Florida Senate - 2022                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1222
       
       
       
       
       
       
                                Ì773004rÎ773004                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  02/07/2022           .                                
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       The Committee on Judiciary (Bean) recommended the following:
       
    1         Senate Substitute for Amendment (874244) (with title
    2  amendment)
    3  
    4         Delete everything after the enacting clause
    5  and insert:
    6         Section 1. Present subsections (1) through (22) of section
    7  401.23, Florida Statutes, are redesignated as subsections (2)
    8  through (23), respectively, a new subsection (1) is added to
    9  that section, and present subsection (19) of that section is
   10  amended, to read:
   11         401.23 Definitions.—As used in this part, the term:
   12         (1) “Acute and post-acute hospital care at home” means
   13  acute and post-acute health care services provided in a
   14  clinically qualified patient’s permanent residence, as defined
   15  in s. 196.012(17), through a program approved by the Centers for
   16  Medicare and Medicaid Services and the Agency for Health Care
   17  Administration.
   18         (20)(19) “Physician” means a practitioner who is licensed
   19  under the provisions of chapter 458 or chapter 459. For the
   20  purpose of providing medical direction “medical direction” as
   21  defined in subsection (14) for the treatment of patients
   22  immediately before prior to or during transportation to a United
   23  States Department of Veterans Affairs medical facility,
   24  “physician” also means a practitioner employed by the United
   25  States Department of Veterans Affairs.
   26         Section 2. Paragraph (c) is added to subsection (2) of
   27  section 401.272, Florida Statutes, to read:
   28         401.272 Emergency medical services community health care.—
   29         (2) Notwithstanding any other provision of law to the
   30  contrary:
   31         (c)Paramedics may provide basic life support services and
   32  advanced life support services to patients receiving acute and
   33  post-acute hospital care at home as specified in the paramedic’s
   34  supervisory relationship with a physician or standing orders as
   35  described in s. 401.265, s. 458.348, or s. 459.025. A physician
   36  who supervises or provides medical direction to a paramedic who
   37  provides basic life support services or advanced life support
   38  services to patients receiving acute and post-acute hospital
   39  care at home pursuant to a formal supervisory relationship or
   40  standing orders is liable for any act or omission of the
   41  paramedic acting under the physician’s supervision or medical
   42  direction when providing such services. The department may adopt
   43  and enforce rules necessary to implement this paragraph.
   44         Section 3. Section 465.003, Florida Statutes, is reordered
   45  and amended to read:
   46         465.003 Definitions.—As used in this chapter, the term:
   47         (1) “Acute and post-acute hospital care at home” means
   48  acute and post-acute health care services provided in a
   49  clinically qualified patient’s permanent residence, as defined
   50  in s. 196.012(17), through a program approved by the Centers for
   51  Medicare and Medicaid Services and the Agency for Health Care
   52  Administration.
   53         (2)(1) “Administration” means the obtaining and giving of a
   54  single dose of medicinal drugs by a legally authorized person to
   55  a patient for her or his consumption.
   56         (4)(2) “Board” means the Board of Pharmacy.
   57         (10)(3) “Consultant pharmacist” means a pharmacist licensed
   58  by the department and certified as a consultant pharmacist
   59  pursuant to s. 465.0125.
   60         (11)(4) “Data communication device” means an electronic
   61  device that receives electronic information from one source and
   62  transmits or routes it to another, including, but not limited
   63  to, any such bridge, router, switch, or gateway.
   64         (12)(5) “Department” means the Department of Health.
   65         (13)(6) “Dispense” means the transfer of possession of one
   66  or more doses of a medicinal drug by a pharmacist to the
   67  ultimate consumer or her or his agent. As an element of
   68  dispensing, the pharmacist shall, prior to the actual physical
   69  transfer, interpret and assess the prescription order for
   70  potential adverse reactions, interactions, and dosage regimen
   71  she or he deems appropriate in the exercise of her or his
   72  professional judgment, and the pharmacist shall certify that the
   73  medicinal drug called for by the prescription is ready for
   74  transfer. The pharmacist shall also provide counseling on proper
   75  drug usage, either orally or in writing, if in the exercise of
   76  her or his professional judgment counseling is necessary. The
   77  actual sales transaction and delivery of such drug shall not be
   78  considered dispensing. The administration shall not be
   79  considered dispensing.
   80         (14)(7) “Institutional formulary system” means a method
   81  whereby the medical staff evaluates, appraises, and selects
   82  those medicinal drugs or proprietary preparations which in the
   83  medical staff’s clinical judgment are most useful in patient
   84  care, and which are available for dispensing by a practicing
   85  pharmacist in a Class II or Class III institutional pharmacy.
   86         (15)(8) “Medicinal drugs” or “drugs” means those substances
   87  or preparations commonly known as “prescription” or “legend”
   88  drugs which are required by federal or state law to be dispensed
   89  only on a prescription, but shall not include patents or
   90  proprietary preparations as hereafter defined.
