HB 915

1	A bill to be entitled
2	An act relating to controlled substances; amending s.
3	456.44, F.S.; revising the definition of the term
4	"addiction medicine specialist" to include a board-
5	certified psychiatrist, rather than a physiatrist;
6	providing that the management of pain in certain
7	patients requires consultation with or referral to a
8	psychiatrist, rather than a physiatrist; providing
9	that a prescription is deemed compliant with the
10	standards of practice and is valid for dispensing when
11	a pharmacy receives it; providing that the standards
12	of practice regarding the prescribing of controlled
13	substances do not apply to certain board-certified
14	psychiatrists and rheumatologists; amending ss.
15	458.3265 and 459.0137, F.S.; requiring that a pain-
16	management clinic register with the Department of
17	Health unless the clinic is wholly owned and operated
18	by certain health care professionals, including a
19	board-certified psychiatrist or rheumatologist;
20	amending s. 465.015, F.S.; revising the requirements
21	for reporting the fraudulent obtaining of a controlled
22	substance; revising the required contents of the
23	report; amending s. 465.022, F.S.; requiring that the
24	Department of Health or the Board of Pharmacy deny an
25	initial or renewal application for a pharmacy permit
26	if an applicant or an affiliated person of record of
27	the applicant, including a health care practitioner,
28	has been convicted of, or entered a plea of guilty or
29	nolo contendere to, regardless of adjudication,
30	unlawfully providing a controlled substance or a
31	prescription for a controlled substance by
32	misrepresentation, fraud, forgery, deception,
33	subterfuge, or concealment of a material fact;
34	amending s. 465.023, F.S.; authorizing the department
35	or the board to revoke or suspend a pharmacy permit
36	and to fine, place on probation, or discipline a
37	pharmacy permittee if the permittee or any affiliated
38	person or agent of the permittee, including a health
39	care practitioner, has been convicted of, or entered a
40	plea of guilty or nolo contendere to, regardless of
41	adjudication, unlawfully providing a controlled
42	substance or a prescription for a controlled substance
43	by misrepresentation, fraud, forgery, deception,
44	subterfuge, or concealment of a material fact;
45	amending s. 499.003, F.S.; defining the term
46	"prescription" as it relates to the Florida Drug and
47	Cosmetic Act; creating s. 499.0032, F.S.; authorizing
48	a pharmacist to fill a prescription for drugs or
49	medicinal supplies which is transmitted or written by
50	a physician, dentist, veterinarian, or other
51	practitioner licensed to practice in another state
52	under certain circumstances; requiring the pharmacist
53	to obtain proof to a reasonable certainty of the
54	validity of the prescription under certain
55	circumstances; prohibiting the issuance of a
56	prescription order for a controlled substance on the
57	same prescription blank with another prescription
58	order for a controlled substance that is named or
59	described in a different schedule; prohibiting the
60	issuance of a prescription order for a controlled
61	substance on the same prescription blank as a
62	prescription order for a medicinal drug; providing
63	that a prescription obtained in violation of state
64	law, or obtained through misrepresentation, fraud,
65	forgery, deception, or subterfuge, is not a valid
66	prescription; amending s. 893.02, F.S.; redefining the
67	term "prescription" as it relates to the Florida
68	Comprehensive Drug Abuse Prevention and Control Act to
69	clarify that a prescription obtained in violation of
70	law is not a valid prescription; amending s. 893.055,
71	F.S.; requiring that a prescriber access information
72	in the prescription drug monitoring database before
73	prescribing certain controlled substances listed in s.
74	893.03, F.S., under certain circumstances; amending s.
75	893.13, F.S.; revising prohibited acts regarding the
76	distribution of controlled substances; providing an
77	effective date.
78
79	Be It Enacted by the Legislature of the State of Florida:
80
81	Section 1.  Paragraph (a) of subsection (1) and subsection
82	(3) of section 456.44, Florida Statutes, are amended to read:
83	456.44  Controlled substance prescribing.-
84	(1)  DEFINITIONS.-
85	(a)  "Addiction medicine specialist" means a board-
86	certified psychiatrist who holds physiatrist with a subspecialty
87	certification in addiction medicine or who is eligible for such
88	subspecialty certification in addiction medicine, an addiction
89	medicine physician who is certified or eligible for
90	certification by the American Society of Addiction Medicine, or
91	an osteopathic physician who holds a certificate of added
92	qualification in Addiction Medicine through the American
93	Osteopathic Association.
94	(3)  STANDARDS OF PRACTICE.-The standards of practice in
95	this section do not supersede the level of care, skill, and
96	treatment recognized in general law related to health care
97	licensure.
