Florida Senate - 2019 CS for CS for SB 1528 By the Committees on Appropriations; and Health Policy; and Senators Bean and Gruters 576-04599-19 20191528c2 1 A bill to be entitled 2 An act relating to prescription drug importation 3 programs; creating s. 381.02035, F.S.; requiring the 4 Agency for Health Care Administration to establish the 5 Canadian Prescription Drug Importation Program; 6 defining terms; requiring the agency to contract with 7 a vendor to facilitate wholesale prescription drug 8 importation under the program; providing 9 responsibilities for the vendor; providing eligibility 10 criteria for prescription drugs, Canadian suppliers, 11 and importers under the program; authorizing a 12 Canadian supplier to export drugs into this state 13 under the program under certain circumstances; 14 providing eligibility criteria and requirements for 15 drug importers; requiring participating Canadian 16 suppliers and importers to comply with specified 17 federal requirements for distributing prescription 18 drugs imported under the program; prohibiting Canadian 19 suppliers and importers from distributing, dispensing, 20 or selling prescription drugs imported under the 21 program outside of this state; requiring the agency to 22 request federal approval of the program; requiring the 23 request to include certain information; requiring the 24 agency to begin operating the program within a 25 specified timeframe after receiving federal approval; 26 providing certain documentation requirements; 27 requiring the agency to suspend the importation of 28 drugs in violation of this section or any federal or 29 state law or regulation; authorizing the agency to 30 revoke the suspension under certain circumstances; 31 requiring the agency to submit an annual report to the 32 Governor and the Legislature by a specified date; 33 providing requirements for such report; requiring the 34 agency to notify the Legislature upon federal approval 35 of the program and to submit a proposal to the 36 Legislature for program implementation and funding 37 before a certain date; requiring the agency to adopt 38 necessary rules; creating s. 465.0157, F.S.; 39 establishing an international export pharmacy permit 40 for participation in the International Prescription 41 Drug Importation Program; providing requirements for 42 permit application and renewal; amending s. 465.017, 43 F.S.; authorizing the Department of Health to inspect 44 international export pharmacy permittees; amending s. 45 499.005, F.S.; providing that the importation of a 46 prescription drug under the International Prescription 47 Drug Importation Program is not a prohibited act under 48 that chapter; amending s. 499.0051, F.S.; providing an 49 exemption from prosecution as a criminal offense for 50 the importation of a prescription drug for wholesale 51 distribution under the International Prescription Drug 52 Importation Program; amending s. 499.01, F.S.; 53 requiring an international prescription drug wholesale 54 distributor to be permitted before operating; 55 requiring nonresident prescription drug manufacturers 56 to register with the Department of Business and 57 Professional Regulation to participate in the program; 58 providing an exception; establishing an international 59 prescription drug wholesale distributor drug permit; 60 providing permit requirements; amending s. 499.012, 61 F.S.; providing application requirements for 62 international prescription drug wholesale distributors 63 and nonresident prescription drug manufacturers to 64 participate in the program; amending s. 499.015, F.S.; 65 establishing that prescription drugs imported under 66 the International Prescription Drug Importation 67 Program are not required to be registered under a 68 specified provision; amending s. 499.065, F.S.; 69 requiring the department to inspect international 70 prescription drug wholesale distributor 71 establishments; authorizing the department to 72 determine that an international prescription drug 73 wholesale distributor establishment is an imminent 74 danger to the public and require its immediate closure 75 under certain conditions; creating s. 499.0285, F.S.; 76 requiring the Department of Business and Professional 77 Regulation to establish the International Prescription 78 Drug Importation Program for a specified purpose; 79 providing definitions; providing eligibility criteria 80 for prescription drugs, exporters, and importers under 81 the program; requiring participating importers to 82 submit certain documentation to the department for 83 prescription drugs imported under the program; 84 requiring the department to immediately suspend the 85 importation of specific prescription drug or the 86 importation of prescription drugs by a specific 87 importer if a violation has occurred under the 88 program; authorizing the department to revoke such 89 suspension under certain circumstances; requiring the 90 department to adopt necessary rules; requiring the 91 agency, in collaboration with the Department of 92 Business and Professional Regulation and the 93 Department of Health, to negotiate a federal 94 arrangement to operate a pilot program for importing 95 prescription drugs into this state; providing that 96 implementation of the act is contingent upon the 97 federal authorization; requiring the department to 98 notify the Legislature before implementation of the 99 pilot program and to submit a proposal for pilot 100 program implementation and funding; providing an 101 effective date. 102 103 Be It Enacted by the Legislature of the State of Florida: 104 105 Section 1. Section 381.02035, Florida Statutes, is created 106 to read: 107 381.02035 Canadian Prescription Drug Importation Program.— 108 (1) PROGRAM ESTABLISHED.—The Agency for Health Care 109 Administration shall establish the Canadian Prescription Drug 110 Importation Program for the importation of safe and effective 111 prescription drugs from Canada which have the highest potential 112 for cost savings to the state. 113 (2) DEFINITIONS.—As used in this section, the term: 114 (a) “Agency” means the Agency for Health Care 115 Administration. 116 (b) “Canadian supplier” means a manufacturer, wholesale 117 distributor, or pharmacy appropriately licensed or permitted 118 under Canadian law to manufacture, distribute, or dispense 119 prescription drugs. 120 (c) “County health department” means a health care facility 121 established under part I of chapter 154. 122 (d) “Department” means the Department of Health. 123 (e) “Drug” or “prescription drug” has the same meaning as 124 “prescription drug” in s. 499.003, but is limited to drugs 125 intended for human use. 126 (f) “Federal act” means the Federal Food, Drug, and 127 Cosmetic Act, 21 U.S.C. ss. 301 et seq.; 52 Stat. 1040 et seq. 128 as amended by the Drug Quality and Security Act, 21 U.S.C. 351 129 et seq. 130 (g)“Free clinic” means a clinic that delivers only medical 131 diagnostic services or nonsurgical medical treatment free of 132 charge to low-income recipients. 133 (h) “Medicaid pharmacy” means a pharmacy licensed under 134 chapter 465 that has a Medicaid provider agreement in effect 135 with the agency and is in good standing with the agency. 136 (i) “Pharmacist” means a person who holds an active and 137 unencumbered license to practice pharmacy pursuant to chapter 138 465. 139 (j) “Program” means the Canadian Prescription Drug 140 Importation Program. 141 (k) “Track-and-trace” means the product-tracing process for 142 the components of the pharmaceutical distribution supply chain 143 as described in Title II of the Drug Quality and Security Act, 144 Drug Supply Chain Security Act, 21 U.S.C. 351 et seq. 145 (l) “Vendor” means the entity contracted by the agency to 146 manage specified functions of the program. 147 (3) IMPORTATION PROCESS.— 148 (a) The agency shall contract with a vendor to provide 149 services under the program. 150 (b) By December 1, 2019, and each year thereafter, the 151 vendor shall develop a Wholesale Prescription Drug Importation 152 List identifying the prescription drugs that have the highest 153 potential for cost savings to the state. In developing the list, 154 the vendor shall consider, at a minimum, which prescription 155 drugs will provide the greatest cost savings to state programs, 156 including prescriptions drugs for which there are shortages, 157 specialty prescription drugs, and high volume prescription 158 drugs. The agency, in consultation with the department, shall 159 review the Wholesale Prescription Drug Importation List every 3 160 months to ensure that it continues to meet the requirements of 161 the programs and may direct the vendor to revise the list, as 162 necessary. 163 (c) The vendor shall submit evidence of a surety bond with 164 any bid or initial contract negotiation documents and shall 165 maintain documentation of evidence of such a bond with the 166 agency throughout the contract term. The surety bond may be from 167 this state or any other state in the United States for at least 168 $25,000. The surety bond or comparable security arrangement must 169 include the State of Florida as a beneficiary. In lieu of the 170 surety bond, the vendor may provide a comparable security 171 agreement, such as an irrevocable letter of credit or a deposit 172 into a trust account or financial institution, which includes 173 the State of Florida as a beneficiary, payable to the State of 174 Florida. The purposes of the bond or other security arrangement 175 for the program are to: 176 1. Ensure payment of any administrative penalties imposed 177 by the agency or any other state agency under the contract, if 178 the vendor fails to pay within 30 days after assessment; 179 2. Ensure that the vendor meets contractual and statutory 180 obligations through use of a surety bond or other comparable 181 security arrangements to pay any other costs or fees incurred by 182 the agency, the state, or other entities acting on behalf of the 183 state if the vendor fails to meet its contractual and statutory 184 obligations. If the vendor is assessed a penalty under the 185 program and fails to pay within 30 days after that assessment, 186 the agency, the state, or an entity acting on behalf of the 187 state may file a claim for reimbursement against the bond or 188 other comparable security arrangement; and 189 3. Allow for claims to be made against the bond or other 190 comparable security arrangements for up to 1 year after the 191 vendor’s contract under the program has ended with the agency or 192 the state or the program has ended, whichever occurs last. 193 194 A surety bond or comparable document is required, regardless of 195 the type of bid or negotiation process the agency used or the 196 type of final contract or agreement executed for services. 