Florida Senate - 2022                        COMMITTEE AMENDMENT
       Bill No. CS for SB 1222
       
       
       
       
       
       
                                Ì874244+Î874244                         
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RS            .                                
                  02/07/2022           .                                
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       The Committee on Judiciary (Bean) recommended the following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Present subsections (1) through (22) of section
    6  401.23, Florida Statutes, are redesignated as subsections (2)
    7  through (23), respectively, a new subsection (1) is added to
    8  that section, and present subsection (19) of that section is
    9  amended, to read:
   10         401.23 Definitions.—As used in this part, the term:
   11         (1) “Acute hospital care at home” means acute and post
   12  acute health care services provided in a clinically qualified
   13  patient’s permanent residence, as defined in s. 196.012(17),
   14  through a program approved by the Centers for Medicare and
   15  Medicaid Services and the Agency for Health Care Administration.
   16         (20)(19) “Physician” means a practitioner who is licensed
   17  under the provisions of chapter 458 or chapter 459. For the
   18  purpose of providing medical direction “medical direction” as
   19  defined in subsection (14) for the treatment of patients
   20  immediately before prior to or during transportation to a United
   21  States Department of Veterans Affairs medical facility,
   22  “physician” also means a practitioner employed by the United
   23  States Department of Veterans Affairs.
   24         Section 2. Paragraph (c) is added to subsection (2) of
   25  section 401.272, Florida Statutes, to read:
   26         401.272 Emergency medical services community health care.—
   27         (2) Notwithstanding any other provision of law to the
   28  contrary:
   29         (c)Paramedics may provide basic life support services and
   30  advanced life support services to patients receiving acute
   31  hospital care at home as specified in the paramedic’s
   32  supervisory relationship with a physician or standing orders as
   33  described in s. 401.265, s. 458.348, or s. 459.025. A physician
   34  who supervises or provides medical direction to a paramedic who
   35  provides basic life support services or advanced life support
   36  services to patients receiving acute hospital care at home
   37  pursuant to a formal supervisory relationship or standing orders
   38  is liable for any act or omission of the paramedic acting under
   39  the physician’s supervision or medical direction when providing
   40  such services. The department may adopt and enforce rules
   41  necessary to implement this paragraph.
   42         Section 3. Section 465.003, Florida Statutes, is reordered
   43  and amended to read:
   44         465.003 Definitions.—As used in this chapter, the term:
   45         (1) “Acute hospital care at home” means acute and post
   46  acute health care services provided in a clinically qualified
   47  patient’s permanent residence, as defined in s. 196.012(17),
   48  through a program approved by the Centers for Medicare and
   49  Medicaid Services and the Agency for Health Care Administration.
   50         (2)(1) “Administration” means the obtaining and giving of a
   51  single dose of medicinal drugs by a legally authorized person to
   52  a patient for her or his consumption.
   53         (4)(2) “Board” means the Board of Pharmacy.
   54         (10)(3) “Consultant pharmacist” means a pharmacist licensed
   55  by the department and certified as a consultant pharmacist
   56  pursuant to s. 465.0125.
   57         (11)(4) “Data communication device” means an electronic
   58  device that receives electronic information from one source and
   59  transmits or routes it to another, including, but not limited
   60  to, any such bridge, router, switch, or gateway.
   61         (12)(5) “Department” means the Department of Health.
   62         (13)(6) “Dispense” means the transfer of possession of one
   63  or more doses of a medicinal drug by a pharmacist to the
   64  ultimate consumer or her or his agent. As an element of
   65  dispensing, the pharmacist shall, prior to the actual physical
   66  transfer, interpret and assess the prescription order for
   67  potential adverse reactions, interactions, and dosage regimen
   68  she or he deems appropriate in the exercise of her or his
   69  professional judgment, and the pharmacist shall certify that the
   70  medicinal drug called for by the prescription is ready for
   71  transfer. The pharmacist shall also provide counseling on proper
   72  drug usage, either orally or in writing, if in the exercise of
   73  her or his professional judgment counseling is necessary. The
   74  actual sales transaction and delivery of such drug shall not be
   75  considered dispensing. The administration shall not be
   76  considered dispensing.
   77         (14)(7) “Institutional formulary system” means a method
   78  whereby the medical staff evaluates, appraises, and selects
   79  those medicinal drugs or proprietary preparations which in the
   80  medical staff’s clinical judgment are most useful in patient
   81  care, and which are available for dispensing by a practicing
   82  pharmacist in a Class II or Class III institutional pharmacy.
   83         (15)(8) “Medicinal drugs” or “drugs” means those substances
   84  or preparations commonly known as “prescription” or “legend”
   85  drugs which are required by federal or state law to be dispensed
   86  only on a prescription, but shall not include patents or
   87  proprietary preparations as hereafter defined.
