Florida Senate - 2015 CS for SB 532
By the Committee on Health Policy; and Senator Grimsley
588-03209-15 2015532c1
1 A bill to be entitled
2 An act relating to the ordering of medication;
3 amending s. 212.08, F.S.; providing that an order for
4 administration is included in the medical exemption
5 from sales tax; revising the term “prescription” to
6 exclude an order for administration; amending ss.
7 458.347 and 459.022, F.S.; revising the authority of a
8 licensed physician assistant to order medication under
9 the direction of a supervisory physician for a
10 specified patient; amending s. 464.012, F.S.;
11 authorizing an advanced registered nurse practitioner
12 to order medication for administration to a specified
13 patient; amending s. 465.003, F.S.; revising the term
14 “prescription” to exclude an order for drugs or
15 medicinal supplies by a licensed practitioner that is
16 dispensed for certain administration; amending s.
17 893.02, F.S.; revising the term “administer” to
18 include the term “administration”; revising the term
19 “prescription” to exclude an order for drugs or
20 medicinal supplies by a licensed practitioner that is
21 dispensed for certain administration; amending s.
22 893.04, F.S.; conforming provisions to changes made by
23 act; amending s. 893.05, F.S.; authorizing a licensed
24 practitioner to authorize a licensed physician
25 assistant or advanced registered nurse practitioner to
26 order controlled substances for a specified patient
27 under certain circumstances; reenacting ss.
28 400.462(26), 401.445(1), 409.906(18), and 766.103(3),
29 F.S., to incorporate the amendments made to ss.
30 458.347 and 459.022, F.S., in references thereto;
31 reenacting ss. 401.445(1) and 766.103(3), F.S., to
32 incorporate the amendment made to s. 464.012, F.S., in
33 references thereto; reenacting ss. 409.9201(1)(a),
34 458.331(1)(pp), 459.015(1)(rr), 465.014(1),
35 465.015(2)(c), 465.016(1)(s), 465.022(5)(j),
36 465.023(1)(h), 465.1901, 499.003(43), and 831.30(1),
37 F.S., to incorporate the amendment made to s. 465.003,
38 F.S., in references thereto; reenacting ss.
39 112.0455(5)(i), 381.986(7)(b), 440.102(1)(l),
40 458.331(1)(pp), 459.015(1)(rr), 465.015(3),
41 465.016(1)(s), 465.022(5)(j), 465.023(1)(h),
42 499.0121(14), 768.36(1)(b), 810.02(3)(f),
43 812.014(2)(c), 856.015(1)(c), 944.47(1)(a), 951.22(1),
44 985.711(1)(a), 1003.57(1)(i), and 1006.09(8), F.S., to
45 incorporate the amendment made to s. 893.02, F.S., in
46 references thereto; reenacting s. 893.0551(3)(e),
47 F.S., to incorporate the amendment made to s. 893.04,
48 F.S., in a reference thereto; reenacting s.
49 893.0551(3)(d), F.S., to incorporate the amendment
50 made to s. 893.05, F.S., in a reference thereto;
51 providing an effective date.
52
53 Be It Enacted by the Legislature of the State of Florida:
54
55 Section 1. Paragraphs (a) and (b) of subsection (2) of
56 section 212.08, Florida Statutes, are amended to read:
57 212.08 Sales, rental, use, consumption, distribution, and
58 storage tax; specified exemptions.—The sale at retail, the
59 rental, the use, the consumption, the distribution, and the
60 storage to be used or consumed in this state of the following
61 are hereby specifically exempt from the tax imposed by this
62 chapter.
