Florida Senate - 2019 SENATOR AMENDMENT
Bill No. CS for HB 831
Ì161690*Î161690
LEGISLATIVE ACTION
Senate . House
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Floor: 1/AD/3R . Floor: C
05/01/2019 02:31 PM . 05/02/2019 12:36 PM
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Senator Bean moved the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Section 456.42, Florida Statutes, is amended to
6 read:
7 456.42 Written prescriptions for medicinal drugs.—
8 (1) A written prescription for a medicinal drug issued by a
9 health care practitioner licensed by law to prescribe such drug
10 must be legibly printed or typed so as to be capable of being
11 understood by the pharmacist filling the prescription; must
12 contain the name of the prescribing practitioner, the name and
13 strength of the drug prescribed, the quantity of the drug
14 prescribed, and the directions for use of the drug; must be
15 dated; and must be signed by the prescribing practitioner on the
16 day when issued. However, a prescription that is electronically
17 generated and transmitted must contain the name of the
18 prescribing practitioner, the name and strength of the drug
19 prescribed, the quantity of the drug prescribed in numerical
20 format, and the directions for use of the drug and must contain
21 the date and an electronic signature, as defined in s.
22 668.003(4), be dated and signed by the prescribing practitioner
23 only on the day issued, which signature may be in an electronic
24 format as defined in s. 668.003(4).
25 (2) A written prescription for a controlled substance
26 listed in chapter 893 must have the quantity of the drug
27 prescribed in both textual and numerical formats, must be dated
28 in numerical, month/day/year format, or with the abbreviated
29 month written out, or the month written out in whole, and must
30 be either written on a standardized counterfeit-proof
31 prescription pad produced by a vendor approved by the department
32 or electronically prescribed as that term is used in s.
33 408.0611. As a condition of being an approved vendor, a
34 prescription pad vendor must submit a monthly report to the
35 department that, at a minimum, documents the number of
36 prescription pads sold and identifies the purchasers. The
37 department may, by rule, require the reporting of additional
38 information.
39 (3) A health care practitioner licensed by law to prescribe
40 a medicinal drug who maintains a system of electronic health
41 records as defined in s. 408.051(2)(a), or who prescribes
42 medicinal drugs as an owner, an employee, or a contractor of a
43 licensed health care facility or practice that maintains such a
44 system and who is prescribing in his or her capacity as such an
45 owner, an employee, or a contractor, may only electronically
46 transmit prescriptions for such drugs. This requirement applies
47 to such a health care practitioner upon renewal of the health
48 care practitioner’s license or by July 1, 2021, whichever is
49 earlier, but does not apply if:
50 (a) The practitioner and the dispenser are the same entity;
51 (b) The prescription cannot be transmitted electronically
52 under the most recently implemented version of the National
53 Council for Prescription Drug Programs SCRIPT Standard;
54 (c) The practitioner has been issued a waiver by the
55 department, not to exceed 1 year in duration, from the
56 requirement to use electronic prescribing due to demonstrated
57 economic hardship, technological limitations that are not
58 reasonably within the control of the practitioner, or another
59 exceptional circumstance demonstrated by the practitioner;
60 (d) The practitioner reasonably determines that it would be
61 impractical for the patient in question to obtain a medicinal
62 drug prescribed by electronic prescription in a timely manner
63 and such delay would adversely impact the patient’s medical
64 condition;
65 (e) The practitioner is prescribing a drug under a research
66 protocol;
67 (f) The prescription is for a drug for which the federal
68 Food and Drug Administration requires the prescription to
69 contain elements that may not be included in electronic
70 prescribing; or
71 (g) The prescription is issued to an individual receiving
72 hospice care or who is a resident of a nursing home facility.
73 (h) The practitioner determines that it is in the best
74 interest of the patient, or the patient determines that it is in
75 his or her own best interest, to compare prescription drug
76 prices among area pharmacies. The practitioner must document
77 such determination in the patient’s medical record.
78
79 The department, in consultation with the Board of Medicine, the
80 Board of Osteopathic Medicine, the Board of Podiatric Medicine,
81 the Board of Dentistry, the Board of Nursing, and the Board of
82 Optometry, may adopt rules to implement this subsection.
83 Section 2. Section 456.43, Florida Statutes, is amended to
84 read:
85 456.43 Electronic prescribing for medicinal drugs.—
86 (1) Electronic prescribing may shall not interfere with a
87 patient’s freedom to choose a pharmacy.
