Bill Text: FL S1192 | 2019 | Regular Session | Comm Sub
Bill Title: Electronic Prescribing
Spectrum:
Status: (Introduced - Dead) 2019-05-01 - Laid on Table, companion bill(s) passed, see CS/HB 831 (Ch. 2019-112) [S1192 Detail]
Download: Florida-2019-S1192-Comm_Sub.html
Florida Senate - 2019 CS for CS for SB 1192 By the Committees on Appropriations; and Health Policy; and Senators Bean, Baxley, and Rouson 576-04635-19 20191192c2 1 A bill to be entitled 2 An act relating to electronic prescribing; amending s. 3 456.42, F.S.; requiring certain health care 4 practitioners to electronically generate and transmit 5 prescriptions for medicinal drugs upon license renewal 6 or by a specified date; providing exceptions; 7 authorizing the Department of Health, in consultation 8 with the Board of Medicine, the Board of Osteopathic 9 Medicine, the Board of Podiatric Medicine, the Board 10 of Dentistry, the Board of Nursing, and the Board of 11 Optometry, to adopt rules; amending s. 456.43, F.S.; 12 revising the definitions of the terms “prescribing 13 decision” and “point of care”; revising the authority 14 for electronic prescribing software to display 15 information regarding a payor’s formulary under 16 certain circumstances; amending ss. 409.912, 456.0392, 17 458.3265, 458.331, 459.0137, and 459.015, F.S.; 18 conforming provisions to changes made by the act; 19 providing an effective date. 20 21 Be It Enacted by the Legislature of the State of Florida: 22 23 Section 1. Section 456.42, Florida Statutes, is amended to 24 read: 25 456.42 Written prescriptions for medicinal drugs.— 26 (1) A written prescription for a medicinal drug issued by a 27 health care practitioner licensed by law to prescribe such drug 28 must be legibly printed or typed so as to be capable of being 29 understood by the pharmacist filling the prescription; must 30 contain the name of the prescribing practitioner, the name and 31 strength of the drug prescribed, the quantity of the drug 32 prescribed, and the directions for use of the drug; must be 33 dated; and must be signed by the prescribing practitioner on the 34 day when issued. However, a prescription that is electronically 35 generated and transmitted must contain the name of the 36 prescribing practitioner, the name and strength of the drug 37 prescribed, the quantity of the drug prescribed in numerical 38 format, and the directions for use of the drug and must contain 39 the date and an electronic signature, as defined in s. 40 668.003(4),be dated and signedby the prescribing practitioner 41 only on the day issued, which signature may be in an electronic42format as defined in s. 668.003(4). 43 (2) A written prescription for a controlled substance 44 listed in chapter 893 must have the quantity of the drug 45 prescribed in both textual and numerical formats, must be dated 46 in numerical, month/day/year format, or with the abbreviated 47 month written out, or the month written out in whole, and must 48 be either written on a standardized counterfeit-proof 49 prescription pad produced by a vendor approved by the department 50 or electronically prescribed as that term is used in s. 51 408.0611. As a condition of being an approved vendor, a 52 prescription pad vendor must submit a monthly report to the 53 department that, at a minimum, documents the number of 54 prescription pads sold and identifies the purchasers. The 55 department may, by rule, require the reporting of additional 56 information. 57 (3) A health care practitioner licensed by law to prescribe 58 a medicinal drug who maintains a system of electronic health 59 records as defined in s. 408.051(2)(a), or who prescribes 60 medicinal drugs as an owner, an employee, or a contractor of a 61 licensed health care facility or practice that maintains such a 62 system and who is prescribing in his or her capacity as such an 63 owner, an employee, or a contractor, may only electronically 64 transmit prescriptions for such drugs. This requirement applies 65 to such a health care practitioner upon renewal of the health 66 care practitioner’s license or by July 1, 2021, whichever is 67 earlier, but does not apply if: 68 (a) The practitioner and the dispenser are the same entity; 69 (b) The prescription cannot be transmitted electronically 70 under the most recently implemented version of the National 71 Council for Prescription Drug Programs SCRIPT Standard; 72 (c) The practitioner has been issued a waiver by the 73 department, not to exceed 1 year in duration, from the 74 requirement to use electronic prescribing due to demonstrated 75 economic hardship, technological limitations that are not 76 reasonably within the control of the practitioner, or another 77 exceptional circumstance demonstrated by the practitioner; 78 (d) The practitioner reasonably determines that it would be 79 impractical for the patient in question to obtain a medicinal 80 drug prescribed by electronic prescription in a timely manner 81 and such delay would adversely impact the patient’s medical 82 condition; 83 (e) The practitioner is prescribing a drug under a research 84 protocol; 85 (f) The prescription is for a drug for which the federal 86 Food and Drug Administration requires the prescription to 87 contain elements that may not be included in electronic 88 prescribing; or 89 (g) The prescription is issued to an individual receiving 90 hospice care or who is a resident of a nursing home facility. 