ENROLLED
       2022 Legislature                           CS for CS for SB 1222
       
       
       
       
       
       
                                                             20221222er
    1  
    2         An act relating to acute and post-acute hospital care
    3         at home; amending s. 401.23, F.S.; defining the term
    4         “acute and post-acute hospital care at home”; amending
    5         s. 401.272, F.S.; authorizing paramedics to perform
    6         certain life support services to patients receiving
    7         acute and post-acute hospital care at home under
    8         certain circumstances; providing that a physician or
    9         medical director who supervises or directs the
   10         provision of such services by a paramedic is liable
   11         for any act or omission during the provision of such
   12         services; authorizing the Department of Health to
   13         adopt and enforce rules; amending s. 465.003, F.S.;
   14         defining the term “acute and post-acute hospital care
   15         at home”; amending s. 465.019, F.S.; specifying that
   16         Class III institutional pharmacies may dispense,
   17         distribute, compound, and fill prescriptions for
   18         medicinal drugs for inpatient treatment and patients
   19         receiving acute and post-acute hospital care at home;
   20         amending ss. 14.33, 125.01045, 166.0446, 252.515,
   21         395.1027, 400.143, 401.245, 401.27, 409.9201, 458.331,
   22         459.015, 465.014, 465.015, 465.0156, 465.016,
   23         465.0197, 465.022, 465.023, 465.1901, 465.1902,
   24         499.003, and 893.02, F.S.; conforming cross
   25         references; providing an effective date.
   26          
   27  Be It Enacted by the Legislature of the State of Florida:
   28  
   29         Section 1. Present subsections (1) through (22) of section
   30  401.23, Florida Statutes, are redesignated as subsections (2)
   31  through (23), respectively, a new subsection (1) is added to
   32  that section, and present subsection (19) of that section is
   33  amended, to read:
   34         401.23 Definitions.—As used in this part, the term:
   35         (1) “Acute and post-acute hospital care at home” means
   36  acute and post-acute health care services provided in a
   37  clinically qualified patient’s permanent residence, as defined
   38  in s. 196.012(17), through a program approved by the Centers for
   39  Medicare and Medicaid Services and the Agency for Health Care
   40  Administration.
   41         (20)(19) “Physician” means a practitioner who is licensed
   42  under the provisions of chapter 458 or chapter 459. For the
   43  purpose of providing medical direction “medical direction” as
   44  defined in subsection (14) for the treatment of patients
   45  immediately before prior to or during transportation to a United
   46  States Department of Veterans Affairs medical facility,
   47  “physician” also means a practitioner employed by the United
   48  States Department of Veterans Affairs.
   49         Section 2. Paragraph (c) is added to subsection (2) of
   50  section 401.272, Florida Statutes, to read:
   51         401.272 Emergency medical services community health care.—
   52         (2) Notwithstanding any other provision of law to the
   53  contrary:
   54         (c)Paramedics may provide basic life support services and
   55  advanced life support services to patients receiving acute and
   56  post-acute hospital care at home as specified in the paramedic’s
   57  supervisory relationship with a physician or standing orders as
   58  described in s. 401.265, s. 458.348, or s. 459.025. A physician
   59  who supervises or provides medical direction to a paramedic who
   60  provides basic life support services or advanced life support
   61  services to patients receiving acute and post-acute hospital
   62  care at home pursuant to a formal supervisory relationship or
   63  standing orders is liable for any act or omission of the
   64  paramedic acting under the physician’s supervision or medical
   65  direction when providing such services. The department may adopt
   66  and enforce rules necessary to implement this paragraph.
   67         Section 3. Section 465.003, Florida Statutes, is reordered
   68  and amended to read:
   69         465.003 Definitions.—As used in this chapter, the term:
   70         (1) “Acute and post-acute hospital care at home” means
   71  acute and post-acute health care services provided in a
   72  clinically qualified patient’s permanent residence, as defined
   73  in s. 196.012(17), through a program approved by the Centers for
   74  Medicare and Medicaid Services and the Agency for Health Care
   75  Administration.
   76         (2)(1) “Administration” means the obtaining and giving of a
   77  single dose of medicinal drugs by a legally authorized person to
   78  a patient for her or his consumption.
   79         (4)(2) “Board” means the Board of Pharmacy.
   80         (10)(3) “Consultant pharmacist” means a pharmacist licensed
   81  by the department and certified as a consultant pharmacist
   82  pursuant to s. 465.0125.
   83         (11)(4) “Data communication device” means an electronic
   84  device that receives electronic information from one source and
   85  transmits or routes it to another, including, but not limited
   86  to, any such bridge, router, switch, or gateway.
   87         (12)(5) “Department” means the Department of Health.