   91         (18)(9) “Patent or proprietary preparation” means a
   92  medicine in its unbroken, original package which is sold to the
   93  public by, or under the authority of, the manufacturer or
   94  primary distributor thereof and which is not misbranded under
   95  the provisions of the Florida Drug and Cosmetic Act.
   96         (19)(10) “Pharmacist” means any person licensed pursuant to
   97  this chapter to practice the profession of pharmacy.
   98         (20)(a)(11)(a) “Pharmacy” includes a community pharmacy, an
   99  institutional pharmacy, a nuclear pharmacy, a special pharmacy,
  100  and an Internet pharmacy.
  101         1. The term “community pharmacy” includes every location
  102  where medicinal drugs are compounded, dispensed, stored, or sold
  103  or where prescriptions are filled or dispensed on an outpatient
  104  basis.
  105         2. The term “institutional pharmacy” includes every
  106  location in a hospital, clinic, nursing home, dispensary,
  107  sanitarium, extended care facility, or other facility,
  108  hereinafter referred to as “health care institutions,” where
  109  medicinal drugs are compounded, dispensed, stored, or sold.
  110         3. The term “nuclear pharmacy” includes every location
  111  where radioactive drugs and chemicals within the classification
  112  of medicinal drugs are compounded, dispensed, stored, or sold.
  113  The term “nuclear pharmacy” does not include hospitals licensed
  114  under chapter 395 or the nuclear medicine facilities of such
  115  hospitals.
  116         4. The term “special pharmacy” includes every location
  117  where medicinal drugs are compounded, dispensed, stored, or sold
  118  if such locations are not otherwise defined in this subsection.
  119         5. The term “Internet pharmacy” includes locations not
  120  otherwise licensed or issued a permit under this chapter, within
  121  or outside this state, which use the Internet to communicate
  122  with or obtain information from consumers in this state and use
  123  such communication or information to fill or refill
  124  prescriptions or to dispense, distribute, or otherwise engage in
  125  the practice of pharmacy in this state. Any act described in
  126  this definition constitutes the practice of the profession of
  127  pharmacy as defined in subsection (13).
  128         (b) The pharmacy department of any permittee shall be
  129  considered closed whenever a Florida licensed pharmacist is not
  130  present and on duty. The term “not present and on duty” shall
  131  not be construed to prevent a pharmacist from exiting the
  132  prescription department for the purposes of consulting or
  133  responding to inquiries or providing assistance to patients or
  134  customers, attending to personal hygiene needs, or performing
  135  any other function for which the pharmacist is responsible,
  136  provided that such activities are conducted in a manner
  137  consistent with the pharmacist’s responsibility to provide
  138  pharmacy services.
  139         (21)(12) “Pharmacy intern” means a person who is currently
  140  registered in, and attending, a duly accredited college or
  141  school of pharmacy, or who is a graduate of such a school or
  142  college of pharmacy, and who is duly and properly registered
  143  with the department as provided for under its rules.
  144         (22)(13) “Practice of the profession of pharmacy” includes
  145  compounding, dispensing, and consulting concerning contents,
  146  therapeutic values, and uses of any medicinal drug; consulting
  147  concerning therapeutic values and interactions of patent or
  148  proprietary preparations, whether pursuant to prescriptions or
  149  in the absence and entirely independent of such prescriptions or
  150  orders; and conducting other pharmaceutical services. For
  151  purposes of this subsection, the term “other pharmaceutical
  152  services” means monitoring the patient’s drug therapy and
  153  assisting the patient in the management of his or her drug
  154  therapy, and includes reviewing, and making recommendations
  155  regarding, the patient’s drug therapy and health care status in
  156  communication with the patient’s prescribing health care
  157  provider as licensed under chapter 458, chapter 459, chapter
  158  461, or chapter 466, or a similar statutory provision in another
  159  jurisdiction, or such provider’s agent or such other persons as
  160  specifically authorized by the patient; and initiating,
  161  modifying, or discontinuing drug therapy for a chronic health
  162  condition under a collaborative pharmacy practice agreement.
  163  This subsection may not be interpreted to permit an alteration
  164  of a prescriber’s directions, the diagnosis or treatment of any
  165  disease, the initiation of any drug therapy, the practice of
  166  medicine, or the practice of osteopathic medicine, unless
  167  otherwise permitted by law or specifically authorized by s.
