Florida Senate - 2019 COMMITTEE AMENDMENT
Bill No. SB 1192
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LEGISLATIVE ACTION
Senate . House
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The Committee on Health Policy (Bean) recommended the following:
1 Senate Amendment (with title amendment)
2
3 Delete everything after the enacting clause
4 and insert:
5 Section 1. Section 456.42, Florida Statutes, is amended to
6 read:
7 456.42 Written prescriptions for medicinal drugs.—
8 (1) A written prescription for a medicinal drug issued by a
9 health care practitioner licensed by law to prescribe such drug
10 must be legibly printed or typed so as to be capable of being
11 understood by the pharmacist filling the prescription; must
12 contain the name of the prescribing practitioner, the name and
13 strength of the drug prescribed, the quantity of the drug
14 prescribed, and the directions for use of the drug; must be
15 dated; and must be signed by the prescribing practitioner on the
16 day when issued. However, a prescription that is electronically
17 generated and transmitted must contain the name of the
18 prescribing practitioner, the name and strength of the drug
19 prescribed, the quantity of the drug prescribed in numerical
20 format, and the directions for use of the drug and must contain
21 the date and an electronic signature, as defined in s.
22 668.003(4), be dated and signed by the prescribing practitioner
23 only on the day issued, which signature may be in an electronic
24 format as defined in s. 668.003(4).
25 (2) A written prescription for a controlled substance
26 listed in chapter 893 must have the quantity of the drug
27 prescribed in both textual and numerical formats, must be dated
28 in numerical, month/day/year format, or with the abbreviated
29 month written out, or the month written out in whole, and must
30 be either written on a standardized counterfeit-proof
31 prescription pad produced by a vendor approved by the department
32 or electronically prescribed as that term is used in s.
33 408.0611. As a condition of being an approved vendor, a
34 prescription pad vendor must submit a monthly report to the
35 department that, at a minimum, documents the number of
36 prescription pads sold and identifies the purchasers. The
37 department may, by rule, require the reporting of additional
38 information.
39 (3) A health care practitioner licensed by law to prescribe
40 a medicinal drug who maintains a system of electronic health
41 records as defined in s. 408.051, or who prescribes medicinal
42 drugs as an owner, employee, or contractor of a licensed health
43 care facility or practice that maintains such a system and who
44 is prescribing in his or her capacity as such an owner,
45 employee, or contractor, may only electronically transmit
46 prescriptions for such drugs. This requirement applies to such a
47 health care practitioner upon renewal of the health care
48 practitioner’s license or by July 1, 2021, whichever is earlier,
49 but does not apply if:
50 (a) The practitioner and the dispenser are the same entity;
51 (b) The prescription cannot be transmitted electronically
52 under the most recently implemented version of the National
53 Council for Prescription Drug Programs SCRIPT Standard;
54 (c) The practitioner has been issued a waiver by the
55 department, not to exceed 1 year in duration, from the
56 requirement to use electronic prescribing due to demonstrated
57 economic hardship, technological limitations that are not
58 reasonably within the control of the practitioner, or other
59 exceptional circumstance demonstrated by the practitioner;
60 (d) The practitioner reasonably determines that it would be
61 impractical for the patient in question to obtain a medicinal
62 drug prescribed by electronic prescription in a timely manner
63 and such delay would adversely impact the patient’s medical
64 condition;
65 (e) The practitioner is prescribing a drug under a research
66 protocol;
67 (f) The prescription is for a drug for which the federal
68 Food and Drug Administration requires the prescription to
69 contain elements that may not be included in electronic
70 prescribing; or
71 (g) The prescription is issued to an individual receiving
72 hospice care or who is a resident of a nursing home facility.
73
74 The department, in consultation with the Board of Medicine and
75 the Board of Osteopathic Medicine, may adopt rules to implement
76 this subsection.
77 Section 2. Section 456.43, Florida Statutes, is amended to
78 read:
79 456.43 Electronic prescribing for medicinal drugs.—
80 (1) Electronic prescribing may shall not interfere with a
81 patient’s freedom to choose a pharmacy.
