Florida Senate - 2015                       CS for CS for SB 532
       
       
        
       By the Committees on Finance and Tax; and Health Policy; and
       Senator Grimsley
       
       
       
       
       593-04002-15                                           2015532c2
    1                        A bill to be entitled                      
    2         An act relating to the ordering of medication;
    3         amending ss. 458.347 and 459.022, F.S.; revising the
    4         authority of a licensed physician assistant to order
    5         medication under the direction of a supervisory
    6         physician for a specified patient; amending s.
    7         464.012, F.S.; authorizing an advanced registered
    8         nurse practitioner to order medication for
    9         administration to a specified patient; amending s.
   10         465.003, F.S.; revising the term “prescription” to
   11         exclude an order for drugs or medicinal supplies by a
   12         licensed practitioner that is dispensed for certain
   13         administration; amending s. 893.02, F.S.; revising the
   14         term “administer” to include the term
   15         “administration”; revising the term “prescription” to
   16         exclude an order for drugs or medicinal supplies by a
   17         licensed practitioner that is dispensed for certain
   18         administration; amending s. 893.04, F.S.; conforming
   19         provisions to changes made by act; amending s. 893.05,
   20         F.S.; authorizing a licensed practitioner to authorize
   21         a licensed physician assistant or advanced registered
   22         nurse practitioner to order controlled substances for
   23         a specified patient under certain circumstances;
   24         reenacting ss. 400.462(26), 401.445(1), 409.906(18),
   25         and 766.103(3), F.S., to incorporate the amendments
   26         made to ss. 458.347 and 459.022, F.S., in references
   27         thereto; reenacting ss. 401.445(1) and 766.103(3),
   28         F.S., to incorporate the amendment made to s. 464.012,
   29         F.S., in references thereto; reenacting ss.
   30         409.9201(1)(a), 458.331(1)(pp), 459.015(1)(rr),
   31         465.014(1), 465.015(2)(c), 465.016(1)(s),
   32         465.022(5)(j), 465.023(1)(h), 465.1901, 499.003(43),
   33         and 831.30(1), F.S., to incorporate the amendment made
   34         to s. 465.003, F.S., in references thereto; reenacting
   35         ss. 112.0455(5)(i), 381.986(7)(b), 440.102(1)(l),
   36         458.331(1)(pp), 459.015(1)(rr), 465.015(3),
   37         465.016(1)(s), 465.022(5)(j), 465.023(1)(h),
   38         499.0121(14), 768.36(1)(b), 810.02(3)(f),
   39         812.014(2)(c), 856.015(1)(c), 944.47(1)(a), 951.22(1),
   40         985.711(1)(a), 1003.57(1)(i), and 1006.09(8), F.S., to
   41         incorporate the amendment made to s. 893.02, F.S., in
   42         references thereto; reenacting s. 893.0551(3)(e),
   43         F.S., to incorporate the amendment made to s. 893.04,
   44         F.S., in a reference thereto; reenacting s.
   45         893.0551(3)(d), F.S., to incorporate the amendment
   46         made to s. 893.05, F.S., in a reference thereto;
   47         providing an effective date.
   48          
   49  Be It Enacted by the Legislature of the State of Florida:
   50  
   51  
   52         Section 1. Paragraph (g) of subsection (4) of section
   53  458.347, Florida Statutes, is amended to read:
   54         458.347 Physician assistants.—
   55         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   56         (g) A supervisory physician may delegate to a licensed
   57  physician assistant the authority to, and the licensed physician
   58  assistant acting under the direction of the supervisory
   59  physician may, order any medication medications for
   60  administration to the supervisory physician’s patient during his
   61  or her care in a facility licensed under chapter 395,
   62  notwithstanding any provisions in chapter 465 or chapter 893
   63  which may prohibit this delegation. For the purpose of this
   64  paragraph, an order is not considered a prescription. A licensed
   65  physician assistant working in a facility that is licensed under
   66  chapter 395 may order any medication under the direction of the
   67  supervisory physician.