  168  465.1865 or s. 465.1895. The term “practice of the profession of
  169  pharmacy” also includes any other act, service, operation,
  170  research, or transaction incidental to, or forming a part of,
  171  any of the foregoing acts, requiring, involving, or employing
  172  the science or art of any branch of the pharmaceutical
  173  profession, study, or training, and shall expressly permit a
  174  pharmacist to transmit information from persons authorized to
  175  prescribe medicinal drugs to their patients. The practice of the
  176  profession of pharmacy also includes the administration of
  177  vaccines to adults pursuant to s. 465.189, the testing or
  178  screening for and treatment of minor, nonchronic health
  179  conditions pursuant to s. 465.1895, and the preparation of
  180  prepackaged drug products in facilities holding Class III
  181  institutional pharmacy permits. The term also includes the
  182  ordering and evaluating of any laboratory or clinical testing;
  183  conducting patient assessments; and modifying, discontinuing, or
  184  administering medicinal drugs pursuant to s. 465.0125 by a
  185  consultant pharmacist.
  186         (23)(14) “Prescription” includes any order for drugs or
  187  medicinal supplies written or transmitted by any means of
  188  communication by a duly licensed practitioner authorized by the
  189  laws of the state to prescribe such drugs or medicinal supplies
  190  and intended to be dispensed by a pharmacist. The term also
  191  includes an orally transmitted order by the lawfully designated
  192  agent of such practitioner. The term also includes an order
  193  written or transmitted by a practitioner licensed to practice in
  194  a jurisdiction other than this state, but only if the pharmacist
  195  called upon to dispense such order determines, in the exercise
  196  of her or his professional judgment, that the order is valid and
  197  necessary for the treatment of a chronic or recurrent illness.
  198  The term “prescription” also includes a pharmacist’s order for a
  199  product selected from the formulary created pursuant to s.
  200  465.186. Prescriptions may be retained in written form or the
  201  pharmacist may cause them to be recorded in a data processing
  202  system, provided that such order can be produced in printed form
  203  upon lawful request.
  204         (16)(15) “Nuclear pharmacist” means a pharmacist licensed
  205  by the department and certified as a nuclear pharmacist pursuant
  206  to s. 465.0126.
  207         (6)(16) “Centralized prescription filling” means the
  208  filling of a prescription by one pharmacy upon request by
  209  another pharmacy to fill or refill the prescription. The term
  210  includes the performance by one pharmacy for another pharmacy of
  211  other pharmacy duties such as drug utilization review,
  212  therapeutic drug utilization review, claims adjudication, and
  213  the obtaining of refill authorizations.
  214         (3)(17) “Automated pharmacy system” means a mechanical
  215  system that delivers prescription drugs received from a Florida
  216  licensed pharmacy and maintains related transaction information.
  217         (9)(18) “Compounding” means combining, mixing, or altering
  218  the ingredients of one or more drugs or products to create
  219  another drug or product.
  220         (17)(19) “Outsourcing facility” means a single physical
  221  location registered as an outsourcing facility under the federal
  222  Drug Quality and Security Act, Pub. L. No. 113-54, at which
  223  sterile compounding of a drug or product is conducted.
  224         (8)(20) “Compounded sterile product” means a drug that is
  225  intended for parenteral administration, an ophthalmic or oral
  226  inhalation drug in aqueous format, or a drug or product that is
  227  required to be sterile under federal or state law or rule, which
  228  is produced through compounding, but is not approved by the
  229  United States Food and Drug Administration.
  230         (5)(21) “Central distribution facility” means a facility
  231  under common control with a hospital holding a Class III
  232  institutional pharmacy permit that may dispense, distribute,
  233  compound, or fill prescriptions for medicinal drugs; prepare
  234  prepackaged drug products; and conduct other pharmaceutical
  235  services.
  236         (7)(22) “Common control” means the power to direct or cause
  237  the direction of the management and policies of a person or an
  238  organization, whether by ownership of stock, voting rights,
  239  contract, or otherwise.
  240         Section 4. Paragraph (d) of subsection (2) and paragraph
  241  (a) of subsection (4) of section 465.019, Florida Statutes, are
  242  amended to read:
  243         465.019 Institutional pharmacies; permits.—
  244         (2) The following classes of institutional pharmacies are
  245  established:
  246         (d)1. “Class III institutional pharmacies” are those
  247  institutional pharmacies, including central distribution
  248  facilities, affiliated with a hospital which that provide the
  249  same services that are authorized by a Class II institutional
  250  pharmacy permit. Class III institutional pharmacies may also:
  251         a. Dispense, distribute, compound, and fill prescriptions
  252  for medicinal drugs for inpatient treatment or for patients
  253  receiving acute and post-acute hospital care at home.
  254         b. Prepare prepackaged drug products.
  255         c. Conduct other pharmaceutical services for the affiliated
  256  hospital and for entities under common control that are each
  257  permitted under this chapter to possess medicinal drugs.
  258         d. Provide the services in sub-subparagraphs a.-c. to an
  259  entity under common control which holds an active health care
  260  clinic establishment permit as required under s. 499.01(2)(r).
  261         2. A Class III institutional pharmacy shall maintain
  262  policies and procedures addressing:
  263         a. The consultant pharmacist responsible for pharmaceutical
  264  services.