197 (d) The vendor must submit evidence at the time of contract 198 award and throughout the contract term of a surety bond or 199 comparable security arrangement from this state or any other 200 state in the United States in an amount no less than $25,000. 201 The surety bond or comparable security arrangement must include 202 the State of Florida as a beneficiary. In lieu of the surety 203 bond, the vendor may provide a comparable security arrangement 204 such as an irrevocable letter of credit or a deposit into a 205 trust account or financial institution which names the State of 206 Florida as a beneficiary. The purposes of the bond or other 207 security arrangements for the program are to: 208 1. Ensure participation of the vendor in any civil or 209 criminal legal action by the state, the agency, any other state 210 agency, or private individuals or entities against the vendor 211 because of the vendor’s failure to perform under the contract, 212 including, but not limited to causes of actions for personal 213 injury, negligence, and wrongful death; 214 2. Ensure payment by the vendor through the use of a bond 215 or other comparable security arrangements of legal judgements 216 and claims that have been awarded to the agency, the state, 217 other entities acting on behalf of the state, individuals, or 218 organizations if the vendor is assessed a final judgement or 219 other monetary penalty in a court of law for a civil or criminal 220 action under the program. The bond or comparable security 221 arrangement will be accessed if the vendor fails to pay any 222 judgement or claim within 60 days after final judgement; and 223 3. Allow for civil and criminal litigation claims to be 224 made against the bond or other comparable security arrangements 225 for up to 1 year after the vendor’s contract under the program 226 has ended with the agency or the state, the vendor’s license is 227 no longer valid, or the program has ended, whichever occurs 228 last. 229 (e) The vendor shall identify Canadian suppliers that are 230 in full compliance with relevant Canadian federal and provincial 231 laws and regulations and the federal act and who have agreed to 232 export drugs identified on the list at prices that will provide 233 cost savings to the state. The vendor must verify that such 234 Canadian suppliers meet all of the requirements of the program, 235 while meeting or exceeding the federal and state track-and-trace 236 laws and regulations. 237 (f) The vendor shall contract with such eligible Canadian 238 suppliers, or facilitate contracts between eligible importers 239 and Canadian suppliers, to import drugs under the program. 240 (g) The vendor shall maintain a list of all registered 241 importers that participate in the program. 242 (h) The vendor shall ensure compliance with Title II of the 243 federal Drug Quality and Security Act, Pub. L. No. 113-54, by 244 all suppliers, importers and other distributors, and 245 participants in the program. 246 (i) The vendor shall assist the agency in the preparation 247 of the annual report required by subsection (11), including the 248 timely provision of any information requested by the agency. 249 (j) The vendor shall provide an annual financial audit of 250 its operations to the agency as required by the agency. The 251 vendor shall also provide quarterly financial reports specific 252 to the program and shall include information on the performance 253 of its subcontractors and vendors. The agency shall determine 254 the format and contents of the reports. 255 (4) ELIGIBLE PRESCRIPTION DRUGS.—Eligible importers, as 256 described in subsection (6), may import a drug from an eligible 257 Canadian supplier, as described in subsection (5), if: 258 (a) The drug meets the United States Food and Drug 259 Administration’s standards related to safety, effectiveness, 260 misbranding, and adulteration; 261 (b) Importing the drug would not violate federal patent 262 laws; 263 (c) Importing the drug is expected to generate cost 264 savings; and 265 (d) The drug is not: 266 1. A controlled substance as defined in 21 U.S.C. s. 802; 267 2. A biological product as defined in 42 U.S.C. s. 262; 268 3. An infused drug; 269 4. An intravenously injected drug; 270 5. A drug that is inhaled during surgery; or 271 6. A drug that is a parenteral drug, the importation of 272 which is determined by the United States Secretary of Health and 273 Human Services to pose a threat to the public health. 274 (5) ELIGIBLE CANADIAN SUPPLIERS.—A Canadian supplier may 275 export prescription drugs into this state under the program if 276 the supplier: 277 (a) Is in full compliance with relevant Canadian federal 278 and provincial laws and regulations; 279 (b) Is identified by the vendor as eligible to participate 280 in the program; and 281 (c) Submits an attestation that the supplier has a 282 registered agent in the United States, including the name and 283 United States address of the registered agent. 284 (6) ELIGIBLE IMPORTERS.—The following entities may import 285 prescription drugs from an eligible Canadian supplier under the 286 program: 287 (a) A pharmacist or wholesaler employed by or under 288 contract with the department’s central pharmacy, for 289 distribution to a county health department or free clinic for 290 dispensing to clients treated in such department or clinic. 291 (b) A pharmacist or wholesaler employed by or under 292 contract with a Medicaid pharmacy, for dispensing to the 293 pharmacy’s Medicaid recipients. 294 (c) A pharmacist or wholesaler employed by or under 295 contract with the Department of Corrections, for dispensing to 296 inmates in the custody of the Department of Corrections. 297 (d) A pharmacist or wholesaler employed by or under 298 contract with a developmental disabilities center, as defined in 299 s. 393.063, for dispensing to clients treated in such center. 300 (e) A pharmacist or wholesaler employed by or under 301 contract with a treatment facility, as defined in s. 394.455, 302 for dispensing to patients treated in such facility. 303 (7) DISTRIBUTION REQUIREMENTS.—Eligible Canadian suppliers 304 and eligible importers participating under the program: 305 (a) Must comply with the tracking and tracing requirements 306 of 21 U.S.C. ss. 360eee et seq. 307 (b) May not distribute, dispense, or sell prescription 308 drugs imported under the program outside of the state. 309 (8) FEDERAL APPROVAL.—By July 1, 2020, the agency shall 310 submit a request to the United States Secretary of Health and 311 Human Services for approval of the program under 21 U.S.C. s. 312 384(l). The agency shall begin operating the program within 6 313 months after receiving such approval. The request must, at a 314 minimum: 315 (a) Describe the agency’s plan for operating the program. 316 (b) Demonstrate how the prescription drugs imported into 317 this state under the program will meet the applicable federal 318 and state standards for safety and effectiveness. 319 (c) Demonstrate how the drugs imported into this state 320 under the program will comply with federal tracing procedures. 321 (d) Include a list of proposed prescription drugs that have 322 the highest potential for cost savings to the state through 323 importation at the time that the request is submitted. 324 (e) Estimate the total cost savings attributable to the 325 program. 326 (f) Provide the costs of program implementation to the 327 state. 328 (g) Include a list of potential Canadian suppliers from 329 which the state would import drugs and demonstrate that the 330 suppliers are in full compliance with relevant Canadian federal 331 and provincial laws and regulations as well as all applicable 332 federal and state laws and regulations. 333 (9) PRESCRIPTION DRUG SUPPLY CHAIN DOCUMENTATION.— 334 (a) The vendor shall ensure the safety and quality of drugs 335 imported under the program. The vendor shall: 336 1. For an initial imported shipment, ensure that each batch 337 of the drug in the shipment is statistically sampled and tested 338 for authenticity and degradation in a manner consistent with the 339 federal act. 340 2. For any subsequent imported shipment, ensure that a 341 statistically valid sample of the shipment is tested for 342 authenticity and degradation in a manner consistent with the 343 federal act. 344 3. Certify that the drug: 345 a. Is approved for marketing in the United States and is 346 not adulterated or misbranded; and 347 b. Meets all of the labeling requirements under 21 U.S.C. 348 s. 352. 349 4. Maintain qualified laboratory records, including 350 complete data derived from all tests necessary to ensure that 351 the drug is in compliance with the requirements of this section. 352 5. Maintain documentation demonstrating that the testing 353 required by this section was conducted at a qualified laboratory 354 in accordance with the federal act and any other applicable 355 federal and state laws and regulations governing laboratory 356 qualifications. 357 (b) All testing required by this section must be conducted 358 in a qualified laboratory that meets the standards under the 359 federal act and any other applicable federal and state laws and 360 regulations governing laboratory qualifications for drug 361 testing. 362 (c) The vendor shall maintain information and documentation 363 submitted under this section for a period of at least 7 years. 364 (d) A participating importer must submit the all of 365 following information to the vendor: 366 1. The name and quantity of the active ingredient of the 367 drug. 368 2. A description of the dosage form of the drug. 369 3. The date on which the drug is received. 370 4. The quantity of the drug that is received. 