88 (2) Electronic prescribing software may shall not use any
89 means or permit any other person to use any means to influence
90 or attempt to influence, through economic incentives or
91 otherwise, the prescribing decision of a prescribing
92 practitioner or his or her agent at the point of care,
93 including, but not limited to, means such as advertising,
94 instant messaging, and pop-up ads, and similar means to
95 influence or attempt to influence, through economic incentives
96 or otherwise, the prescribing decision of a prescribing
97 practitioner at the point of care. Such means shall not be
98 triggered by or in specific response to the input, selection, or
99 act of a prescribing practitioner or his or her agent in
100 prescribing a certain medicinal drug pharmaceutical or directing
101 a patient to a certain pharmacy. For purposes of this
102 subsection, the term:
103 (a) The term “Prescribing decision” means a prescribing
104 practitioner’s or his or her agent’s decision to prescribe any
105 medicinal drug a certain pharmaceutical.
106 (b) The term “Point of care” means the time at which that a
107 prescribing practitioner or his or her agent prescribes any
108 medicinal drug is in the act of prescribing a certain
109 pharmaceutical.
110 (3) Electronic prescribing software may display show
111 information regarding a payor’s formulary if as long as nothing
112 is designed to preclude or make more difficult the selection of
113 the act of a prescribing practitioner or patient selecting any
114 particular pharmacy by a patient or the selection of a certain
115 medicinal drug by a prescribing practitioner or his or her agent
116 pharmaceutical.
117 Section 3. Paragraph (a) of subsection (5) of section
118 409.912, Florida Statutes, is amended to read:
119 409.912 Cost-effective purchasing of health care.—The
120 agency shall purchase goods and services for Medicaid recipients
121 in the most cost-effective manner consistent with the delivery
122 of quality medical care. To ensure that medical services are
123 effectively utilized, the agency may, in any case, require a
124 confirmation or second physician’s opinion of the correct
125 diagnosis for purposes of authorizing future services under the
126 Medicaid program. This section does not restrict access to
127 emergency services or poststabilization care services as defined
128 in 42 C.F.R. s. 438.114. Such confirmation or second opinion
129 shall be rendered in a manner approved by the agency. The agency
130 shall maximize the use of prepaid per capita and prepaid
131 aggregate fixed-sum basis services when appropriate and other
132 alternative service delivery and reimbursement methodologies,
133 including competitive bidding pursuant to s. 287.057, designed
134 to facilitate the cost-effective purchase of a case-managed
135 continuum of care. The agency shall also require providers to
136 minimize the exposure of recipients to the need for acute
137 inpatient, custodial, and other institutional care and the
138 inappropriate or unnecessary use of high-cost services. The
139 agency shall contract with a vendor to monitor and evaluate the
140 clinical practice patterns of providers in order to identify
141 trends that are outside the normal practice patterns of a
142 provider’s professional peers or the national guidelines of a
143 provider’s professional association. The vendor must be able to
144 provide information and counseling to a provider whose practice
145 patterns are outside the norms, in consultation with the agency,
146 to improve patient care and reduce inappropriate utilization.
147 The agency may mandate prior authorization, drug therapy
148 management, or disease management participation for certain
149 populations of Medicaid beneficiaries, certain drug classes, or
150 particular drugs to prevent fraud, abuse, overuse, and possible
151 dangerous drug interactions. The Pharmaceutical and Therapeutics
152 Committee shall make recommendations to the agency on drugs for
153 which prior authorization is required. The agency shall inform
154 the Pharmaceutical and Therapeutics Committee of its decisions
155 regarding drugs subject to prior authorization. The agency is
156 authorized to limit the entities it contracts with or enrolls as
157 Medicaid providers by developing a provider network through
158 provider credentialing. The agency may competitively bid single
159 source-provider contracts if procurement of goods or services
160 results in demonstrated cost savings to the state without
161 limiting access to care. The agency may limit its network based
162 on the assessment of beneficiary access to care, provider
163 availability, provider quality standards, time and distance
164 standards for access to care, the cultural competence of the
165 provider network, demographic characteristics of Medicaid
166 beneficiaries, practice and provider-to-beneficiary standards,
167 appointment wait times, beneficiary use of services, provider
168 turnover, provider profiling, provider licensure history,
169 previous program integrity investigations and findings, peer
170 review, provider Medicaid policy and billing compliance records,
171 clinical and medical record audits, and other factors. Providers
172 are not entitled to enrollment in the Medicaid provider network.
