Florida Senate - 2014                       CS for CS for SB 662
       
       
        
       By the Committees on Appropriations; Regulated Industries; and
       Health Policy
       
       
       
       
       576-04577-14                                           2014662c2
    1                        A bill to be entitled                      
    2         An act relating to nonresident sterile compounding
    3         permits; amending s. 465.003, F.S.; defining the terms
    4         “compounding,” “outsourcing facility,” and “compounded
    5         sterile product”; amending s. 465.0156, F.S.;
    6         conforming provisions to changes made by the act;
    7         expanding penalties to apply to injury to a nonhuman
    8         animal; deleting a requirement that the Board of
    9         Pharmacy refer regulatory issues affecting a
   10         nonresident pharmacy to the state where the pharmacy
   11         is located; providing that a nonresident pharmacy is
   12         subject to certain health care fraud provisions;
   13         creating s. 465.0158, F.S.; requiring registered
   14         nonresident pharmacies and outsourcing facilities to
   15         obtain a permit in order to ship, mail, deliver, or
   16         dispense compounded sterile products into this state;
   17         requiring submission of an application and a
   18         nonrefundable fee; providing application requirements;
   19         authorizing the board to deny, revoke, or suspend a
   20         permit, or impose a fine or reprimand for certain
   21         actions; providing dates by which certain nonresident
   22         pharmacies must obtain a permit; authorizing the board
   23         to adopt rules; amending s. 465.017, F.S.; authorizing
   24         the department to inspect nonresident pharmacies and
   25         nonresident sterile compounding permittees; requiring
   26         such pharmacies and permittees to pay for the costs of
   27         such inspections; providing an effective date.
   28          
   29  Be It Enacted by the Legislature of the State of Florida:
   30  
   31  
   32         Section 1. Subsections (18), (19) and (20) are added to
   33  section 465.003, Florida Statutes, to read:
   34         465.003 Definitions.—As used in this chapter, the term:
   35         (18) “Compounding” means combining, mixing, or altering the
   36  ingredients of one or more drugs or products to create another
   37  drug or product.
   38         (19) “Outsourcing facility” means a single physical
   39  location registered as an outsourcing facility under the federal
   40  Drug Quality and Security Act, Pub. L. No. 113-54, at which
   41  sterile compounding of a drug or product is conducted.
   42         (20)  “Compounded sterile product” means a drug intended
   43  for parenteral administration, an ophthalmic or oral inhalation
   44  drug in aqueous format, or a drug or product required to be
   45  sterile under federal or state law or rule, which is produced
   46  through compounding but is not approved by the federal Food and
   47  Drug Administration.
   48         Section 2. Subsections (4) and (5) of section 465.0156,
   49  Florida Statutes, are amended, present subsections (6) through
   50  (8) of that section are redesignated as subsections (7) through
   51  (9), respectively, and a new subsection (6) is added to that
   52  section, to read:
   53         465.0156 Registration of nonresident pharmacies.—
   54         (4) The board may deny, revoke, or suspend registration of,
   55  or fine or reprimand, a nonresident pharmacy for failure to
   56  comply with s. 465.0158, s. 465.017(2), or s. 465.025, or with
   57  any requirement of this section in accordance with the
   58  provisions of this chapter.
   59         (5) In addition to the prohibitions of subsection (4) the
   60  board may deny, revoke, or suspend registration of, or fine or
   61  reprimand, a nonresident pharmacy in accordance with the
   62  provisions of this chapter for conduct which causes or could
   63  cause serious bodily injury or serious psychological injury to a
   64  human or serious bodily injury to a nonhuman animal in resident
   65  of this state if the board has referred the matter to the
   66  regulatory or licensing agency in the state in which the
   67  pharmacy is located and the regulatory or licensing agency fails
   68  to investigate within 180 days of the referral.
   69         (6) A nonresident pharmacy is subject to s. 456.0635.