371 5. The point of origin and destination of the drug. 372 6. The price paid by the importer for the drug. 373 (e) A participating Canadian supplier must submit the 374 following information and documentation to the vendor specifying 375 all of the following: 376 1. The original source of the drug, including: 377 a. The name of the manufacturer of the drug. 378 b. The date on which the drug was manufactured. 379 c. The location (country, state or province, and city) 380 where the drug was manufactured. 381 2. The date on which the drug is shipped. 382 3. The quantity of the drug that is shipped. 383 4. The quantity of each lot of the drug originally received 384 and the source of the lot. 385 5. The lot or control number and the batch number assigned 386 to the drug by the manufacturer. 387 (f) The agency may require that the vendor collect any 388 other information necessary to ensure the protection of the 389 public health. 390 (10) IMMEDIATE SUSPENSION.—The agency shall immediately 391 suspend the importation of a specific drug or the importation of 392 drugs by a specific importer if it discovers that any drug or 393 activity is in violation of this section or any federal or state 394 law or regulation. The agency may revoke the suspension if, 395 after conducting an investigation, it determines that the public 396 is adequately protected from counterfeit or unsafe drugs being 397 imported into this state. 398 (11) ANNUAL REPORT.—By December 1 of each year, the agency 399 shall submit a report to the Governor, the President of the 400 Senate, and the Speaker of the House of Representatives on the 401 operation of the program during the previous fiscal year. The 402 report must include, at a minimum: 403 (a) A list of the prescription drugs that were imported 404 under the program; 405 (b) The number of participating entities; 406 (c) The number of prescriptions dispensed through the 407 program; 408 (d) The estimated cost savings during the previous fiscal 409 year and to date attributable the program; 410 (e) A description of the methodology used to determine 411 which drugs should be included on the Wholesale Prescription 412 Drug Importation List; and 413 (f) Documentation as to how the program ensures the 414 following: 415 1. That Canadian suppliers participating in the program are 416 of high quality, high performance, and in full compliance with 417 relevant Canadian federal and provincial laws and regulations as 418 well as all federal laws and regulations and state laws and 419 rules; 420 2. That prescription drugs imported under the program are 421 not shipped, sold, or dispensed outside of this state once in 422 the possession of the importer; 423 3. That prescription drugs imported under the program are 424 pure, unadulterated, potent, and safe; 425 4. That the program does not put consumers at a higher 426 health and safety risk than if the consumer did not participate; 427 and 428 5. That the program provides cost savings to the state on 429 imported prescription drugs. 430 (12) NOTIFICATION OF FEDERAL APPROVAL.—Upon receipt of 431 federal approval of the program, the agency shall notify the 432 President of the Senate, the Speaker of the House of 433 Representatives, and the relevant committees of the Senate and 434 the House of Representatives. After approval is received and 435 before the start of the next regular session of the Legislature 436 in which the proposal could be funded, the agency shall submit 437 to all parties a proposal for program implementation and program 438 funding. 439 (13) RULEMAKING.—The agency shall adopt rules necessary to 440 implement this section. 441 Section 2. Section 465.0157, Florida Statutes, is created 442 to read: 443 465.0157 International export pharmacy permit.— 444 (1) To participate as an exporter of prescription drugs 445 into this state under the International Prescription Drug 446 Importation Program established in s. 499.0285, a pharmacy 447 located outside of the United States must hold an international 448 export pharmacy permit. 449 (2) An international export pharmacy shall maintain at all 450 times an active and unencumbered license or permit to operate 451 the pharmacy in compliance with the laws of the jurisdiction in 452 which the dispensing facility is located and from which the 453 prescription drugs will be exported. Such jurisdiction must be 454 in a country with which the United States has a current mutual 455 recognition agreement, cooperation agreement, memorandum of 456 understanding, or other federal mechanism recognizing the 457 country’s adherence to current good manufacturing practices for 458 pharmaceutical products. 459 (3) An application for an international export pharmacy 460 permit must be submitted on a form developed and provided by the 461 board. The board may require an applicant to provide any 462 information it deems reasonably necessary to carry out the 463 purposes of this section. 464 (4) An applicant shall submit the following to the board to 465 obtain an initial permit, or to the department to renew a 466 permit: 467 (a) Proof of an active and unencumbered license or permit 468 to operate the pharmacy in compliance with the laws of the 469 jurisdiction in which the dispensing facility is located and 470 from which the prescription drugs will be exported. 471 (b) Documentation demonstrating that the country in which 472 the pharmacy operates has a current mutual recognition 473 agreement, cooperation agreement, memorandum of understanding, 474 or other federal mechanism recognizing the country’s adherence 475 to current good manufacturing practices for pharmaceutical 476 products. 477 (c) Evidence of a surety bond with any application or 478 filing for pharmacy permit under this section and shall maintain 479 documentation of evidence of such a bond with the Department of 480 Business and Professional Regulation throughout the permit term. 481 The surety bond may be from this state or any other state in the 482 United States for no less than $25,000. The surety bond or 483 comparable security arrangement must include the State of 484 Florida as a beneficiary. In lieu of the surety bond, the 485 pharmacy may provide a comparable security agreement, such as an 486 irrevocable letter of credit or a deposit into a trust account 487 or financial institution which includes the State of Florida as 488 a beneficiary, payable to the State of Florida. The purposes of 489 the bond or other security arrangement for the program are to: 490 1. Ensure payment of any administrative penalties imposed 491 by the department or any other state agency under the contract 492 when the pharmacy fails to pay within 30 days after assessment; 493 2. Ensure that the pharmacy meets contractual and statutory 494 obligations through use of a surety bond or other comparable 495 security arrangements to pay any other costs or fees incurred by 496 the Department of Business of Professional Regulation, the 497 state, or other entities acting on behalf of the state if the 498 pharmacy fails to meet its obligations. If the pharmacy is 499 assessed a penalty under the program and fails to pay within 30 500 days after that assessment, the Department of Business and 501 Professional Regulation, the state, or an entity acting on 502 behalf of the state may file a claim for reimbursement against 503 the bond or other comparable security arrangement; and 504 3. Allow for claims to be made against the bond or other 505 comparable security arrangements for up to 1 year after the 506 pharmacy’s permit under the program has ended with this section 507 or the program has ended, whichever occurs last. 508 (d) The eligible pharmacy must submit evidence at the time 509 of application and throughout the permit term of a surety bond 510 or comparable security arrangement from this state or any other 511 state in the United States in an amount no less than $25,000. 512 The surety bond or comparable security arrangement must include 513 the State of Florida as a beneficiary. In lieu of the surety 514 bond, the pharmacy may provide a comparable security arrangement 515 such as an irrevocable letter of credit or a deposit into a 516 trust account or financial institution which names the State of 517 Florida as a beneficiary. The purposes of the bond or other 518 security arrangements for the program are to: 519 1. Ensure participation of the pharmacy in any civil or 520 criminal legal action by the state, the Department of Business 521 of Professional Regulation, any other state agency, or private 522 individuals or entities against the pharmacy or because of the 523 pharmacy’s failure to perform under the contract, including, but 524 not limited to causes of actions for personal injury, 525 negligence, and wrongful death; 526 2. Ensure payment by the pharmacy through the use of a bond 527 or other comparable security arrangements of legal judgements 528 and claims that have been awarded to the Department of Business 529 and Professional Regulation, the state, other entities acting on 530 behalf of the state, individuals, or organizations if the 531 pharmacy is assessed a final judgement or other monetary penalty 532 in a court of law for a civil or criminal action under the 533 program. The bond or comparable security arrangement will be 534 accessed if the pharmacy fails to pay any judgement or claim 535 within 60 days after final judgement; and 536 3. Allow for civil and criminal litigation claims to be 537 made against the bond or other comparable security arrangements 538 for up to 1 year after the pharmacy’s contract under the program 539 has ended with the agency or the state, the pharmacy’s license 540 is no longer valid, or the program has ended, whichever occurs 541 last. 542 (e) The location, names, and titles of all principal 543 corporate officers and the pharmacist who serves as the 544 prescription department manager for prescription drugs exported 545 into this state under the International Prescription Drug 546 Importation Program. 547 (f) Written attestation by an owner or officer of the 548 applicant, and by the applicant’s prescription department 549 manager, that: 550 1. The attestor has read and understands the laws and rules 551 governing the manufacture, distribution, and dispensing of 552 prescription drugs in this state. 