98	(a)  A complete medical history and a physical examination
99	must be conducted before beginning any treatment and must be
100	documented in the medical record. The exact components of the
101	physical examination shall be left to the judgment of the
102	clinician who is expected to perform a physical examination
103	proportionate to the diagnosis that justifies a treatment. The
104	medical record must, at a minimum, document the nature and
105	intensity of the pain, current and past treatments for pain,
106	underlying or coexisting diseases or conditions, the effect of
107	the pain on physical and psychological function, a review of
108	previous medical records, previous diagnostic studies, and
109	history of alcohol and substance abuse. The medical record must
110	shall also document the presence of one or more recognized
111	medical indications for the use of a controlled substance. Each
112	registrant must develop a written plan for assessing each
113	patient's risk of aberrant drug-related behavior, which may
114	include patient drug testing. Registrants must assess each
115	patient's risk for aberrant drug-related behavior and monitor
116	that risk on an ongoing basis in accordance with the plan.
117	(b)  Each registrant must develop a written individualized
118	treatment plan for each patient. The treatment plan must shall
119	state objectives that will be used to determine treatment
120	success, such as pain relief and improved physical and
121	psychosocial function, and must shall indicate if any further
122	diagnostic evaluations or other treatments are planned. After
123	treatment begins, the physician shall adjust drug therapy to the
124	individual medical needs of each patient. Other treatment
125	modalities, including a rehabilitation program, shall be
126	considered depending on the etiology of the pain and the extent
127	to which the pain is associated with physical and psychosocial
128	impairment. The interdisciplinary nature of the treatment plan
129	shall be documented.
130	(c)  The physician shall discuss the risks and benefits of
131	the use of controlled substances, including the risks of abuse
132	and addiction, as well as physical dependence and its
133	consequences, with the patient, persons designated by the
134	patient, or the patient's surrogate or guardian if the patient
135	is incompetent. The physician shall use a written controlled
136	substance agreement between the physician and the patient
137	outlining the patient's responsibilities, including, but not
138	limited to:
139	1.  Number and frequency of prescriptions and refills for
140	controlled substances substance prescriptions and refills.
141	2.  Patient compliance and reasons for which drug therapy
142	may be discontinued, such as a violation of the agreement.
143	3.  An agreement that controlled substances for the
144	treatment of chronic nonmalignant pain shall be prescribed by a
145	single treating physician unless otherwise authorized by the
146	treating physician and documented in the medical record.
147	(d)  The patient shall be seen by the physician at regular
148	intervals, not to exceed 3 months, to assess the efficacy of
149	treatment, ensure that controlled-substance controlled substance
150	therapy remains indicated, evaluate the patient's progress
151	toward treatment objectives, consider adverse drug effects, and
152	review the etiology of the pain. Continuation or modification of
153	therapy depends shall depend on the physician's evaluation of
154	the patient's progress. If treatment goals are not being
155	achieved, despite medication adjustments, the physician shall
156	reevaluate the appropriateness of continued treatment. The
157	physician shall monitor patient compliance in medication usage,
158	related treatment plans, controlled substance agreements, and
159	indications of substance abuse or diversion at a minimum of 3-
160	month intervals.
161	(e)  The physician shall refer the patient as necessary for
162	additional evaluation and treatment in order to achieve
163	treatment objectives. Special attention shall be given to those
164	patients who are at risk for misusing their medications and
165	those whose living arrangements pose a risk for medication
166	misuse or diversion. The management of pain in patients with a
167	history of substance abuse or with a comorbid psychiatric
168	disorder requires extra care, monitoring, and documentation and
169	requires consultation with or referral to an addictionologist or
170	psychiatrist physiatrist.