63 (2) EXEMPTIONS; MEDICAL.—
64 (a) There shall be exempt from the tax imposed by this
65 chapter any medical products and supplies or medicine dispensed
66 according to an individual prescription or prescriptions or an
67 order for administration, written by a prescriber authorized by
68 law to prescribe medicinal drugs; hypodermic needles; hypodermic
69 syringes; chemical compounds and test kits used for the
70 diagnosis or treatment of human disease, illness, or injury; and
71 common household remedies recommended and generally sold for
72 internal or external use in the cure, mitigation, treatment, or
73 prevention of illness or disease in human beings, but not
74 including cosmetics or toilet articles, notwithstanding the
75 presence of medicinal ingredients therein, according to a list
76 prescribed and approved by the Department of Business and
77 Professional Regulation, which list shall be certified to the
78 Department of Revenue from time to time and included in the
79 rules promulgated by the Department of Revenue. There shall also
80 be exempt from the tax imposed by this chapter artificial eyes
81 and limbs; orthopedic shoes; prescription eyeglasses and items
82 incidental thereto or which become a part thereof; dentures;
83 hearing aids; crutches; prosthetic and orthopedic appliances;
84 and funerals. In addition, any items intended for one-time use
85 which transfer essential optical characteristics to contact
86 lenses shall be exempt from the tax imposed by this chapter;
87 however, this exemption shall apply only after $100,000 of the
88 tax imposed by this chapter on such items has been paid in any
89 calendar year by a taxpayer who claims the exemption in such
90 year. Funeral directors shall pay tax on all tangible personal
91 property used by them in their business.
92 (b) For the purposes of this subsection:
93 1. “Prosthetic and orthopedic appliances” means any
94 apparatus, instrument, device, or equipment used to replace or
95 substitute for any missing part of the body, to alleviate the
96 malfunction of any part of the body, or to assist any disabled
97 person in leading a normal life by facilitating such person’s
98 mobility. Such apparatus, instrument, device, or equipment shall
99 be exempted according to an individual prescription or
100 prescriptions written by a physician licensed under chapter 458,
101 chapter 459, chapter 460, chapter 461, or chapter 466, or
102 according to a list prescribed and approved by the Department of
103 Health, which list shall be certified to the Department of
104 Revenue from time to time and included in the rules promulgated
105 by the Department of Revenue.
106 2. “Cosmetics” means articles intended to be rubbed,
107 poured, sprinkled, or sprayed on, introduced into, or otherwise
108 applied to the human body for cleansing, beautifying, promoting
109 attractiveness, or altering the appearance and also means
110 articles intended for use as a compound of any such articles,
111 including, but not limited to, cold creams, suntan lotions,
112 makeup, and body lotions.
113 3. “Toilet articles” means any article advertised or held
114 out for sale for grooming purposes and those articles that are
115 customarily used for grooming purposes, regardless of the name
116 by which they may be known, including, but not limited to, soap,
117 toothpaste, hair spray, shaving products, colognes, perfumes,
118 shampoo, deodorant, and mouthwash.
119 4. “Prescription” includes any order for drugs or medicinal
120 supplies written or transmitted by any means of communication by
121 a duly licensed practitioner authorized by the laws of this the
122 state to prescribe such drugs or medicinal supplies and intended
123 to be dispensed by a pharmacist, except for an order that is
124 dispensed for administration. The term also includes an orally
125 transmitted order by the lawfully designated agent of such
126 practitioner;. The term also includes an order written or
127 transmitted by a practitioner licensed to practice in a
128 jurisdiction other than this state, but only if the pharmacist
129 called upon to dispense such order determines, in the exercise
130 of his or her professional judgment, that the order is valid and
131 necessary for the treatment of a chronic or recurrent illness;
132 and. The term also includes a pharmacist’s order for a product
133 selected from the formulary created pursuant to s. 465.186. A
134 prescription may be retained in written form, or the pharmacist
135 may cause it to be recorded in a data processing system,
136 provided that such order can be produced in printed form upon
137 lawful request.
