Florida Senate - 2015 SB 614
By Senator Grimsley
1 A bill to be entitled
2 An act relating to drug prescription by advanced
3 registered nurse practitioners and physician
4 assistants; amending s. 110.12315, F.S.; expanding the
5 categories of persons who may prescribe brand drugs
6 under the prescription drug program when medically
7 necessary; amending ss. 310.071, 310.073, and 310.081,
8 F.S.; exempting controlled substances prescribed by an
9 advanced registered nurse practitioner or a physician
10 assistant from the disqualifications for certification
11 or licensure, and for continued certification or
12 licensure, as a deputy or state pilot; amending s.
13 456.072, F.S.; applying existing penalties for
14 violations relating to the prescribing or dispensing
15 of controlled substances to an advanced registered
16 nurse practitioner; amending s. 456.44, F.S.; deleting
17 an obsolete date; requiring advanced registered nurse
18 practitioners and physician assistants who prescribe
19 controlled substances for certain pain to make a
20 certain designation, comply with registration
21 requirements, and follow specified standards of
22 practice; providing applicability; amending 458.347,
23 F.S.; expanding the prescribing authority of a
24 licensed physician assistant; amending s. 464.012,
25 F.S.; authorizing an advanced registered nurse
26 practitioner to prescribe, dispense, administer, or
27 order drugs, rather than to monitor and alter drug
28 therapies; amending s. 464.018, F.S.; specifying acts
29 that constitute grounds for denial of a license for or
30 disciplinary action against an advanced registered
31 nurse practitioner; amending s. 893.02, F.S.;
32 redefining the term “practitioner” to include advanced
33 registered nurse practitioners and physician
34 assistants under the Florida Comprehensive Drug Abuse
35 Prevention and Control Act; amending s. 948.03, F.S.;
36 providing that possession of drugs or narcotics
37 prescribed by an advanced registered nurse
38 practitioner or physician assistant is an exception
39 from a prohibition relating to the possession of drugs
40 or narcotics during probation; reenacting s.
41 310.071(3), F.S., to incorporate the amendment made to
42 s. 310.071, F.S., in a reference thereto; reenacting
43 ss. 456.072(1)(mm) and 466.02751, F.S., to incorporate
44 the amendment made to s. 456.44, F.S., in references
45 thereto; reenacting ss. 458.303, 458.347(4)(e) and
46 (9)(c), 458.3475(7)(b), 459.022(4)(e) and (9)(c), and
47 459.023(7)(b), F.S., to incorporate the amendment made
48 to s. 458.347, F.S., in references thereto; reenacting
49 ss. 456.041(1)(a), 458.348(1) and (2), and 459.025(1),
50 F.S., to incorporate the amendment made to s. 464.012,
51 F.S., in references thereto; reenacting ss.
52 320.0848(11), 464.008(2), 464.009(5), 464.018(2), and
53 464.0205(1)(b), (3), and (4)(b), F.S., to incorporate
54 the amendment made to s. 464.018, F.S., in references
55 thereto; reenacting s. 775.051, F.S., to incorporate
56 the amendment made to s. 893.02, F.S., in a reference
57 thereto; reenacting ss. 944.17(3)(a), 948.001(8), and
58 948.101(1)(e), F.S., to incorporate the amendment made
59 to s. 948.03, F.S., in references thereto; providing
60 an effective date.
62 Be It Enacted by the Legislature of the State of Florida:
64 Section 1. Subsection (7) of section 110.12315, Florida
65 Statutes, is amended to read:
66 110.12315 Prescription drug program.—The state employees’
67 prescription drug program is established. This program shall be
68 administered by the Department of Management Services, according
69 to the terms and conditions of the plan as established by the
70 relevant provisions of the annual General Appropriations Act and
71 implementing legislation, subject to the following conditions:
72 (7) The department shall establish the reimbursement
73 schedule for prescription pharmaceuticals dispensed under the
74 program. Reimbursement rates for a prescription pharmaceutical
75 must be based on the cost of the generic equivalent drug if a
76 generic equivalent exists, unless the physician, advanced
77 registered nurse practitioner, or physician assistant
78 prescribing the pharmaceutical clearly states on the
79 prescription that the brand name drug is medically necessary or
80 that the drug product is included on the formulary of drug
81 products that may not be interchanged as provided in chapter
82 465, in which case reimbursement must be based on the cost of
83 the brand name drug as specified in the reimbursement schedule
84 adopted by the department.