171	(f)  A physician registered under this section must
172	maintain accurate, current, and complete records that are
173	accessible and readily available for review and comply with the
174	requirements of this section, the applicable practice act, and
175	applicable board rules. The medical records must include, but
176	are not limited to:
177	1.  The complete medical history and a physical
178	examination, including history of drug abuse or dependence.
179	2.  Diagnostic, therapeutic, and laboratory results.
180	3.  Evaluations and consultations.
181	4.  Treatment objectives.
182	5.  Discussion of risks and benefits.
183	6.  Treatments.
184	7.  Medications, including date, type, dosage, and quantity
185	prescribed.
186	8.  Instructions and agreements.
187	9.  Periodic reviews.
188	10.  Results of any drug testing.
189	11.  A photocopy of the patient's government-issued photo
190	identification.
191	12.  If a written prescription for a controlled substance
192	is given to the patient, a duplicate of the prescription.
193	13.  The physician's full name presented in a legible
194	manner.
195	(g)  Patients with signs or symptoms of substance abuse
196	shall be immediately referred to a board-certified pain
197	management physician, an addiction medicine specialist, or a
198	mental health addiction facility as it pertains to drug abuse or
199	addiction unless the physician is board-certified or board-
200	eligible in pain management. Throughout the period of time
201	before receiving the consultant's report, a prescribing
202	physician shall clearly and completely document medical
203	justification for continued treatment with controlled substances
204	and those steps taken to ensure medically appropriate use of
205	controlled substances by the patient. Upon receipt of the
206	consultant's written report, the prescribing physician shall
207	incorporate the consultant's recommendations for continuing,
208	modifying, or discontinuing the controlled-substance controlled
209	substance therapy. The resulting changes in treatment shall be
210	specifically documented in the patient's medical record.
211	Evidence or behavioral indications of diversion shall be
212	followed by discontinuation of the controlled-substance
213	controlled substance therapy, and the patient shall be
214	discharged, and all results of testing and actions taken by the
215	physician shall be documented in the patient's medical record.
216	(h)  When a pharmacy subject to this section receives a
217	prescription, the prescription is deemed compliant with the
218	standards of practice under this section and, therefore, valid
219	for dispensing.
220
221	This subsection does not apply to a board-certified
222	anesthesiologist, physiatrist, psychiatrist, rheumatologist, or
223	neurologist, or to a board-certified physician who has surgical
224	privileges at a hospital or ambulatory surgery center and
225	primarily provides surgical services. This subsection does not
226	apply to a board-certified medical specialist who has also
227	completed a fellowship in pain medicine approved by the
228	Accreditation Council for Graduate Medical Education or the
229	American Osteopathic Association, or who is board certified in
230	pain medicine by a board approved by the American Board of
231	Medical Specialties or the American Osteopathic Association and
232	performs interventional pain procedures of the type routinely
233	billed using surgical codes.
234	Section 2.  Paragraph (a) of subsection (1) of section
235	458.3265, Florida Statutes, is amended to read:
236	458.3265  Pain-management clinics.-
237	(1)  REGISTRATION.-
238	(a)1.  As used in this section, the term:
239	a.  "Chronic nonmalignant pain" means pain unrelated to
240	cancer or rheumatoid arthritis which persists beyond the usual
241	course of disease or beyond the injury that is the cause of the
242	pain or which persists more than 90 days after surgery.
243	b.  "Pain-management clinic" or "clinic" means any publicly
244	or privately owned facility:
245	(I)  That advertises in any medium for any type of pain-
246	management services; or
247	(II)  Where in any month a majority of patients are
248	prescribed opioids, benzodiazepines, barbiturates, or
249	carisoprodol for the treatment of chronic nonmalignant pain.