   88         (18)(9) “Patent or proprietary preparation” means a
   89  medicine in its unbroken, original package which is sold to the
   90  public by, or under the authority of, the manufacturer or
   91  primary distributor thereof and which is not misbranded under
   92  the provisions of the Florida Drug and Cosmetic Act.
   93         (19)(10) “Pharmacist” means any person licensed pursuant to
   94  this chapter to practice the profession of pharmacy.
   95         (20)(a)(11)(a) “Pharmacy” includes a community pharmacy, an
   96  institutional pharmacy, a nuclear pharmacy, a special pharmacy,
   97  and an Internet pharmacy.
   98         1. The term “community pharmacy” includes every location
   99  where medicinal drugs are compounded, dispensed, stored, or sold
  100  or where prescriptions are filled or dispensed on an outpatient
  101  basis.
  102         2. The term “institutional pharmacy” includes every
  103  location in a hospital, clinic, nursing home, dispensary,
  104  sanitarium, extended care facility, or other facility,
  105  hereinafter referred to as “health care institutions,” where
  106  medicinal drugs are compounded, dispensed, stored, or sold.
  107         3. The term “nuclear pharmacy” includes every location
  108  where radioactive drugs and chemicals within the classification
  109  of medicinal drugs are compounded, dispensed, stored, or sold.
  110  The term “nuclear pharmacy” does not include hospitals licensed
  111  under chapter 395 or the nuclear medicine facilities of such
  112  hospitals.
  113         4. The term “special pharmacy” includes every location
  114  where medicinal drugs are compounded, dispensed, stored, or sold
  115  if such locations are not otherwise defined in this subsection.
  116         5. The term “Internet pharmacy” includes locations not
  117  otherwise licensed or issued a permit under this chapter, within
  118  or outside this state, which use the Internet to communicate
  119  with or obtain information from consumers in this state and use
  120  such communication or information to fill or refill
  121  prescriptions or to dispense, distribute, or otherwise engage in
  122  the practice of pharmacy in this state. Any act described in
  123  this definition constitutes the practice of the profession of
  124  pharmacy as defined in subsection (13).
  125         (b) The pharmacy department of any permittee shall be
  126  considered closed whenever a Florida licensed pharmacist is not
  127  present and on duty. The term “not present and on duty” shall
  128  not be construed to prevent a pharmacist from exiting the
  129  prescription department for the purposes of consulting or
  130  responding to inquiries or providing assistance to patients or
  131  customers, attending to personal hygiene needs, or performing
  132  any other function for which the pharmacist is responsible,
  133  provided that such activities are conducted in a manner
  134  consistent with the pharmacist’s responsibility to provide
  135  pharmacy services.
  136         (21)(12) “Pharmacy intern” means a person who is currently
  137  registered in, and attending, a duly accredited college or
  138  school of pharmacy, or who is a graduate of such a school or
  139  college of pharmacy, and who is duly and properly registered
  140  with the department as provided for under its rules.
  141         (22)(13) “Practice of the profession of pharmacy” includes
  142  compounding, dispensing, and consulting concerning contents,
  143  therapeutic values, and uses of any medicinal drug; consulting
  144  concerning therapeutic values and interactions of patent or
  145  proprietary preparations, whether pursuant to prescriptions or
  146  in the absence and entirely independent of such prescriptions or
  147  orders; and conducting other pharmaceutical services. For
  148  purposes of this subsection, the term “other pharmaceutical
  149  services” means monitoring the patient’s drug therapy and
  150  assisting the patient in the management of his or her drug
  151  therapy, and includes reviewing, and making recommendations
  152  regarding, the patient’s drug therapy and health care status in
  153  communication with the patient’s prescribing health care
  154  provider as licensed under chapter 458, chapter 459, chapter
  155  461, or chapter 466, or a similar statutory provision in another
  156  jurisdiction, or such provider’s agent or such other persons as
  157  specifically authorized by the patient; and initiating,
  158  modifying, or discontinuing drug therapy for a chronic health
  159  condition under a collaborative pharmacy practice agreement.
  160  This subsection may not be interpreted to permit an alteration
  161  of a prescriber’s directions, the diagnosis or treatment of any
  162  disease, the initiation of any drug therapy, the practice of
  163  medicine, or the practice of osteopathic medicine, unless
  164  otherwise permitted by law or specifically authorized by s.