553 2. A prescription drug shipped, mailed, or delivered into 554 this state meets or exceeds this state’s standards for safety 555 and efficacy. 556 3. A prescription drug product shipped, mailed, or 557 delivered into this state must not have been, and may not be, 558 manufactured or distributed in violation of the laws and rules 559 of the jurisdiction in which the applicant is located and from 560 which the prescription drugs shall be exported. 561 (g) A current inspection report from an inspection 562 conducted by the regulatory or licensing agency of the 563 jurisdiction in which the applicant is located. The inspection 564 report must reflect compliance with this section. An inspection 565 report is current if the inspection was conducted within 6 566 months before the date of submitting the application for the 567 initial permit or within 1 year before the date of submitting an 568 application for permit renewal. If the applicant is unable to 569 submit a current inspection report conducted by the regulatory 570 or licensing agency of the jurisdiction in which the applicant 571 is located and from which the prescription drugs will be 572 exported, due to acceptable circumstances, as established by 573 rule, or if an inspection has not been performed, the department 574 must: 575 1. Conduct, or contract with an entity to conduct, an 576 onsite inspection, with all related costs borne by the 577 applicant; 578 2. Accept a current and satisfactory inspection report, as 579 determined by rule, from an entity approved by the board; or 580 3. Accept a current inspection report from the United 581 States Food and Drug Administration conducted pursuant to the 582 federal Drug Quality and Security Act, Pub. L. No. 113-54. 583 Section 3. Subsection (2) of section 465.017, Florida 584 Statutes, is amended to read: 585 465.017 Authority to inspect; disposal.— 586 (2) Duly authorized agents and employees of the department 587 may inspect a nonresident pharmacy registered under s. 465.0156, 588 an international export pharmacy permittee under s. 465.0157, or 589 a nonresident sterile compounding permittee under s. 465.0158 590 pursuant to this section. The costs of such inspections shall be 591 borne by such pharmacy or permittee. 592 Section 4. Subsection (20) of section 499.005, Florida 593 Statutes, is amended to read: 594 499.005 Prohibited acts.—It is unlawful for a person to 595 perform or cause the performance of any of the following acts in 596 this state: 597 (20) The importation of a prescription drug except as 598 provided by s. 801(d) of the Federal Food, Drug, and Cosmetic 599 Act or s. 499.0285. 600 Section 5. Paragraph (e) of subsection (12) of section 601 499.0051, Florida Statutes, is amended to read: 602 499.0051 Criminal acts.— 603 (12) REFUSAL TO ALLOW INSPECTION; SELLING, PURCHASING, OR 604 TRADING DRUG SAMPLES; FAILURE TO MAINTAIN RECORDS RELATING TO 605 PRESCRIPTION DRUGS.—Any person who violates any of the following 606 provisions commits a felony of the third degree, punishable as 607 provided in s. 775.082, s. 775.083, or s. 775.084, or as 608 otherwise provided in this part: 609 (e) The importation of a prescription drug for wholesale 610 distribution, except as provided by s. 801(d) of the Federal 611 Food, Drug, and Cosmetic Act or s. 499.0285. 612 Section 6. Subsection (1) and paragraph (c) of subsection 613 (2) of section 499.01, Florida Statutes, are amended, and 614 paragraph (s) is added to subsection (2) of that section, to 615 read: 616 499.01 Permits.— 617 (1) Before operating, a permit is required for each person 618 and establishment that intends to operate as: 619 (a) A prescription drug manufacturer; 620 (b) A prescription drug repackager; 621 (c) A nonresident prescription drug manufacturer; 622 (d) A nonresident prescription drug repackager; 623 (e) A prescription drug wholesale distributor; 624 (f) An out-of-state prescription drug wholesale 625 distributor; 626 (g) A retail pharmacy drug wholesale distributor; 627 (h) A restricted prescription drug distributor; 628 (i) A complimentary drug distributor; 629 (j) A freight forwarder; 630 (k) A veterinary prescription drug retail establishment; 631 (l) A veterinary prescription drug wholesale distributor; 632 (m) A limited prescription drug veterinary wholesale 633 distributor; 634 (n) An over-the-counter drug manufacturer; 635 (o) A device manufacturer; 636 (p) A cosmetic manufacturer; 637 (q) A third party logistics provider;or638 (r) A health care clinic establishment; or 639 (s) An international prescription drug wholesale 640 distributor. 641 (2) The following permits are established: 642 (c) Nonresident prescription drug manufacturer permit.—A 643 nonresident prescription drug manufacturer permit is required 644 for any person that is a manufacturer of prescription drugs, 645 unless permitted as a third party logistics provider, located 646 outside of this state or outside the United States and that 647 engages in the distribution in this state of such prescription 648 drugs. Each such manufacturer must be permitted by the 649 department and comply with all of the provisions required of a 650 prescription drug manufacturer under this part. The department 651 shall adopt rules for issuing a virtual nonresident prescription 652 drug manufacturer permit to a person who engages in the 653 manufacture of prescription drugs but does not make or take 654 physical possession of any prescription drugs. The rules adopted 655 by the department under this section may exempt virtual 656 nonresident manufacturers from certain establishment, security, 657 and storage requirements set forth in s. 499.0121. 658 1. A person that distributes prescription drugs for which 659 the person is not the manufacturer must also obtain an out-of 660 state prescription drug wholesale distributor permit, an 661 international prescription drug wholesale distributor permit, or 662 third party logistics provider permit pursuant to this section 663 to engage in the distribution of such prescription drugs when 664 required by this part. This subparagraph does not apply to a 665 manufacturer that distributes prescription drugs only for the 666 manufacturer of the prescription drugs where both manufacturers 667 are affiliates. 668 2. Any such person must comply with the licensing or 669 permitting requirements of the jurisdiction in which the 670 establishment is located and the federal act, and any 671 prescription drug distributed into this state must comply with 672 this part. If a person intends to import prescription drugs from 673 a foreign country into this state, the nonresident prescription 674 drug manufacturer must provide to the department a list 675 identifying each prescription drug it intends to import and 676 document approval by the United States Food and Drug 677 Administration for such importation. 678 3.a. A nonresident prescription drug manufacturer that has 679 registered to participate in the International Prescription Drug 680 Importation Program pursuant to this section is not required to 681 provide the list and approval required by subparagraph 2. for 682 prescription drugs imported under that program. 683 b. To participate as an exporter of prescription drugs into 684 this state under the International Prescription Drug Importation 685 Program established under s. 499.0285, a nonresident 686 prescription drug manufacturer located outside of the United 687 States must register with the Department of Business and 688 Professional Regulation before engaging in any activities under 689 that section. Such manufacturer must be licensed or permitted in 690 a country with which the United States has a current mutual 691 recognition agreement, cooperation agreement, memorandum of 692 understanding, or other federal mechanism recognizing the 693 country’s adherence to current good manufacturing practices for 694 pharmaceutical products. 695 c. The nonresident prescription drug manufacturer shall 696 submit evidence of a surety bond with any application or filing 697 for registration under this section and shall maintain 698 documentation of evidence of such a bond with the Department of 699 Business and Professional Regulation throughout the registration 700 term. The surety bond may be from this state or any other state 701 in the United States in an amount equal to 10 percent of the 702 manufacturer’s annual sales or $1 million, whichever is higher. 703 The surety bond or comparable security arrangement must include 704 the State of Florida as a beneficiary. In lieu of the surety 705 bond, the manufacturer may provide a comparable security 706 agreement, such as an irrevocable letter of credit or a deposit 707 into a trust account or financial institution which includes the 708 State of Florida as a beneficiary, payable to the State of 709 Florida. The purposes of the bond or other security arrangement 710 for the program are to: 711 (I) Ensure payment of any administrative penalties imposed 712 by the Department of Business and Professional Regulation or any 713 other state agency under the contract when the manufacturer 714 fails to pay within 30 days after assessment; 715 (II) Ensure that if the manufacturer fails to meets its 716 obligations through use of a surety bond or other comparable 717 security arrangements to pay any other costs or fees incurred by 718 the Department of Business of Professional Regulation, the 719 state, or other entities acting on behalf of the state if the 720 manufacturer fails to meet its obligations. If the manufacturer 721 is assessed a penalty under the program and fails to pay within 722 30 days after that assessment, the Department of Business and 723 Professional Regulation, the state, or an entity acting on 724 behalf of the state may file a claim for reimbursement against 725 the bond or other comparable security arrangement; and 726 (III) Allow for claims to be made against the bond or other 727 comparable security arrangements for up to 1 year after the 728 manufacturer’s permit under the program has ended with this 729 section or the program has ended, whichever occurs last. 730 4. The eligible manufacturer must submit evidence at the 731 time of application and throughout the permit term of a surety 732 bond or comparable security arrangement from this state or any 733 other state in the United States in an amount equal to 10 734 percent of the manufacturer’s annual sales or $1 million, 735 whichever is greater. The surety bond or comparable security 736 arrangement must include the State of Florida as a beneficiary. 