250	2.  Each pain-management clinic must register with the
251	department unless:
252	a.  The That clinic is licensed as a facility pursuant to
253	chapter 395;
254	b.  The majority of the physicians who provide services in
255	the clinic primarily provide primarily surgical services;
256	c.  The clinic is owned by a publicly held corporation
257	whose shares are traded on a national exchange or on the over-
258	the-counter market and whose total assets at the end of the
259	corporation's most recent fiscal quarter exceeded $50 million;
260	d.  The clinic is affiliated with an accredited medical
261	school at which training is provided for medical students,
262	residents, or fellows;
263	e.  The clinic does not prescribe controlled substances for
264	the treatment of pain;
265	f.  The clinic is owned by a corporate entity exempt from
266	federal taxation under 26 U.S.C. s. 501(c)(3);
267	g.  The clinic is wholly owned and operated by one or more
268	board-certified anesthesiologists, physiatrists, psychiatrists,
269	rheumatologists, or neurologists; or
270	h.  The clinic is wholly owned and operated by one or more
271	board-certified medical specialists who have also completed
272	fellowships in pain medicine approved by the Accreditation
273	Council for Graduate Medical Education, or who are also board-
274	certified in pain medicine by a board approved by the American
275	Board of Medical Specialties and perform interventional pain
276	procedures of the type routinely billed using surgical codes.
277	Section 3.  Paragraph (a) of subsection (1) of section
278	459.0137, Florida Statutes, is amended to read:
279	459.0137  Pain-management clinics.-
280	(1)  REGISTRATION.-
281	(a)1.  As used in this section, the term:
282	a.  "Chronic nonmalignant pain" means pain unrelated to
283	cancer or rheumatoid arthritis which persists beyond the usual
284	course of disease or beyond the injury that is the cause of the
285	pain or which persists more than 90 days after surgery.
286	b.  "Pain-management clinic" or "clinic" means any publicly
287	or privately owned facility:
288	(I)  That advertises in any medium for any type of pain-
289	management services; or
290	(II)  Where in any month a majority of patients are
291	prescribed opioids, benzodiazepines, barbiturates, or
292	carisoprodol for the treatment of chronic nonmalignant pain.
293	2.  Each pain-management clinic must register with the
294	department unless:
295	a.  The That clinic is licensed as a facility pursuant to
296	chapter 395;
297	b.  The majority of the physicians who provide services in
298	the clinic primarily provide primarily surgical services;
299	c.  The clinic is owned by a publicly held corporation
300	whose shares are traded on a national exchange or on the over-
301	the-counter market and whose total assets at the end of the
302	corporation's most recent fiscal quarter exceeded $50 million;
303	d.  The clinic is affiliated with an accredited medical
304	school at which training is provided for medical students,
305	residents, or fellows;
306	e.  The clinic does not prescribe controlled substances for
307	the treatment of pain;
308	f.  The clinic is owned by a corporate entity exempt from
309	federal taxation under 26 U.S.C. s. 501(c)(3);
310	g.  The clinic is wholly owned and operated by one or more
311	board-certified anesthesiologists, physiatrists, psychiatrists,
312	rheumatologists, or neurologists; or
313	h.  The clinic is wholly owned and operated by one or more
314	board-certified medical specialists who have also completed
315	fellowships in pain medicine approved by the Accreditation
316	Council for Graduate Medical Education or the American
317	Osteopathic Association, or who are also board-certified in pain
318	medicine by a board approved by the American Board of Medical
319	Specialties or the American Osteopathic Association and perform
320	interventional pain procedures of the type routinely billed
321	using surgical codes.
322	Section 4.  Subsection (3) of section 465.015, Florida
323	Statutes, is amended to read:
324	465.015  Violations and penalties.-
325	(3)(a)  It is unlawful for any pharmacist to knowingly fail
326	to report any instance in which the pharmacist knows or believes
327	that a person obtained or attempted to obtain, through a
328	fraudulent method or representation, a controlled substance as
329	defined in s. 893.02 from the pharmacy at which the pharmacist
330	practices pharmacy. The pharmacist shall report to the sheriff
331	or other chief law enforcement agency of the county where the
332	pharmacy is located within 24 hours after learning of the fraud
333	or attempted fraud any instance in which a person obtained or
334	attempted to obtain a controlled substance, as defined in s.
335	893.02, or at the close of business on the next business day,
336	whichever occurs is later, that the pharmacist knew or believed
337	was obtained or attempted to be obtained through fraudulent
338	methods or representations from the pharmacy at which the
339	pharmacist practiced pharmacy. Any pharmacist who knowingly
340	fails to make such a report within 24 hours after learning of
341	the fraud or attempted fraud or at the close of business on the
342	next business day, whichever occurs is later, commits a
343	misdemeanor of the first degree, punishable as provided in s.
344	775.082 or s. 775.083.
