  controlled substance, in the exercise of her or his professional
  268  judgment, when the pharmacist or pharmacist’s agent has obtained
  269  satisfactory patient information from the patient or the
  270  patient’s agent.
  271         (d) Each written prescription written prescribed by a
  272  practitioner in this state for a controlled substance listed in
  273  Schedule II, Schedule III, or Schedule IV must include both a
  274  written and a numerical notation of the quantity of the
  275  controlled substance prescribed and a notation of the date in
  276  numerical, month/day/year format, or with the abbreviated month
  277  written out, or the month written out in whole. A pharmacist
  278  may, upon verification by the prescriber, document any
  279  information required by this paragraph. If the prescriber is not
  280  available to verify a prescription, the pharmacist may dispense
  281  the controlled substance, but may insist that the person to whom
  282  the controlled substance is dispensed provide valid photographic
  283  identification. If a prescription includes a numerical notation
  284  of the quantity of the controlled substance or date, but does
  285  not include the quantity or date written out in textual format,
  286  the pharmacist may dispense the controlled substance without
  287  verification by the prescriber of the quantity or date if the
  288  pharmacy previously dispensed another prescription for the
  289  person to whom the prescription was written.
  290         (f) A pharmacist may not knowingly dispense fill a
  291  prescription that has been forged for a controlled substance
  292  listed in Schedule II, Schedule III, or Schedule IV.
  293         Section 8. Subsection (1) of section 893.05, Florida
  294  Statutes, is amended to read:
  295         893.05 Practitioners and persons administering controlled
  296  substances in their absence.—
  297         (1)(a) A practitioner, in good faith and in the course of
  298  his or her professional practice only, may prescribe,
  299  administer, dispense, mix, or otherwise prepare a controlled
  300  substance, or the practitioner may cause the controlled
  301  substance same to be administered by a licensed nurse or an
  302  intern practitioner under his or her direction and supervision
  303  only.
  304         (b)Pursuant to s. 458.347(4)(g), s. 459.022(4)(f), or s.
  305  464.012(3), as applicable, a practitioner who supervises a
  306  licensed physician assistant or advanced registered nurse
  307  practitioner may authorize the licensed physician assistant or
  308  advanced registered nurse practitioner to order controlled
  309  substances for administration to a patient in a facility
  310  licensed under chapter 395.
  311         (c) A veterinarian may so prescribe, administer, dispense,
  312  mix, or prepare a controlled substance for use on animals only,
  313  and may cause the controlled substance it to be administered by
  314  an assistant or orderly under the veterinarian’s direction and
  315  supervision only.
  316         (d) A certified optometrist licensed under chapter 463 may
  317  not administer or prescribe a controlled substance listed in
  318  Schedule I or Schedule II of s. 893.03.
  319         Section 9. Subsection (26) of s. 400.462, subsection (1) of
  320  s. 401.445, subsection (18) of s. 409.906, and subsection (3) of
  321  s. 766.103, Florida Statutes, are reenacted for the purpose of
  322  incorporating the amendments made by this act to ss. 458.347 and
  323  459.022, Florida Statutes, in references thereto.
  324         Section 10. Subsection (1) of s. 401.445 and subsection (3)
  325  of s. 766.103, Florida Statutes, are reenacted for the purpose
  326  of incorporating the amendment made by this act to s. 464.012,
  327  Florida Statutes, in references thereto.
  328         Section 11. Paragraph (a) of subsection (1) of s. 409.9201,
  329  paragraph (pp) of subsection (1) of s. 458.331, paragraph (rr)
  330  of subsection (1) of s. 459.015, subsection (1) of s. 465.014,
  331  paragraph (c) of subsection (2) of s. 465.015, paragraph (s) of
  332  subsection (1) of s. 465.016, paragraph (j) of subsection (5) of
  333  s. 465.022, paragraph (h) of subsection (1) of s. 465.023, s.
  334  465.1901, subsection (43) of s. 499.003, and subsection (1) of
  335  s. 831.30, Florida Statutes, are reenacted for the purpose of
  336  incorporating the amendments made by this act to s. 465.003,
  337  Florida Statutes, in references thereto.
  338         Section 12. Paragraph (i) of subsection (5) of s. 112.0455,
  339  paragraph (b) of subsection (7) of s. 381.986, paragraph (l) of
  340  subsection (1) of s. 440.102, paragraph (pp) of subsection (1)
  341  of s. 458.331, paragraph (rr) of subsection (1) of s. 459.015,
  342  subsection (3) of s. 465.015, paragraph (s) of subsection (1) of
  343  s. 465.016, paragraph (j) of subsection (5) of s. 465.022,
  344  paragraph (h) of subsection (1) of s. 465.023, subsection (14)
  345  of s. 499.0121, paragraph (b) of subsection (1) of s. 768.36,
  346  paragraph (f) of subsection (3) of s. 810.02, paragraph (c) of
  347  subsection (2) of s. 812.014, paragraph (c) of subsection (1) of
  348  s. 856.015, paragraph (a) of subsection (1) of s. 944.47,
  349  subsection (1) of s. 951.22, paragraph (a) of subsection (1) of
  350  s. 985.711, paragraph (i) of subsection (1) of s. 1003.57, and
  351  subsection (8) of s. 1006.09, Florida Statutes, are reenacted
  352  for the purpose of incorporating the amendments made by this act
  353  to s. 893.02, Florida Statutes, in references thereto.
  354         Section 13. Paragraph (e) of subsection (3) of s. 893.0551,
  355  Florida Statutes, is reenacted for the purpose of incorporating
  356  the amendments made by this act to s. 893.04, Florida Statutes,
  357  in a reference thereto.
  358         Section 14. Paragraph (d) of subsection (3) of s. 893.0551,
  359  Florida Statutes, is reenacted for the purpose of incorporating
  360  the amendments made by this act to s. 893.05, Florida Statutes,
  361  in a reference thereto.
  362         Section 15. This act shall take effect July 1, 2015.