85 Section 2. Paragraph (c) of subsection (1) of section
86 310.071, Florida Statutes, is amended to read:
87 310.071 Deputy pilot certification.—
88 (1) In addition to meeting other requirements specified in
89 this chapter, each applicant for certification as a deputy pilot
91 (c) Be in good physical and mental health, as evidenced by
92 documentary proof of having satisfactorily passed a complete
93 physical examination administered by a licensed physician within
94 the preceding 6 months. The board shall adopt rules to establish
95 requirements for passing the physical examination, which rules
96 shall establish minimum standards for the physical or mental
97 capabilities necessary to carry out the professional duties of a
98 certificated deputy pilot. Such standards shall include zero
99 tolerance for any controlled substance regulated under chapter
100 893 unless that individual is under the care of a physician,
101 advanced registered nurse practitioner, or physician assistant
102 and that controlled substance was prescribed by that physician,
103 advanced registered nurse practitioner, or physician assistant.
104 To maintain eligibility as a certificated deputy pilot, each
105 certificated deputy pilot must annually provide documentary
106 proof of having satisfactorily passed a complete physical
107 examination administered by a licensed physician. The physician
108 must know the minimum standards and certify that the
109 certificateholder satisfactorily meets the standards. The
110 standards for certificateholders shall include a drug test.
111 Section 3. Subsection (3) of section 310.073, Florida
112 Statutes, is amended to read:
113 310.073 State pilot licensing.—In addition to meeting other
114 requirements specified in this chapter, each applicant for
115 license as a state pilot must:
116 (3) Be in good physical and mental health, as evidenced by
117 documentary proof of having satisfactorily passed a complete
118 physical examination administered by a licensed physician within
119 the preceding 6 months. The board shall adopt rules to establish
120 requirements for passing the physical examination, which rules
121 shall establish minimum standards for the physical or mental
122 capabilities necessary to carry out the professional duties of a
123 licensed state pilot. Such standards shall include zero
124 tolerance for any controlled substance regulated under chapter
125 893 unless that individual is under the care of a physician,
126 advanced registered nurse practitioner, or physician assistant
127 and that controlled substance was prescribed by that physician,
128 advanced registered nurse practitioner, or physician assistant.
129 To maintain eligibility as a licensed state pilot, each licensed
130 state pilot must annually provide documentary proof of having
131 satisfactorily passed a complete physical examination
132 administered by a licensed physician. The physician must know
133 the minimum standards and certify that the licensee
134 satisfactorily meets the standards. The standards for licensees
135 shall include a drug test.
136 Section 4. Paragraph (b) of subsection (3) of section
137 310.081, Florida Statutes, is amended to read:
138 310.081 Department to examine and license state pilots and
139 certificate deputy pilots; vacancies.—
140 (3) Pilots shall hold their licenses or certificates
141 pursuant to the requirements of this chapter so long as they:
142 (b) Are in good physical and mental health as evidenced by
143 documentary proof of having satisfactorily passed a physical
144 examination administered by a licensed physician or physician
145 assistant within each calendar year. The board shall adopt rules
146 to establish requirements for passing the physical examination,
147 which rules shall establish minimum standards for the physical
148 or mental capabilities necessary to carry out the professional
149 duties of a licensed state pilot or a certificated deputy pilot.