82 (2) Electronic prescribing software may shall not use any
83 means or permit any other person to use any means to influence
84 or attempt to influence, through economic incentives or
85 otherwise, the prescribing decision of a prescribing
86 practitioner or his or her agent at the point of care,
87 including, but not limited to, means such as advertising,
88 instant messaging, and pop-up ads, and similar means to
89 influence or attempt to influence, through economic incentives
90 or otherwise, the prescribing decision of a prescribing
91 practitioner at the point of care. Such means shall not be
92 triggered by or in specific response to the input, selection, or
93 act of a prescribing practitioner or his or her agent in
94 prescribing a certain medicinal drug pharmaceutical or directing
95 a patient to a certain pharmacy. For purposes of this
96 subsection, the term:
97 (a) The term “Prescribing decision” means a prescribing
98 practitioner’s or his or her agent’s decision to prescribe any
99 medicinal drug a certain pharmaceutical.
100 (b) The term “Point of care” means the time at which that a
101 prescribing practitioner or his or her agent prescribes any
102 medicinal drug is in the act of prescribing a certain
103 pharmaceutical.
104 (3) Electronic prescribing software may display show
105 information regarding a payor’s formulary if as long as nothing
106 is designed to preclude or make more difficult the selection of
107 the act of a prescribing practitioner or patient selecting any
108 particular pharmacy by a patient or the selection of a certain
109 medicinal drug by a prescribing practitioner or his or her agent
110 pharmaceutical.
111 Section 3. Paragraph (a) of subsection (5) of section
112 409.912, Florida Statutes, is amended to read:
113 409.912 Cost-effective purchasing of health care.—The
114 agency shall purchase goods and services for Medicaid recipients
115 in the most cost-effective manner consistent with the delivery
116 of quality medical care. To ensure that medical services are
117 effectively utilized, the agency may, in any case, require a
118 confirmation or second physician’s opinion of the correct
119 diagnosis for purposes of authorizing future services under the
120 Medicaid program. This section does not restrict access to
121 emergency services or poststabilization care services as defined
122 in 42 C.F.R. s. 438.114. Such confirmation or second opinion
123 shall be rendered in a manner approved by the agency. The agency
124 shall maximize the use of prepaid per capita and prepaid
125 aggregate fixed-sum basis services when appropriate and other
126 alternative service delivery and reimbursement methodologies,
127 including competitive bidding pursuant to s. 287.057, designed
128 to facilitate the cost-effective purchase of a case-managed
129 continuum of care. The agency shall also require providers to
130 minimize the exposure of recipients to the need for acute
131 inpatient, custodial, and other institutional care and the
132 inappropriate or unnecessary use of high-cost services. The
133 agency shall contract with a vendor to monitor and evaluate the
134 clinical practice patterns of providers in order to identify
135 trends that are outside the normal practice patterns of a
136 provider’s professional peers or the national guidelines of a
137 provider’s professional association. The vendor must be able to
138 provide information and counseling to a provider whose practice
139 patterns are outside the norms, in consultation with the agency,
140 to improve patient care and reduce inappropriate utilization.
141 The agency may mandate prior authorization, drug therapy
142 management, or disease management participation for certain
143 populations of Medicaid beneficiaries, certain drug classes, or
144 particular drugs to prevent fraud, abuse, overuse, and possible
145 dangerous drug interactions. The Pharmaceutical and Therapeutics
146 Committee shall make recommendations to the agency on drugs for
147 which prior authorization is required. The agency shall inform
148 the Pharmaceutical and Therapeutics Committee of its decisions
149 regarding drugs subject to prior authorization. The agency is
150 authorized to limit the entities it contracts with or enrolls as
151 Medicaid providers by developing a provider network through
152 provider credentialing. The agency may competitively bid single
153 source-provider contracts if procurement of goods or services
154 results in demonstrated cost savings to the state without
155 limiting access to care. The agency may limit its network based
156 on the assessment of beneficiary access to care, provider
157 availability, provider quality standards, time and distance
158 standards for access to care, the cultural competence of the
159 provider network, demographic characteristics of Medicaid
160 beneficiaries, practice and provider-to-beneficiary standards,
161 appointment wait times, beneficiary use of services, provider
162 turnover, provider profiling, provider licensure history,
163 previous program integrity investigations and findings, peer
164 review, provider Medicaid policy and billing compliance records,
165 clinical and medical record audits, and other factors. Providers
166 are not entitled to enrollment in the Medicaid provider network.