  165  465.1865 or s. 465.1895. The term “practice of the profession of
  166  pharmacy” also includes any other act, service, operation,
  167  research, or transaction incidental to, or forming a part of,
  168  any of the foregoing acts, requiring, involving, or employing
  169  the science or art of any branch of the pharmaceutical
  170  profession, study, or training, and shall expressly permit a
  171  pharmacist to transmit information from persons authorized to
  172  prescribe medicinal drugs to their patients. The practice of the
  173  profession of pharmacy also includes the administration of
  174  vaccines to adults pursuant to s. 465.189, the testing or
  175  screening for and treatment of minor, nonchronic health
  176  conditions pursuant to s. 465.1895, and the preparation of
  177  prepackaged drug products in facilities holding Class III
  178  institutional pharmacy permits. The term also includes the
  179  ordering and evaluating of any laboratory or clinical testing;
  180  conducting patient assessments; and modifying, discontinuing, or
  181  administering medicinal drugs pursuant to s. 465.0125 by a
  182  consultant pharmacist.
  183         (23)(14) “Prescription” includes any order for drugs or
  184  medicinal supplies written or transmitted by any means of
  185  communication by a duly licensed practitioner authorized by the
  186  laws of the state to prescribe such drugs or medicinal supplies
  187  and intended to be dispensed by a pharmacist. The term also
  188  includes an orally transmitted order by the lawfully designated
  189  agent of such practitioner. The term also includes an order
  190  written or transmitted by a practitioner licensed to practice in
  191  a jurisdiction other than this state, but only if the pharmacist
  192  called upon to dispense such order determines, in the exercise
  193  of her or his professional judgment, that the order is valid and
  194  necessary for the treatment of a chronic or recurrent illness.
  195  The term “prescription” also includes a pharmacist’s order for a
  196  product selected from the formulary created pursuant to s.
  197  465.186. Prescriptions may be retained in written form or the
  198  pharmacist may cause them to be recorded in a data processing
  199  system, provided that such order can be produced in printed form
  200  upon lawful request.
  201         (16)(15) “Nuclear pharmacist” means a pharmacist licensed
  202  by the department and certified as a nuclear pharmacist pursuant
  203  to s. 465.0126.
  204         (6)(16) “Centralized prescription filling” means the
  205  filling of a prescription by one pharmacy upon request by
  206  another pharmacy to fill or refill the prescription. The term
  207  includes the performance by one pharmacy for another pharmacy of
  208  other pharmacy duties such as drug utilization review,
  209  therapeutic drug utilization review, claims adjudication, and
  210  the obtaining of refill authorizations.
  211         (3)(17) “Automated pharmacy system” means a mechanical
  212  system that delivers prescription drugs received from a Florida
  213  licensed pharmacy and maintains related transaction information.
  214         (9)(18) “Compounding” means combining, mixing, or altering
  215  the ingredients of one or more drugs or products to create
  216  another drug or product.
  217         (17)(19) “Outsourcing facility” means a single physical
  218  location registered as an outsourcing facility under the federal
  219  Drug Quality and Security Act, Pub. L. No. 113-54, at which
  220  sterile compounding of a drug or product is conducted.
  221         (8)(20) “Compounded sterile product” means a drug that is
  222  intended for parenteral administration, an ophthalmic or oral
  223  inhalation drug in aqueous format, or a drug or product that is
  224  required to be sterile under federal or state law or rule, which
  225  is produced through compounding, but is not approved by the
  226  United States Food and Drug Administration.
  227         (5)(21) “Central distribution facility” means a facility
  228  under common control with a hospital holding a Class III
  229  institutional pharmacy permit that may dispense, distribute,
  230  compound, or fill prescriptions for medicinal drugs; prepare
  231  prepackaged drug products; and conduct other pharmaceutical
  232  services.
  233         (7)(22) “Common control” means the power to direct or cause
  234  the direction of the management and policies of a person or an
  235  organization, whether by ownership of stock, voting rights,
  236  contract, or otherwise.
  237         Section 4. Paragraph (d) of subsection (2) and paragraph
  238  (a) of subsection (4) of section 465.019, Florida Statutes, are
  239  amended to read:
  240         465.019 Institutional pharmacies; permits.—
  241         (2) The following classes of institutional pharmacies are
  242  established:
  243         (d)1. “Class III institutional pharmacies” are those
  244  institutional pharmacies, including central distribution
  245  facilities, affiliated with a hospital which that provide the
  246  same services that are authorized by a Class II institutional
  247  pharmacy permit. Class III institutional pharmacies may also:
  248         a. Dispense, distribute, compound, and fill prescriptions
  249  for medicinal drugs for inpatient treatment or for patients
  250  receiving acute hospital care at home.
  251         b. Prepare prepackaged drug products.
  252         c. Conduct other pharmaceutical services for the affiliated
  253  hospital and for entities under common control that are each
  254  permitted under this chapter to possess medicinal drugs.
  255         d. Provide the services in sub-subparagraphs a.-c. to an
  256  entity under common control which holds an active health care
  257  clinic establishment permit as required under s. 499.01(2)(r).