150 Such standards shall include zero tolerance for any controlled
151 substance regulated under chapter 893 unless that individual is
152 under the care of a physician, advanced registered nurse
153 practitioner, or physician assistant and that controlled
154 substance was prescribed by that physician, advanced registered
155 nurse practitioner, or physician assistant. To maintain
156 eligibility as a certificated deputy pilot or licensed state
157 pilot, each certificated deputy pilot or licensed state pilot
158 must annually provide documentary proof of having satisfactorily
159 passed a complete physical examination administered by a
160 licensed physician. The physician must know the minimum
161 standards and certify that the certificateholder or licensee
162 satisfactorily meets the standards. The standards for
163 certificateholders and for licensees shall include a drug test.
165 Upon resignation or in the case of disability permanently
166 affecting a pilot’s ability to serve, the state license or
167 certificate issued under this chapter shall be revoked by the
169 Section 5. Subsection (7) of section 456.072, Florida
170 Statutes, is amended to read:
171 456.072 Grounds for discipline; penalties; enforcement.—
172 (7) Notwithstanding subsection (2), upon a finding that a
173 physician has prescribed or dispensed a controlled substance, or
174 caused a controlled substance to be prescribed or dispensed, in
175 a manner that violates the standard of practice set forth in s.
176 458.331(1)(q) or (t), s. 459.015(1)(t) or (x), s. 461.013(1)(o)
177 or (s), or s. 466.028(1)(p) or (x), or that an advanced
178 registered nurse practitioner has prescribed or dispensed a
179 controlled substance, or caused a controlled substance to be
180 prescribed or dispensed, in a manner that violates the standard
181 of practice set forth in s. 464.018(1)(n) or (p)6., the
182 physician or advanced registered nurse practitioner shall be
183 suspended for a period of not less than 6 months and pay a fine
184 of not less than $10,000 per count. Repeated violations shall
185 result in increased penalties.
186 Section 6. Subsections (2) and (3) of section 456.44,
187 Florida Statutes, are amended to read:
188 456.44 Controlled substance prescribing.—
189 (2) REGISTRATION.—
Effective January 1, 2012, A physician
190 licensed under chapter 458, chapter 459, chapter 461, or chapter
191 466, a physician assistant licensed under chapter 458 or chapter
192 459, or an advanced registered nurse practitioner certified
193 under part I of chapter 464 who prescribes any controlled
194 substance, listed in Schedule II, Schedule III, or Schedule IV
195 as defined in s. 893.03, for the treatment of chronic
196 nonmalignant pain, must:
197 (a) Designate himself or herself as a controlled substance
198 prescribing practitioner on his or her the physician’s
199 practitioner profile.
200 (b) Comply with the requirements of this section and
201 applicable board rules.
202 (3) STANDARDS OF PRACTICE.—The standards of practice in
203 this section do not supersede the level of care, skill, and
204 treatment recognized in general law related to health care
206 (a) A complete medical history and a physical examination
207 must be conducted before beginning any treatment and must be
208 documented in the medical record. The exact components of the
209 physical examination shall be left to the judgment of the
210 registrant clinician who is expected to perform a physical
211 examination proportionate to the diagnosis that justifies a
212 treatment. The medical record must, at a minimum, document the
213 nature and intensity of the pain, current and past treatments
214 for pain, underlying or coexisting diseases or conditions, the
215 effect of the pain on physical and psychological function, a
216 review of previous medical records, previous diagnostic studies,
217 and history of alcohol and substance abuse. The medical record
218 shall also document the presence of one or more recognized
219 medical indications for the use of a controlled substance. Each
220 registrant must develop a written plan for assessing each
221 patient’s risk of aberrant drug-related behavior, which may
222 include patient drug testing. Registrants must assess each
223 patient’s risk for aberrant drug-related behavior and monitor
224 that risk on an ongoing basis in accordance with the plan.
225 (b) Each registrant must develop a written individualized
226 treatment plan for each patient. The treatment plan shall state
227 objectives that will be used to determine treatment success,
228 such as pain relief and improved physical and psychosocial
229 function, and shall indicate if any further diagnostic
230 evaluations or other treatments are planned. After treatment
231 begins, the registrant physician shall adjust drug therapy to
232 the individual medical needs of each patient. Other treatment
233 modalities, including a rehabilitation program, shall be
234 considered depending on the etiology of the pain and the extent
235 to which the pain is associated with physical and psychosocial
236 impairment. The interdisciplinary nature of the treatment plan
237 shall be documented.