138 Section 2. Paragraph (g) of subsection (4) of section
139 458.347, Florida Statutes, is amended to read:
140 458.347 Physician assistants.—
141 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
142 (g) A supervisory physician may delegate to a licensed
143 physician assistant the authority to, and the licensed physician
144 assistant acting under the direction of the supervisory
145 physician may, order any medication medications for
146 administration to the supervisory physician’s patient during his
147 or her care in a facility licensed under chapter 395,
148 notwithstanding any provisions in chapter 465 or chapter 893
149 which may prohibit this delegation. For the purpose of this
150 paragraph, an order is not considered a prescription. A licensed
151 physician assistant working in a facility that is licensed under
152 chapter 395 may order any medication under the direction of the
153 supervisory physician.
154 Section 3. Paragraph (f) of subsection (4) of section
155 459.022, Florida Statutes, is amended to read:
156 459.022 Physician assistants.—
157 (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
158 (f) A supervisory physician may delegate to a licensed
159 physician assistant the authority to, and the licensed physician
160 assistant acting under the direction of the supervisory
161 physician may, order any medication medications for
162 administration to the supervisory physician’s patient during his
163 or her care in a facility licensed under chapter 395,
164 notwithstanding any provisions in chapter 465 or chapter 893
165 which may prohibit this delegation. For the purpose of this
166 paragraph, an order is not considered a prescription. A licensed
167 physician assistant working in a facility that is licensed under
168 chapter 395 may order any medication under the direction of the
169 supervisory physician.
170 Section 4. Paragraph (a) of subsection (3) of section
171 464.012, Florida Statutes, is amended to read:
172 464.012 Certification of advanced registered nurse
173 practitioners; fees.—
174 (3) An advanced registered nurse practitioner shall perform
175 those functions authorized in this section within the framework
176 of an established protocol that is filed with the board upon
177 biennial license renewal and within 30 days after entering into
178 a supervisory relationship with a physician or changes to the
179 protocol. The board shall review the protocol to ensure
180 compliance with applicable regulatory standards for protocols.
181 The board shall refer to the department licensees submitting
182 protocols that are not compliant with the regulatory standards
183 for protocols. A practitioner currently licensed under chapter
184 458, chapter 459, or chapter 466 shall maintain supervision for
185 directing the specific course of medical treatment. Within the
186 established framework, an advanced registered nurse practitioner
187 may:
188 (a) Monitor and alter drug therapies and order any
189 medication for administration to a patient in a facility
190 licensed under chapter 395.
191 Section 5. Subsection (14) of section 465.003, Florida
192 Statutes, is amended to read:
193 465.003 Definitions.—As used in this chapter, the term:
194 (14) “Prescription” includes any order for drugs or
195 medicinal supplies written or transmitted by any means of
196 communication by a duly licensed practitioner authorized by the
197 laws of this the state to prescribe such drugs or medicinal
198 supplies and intended to be dispensed by a pharmacist, except
199 for an order that is dispensed for administration. The term also
200 includes an orally transmitted order by the lawfully designated
201 agent of such practitioner;. The term also includes an order
202 written or transmitted by a practitioner licensed to practice in
203 a jurisdiction other than this state, but only if the pharmacist
204 called upon to dispense such order determines, in the exercise
205 of her or his professional judgment, that the order is valid and
206 necessary for the treatment of a chronic or recurrent illness;
207 and. The term “prescription” also includes a pharmacist’s order
208 for a product selected from the formulary created pursuant to s.
209 465.186. Prescriptions may be retained in written form or the
210 pharmacist may cause them to be recorded in a data processing
211 system, provided that such order can be produced in printed form
212 upon lawful request.
213 Section 6. Subsections (1) and (22) of section 893.02,
214 Florida Statutes, are amended to read:
215 893.02 Definitions.—The following words and phrases as used
216 in this chapter shall have the following meanings, unless the
217 context otherwise requires:
218 (1) “Administer” or “administration” means the direct
219 application of a controlled substance, whether by injection,
220 inhalation, ingestion, or any other means, to the body of a
221 person or animal.