   88         (13)(6) “Dispense” means the transfer of possession of one
   89  or more doses of a medicinal drug by a pharmacist to the
   90  ultimate consumer or her or his agent. As an element of
   91  dispensing, the pharmacist shall, prior to the actual physical
   92  transfer, interpret and assess the prescription order for
   93  potential adverse reactions, interactions, and dosage regimen
   94  she or he deems appropriate in the exercise of her or his
   95  professional judgment, and the pharmacist shall certify that the
   96  medicinal drug called for by the prescription is ready for
   97  transfer. The pharmacist shall also provide counseling on proper
   98  drug usage, either orally or in writing, if in the exercise of
   99  her or his professional judgment counseling is necessary. The
  100  actual sales transaction and delivery of such drug shall not be
  101  considered dispensing. The administration shall not be
  102  considered dispensing.
  103         (14)(7) “Institutional formulary system” means a method
  104  whereby the medical staff evaluates, appraises, and selects
  105  those medicinal drugs or proprietary preparations which in the
  106  medical staff’s clinical judgment are most useful in patient
  107  care, and which are available for dispensing by a practicing
  108  pharmacist in a Class II or Class III institutional pharmacy.
  109         (15)(8) “Medicinal drugs” or “drugs” means those substances
  110  or preparations commonly known as “prescription” or “legend”
  111  drugs which are required by federal or state law to be dispensed
  112  only on a prescription, but shall not include patents or
  113  proprietary preparations as hereafter defined.
  114         (18)(9) “Patent or proprietary preparation” means a
  115  medicine in its unbroken, original package which is sold to the
  116  public by, or under the authority of, the manufacturer or
  117  primary distributor thereof and which is not misbranded under
  118  the provisions of the Florida Drug and Cosmetic Act.
  119         (19)(10) “Pharmacist” means any person licensed pursuant to
  120  this chapter to practice the profession of pharmacy.
  121         (20)(a)(11)(a) “Pharmacy” includes a community pharmacy, an
  122  institutional pharmacy, a nuclear pharmacy, a special pharmacy,
  123  and an Internet pharmacy.
  124         1. The term “community pharmacy” includes every location
  125  where medicinal drugs are compounded, dispensed, stored, or sold
  126  or where prescriptions are filled or dispensed on an outpatient
  127  basis.
  128         2. The term “institutional pharmacy” includes every
  129  location in a hospital, clinic, nursing home, dispensary,
  130  sanitarium, extended care facility, or other facility,
  131  hereinafter referred to as “health care institutions,” where
  132  medicinal drugs are compounded, dispensed, stored, or sold.
  133         3. The term “nuclear pharmacy” includes every location
  134  where radioactive drugs and chemicals within the classification
  135  of medicinal drugs are compounded, dispensed, stored, or sold.
  136  The term “nuclear pharmacy” does not include hospitals licensed
  137  under chapter 395 or the nuclear medicine facilities of such
  138  hospitals.
  139         4. The term “special pharmacy” includes every location
  140  where medicinal drugs are compounded, dispensed, stored, or sold
  141  if such locations are not otherwise defined in this subsection.
  142         5. The term “Internet pharmacy” includes locations not
  143  otherwise licensed or issued a permit under this chapter, within
  144  or outside this state, which use the Internet to communicate
  145  with or obtain information from consumers in this state and use
  146  such communication or information to fill or refill
  147  prescriptions or to dispense, distribute, or otherwise engage in
  148  the practice of pharmacy in this state. Any act described in
  149  this definition constitutes the practice of the profession of
  150  pharmacy as defined in subsection (13).
  151         (b) The pharmacy department of any permittee shall be
  152  considered closed whenever a Florida licensed pharmacist is not
  153  present and on duty. The term “not present and on duty” shall
  154  not be construed to prevent a pharmacist from exiting the
  155  prescription department for the purposes of consulting or
  156  responding to inquiries or providing assistance to patients or
  157  customers, attending to personal hygiene needs, or performing
  158  any other function for which the pharmacist is responsible,
  159  provided that such activities are conducted in a manner
  160  consistent with the pharmacist’s responsibility to provide
  161  pharmacy services.
  162         (21)(12) “Pharmacy intern” means a person who is currently
  163  registered in, and attending, a duly accredited college or
  164  school of pharmacy, or who is a graduate of such a school or
  165  college of pharmacy, and who is duly and properly registered
  166  with the department as provided for under its rules.
  167         (22)(13) “Practice of the profession of pharmacy” includes
  168  compounding, dispensing, and consulting concerning contents,
  169  therapeutic values, and uses of any medicinal drug; consulting
  170  concerning therapeutic values and interactions of patent or
  171  proprietary preparations, whether pursuant to prescriptions or
  172  in the absence and entirely independent of such prescriptions or
  173  orders; and conducting other pharmaceutical services. For
  174  purposes of this subsection, the term “other pharmaceutical
  175  services” means monitoring the patient’s drug therapy and
  176  assisting the patient in the management of his or her drug
  177  therapy, and includes reviewing, and making recommendations
  178  regarding, the patient’s drug therapy and health care status in
  179  communication with the patient’s prescribing health care
  180  provider as licensed under chapter 458, chapter 459, chapter
  181  461, or chapter 466, or a similar statutory provision in another
  182  jurisdiction, or such provider’s agent or such other persons as
  183  specifically authorized by the patient; and initiating,
  184  modifying, or discontinuing drug therapy for a chronic health
  185  condition under a collaborative pharmacy practice agreement.