238 (c) The registrant physician shall discuss the risks and
239 benefits of the use of controlled substances, including the
240 risks of abuse and addiction, as well as physical dependence and
241 its consequences, with the patient, persons designated by the
242 patient, or the patient’s surrogate or guardian if the patient
243 is incompetent. The registrant physician shall use a written
244 controlled substance agreement between the registrant physician
245 and the patient outlining the patient’s responsibilities,
246 including, but not limited to:
247 1. Number and frequency of controlled substance
248 prescriptions and refills.
249 2. Patient compliance and reasons for which drug therapy
250 may be discontinued, such as a violation of the agreement.
251 3. An agreement that controlled substances for the
252 treatment of chronic nonmalignant pain shall be prescribed by a
253 single treating registrant physician unless otherwise authorized
254 by the treating registrant physician and documented in the
255 medical record.
256 (d) The patient shall be seen by the registrant physician
257 at regular intervals, not to exceed 3 months, to assess the
258 efficacy of treatment, ensure that controlled substance therapy
259 remains indicated, evaluate the patient’s progress toward
260 treatment objectives, consider adverse drug effects, and review
261 the etiology of the pain. Continuation or modification of
262 therapy shall depend on the registrant’s physician’s evaluation
263 of the patient’s progress. If treatment goals are not being
264 achieved, despite medication adjustments, the registrant
265 physician shall reevaluate the appropriateness of continued
266 treatment. The registrant physician shall monitor patient
267 compliance in medication usage, related treatment plans,
268 controlled substance agreements, and indications of substance
269 abuse or diversion at a minimum of 3-month intervals.
270 (e) The registrant physician shall refer the patient as
271 necessary for additional evaluation and treatment in order to
272 achieve treatment objectives. Special attention shall be given
273 to those patients who are at risk for misusing their medications
274 and those whose living arrangements pose a risk for medication
275 misuse or diversion. The management of pain in patients with a
276 history of substance abuse or with a comorbid psychiatric
277 disorder requires extra care, monitoring, and documentation and
278 requires consultation with or referral to an addiction medicine
279 specialist or psychiatrist.
280 (f) A registrant physician registered under this section
281 must maintain accurate, current, and complete records that are
282 accessible and readily available for review and comply with the
283 requirements of this section, the applicable practice act, and
284 applicable board rules. The medical records must include, but
285 are not limited to:
286 1. The complete medical history and a physical examination,
287 including history of drug abuse or dependence.
288 2. Diagnostic, therapeutic, and laboratory results.
289 3. Evaluations and consultations.
290 4. Treatment objectives.
291 5. Discussion of risks and benefits.
292 6. Treatments.
293 7. Medications, including date, type, dosage, and quantity
295 8. Instructions and agreements.
296 9. Periodic reviews.
297 10. Results of any drug testing.
298 11. A photocopy of the patient’s government-issued photo
300 12. If a written prescription for a controlled substance is
301 given to the patient, a duplicate of the prescription.
302 13. The registrant’s physician’s full name presented in a
303 legible manner.
304 (g) Patients with signs or symptoms of substance abuse
305 shall be immediately referred to a board-certified pain
306 management physician, an addiction medicine specialist, or a
307 mental health addiction facility as it pertains to drug abuse or
308 addiction unless the registrant is a physician who is board
309 certified or board-eligible in pain management. Throughout the
310 period of time before receiving the consultant’s report, a
311 prescribing registrant physician shall clearly and completely
312 document medical justification for continued treatment with
313 controlled substances and those steps taken to ensure medically
314 appropriate use of controlled substances by the patient. Upon
315 receipt of the consultant’s written report, the prescribing
316 registrant physician shall incorporate the consultant’s
317 recommendations for continuing, modifying, or discontinuing
318 controlled substance therapy. The resulting changes in treatment
319 shall be specifically documented in the patient’s medical
320 record. Evidence or behavioral indications of diversion shall be
321 followed by discontinuation of controlled substance therapy, and
322 the patient shall be discharged, and all results of testing and
323 actions taken by the registrant physician shall be documented in
324 the patient’s medical record.