   70         Section 3. Section 465.0158, Florida Statutes, is created
   71  to read:
   72         465.0158 Nonresident sterile compounding permit.—
   73         (1) In order to ship, mail, deliver, or dispense, in any
   74  manner, a compounded sterile product into this state, a
   75  nonresident pharmacy registered under s. 465.0156, or an
   76  outsourcing facility, must hold a nonresident sterile
   77  compounding permit.
   78         (2) An application for a nonresident sterile compounding
   79  permit shall be submitted on a form furnished by the board. The
   80  board may require such information as it deems reasonably
   81  necessary to carry out the purposes of this section. The fee for
   82  an initial permit and biennial renewal of the permit shall be
   83  set by the board pursuant to s. 465.022(14).
   84         (3) An applicant must submit the following to the board to
   85  obtain an initial permit, or to the department to renew a
   86  permit:
   87         (a) Proof of registration as an outsourcing facility with
   88  the Secretary of the United States Department of Health and
   89  Human Services if the applicant is eligible for such
   90  registration pursuant to the federal Drug Quality and Security
   91  Act, Pub. L. No. 113-54.
   92         (b) Proof of registration as a nonresident pharmacy,
   93  pursuant to s. 465.0156, unless the applicant is an outsourcing
   94  facility and not a pharmacy, in which case the application must
   95  include proof of an active and unencumbered license, permit, or
   96  registration issued by the state, territory, or district in
   97  which the outsourcing facility is physically located which
   98  allows the outsourcing facility to engage in compounding and to
   99  ship, mail, deliver, or dispense a compounded sterile product
  100  into this state if required by the state, territory, or district
  101  in which the outsourcing facility is physically located.
  102         (c) Written attestation by an owner or officer of the
  103  applicant, and by the applicant’s prescription department
  104  manager or pharmacist in charge, that:
  105         1. The attestor has read and understands the laws and rules
  106  governing sterile compounding in this state.
  107         2. A compounded sterile product shipped, mailed, delivered,
  108  or dispensed into this state meets or exceeds this state’s
  109  standards for sterile compounding.
  110         3. A compounded sterile product shipped, mailed, delivered,
  111  or dispensed into this state must not have been, and may not be,
  112  compounded in violation of the laws and rules of the state,
  113  territory or district in which the applicant is located.
  114         (d) The applicant’s existing policies and procedures for
  115  sterile compounding, which must comply with pharmaceutical
  116  standards in chapter 797 of the United States Pharmacopoeia and
  117  any standards for sterile compounding required by board rule or
  118  current good manufacturing practices for an outsourcing
  119  facility.
  120         (e) A current inspection report from an inspection
  121  conducted by the regulatory or licensing agency of the state,
  122  territory, or district in which the applicant is located. The
  123  inspection report must reflect compliance with this section. An
  124  inspection report is current if the inspection was conducted
  125  within 6 months before the date of submitting the application
  126  for the initial permit or within 1 year before the date of
  127  submitting an application for permit renewal. If the applicant
  128  is unable to submit a current inspection report conducted by the
  129  regulatory or licensing agency of the state, territory, or
  130  district in which the applicant is located due to acceptable
  131  circumstances, as established by rule, or if an inspection has
  132  not been performed, the department shall:
  133         1. Conduct, or contract with an entity to conduct, an
  134  onsite inspection for which all costs shall be borne by the
  135  applicant;
  136         2. Accept a current and satisfactory inspection report, as
  137  determined by rule, from an entity approved by the board; or
  138         3. Accept a current inspection report from the United
  139  States Food and Drug Administration conducted pursuant to the
  140  federal Drug Quality and Security Act, Pub. L. No. 113-54.
  141         (4) A permittee may not ship, mail, deliver, or dispense a
  142  compounded sterile product into this state if the product was
  143  compounded in violation of the laws or rules of the state,
  144  territory, or district in which the permittee is located or does
  145  not meet or exceed this state’s sterile compounding standards.
  146         (5) In accordance with this chapter, the board may deny,
  147  revoke, or suspend the permit of, fine, or reprimand a permittee
  148  for:
  149         (a) Failure to comply with this section;
  150         (b) A violation listed under s. 456.0635, s. 456.065, or s.