91 (h) The practitioner determines that it is in the best 92 interest of the patient, or the patient determines that it is in 93 his or her own best interest, to compare prescription drug 94 prices among area pharmacies. The practitioner must document 95 such determination in the patient’s medical record. 96 97 The department, in consultation with the Board of Medicine, the 98 Board of Osteopathic Medicine, the Board of Podiatric Medicine, 99 the Board of Dentistry, the Board of Nursing, and the Board of 100 Optometry, may adopt rules to implement this subsection. 101 Section 2. Section 456.43, Florida Statutes, is amended to 102 read: 103 456.43 Electronic prescribing for medicinal drugs.— 104 (1) Electronic prescribing mayshallnot interfere with a 105 patient’s freedom to choose a pharmacy. 106 (2) Electronic prescribing software mayshallnot use any 107 means or permit any other person to use any means to influence 108 or attempt to influence, through economic incentives or 109 otherwise, the prescribing decision of a prescribing 110 practitioner or his or her agent at the point of care, 111 including, but not limited to, means such as advertising, 112 instant messaging,andpop-up ads, and similar meansto113influence or attempt to influence, through economic incentives114or otherwise, the prescribing decision of a prescribing115practitioner at the point of care. Such means shall not be116 triggered by or in specific response to the input, selection, or 117 act of a prescribing practitioner or his or her agent in 118 prescribing a certain medicinal drugpharmaceuticalor directing 119 a patient to a certain pharmacy. For purposes of this 120 subsection, the term: 121 (a)The term“Prescribing decision” means a prescribing 122 practitioner’s or his or her agent’s decision to prescribe any 123 medicinal druga certain pharmaceutical. 124 (b)The term“Point of care” means the time at whichthata 125 prescribing practitioner or his or her agent prescribes any 126 medicinal drugis in the act of prescribing a certain127pharmaceutical. 128 (3) Electronic prescribing software may displayshow129 information regarding a payor’s formulary ifas long asnothing 130 is designed to preclude or make more difficult the selection of 131the act of a prescribing practitioner or patient selectingany 132 particular pharmacy by a patient or the selection of a certain 133 medicinal drug by a prescribing practitioner or his or her agent 134pharmaceutical. 135 Section 3. Paragraph (a) of subsection (5) of section 136 409.912, Florida Statutes, is amended to read: 137 409.912 Cost-effective purchasing of health care.—The 138 agency shall purchase goods and services for Medicaid recipients 139 in the most cost-effective manner consistent with the delivery 140 of quality medical care. To ensure that medical services are 141 effectively utilized, the agency may, in any case, require a 142 confirmation or second physician’s opinion of the correct 143 diagnosis for purposes of authorizing future services under the 144 Medicaid program. This section does not restrict access to 145 emergency services or poststabilization care services as defined 146 in 42 C.F.R. s. 438.114. Such confirmation or second opinion 147 shall be rendered in a manner approved by the agency. The agency 148 shall maximize the use of prepaid per capita and prepaid 149 aggregate fixed-sum basis services when appropriate and other 150 alternative service delivery and reimbursement methodologies, 151 including competitive bidding pursuant to s. 287.057, designed 152 to facilitate the cost-effective purchase of a case-managed 153 continuum of care. The agency shall also require providers to 154 minimize the exposure of recipients to the need for acute 155 inpatient, custodial, and other institutional care and the 156 inappropriate or unnecessary use of high-cost services. The 157 agency shall contract with a vendor to monitor and evaluate the 158 clinical practice patterns of providers in order to identify 159 trends that are outside the normal practice patterns of a 160 provider’s professional peers or the national guidelines of a 161 provider’s professional association. The vendor must be able to 162 provide information and counseling to a provider whose practice 163 patterns are outside the norms, in consultation with the agency, 164 to improve patient care and reduce inappropriate utilization. 165 The agency may mandate prior authorization, drug therapy 166 management, or disease management participation for certain 167 populations of Medicaid beneficiaries, certain drug classes, or 168 particular drugs to prevent fraud, abuse, overuse, and possible 169 dangerous drug interactions. The Pharmaceutical and Therapeutics 170 Committee shall make recommendations to the agency on drugs for 171 which prior authorization is required. The agency shall inform 172 the Pharmaceutical and Therapeutics Committee of its decisions 173 regarding drugs subject to prior authorization. The agency is 174 authorized to limit the entities it contracts with or enrolls as 175 Medicaid providers by developing a provider network through 176 provider credentialing. The agency may competitively bid single 177 source-provider contracts if procurement of goods