Florida Senate - 2025                             CS for SB 1568
       
       
        
       By the Appropriations Committee on Health and Human Services;
       and Senator Brodeur
       
       
       
       
       603-03457-25                                          20251568c1
    1                        A bill to be entitled                      
    2         An act relating to electronic prescribing; amending s.
    3         456.42, F.S.; revising health care practitioners who
    4         may only electronically transmit prescriptions for
    5         certain drugs; revising exceptions; providing
    6         construction; republishing s. 456.43(1), F.S.,
    7         relating to electronic prescribing for medicinal
    8         drugs; amending ss. 458.347 and 459.022, F.S.;
    9         conforming cross-references; providing an effective
   10         date.
   11          
   12  Be It Enacted by the Legislature of the State of Florida:
   13  
   14         Section 1. Present subsections (1) and (2) of section
   15  456.42, Florida Statutes, are redesignated as subsections (2)
   16  and (3), respectively, and present subsection (3) of that
   17  section is redesignated as subsection (1) and amended, to read:
   18         456.42 Written Prescriptions for medicinal drugs.—
   19         (1)(3) A health care practitioner licensed by law to
   20  prescribe a medicinal drug who maintains a system of electronic
   21  health records as defined in s. 408.051(2)(c), or who prescribes
   22  medicinal drugs as an owner, an employee, or a contractor of a
   23  licensed health care facility or practice that maintains such a
   24  system of electronic health records as defined in s.
   25  408.051(2)(c) and who is prescribing in his or her capacity as
   26  such an owner, an employee, or a contractor, may only
   27  electronically transmit prescriptions for such drugs. This
   28  requirement applies to such a health care practitioner upon
   29  renewal of the health care practitioner’s license or by July 1,
   30  2026 2021, whichever is earlier, but does not apply if:
   31         (a)The practitioner prescribes fewer than 100 such
   32  prescriptions annually;
   33         (b)The practitioner is located in an area for which a
   34  state of emergency is declared pursuant to s. 252.36;
   35         (a)The practitioner and the dispenser are the same entity;
   36         (b)The prescription cannot be transmitted electronically
   37  under the most recently implemented version of the National
   38  Council for Prescription Drug Programs SCRIPT Standard;
   39         (c) The practitioner has been issued a waiver by the
   40  department, not to exceed 1 year in duration, from the
   41  requirement to use electronic prescribing due to demonstrated
   42  economic hardship, technological limitations that are not
   43  reasonably within the control of the practitioner, or another
   44  exceptional circumstance demonstrated by the practitioner;
   45         (d) The practitioner reasonably determines that it would be
   46  impractical for the patient in question to obtain a medicinal
   47  drug prescribed by electronic prescription in a timely manner
   48  and such delay would adversely impact the patient’s medical
   49  condition;
   50         (e) The prescription cannot be electronically prescribed
   51  due to a temporary technological or electrical failure that is
   52  not in the control of the prescribing practitioner, and such
   53  failure is documented in the patient record The practitioner is
   54  prescribing a drug under a research protocol;
   55         (f) The prescription is for a drug for which the federal
   56  Food and Drug Administration requires the prescription to
   57  contain elements that may not be included in electronic
   58  prescribing;
   59         (g) The prescription is issued to an individual receiving
   60  hospice care or who is a resident of a nursing home facility; or
   61         (g)(h) The practitioner determines that it is in the best
   62  interest of the patient, or the patient determines that it is in
   63  his or her own best interest, to compare prescription drug
   64  prices among area pharmacies. The practitioner must document
   65  such determination in the patient’s medical record.
   66  
   67  The department, in consultation with the Board of Medicine, the
   68  Board of Osteopathic Medicine, the Board of Podiatric Medicine,
   69  the Board of Dentistry, the Board of Nursing, and the Board of
   70  Optometry, may adopt rules to implement this subsection. This
   71  subsection does not prohibit a pharmacist licensed in this state
   72  from filling or refilling a valid prescription submitted
   73  electronically or in writing, or require or authorize a change
   74  in prescription drug claims adjudication and review procedures
   75  by payors related to filling or refilling a valid prescription
   76  submitted electronically or in writing. This subsection does not
   77  prohibit a pharmacist licensed in this state from filling or
   78  refilling a valid prescription that is issued in writing by a
   79  prescriber located in another state or that is transcribed by
   80  the pharmacy when a prescription is called in by telephone.
   81         Section 2. Subsection (1) of section 456.43, Florida
   82  Statutes, is republished to read:
   83         456.43 Electronic prescribing for medicinal drugs.—
   84         (1) Electronic prescribing may not interfere with a
   85  patient’s freedom to choose a pharmacy.
   86         Section 3. Paragraph (e) of subsection (4) of section
   87  458.347, Florida Statutes, is amended to read:
   88         458.347 Physician assistants.—