167 The agency shall determine instances in which allowing Medicaid
168 beneficiaries to purchase durable medical equipment and other
169 goods is less expensive to the Medicaid program than long-term
170 rental of the equipment or goods. The agency may establish rules
171 to facilitate purchases in lieu of long-term rentals in order to
172 protect against fraud and abuse in the Medicaid program as
173 defined in s. 409.913. The agency may seek federal waivers
174 necessary to administer these policies.
175 (5)(a) The agency shall implement a Medicaid prescribed
176 drug spending-control program that includes the following
177 components:
178 1. A Medicaid preferred drug list, which shall be a listing
179 of cost-effective therapeutic options recommended by the
180 Medicaid Pharmacy and Therapeutics Committee established
181 pursuant to s. 409.91195 and adopted by the agency for each
182 therapeutic class on the preferred drug list. At the discretion
183 of the committee, and when feasible, the preferred drug list
184 should include at least two products in a therapeutic class. The
185 agency may post the preferred drug list and updates to the list
186 on an Internet website without following the rulemaking
187 procedures of chapter 120. Antiretroviral agents are excluded
188 from the preferred drug list. The agency shall also limit the
189 amount of a prescribed drug dispensed to no more than a 34-day
190 supply unless the drug products’ smallest marketed package is
191 greater than a 34-day supply, or the drug is determined by the
192 agency to be a maintenance drug in which case a 100-day maximum
193 supply may be authorized. The agency may seek any federal
194 waivers necessary to implement these cost-control programs and
195 to continue participation in the federal Medicaid rebate
196 program, or alternatively to negotiate state-only manufacturer
197 rebates. The agency may adopt rules to administer this
198 subparagraph. The agency shall continue to provide unlimited
199 contraceptive drugs and items. The agency must establish
200 procedures to ensure that:
201 a. There is a response to a request for prior consultation
202 by telephone or other telecommunication device within 24 hours
203 after receipt of a request for prior consultation; and
204 b. A 72-hour supply of the drug prescribed is provided in
205 an emergency or when the agency does not provide a response
206 within 24 hours as required by sub-subparagraph a.
207 2. Reimbursement to pharmacies for Medicaid prescribed
208 drugs shall be set at the lowest of: the average wholesale price
209 (AWP) minus 16.4 percent, the wholesaler acquisition cost (WAC)
210 plus 1.5 percent, the federal upper limit (FUL), the state
211 maximum allowable cost (SMAC), or the usual and customary (UAC)
212 charge billed by the provider.
213 3. The agency shall develop and implement a process for
214 managing the drug therapies of Medicaid recipients who are using
215 significant numbers of prescribed drugs each month. The
216 management process may include, but is not limited to,
217 comprehensive, physician-directed medical-record reviews, claims
218 analyses, and case evaluations to determine the medical
219 necessity and appropriateness of a patient’s treatment plan and
220 drug therapies. The agency may contract with a private
221 organization to provide drug-program-management services. The
222 Medicaid drug benefit management program shall include
223 initiatives to manage drug therapies for HIV/AIDS patients,
224 patients using 20 or more unique prescriptions in a 180-day
225 period, and the top 1,000 patients in annual spending. The
226 agency shall enroll any Medicaid recipient in the drug benefit
227 management program if he or she meets the specifications of this
228 provision and is not enrolled in a Medicaid health maintenance
229 organization.
230 4. The agency may limit the size of its pharmacy network
231 based on need, competitive bidding, price negotiations,
232 credentialing, or similar criteria. The agency shall give
233 special consideration to rural areas in determining the size and
234 location of pharmacies included in the Medicaid pharmacy
235 network. A pharmacy credentialing process may include criteria
236 such as a pharmacy’s full-service status, location, size,
237 patient educational programs, patient consultation, disease
238 management services, and other characteristics. The agency may
239 impose a moratorium on Medicaid pharmacy enrollment if it is
240 determined that it has a sufficient number of Medicaid
241 participating providers. The agency must allow dispensing
242 practitioners to participate as a part of the Medicaid pharmacy
243 network regardless of the practitioner’s proximity to any other
244 entity that is dispensing prescription drugs under the Medicaid
245 program. A dispensing practitioner must meet all credentialing
246 requirements applicable to his or her practice, as determined by
247 the agency.