  258         2. A Class III institutional pharmacy shall maintain
  259  policies and procedures addressing:
  260         a. The consultant pharmacist responsible for pharmaceutical
  261  services.
  262         b. Safe practices for the preparation, dispensing,
  263  prepackaging, distribution, and transportation of medicinal
  264  drugs and prepackaged drug products.
  265         c. Recordkeeping to monitor the movement, distribution, and
  266  transportation of medicinal drugs and prepackaged drug products.
  267         d. Recordkeeping of pharmacy staff responsible for each
  268  step in the preparation, dispensing, prepackaging,
  269  transportation, and distribution of medicinal drugs and
  270  prepackaged drug products.
  271         e. Medicinal drugs and prepackaged drug products that may
  272  not be safely distributed among Class III institutional
  273  pharmacies.
  274         (4)(a) Medicinal drugs shall be dispensed by in an
  275  institutional pharmacy to outpatients only when that institution
  276  has secured a community pharmacy permit from the department.
  277  However, medicinal drugs may be dispensed by a hospital that
  278  operates a Class II or Class III institutional pharmacy to a
  279  patient of the hospital’s emergency department or a hospital
  280  inpatient upon discharge if a prescriber, as defined in s.
  281  465.025(1), treating the patient in such hospital determines
  282  that the medicinal drug is warranted and that community pharmacy
  283  services are not readily accessible, geographically or
  284  otherwise, to the patient. Such prescribing and dispensing must
  285  be for a supply of the drug that will last for the greater of
  286  the following:
  287         1. Up to 48 hours; or
  288         2. Through the end of the next business day.
  289         Section 5. Subsection (1) of section 14.33, Florida
  290  Statutes, is amended to read:
  291         14.33 Medal of Heroism.—
  292         (1) The Governor may award a Medal of Heroism of
  293  appropriate design, with ribbons and appurtenances, to a law
  294  enforcement, correctional, or correctional probation officer, as
  295  defined in s. 943.10(14); a firefighter, as defined in s.
  296  112.191(1)(b); an emergency medical technician, as defined in s.
  297  401.23 s. 401.23(11); or a paramedic, as defined in s. 401.23 s.
  298  401.23(17). A recipient must have distinguished himself or
  299  herself conspicuously by gallantry and intrepidity, must have
  300  risked his or her life deliberately above and beyond the call of
  301  duty while performing duty in his or her respective position,
  302  and must have engaged in hazardous or perilous activities to
  303  preserve lives with the knowledge that such activities might
  304  result in great personal harm.
  305         Section 6. Subsection (1) of section 125.01045, Florida
  306  Statutes, is amended to read:
  307         125.01045 Prohibition of fees for first responder
  308  services.—
  309         (1) A county may not impose a fee or seek reimbursement for
  310  any costs or expenses that may be incurred for services provided
  311  by a first responder, including costs or expenses related to
  312  personnel, supplies, motor vehicles, or equipment in response to
  313  a motor vehicle accident, except for costs to contain or clean
  314  up hazardous materials in quantities reportable to the Florida
  315  State Warning Point at the Division of Emergency Management, and
  316  costs for transportation and treatment provided by ambulance
  317  services licensed pursuant to part III of chapter 401 s.
  318  401.23(4) and (5).
  319         Section 7. Subsection (1) of section 166.0446, Florida
  320  Statutes, is amended to read:
  321         166.0446 Prohibition of fees for first responder services.—
  322         (1) A municipality may not impose a fee or seek
  323  reimbursement for any costs or expenses that may be incurred for
  324  services provided by a first responder, including costs or
  325  expenses related to personnel, supplies, motor vehicles, or
  326  equipment in response to a motor vehicle accident, except for
  327  costs to contain or clean up hazardous materials in quantities
  328  reportable to the Florida State Warning Point at the Division of
  329  Emergency Management, and costs for transportation and treatment
  330  provided by ambulance services licensed pursuant to part III of
  331  chapter 401 s. 401.23(4) and (5).
  332         Section 8. Paragraph (a) of subsection (3) of section
  333  252.515, Florida Statutes, is amended to read:
  334         252.515 Postdisaster Relief Assistance Act; immunity from
  335  civil liability.—
  336         (3) As used in this section, the term:
  337         (a) “Emergency first responder” means:
  338         1. A physician licensed under chapter 458.
  339         2. An osteopathic physician licensed under chapter 459.
  340         3. A chiropractic physician licensed under chapter 460.
  341         4. A podiatric physician licensed under chapter 461.
  342         5. A dentist licensed under chapter 466.
  343         6. An advanced practice registered nurse licensed under s.
  344  464.012.
  345         7. A physician assistant licensed under s. 458.347 or s.
  346  459.022.
  347         8. A worker employed by a public or private hospital in the
  348  state.