  186  This subsection may not be interpreted to permit an alteration
  187  of a prescriber’s directions, the diagnosis or treatment of any
  188  disease, the initiation of any drug therapy, the practice of
  189  medicine, or the practice of osteopathic medicine, unless
  190  otherwise permitted by law or specifically authorized by s.
  191  465.1865 or s. 465.1895. The term “practice of the profession of
  192  pharmacy” also includes any other act, service, operation,
  193  research, or transaction incidental to, or forming a part of,
  194  any of the foregoing acts, requiring, involving, or employing
  195  the science or art of any branch of the pharmaceutical
  196  profession, study, or training, and shall expressly permit a
  197  pharmacist to transmit information from persons authorized to
  198  prescribe medicinal drugs to their patients. The practice of the
  199  profession of pharmacy also includes the administration of
  200  vaccines to adults pursuant to s. 465.189, the testing or
  201  screening for and treatment of minor, nonchronic health
  202  conditions pursuant to s. 465.1895, and the preparation of
  203  prepackaged drug products in facilities holding Class III
  204  institutional pharmacy permits. The term also includes the
  205  ordering and evaluating of any laboratory or clinical testing;
  206  conducting patient assessments; and modifying, discontinuing, or
  207  administering medicinal drugs pursuant to s. 465.0125 by a
  208  consultant pharmacist.
  209         (23)(14) “Prescription” includes any order for drugs or
  210  medicinal supplies written or transmitted by any means of
  211  communication by a duly licensed practitioner authorized by the
  212  laws of the state to prescribe such drugs or medicinal supplies
  213  and intended to be dispensed by a pharmacist. The term also
  214  includes an orally transmitted order by the lawfully designated
  215  agent of such practitioner. The term also includes an order
  216  written or transmitted by a practitioner licensed to practice in
  217  a jurisdiction other than this state, but only if the pharmacist
  218  called upon to dispense such order determines, in the exercise
  219  of her or his professional judgment, that the order is valid and
  220  necessary for the treatment of a chronic or recurrent illness.
  221  The term “prescription” also includes a pharmacist’s order for a
  222  product selected from the formulary created pursuant to s.
  223  465.186. Prescriptions may be retained in written form or the
  224  pharmacist may cause them to be recorded in a data processing
  225  system, provided that such order can be produced in printed form
  226  upon lawful request.
  227         (16)(15) “Nuclear pharmacist” means a pharmacist licensed
  228  by the department and certified as a nuclear pharmacist pursuant
  229  to s. 465.0126.
  230         (6)(16) “Centralized prescription filling” means the
  231  filling of a prescription by one pharmacy upon request by
  232  another pharmacy to fill or refill the prescription. The term
  233  includes the performance by one pharmacy for another pharmacy of
  234  other pharmacy duties such as drug utilization review,
  235  therapeutic drug utilization review, claims adjudication, and
  236  the obtaining of refill authorizations.
  237         (3)(17) “Automated pharmacy system” means a mechanical
  238  system that delivers prescription drugs received from a Florida
  239  licensed pharmacy and maintains related transaction information.
  240         (9)(18) “Compounding” means combining, mixing, or altering
  241  the ingredients of one or more drugs or products to create
  242  another drug or product.
  243         (17)(19) “Outsourcing facility” means a single physical
  244  location registered as an outsourcing facility under the federal
  245  Drug Quality and Security Act, Pub. L. No. 113-54, at which
  246  sterile compounding of a drug or product is conducted.
  247         (8)(20) “Compounded sterile product” means a drug that is
  248  intended for parenteral administration, an ophthalmic or oral
  249  inhalation drug in aqueous format, or a drug or product that is
  250  required to be sterile under federal or state law or rule, which
  251  is produced through compounding, but is not approved by the
  252  United States Food and Drug Administration.
  253         (5)(21) “Central distribution facility” means a facility
  254  under common control with a hospital holding a Class III
  255  institutional pharmacy permit that may dispense, distribute,
  256  compound, or fill prescriptions for medicinal drugs; prepare
  257  prepackaged drug products; and conduct other pharmaceutical
  258  services.
  259         (7)(22) “Common control” means the power to direct or cause
  260  the direction of the management and policies of a person or an
  261  organization, whether by ownership of stock, voting rights,
  262  contract, or otherwise.