248 5. The agency shall develop and implement a program that
249 requires Medicaid practitioners who issue written prescriptions
250 for medicinal prescribe drugs to use a counterfeit-proof
251 prescription pad for Medicaid prescriptions. The agency shall
252 require the use of standardized counterfeit-proof prescription
253 pads by Medicaid-participating prescribers or prescribers who
254 issue written write prescriptions for Medicaid recipients. The
255 agency may implement the program in targeted geographic areas or
256 statewide.
257 6. The agency may enter into arrangements that require
258 manufacturers of generic drugs prescribed to Medicaid recipients
259 to provide rebates of at least 15.1 percent of the average
260 manufacturer price for the manufacturer’s generic products.
261 These arrangements shall require that if a generic-drug
262 manufacturer pays federal rebates for Medicaid-reimbursed drugs
263 at a level below 15.1 percent, the manufacturer must provide a
264 supplemental rebate to the state in an amount necessary to
265 achieve a 15.1-percent rebate level.
266 7. The agency may establish a preferred drug list as
267 described in this subsection, and, pursuant to the establishment
268 of such preferred drug list, negotiate supplemental rebates from
269 manufacturers that are in addition to those required by Title
270 XIX of the Social Security Act and at no less than 14 percent of
271 the average manufacturer price as defined in 42 U.S.C. s. 1936
272 on the last day of a quarter unless the federal or supplemental
273 rebate, or both, equals or exceeds 29 percent. There is no upper
274 limit on the supplemental rebates the agency may negotiate. The
275 agency may determine that specific products, brand-name or
276 generic, are competitive at lower rebate percentages. Agreement
277 to pay the minimum supplemental rebate percentage guarantees a
278 manufacturer that the Medicaid Pharmaceutical and Therapeutics
279 Committee will consider a product for inclusion on the preferred
280 drug list. However, a pharmaceutical manufacturer is not
281 guaranteed placement on the preferred drug list by simply paying
282 the minimum supplemental rebate. Agency decisions will be made
283 on the clinical efficacy of a drug and recommendations of the
284 Medicaid Pharmaceutical and Therapeutics Committee, as well as
285 the price of competing products minus federal and state rebates.
286 The agency may contract with an outside agency or contractor to
287 conduct negotiations for supplemental rebates. For the purposes
288 of this section, the term “supplemental rebates” means cash
289 rebates. Value-added programs as a substitution for supplemental
290 rebates are prohibited. The agency may seek any federal waivers
291 to implement this initiative.
292 8. The agency shall expand home delivery of pharmacy
293 products. The agency may amend the state plan and issue a
294 procurement, as necessary, in order to implement this program.
295 The procurements must include agreements with a pharmacy or
296 pharmacies located in the state to provide mail order delivery
297 services at no cost to the recipients who elect to receive home
298 delivery of pharmacy products. The procurement must focus on
299 serving recipients with chronic diseases for which pharmacy
300 expenditures represent a significant portion of Medicaid
301 pharmacy expenditures or which impact a significant portion of
302 the Medicaid population. The agency may seek and implement any
303 federal waivers necessary to implement this subparagraph.
304 9. The agency shall limit to one dose per month any drug
305 prescribed to treat erectile dysfunction.
306 10.a. The agency may implement a Medicaid behavioral drug
307 management system. The agency may contract with a vendor that
308 has experience in operating behavioral drug management systems
309 to implement this program. The agency may seek federal waivers
310 to implement this program.