  349         9. A paramedic as defined in s. 401.23 s. 401.23(17).
  350         10. An emergency medical technician as defined in s. 401.23
  351  s. 401.23(11).
  352         11. A firefighter as defined in s. 633.102.
  353         12. A law enforcement officer as defined in s. 943.10.
  354         13. A member of the Florida National Guard.
  355         14. Any other personnel designated as emergency personnel
  356  by the Governor pursuant to a declared emergency.
  357         Section 9. Subsection (5) of section 395.1027, Florida
  358  Statutes, is amended to read:
  359         395.1027 Regional poison control centers.—
  360         (5) By October 1, 1999, each regional poison control center
  361  shall develop a prehospital emergency dispatch protocol with
  362  each licensee as defined in s. 401.23 by s. 401.23(13) in the
  363  geographic area covered by the regional poison control center.
  364  The prehospital emergency dispatch protocol shall be developed
  365  by each licensee’s medical director in conjunction with the
  366  designated regional poison control center responsible for the
  367  geographic area in which the licensee operates. The protocol
  368  shall define toxic substances and describe the procedure by
  369  which the designated regional poison control center may be
  370  consulted by the licensee. If a call is transferred to the
  371  designated regional poison control center in accordance with the
  372  protocol established under this section and s. 401.268, the
  373  designated regional poison control center shall assume
  374  responsibility and liability for the call.
  375         Section 10. Paragraph (b) of subsection (1) of section
  376  400.143, Florida Statutes, is amended to read:
  377         400.143 Institutional formularies established by nursing
  378  home facilities.—
  379         (1) For purposes of this section, the term:
  380         (b) “Medicinal drug” has the same meaning as provided in s.
  381  465.003 s. 465.003(8).
  382         Section 11. Paragraph (b) of subsection (2) of section
  383  401.245, Florida Statutes, is amended to read:
  384         401.245 Emergency Medical Services Advisory Council.—
  385         (2)(b) Representation on the Emergency Medical Services
  386  Advisory Council shall include: two licensed physicians who are
  387  medical directors “medical directors” as defined in s. 401.23 s.
  388  401.23(15) or whose medical practice is closely related to
  389  emergency medical services; two emergency medical service
  390  administrators, one of whom is employed by a fire service; two
  391  certified paramedics, one of whom is employed by a fire service;
  392  two certified emergency medical technicians, one of whom is
  393  employed by a fire service; one emergency medical services
  394  educator; one emergency nurse; one hospital administrator; one
  395  representative of air ambulance services; one representative of
  396  a commercial ambulance operator; and two laypersons who are in
  397  no way connected with emergency medical services, one of whom is
  398  a representative of the elderly. Ex officio members of the
  399  advisory council from state agencies shall include, but are
  400  shall not be limited to, representatives from the Department of
  401  Education, the Department of Management Services, the State Fire
  402  Marshal, the Department of Highway Safety and Motor Vehicles,
  403  the Department of Transportation, and the Division of Emergency
  404  Management.
  405         Section 12. Subsection (2) of section 401.27, Florida
  406  Statutes, is amended to read:
  407         401.27 Personnel; standards and certification.—
  408         (2) The department shall establish by rule educational and
  409  training criteria and examinations for the certification and
  410  recertification of emergency medical technicians and paramedics.
  411  Such rules must require, but need not be limited to:
  412         (a) For emergency medical technicians, proficiency in basic
  413  life support as defined techniques identified in s. 401.23 s.
  414  401.23(7) and in rules of the department.
  415         (b) For paramedics, proficiency in advanced life support as
  416  defined techniques identified in s. 401.23 s. 401.23(1) and in
  417  rules of the department.
  418         Section 13. Paragraph (a) of subsection (1) of section
  419  409.9201, Florida Statutes, is amended to read:
  420         409.9201 Medicaid fraud.—
  421         (1) As used in this section, the term:
  422         (a) “Prescription drug” means any drug, including, but not
  423  limited to, finished dosage forms or active ingredients that are
  424  subject to, defined in, or described in s. 503(b) of the Federal
  425  Food, Drug, and Cosmetic Act or in s. 465.003 s. 465.003(8), s.
  426  499.003(17), s. 499.007(13), or s. 499.82(10).
  427  
  428  The value of individual items of the legend drugs or goods or
  429  services involved in distinct transactions committed during a
  430  single scheme or course of conduct, whether involving a single
  431  person or several persons, may be aggregated when determining
  432  the punishment for the offense.