  263         Section 4. Paragraph (d) of subsection (2) and paragraph
  264  (a) of subsection (4) of section 465.019, Florida Statutes, are
  265  amended to read:
  266         465.019 Institutional pharmacies; permits.—
  267         (2) The following classes of institutional pharmacies are
  268  established:
  269         (d)1. “Class III institutional pharmacies” are those
  270  institutional pharmacies, including central distribution
  271  facilities, affiliated with a hospital which that provide the
  272  same services that are authorized by a Class II institutional
  273  pharmacy permit. Class III institutional pharmacies may also:
  274         a. Dispense, distribute, compound, and fill prescriptions
  275  for medicinal drugs for inpatient treatment or for patients
  276  receiving acute and post-acute hospital care at home.
  277         b. Prepare prepackaged drug products.
  278         c. Conduct other pharmaceutical services for the affiliated
  279  hospital and for entities under common control that are each
  280  permitted under this chapter to possess medicinal drugs.
  281         d. Provide the services in sub-subparagraphs a.-c. to an
  282  entity under common control which holds an active health care
  283  clinic establishment permit as required under s. 499.01(2)(r).
  284         2. A Class III institutional pharmacy shall maintain
  285  policies and procedures addressing:
  286         a. The consultant pharmacist responsible for pharmaceutical
  287  services.
  288         b. Safe practices for the preparation, dispensing,
  289  prepackaging, distribution, and transportation of medicinal
  290  drugs and prepackaged drug products.
  291         c. Recordkeeping to monitor the movement, distribution, and
  292  transportation of medicinal drugs and prepackaged drug products.
  293         d. Recordkeeping of pharmacy staff responsible for each
  294  step in the preparation, dispensing, prepackaging,
  295  transportation, and distribution of medicinal drugs and
  296  prepackaged drug products.
  297         e. Medicinal drugs and prepackaged drug products that may
  298  not be safely distributed among Class III institutional
  299  pharmacies.
  300         (4)(a) Medicinal drugs shall be dispensed by in an
  301  institutional pharmacy to outpatients only when that institution
  302  has secured a community pharmacy permit from the department.
  303  However, medicinal drugs may be dispensed by a hospital that
  304  operates a Class II or Class III institutional pharmacy to a
  305  patient of the hospital’s emergency department or a hospital
  306  inpatient upon discharge if a prescriber, as defined in s.
  307  465.025(1), treating the patient in such hospital determines
  308  that the medicinal drug is warranted and that community pharmacy
  309  services are not readily accessible, geographically or
  310  otherwise, to the patient. Such prescribing and dispensing must
  311  be for a supply of the drug that will last for the greater of
  312  the following:
  313         1. Up to 48 hours; or
  314         2. Through the end of the next business day.
  315         Section 5. Subsection (1) of section 14.33, Florida
  316  Statutes, is amended to read:
  317         14.33 Medal of Heroism.—
  318         (1) The Governor may award a Medal of Heroism of
  319  appropriate design, with ribbons and appurtenances, to a law
  320  enforcement, correctional, or correctional probation officer, as
  321  defined in s. 943.10(14); a firefighter, as defined in s.
  322  112.191(1)(b); an emergency medical technician, as defined in s.
  323  401.23 s. 401.23(11); or a paramedic, as defined in s. 401.23 s.
  324  401.23(17). A recipient must have distinguished himself or
  325  herself conspicuously by gallantry and intrepidity, must have
  326  risked his or her life deliberately above and beyond the call of
  327  duty while performing duty in his or her respective position,
  328  and must have engaged in hazardous or perilous activities to
  329  preserve lives with the knowledge that such activities might
  330  result in great personal harm.
  331         Section 6. Subsection (1) of section 125.01045, Florida
  332  Statutes, is amended to read:
  333         125.01045 Prohibition of fees for first responder
  334  services.—
  335         (1) A county may not impose a fee or seek reimbursement for
  336  any costs or expenses that may be incurred for services provided
  337  by a first responder, including costs or expenses related to
  338  personnel, supplies, motor vehicles, or equipment in response to
  339  a motor vehicle accident, except for costs to contain or clean
  340  up hazardous materials in quantities reportable to the Florida
  341  State Warning Point at the Division of Emergency Management, and
  342  costs for transportation and treatment provided by air ambulance
  343  services or emergency medical services vehicles, as those terms
  344  are defined in s. 401.23 ambulance services licensed pursuant to
  345  s. 401.23(4) and (5).
  346         Section 7. Subsection (1) of section 166.0446, Florida
  347  Statutes, is amended to read:
  348         166.0446 Prohibition of fees for first responder services.—
  349         (1) A municipality may not impose a fee or seek
  350  reimbursement for any costs or expenses that may be incurred for
  351  services provided by a first responder, including costs or
  352  expenses related to personnel, supplies, motor vehicles, or
  353  equipment in response to a motor vehicle accident, except for
  354  costs to contain or clean up hazardous materials in quantities
  355  reportable to the Florida State Warning Point at the Division of
  356  Emergency Management, and costs for transportation and treatment
  357  provided by air ambulance services or emergency medical services
  358  vehicles, as those terms are defined in s. 401.23 ambulance
  359  services licensed pursuant to s. 401.23(4) and (5).