311 b. The agency, in conjunction with the Department of
312 Children and Families, may implement the Medicaid behavioral
313 drug management system that is designed to improve the quality
314 of care and behavioral health prescribing practices based on
315 best practice guidelines, improve patient adherence to
316 medication plans, reduce clinical risk, and lower prescribed
317 drug costs and the rate of inappropriate spending on Medicaid
318 behavioral drugs. The program may include the following
319 elements:
320 (I) Provide for the development and adoption of best
321 practice guidelines for behavioral health-related drugs such as
322 antipsychotics, antidepressants, and medications for treating
323 bipolar disorders and other behavioral conditions; translate
324 them into practice; review behavioral health prescribers and
325 compare their prescribing patterns to a number of indicators
326 that are based on national standards; and determine deviations
327 from best practice guidelines.
328 (II) Implement processes for providing feedback to and
329 educating prescribers using best practice educational materials
330 and peer-to-peer consultation.
331 (III) Assess Medicaid beneficiaries who are outliers in
332 their use of behavioral health drugs with regard to the numbers
333 and types of drugs taken, drug dosages, combination drug
334 therapies, and other indicators of improper use of behavioral
335 health drugs.
336 (IV) Alert prescribers to patients who fail to refill
337 prescriptions in a timely fashion, are prescribed multiple same
338 class behavioral health drugs, and may have other potential
339 medication problems.
340 (V) Track spending trends for behavioral health drugs and
341 deviation from best practice guidelines.
342 (VI) Use educational and technological approaches to
343 promote best practices, educate consumers, and train prescribers
344 in the use of practice guidelines.
345 (VII) Disseminate electronic and published materials.
346 (VIII) Hold statewide and regional conferences.
347 (IX) Implement a disease management program with a model
348 quality-based medication component for severely mentally ill
349 individuals and emotionally disturbed children who are high
350 users of care.
351 11. The agency shall implement a Medicaid prescription drug
352 management system.
353 a. The agency may contract with a vendor that has
354 experience in operating prescription drug management systems in
355 order to implement this system. Any management system that is
356 implemented in accordance with this subparagraph must rely on
357 cooperation between physicians and pharmacists to determine
358 appropriate practice patterns and clinical guidelines to improve
359 the prescribing, dispensing, and use of drugs in the Medicaid
360 program. The agency may seek federal waivers to implement this
361 program.
362 b. The drug management system must be designed to improve
363 the quality of care and prescribing practices based on best
364 practice guidelines, improve patient adherence to medication
365 plans, reduce clinical risk, and lower prescribed drug costs and
366 the rate of inappropriate spending on Medicaid prescription
367 drugs. The program must:
368 (I) Provide for the adoption of best practice guidelines
369 for the prescribing and use of drugs in the Medicaid program,
370 including translating best practice guidelines into practice;
371 reviewing prescriber patterns and comparing them to indicators
372 that are based on national standards and practice patterns of
373 clinical peers in their community, statewide, and nationally;
374 and determine deviations from best practice guidelines.
375 (II) Implement processes for providing feedback to and
376 educating prescribers using best practice educational materials
377 and peer-to-peer consultation.
378 (III) Assess Medicaid recipients who are outliers in their
379 use of a single or multiple prescription drugs with regard to
380 the numbers and types of drugs taken, drug dosages, combination
381 drug therapies, and other indicators of improper use of
382 prescription drugs.
383 (IV) Alert prescribers to recipients who fail to refill
384 prescriptions in a timely fashion, are prescribed multiple drugs
385 that may be redundant or contraindicated, or may have other
386 potential medication problems.
387 12. The agency may contract for drug rebate administration,
388 including, but not limited to, calculating rebate amounts,
389 invoicing manufacturers, negotiating disputes with
390 manufacturers, and maintaining a database of rebate collections.
391 13. The agency may specify the preferred daily dosing form
392 or strength for the purpose of promoting best practices with
393 regard to the prescribing of certain drugs as specified in the
394 General Appropriations Act and ensuring cost-effective
395 prescribing practices.
396 14. The agency may require prior authorization for
397 Medicaid-covered prescribed drugs. The agency may prior
398 authorize the use of a product:
399 a. For an indication not approved in labeling;
400 b. To comply with certain clinical guidelines; or
401 c. If the product has the potential for overuse, misuse, or
402 abuse.