737 In lieu of the surety bond, the manufacturer may provide a 738 comparable security arrangement such as an irrevocable letter of 739 credit or a deposit into a trust account or financial 740 institution which names the State of Florida as a beneficiary. 741 The purposes of the bond or other security arrangements for the 742 program are to: 743 a. Ensure participation of the manufacturer in any civil or 744 criminal legal action by the state, the Department of Business 745 of Professional Regulation, any other state agency, or private 746 individuals or entities against the manufacturer or because of 747 the manufacturer’s failure to perform according to the contract, 748 permit, or federal or state law and regulations, including, but 749 not limited to causes of actions for personal injury, 750 negligence, and wrongful death; 751 b. Ensure payment by the manufacturer through the use of a 752 bond or other comparable security arrangements of legal 753 judgements and claims that have been awarded to the Department 754 of Business and Professional Regulation, the state, other 755 entities acting on behalf of the state, individuals, or 756 organizations if the pharmacy is assessed a final judgement or 757 other monetary penalty in a court of law for a civil or criminal 758 action under the program. The bond or comparable security 759 arrangement will be accessed if the manufacturer fails to pay 760 any judgement or claim within 60 days after final judgement; and 761 c. Allow for civil and criminal litigation claims to be 762 made against the bond or other comparable security arrangements 763 for up to 1 year after the manufacturer’s permit under the 764 program has ended with the Department of Professional and 765 Business Regulation or the state, the manufacturer’s permit or 766 comparable legal document is no longer valid, or the program has 767 ended, whichever occurs last. 768 (s) International prescription drug wholesale distributor.— 769 1. A wholesale distributor located outside of the United 770 States must obtain an international prescription drug wholesale 771 distributor permit to engage in the wholesale exportation and 772 distribution of prescription drugs in the state under the 773 International Prescription Drug Importation Program established 774 in s. 499.0285. The wholesale distributor must be licensed or 775 permitted to operate in a country with which the United States 776 has a mutual recognition agreement, cooperation agreement, 777 memorandum of understanding, or other federal mechanism 778 recognizing the country’s adherence to current good 779 manufacturing practices for pharmaceutical products. The 780 wholesale distributor must maintain at all times a license or 781 permit to engage in the wholesale distribution of prescription 782 drugs in compliance with the laws of the jurisdiction in which 783 it operates. An international prescription drug wholesale 784 distributor permit may not be issued to a wholesale distributor 785 if the jurisdiction in which the wholesale distributor operates 786 does not require a license to engage in the wholesale 787 distribution of prescription drugs. 788 2. In order to participate in the International 789 Prescription Drug Importation Program established under s. 790 499.0285, the international wholesale distributor shall submit 791 evidence of a surety bond with any application or filing for a 792 permit under this section and shall maintain documentation of 793 evidence of such a bond with the Department of Business and 794 Professional Regulation throughout the permit term. The surety 795 bond may be from this state or any other state in the United 796 States in an amount equal to 10 percent of the international 797 wholesale distributor’s annual sales or $1 million, whichever is 798 greater. The surety bond or comparable security arrangement must 799 include the State of Florida as a beneficiary. In lieu of the 800 surety bond, the wholesale distributor may provide a comparable 801 security agreement, such as an irrevocable letter of credit or a 802 deposit into a trust account or financial institution which 803 names the State of Florida as a beneficiary. The purposes of the 804 bond or other security arrangement for the program are to: 805 a. Ensure payment of any administrative penalties imposed 806 by the Department of Business and Professional Regulation or any 807 other state agency under the contract when the wholesale 808 distributor fails to pay within 30 days after assessment; 809 b. Ensure that the wholesale distributor meets contractual 810 and statutory obligations through use of a surety bond or other 811 comparable security arrangements to pay any other costs or fees 812 incurred by the Department of Business of Professional 813 Regulation, the state, or other entities acting on behalf of the 814 state if the wholesale distributor fails to meet its 815 obligations. If the wholesale distributor is assessed a penalty 816 under the program and fails to pay within 30 days after that 817 assessment, the Department of Business and Professional 818 Regulation, the state, or an entity acting on behalf of the 819 state may file a claim for reimbursement against the bond or 820 other comparable security arrangement; and 821 c. Allow for claims to be made against the bond or other 822 comparable security arrangements for up to 1 year after the 823 wholesale distributor’s permit under the program has ended with 824 this section or the program has ended, whichever occurs last. 825 3. The eligible wholesale distributor must submit evidence 826 at the time of application and throughout the permit term of a 827 surety bond or comparable security arrangement from this state 828 or any other state in the United States in an amount equal to 10 829 percent of the international wholesale distributor’s annual 830 sales or $1 million, whichever is greater. The surety bond or 831 comparable security arrangement must include the State of 832 Florida as a beneficiary. In lieu of the surety bond, the 833 wholesale distributor may provide a comparable security 834 arrangement such as an irrevocable letter of credit or a deposit 835 into a trust account or financial institution which names the 836 State of Florida as a beneficiary. The purposes of the bond or 837 other security arrangements for the program are to: 838 a. Ensure participation of the wholesale distributor in any 839 civil or criminal legal action by the state, the Department of 840 Business of Professional Regulation, any other state agency, or 841 private individuals or entities against the wholesale 842 distributor or because of the wholesale distributor’s failure to 843 perform under the contract, including, but not limited to causes 844 of actions for personal injury, negligence, and wrongful death; 845 b. Ensure payment by the wholesale distributor through the 846 use of a bond or other comparable security arrangements of legal 847 judgements and claims that have been awarded to the Department 848 of Business and Professional Regulation, the state, other 849 entities acting on behalf of the state, individuals, or 850 organizations if the wholesale distributor is assessed a final 851 judgement or other monetary penalty in a court of law for a 852 civil or criminal action under the program. The bond or 853 comparable security arrangement will be accessed if the 854 wholesale distributor fails to pay any judgement or claim within 855 60 days after final judgement; and 856 c. Allow for civil and criminal litigation claims to be 857 made against the bond or other comparable security arrangements 858 for up to 1 year after the wholesale distributor’s permit under 859 the program has ended with the agency or the state, the 860 pharmacy’s permit or comparable legal document is no longer 861 valid, or the program has ended, whichever occurs last. 862 Section 7. Subsection (2), paragraph (a) of subsection (4), 863 subsections (8), (10), (11), and (14), and paragraphs (a), (b), 864 and (f) of subsection (15) of section 499.012, Florida Statutes, 865 are amended to read: 866 499.012 Permit application requirements.— 867 (2) Notwithstanding subsection (6), a permitted person in 868 good standing may change the type of permit issued to that 869 person by completing a new application for the requested permit, 870 paying the amount of the difference in the permit fees if the 871 fee for the new permit is more than the fee for the original 872 permit, and meeting the applicable permitting conditions for the 873 new permit type. The new permit expires on the expiration date 874 of the original permit being changed; however, a new permit for 875 a prescription drug wholesale distributor, an out-of-state 876 prescription drug wholesale distributor, an international 877 prescription drug wholesale distributor, or a retail pharmacy 878 drug wholesale distributor shall expire on the expiration date 879 of the original permit or 1 year after the date of issuance of 880 the new permit, whichever is earlier. A refund may not be issued 881 if the fee for the new permit is less than the fee that was paid 882 for the original permit. 