173 The agency shall determine instances in which allowing Medicaid
174 beneficiaries to purchase durable medical equipment and other
175 goods is less expensive to the Medicaid program than long-term
176 rental of the equipment or goods. The agency may establish rules
177 to facilitate purchases in lieu of long-term rentals in order to
178 protect against fraud and abuse in the Medicaid program as
179 defined in s. 409.913. The agency may seek federal waivers
180 necessary to administer these policies.
181 (5)(a) The agency shall implement a Medicaid prescribed
182 drug spending-control program that includes the following
183 components:
184 1. A Medicaid preferred drug list, which shall be a listing
185 of cost-effective therapeutic options recommended by the
186 Medicaid Pharmacy and Therapeutics Committee established
187 pursuant to s. 409.91195 and adopted by the agency for each
188 therapeutic class on the preferred drug list. At the discretion
189 of the committee, and when feasible, the preferred drug list
190 should include at least two products in a therapeutic class. The
191 agency may post the preferred drug list and updates to the list
192 on an Internet website without following the rulemaking
193 procedures of chapter 120. Antiretroviral agents are excluded
194 from the preferred drug list. The agency shall also limit the
195 amount of a prescribed drug dispensed to no more than a 34-day
196 supply unless the drug products’ smallest marketed package is
197 greater than a 34-day supply, or the drug is determined by the
198 agency to be a maintenance drug in which case a 100-day maximum
199 supply may be authorized. The agency may seek any federal
200 waivers necessary to implement these cost-control programs and
201 to continue participation in the federal Medicaid rebate
202 program, or alternatively to negotiate state-only manufacturer
203 rebates. The agency may adopt rules to administer this
204 subparagraph. The agency shall continue to provide unlimited
205 contraceptive drugs and items. The agency must establish
206 procedures to ensure that:
207 a. There is a response to a request for prior consultation
208 by telephone or other telecommunication device within 24 hours
209 after receipt of a request for prior consultation; and
210 b. A 72-hour supply of the drug prescribed is provided in
211 an emergency or when the agency does not provide a response
212 within 24 hours as required by sub-subparagraph a.
213 2. Reimbursement to pharmacies for Medicaid prescribed
214 drugs shall be set at the lowest of: the average wholesale price
215 (AWP) minus 16.4 percent, the wholesaler acquisition cost (WAC)
216 plus 1.5 percent, the federal upper limit (FUL), the state
217 maximum allowable cost (SMAC), or the usual and customary (UAC)
218 charge billed by the provider.
219 3. The agency shall develop and implement a process for
220 managing the drug therapies of Medicaid recipients who are using
221 significant numbers of prescribed drugs each month. The
222 management process may include, but is not limited to,
223 comprehensive, physician-directed medical-record reviews, claims
224 analyses, and case evaluations to determine the medical
225 necessity and appropriateness of a patient’s treatment plan and
226 drug therapies. The agency may contract with a private
227 organization to provide drug-program-management services. The
228 Medicaid drug benefit management program shall include
229 initiatives to manage drug therapies for HIV/AIDS patients,
230 patients using 20 or more unique prescriptions in a 180-day
231 period, and the top 1,000 patients in annual spending. The
232 agency shall enroll any Medicaid recipient in the drug benefit
233 management program if he or she meets the specifications of this
234 provision and is not enrolled in a Medicaid health maintenance
235 organization.