  360         Section 8. Paragraph (a) of subsection (3) of section
  361  252.515, Florida Statutes, is amended to read:
  362         252.515 Postdisaster Relief Assistance Act; immunity from
  363  civil liability.—
  364         (3) As used in this section, the term:
  365         (a) “Emergency first responder” means:
  366         1. A physician licensed under chapter 458.
  367         2. An osteopathic physician licensed under chapter 459.
  368         3. A chiropractic physician licensed under chapter 460.
  369         4. A podiatric physician licensed under chapter 461.
  370         5. A dentist licensed under chapter 466.
  371         6. An advanced practice registered nurse licensed under s.
  372  464.012.
  373         7. A physician assistant licensed under s. 458.347 or s.
  374  459.022.
  375         8. A worker employed by a public or private hospital in the
  376  state.
  377         9. A paramedic as defined in s. 401.23 s. 401.23(17).
  378         10. An emergency medical technician as defined in s. 401.23
  379  s. 401.23(11).
  380         11. A firefighter as defined in s. 633.102.
  381         12. A law enforcement officer as defined in s. 943.10.
  382         13. A member of the Florida National Guard.
  383         14. Any other personnel designated as emergency personnel
  384  by the Governor pursuant to a declared emergency.
  385         Section 9. Subsection (5) of section 395.1027, Florida
  386  Statutes, is amended to read:
  387         395.1027 Regional poison control centers.—
  388         (5) By October 1, 1999, each regional poison control center
  389  shall develop a prehospital emergency dispatch protocol with
  390  each licensee as defined in s. 401.23 by s. 401.23(13) in the
  391  geographic area covered by the regional poison control center.
  392  The prehospital emergency dispatch protocol shall be developed
  393  by each licensee’s medical director in conjunction with the
  394  designated regional poison control center responsible for the
  395  geographic area in which the licensee operates. The protocol
  396  shall define toxic substances and describe the procedure by
  397  which the designated regional poison control center may be
  398  consulted by the licensee. If a call is transferred to the
  399  designated regional poison control center in accordance with the
  400  protocol established under this section and s. 401.268, the
  401  designated regional poison control center shall assume
  402  responsibility and liability for the call.
  403         Section 10. Paragraph (b) of subsection (1) of section
  404  400.143, Florida Statutes, is amended to read:
  405         400.143 Institutional formularies established by nursing
  406  home facilities.—
  407         (1) For purposes of this section, the term:
  408         (b) “Medicinal drug” has the same meaning as provided in s.
  409  465.003 s. 465.003(8).
  410         Section 11. Paragraph (b) of subsection (2) of section
  411  401.245, Florida Statutes, is amended to read:
  412         401.245 Emergency Medical Services Advisory Council.—
  413         (2)(b) Representation on the Emergency Medical Services
  414  Advisory Council shall include: two licensed physicians who are
  415  medical directors “medical directors” as defined in s. 401.23 s.
  416  401.23(15) or whose medical practice is closely related to
  417  emergency medical services; two emergency medical service
  418  administrators, one of whom is employed by a fire service; two
  419  certified paramedics, one of whom is employed by a fire service;
  420  two certified emergency medical technicians, one of whom is
  421  employed by a fire service; one emergency medical services
  422  educator; one emergency nurse; one hospital administrator; one
  423  representative of air ambulance services; one representative of
  424  a commercial ambulance operator; and two laypersons who are in
  425  no way connected with emergency medical services, one of whom is
  426  a representative of the elderly. Ex officio members of the
  427  advisory council from state agencies shall include, but are
  428  shall not be limited to, representatives from the Department of
  429  Education, the Department of Management Services, the State Fire
  430  Marshal, the Department of Highway Safety and Motor Vehicles,
  431  the Department of Transportation, and the Division of Emergency
  432  Management.
  433         Section 12. Subsection (2) of section 401.27, Florida
  434  Statutes, is amended to read:
  435         401.27 Personnel; standards and certification.—
  436         (2) The department shall establish by rule educational and
  437  training criteria and examinations for the certification and
  438  recertification of emergency medical technicians and paramedics.
  439  Such rules must require, but need not be limited to:
  440         (a) For emergency medical technicians, proficiency in basic
  441  life support as defined techniques identified in s. 401.23 s.
  442  401.23(7) and in rules of the department.
  443         (b) For paramedics, proficiency in advanced life support as
  444  defined techniques identified in s. 401.23 s. 401.23(1) and in
  445  rules of the department.