222 (22) “Prescription” means and includes any an order for
223 drugs or medicinal supplies which is written, signed, or
224 transmitted by any word of mouth, telephone, telegram, or other
225 means of communication by a duly licensed practitioner
226 authorized licensed by the laws of this the state to prescribe
227 such drugs or medicinal supplies, is issued in good faith and in
228 the course of professional practice, is intended to be filled,
229 compounded, or dispensed by a another person authorized licensed
230 by the laws of this the state to do so, and meets meeting the
231 requirements of s. 893.04.
232 (a) The term also includes an order for drugs or medicinal
233 supplies so transmitted or written by a physician, dentist,
234 veterinarian, or other practitioner licensed to practice in a
235 state other than Florida, but only if the pharmacist called upon
236 to fill such an order determines, in the exercise of his or her
237 professional judgment, that the order was issued pursuant to a
238 valid patient-physician relationship, that it is authentic, and
239 that the drugs or medicinal supplies so ordered are considered
240 necessary for the continuation of treatment of a chronic or
241 recurrent illness.
242 (b) The term does not include an order that is dispensed
243 for administration by a licensed practitioner authorized by the
244 laws of this state to administer such drugs or medicinal
245 supplies.
246 (c) However, If the physician writing the prescription is
247 not known to the pharmacist, the pharmacist shall obtain proof
248 to a reasonable certainty of the validity of the said
249 prescription.
250 (d) A prescription order for a controlled substance may
251 shall not be issued on the same prescription blank with another
252 prescription order for a controlled substance that which is
253 named or described in a different schedule or with another, nor
254 shall any prescription order for a controlled substance be
255 issued on the same prescription blank as a prescription order
256 for a medicinal drug, as defined in s. 465.003(8), that is which
257 does not fall within the definition of a controlled substance as
258 defined in this act.
259 Section 7. Paragraphs (a), (d), and (f) of subsection (2)
260 of section 893.04, Florida Statutes, are amended to read:
261 893.04 Pharmacist and practitioner.—
262 (2)(a) A pharmacist may not dispense a controlled substance
263 listed in Schedule II, Schedule III, or Schedule IV to any
264 patient or patient’s agent without first determining, in the
265 exercise of her or his professional judgment, that the
266 prescription order is valid. The pharmacist may dispense the
267 controlled substance, in the exercise of her or his professional
268 judgment, when the pharmacist or pharmacist’s agent has obtained
269 satisfactory patient information from the patient or the
270 patient’s agent.
271 (d) Each written prescription written prescribed by a
272 practitioner in this state for a controlled substance listed in
273 Schedule II, Schedule III, or Schedule IV must include both a
274 written and a numerical notation of the quantity of the
275 controlled substance prescribed and a notation of the date in
276 numerical, month/day/year format, or with the abbreviated month
277 written out, or the month written out in whole. A pharmacist
278 may, upon verification by the prescriber, document any
279 information required by this paragraph. If the prescriber is not
280 available to verify a prescription, the pharmacist may dispense
281 the controlled substance, but may insist that the person to whom
282 the controlled substance is dispensed provide valid photographic
283 identification. If a prescription includes a numerical notation
284 of the quantity of the controlled substance or date, but does
285 not include the quantity or date written out in textual format,
286 the pharmacist may dispense the controlled substance without
287 verification by the prescriber of the quantity or date if the
288 pharmacy previously dispensed another prescription for the
289 person to whom the prescription was written.
290 (f) A pharmacist may not knowingly dispense fill a
291 prescription that has been forged for a controlled substance
292 listed in Schedule II, Schedule III, or Schedule IV.
293 Section 8. Subsection (1) of section 893.05, Florida
294 Statutes, is amended to read:
295 893.05 Practitioners and persons administering controlled
296 substances in their absence.—
297 (1)(a) A practitioner, in good faith and in the course of
298 his or her professional practice only, may prescribe,
299 administer, dispense, mix, or otherwise prepare a controlled
300 substance, or the practitioner may cause the controlled
301 substance same to be administered by a licensed nurse or an
302 intern practitioner under his or her direction and supervision
303 only.