   89         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
   90         (e) A supervising physician may delegate to a fully
   91  licensed physician assistant the authority to prescribe or
   92  dispense any medication used in the supervising physician’s
   93  practice unless such medication is listed on the formulary
   94  created pursuant to paragraph (f). A fully licensed physician
   95  assistant may only prescribe or dispense such medication under
   96  the following circumstances:
   97         1. A physician assistant must clearly identify to the
   98  patient that he or she is a physician assistant.
   99         2. The supervising physician must notify the department of
  100  his or her intent to delegate, on a department-approved form,
  101  before delegating such authority and of any change in
  102  prescriptive privileges of the physician assistant. Authority to
  103  dispense may be delegated only by a supervising physician who is
  104  registered as a dispensing practitioner in compliance with s.
  105  465.0276.
  106         3. A fully licensed physician assistant may procure medical
  107  devices and drugs unless the medication is listed on the
  108  formulary created pursuant to paragraph (f).
  109         4. The physician assistant must complete a minimum of 10
  110  continuing medical education hours in the specialty practice in
  111  which the physician assistant has prescriptive privileges with
  112  each licensure renewal. Three of the 10 hours must consist of a
  113  continuing education course on the safe and effective
  114  prescribing of controlled substance medications which is offered
  115  by a statewide professional association of physicians in this
  116  state accredited to provide educational activities designated
  117  for the American Medical Association Physician’s Recognition
  118  Award Category 1 credit, designated by the American Academy of
  119  Physician Assistants as a Category 1 credit, or designated by
  120  the American Osteopathic Association as a Category 1-A credit.
  121         5. The prescription may be in paper or electronic form but
  122  must comply with ss. 456.0392(1) and 456.42(2) 456.42(1) and
  123  chapter 499 and must contain the physician assistant’s name,
  124  address, and telephone number and the name of each of his or her
  125  supervising physicians. Unless it is a drug or drug sample
  126  dispensed by the physician assistant, the prescription must be
  127  filled in a pharmacy permitted under chapter 465 and must be
  128  dispensed in that pharmacy by a pharmacist licensed under
  129  chapter 465.
  130         6. The physician assistant must note the prescription or
  131  dispensing of medication in the appropriate medical record.
  132         Section 4. Paragraph (e) of subsection (4) of section
  133  459.022, Florida Statutes, is amended to read:
  134         459.022 Physician assistants.—
  135         (4) PERFORMANCE OF PHYSICIAN ASSISTANTS.—
  136         (e) A supervising physician may delegate to a fully
  137  licensed physician assistant the authority to prescribe or
  138  dispense any medication used in the supervising physician’s
  139  practice unless such medication is listed on the formulary
  140  created pursuant to s. 458.347. A fully licensed physician
  141  assistant may only prescribe or dispense such medication under
  142  the following circumstances:
  143         1. A physician assistant must clearly identify to the
  144  patient that she or he is a physician assistant.
  145         2. The supervising physician must notify the department of
  146  her or his intent to delegate, on a department-approved form,
  147  before delegating such authority and of any change in
  148  prescriptive privileges of the physician assistant. Authority to
  149  dispense may be delegated only by a supervising physician who is
  150  registered as a dispensing practitioner in compliance with s.
  151  465.0276.
  152         3. A fully licensed physician assistant may procure medical
  153  devices and drugs unless the medication is listed on the
  154  formulary created pursuant to s. 458.347(4)(f).
  155         4. The physician assistant must complete a minimum of 10
  156  continuing medical education hours in the specialty practice in
  157  which the physician assistant has prescriptive privileges with
  158  each licensure renewal. Three of the 10 hours must consist of a
  159  continuing education course on the safe and effective
  160  prescribing of controlled substance medications which is offered
  161  by a provider that has been approved by the American Academy of
  162  Physician Assistants and which is designated for the American
  163  Medical Association Physician’s Recognition Award Category 1
  164  credit, designated by the American Academy of Physician
  165  Assistants as a Category 1 credit, or designated by the American
  166  Osteopathic Association as a Category 1-A credit.
  167         5. The prescription may be in paper or electronic form but
  168  must comply with ss. 456.0392(1) and 456.42(2) 456.42(1) and
  169  chapter 499 and must contain the physician assistant’s name,
  170  address, and telephone number and the name of each of his or her
  171  supervising physicians. Unless it is a drug or drug sample
  172  dispensed by the physician assistant, the prescription must be
  173  filled in a pharmacy permitted under chapter 465, and must be
  174  dispensed in that pharmacy by a pharmacist licensed under
  175  chapter 465.
  176         6. The physician assistant must note the prescription or
  177  dispensing of medication in the appropriate medical record.
  178         Section 5. This act shall take effect July 1, 2025.