  265         b. Safe practices for the preparation, dispensing,
  266  prepackaging, distribution, and transportation of medicinal
  267  drugs and prepackaged drug products.
  268         c. Recordkeeping to monitor the movement, distribution, and
  269  transportation of medicinal drugs and prepackaged drug products.
  270         d. Recordkeeping of pharmacy staff responsible for each
  271  step in the preparation, dispensing, prepackaging,
  272  transportation, and distribution of medicinal drugs and
  273  prepackaged drug products.
  274         e. Medicinal drugs and prepackaged drug products that may
  275  not be safely distributed among Class III institutional
  276  pharmacies.
  277         (4)(a) Medicinal drugs shall be dispensed by in an
  278  institutional pharmacy to outpatients only when that institution
  279  has secured a community pharmacy permit from the department.
  280  However, medicinal drugs may be dispensed by a hospital that
  281  operates a Class II or Class III institutional pharmacy to a
  282  patient of the hospital’s emergency department or a hospital
  283  inpatient upon discharge if a prescriber, as defined in s.
  284  465.025(1), treating the patient in such hospital determines
  285  that the medicinal drug is warranted and that community pharmacy
  286  services are not readily accessible, geographically or
  287  otherwise, to the patient. Such prescribing and dispensing must
  288  be for a supply of the drug that will last for the greater of
  289  the following:
  290         1. Up to 48 hours; or
  291         2. Through the end of the next business day.
  292         Section 5. Subsection (1) of section 14.33, Florida
  293  Statutes, is amended to read:
  294         14.33 Medal of Heroism.—
  295         (1) The Governor may award a Medal of Heroism of
  296  appropriate design, with ribbons and appurtenances, to a law
  297  enforcement, correctional, or correctional probation officer, as
  298  defined in s. 943.10(14); a firefighter, as defined in s.
  299  112.191(1)(b); an emergency medical technician, as defined in s.
  300  401.23 s. 401.23(11); or a paramedic, as defined in s. 401.23 s.
  301  401.23(17). A recipient must have distinguished himself or
  302  herself conspicuously by gallantry and intrepidity, must have
  303  risked his or her life deliberately above and beyond the call of
  304  duty while performing duty in his or her respective position,
  305  and must have engaged in hazardous or perilous activities to
  306  preserve lives with the knowledge that such activities might
  307  result in great personal harm.
  308         Section 6. Subsection (1) of section 125.01045, Florida
  309  Statutes, is amended to read:
  310         125.01045 Prohibition of fees for first responder
  311  services.—
  312         (1) A county may not impose a fee or seek reimbursement for
  313  any costs or expenses that may be incurred for services provided
  314  by a first responder, including costs or expenses related to
  315  personnel, supplies, motor vehicles, or equipment in response to
  316  a motor vehicle accident, except for costs to contain or clean
  317  up hazardous materials in quantities reportable to the Florida
  318  State Warning Point at the Division of Emergency Management, and
  319  costs for transportation and treatment provided by air ambulance
  320  services or emergency medical services vehicles, as those terms
  321  are defined in s. 401.23 ambulance services licensed pursuant to
  322  s. 401.23(4) and (5).
  323         Section 7. Subsection (1) of section 166.0446, Florida
  324  Statutes, is amended to read:
  325         166.0446 Prohibition of fees for first responder services.—
  326         (1) A municipality may not impose a fee or seek
  327  reimbursement for any costs or expenses that may be incurred for
  328  services provided by a first responder, including costs or
  329  expenses related to personnel, supplies, motor vehicles, or
  330  equipment in response to a motor vehicle accident, except for
  331  costs to contain or clean up hazardous materials in quantities
  332  reportable to the Florida State Warning Point at the Division of
  333  Emergency Management, and costs for transportation and treatment
  334  provided by air ambulance services or emergency medical services
  335  vehicles, as those terms are defined in s. 401.23 ambulance
  336  services licensed pursuant to s. 401.23(4) and (5).
  337         Section 8. Paragraph (a) of subsection (3) of section
  338  252.515, Florida Statutes, is amended to read:
  339         252.515 Postdisaster Relief Assistance Act; immunity from
  340  civil liability.—
  341         (3) As used in this section, the term:
  342         (a) “Emergency first responder” means:
  343         1. A physician licensed under chapter 458.
  344         2. An osteopathic physician licensed under chapter 459.
  345         3. A chiropractic physician licensed under chapter 460.
  346         4. A podiatric physician licensed under chapter 461.
  347         5. A dentist licensed under chapter 466.
  348         6. An advanced practice registered nurse licensed under s.
  349  464.012.
  350         7. A physician assistant licensed under s. 458.347 or s.
  351  459.022.
  352         8. A worker employed by a public or private hospital in the
  353  state.
  354         9. A paramedic as defined in s. 401.23 s. 401.23(17).