883 (4)(a) Except for a permit for a prescription drug 884 wholesale distributor, an international prescription drug 885 wholesale distributor, or an out-of-state prescription drug 886 wholesale distributor, an application for a permit must include: 887 1. The name, full business address, and telephone number of 888 the applicant; 889 2. All trade or business names used by the applicant; 890 3. The address, telephone numbers, and the names of contact 891 persons for each facility used by the applicant for the storage, 892 handling, and distribution of prescription drugs; 893 4. The type of ownership or operation, such as a 894 partnership, corporation, or sole proprietorship; and 895 5. The names of the owner and the operator of the 896 establishment, including: 897 a. If an individual, the name of the individual; 898 b. If a partnership, the name of each partner and the name 899 of the partnership; 900 c. If a corporation, the name and title of each corporate 901 officer and director, the corporate names, and the name of the 902 state of incorporation; 903 d. If a sole proprietorship, the full name of the sole 904 proprietor and the name of the business entity; 905 e. If a limited liability company, the name of each member, 906 the name of each manager, the name of the limited liability 907 company, and the name of the state in which the limited 908 liability company was organized; and 909 f. Any other relevant information that the department 910 requires. 911 (8) An application for a permit or to renew a permit for a 912 prescription drug wholesale distributor, an international 913 prescription drug wholesale distributor, or an out-of-state 914 prescription drug wholesale distributor submitted to the 915 department must include: 916 (a) The name, full business address, and telephone number 917 of the applicant. 918 (b) All trade or business names used by the applicant. 919 (c) The address, telephone numbers, and the names of 920 contact persons for each facility used by the applicant for the 921 storage, handling, and distribution of prescription drugs. 922 (d) The type of ownership or operation, such as a 923 partnership, corporation, or sole proprietorship. 924 (e) The names of the owner and the operator of the 925 establishment, including: 926 1. If an individual, the name of the individual. 927 2. If a partnership, the name of each partner and the name 928 of the partnership. 929 3. If a corporation: 930 a. The name, address, and title of each corporate officer 931 and director. 932 b. The name and address of the corporation, resident agent 933 of the corporation, the resident agent’s address, and the 934 corporation’s state of incorporation. 935 c. The name and address of each shareholder of the 936 corporation that owns 5 percent or more of the outstanding stock 937 of the corporation. 938 4. If a sole proprietorship, the full name of the sole 939 proprietor and the name of the business entity. 940 5. If a limited liability company: 941 a. The name and address of each member. 942 b. The name and address of each manager. 943 c. The name and address of the limited liability company, 944 the resident agent of the limited liability company, and the 945 name of the state in which the limited liability company was 946 organized. 947 (f) If applicable, the name and address of each affiliate 948 of the applicant. 949 (g) The applicant’s gross annual receipts attributable to 950 prescription drug wholesale distribution activities for the 951 previous tax year. 952 (h) The tax year of the applicant. 953 (i) A copy of the deed for the property on which 954 applicant’s establishment is located, if the establishment is 955 owned by the applicant, or a copy of the applicant’s lease for 956 the property on which applicant’s establishment is located that 957 has an original term of not less than 1 calendar year, if the 958 establishment is not owned by the applicant. 959 (j) A list of all licenses and permits issued to the 960 applicant by any other state or jurisdiction which authorize the 961 applicant to purchase or possess prescription drugs. 962 (k) The name of the manager of the establishment that is 963 applying for the permit or to renew the permit, the next four 964 highest ranking employees responsible for prescription drug 965 wholesale operations for the establishment, and the name of all 966 affiliated parties for the establishment, together with the 967 personal information statement and fingerprints required 968 pursuant to subsection (9) for each of such persons. 969 (l) The name of each of the applicant’s designated 970 representatives as required by subsection (15), together with 971 the personal information statement and fingerprints required 972 pursuant to subsection (9) for each such person. 973 (m) Evidence of a surety bond in this state or any other 974 state in the United States in the amount of $100,000. If the 975 annual gross receipts of the applicant’s previous tax year are 976 $10 million or less, evidence of a surety bond in the amount of 977 $25,000. The specific language of the surety bond must include 978 the State of Florida as a beneficiary, payable to the 979 Professional Regulation Trust Fund. In lieu of the surety bond, 980 the applicant may provide other equivalent security such as an 981 irrevocable letter of credit, or a deposit in a trust account or 982 financial institution, which includes the State of Florida as a 983 beneficiary, payable to the Professional Regulation Trust Fund. 984 The purpose of the bond or other security is to secure payment 985 of any administrative penalties imposed by the department and 986 any fees and costs incurred by the department regarding that 987 permit which are authorized under state law and which the 988 permittee fails to pay 30 days after the fine or costs become 989 final. The department may make a claim against such bond or 990 security until 1 year after the permittee’s license ceases to be 991 valid or until 60 days after any administrative or legal 992 proceeding authorized in this part which involves the permittee 993 is concluded, including any appeal, whichever occurs later. 994 (n) For establishments used in wholesale distribution, 995 proof of an inspection conducted by the department, the United 996 States Food and Drug Administration, or another governmental 997 entity charged with the regulation of good manufacturing 998 practices related to wholesale distribution of prescription 999 drugs, within timeframes set forth by the department in 1000 departmental rules, which demonstrates substantial compliance 1001 with current good manufacturing practices applicable to 1002 wholesale distribution of prescription drugs. The department may 1003 recognize another state’s or jurisdiction’s inspection of a 1004 wholesale distributor located in that state or jurisdiction if 1005 such state’s or jurisdiction’s laws are deemed to be 1006 substantially equivalent to the law of this state by the 1007 department. The department may accept an inspection by a third 1008 party accreditation or inspection service which meets the 1009 criteria set forth in department rule. 1010 (o) Any other relevant information that the department 1011 requires. 1012 (p) Documentation of the credentialing policies and 1013 procedures required by s. 499.0121(15). 1014 (q) For international prescription drug wholesale 1015 distributors and nonresident prescription drug manufacturers to 1016 participate in the International Prescription Drug Importation 1017 Program established under s. 499.0285, documentation 1018 demonstrating that the applicant is appropriately licensed or 1019 permitted by a country with which the United States has a mutual 1020 recognition agreement, cooperation agreement, memorandum of 1021 understanding, or other mechanism recognizing the country’s 1022 adherence to current good manufacturing practices for 1023 pharmaceutical products. 1024 (10) The department may deny an application for a permit or 1025 refuse to renew a permit for a prescription drug wholesale 1026 distributor, an international prescription drug wholesale 1027 distributor, or an out-of-state prescription drug wholesale 1028 distributor if: 1029 (a) The applicant has not met the requirements for the 1030 permit. 1031 (b) The management, officers, or directors of the applicant 1032 or any affiliated party are found by the department to be 1033 incompetent or untrustworthy. 1034 (c) The applicant is so lacking in experience in managing a 1035 wholesale distributor as to make the issuance of the proposed 1036 permit hazardous to the public health. 1037 (d) The applicant is so lacking in experience in managing a 1038 wholesale distributor as to jeopardize the reasonable promise of 1039 successful operation of the wholesale distributor. 1040 (e) The applicant is lacking in experience in the 1041 distribution of prescription drugs. 1042 (f) The applicant’s past experience in manufacturing or 1043 distributing prescription drugs indicates that the applicant 1044 poses a public health risk. 1045 (g) The applicant is affiliated directly or indirectly 1046 through ownership, control, or other business relations, with 1047 any person or persons whose business operations are or have been 1048 detrimental to the public health. 1049 (h) The applicant, or any affiliated party, has been found 1050 guilty of or has pleaded guilty or nolo contendere to any felony 1051 or crime punishable by imprisonment for 1 year or more under the 1052 laws of the United States, any state, or any other country, 1053 regardless of whether adjudication of guilt was withheld. 1054 (i) The applicant or any affiliated party has been charged 1055 with a felony in a state or federal court and the disposition of 1056 that charge is pending during the application review or renewal 1057 review period. 1058 (j) The applicant has furnished false or fraudulent 1059 information or material in any application made in this state or 1060 any other state in connection with obtaining a permit or license 1061 to manufacture or distribute drugs, devices, or cosmetics. 1062 (k) That a federal, state, or local government permit 1063 currently or previously held by the applicant, or any affiliated 1064 party, for the manufacture or distribution of any drugs, 1065 devices, or cosmetics has been disciplined, suspended, or 1066 revoked and has not been reinstated. 1067 (l) The applicant does not possess the financial or 1068 physical resources to operate in compliance with the permit 1069 being sought, this chapter, and the rules adopted under this 1070 chapter. 