  433         Section 14. Paragraph (pp) of subsection (1) of section
  434  458.331, Florida Statutes, is amended to read:
  435         458.331 Grounds for disciplinary action; action by the
  436  board and department.—
  437         (1) The following acts constitute grounds for denial of a
  438  license or disciplinary action, as specified in s. 456.072(2):
  439         (pp) Applicable to a licensee who serves as the designated
  440  physician of a pain-management clinic as defined in s. 458.3265
  441  or s. 459.0137:
  442         1. Registering a pain-management clinic through
  443  misrepresentation or fraud;
  444         2. Procuring, or attempting to procure, the registration of
  445  a pain-management clinic for any other person by making or
  446  causing to be made, any false representation;
  447         3. Failing to comply with any requirement of chapter 499,
  448  the Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the
  449  Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq.,
  450  the Drug Abuse Prevention and Control Act; or chapter 893, the
  451  Florida Comprehensive Drug Abuse Prevention and Control Act;
  452         4. Being convicted or found guilty of, regardless of
  453  adjudication to, a felony or any other crime involving moral
  454  turpitude, fraud, dishonesty, or deceit in any jurisdiction of
  455  the courts of this state, of any other state, or of the United
  456  States;
  457         5. Being convicted of, or disciplined by a regulatory
  458  agency of the Federal Government or a regulatory agency of
  459  another state for, any offense that would constitute a violation
  460  of this chapter;
  461         6. Being convicted of, or entering a plea of guilty or nolo
  462  contendere to, regardless of adjudication, a crime in any
  463  jurisdiction of the courts of this state, of any other state, or
  464  of the United States which relates to the practice of, or the
  465  ability to practice, a licensed health care profession;
  466         7. 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 health care fraud;
  470         8. Dispensing any medicinal drug based upon a communication
  471  that purports to be a prescription as defined in s. 465.003 s.
  472  465.003(14) or s. 893.02 if the dispensing practitioner knows or
  473  has reason to believe that the purported prescription is not
  474  based upon a valid practitioner-patient relationship; or
  475         9. Failing to timely notify the board of the date of his or
  476  her termination from a pain-management clinic as required by s.
  477  458.3265(3).
  478         Section 15. Paragraph (rr) of subsection (1) of section
  479  459.015, Florida Statutes, is amended to read:
  480         459.015 Grounds for disciplinary action; action by the
  481  board and department.—
  482         (1) The following acts constitute grounds for denial of a
  483  license or disciplinary action, as specified in s. 456.072(2):
  484         (rr) Applicable to a licensee who serves as the designated
  485  physician of a pain-management clinic as defined in s. 458.3265
  486  or s. 459.0137:
  487         1. Registering a pain-management clinic through
  488  misrepresentation or fraud;
  489         2. Procuring, or attempting to procure, the registration of
  490  a pain-management clinic for any other person by making or
  491  causing to be made, any false representation;
  492         3. Failing to comply with any requirement of chapter 499,
  493  the Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the
  494  Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq.,
  495  the Drug Abuse Prevention and Control Act; or chapter 893, the
  496  Florida Comprehensive Drug Abuse Prevention and Control Act;
  497         4. Being convicted or found guilty of, regardless of
  498  adjudication to, a felony or any other crime involving moral
  499  turpitude, fraud, dishonesty, or deceit in any jurisdiction of
  500  the courts of this state, of any other state, or of the United
  501  States;
  502         5. Being convicted of, or disciplined by a regulatory
  503  agency of the Federal Government or a regulatory agency of
  504  another state for, any offense that would constitute a violation
  505  of this chapter;
  506         6. Being convicted of, or entering a plea of guilty or nolo
  507  contendere to, regardless of adjudication, a crime in any
  508  jurisdiction of the courts of this state, of any other state, or
  509  of the United States which relates to the practice of, or the
  510  ability to practice, a licensed health care profession;
  511         7. 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 health care fraud;
  515         8. Dispensing any medicinal drug based upon a communication
  516  that purports to be a prescription as defined in s. 465.003 s.
  517  465.003(14) or s. 893.02 if the dispensing practitioner knows or
  518  has reason to believe that the purported prescription is not
  519  based upon a valid practitioner-patient relationship; or
  520         9. Failing to timely notify the board of the date of his or
  521  her termination from a pain-management clinic as required by s.
  522  459.0137(3).
  523         Section 16. Subsection (1) of section 465.014, Florida
  524  Statutes, is amended to read:
  525         465.014 Pharmacy technician.—
  526         (1) A person other than a licensed pharmacist or pharmacy
  527  intern may not engage in the practice of the profession of
  528  pharmacy, except that a licensed pharmacist may delegate to
  529  pharmacy technicians who are registered pursuant to this section
  530  those duties, tasks, and functions that do not fall within the
  531  purview of s. 465.003 s. 465.003(13). All such delegated acts
  532  must be performed under the direct supervision of a licensed
  533  pharmacist who is responsible for all such acts performed by
  534  persons under his or her supervision. A registered pharmacy
  535  technician, under the supervision of a pharmacist, may initiate
  536  or receive communications with a practitioner or his or her
  537  agent, on behalf of a patient, regarding refill authorization
  538  requests. A licensed pharmacist may not supervise more than one
  539  registered pharmacy technician unless otherwise permitted by the
  540  guidelines adopted by the board. The board shall establish
  541  guidelines to be followed by licensees or permittees in
  542  determining the circumstances under which a licensed pharmacist
  543  may supervise more than one pharmacy technician.