   68         Section 2. Paragraph (f) of subsection (4) of section
   69  459.022, Florida Statutes, is amended to read:
   70         459.022 Physician assistants.—
   71         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   72         (f) A supervisory physician may delegate to a licensed
   73  physician assistant the authority to, and the licensed physician
   74  assistant acting under the direction of the supervisory
   75  physician may, order any medication medications for
   76  administration to the supervisory physician’s patient during his
   77  or her care in a facility licensed under chapter 395,
   78  notwithstanding any provisions in chapter 465 or chapter 893
   79  which may prohibit this delegation. For the purpose of this
   80  paragraph, an order is not considered a prescription. A licensed
   81  physician assistant working in a facility that is licensed under
   82  chapter 395 may order any medication under the direction of the
   83  supervisory physician.
   84         Section 3. Paragraph (a) of subsection (3) of section
   85  464.012, Florida Statutes, is amended to read:
   86         464.012 Certification of advanced registered nurse
   87  practitioners; fees.—
   88         (3) An advanced registered nurse practitioner shall perform
   89  those functions authorized in this section within the framework
   90  of an established protocol that is filed with the board upon
   91  biennial license renewal and within 30 days after entering into
   92  a supervisory relationship with a physician or changes to the
   93  protocol. The board shall review the protocol to ensure
   94  compliance with applicable regulatory standards for protocols.
   95  The board shall refer to the department licensees submitting
   96  protocols that are not compliant with the regulatory standards
   97  for protocols. A practitioner currently licensed under chapter
   98  458, chapter 459, or chapter 466 shall maintain supervision for
   99  directing the specific course of medical treatment. Within the
  100  established framework, an advanced registered nurse practitioner
  101  may:
  102         (a) Monitor and alter drug therapies and order any
  103  medication for administration to a patient in a facility
  104  licensed under chapter 395.
  105         Section 4. Subsection (14) of section 465.003, Florida
  106  Statutes, is amended to read:
  107         465.003 Definitions.—As used in this chapter, the term:
  108         (14) “Prescription” includes any order for drugs or
  109  medicinal supplies written or transmitted by any means of
  110  communication by a duly licensed practitioner authorized by the
  111  laws of this the state to prescribe such drugs or medicinal
  112  supplies and intended to be dispensed by a pharmacist, except
  113  for an order that is dispensed for administration. The term also
  114  includes an orally transmitted order by the lawfully designated
  115  agent of such practitioner;. The term also includes an order
  116  written or transmitted by a practitioner licensed to practice in
  117  a jurisdiction other than this state, but only if the pharmacist
  118  called upon to dispense such order determines, in the exercise
  119  of her or his professional judgment, that the order is valid and
  120  necessary for the treatment of a chronic or recurrent illness;
  121  and. The term “prescription” also includes a pharmacist’s order
  122  for a product selected from the formulary created pursuant to s.
  123  465.186. Prescriptions may be retained in written form or the
  124  pharmacist may cause them to be recorded in a data processing
  125  system, provided that such order can be produced in printed form
  126  upon lawful request.
  127         Section 5. Subsections (1) and (22) of section 893.02,
  128  Florida Statutes, are amended to read:
  129         893.02 Definitions.—The following words and phrases as used
  130  in this chapter shall have the following meanings, unless the
  131  context otherwise requires:
  132         (1) “Administer” or “administration” means the direct
  133  application of a controlled substance, whether by injection,
  134  inhalation, ingestion, or any other means, to the body of a
  135  person or animal.
  136         (22) “Prescription” means and includes any an order for
  137  drugs or medicinal supplies which is written, signed, or
  138  transmitted by any word of mouth, telephone, telegram, or other
  139  means of communication by a duly licensed practitioner
  140  authorized licensed by the laws of this the state to prescribe
  141  such drugs or medicinal supplies, is issued in good faith and in
  142  the course of professional practice, is intended to be filled,
  143  compounded, or dispensed by a another person authorized licensed
  144  by the laws of this the state to do so, and meets meeting the
  145  requirements of s. 893.04.