1071 (m) The applicant or any affiliated party receives, 1072 directly or indirectly, financial support and assistance from a 1073 person who was an affiliated party of a permittee whose permit 1074 was subject to discipline or was suspended or revoked, other 1075 than through the ownership of stock in a publicly traded company 1076 or a mutual fund. 1077 (n) The applicant or any affiliated party receives, 1078 directly or indirectly, financial support and assistance from a 1079 person who has been found guilty of any violation of this part 1080 or chapter 465, chapter 501, or chapter 893, any rules adopted 1081 under this part or those chapters, any federal or state drug 1082 law, or any felony where the underlying facts related to drugs, 1083 regardless of whether the person has been pardoned, had her or 1084 his civil rights restored, or had adjudication withheld, other 1085 than through the ownership of stock in a publicly traded company 1086 or a mutual fund. 1087 (o) The applicant for renewal of a permit under s. 1088 499.01(2)(e) or (f) has not actively engaged in the wholesale 1089 distribution of prescription drugs, as demonstrated by the 1090 regular and systematic distribution of prescription drugs 1091 throughout the year as evidenced by not fewer than 12 wholesale 1092 distributions in the previous year and not fewer than three 1093 wholesale distributions in the previous 6 months. 1094 (p) Information obtained in response to s. 499.01(2)(e) or 1095 (f) demonstrates it would not be in the best interest of the 1096 public health, safety, and welfare to issue a permit. 1097 (q) The applicant does not possess the financial standing 1098 and business experience for the successful operation of the 1099 applicant. 1100 (r) The applicant or any affiliated party has failed to 1101 comply with the requirements for manufacturing or distributing 1102 prescription drugs under this part, similar federal laws, 1103 similar laws in other states, or the rules adopted under such 1104 laws. 1105 (11) Upon approval of the application by the department and 1106 payment of the required fee, the department shall issue or renew 1107 a prescription drug wholesale distributor, an international 1108 prescription drug wholesale distributor, or an out-of-state 1109 prescription drug wholesale distributor permit to the applicant. 1110 (14) The name of a permittee or establishment on a 1111 prescription drug wholesale distributor permit, an international 1112 prescription drug wholesale distributor permit, or an out-of 1113 state prescription drug wholesale distributor permit may not 1114 include any indicia of attainment of any educational degree, any 1115 indicia that the permittee or establishment possesses a 1116 professional license, or any name or abbreviation that the 1117 department determines is likely to cause confusion or mistake or 1118 that the department determines is deceptive, including that of 1119 any other entity authorized to purchase prescription drugs. 1120 (15)(a) Each establishment that is issued an initial or 1121 renewal permit as a prescription drug wholesale distributor, an 1122 international prescription drug wholesale distributor, or an 1123 out-of-state prescription drug wholesale distributor must 1124 designate in writing to the department at least one natural 1125 person to serve as the designated representative of the 1126 wholesale distributor. Such person must have an active 1127 certification as a designated representative from the 1128 department. 1129 (b) To be certified as a designated representative, a 1130 natural person must: 1131 1. Submit an application on a form furnished by the 1132 department and pay the appropriate fees. 1133 2. Be at least 18 years of age. 1134 3. Have at least 2 years of verifiable full-time: 1135 a. Work experience in a pharmacy licensed in this state or 1136 another state or jurisdiction, where the person’s 1137 responsibilities included, but were not limited to, 1138 recordkeeping for prescription drugs; 1139 b. Managerial experience with a prescription drug wholesale 1140 distributor licensed in this state or in another state or 1141 jurisdiction; or 1142 c. Managerial experience with the United States Armed 1143 Forces, where the person’s responsibilities included, but were 1144 not limited to, recordkeeping, warehousing, distributing, or 1145 other logistics services pertaining to prescription drugs. 1146 4. Receive a passing score of at least 75 percent on an 1147 examination given by the department regarding federal laws 1148 governing distribution of prescription drugs and this part and 1149 the rules adopted by the department governing the wholesale 1150 distribution of prescription drugs. This requirement shall be 1151 effective 1 year after the results of the initial examination 1152 are mailed to the persons that took the examination. The 1153 department shall offer such examinations at least four times 1154 each calendar year. 1155 5. Provide the department with a personal information 1156 statement and fingerprints pursuant to subsection (9). 1157 (f) A wholesale distributor may not operate under a 1158 prescription drug wholesale distributor permit, an international 1159 prescription drug wholesale distributor permit, or an out-of 1160 state prescription drug wholesale distributor permit for more 1161 than 10 business days after the designated representative leaves 1162 the employ of the wholesale distributor, unless the wholesale 1163 distributor employs another designated representative and 1164 notifies the department within 10 business days of the identity 1165 of the new designated representative. 1166 Section 8. Subsection (1) of section 499.015, Florida 1167 Statutes, is amended to read: 1168 499.015 Registration of drugs and devices; issuance of 1169 certificates of free sale.— 1170 (1)(a) Except for those persons exempted from the 1171 definition of manufacturer in s. 499.003, any person who 1172 manufactures, packages, repackages, labels, or relabels a drug 1173 or device in this state must register such drug or device 1174 biennially with the department; pay a fee in accordance with the 1175 fee schedule provided by s. 499.041; and comply with this 1176 section. The registrant must list each separate and distinct 1177 drug or device at the time of registration. 1178 (b) The department may not register any product that does 1179 not comply with the Federal Food, Drug, and Cosmetic Act, as 1180 amended, or Title 21 C.F.R. Registration of a product by the 1181 department does not mean that the product does in fact comply 1182 with all provisions of the Federal Food, Drug, and Cosmetic Act, 1183 as amended. 1184 (c) Registration under this section is not required for 1185 prescription drugs imported under the International Prescription 1186 Drug Importation Program established in s. 499.0285. 1187 Section 9. Subsections (1) and (3) of section 499.065, 1188 Florida Statutes, are amended to read: 1189 499.065 Inspections; imminent danger.— 1190 (1) Notwithstanding s. 499.051, the department shall 1191 inspect each prescription drug wholesale distributor 1192 establishment, international prescription drug wholesale 1193 distributor establishment, prescription drug repackager 1194 establishment, veterinary prescription drug wholesale 1195 distributor establishment, limited prescription drug veterinary 1196 wholesale distributor establishment, and retail pharmacy drug 1197 wholesale distributor establishment that is required to be 1198 permitted under this part as often as necessary to ensure 1199 compliance with applicable laws and rules. The department shall 1200 have the right of entry and access to these facilities at any 1201 reasonable time. 1202 (3) The department may determine that a prescription drug 1203 wholesale distributor establishment, international prescription 1204 drug wholesale distributor establishment, prescription drug 1205 repackager establishment, veterinary prescription drug wholesale 1206 distributor establishment, limited prescription drug veterinary 1207 wholesale distributor establishment, or retail pharmacy drug 1208 wholesale distributor establishment that is required to be 1209 permitted under this part is an imminent danger to the public 1210 health and shall require its immediate closure if the 1211 establishment fails to comply with applicable laws and rules 1212 and, because of the failure, presents an imminent threat to the 1213 public’s health, safety, or welfare. Any establishment so deemed 1214 and closed shall remain closed until allowed by the department 1215 or by judicial order to reopen. 1216 Section 10. Section 499.0285, Florida Statutes, is created 1217 to read: 1218 499.0285 International Prescription Drug Importation 1219 Program.— 1220 (1) PROGRAM ESTABLISHED.—The department shall establish a 1221 program for the importation of safe and effective prescription 1222 drugs from foreign nations with which the United States has 1223 current mutual recognition agreements, cooperation agreements, 1224 memoranda of understanding, or other federal mechanisms 1225 recognizing their adherence to current good manufacturing 1226 practices for pharmaceutical products. The program shall be open 1227 to individual Florida residents and to those participating in 1228 the Canadian Drug Importation Program under s. 381.02035. 1229 (2) DEFINITIONS.—As used in this section, the term: 1230 (a) “Exporter” means an international prescription drug 1231 wholesale distributor, a nonresident prescription drug 1232 manufacturer registered to participate in the program, or an 1233 international export pharmacy that exports prescription drugs 1234 into this state under the program. 1235 (b) “Federal Act” means the Federal Food, Drug, and 1236 Cosmetic Act, 21 U.S.C. ss. 301 et seq.; 52 Stat. 1040 et seq. 1237 as amended by the Drug Quality and Security Act, 21 U.S.C. 351 1238 et seq. 1239 (c) “Foreign recipient” means an entity other than the 1240 original prescription drug manufacturer which receives the 1241 prescription drug before its importation into this state under 1242 the program. 1243 (d) “Good manufacturing practice” refers to the good 1244 manufacturing practice regulations in 21 C.F.R. parts 210 and 1245 211. 1246 (e) “Importer” means a wholesale distributor, pharmacy, or 1247 pharmacist importing prescription drugs into this state under 1248 the program. 1249 (f) “International export pharmacy” means a pharmacy 1250 located outside of the United States which holds an active and 1251 unencumbered permit under chapter 465 to export prescription 1252 drugs into this state under the program. 