326 This subsection does not apply to a board-eligible or board
327 certified anesthesiologist, physiatrist, rheumatologist, or
328 neurologist, or to a board-certified physician who has surgical
329 privileges at a hospital or ambulatory surgery center and
330 primarily provides surgical services. This subsection does not
331 apply to a board-eligible or board-certified medical specialist
332 who has also completed a fellowship in pain medicine approved by
333 the Accreditation Council for Graduate Medical Education or the
334 American Osteopathic Association, or who is board eligible or
335 board certified in pain medicine by the American Board of Pain
336 Medicine, the American Board of Interventional Pain Physicians,
337 the American Association of Physician Specialists, or a board
338 approved by the American Board of Medical Specialties or the
339 American Osteopathic Association and performs interventional
340 pain procedures of the type routinely billed using surgical
341 codes. This subsection does not apply to a registrant, advanced
342 registered nurse practitioner, or physician assistant who
343 prescribes medically necessary controlled substances for a
344 patient during an inpatient stay in a hospital licensed under
345 chapter 395.
346 Section 7. Paragraph (f) of subsection (4) of section
347 458.347, Florida Statutes, is amended to read:
348 458.347 Physician assistants.—
349 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
350 (f)1. The council shall establish a formulary of medicinal
351 drugs that a fully licensed physician assistant having
352 prescribing authority under this section or s. 459.022 may not
353 prescribe. The formulary must include controlled substances as
354 defined in chapter 893, general anesthetics , and radiographic
355 contrast materials.
356 2. In establishing the formulary, the council shall consult
357 with a pharmacist licensed under chapter 465, but not licensed
358 under this chapter or chapter 459, who shall be selected by the
359 State Surgeon General.
360 3. Only the council shall add to, delete from, or modify
361 the formulary. Any person who requests an addition, deletion, or
362 modification of a medicinal drug listed on such formulary has
363 the burden of proof to show cause why such addition, deletion,
364 or modification should be made.
365 4. The boards shall adopt the formulary required by this
366 paragraph, and each addition, deletion, or modification to the
367 formulary, by rule. Notwithstanding any provision of chapter 120
368 to the contrary, the formulary rule shall be effective 60 days
369 after the date it is filed with the Secretary of State. Upon
370 adoption of the formulary, the department shall mail a copy of
371 such formulary to each fully licensed physician assistant having
372 prescribing authority under this section or s. 459.022, and to
373 each pharmacy licensed by the state. The boards shall establish,
374 by rule, a fee not to exceed $200 to fund the provisions of this
375 paragraph and paragraph (e).
376 Section 8. Section 464.012, Florida Statutes, is amended to
378 464.012 Certification of advanced registered nurse
379 practitioners; fees; controlled substance prescribing.—
380 (1) Any nurse desiring to be certified as an advanced
381 registered nurse practitioner shall apply to the department and
382 submit proof that he or she holds a current license to practice
383 professional nursing and that he or she meets one or more of the
384 following requirements as determined by the board:
385 (a) Satisfactory completion of a formal postbasic
386 educational program of at least one academic year, the primary
387 purpose of which is to prepare nurses for advanced or
388 specialized practice.
389 (b) Certification by an appropriate specialty board. Such
390 certification shall be required for initial state certification
391 and any recertification as a registered nurse anesthetist or
392 nurse midwife. The board may by rule provide for provisional
393 state certification of graduate nurse anesthetists and nurse
394 midwives for a period of time determined to be appropriate for
395 preparing for and passing the national certification
397 (c) Graduation from a program leading to a master’s degree
398 in a nursing clinical specialty area with preparation in
399 specialized practitioner skills. For applicants graduating on or
400 after October 1, 1998, graduation from a master’s degree program
401 shall be required for initial certification as a nurse
402 practitioner under paragraph (4)(c). For applicants graduating
403 on or after October 1, 2001, graduation from a master’s degree
404 program shall be required for initial certification as a
405 registered nurse anesthetist under paragraph (4)(a).