  544         Section 17. Paragraph (c) of subsection (2) of section
  545  465.015, Florida Statutes, is amended to read:
  546         465.015 Violations and penalties.—
  547         (2) It is unlawful for any person:
  548         (c) To sell or dispense drugs as defined in s. 465.003 s.
  549  465.003(8) without first being furnished with a prescription.
  550         Section 18. Subsection (9) of section 465.0156, Florida
  551  Statutes, is amended to read:
  552         465.0156 Registration of nonresident pharmacies.—
  553         (9) Notwithstanding s. 465.003 s. 465.003(10), for purposes
  554  of this section, the registered pharmacy and the pharmacist
  555  designated by the registered pharmacy as the prescription
  556  department manager or the equivalent must be licensed in the
  557  state of location in order to dispense into this state.
  558         Section 19. Paragraph (s) of subsection (1) of section
  559  465.016, Florida Statutes, is amended to read:
  560         465.016 Disciplinary actions.—
  561         (1) The following acts constitute grounds for denial of a
  562  license or disciplinary action, as specified in s. 456.072(2):
  563         (s) Dispensing any medicinal drug based upon a
  564  communication that purports to be a prescription as defined in
  565  s. 465.003 by s. 465.003(14) or s. 893.02 when the pharmacist
  566  knows or has reason to believe that the purported prescription
  567  is not based upon a valid practitioner-patient relationship.
  568         Section 20. Subsection (4) of section 465.0197, Florida
  569  Statutes, is amended to read:
  570         465.0197 Internet pharmacy permits.—
  571         (4) Notwithstanding s. 465.003 s. 465.003(10), for purposes
  572  of this section, the Internet pharmacy and the pharmacist
  573  designated by the Internet pharmacy as the prescription
  574  department manager or the equivalent must be licensed in the
  575  state of location in order to dispense into this state.
  576         Section 21. Paragraph (j) of subsection (5) of section
  577  465.022, Florida Statutes, is amended to read:
  578         465.022 Pharmacies; general requirements; fees.—
  579         (5) The department or board shall deny an application for a
  580  pharmacy permit if the applicant or an affiliated person,
  581  partner, officer, director, or prescription department manager
  582  or consultant pharmacist of record of the applicant:
  583         (j) Has dispensed any medicinal drug based upon a
  584  communication that purports to be a prescription as defined in
  585  s. 465.003 by s. 465.003(14) or s. 893.02 when the pharmacist
  586  knows or has reason to believe that the purported prescription
  587  is not based upon a valid practitioner-patient relationship that
  588  includes a documented patient evaluation, including history and
  589  a physical examination adequate to establish the diagnosis for
  590  which any drug is prescribed and any other requirement
  591  established by board rule under chapter 458, chapter 459,
  592  chapter 461, chapter 463, chapter 464, or chapter 466.
  593  
  594  For felonies in which the defendant entered a plea of guilty or
  595  nolo contendere in an agreement with the court to enter a
  596  pretrial intervention or drug diversion program, the department
  597  shall deny the application if upon final resolution of the case
  598  the licensee has failed to successfully complete the program.
  599         Section 22. Paragraph (h) of subsection (1) of section
  600  465.023, Florida Statutes, is amended to read:
  601         465.023 Pharmacy permittee; disciplinary action.—
  602         (1) The department or the board may revoke or suspend the
  603  permit of any pharmacy permittee, and may fine, place on
  604  probation, or otherwise discipline any pharmacy permittee if the
  605  permittee, or any affiliated person, partner, officer, director,
  606  or agent of the permittee, including a person fingerprinted
  607  under s. 465.022(3), has:
  608         (h) Dispensed any medicinal drug based upon a communication
  609  that purports to be a prescription as defined in s. 465.003 by
  610  s. 465.003(14) or s. 893.02 when the pharmacist knows or has
  611  reason to believe that the purported prescription is not based
  612  upon a valid practitioner-patient relationship that includes a
  613  documented patient evaluation, including history and a physical
  614  examination adequate to establish the diagnosis for which any
  615  drug is prescribed and any other requirement established by
  616  board rule under chapter 458, chapter 459, chapter 461, chapter
  617  463, chapter 464, or chapter 466.