  355         10. An emergency medical technician as defined in s. 401.23
  356  s. 401.23(11).
  357         11. A firefighter as defined in s. 633.102.
  358         12. A law enforcement officer as defined in s. 943.10.
  359         13. A member of the Florida National Guard.
  360         14. Any other personnel designated as emergency personnel
  361  by the Governor pursuant to a declared emergency.
  362         Section 9. Subsection (5) of section 395.1027, Florida
  363  Statutes, is amended to read:
  364         395.1027 Regional poison control centers.—
  365         (5) By October 1, 1999, each regional poison control center
  366  shall develop a prehospital emergency dispatch protocol with
  367  each licensee as defined in s. 401.23 by s. 401.23(13) in the
  368  geographic area covered by the regional poison control center.
  369  The prehospital emergency dispatch protocol shall be developed
  370  by each licensee’s medical director in conjunction with the
  371  designated regional poison control center responsible for the
  372  geographic area in which the licensee operates. The protocol
  373  shall define toxic substances and describe the procedure by
  374  which the designated regional poison control center may be
  375  consulted by the licensee. If a call is transferred to the
  376  designated regional poison control center in accordance with the
  377  protocol established under this section and s. 401.268, the
  378  designated regional poison control center shall assume
  379  responsibility and liability for the call.
  380         Section 10. Paragraph (b) of subsection (1) of section
  381  400.143, Florida Statutes, is amended to read:
  382         400.143 Institutional formularies established by nursing
  383  home facilities.—
  384         (1) For purposes of this section, the term:
  385         (b) “Medicinal drug” has the same meaning as provided in s.
  386  465.003 s. 465.003(8).
  387         Section 11. Paragraph (b) of subsection (2) of section
  388  401.245, Florida Statutes, is amended to read:
  389         401.245 Emergency Medical Services Advisory Council.—
  390         (2)(b) Representation on the Emergency Medical Services
  391  Advisory Council shall include: two licensed physicians who are
  392  medical directors “medical directors” as defined in s. 401.23 s.
  393  401.23(15) or whose medical practice is closely related to
  394  emergency medical services; two emergency medical service
  395  administrators, one of whom is employed by a fire service; two
  396  certified paramedics, one of whom is employed by a fire service;
  397  two certified emergency medical technicians, one of whom is
  398  employed by a fire service; one emergency medical services
  399  educator; one emergency nurse; one hospital administrator; one
  400  representative of air ambulance services; one representative of
  401  a commercial ambulance operator; and two laypersons who are in
  402  no way connected with emergency medical services, one of whom is
  403  a representative of the elderly. Ex officio members of the
  404  advisory council from state agencies shall include, but are
  405  shall not be limited to, representatives from the Department of
  406  Education, the Department of Management Services, the State Fire
  407  Marshal, the Department of Highway Safety and Motor Vehicles,
  408  the Department of Transportation, and the Division of Emergency
  409  Management.
  410         Section 12. Subsection (2) of section 401.27, Florida
  411  Statutes, is amended to read:
  412         401.27 Personnel; standards and certification.—
  413         (2) The department shall establish by rule educational and
  414  training criteria and examinations for the certification and
  415  recertification of emergency medical technicians and paramedics.
  416  Such rules must require, but need not be limited to:
  417         (a) For emergency medical technicians, proficiency in basic
  418  life support as defined techniques identified in s. 401.23 s.
  419  401.23(7) and in rules of the department.
  420         (b) For paramedics, proficiency in advanced life support as
  421  defined techniques identified in s. 401.23 s. 401.23(1) and in
  422  rules of the department.
  423         Section 13. Paragraph (a) of subsection (1) of section
  424  409.9201, Florida Statutes, is amended to read:
  425         409.9201 Medicaid fraud.—
  426         (1) As used in this section, the term:
  427         (a) “Prescription drug” means any drug, including, but not
  428  limited to, finished dosage forms or active ingredients that are
  429  subject to, defined in, or described in s. 503(b) of the Federal
  430  Food, Drug, and Cosmetic Act or in s. 465.003 s. 465.003(8), s.
  431  499.003(17), s. 499.007(13), or s. 499.82(10).
  432  
  433  The value of individual items of the legend drugs or goods or
  434  services involved in distinct transactions committed during a
  435  single scheme or course of conduct, whether involving a single
  436  person or several persons, may be aggregated when determining
  437  the punishment for the offense.