345	(b)  A sufficient report of the fraudulent obtaining of a
346	controlled substance substances under this subsection must
347	contain, at a minimum, a copy of the prescription used or
348	presented and a narrative, including all information available
349	to the pharmacist concerning the transaction, such as the name
350	and telephone number of the prescribing physician; the name,
351	description, and any personal identification information
352	pertaining to the person who presented the prescription; and all
353	other material information, such as photographic or video
354	surveillance of the transaction. Any sheriff or chief law
355	enforcement officer of a jurisdiction, or the agent of any such
356	person, who receives a report from a pharmacist under this
357	subsection must receive and document such report. If the sheriff
358	or chief law enforcement officer of a jurisdiction, or the agent
359	of any such person, refuses to take the pharmacist's report, the
360	pharmacist shall be deemed to have complied with this subsection
361	if the pharmacist documents such refusal.
362	Section 5.  Subsection (5) of section 465.022, Florida
363	Statutes, is amended to read:
364	465.022  Pharmacies; general requirements; fees.-
365	(5)  The department or board shall deny an application for
366	a pharmacy permit if the applicant or an affiliated person,
367	partner, officer, director, or prescription department manager,
368	health care practitioner, or consultant pharmacist of record of
369	the applicant:
370	(a)  Has obtained a permit by misrepresentation or fraud.
371	(b)  Has attempted to procure, or has procured, a permit
372	for any other person by making, or causing to be made, any false
373	representation.
374	(c)  Has been convicted of, or entered a plea of guilty or
375	nolo contendere to, regardless of adjudication, a crime in any
376	jurisdiction which relates to the practice of, or the ability to
377	practice, the profession of pharmacy.
378	(d)  Has been convicted of, or entered a plea of guilty or
379	nolo contendere to, regardless of adjudication, a crime in any
380	jurisdiction which relates to health care fraud.
381	(e)  Has been convicted of, or entered a plea of guilty or
382	nolo contendere to, regardless of adjudication, a felony under
383	chapter 409, chapter 817, or chapter 893, or a similar felony
384	offense committed in another state or jurisdiction, since July
385	1, 2009.
386	(f)  Has been convicted of, or entered a plea of guilty or
387	nolo contendere to, regardless of adjudication, a felony under
388	21 U.S.C. ss. 801-970 or 42 U.S.C. ss. 1395-1396 since July 1,
389	2009.
390	(g)  Has been terminated for cause from the Florida
391	Medicaid program pursuant to s. 409.913, unless the applicant
392	has been in good standing with the Florida Medicaid program for
393	the most recent 5-year period.
394	(h)  Has been terminated for cause, pursuant to the appeals
395	procedures established by the state, from any other state
396	Medicaid program, unless the applicant has been in good standing
397	with a state Medicaid program for the most recent 5-year period
398	and the termination occurred at least 20 years before the date
399	of the application.
400	(i)  Is currently listed on the List of Excluded
401	Individuals and Entities that is maintained by the United States
402	Department of Health and Human Services Office of Inspector
403	General General's List of Excluded Individuals and Entities.
404	(j)  Has dispensed any medicinal drug based upon a
405	communication that purports to be a prescription as defined by
406	s. 465.003(14) or s. 893.02 when the pharmacist knows or has
407	reason to believe that the purported prescription is not based
408	upon a valid practitioner-patient relationship that includes a
409	documented patient evaluation, including history and a physical
410	examination adequate to establish the diagnosis for which any
411	drug is prescribed and any other requirement established by
412	board rule under chapter 458, chapter 459, chapter 461, chapter
413	463, chapter 464, or chapter 466.
414	(k)  Has been convicted of, or entered a plea of guilty or
415	nolo contendere to, regardless of adjudication, a felony under
416	s. 893.13(7)(b).
417
418	For felonies in which the defendant entered a plea of guilty or
419	nolo contendere in an agreement with the court to enter a
420	pretrial intervention or drug diversion program, the department
421	shall deny the application if, upon final resolution of the
422	case, the licensee has failed to successfully complete the
423	program.