304 (b) Pursuant to s. 458.347(4)(g), s. 459.022(4)(f), or s.
305 464.012(3), as applicable, a practitioner who supervises a
306 licensed physician assistant or advanced registered nurse
307 practitioner may authorize the licensed physician assistant or
308 advanced registered nurse practitioner to order controlled
309 substances for administration to a patient in a facility
310 licensed under chapter 395.
311 (c) A veterinarian may so prescribe, administer, dispense,
312 mix, or prepare a controlled substance for use on animals only,
313 and may cause the controlled substance it to be administered by
314 an assistant or orderly under the veterinarian’s direction and
315 supervision only.
316 (d) A certified optometrist licensed under chapter 463 may
317 not administer or prescribe a controlled substance listed in
318 Schedule I or Schedule II of s. 893.03.
319 Section 9. Subsection (26) of s. 400.462, subsection (1) of
320 s. 401.445, subsection (18) of s. 409.906, and subsection (3) of
321 s. 766.103, Florida Statutes, are reenacted for the purpose of
322 incorporating the amendments made by this act to ss. 458.347 and
323 459.022, Florida Statutes, in references thereto.
324 Section 10. Subsection (1) of s. 401.445 and subsection (3)
325 of s. 766.103, Florida Statutes, are reenacted for the purpose
326 of incorporating the amendment made by this act to s. 464.012,
327 Florida Statutes, in references thereto.
328 Section 11. Paragraph (a) of subsection (1) of s. 409.9201,
329 paragraph (pp) of subsection (1) of s. 458.331, paragraph (rr)
330 of subsection (1) of s. 459.015, subsection (1) of s. 465.014,
331 paragraph (c) of subsection (2) of s. 465.015, paragraph (s) of
332 subsection (1) of s. 465.016, paragraph (j) of subsection (5) of
333 s. 465.022, paragraph (h) of subsection (1) of s. 465.023, s.
334 465.1901, subsection (43) of s. 499.003, and subsection (1) of
335 s. 831.30, Florida Statutes, are reenacted for the purpose of
336 incorporating the amendments made by this act to s. 465.003,
337 Florida Statutes, in references thereto.
338 Section 12. Paragraph (i) of subsection (5) of s. 112.0455,
339 paragraph (b) of subsection (7) of s. 381.986, paragraph (l) of
340 subsection (1) of s. 440.102, paragraph (pp) of subsection (1)
341 of s. 458.331, paragraph (rr) of subsection (1) of s. 459.015,
342 subsection (3) of s. 465.015, paragraph (s) of subsection (1) of
343 s. 465.016, paragraph (j) of subsection (5) of s. 465.022,
344 paragraph (h) of subsection (1) of s. 465.023, subsection (14)
345 of s. 499.0121, paragraph (b) of subsection (1) of s. 768.36,
346 paragraph (f) of subsection (3) of s. 810.02, paragraph (c) of
347 subsection (2) of s. 812.014, paragraph (c) of subsection (1) of
348 s. 856.015, paragraph (a) of subsection (1) of s. 944.47,
349 subsection (1) of s. 951.22, paragraph (a) of subsection (1) of
350 s. 985.711, paragraph (i) of subsection (1) of s. 1003.57, and
351 subsection (8) of s. 1006.09, Florida Statutes, are reenacted
352 for the purpose of incorporating the amendments made by this act
353 to s. 893.02, Florida Statutes, in references thereto.
354 Section 13. Paragraph (e) of subsection (3) of s. 893.0551,
355 Florida Statutes, is reenacted for the purpose of incorporating
356 the amendments made by this act to s. 893.04, Florida Statutes,
357 in a reference thereto.
358 Section 14. Paragraph (d) of subsection (3) of s. 893.0551,
359 Florida Statutes, is reenacted for the purpose of incorporating
360 the amendments made by this act to s. 893.05, Florida Statutes,
361 in a reference thereto.
362 Section 15. This act shall take effect July 1, 2015.