  446         Section 13. Paragraph (a) of subsection (1) of section
  447  409.9201, Florida Statutes, is amended to read:
  448         409.9201 Medicaid fraud.—
  449         (1) As used in this section, the term:
  450         (a) “Prescription drug” means any drug, including, but not
  451  limited to, finished dosage forms or active ingredients that are
  452  subject to, defined in, or described in s. 503(b) of the Federal
  453  Food, Drug, and Cosmetic Act or in s. 465.003 s. 465.003(8), s.
  454  499.003(17), s. 499.007(13), or s. 499.82(10).
  455  
  456  The value of individual items of the legend drugs or goods or
  457  services involved in distinct transactions committed during a
  458  single scheme or course of conduct, whether involving a single
  459  person or several persons, may be aggregated when determining
  460  the punishment for the offense.
  461         Section 14. Paragraph (pp) of subsection (1) of section
  462  458.331, Florida Statutes, is amended to read:
  463         458.331 Grounds for disciplinary action; action by the
  464  board and department.—
  465         (1) The following acts constitute grounds for denial of a
  466  license or disciplinary action, as specified in s. 456.072(2):
  467         (pp) Applicable to a licensee who serves as the designated
  468  physician of a pain-management clinic as defined in s. 458.3265
  469  or s. 459.0137:
  470         1. Registering a pain-management clinic through
  471  misrepresentation or fraud;
  472         2. Procuring, or attempting to procure, the registration of
  473  a pain-management clinic for any other person by making or
  474  causing to be made, any false representation;
  475         3. Failing to comply with any requirement of chapter 499,
  476  the Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the
  477  Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq.,
  478  the Drug Abuse Prevention and Control Act; or chapter 893, the
  479  Florida Comprehensive Drug Abuse Prevention and Control Act;
  480         4. Being convicted or found guilty of, regardless of
  481  adjudication to, a felony or any other crime involving moral
  482  turpitude, fraud, dishonesty, or deceit in any jurisdiction of
  483  the courts of this state, of any other state, or of the United
  484  States;
  485         5. Being convicted of, or disciplined by a regulatory
  486  agency of the Federal Government or a regulatory agency of
  487  another state for, any offense that would constitute a violation
  488  of this chapter;
  489         6. Being convicted of, or entering a plea of guilty or nolo
  490  contendere to, regardless of adjudication, a crime in any
  491  jurisdiction of the courts of this state, of any other state, or
  492  of the United States which relates to the practice of, or the
  493  ability to practice, a licensed health care profession;
  494         7. Being convicted of, or entering a plea of guilty or nolo
  495  contendere to, regardless of adjudication, a crime in any
  496  jurisdiction of the courts of this state, of any other state, or
  497  of the United States which relates to health care fraud;
  498         8. Dispensing any medicinal drug based upon a communication
  499  that purports to be a prescription as defined in s. 465.003 s.
  500  465.003(14) or s. 893.02 if the dispensing practitioner knows or
  501  has reason to believe that the purported prescription is not
  502  based upon a valid practitioner-patient relationship; or
  503         9. Failing to timely notify the board of the date of his or
  504  her termination from a pain-management clinic as required by s.
  505  458.3265(3).
  506         Section 15. Paragraph (rr) of subsection (1) of section
  507  459.015, Florida Statutes, is amended to read:
  508         459.015 Grounds for disciplinary action; action by the
  509  board and department.—
  510         (1) The following acts constitute grounds for denial of a
  511  license or disciplinary action, as specified in s. 456.072(2):
  512         (rr) Applicable to a licensee who serves as the designated
  513  physician of a pain-management clinic as defined in s. 458.3265
  514  or s. 459.0137:
  515         1. Registering a pain-management clinic through
  516  misrepresentation or fraud;
  517         2. Procuring, or attempting to procure, the registration of
  518  a pain-management clinic for any other person by making or
  519  causing to be made, any false representation;
  520         3. Failing to comply with any requirement of chapter 499,
  521  the Florida Drug and Cosmetic Act; 21 U.S.C. ss. 301-392, the
  522  Federal Food, Drug, and Cosmetic Act; 21 U.S.C. ss. 821 et seq.,
  523  the Drug Abuse Prevention and Control Act; or chapter 893, the
  524  Florida Comprehensive Drug Abuse Prevention and Control Act;
  525         4. Being convicted or found guilty of, regardless of
  526  adjudication to, a felony or any other crime involving moral
  527  turpitude, fraud, dishonesty, or deceit in any jurisdiction of
  528  the courts of this state, of any other state, or of the United
  529  States;
  530         5. Being convicted of, or disciplined by a regulatory
  531  agency of the Federal Government or a regulatory agency of
  532  another state for, any offense that would constitute a violation
  533  of this chapter;
  534         6. Being convicted of, or entering a plea of guilty or nolo
  535  contendere to, regardless of adjudication, a crime in any
  536  jurisdiction of the courts of this state, of any other state, or
  537  of the United States which relates to the practice of, or the
  538  ability to practice, a licensed health care profession;
  539         7. Being convicted of, or entering a plea of guilty or nolo
  540  contendere to, regardless of adjudication, a crime in any
  541  jurisdiction of the courts of this state, of any other state, or
  542  of the United States which relates to health care fraud;
  543         8. Dispensing any medicinal drug based upon a communication
  544  that purports to be a prescription as defined in s. 465.003 s.