  438         Section 14. Paragraph (pp) of subsection (1) of section
  439  458.331, Florida Statutes, is amended to read:
  440         458.331 Grounds for disciplinary action; action by the
  441  board and department.—
  442         (1) The following acts constitute grounds for denial of a
  443  license or disciplinary action, as specified in s. 456.072(2):
  444         (pp) Applicable to a licensee who serves as the designated
  445  physician of a pain-management clinic as defined in s. 458.3265
  446  or s. 459.0137:
  447         1. Registering a pain-management clinic through
  448  misrepresentation or fraud;
  449         2. Procuring, or attempting to procure, the registration of
  450  a pain-management clinic for any other person by making or
  451  causing to be made, any false representation;
  452         3. Failing to comply with any requirement of chapter 499,
  453  the Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the
  454  Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq.,
  455  the Drug Abuse Prevention and Control Act; or chapter 893, the
  456  Florida Comprehensive Drug Abuse Prevention and Control Act;
  457         4. Being convicted or found guilty of, regardless of
  458  adjudication to, a felony or any other crime involving moral
  459  turpitude, fraud, dishonesty, or deceit in any jurisdiction of
  460  the courts of this state, of any other state, or of the United
  461  States;
  462         5. Being convicted of, or disciplined by a regulatory
  463  agency of the Federal Government or a regulatory agency of
  464  another state for, any offense that would constitute a violation
  465  of this chapter;
  466         6. Being convicted of, or entering a plea of guilty or nolo
  467  contendere to, regardless of adjudication, a crime in any
  468  jurisdiction of the courts of this state, of any other state, or
  469  of the United States which relates to the practice of, or the
  470  ability to practice, a licensed health care profession;
  471         7. Being convicted of, or entering a plea of guilty or nolo
  472  contendere to, regardless of adjudication, a crime in any
  473  jurisdiction of the courts of this state, of any other state, or
  474  of the United States which relates to health care fraud;
  475         8. Dispensing any medicinal drug based upon a communication
  476  that purports to be a prescription as defined in s. 465.003 s.
  477  465.003(14) or s. 893.02 if the dispensing practitioner knows or
  478  has reason to believe that the purported prescription is not
  479  based upon a valid practitioner-patient relationship; or
  480         9. Failing to timely notify the board of the date of his or
  481  her termination from a pain-management clinic as required by s.
  482  458.3265(3).
  483         Section 15. Paragraph (rr) of subsection (1) of section
  484  459.015, Florida Statutes, is amended to read:
  485         459.015 Grounds for disciplinary action; action by the
  486  board and department.—
  487         (1) The following acts constitute grounds for denial of a
  488  license or disciplinary action, as specified in s. 456.072(2):
  489         (rr) Applicable to a licensee who serves as the designated
  490  physician of a pain-management clinic as defined in s. 458.3265
  491  or s. 459.0137:
  492         1. Registering a pain-management clinic through
  493  misrepresentation or fraud;
  494         2. Procuring, or attempting to procure, the registration of
  495  a pain-management clinic for any other person by making or
  496  causing to be made, any false representation;
  497         3. Failing to comply with any requirement of chapter 499,
  498  the Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the
  499  Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq.,
  500  the Drug Abuse Prevention and Control Act; or chapter 893, the
  501  Florida Comprehensive Drug Abuse Prevention and Control Act;
  502         4. Being convicted or found guilty of, regardless of
  503  adjudication to, a felony or any other crime involving moral
  504  turpitude, fraud, dishonesty, or deceit in any jurisdiction of
  505  the courts of this state, of any other state, or of the United
  506  States;
  507         5. Being convicted of, or disciplined by a regulatory
  508  agency of the Federal Government or a regulatory agency of
  509  another state for, any offense that would constitute a violation
  510  of this chapter;
  511         6. Being convicted of, or entering a plea of guilty or nolo
  512  contendere to, regardless of adjudication, a crime in any
  513  jurisdiction of the courts of this state, of any other state, or
  514  of the United States which relates to the practice of, or the
  515  ability to practice, a licensed health care profession;
  516         7. Being convicted of, or entering a plea of guilty or nolo
  517  contendere to, regardless of adjudication, a crime in any
  518  jurisdiction of the courts of this state, of any other state, or
  519  of the United States which relates to health care fraud;
  520         8. Dispensing any medicinal drug based upon a communication
  521  that purports to be a prescription as defined in s. 465.003 s.
  522  465.003(14) or s. 893.02 if the dispensing practitioner knows or
  523  has reason to believe that the purported prescription is not
  524  based upon a valid practitioner-patient relationship; or
  525         9. Failing to timely notify the board of the date of his or
  526  her termination from a pain-management clinic as required by s.
  527  459.0137(3).
  528         Section 16. Subsection (1) of section 465.014, Florida
  529  Statutes, is amended to read:
  530         465.014 Pharmacy technician.—
  531         (1) A person other than a licensed pharmacist or pharmacy
  532  intern may not engage in the practice of the profession of
  533  pharmacy, except that a licensed pharmacist may delegate to
  534  pharmacy technicians who are registered pursuant to this section
  535  those duties, tasks, and functions that do not fall within the
  536  purview of s. 465.003 s. 465.003(13). All such delegated acts
  537  must be performed under the direct supervision of a licensed
  538  pharmacist who is responsible for all such acts performed by
  539  persons under his or her supervision. A registered pharmacy
  540  technician, under the supervision of a pharmacist, may initiate
  541  or receive communications with a practitioner or his or her
  542  agent, on behalf of a patient, regarding refill authorization
  543  requests. A licensed pharmacist may not supervise more than one
  544  registered pharmacy technician unless otherwise permitted by the
  545  guidelines adopted by the board. The board shall establish
  546  guidelines to be followed by licensees or permittees in
  547  determining the circumstances under which a licensed pharmacist
  548  may supervise more than one pharmacy technician.