236 4. The agency may limit the size of its pharmacy network
237 based on need, competitive bidding, price negotiations,
238 credentialing, or similar criteria. The agency shall give
239 special consideration to rural areas in determining the size and
240 location of pharmacies included in the Medicaid pharmacy
241 network. A pharmacy credentialing process may include criteria
242 such as a pharmacy’s full-service status, location, size,
243 patient educational programs, patient consultation, disease
244 management services, and other characteristics. The agency may
245 impose a moratorium on Medicaid pharmacy enrollment if it is
246 determined that it has a sufficient number of Medicaid
247 participating providers. The agency must allow dispensing
248 practitioners to participate as a part of the Medicaid pharmacy
249 network regardless of the practitioner’s proximity to any other
250 entity that is dispensing prescription drugs under the Medicaid
251 program. A dispensing practitioner must meet all credentialing
252 requirements applicable to his or her practice, as determined by
253 the agency.
254 5. The agency shall develop and implement a program that
255 requires Medicaid practitioners who issue written prescriptions
256 for medicinal prescribe drugs to use a counterfeit-proof
257 prescription pad for Medicaid prescriptions. The agency shall
258 require the use of standardized counterfeit-proof prescription
259 pads by Medicaid-participating prescribers or prescribers who
260 issue written write prescriptions for Medicaid recipients. The
261 agency may implement the program in targeted geographic areas or
262 statewide.
263 6. The agency may enter into arrangements that require
264 manufacturers of generic drugs prescribed to Medicaid recipients
265 to provide rebates of at least 15.1 percent of the average
266 manufacturer price for the manufacturer’s generic products.
267 These arrangements shall require that if a generic-drug
268 manufacturer pays federal rebates for Medicaid-reimbursed drugs
269 at a level below 15.1 percent, the manufacturer must provide a
270 supplemental rebate to the state in an amount necessary to
271 achieve a 15.1-percent rebate level.
272 7. The agency may establish a preferred drug list as
273 described in this subsection, and, pursuant to the establishment
274 of such preferred drug list, negotiate supplemental rebates from
275 manufacturers that are in addition to those required by Title
276 XIX of the Social Security Act and at no less than 14 percent of
277 the average manufacturer price as defined in 42 U.S.C. s. 1936
278 on the last day of a quarter unless the federal or supplemental
279 rebate, or both, equals or exceeds 29 percent. There is no upper
280 limit on the supplemental rebates the agency may negotiate. The
281 agency may determine that specific products, brand-name or
282 generic, are competitive at lower rebate percentages. Agreement
283 to pay the minimum supplemental rebate percentage guarantees a
284 manufacturer that the Medicaid Pharmaceutical and Therapeutics
285 Committee will consider a product for inclusion on the preferred
286 drug list. However, a pharmaceutical manufacturer is not
287 guaranteed placement on the preferred drug list by simply paying
288 the minimum supplemental rebate. Agency decisions will be made
289 on the clinical efficacy of a drug and recommendations of the
290 Medicaid Pharmaceutical and Therapeutics Committee, as well as
291 the price of competing products minus federal and state rebates.
292 The agency may contract with an outside agency or contractor to
293 conduct negotiations for supplemental rebates. For the purposes
294 of this section, the term “supplemental rebates” means cash
295 rebates. Value-added programs as a substitution for supplemental
296 rebates are prohibited. The agency may seek any federal waivers
297 to implement this initiative.
298 8. The agency shall expand home delivery of pharmacy
299 products. The agency may amend the state plan and issue a
300 procurement, as necessary, in order to implement this program.
301 The procurements must include agreements with a pharmacy or
302 pharmacies located in the state to provide mail order delivery
303 services at no cost to the recipients who elect to receive home
304 delivery of pharmacy products. The procurement must focus on
305 serving recipients with chronic diseases for which pharmacy
306 expenditures represent a significant portion of Medicaid
307 pharmacy expenditures or which impact a significant portion of
308 the Medicaid population. The agency may seek and implement any
309 federal waivers necessary to implement this subparagraph.
310 9. The agency shall limit to one dose per month any drug
311 prescribed to treat erectile dysfunction.
312 10.a. The agency may implement a Medicaid behavioral drug
313 management system. The agency may contract with a vendor that
314 has experience in operating behavioral drug management systems
315 to implement this program. The agency may seek federal waivers
316 to implement this program.