406 (2) The board shall provide by rule the appropriate
407 requirements for advanced registered nurse practitioners in the
408 categories of certified registered nurse anesthetist, certified
409 nurse midwife, and certified nurse practitioner.
410 (3) An advanced registered nurse practitioner shall perform
411 those functions authorized in this section within the framework
412 of an established protocol that is filed with the board upon
413 biennial license renewal and within 30 days after entering into
414 a supervisory relationship with a physician or changes to the
415 protocol. The board shall review the protocol to ensure
416 compliance with applicable regulatory standards for protocols.
417 The board shall refer to the department licensees submitting
418 protocols that are not compliant with the regulatory standards
419 for protocols. A practitioner currently licensed under chapter
420 458, chapter 459, or chapter 466 shall maintain supervision for
421 directing the specific course of medical treatment. Within the
422 established framework, an advanced registered nurse practitioner
424 (a) Prescribe, dispense, administer, or order any Monitor
425 and alter drug therapies.
426 (b) Initiate appropriate therapies for certain conditions.
427 (c) Perform additional functions as may be determined by
428 rule in accordance with s. 464.003(2).
429 (d) Order diagnostic tests and physical and occupational
431 (4) In addition to the general functions specified in
432 subsection (3), an advanced registered nurse practitioner may
433 perform the following acts within his or her specialty:
434 (a) The certified registered nurse anesthetist may, to the
435 extent authorized by established protocol approved by the
436 medical staff of the facility in which the anesthetic service is
437 performed, perform any or all of the following:
438 1. Determine the health status of the patient as it relates
439 to the risk factors and to the anesthetic management of the
440 patient through the performance of the general functions.
441 2. Based on history, physical assessment, and supplemental
442 laboratory results, determine, with the consent of the
443 responsible physician, the appropriate type of anesthesia within
444 the framework of the protocol.
445 3. Order under the protocol preanesthetic medication.
446 4. Perform under the protocol procedures commonly used to
447 render the patient insensible to pain during the performance of
448 surgical, obstetrical, therapeutic, or diagnostic clinical
449 procedures. These procedures include ordering and administering
450 regional, spinal, and general anesthesia; inhalation agents and
451 techniques; intravenous agents and techniques; and techniques of
453 5. Order or perform monitoring procedures indicated as
454 pertinent to the anesthetic health care management of the
456 6. Support life functions during anesthesia health care,
457 including induction and intubation procedures, the use of
458 appropriate mechanical supportive devices, and the management of
459 fluid, electrolyte, and blood component balances.
460 7. Recognize and take appropriate corrective action for
461 abnormal patient responses to anesthesia, adjunctive medication,
462 or other forms of therapy.
463 8. Recognize and treat a cardiac arrhythmia while the
464 patient is under anesthetic care.
465 9. Participate in management of the patient while in the
466 postanesthesia recovery area, including ordering the
467 administration of fluids and drugs.
468 10. Place special peripheral and central venous and
469 arterial lines for blood sampling and monitoring as appropriate.
470 (b) The certified nurse midwife may, to the extent
471 authorized by an established protocol which has been approved by
472 the medical staff of the health care facility in which the
473 midwifery services are performed, or approved by the nurse
474 midwife’s physician backup when the delivery is performed in a
475 patient’s home, perform any or all of the following:
476 1. Perform superficial minor surgical procedures.
477 2. Manage the patient during labor and delivery to include
478 amniotomy, episiotomy, and repair.
479 3. Order, initiate, and perform appropriate anesthetic
481 4. Perform postpartum examination.
482 5. Order appropriate medications.
483 6. Provide family-planning services and well-woman care.
484 7. Manage the medical care of the normal obstetrical
485 patient and the initial care of a newborn patient.