403
404 The agency may require the prescribing professional to provide
405 information about the rationale and supporting medical evidence
406 for the use of a drug. The agency shall post prior
407 authorization, step-edit criteria and protocol, and updates to
408 the list of drugs that are subject to prior authorization on the
409 agency’s Internet website within 21 days after the prior
410 authorization and step-edit criteria and protocol and updates
411 are approved by the agency. For purposes of this subparagraph,
412 the term “step-edit” means an automatic electronic review of
413 certain medications subject to prior authorization.
414 15. The agency, in conjunction with the Pharmaceutical and
415 Therapeutics Committee, may require age-related prior
416 authorizations for certain prescribed drugs. The agency may
417 preauthorize the use of a drug for a recipient who may not meet
418 the age requirement or may exceed the length of therapy for use
419 of this product as recommended by the manufacturer and approved
420 by the Food and Drug Administration. Prior authorization may
421 require the prescribing professional to provide information
422 about the rationale and supporting medical evidence for the use
423 of a drug.
424 16. The agency shall implement a step-therapy prior
425 authorization approval process for medications excluded from the
426 preferred drug list. Medications listed on the preferred drug
427 list must be used within the previous 12 months before the
428 alternative medications that are not listed. The step-therapy
429 prior authorization may require the prescriber to use the
430 medications of a similar drug class or for a similar medical
431 indication unless contraindicated in the Food and Drug
432 Administration labeling. The trial period between the specified
433 steps may vary according to the medical indication. The step
434 therapy approval process shall be developed in accordance with
435 the committee as stated in s. 409.91195(7) and (8). A drug
436 product may be approved without meeting the step-therapy prior
437 authorization criteria if the prescribing physician provides the
438 agency with additional written medical or clinical documentation
439 that the product is medically necessary because:
440 a. There is not a drug on the preferred drug list to treat
441 the disease or medical condition which is an acceptable clinical
442 alternative;
443 b. The alternatives have been ineffective in the treatment
444 of the beneficiary’s disease; or
445 c. Based on historic evidence and known characteristics of
446 the patient and the drug, the drug is likely to be ineffective,
447 or the number of doses have been ineffective.
448
449 The agency shall work with the physician to determine the best
450 alternative for the patient. The agency may adopt rules waiving
451 the requirements for written clinical documentation for specific
452 drugs in limited clinical situations.
453 17. The agency shall implement a return and reuse program
454 for drugs dispensed by pharmacies to institutional recipients,
455 which includes payment of a $5 restocking fee for the
456 implementation and operation of the program. The return and
457 reuse program shall be implemented electronically and in a
458 manner that promotes efficiency. The program must permit a
459 pharmacy to exclude drugs from the program if it is not
460 practical or cost-effective for the drug to be included and must
461 provide for the return to inventory of drugs that cannot be
462 credited or returned in a cost-effective manner. The agency
463 shall determine if the program has reduced the amount of
464 Medicaid prescription drugs which are destroyed on an annual
465 basis and if there are additional ways to ensure more
466 prescription drugs are not destroyed which could safely be
467 reused.
468 Section 4. Section 456.0392, Florida Statutes, is amended
469 to read:
470 456.0392 Prescription labeling.—
471 (1) A prescription issued written by a practitioner who is
472 authorized under the laws of this state to prescribe write
473 prescriptions for drugs that are not listed as controlled
474 substances in chapter 893 but who is not eligible for a federal
475 Drug Enforcement Administration number shall include that
476 practitioner’s name and professional license number. The
477 pharmacist or dispensing practitioner must include the
478 practitioner’s name on the container of the drug that is
479 dispensed. A pharmacist shall be permitted, upon verification by
480 the prescriber, to document any information required by this
481 section.
482 (2) A prescription for a drug that is not listed as a
483 controlled substance in chapter 893 which is issued written by
484 an advanced practice registered nurse licensed under s. 464.012
485 is presumed, subject to rebuttal, to be valid and within the
486 parameters of the prescriptive authority delegated by a
487 practitioner licensed under chapter 458, chapter 459, or chapter
488 466.
489 (3) A prescription for a drug that is not listed as a
490 controlled substance in chapter 893 which is issued written by a
491 physician assistant licensed under chapter 458 or chapter 459 is
492 presumed, subject to rebuttal, to be valid and within the
493 parameters of the prescriptive authority delegated by the
494 physician assistant’s supervising physician.