317 b. The agency, in conjunction with the Department of
318 Children and Families, may implement the Medicaid behavioral
319 drug management system that is designed to improve the quality
320 of care and behavioral health prescribing practices based on
321 best practice guidelines, improve patient adherence to
322 medication plans, reduce clinical risk, and lower prescribed
323 drug costs and the rate of inappropriate spending on Medicaid
324 behavioral drugs. The program may include the following
325 elements:
326 (I) Provide for the development and adoption of best
327 practice guidelines for behavioral health-related drugs such as
328 antipsychotics, antidepressants, and medications for treating
329 bipolar disorders and other behavioral conditions; translate
330 them into practice; review behavioral health prescribers and
331 compare their prescribing patterns to a number of indicators
332 that are based on national standards; and determine deviations
333 from best practice guidelines.
334 (II) Implement processes for providing feedback to and
335 educating prescribers using best practice educational materials
336 and peer-to-peer consultation.
337 (III) Assess Medicaid beneficiaries who are outliers in
338 their use of behavioral health drugs with regard to the numbers
339 and types of drugs taken, drug dosages, combination drug
340 therapies, and other indicators of improper use of behavioral
341 health drugs.
342 (IV) Alert prescribers to patients who fail to refill
343 prescriptions in a timely fashion, are prescribed multiple same
344 class behavioral health drugs, and may have other potential
345 medication problems.
346 (V) Track spending trends for behavioral health drugs and
347 deviation from best practice guidelines.
348 (VI) Use educational and technological approaches to
349 promote best practices, educate consumers, and train prescribers
350 in the use of practice guidelines.
351 (VII) Disseminate electronic and published materials.
352 (VIII) Hold statewide and regional conferences.
353 (IX) Implement a disease management program with a model
354 quality-based medication component for severely mentally ill
355 individuals and emotionally disturbed children who are high
356 users of care.
357 11. The agency shall implement a Medicaid prescription drug
358 management system.
359 a. The agency may contract with a vendor that has
360 experience in operating prescription drug management systems in
361 order to implement this system. Any management system that is
362 implemented in accordance with this subparagraph must rely on
363 cooperation between physicians and pharmacists to determine
364 appropriate practice patterns and clinical guidelines to improve
365 the prescribing, dispensing, and use of drugs in the Medicaid
366 program. The agency may seek federal waivers to implement this
367 program.
368 b. The drug management system must be designed to improve
369 the quality of care and prescribing practices based on best
370 practice guidelines, improve patient adherence to medication
371 plans, reduce clinical risk, and lower prescribed drug costs and
372 the rate of inappropriate spending on Medicaid prescription
373 drugs. The program must:
374 (I) Provide for the adoption of best practice guidelines
375 for the prescribing and use of drugs in the Medicaid program,
376 including translating best practice guidelines into practice;
377 reviewing prescriber patterns and comparing them to indicators
378 that are based on national standards and practice patterns of
379 clinical peers in their community, statewide, and nationally;
380 and determine deviations from best practice guidelines.
381 (II) Implement processes for providing feedback to and
382 educating prescribers using best practice educational materials
383 and peer-to-peer consultation.
384 (III) Assess Medicaid recipients who are outliers in their
385 use of a single or multiple prescription drugs with regard to
386 the numbers and types of drugs taken, drug dosages, combination
387 drug therapies, and other indicators of improper use of
388 prescription drugs.
389 (IV) Alert prescribers to recipients who fail to refill
390 prescriptions in a timely fashion, are prescribed multiple drugs
391 that may be redundant or contraindicated, or may have other
392 potential medication problems.
393 12. The agency may contract for drug rebate administration,
394 including, but not limited to, calculating rebate amounts,
395 invoicing manufacturers, negotiating disputes with
396 manufacturers, and maintaining a database of rebate collections.
397 13. The agency may specify the preferred daily dosing form
398 or strength for the purpose of promoting best practices with
399 regard to the prescribing of certain drugs as specified in the
400 General Appropriations Act and ensuring cost-effective
401 prescribing practices.
402 14. The agency may require prior authorization for
403 Medicaid-covered prescribed drugs. The agency may prior
404 authorize the use of a product:
405 a. For an indication not approved in labeling;
406 b. To comply with certain clinical guidelines; or
407 c. If the product has the potential for overuse, misuse, or
408 abuse.