1253 (g) “International prescription drug wholesale distributor” 1254 means a prescription drug wholesale distributor located outside 1255 of the United States which holds an active and unencumbered 1256 permit under this part to export and distribute prescription 1257 drugs into this state under the program. 1258 (h) “Nonresident prescription drug manufacturer” means an 1259 entity located outside of the United States which holds an 1260 active and unencumbered permit under this part to manufacture 1261 prescription drugs and has registered with the department to 1262 export and distribute such prescription drugs into this state 1263 under the program. 1264 (i) “Pharmacist” means a person who holds an active and 1265 unencumbered license to practice pharmacy under chapter 465. 1266 (j) “Pharmacy” means an entity that holds an active and 1267 unencumbered permit under chapter 465. 1268 (k) “Prescription drug” has the same meaning as defined in 1269 this part, but is limited to drugs intended for human use. 1270 (l) “Program” means the International Prescription Drug 1271 Importation Program established under this section. 1272 (m) “Qualified laboratory” means a laboratory that has been 1273 approved by the department for the purposes of this section. 1274 (3) ELIGIBLE PRESCRIPTION DRUGS.—An eligible importer may 1275 import a prescription drug from an eligible exporter if: 1276 (a) The drug meets the United States Food and Drug 1277 Administration’s standards related to safety, effectiveness, 1278 misbranding, and adulteration; 1279 (b) Importing the drug would not violate the patent laws of 1280 the United States; and 1281 (c) The drug is not: 1282 1. A controlled substance as defined in 21 U.S.C. s. 802; 1283 2. A biological product as defined in 42 U.S.C. s. 262; 1284 3. An infused drug; 1285 4. An intravenously injected drug; 1286 5. A drug that is inhaled during surgery; or 1287 6. A drug that is a parenteral drug, the importation of 1288 which is determined by the United States Secretary of Health and 1289 Human Services to pose a threat to the public health. 1290 (4) EXPORTERS.— 1291 (a) The following entities may export prescription drugs 1292 into this state under the program: 1293 1. An international prescription drug wholesale 1294 distributor. 1295 2. A nonresident prescription drug manufacturer. 1296 3. An international export pharmacy. 1297 (b) An eligible exporter must register with the department 1298 before exporting prescription drugs into this state under the 1299 program. 1300 (c) An exporter may not distribute, sell, or dispense 1301 prescription drugs imported under the program to any person 1302 residing outside of the state. 1303 (5) IMPORTERS.— 1304 (a) The following entities may import prescription drugs 1305 under the program: 1306 1. A wholesale distributor. 1307 2. A pharmacy. 1308 3. A pharmacist. 1309 (b) An eligible importer must register with the department 1310 before importing prescription drugs into this state under the 1311 program. 1312 (c) An importer may not distribute, sell, or dispense 1313 prescription drugs imported under the program to any person 1314 residing outside of the state. 1315 (6) PRESCRIPTION DRUG SUPPLY CHAIN DOCUMENTATION.— 1316 (a) A participating importer must submit the following 1317 information and documentation to the department: 1318 1. The name and quantity of the active ingredient of the 1319 prescription drug. 1320 2. A description of the dosage form of the prescription 1321 drug. 1322 3. The date on which the prescription drug is shipped. 1323 4. The quantity of the prescription drug that is shipped. 1324 5. The point of origin and destination of the prescription 1325 drug. 1326 6. The price paid by the importer for the prescription 1327 drug. 1328 7. Documentation from the exporter specifying: 1329 a. The original source of the prescription drug; and 1330 b. The quantity of each lot of the prescription drug 1331 originally received by the seller from that source. 1332 8. The lot or control number assigned to the prescription 1333 drug by the manufacturer. 1334 9. The name, address, telephone number, and professional 1335 license or permit number of the importer. 1336 10. In the case of a prescription drug that is shipped 1337 directly by the first foreign recipient from the manufacturer: 1338 a. Documentation demonstrating that the prescription drug 1339 was received by the recipient from the manufacturer and 1340 subsequently shipped by the first foreign recipient to the 1341 importer. 1342 b. Documentation of the quantity of each lot of the 1343 prescription drug received by the first foreign recipient 1344 demonstrating that the quantity being imported into this state 1345 is not more than the quantity that was received by the first 1346 foreign recipient. 1347 c. For an initial imported shipment, documentation 1348 demonstrating that each batch of the prescription drug in the 1349 shipment was statistically sampled and tested for authenticity 1350 and degradation. 1351 11. In the case of a prescription drug that is not shipped 1352 directly from the first foreign recipient, documentation 1353 demonstrating that each batch in each shipment offered for 1354 importation into this state was statistically sampled and tested 1355 for authenticity and degradation. 1356 12. For an initial imported shipment, the agency shall 1357 ensure that each batch of the drug in the shipment is 1358 statistically sampled and tested for authenticity and 1359 degradation in a manner consistent with the federal act. The 1360 agency may contract with a vendor for these functions. 1361 13. For any subsequent imported shipment, the department 1362 shall ensure that a statistically valid sample of the shipment 1363 was tested for authenticity and degradation in a manner 1364 consistent with the federal act. 1365 14. Certify that the drug: 1366 a. Is approved for marketing in the United States and is 1367 not adulterated or misbranded; and 1368 b. Meets all of the labeling requirements under 21 U.S.C. 1369 s. 352. 1370 15. Maintain qualified laboratory records, including 1371 complete data derived from all tests necessary to ensure that 1372 the drug is in compliance with the requirements of this section. 1373 16. Maintain documentation demonstrating that the testing 1374 required by this section was conducted at a qualified laboratory 1375 in accordance with the federal act and any other applicable 1376 federal and state laws and regulations governing laboratory 1377 qualifications. 1378 (b) All testing required by this section must be conducted 1379 in a qualified laboratory that meets the standards under the 1380 federal act and any other applicable federal and state laws and 1381 regulations governing laboratory qualifications for drug 1382 testing. 1383 (c) The vendor shall maintain information and documentation 1384 submitted under this section for a period of at least 7 years. 1385 (d) A participating importer must submit the all of 1386 following information to the department: 1387 1. The name and quantity of the active ingredient of the 1388 drug. 1389 2. A description of the dosage form of the drug. 1390 3. The date on which the drug is received. 1391 4. The quantity of the drug that is received. 1392 5. The point of origin and destination of the drug. 1393 6. The price paid by the importer for the drug. 1394 (e) A participating International Importation Drug supplier 1395 must submit the following information and documentation to the 1396 agency or the agency’s designated vendor specifying all of the 1397 following: 1398 1. The original source of the drug, including: 1399 a. The name of the manufacturer of the drug. 1400 b. The date on which the drug was manufactured. 1401 c. The location (country, state or province, and city) 1402 where the drug was manufactured. 1403 2. The date on which the drug is shipped. 1404 3. The quantity of the drug that is shipped. 1405 4. The quantity of each lot of the drug originally received 1406 and from which source. 1407 5. The lot or control number and the batch number assigned 1408 to the drug by the manufacturer. 1409 6. The name, address, and telephone number, and 1410 professional license or permit number of the importer. 1411 (f) The department may require any other information 1412 necessary to ensure the protection of the public health. 1413 (7) IMMEDIATE SUSPENSION.—The department shall immediately 1414 suspend the importation of a specific prescription drug or the 1415 importation of prescription drugs by a specific importer if it 1416 discovers that any prescription drug or activity is in violation 1417 of this section. The department may revoke the suspension if, 1418 after conducting an investigation, it determines that the public 1419 is adequately protected from counterfeit or unsafe prescription 1420 drugs being imported into this state. 1421 (8) RULEMAKING AUTHORITY.—The department shall adopt rules 1422 necessary to implement this section. 1423 Section 11. Notwithstanding the Federal Food, Drug, and 1424 Cosmetic Act, the Department of Business and Professional 1425 Regulation, in collaboration with the Department of Health, 1426 shall negotiate a federal arrangement to operate a pilot program 1427 for importing prescription drugs into this state. The proposal 1428 to operate such a pilot program shall demonstrate that the 1429 program sets safety standards consistent with the current 1430 federal requirements for the manufacturing and distribution of 1431 prescription drugs; limits the importation of prescription drugs 1432 under the program to entities licensed or permitted by the state 1433 to manufacture, distribute, or dispense prescription drugs; and 1434 includes inspection and enforcement authority. Implementation of 1435 sections 2 through 10 of this act is contingent upon 1436 authorization granted under federal law or rule. The department 1437 shall notify the President of the Senate, the Speaker of the 1438 House of Representatives, and the relevant committees of the 1439 Senate and the House of Representatives before implementation of 1440 the pilot program. The department shall submit to all parties a 1441 proposal for program implementation and program funding. 1442 Section 12. This act shall take effect July 1, 2019.