  549         Section 17. Paragraph (c) of subsection (2) of section
  550  465.015, Florida Statutes, is amended to read:
  551         465.015 Violations and penalties.—
  552         (2) It is unlawful for any person:
  553         (c) To sell or dispense drugs as defined in s. 465.003 s.
  554  465.003(8) without first being furnished with a prescription.
  555         Section 18. Subsection (9) of section 465.0156, Florida
  556  Statutes, is amended to read:
  557         465.0156 Registration of nonresident pharmacies.—
  558         (9) Notwithstanding s. 465.003 s. 465.003(10), for purposes
  559  of this section, the registered pharmacy and the pharmacist
  560  designated by the registered pharmacy as the prescription
  561  department manager or the equivalent must be licensed in the
  562  state of location in order to dispense into this state.
  563         Section 19. Paragraph (s) of subsection (1) of section
  564  465.016, Florida Statutes, is amended to read:
  565         465.016 Disciplinary actions.—
  566         (1) The following acts constitute grounds for denial of a
  567  license or disciplinary action, as specified in s. 456.072(2):
  568         (s) Dispensing any medicinal drug based upon a
  569  communication that purports to be a prescription as defined in
  570  s. 465.003 by s. 465.003(14) or s. 893.02 when the pharmacist
  571  knows or has reason to believe that the purported prescription
  572  is not based upon a valid practitioner-patient relationship.
  573         Section 20. Subsection (4) of section 465.0197, Florida
  574  Statutes, is amended to read:
  575         465.0197 Internet pharmacy permits.—
  576         (4) Notwithstanding s. 465.003 s. 465.003(10), for purposes
  577  of this section, the Internet pharmacy and the pharmacist
  578  designated by the Internet pharmacy as the prescription
  579  department manager or the equivalent must be licensed in the
  580  state of location in order to dispense into this state.
  581         Section 21. Paragraph (j) of subsection (5) of section
  582  465.022, Florida Statutes, is amended to read:
  583         465.022 Pharmacies; general requirements; fees.—
  584         (5) The department or board shall deny an application for a
  585  pharmacy permit if the applicant or an affiliated person,
  586  partner, officer, director, or prescription department manager
  587  or consultant pharmacist of record of the applicant:
  588         (j) Has dispensed any medicinal drug based upon a
  589  communication that purports to be a prescription as defined in
  590  s. 465.003 by s. 465.003(14) or s. 893.02 when the pharmacist
  591  knows or has reason to believe that the purported prescription
  592  is not based upon a valid practitioner-patient relationship that
  593  includes a documented patient evaluation, including history and
  594  a physical examination adequate to establish the diagnosis for
  595  which any drug is prescribed and any other requirement
  596  established by board rule under chapter 458, chapter 459,
  597  chapter 461, chapter 463, chapter 464, or chapter 466.
  598  
  599  For felonies in which the defendant entered a plea of guilty or
  600  nolo contendere in an agreement with the court to enter a
  601  pretrial intervention or drug diversion program, the department
  602  shall deny the application if upon final resolution of the case
  603  the licensee has failed to successfully complete the program.
  604         Section 22. Paragraph (h) of subsection (1) of section
  605  465.023, Florida Statutes, is amended to read:
  606         465.023 Pharmacy permittee; disciplinary action.—
  607         (1) The department or the board may revoke or suspend the
  608  permit of any pharmacy permittee, and may fine, place on
  609  probation, or otherwise discipline any pharmacy permittee if the
  610  permittee, or any affiliated person, partner, officer, director,
  611  or agent of the permittee, including a person fingerprinted
  612  under s. 465.022(3), has:
  613         (h) Dispensed any medicinal drug based upon a communication
  614  that purports to be a prescription as defined in s. 465.003 by
  615  s. 465.003(14) or s. 893.02 when the pharmacist knows or has
  616  reason to believe that the purported prescription is not based
  617  upon a valid practitioner-patient relationship that includes a
  618  documented patient evaluation, including history and a physical
  619  examination adequate to establish the diagnosis for which any
  620  drug is prescribed and any other requirement established by
  621  board rule under chapter 458, chapter 459, chapter 461, chapter
  622  463, chapter 464, or chapter 466.