409
410 The agency may require the prescribing professional to provide
411 information about the rationale and supporting medical evidence
412 for the use of a drug. The agency shall post prior
413 authorization, step-edit criteria and protocol, and updates to
414 the list of drugs that are subject to prior authorization on the
415 agency’s Internet website within 21 days after the prior
416 authorization and step-edit criteria and protocol and updates
417 are approved by the agency. For purposes of this subparagraph,
418 the term “step-edit” means an automatic electronic review of
419 certain medications subject to prior authorization.
420 15. The agency, in conjunction with the Pharmaceutical and
421 Therapeutics Committee, may require age-related prior
422 authorizations for certain prescribed drugs. The agency may
423 preauthorize the use of a drug for a recipient who may not meet
424 the age requirement or may exceed the length of therapy for use
425 of this product as recommended by the manufacturer and approved
426 by the Food and Drug Administration. Prior authorization may
427 require the prescribing professional to provide information
428 about the rationale and supporting medical evidence for the use
429 of a drug.
430 16. The agency shall implement a step-therapy prior
431 authorization approval process for medications excluded from the
432 preferred drug list. Medications listed on the preferred drug
433 list must be used within the previous 12 months before the
434 alternative medications that are not listed. The step-therapy
435 prior authorization may require the prescriber to use the
436 medications of a similar drug class or for a similar medical
437 indication unless contraindicated in the Food and Drug
438 Administration labeling. The trial period between the specified
439 steps may vary according to the medical indication. The step
440 therapy approval process shall be developed in accordance with
441 the committee as stated in s. 409.91195(7) and (8). A drug
442 product may be approved without meeting the step-therapy prior
443 authorization criteria if the prescribing physician provides the
444 agency with additional written medical or clinical documentation
445 that the product is medically necessary because:
446 a. There is not a drug on the preferred drug list to treat
447 the disease or medical condition which is an acceptable clinical
448 alternative;
449 b. The alternatives have been ineffective in the treatment
450 of the beneficiary’s disease; or
451 c. Based on historic evidence and known characteristics of
452 the patient and the drug, the drug is likely to be ineffective,
453 or the number of doses have been ineffective.
454
455 The agency shall work with the physician to determine the best
456 alternative for the patient. The agency may adopt rules waiving
457 the requirements for written clinical documentation for specific
458 drugs in limited clinical situations.
459 17. The agency shall implement a return and reuse program
460 for drugs dispensed by pharmacies to institutional recipients,
461 which includes payment of a $5 restocking fee for the
462 implementation and operation of the program. The return and
463 reuse program shall be implemented electronically and in a
464 manner that promotes efficiency. The program must permit a
465 pharmacy to exclude drugs from the program if it is not
466 practical or cost-effective for the drug to be included and must
467 provide for the return to inventory of drugs that cannot be
468 credited or returned in a cost-effective manner. The agency
469 shall determine if the program has reduced the amount of
470 Medicaid prescription drugs which are destroyed on an annual
471 basis and if there are additional ways to ensure more
472 prescription drugs are not destroyed which could safely be
473 reused.
474 Section 4. Section 456.0392, Florida Statutes, is amended
475 to read:
476 456.0392 Prescription labeling.—
477 (1) A prescription issued written by a practitioner who is
478 authorized under the laws of this state to prescribe write
479 prescriptions for drugs that are not listed as controlled
480 substances in chapter 893 but who is not eligible for a federal
481 Drug Enforcement Administration number shall include that
482 practitioner’s name and professional license number. The
483 pharmacist or dispensing practitioner must include the
484 practitioner’s name on the container of the drug that is
485 dispensed. A pharmacist shall be permitted, upon verification by
486 the prescriber, to document any information required by this
487 section.
488 (2) A prescription for a drug that is not listed as a
489 controlled substance in chapter 893 which is issued written by
490 an advanced practice registered nurse licensed under s. 464.012
491 is presumed, subject to rebuttal, to be valid and within the
492 parameters of the prescriptive authority delegated by a
493 practitioner licensed under chapter 458, chapter 459, or chapter
494 466.
495 (3) A prescription for a drug that is not listed as a
496 controlled substance in chapter 893 which is issued written by a
497 physician assistant licensed under chapter 458 or chapter 459 is
498 presumed, subject to rebuttal, to be valid and within the
499 parameters of the prescriptive authority delegated by the
500 physician assistant’s supervising physician.