424	Section 6.  Subsection (1) of section 465.023, Florida
425	Statutes, is amended to read:
426	465.023  Pharmacy permittee; disciplinary action.-
427	(1)  The department or the board may revoke or suspend the
428	permit of any pharmacy permittee, and may fine, place on
429	probation, or otherwise discipline any pharmacy permittee if the
430	permittee, or any affiliated person, partner, officer, health
431	care practitioner, director, or agent of the permittee,
432	including a person fingerprinted under s. 465.022(3), has:
433	(a)  Obtained a permit by misrepresentation or fraud or
434	through an error of the department or the board;
435	(b)  Attempted to procure, or has procured, a permit for
436	any other person by making, or causing to be made, any false
437	representation;
438	(c)  Violated any of the requirements of this chapter or
439	any of the rules of the Board of Pharmacy; of chapter 499, known
440	as the "Florida Drug and Cosmetic Act"; of 21 U.S.C. ss. 301-
441	392, known as the "Federal Food, Drug, and Cosmetic Act"; of 21
442	U.S.C. ss. 821 et seq., known as the Comprehensive Drug Abuse
443	Prevention and Control Act; or of chapter 893;
444	(d)  Been convicted or found guilty, regardless of
445	adjudication, of a felony or any other crime involving moral
446	turpitude in any of the courts of this state, of any other
447	state, or of the United States;
448	(e)  Been convicted or disciplined by a regulatory agency
449	of the Federal Government or a regulatory agency of another
450	state for any offense that would constitute a violation of this
451	chapter;
452	(f)  Been convicted of, or entered a plea of guilty or nolo
453	contendere to, regardless of adjudication, a crime in any
454	jurisdiction which relates to the practice of, or the ability to
455	practice, the profession of pharmacy;
456	(g)  Been convicted of, or entered a plea of guilty or nolo
457	contendere to, regardless of adjudication, a crime in any
458	jurisdiction which relates to health care fraud; or
459	(h)  Dispensed any medicinal drug based upon a
460	communication that purports to be a prescription as defined by
461	s. 465.003(14) or s. 893.02 when the pharmacist knows or has
462	reason to believe that the purported prescription is not based
463	upon a valid practitioner-patient relationship that includes a
464	documented patient evaluation, including history and a physical
465	examination adequate to establish the diagnosis for which any
466	drug is prescribed and any other requirement established by
467	board rule under chapter 458, chapter 459, chapter 461, chapter
468	463, chapter 464, or chapter 466; or.
469	(i)  Been convicted of, or entered a plea of guilty or nolo
470	contendere to, regardless of adjudication, a felony under s.
471	893.13(7)(b).
472	Section 7.  Subsection (56) is added to section 499.003,
473	Florida Statutes, to read:
474	499.003  Definitions of terms used in this part.-As used in
475	this part, the term:
476	(56)  "Prescription" means an order for drugs or medicinal
477	supplies written, signed, or transmitted by word of mouth,
478	telephone, telegram, or other means of communication by a duly
479	licensed practitioner licensed in this state to prescribe such
480	drugs or medicinal supplies, issued in good faith and in the
481	course of professional practice, intended to be filled,
482	compounded, or dispensed by another person licensed in this
483	state to do so, and meeting the requirements of s. 893.04. The
484	term also includes an order for drugs or medicinal supplies so
485	transmitted or written by a physician, dentist, veterinarian, or
486	other practitioner licensed to practice in another state.
487	Section 8.  Section 499.0032, Florida Statutes, is created
488	to read:
489	499.0032  Prescriptions.-A pharmacist licensed in this
490	state may fill a prescription for drugs or medicinal supplies
491	which is transmitted or written by a physician, dentist,
492	veterinarian, or other practitioner licensed to practice in
493	another state if the pharmacist determines, in the exercise of
494	his or her professional judgment, that the order was issued
495	pursuant to a valid patient-physician relationship, that it is
496	authentic, and that the drugs or medicinal supplies so ordered
497	are considered necessary for the continuation of treatment of a
498	chronic or recurrent illness. However, if the physician writing
499	the prescription is not known to the pharmacist, the pharmacist
500	shall obtain proof to a reasonable certainty of the validity of
501	the prescription. A prescription order for a controlled
502	substance may not be issued on the same prescription blank with
503	another prescription order for a controlled substance that is
504	named or described in a different schedule. A prescription order
505	for a controlled substance may not be issued on the same
506	prescription blank as a prescription order for a medicinal drug,
507	as defined in s. 465.003(8), which does not fall within the
508	definition of a controlled substance as defined in s. 893.02. A
509	prescription obtained in violation of state law, or obtained
510	through misrepresentation, fraud, forgery, deception, or
511	subterfuge is not a valid prescription.