  618         Section 23. Section 465.1901, Florida Statutes, is amended
  619  to read:
  620         465.1901 Practice of orthotics and pedorthics.—The
  621  provisions of chapter 468 relating to orthotics or pedorthics do
  622  not apply to any licensed pharmacist or to any person acting
  623  under the supervision of a licensed pharmacist. The practice of
  624  orthotics or pedorthics by a pharmacist or any of the
  625  pharmacist’s employees acting under the supervision of a
  626  pharmacist shall be construed to be within the meaning of the
  627  term “practice of the profession of pharmacy” as defined set
  628  forth in s. 465.003 s. 465.003(13), and shall be subject to
  629  regulation in the same manner as any other pharmacy practice.
  630  The Board of Pharmacy shall develop rules regarding the practice
  631  of orthotics and pedorthics by a pharmacist. Any pharmacist or
  632  person under the supervision of a pharmacist engaged in the
  633  practice of orthotics or pedorthics is not precluded from
  634  continuing that practice pending adoption of these rules.
  635         Section 24. Paragraph (j) of subsection (2) of section
  636  465.1902, Florida Statutes, is amended to read:
  637         465.1902 Prescription Drug Donation Repository Program.—
  638         (2) DEFINITIONS.—As used in this section, the term:
  639         (j) “Prescription drug” has the same meaning as the term
  640  “medicinal drugs” or “drugs,” as those terms are defined in s.
  641  465.003 s. 465.003(8), but does not include controlled
  642  substances, cancer drugs donated under s. 499.029, or drugs with
  643  an approved United States Food and Drug Administration risk
  644  evaluation and mitigation strategy that includes elements to
  645  assure safe use.
  646         Section 25. Subsection (40) of section 499.003, Florida
  647  Statutes, is amended to read:
  648         499.003 Definitions of terms used in this part.—As used in
  649  this part, the term:
  650         (40) “Prescription drug” means a prescription, medicinal,
  651  or legend drug, including, but not limited to, finished dosage
  652  forms or active pharmaceutical ingredients subject to, defined
  653  by, or described by s. 503(b) of the federal act or s. 465.003
  654  s. 465.003(8), s. 499.007(13), subsection (31), or subsection
  655  (47), except that an active pharmaceutical ingredient is a
  656  prescription drug only if substantially all finished dosage
  657  forms in which it may be lawfully dispensed or administered in
  658  this state are also prescription drugs.
  659         Section 26. Paragraph (c) of subsection (24) of section
  660  893.02, Florida Statutes, is amended to read:
  661         893.02 Definitions.—The following words and phrases as used
  662  in this chapter shall have the following meanings, unless the
  663  context otherwise requires:
  664         (24) “Prescription” includes any order for drugs or
  665  medicinal supplies which is written or transmitted by any means
  666  of communication by a licensed practitioner authorized by the
  667  laws of this state to prescribe such drugs or medicinal
  668  supplies, is issued in good faith and in the course of
  669  professional practice, is intended to be dispensed by a person
  670  authorized by the laws of this state to do so, and meets the
  671  requirements of s. 893.04.
  672         (c) A prescription for a controlled substance may not be
  673  issued on the same prescription blank with another prescription
  674  for a controlled substance that is named or described in a
  675  different schedule or with another prescription for a medicinal
  676  drug, as defined in s. 465.003 s. 465.003(8), that is not a
  677  controlled substance.
  678         Section 27. This act shall take effect July 1, 2022.
  679  
  680  ================= T I T L E  A M E N D M E N T ================
  681  And the title is amended as follows:
  682         Delete everything before the enacting clause
  683  and insert:
  684                        A bill to be entitled                      
  685         An act relating to acute hospital care at home;
  686         amending s. 401.23, F.S.; defining the term “acute
  687         hospital care at home”; amending s. 401.272, F.S.;
  688         authorizing paramedics to perform certain life support
  689         services to patients receiving acute hospital care at
  690         home under certain circumstances; providing that a
  691         physician or medical director who supervises or
  692         directs the provision of such services by a paramedic
  693         is liable for any act or omission during the provision
  694         of such services; authorizing the Department of Health
  695         to adopt and enforce rules; amending s. 465.003, F.S.;
  696         defining the term “acute hospital care at home”;
  697         amending s. 465.019, F.S.; specifying that Class III
  698         institutional pharmacies may dispense, distribute,
  699         compound, and fill prescriptions for medicinal drugs
  700         for inpatient treatment and patients receiving acute
  701         hospital care at home; amending ss. 14.33, 125.01045,
  702         166.0446, 252.515, 395.1027, 400.143, 401.245, 401.27,
  703         409.9201, 458.331, 459.015, 465.014, 465.015,
  704         465.0156, 465.016, 465.0197, 465.022, 465.023,
  705         465.1901, 465.1902, 499.003, and 893.02, F.S.;
  706         conforming cross-references; providing an effective
  707         date.