486 (c) The nurse practitioner may perform any or all of the
487 following acts within the framework of established protocol:
488 1. Manage selected medical problems.
489 2. Order physical and occupational therapy.
490 3. Initiate, monitor, or alter therapies for certain
491 uncomplicated acute illnesses.
492 4. Monitor and manage patients with stable chronic
494 5. Establish behavioral problems and diagnosis and make
495 treatment recommendations.
496 (5) The board shall certify, and the department shall issue
497 a certificate to, any nurse meeting the qualifications in this
498 section. The board shall establish an application fee not to
499 exceed $100 and a biennial renewal fee not to exceed $50. The
500 board is authorized to adopt such other rules as are necessary
501 to implement the provisions of this section.
502 Section 9. Paragraph (p) is added to subsection (1) of
503 section 464.018, Florida Statutes, to read:
504 464.018 Disciplinary actions.—
505 (1) The following acts constitute grounds for denial of a
506 license or disciplinary action, as specified in s. 456.072(2):
507 (p) For an advanced registered nurse practitioner:
508 1. Presigning blank prescription forms.
509 2. Prescribing for office use any medicinal drug appearing
510 on Schedule II in chapter 893.
511 3. Prescribing, ordering, dispensing, administering,
512 supplying, selling, or giving a drug that is an amphetamine or a
513 sympathomimetic amine drug, or a compound designated pursuant to
514 chapter 893 as a Schedule II controlled substance, to or for any
515 person except for:
516 a. The treatment of narcolepsy; hyperkinesis; behavioral
517 syndrome in children characterized by the developmentally
518 inappropriate symptoms of moderate to severe distractibility,
519 short attention span, hyperactivity, emotional lability, and
520 impulsivity; or drug-induced brain dysfunction.
521 b. The differential diagnostic psychiatric evaluation of
522 depression or the treatment of depression shown to be refractory
523 to other therapeutic modalities.
524 c. The clinical investigation of the effects of such drugs
525 or compounds when an investigative protocol is submitted to,
526 reviewed by, and approved by the department before such
527 investigation is begun.
528 4. Prescribing, ordering, dispensing, administering,
529 supplying, selling, or giving growth hormones, testosterone or
530 its analogs, human chorionic gonadotropin (HCG), or other
531 hormones for the purpose of muscle building or to enhance
532 athletic performance. As used in this subparagraph, the term
533 “muscle building” does not include the treatment of injured
534 muscle. A prescription written for the drug products listed in
535 this paragraph may be dispensed by a pharmacist with the
536 presumption that the prescription is for legitimate medical use.
537 5. Promoting or advertising on any prescription form a
538 community pharmacy unless the form also states: “This
539 prescription may be filled at any pharmacy of your choice.”
540 6. Prescribing, dispensing, administering, mixing, or
541 otherwise preparing a legend drug, including a controlled
542 substance, other than in the course of his or her professional
543 practice. For the purposes of this subparagraph, it is legally
544 presumed that prescribing, dispensing, administering, mixing, or
545 otherwise preparing legend drugs, including all controlled
546 substances, inappropriately or in excessive or inappropriate
547 quantities is not in the best interest of the patient and is not
548 in the course of the advanced registered nurse practitioner’s
549 professional practice, without regard to his or her intent.
550 7. Prescribing, dispensing, or administering a medicinal
551 drug appearing on any schedule set forth in chapter 893 to
552 himself or herself, except a drug prescribed, dispensed, or
553 administered to the advanced registered nurse practitioner by
554 another practitioner authorized to prescribe, dispense, or
555 administer medicinal drugs.
556 8. Prescribing, ordering, dispensing, administering,
557 supplying, selling, or giving amygdalin (laetrile) to any
559 9. Dispensing a controlled substance listed on Schedule II
560 or Schedule III in chapter 893 in violation of s. 465.0276.
561 10. Promoting or advertising through any communication
562 medium the use, sale, or dispensing of a controlled substance
563 appearing on any schedule in chapter 893.