512	Section 9.  Subsection (22) of section 893.02, Florida
513	Statutes, is amended to read:
514	893.02  Definitions.-The following words and phrases as
515	used in this chapter shall have the following meanings, unless
516	the context otherwise requires:
517	(22)  "Prescription" means and includes an order for drugs
518	or medicinal supplies written, signed, or transmitted by word of
519	mouth, telephone, telegram, or other means of communication by a
520	duly licensed practitioner licensed by the laws of the state to
521	prescribe such drugs or medicinal supplies, issued in good faith
522	and in the course of professional practice, intended to be
523	filled, compounded, or dispensed by another person licensed by
524	the laws of the state to do so, and meeting the requirements of
525	s. 893.04. The term also includes an order for drugs or
526	medicinal supplies so transmitted or written by a physician,
527	dentist, veterinarian, or other practitioner licensed to
528	practice in a state other than Florida, but only if the
529	pharmacist called upon to fill such an order determines, in the
530	exercise of his or her professional judgment, that the order was
531	issued pursuant to a valid patient-physician relationship, that
532	it is authentic, and that the drugs or medicinal supplies so
533	ordered are considered necessary for the continuation of
534	treatment of a chronic or recurrent illness. However, if the
535	physician writing the prescription is not known to the
536	pharmacist, the pharmacist shall obtain proof to a reasonable
537	certainty of the validity of said prescription. A prescription
538	order for a controlled substance shall not be issued on the same
539	prescription blank with another prescription order for a
540	controlled substance which is named or described in a different
541	schedule, nor shall any prescription order for a controlled
542	substance be issued on the same prescription blank as a
543	prescription order for a medicinal drug, as defined in s.
544	465.003(8), which does not fall within the definition of a
545	controlled substance as defined in this act. A prescription
546	obtained in violation of state law or through misrepresentation,
547	fraud, forgery, deception, or subterfuge is not a valid
548	prescription.
549	Section 10.  Paragraph (b) of subsection (7) of section
550	893.055, Florida Statutes, is amended to read:
551	893.055  Prescription drug monitoring program.-
552	(7)
553	(b)1.  A pharmacy, prescriber, or dispenser shall have
554	access to information in the prescription drug monitoring
555	program's database which relates to a patient of that pharmacy,
556	prescriber, or dispenser in a manner established by the
557	department as needed for the purpose of reviewing the patient's
558	controlled substance prescription history. Before prescribing a
559	controlled substance listed in Schedule II, Schedule III, or
560	Schedule IV in s. 893.03, a prescriber must access information
561	in the prescription drug monitoring database for the purpose of
562	reviewing the patient's controlled substance prescription
563	history and must indicate on the face of the prescription that
564	such review was completed.
565	2.  A dispensing pharmacist who:
566	a.  Believes, or reasonably should believe, that a patient
567	has been prescribed a controlled substance listed in Schedule
568	II, Schedule III, or Schedule IV in s. 893.03 by a prescriber
569	who has not reviewed the prescription drug monitoring database
570	for the purpose of reviewing the patient's controlled substance
571	prescription history; or
572	b.  Does not have any prior dispensing history or
573	relationship with the patient for whom the controlled substance
574	prescription was written,
575
576	must access information in the prescription drug monitoring
577	database for the purpose of reviewing the patient's controlled
578	substance prescription history and may not dispense the
579	controlled substance prescription if there is any clear pattern
580	of doctor-shopping or fraudulent activity by the patient
581	presenting the prescription. Notwithstanding any other provision
582	of law, the dispensing pharmacist is not obligated to review the
583	prescription drug monitoring database before dispensing any
584	prescription for any hospice patient or established patient of
585	the pharmacy. A pharmacist may orally confirm a prescriber's
586	compliance with this paragraph and document such confirmation on
587	the prescription.