  151  456.072, except s. 456.072(1)(s) or (1)(u);
  152         (c) A violation under s. 465.0156(5); or
  153         (d) A violation listed under s. 465.016.
  154         (6) A nonresident pharmacy registered under s. 465.0156
  155  which ships, mails, delivers, or dispenses a compounded sterile
  156  product into this state may continue to do so if the product
  157  meets or exceeds the standards for sterile compounding in this
  158  state, the product is not compounded in violation of any law or
  159  rule of the state, territory, or district where the pharmacy is
  160  located, and the pharmacy is issued a permit under this section
  161  on or before February 28, 2015.
  162         (7) An applicant registering on or after October 1, 2014,
  163  as a nonresident pharmacy under s. 465.0156 may not ship, mail,
  164  deliver, or dispense a compounded sterile product into this
  165  state until the applicant is registered as a nonresident
  166  pharmacy and is issued a permit under this section.
  167         (8) The board shall adopt rules as necessary to administer
  168  this section, including rules for:
  169         (a) Submitting an application for the permit required by
  170  this section.
  171         (b) Determining how, when, and under what circumstances an
  172  inspection of a nonresident sterile compounding permittee must
  173  be conducted.
  174         (c) Evaluating and approving entities from which a
  175  satisfactory inspection report will be accepted in lieu of an
  176  onsite inspection by the department or an inspection by the
  177  licensing or regulatory agency of the state, territory, or
  178  district where the applicant is located.
  179         Section 4. Section 465.017, Florida Statutes, is amended to
  180  read:
  181         465.017 Authority to inspect; disposal.—
  182         (1) Duly authorized agents and employees of the department
  183  may shall have the power to inspect in a lawful manner at all
  184  reasonable hours any pharmacy, hospital, clinic, wholesale
  185  establishment, manufacturer, physician’s office, or any other
  186  place in the state in which drugs and medical supplies are
  187  compounded, manufactured, packed, packaged, made, stored, sold,
  188  offered for sale, exposed for sale, or kept for sale for the
  189  purpose of:
  190         (a) Determining if any provision of the provisions of this
  191  chapter or any rule adopted promulgated under its authority is
  192  being violated;
  193         (b) Securing samples or specimens of any drug or medical
  194  supply after paying or offering to pay for such sample or
  195  specimen; or
  196         (c) Securing such other evidence as may be needed for
  197  prosecution under this chapter.
  198         (2) Duly authorized agents and employees of the department
  199  may inspect a nonresident pharmacy registered under s. 465.0156
  200  or a nonresident sterile compounding permittee under s. 465.0158
  201  pursuant to this section. The costs of such inspections shall be
  202  borne by such pharmacy or permittee.
  203         (3)(2)(a) Except as permitted by this chapter, and chapters
  204  406, 409, 456, 499, and 893, records maintained in a pharmacy
  205  relating to the filling of prescriptions and the dispensing of
  206  medicinal drugs may shall not be furnished only to any person
  207  other than to the patient for whom the drugs were dispensed, or
  208  her or his legal representative, or to the department pursuant
  209  to existing law, or, if in the event that the patient is
  210  incapacitated or unable to request such said records, her or his
  211  spouse except upon the written authorization of such patient.
  212         (a) Such records may be furnished in any civil or criminal
  213  proceeding, upon the issuance of a subpoena from a court of
  214  competent jurisdiction and proper notice to the patient or her
  215  or his legal representative by the party seeking such records.
  216         (b) The board shall adopt rules establishing to establish
  217  practice guidelines for pharmacies to dispose of records
  218  maintained in a pharmacy relating to the filling of
  219  prescriptions and the dispensing of medicinal drugs. Such rules
  220  must shall be consistent with the duty to preserve the
  221  confidentiality of such records in accordance with applicable
  222  state and federal law.
  223         Section 5. This act shall take effect October 1, 2014.