  623         Section 23. Section 465.1901, Florida Statutes, is amended
  624  to read:
  625         465.1901 Practice of orthotics and pedorthics.—The
  626  provisions of chapter 468 relating to orthotics or pedorthics do
  627  not apply to any licensed pharmacist or to any person acting
  628  under the supervision of a licensed pharmacist. The practice of
  629  orthotics or pedorthics by a pharmacist or any of the
  630  pharmacist’s employees acting under the supervision of a
  631  pharmacist shall be construed to be within the meaning of the
  632  term “practice of the profession of pharmacy” as defined set
  633  forth in s. 465.003 s. 465.003(13), and shall be subject to
  634  regulation in the same manner as any other pharmacy practice.
  635  The Board of Pharmacy shall develop rules regarding the practice
  636  of orthotics and pedorthics by a pharmacist. Any pharmacist or
  637  person under the supervision of a pharmacist engaged in the
  638  practice of orthotics or pedorthics is not precluded from
  639  continuing that practice pending adoption of these rules.
  640         Section 24. Paragraph (j) of subsection (2) of section
  641  465.1902, Florida Statutes, is amended to read:
  642         465.1902 Prescription Drug Donation Repository Program.—
  643         (2) DEFINITIONS.—As used in this section, the term:
  644         (j) “Prescription drug” has the same meaning as the term
  645  “medicinal drugs” or “drugs,” as those terms are defined in s.
  646  465.003 s. 465.003(8), but does not include controlled
  647  substances, cancer drugs donated under s. 499.029, or drugs with
  648  an approved United States Food and Drug Administration risk
  649  evaluation and mitigation strategy that includes elements to
  650  assure safe use.
  651         Section 25. Subsection (40) of section 499.003, Florida
  652  Statutes, is amended to read:
  653         499.003 Definitions of terms used in this part.—As used in
  654  this part, the term:
  655         (40) “Prescription drug” means a prescription, medicinal,
  656  or legend drug, including, but not limited to, finished dosage
  657  forms or active pharmaceutical ingredients subject to, defined
  658  by, or described by s. 503(b) of the federal act or s. 465.003
  659  s. 465.003(8), s. 499.007(13), subsection (31), or subsection
  660  (47), except that an active pharmaceutical ingredient is a
  661  prescription drug only if substantially all finished dosage
  662  forms in which it may be lawfully dispensed or administered in
  663  this state are also prescription drugs.
  664         Section 26. Paragraph (c) of subsection (24) of section
  665  893.02, Florida Statutes, is amended to read:
  666         893.02 Definitions.—The following words and phrases as used
  667  in this chapter shall have the following meanings, unless the
  668  context otherwise requires:
  669         (24) “Prescription” includes any order for drugs or
  670  medicinal supplies which is written or transmitted by any means
  671  of communication by a licensed practitioner authorized by the
  672  laws of this state to prescribe such drugs or medicinal
  673  supplies, is issued in good faith and in the course of
  674  professional practice, is intended to be dispensed by a person
  675  authorized by the laws of this state to do so, and meets the
  676  requirements of s. 893.04.
  677         (c) A prescription for a controlled substance may not be
  678  issued on the same prescription blank with another prescription
  679  for a controlled substance that is named or described in a
  680  different schedule or with another prescription for a medicinal
  681  drug, as defined in s. 465.003 s. 465.003(8), that is not a
  682  controlled substance.
  683         Section 27. This act shall take effect July 1, 2022.
  684  
  685  ================= T I T L E  A M E N D M E N T ================
  686  And the title is amended as follows:
  687         Delete everything before the enacting clause
  688  and insert:
  689                        A bill to be entitled                      
  690         An act relating to acute and post-acute hospital care
  691         at home; amending s. 401.23, F.S.; defining the term
  692         “acute and post-acute hospital care at home”; amending
  693         s. 401.272, F.S.; authorizing paramedics to perform
  694         certain life support services to patients receiving
  695         acute and post-acute hospital care at home under
  696         certain circumstances; providing that a physician or
  697         medical director who supervises or directs the
  698         provision of such services by a paramedic is liable
  699         for any act or omission during the provision of such
  700         services; authorizing the Department of Health to
  701         adopt and enforce rules; amending s. 465.003, F.S.;
  702         defining the term “acute and post-acute hospital care
  703         at home”; amending s. 465.019, F.S.; specifying that
  704         Class III institutional pharmacies may dispense,
  705         distribute, compound, and fill prescriptions for
  706         medicinal drugs for inpatient treatment and patients
  707         receiving acute and post-acute hospital care at home;
  708         amending ss. 14.33, 125.01045, 166.0446, 252.515,
  709         395.1027, 400.143, 401.245, 401.27, 409.9201, 458.331,
  710         459.015, 465.014, 465.015, 465.0156, 465.016,
  711         465.0197, 465.022, 465.023, 465.1901, 465.1902,
  712         499.003, and 893.02, F.S.; conforming cross
  713         references; providing an effective date.