  146         (a) The term also includes an order for drugs or medicinal
  147  supplies so transmitted or written by a physician, dentist,
  148  veterinarian, or other practitioner licensed to practice in a
  149  state other than Florida, but only if the pharmacist called upon
  150  to fill such an order determines, in the exercise of his or her
  151  professional judgment, that the order was issued pursuant to a
  152  valid patient-physician relationship, that it is authentic, and
  153  that the drugs or medicinal supplies so ordered are considered
  154  necessary for the continuation of treatment of a chronic or
  155  recurrent illness.
  156         (b) The term does not include an order that is dispensed
  157  for administration by a licensed practitioner authorized by the
  158  laws of this state to administer such drugs or medicinal
  159  supplies.
  160         (c)However, If the physician writing the prescription is
  161  not known to the pharmacist, the pharmacist shall obtain proof
  162  to a reasonable certainty of the validity of the said
  163  prescription.
  164         (d) A prescription order for a controlled substance may
  165  shall not be issued on the same prescription blank with another
  166  prescription order for a controlled substance that which is
  167  named or described in a different schedule or with another, nor
  168  shall any prescription order for a controlled substance be
  169  issued on the same prescription blank as a prescription order
  170  for a medicinal drug, as defined in s. 465.003(8), that is which
  171  does not fall within the definition of a controlled substance as
  172  defined in this act.
  173         Section 6. Paragraphs (a), (d), and (f) of subsection (2)
  174  of section 893.04, Florida Statutes, are amended to read:
  175         893.04 Pharmacist and practitioner.—
  176         (2)(a) A pharmacist may not dispense a controlled substance
  177  listed in Schedule II, Schedule III, or Schedule IV to any
  178  patient or patient’s agent without first determining, in the
  179  exercise of her or his professional judgment, that the
  180  prescription order is valid. The pharmacist may dispense the
  181  controlled substance, in the exercise of her or his professional
  182  judgment, when the pharmacist or pharmacist’s agent has obtained
  183  satisfactory patient information from the patient or the
  184  patient’s agent.
  185         (d) Each written prescription written prescribed by a
  186  practitioner in this state for a controlled substance listed in
  187  Schedule II, Schedule III, or Schedule IV must include both a
  188  written and a numerical notation of the quantity of the
  189  controlled substance prescribed and a notation of the date in
  190  numerical, month/day/year format, or with the abbreviated month
  191  written out, or the month written out in whole. A pharmacist
  192  may, upon verification by the prescriber, document any
  193  information required by this paragraph. If the prescriber is not
  194  available to verify a prescription, the pharmacist may dispense
  195  the controlled substance, but may insist that the person to whom
  196  the controlled substance is dispensed provide valid photographic
  197  identification. If a prescription includes a numerical notation
  198  of the quantity of the controlled substance or date, but does
  199  not include the quantity or date written out in textual format,
  200  the pharmacist may dispense the controlled substance without
  201  verification by the prescriber of the quantity or date if the
  202  pharmacy previously dispensed another prescription for the
  203  person to whom the prescription was written.
  204         (f) A pharmacist may not knowingly dispense fill a
  205  prescription that has been forged for a controlled substance
  206  listed in Schedule II, Schedule III, or Schedule IV.
  207         Section 7. Subsection (1) of section 893.05, Florida
  208  Statutes, is amended to read:
  209         893.05 Practitioners and persons administering controlled
  210  substances in their absence.—
  211         (1)(a) A practitioner, in good faith and in the course of
  212  his or her professional practice only, may prescribe,
  213  administer, dispense, mix, or otherwise prepare a controlled
  214  substance, or the practitioner may cause the controlled
  215  substance same to be administered by a licensed nurse or an
  216  intern practitioner under his or her direction and supervision
  217  only.
  218         (b)Pursuant to s. 458.347(4)(g), s. 459.022(4)(f), or s.