588	3.  Other access to the program's database shall be limited
589	to the program program's manager and to the designated program
590	and support staff, who may act only at the direction of the
591	program manager or, in the absence of the program manager, as
592	authorized. Access by the program manager or such designated
593	staff is for prescription drug program management only or for
594	management of the program's database and its system in support
595	of the requirements of this section and in furtherance of the
596	prescription drug monitoring program. Confidential and exempt
597	information in the database shall be released only as provided
598	in paragraph (c) and s. 893.0551. The program manager, the
599	designated program and support staff who act at the direction of
600	or in the absence of the program manager, and any individual who
601	has similar access regarding the management of the database from
602	the prescription drug monitoring program shall submit
603	fingerprints to the department for background screening. The
604	department shall follow the procedure established by the
605	Department of Law Enforcement to request a statewide criminal
606	history record check and to request that the Department of Law
607	Enforcement forward the fingerprints to the Federal Bureau of
608	Investigation for a national criminal history record check.
609	Section 11.  Paragraph (a) of subsection (7) of section
610	893.13, Florida Statutes, is amended to read:
611	893.13  Prohibited acts; penalties.-
612	(7)(a)  A person may not:
613	1.  Distribute or dispense a controlled substance in
614	violation of this chapter.
615	2.  Refuse or fail to make, keep, or furnish any record,
616	notification, order form, statement, invoice, or information
617	required under this chapter.
618	3.  Refuse entry into any premises for any inspection or
619	refuse to allow any inspection authorized by this chapter.
620	4.  Distribute a controlled substance named or described in
621	s. 893.03(1) or (2) except pursuant to an order form as required
622	by s. 893.06.
623	5.  Keep or maintain any store, shop, warehouse, dwelling,
624	building, vehicle, boat, aircraft, or other structure or place
625	which is resorted to by persons using controlled substances in
626	violation of this chapter for the purpose of using these
627	substances, or which is used for keeping or selling them in
628	violation of this chapter.
629	6.  Use to his or her own personal advantage, or reveal,
630	any information obtained in enforcement of this chapter except
631	in a prosecution or administrative hearing for a violation of
632	this chapter.
633	7.  Possess a prescription form which has not been
634	completed and signed by the practitioner whose name appears
635	printed thereon, unless the person is that practitioner, is an
636	agent or employee of that practitioner, is a pharmacist, or is a
637	supplier of prescription forms who is authorized by that
638	practitioner to possess those forms.
639	8.  Fail to affirmatively disclose to Withhold information
640	from a practitioner or pharmacist from whom the person acquires
641	or obtains, or attempts to acquire or seeks to obtain, a
642	controlled substance or a prescription for a controlled
643	substance that the person acquired or obtained making the
644	request has received a controlled substance or a prescription
645	for a controlled substance of like therapeutic use from another
646	practitioner within the previous 30 days, the name of the
647	prescribing practitioner from whom such previous prescription
648	was sought, the quantity, and the dosage.
649	9.  Acquire or obtain, or attempt to acquire or obtain,
650	possession of a controlled substance by misrepresentation,
651	fraud, forgery, deception, or subterfuge.
652	10.  Affix any false or forged label to a package or
653	receptacle containing a controlled substance.
654	11.  Furnish false or fraudulent material information in,
655	or omit any material information from, any report or other
656	document required to be kept or filed under this chapter or any
657	record required to be kept by this chapter.
658	12.  Store anhydrous ammonia in a container that is not
659	approved by the United States Department of Transportation to
660	hold anhydrous ammonia or is not constructed in accordance with
661	sound engineering, agricultural, or commercial practices.
662	13.  With the intent to obtain a controlled substance or
663	combination of controlled substances that are not medically
664	necessary for the person or an amount of a controlled substance
665	or substances that is not medically necessary for the person,
666	obtain or attempt to obtain from a practitioner a controlled
667	substance or a prescription for a controlled substance by
668	misrepresentation, fraud, forgery, deception, subterfuge, or
669	concealment of a material fact. For purposes of this
670	subparagraph, a material fact includes whether the person has an
671	existing prescription for a controlled substance issued for the
672	same period of time by another practitioner or as described in
673	subparagraph 8.
674	Section 12.  This act shall take effect October 1, 2012.

CODING: Words stricken are deletions; words underlined are additions.