564 Section 10. Subsection (21) of section 893.02, Florida
565 Statutes, is amended to read:
566 893.02 Definitions.—The following words and phrases as used
567 in this chapter shall have the following meanings, unless the
568 context otherwise requires:
569 (21) “Practitioner” means a physician licensed under
570 pursuant to chapter 458, a dentist licensed under pursuant to
571 chapter 466, a veterinarian licensed under pursuant to chapter
572 474, an osteopathic physician licensed under pursuant to chapter
573 459, an advanced registered nurse practitioner certified under
574 chapter 464, a naturopath licensed under pursuant to chapter
575 462, a certified optometrist licensed under pursuant to chapter
576 463, or a podiatric physician licensed under pursuant to chapter
577 461, or a physician assistant licensed under chapter 458 or
578 chapter 459, provided such practitioner holds a valid federal
579 controlled substance registry number.
580 Section 11. Paragraph (n) of subsection (1) of section
581 948.03, Florida Statutes, is amended to read:
582 948.03 Terms and conditions of probation.—
583 (1) The court shall determine the terms and conditions of
584 probation. Conditions specified in this section do not require
585 oral pronouncement at the time of sentencing and may be
586 considered standard conditions of probation. These conditions
587 may include among them the following, that the probationer or
588 offender in community control shall:
589 (n) Be prohibited from using intoxicants to excess or
590 possessing any drugs or narcotics unless prescribed by a
591 physician, advanced registered nurse practitioner, or physician
592 assistant. The probationer or community controllee may shall not
593 knowingly visit places where intoxicants, drugs, or other
594 dangerous substances are unlawfully sold, dispensed, or used.
595 Section 12. Subsection (3) of s. 310.071, Florida Statutes,
596 is reenacted for the purpose of incorporating the amendment made
597 by this act to s. 310.071, Florida Statutes, in a reference
599 Section 13. Paragraph (mm) of subsection (1) of s. 456.072
600 and s. 466.02751, Florida Statutes, are reenacted for the
601 purpose of incorporating the amendment made by this act to s.
602 456.44, Florida Statutes, in references thereto.
603 Section 14. Section 458.303, paragraph (e) of subsection
604 (4) and paragraph (c) of subsection (9) of s. 458.347, paragraph
605 (b) of subsection (7) of s. 458.3475, paragraph (e) of
606 subsection (4) and paragraph (c) of subsection (9) of s.
607 459.022, and paragraph (b) of subsection (7) of s. 459.023,
608 Florida Statutes, are reenacted for the purpose of incorporating
609 the amendment made by this act to s. 458.347, Florida Statutes,
610 in references thereto.
611 Section 15. Paragraph (a) of subsection (1) of s. 456.041,
612 subsections (1) and (2) of s. 458.348, and subsection (1) of s.
613 459.025, Florida Statutes, are reenacted for the purpose of
614 incorporating the amendment made by this act to s. 464.012,
615 Florida Statutes, in references thereto.
616 Section 16. Subsection (11) of s. 320.0848, subsection (2)
617 of s. 464.008, subsection (5) of s. 464.009, subsection (2) of
618 s. 464.018, and paragraph (b) of subsection (1), subsection (3),
619 and paragraph (b) of subsection (4) of s. 464.0205, Florida
620 Statutes, are reenacted for the purpose of incorporating the
621 amendment made by this act to s. 464.018, Florida Statutes, in
622 references thereto.
623 Section 17. Section 775.051, Florida Statutes, is reenacted
624 for the purpose of incorporating the amendment made by this act
625 to s. 893.02, Florida Statutes, in a reference thereto.
626 Section 18. Paragraph (a) of subsection (3) of s. 944.17,
627 subsection (8) of s. 948.001, and paragraph (e) of subsection
628 (1) of s. 948.101, Florida Statutes, are reenacted for the
629 purpose of incorporating the amendment made by this act to s.
630 948.03, Florida Statutes, in references thereto.
631 Section 19. This act shall take effect July 1, 2015.