  545  465.003(14) or s. 893.02 if the dispensing practitioner knows or
  546  has reason to believe that the purported prescription is not
  547  based upon a valid practitioner-patient relationship; or
  548         9. Failing to timely notify the board of the date of his or
  549  her termination from a pain-management clinic as required by s.
  550  459.0137(3).
  551         Section 16. Subsection (1) of section 465.014, Florida
  552  Statutes, is amended to read:
  553         465.014 Pharmacy technician.—
  554         (1) A person other than a licensed pharmacist or pharmacy
  555  intern may not engage in the practice of the profession of
  556  pharmacy, except that a licensed pharmacist may delegate to
  557  pharmacy technicians who are registered pursuant to this section
  558  those duties, tasks, and functions that do not fall within the
  559  purview of s. 465.003 s. 465.003(13). All such delegated acts
  560  must be performed under the direct supervision of a licensed
  561  pharmacist who is responsible for all such acts performed by
  562  persons under his or her supervision. A registered pharmacy
  563  technician, under the supervision of a pharmacist, may initiate
  564  or receive communications with a practitioner or his or her
  565  agent, on behalf of a patient, regarding refill authorization
  566  requests. A licensed pharmacist may not supervise more than one
  567  registered pharmacy technician unless otherwise permitted by the
  568  guidelines adopted by the board. The board shall establish
  569  guidelines to be followed by licensees or permittees in
  570  determining the circumstances under which a licensed pharmacist
  571  may supervise more than one pharmacy technician.
  572         Section 17. Paragraph (c) of subsection (2) of section
  573  465.015, Florida Statutes, is amended to read:
  574         465.015 Violations and penalties.—
  575         (2) It is unlawful for any person:
  576         (c) To sell or dispense drugs as defined in s. 465.003 s.
  577  465.003(8) without first being furnished with a prescription.
  578         Section 18. Subsection (9) of section 465.0156, Florida
  579  Statutes, is amended to read:
  580         465.0156 Registration of nonresident pharmacies.—
  581         (9) Notwithstanding s. 465.003 s. 465.003(10), for purposes
  582  of this section, the registered pharmacy and the pharmacist
  583  designated by the registered pharmacy as the prescription
  584  department manager or the equivalent must be licensed in the
  585  state of location in order to dispense into this state.
  586         Section 19. Paragraph (s) of subsection (1) of section
  587  465.016, Florida Statutes, is amended to read:
  588         465.016 Disciplinary actions.—
  589         (1) The following acts constitute grounds for denial of a
  590  license or disciplinary action, as specified in s. 456.072(2):
  591         (s) Dispensing any medicinal drug based upon a
  592  communication that purports to be a prescription as defined in
  593  s. 465.003 by s. 465.003(14) or s. 893.02 when the pharmacist
  594  knows or has reason to believe that the purported prescription
  595  is not based upon a valid practitioner-patient relationship.
  596         Section 20. Subsection (4) of section 465.0197, Florida
  597  Statutes, is amended to read:
  598         465.0197 Internet pharmacy permits.—
  599         (4) Notwithstanding s. 465.003 s. 465.003(10), for purposes
  600  of this section, the Internet pharmacy and the pharmacist
  601  designated by the Internet pharmacy as the prescription
  602  department manager or the equivalent must be licensed in the
  603  state of location in order to dispense into this state.
  604         Section 21. Paragraph (j) of subsection (5) of section
  605  465.022, Florida Statutes, is amended to read:
  606         465.022 Pharmacies; general requirements; fees.—
  607         (5) The department or board shall deny an application for a
  608  pharmacy permit if the applicant or an affiliated person,
  609  partner, officer, director, or prescription department manager
  610  or consultant pharmacist of record of the applicant:
  611         (j) Has dispensed any medicinal drug based upon a
  612  communication that purports to be a prescription as defined in
  613  s. 465.003 by s. 465.003(14) or s. 893.02 when the pharmacist
  614  knows or has reason to believe that the purported prescription
  615  is not based upon a valid practitioner-patient relationship that
  616  includes a documented patient evaluation, including history and
  617  a physical examination adequate to establish the diagnosis for
  618  which any drug is prescribed and any other requirement
  619  established by board rule under chapter 458, chapter 459,
  620  chapter 461, chapter 463, chapter 464, or chapter 466.