495 Section 5. Paragraph (d) of subsection (3) of section
496 458.3265, Florida Statutes, is amended to read:
497 458.3265 Pain-management clinics.—
498 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
499 apply to any physician who provides professional services in a
500 pain-management clinic that is required to be registered in
501 subsection (1).
502 (d) A physician authorized to prescribe controlled
503 substances who practices at a pain-management clinic is
504 responsible for maintaining the control and security of his or
505 her prescription blanks or electronic prescribing software and
506 any other method used for prescribing controlled substance pain
507 medication. A The physician who issues written prescriptions
508 shall comply with the requirements for counterfeit-resistant
509 prescription blanks in s. 893.065 and the rules adopted pursuant
510 to that section. A The physician shall notify, in writing, the
511 department within 24 hours after following any theft or loss of
512 a prescription blank or breach of his or her electronic
513 prescribing software used any other method for prescribing pain
514 medication.
515 Section 6. Paragraph (qq) of subsection (1) of section
516 458.331, Florida Statutes, is amended to read:
517 458.331 Grounds for disciplinary action; action by the
518 board and department.—
519 (1) The following acts constitute grounds for denial of a
520 license or disciplinary action, as specified in s. 456.072(2):
521 (qq) Failing to timely notify the department of the theft
522 of prescription blanks from a pain-management clinic or a breach
523 of a physician’s electronic prescribing software other methods
524 for prescribing within 24 hours as required by s. 458.3265(3).
525 Section 7. Paragraph (d) of subsection (3) of section
526 459.0137, Florida Statutes, is amended to read:
527 459.0137 Pain-management clinics.—
528 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities
529 apply to any osteopathic physician who provides professional
530 services in a pain-management clinic that is required to be
531 registered in subsection (1).
532 (d) An osteopathic physician authorized to prescribe
533 controlled substances who practices at a pain-management clinic
534 is responsible for maintaining the control and security of his
535 or her prescription blanks or electronic prescribing software
536 and any other method used for prescribing controlled substance
537 pain medication. An The osteopathic physician who issues written
538 prescriptions shall comply with the requirements for
539 counterfeit-resistant prescription blanks in s. 893.065 and the
540 rules adopted pursuant to that section. An The osteopathic
541 physician shall notify, in writing, the department within 24
542 hours after following any theft or loss of a prescription blank
543 or breach of his or her electronic prescribing software used any
544 other method for prescribing pain medication.
545 Section 8. Paragraph (ss) of subsection (1) of section
546 459.015, Florida Statutes, is amended to read:
547 459.015 Grounds for disciplinary action; action by the
548 board and department.—
549 (1) The following acts constitute grounds for denial of a
550 license or disciplinary action, as specified in s. 456.072(2):
551 (ss) Failing to timely notify the department of the theft
552 of prescription blanks from a pain-management clinic or a breach
553 of an osteopathic physician’s electronic prescribing software
554 other methods for prescribing within 24 hours as required by s.
555 459.0137(3).
556 Section 9. This act shall take effect January 1, 2020.
557
558
559 ================= T I T L E A M E N D M E N T ================
560 And the title is amended as follows:
561 Delete everything before the enacting clause
562 and insert:
563 A bill to be entitled
564 An act relating to electronic prescribing; amending s.
565 456.42, F.S.; requiring certain health care
566 practitioners to electronically generate and transmit
567 prescriptions for medicinal drugs upon license renewal
568 or by a specified date; providing exceptions;
569 authorizing the Department of Health, in consultation
570 with the Board of Medicine and the Board of
571 Osteopathic Medicine, to adopt rules; amending s.
572 456.43, F.S.; revising the definitions of the terms
573 “prescribing decision” and “point of care”; revising
574 the authority for electronic prescribing software to
575 display information regarding a payor’s formulary
576 under certain circumstances; amending ss. 409.912,
577 456.0392, 458.3265, 458.331, 459.0137, and 459.015,
578 F.S.; conforming provisions to changes made by the
579 act; providing an effective date.