501 Section 5. Paragraph (d) of subsection (3) of section
502 458.3265, Florida Statutes, is amended to read:
503 458.3265 Pain-management clinics.—
504 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
505 apply to any physician who provides professional services in a
506 pain-management clinic that is required to be registered in
507 subsection (1).
508 (d) A physician authorized to prescribe controlled
509 substances who practices at a pain-management clinic is
510 responsible for maintaining the control and security of his or
511 her prescription blanks or electronic prescribing software and
512 any other method used for prescribing controlled substance pain
513 medication. A The physician who issues written prescriptions
514 shall comply with the requirements for counterfeit-resistant
515 prescription blanks in s. 893.065 and the rules adopted pursuant
516 to that section. A The physician shall notify, in writing, the
517 department within 24 hours after following any theft or loss of
518 a prescription blank or breach of his or her electronic
519 prescribing software used any other method for prescribing pain
520 medication.
521 Section 6. Paragraph (qq) of subsection (1) of section
522 458.331, Florida Statutes, is amended to read:
523 458.331 Grounds for disciplinary action; action by the
524 board and department.—
525 (1) The following acts constitute grounds for denial of a
526 license or disciplinary action, as specified in s. 456.072(2):
527 (qq) Failing to timely notify the department of the theft
528 of prescription blanks from a pain-management clinic or a breach
529 of a physician’s electronic prescribing software other methods
530 for prescribing within 24 hours as required by s. 458.3265(3).
531 Section 7. Paragraph (d) of subsection (3) of section
532 459.0137, Florida Statutes, is amended to read:
533 459.0137 Pain-management clinics.—
534 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
535 apply to any osteopathic physician who provides professional
536 services in a pain-management clinic that is required to be
537 registered in subsection (1).
538 (d) An osteopathic physician authorized to prescribe
539 controlled substances who practices at a pain-management clinic
540 is responsible for maintaining the control and security of his
541 or her prescription blanks or electronic prescribing software
542 and any other method used for prescribing controlled substance
543 pain medication. An The osteopathic physician who issues written
544 prescriptions shall comply with the requirements for
545 counterfeit-resistant prescription blanks in s. 893.065 and the
546 rules adopted pursuant to that section. An The osteopathic
547 physician shall notify, in writing, the department within 24
548 hours after following any theft or loss of a prescription blank
549 or breach of his or her electronic prescribing software used any
550 other method for prescribing pain medication.
551 Section 8. Paragraph (ss) of subsection (1) of section
552 459.015, Florida Statutes, is amended to read:
553 459.015 Grounds for disciplinary action; action by the
554 board and department.—
555 (1) The following acts constitute grounds for denial of a
556 license or disciplinary action, as specified in s. 456.072(2):
557 (ss) Failing to timely notify the department of the theft
558 of prescription blanks from a pain-management clinic or a breach
559 of an osteopathic physician’s electronic prescribing software
560 other methods for prescribing within 24 hours as required by s.
561 459.0137(3).
562 Section 9. This act shall take effect January 1, 2020.
563
564 ================= T I T L E A M E N D M E N T ================
565 And the title is amended as follows:
566 Delete everything before the enacting clause
567 and insert:
568 A bill to be entitled
569 An act relating to electronic prescribing; amending s.
570 456.42, F.S.; requiring certain health care
571 practitioners to electronically generate and transmit
572 prescriptions for medicinal drugs upon license renewal
573 or by a specified date; providing exceptions;
574 authorizing the Department of Health, in consultation
575 with the Board of Medicine, the Board of Osteopathic
576 Medicine, the Board of Podiatric Medicine, the Board
577 of Dentistry, the Board of Nursing, and the Board of
578 Optometry, to adopt rules; amending s. 456.43, F.S.;
579 revising the definitions of the terms “prescribing
580 decision” and “point of care”; revising the authority
581 for electronic prescribing software to display
582 information regarding a payor’s formulary under
583 certain circumstances; amending ss. 409.912, 456.0392,
584 458.3265, 458.331, 459.0137, and 459.015, F.S.;
585 conforming provisions to changes made by the act;
586 providing an effective date.