  621  
  622  For felonies in which the defendant entered a plea of guilty or
  623  nolo contendere in an agreement with the court to enter a
  624  pretrial intervention or drug diversion program, the department
  625  shall deny the application if upon final resolution of the case
  626  the licensee has failed to successfully complete the program.
  627         Section 22. Paragraph (h) of subsection (1) of section
  628  465.023, Florida Statutes, is amended to read:
  629         465.023 Pharmacy permittee; disciplinary action.—
  630         (1) The department or the board may revoke or suspend the
  631  permit of any pharmacy permittee, and may fine, place on
  632  probation, or otherwise discipline any pharmacy permittee if the
  633  permittee, or any affiliated person, partner, officer, director,
  634  or agent of the permittee, including a person fingerprinted
  635  under s. 465.022(3), has:
  636         (h) Dispensed any medicinal drug based upon a communication
  637  that purports to be a prescription as defined in s. 465.003 by
  638  s. 465.003(14) or s. 893.02 when the pharmacist knows or has
  639  reason to believe that the purported prescription is not based
  640  upon a valid practitioner-patient relationship that includes a
  641  documented patient evaluation, including history and a physical
  642  examination adequate to establish the diagnosis for which any
  643  drug is prescribed and any other requirement established by
  644  board rule under chapter 458, chapter 459, chapter 461, chapter
  645  463, chapter 464, or chapter 466.
  646         Section 23. Section 465.1901, Florida Statutes, is amended
  647  to read:
  648         465.1901 Practice of orthotics and pedorthics.—The
  649  provisions of chapter 468 relating to orthotics or pedorthics do
  650  not apply to any licensed pharmacist or to any person acting
  651  under the supervision of a licensed pharmacist. The practice of
  652  orthotics or pedorthics by a pharmacist or any of the
  653  pharmacist’s employees acting under the supervision of a
  654  pharmacist shall be construed to be within the meaning of the
  655  term “practice of the profession of pharmacy” as defined set
  656  forth in s. 465.003 s. 465.003(13), and shall be subject to
  657  regulation in the same manner as any other pharmacy practice.
  658  The Board of Pharmacy shall develop rules regarding the practice
  659  of orthotics and pedorthics by a pharmacist. Any pharmacist or
  660  person under the supervision of a pharmacist engaged in the
  661  practice of orthotics or pedorthics is not precluded from
  662  continuing that practice pending adoption of these rules.
  663         Section 24. Paragraph (j) of subsection (2) of section
  664  465.1902, Florida Statutes, is amended to read:
  665         465.1902 Prescription Drug Donation Repository Program.—
  666         (2) DEFINITIONS.—As used in this section, the term:
  667         (j) “Prescription drug” has the same meaning as the term
  668  “medicinal drugs” or “drugs,” as those terms are defined in s.
  669  465.003 s. 465.003(8), but does not include controlled
  670  substances, cancer drugs donated under s. 499.029, or drugs with
  671  an approved United States Food and Drug Administration risk
  672  evaluation and mitigation strategy that includes elements to
  673  assure safe use.
  674         Section 25. Subsection (40) of section 499.003, Florida
  675  Statutes, is amended to read:
  676         499.003 Definitions of terms used in this part.—As used in
  677  this part, the term:
  678         (40) “Prescription drug” means a prescription, medicinal,
  679  or legend drug, including, but not limited to, finished dosage
  680  forms or active pharmaceutical ingredients subject to, defined
  681  by, or described by s. 503(b) of the federal act or s. 465.003
  682  s. 465.003(8), s. 499.007(13), subsection (31), or subsection
  683  (47), except that an active pharmaceutical ingredient is a
  684  prescription drug only if substantially all finished dosage
  685  forms in which it may be lawfully dispensed or administered in
  686  this state are also prescription drugs.
  687         Section 26. Paragraph (c) of subsection (24) of section
  688  893.02, Florida Statutes, is amended to read:
  689         893.02 Definitions.—The following words and phrases as used
  690  in this chapter shall have the following meanings, unless the
  691  context otherwise requires:
  692         (24) “Prescription” includes any order for drugs or
  693  medicinal supplies which is written or transmitted by any means
  694  of communication by a licensed practitioner authorized by the
  695  laws of this state to prescribe such drugs or medicinal
  696  supplies, is issued in good faith and in the course of
  697  professional practice, is intended to be dispensed by a person
  698  authorized by the laws of this state to do so, and meets the
  699  requirements of s. 893.04.
  700         (c) A prescription for a controlled substance may not be
  701  issued on the same prescription blank with another prescription
  702  for a controlled substance that is named or described in a
  703  different schedule or with another prescription for a medicinal
  704  drug, as defined in s. 465.003 s. 465.003(8), that is not a
  705  controlled substance.
  706         Section 27. This act shall take effect July 1, 2022.