  219  464.012(3), as applicable, a practitioner who supervises a
  220  licensed physician assistant or advanced registered nurse
  221  practitioner may authorize the licensed physician assistant or
  222  advanced registered nurse practitioner to order controlled
  223  substances for administration to a patient in a facility
  224  licensed under chapter 395.
  225         (c) A veterinarian may so prescribe, administer, dispense,
  226  mix, or prepare a controlled substance for use on animals only,
  227  and may cause the controlled substance it to be administered by
  228  an assistant or orderly under the veterinarian’s direction and
  229  supervision only.
  230         (d) A certified optometrist licensed under chapter 463 may
  231  not administer or prescribe a controlled substance listed in
  232  Schedule I or Schedule II of s. 893.03.
  233         Section 8. Subsection (26) of s. 400.462, subsection (1) of
  234  s. 401.445, subsection (18) of s. 409.906, and subsection (3) of
  235  s. 766.103, Florida Statutes, are reenacted for the purpose of
  236  incorporating the amendments made by this act to ss. 458.347 and
  237  459.022, Florida Statutes, in references thereto.
  238         Section 9. Subsection (1) of s. 401.445 and subsection (3)
  239  of s. 766.103, Florida Statutes, are reenacted for the purpose
  240  of incorporating the amendment made by this act to s. 464.012,
  241  Florida Statutes, in references thereto.
  242         Section 10. Paragraph (a) of subsection (1) of s. 409.9201,
  243  paragraph (pp) of subsection (1) of s. 458.331, paragraph (rr)
  244  of subsection (1) of s. 459.015, subsection (1) of s. 465.014,
  245  paragraph (c) of subsection (2) of s. 465.015, paragraph (s) of
  246  subsection (1) of s. 465.016, paragraph (j) of subsection (5) of
  247  s. 465.022, paragraph (h) of subsection (1) of s. 465.023, s.
  248  465.1901, subsection (43) of s. 499.003, and subsection (1) of
  249  s. 831.30, Florida Statutes, are reenacted for the purpose of
  250  incorporating the amendments made by this act to s. 465.003,
  251  Florida Statutes, in references thereto.
  252         Section 11. Paragraph (i) of subsection (5) of s. 112.0455,
  253  paragraph (b) of subsection (7) of s. 381.986, paragraph (l) of
  254  subsection (1) of s. 440.102, paragraph (pp) of subsection (1)
  255  of s. 458.331, paragraph (rr) of subsection (1) of s. 459.015,
  256  subsection (3) of s. 465.015, paragraph (s) of subsection (1) of
  257  s. 465.016, paragraph (j) of subsection (5) of s. 465.022,
  258  paragraph (h) of subsection (1) of s. 465.023, subsection (14)
  259  of s. 499.0121, paragraph (b) of subsection (1) of s. 768.36,
  260  paragraph (f) of subsection (3) of s. 810.02, paragraph (c) of
  261  subsection (2) of s. 812.014, paragraph (c) of subsection (1) of
  262  s. 856.015, paragraph (a) of subsection (1) of s. 944.47,
  263  subsection (1) of s. 951.22, paragraph (a) of subsection (1) of
  264  s. 985.711, paragraph (i) of subsection (1) of s. 1003.57, and
  265  subsection (8) of s. 1006.09, Florida Statutes, are reenacted
  266  for the purpose of incorporating the amendments made by this act
  267  to s. 893.02, Florida Statutes, in references thereto.
  268         Section 12. Paragraph (e) of subsection (3) of s. 893.0551,
  269  Florida Statutes, is reenacted for the purpose of incorporating
  270  the amendments made by this act to s. 893.04, Florida Statutes,
  271  in a reference thereto.
  272         Section 13. Paragraph (d) of subsection (3) of s. 893.0551,
  273  Florida Statutes, is reenacted for the purpose of incorporating
  274  the amendments made by this act to s. 893.05, Florida Statutes,
  275  in a reference thereto.
  276         Section 14. This act shall take effect July 1, 2015.