or services 178 results in demonstrated cost savings to the state without 179 limiting access to care. The agency may limit its network based 180 on the assessment of beneficiary access to care, provider 181 availability, provider quality standards, time and distance 182 standards for access to care, the cultural competence of the 183 provider network, demographic characteristics of Medicaid 184 beneficiaries, practice and provider-to-beneficiary standards, 185 appointment wait times, beneficiary use of services, provider 186 turnover, provider profiling, provider licensure history, 187 previous program integrity investigations and findings, peer 188 review, provider Medicaid policy and billing compliance records, 189 clinical and medical record audits, and other factors. Providers 190 are not entitled to enrollment in the Medicaid provider network. 191 The agency shall determine instances in which allowing Medicaid 192 beneficiaries to purchase durable medical equipment and other 193 goods is less expensive to the Medicaid program than long-term 194 rental of the equipment or goods. The agency may establish rules 195 to facilitate purchases in lieu of long-term rentals in order to 196 protect against fraud and abuse in the Medicaid program as 197 defined in s. 409.913. The agency may seek federal waivers 198 necessary to administer these policies. 199 (5)(a) The agency shall implement a Medicaid prescribed 200 drug spending-control program that includes the following 201 components: 202 1. A Medicaid preferred drug list, which shall be a listing 203 of cost-effective therapeutic options recommended by the 204 Medicaid Pharmacy and Therapeutics Committee established 205 pursuant to s. 409.91195 and adopted by the agency for each 206 therapeutic class on the preferred drug list. At the discretion 207 of the committee, and when feasible, the preferred drug list 208 should include at least two products in a therapeutic class. The 209 agency may post the preferred drug list and updates to the list 210 on an Internet website without following the rulemaking 211 procedures of chapter 120. Antiretroviral agents are excluded 212 from the preferred drug list. The agency shall also limit the 213 amount of a prescribed drug dispensed to no more than a 34-day 214 supply unless the drug products’ smallest marketed package is 215 greater than a 34-day supply, or the drug is determined by the 216 agency to be a maintenance drug in which case a 100-day maximum 217 supply may be authorized. The agency may seek any federal 218 waivers necessary to implement these cost-control programs and 219 to continue participation in the federal Medicaid rebate 220 program, or alternatively to negotiate state-only manufacturer 221 rebates. The agency may adopt rules to administer this 222 subparagraph. The agency shall continue to provide unlimited 223 contraceptive drugs and items. The agency must establish 224 procedures to ensure that: 225 a. There is a response to a request for prior consultation 226 by telephone or other telecommunication device within 24 hours 227 after receipt of a request for prior consultation; and 228 b. A 72-hour supply of the drug prescribed is provided in 229 an emergency or when the agency does not provide a response 230 within 24 hours as required by sub-subparagraph a. 231 2. Reimbursement to pharmacies for Medicaid prescribed 232 drugs shall be set at the lowest of: the average wholesale price 233 (AWP) minus 16.4 percent, the wholesaler acquisition cost (WAC) 234 plus 1.5 percent, the federal upper limit (FUL), the state 235 maximum allowable cost (SMAC), or the usual and customary (UAC) 236 charge billed by the provider. 237 3. The agency shall develop and implement a process for 238 managing the drug therapies of Medicaid recipients who are using 239 significant numbers of prescribed drugs each month. The 240 management process may include, but is not limited to, 241 comprehensive, physician-directed medical-record reviews, claims 242 analyses, and case evaluations to determine the medical 243 necessity and appropriateness of a patient’s treatment plan and 244 drug therapies. The agency may contract with a private 245 organization to provide drug-program-management services. The 246 Medicaid drug benefit management program shall include 247 initiatives to manage drug therapies for HIV/AIDS patients, 248 patients using 20 or more unique prescriptions in a 180-day 249 period, and the top 1,000 patients in annual spending. The 250 agency shall enroll any Medicaid recipient in the drug benefit 251 management program if he or she meets the specifications of this 252 provision and is not enrolled in a Medicaid health maintenance 253 organization. 254 4. The agency may limit the size of its pharmacy network 255 based on need, competitive bidding, price negotiations, 256 credentialing, or similar criteria. The agency shall give 257 special consideration to rural areas in determining the size and 258 location of pharmacies included in the Medicaid pharmacy 259 network. A pharmacy credentialing process may include criteria 260 such as a pharmacy’s full-service status, location, size, 261 patient educational programs, patient consultation, disease 262 management services, and other characteristics. The agency may 263 impose a moratorium on Medicaid pharmacy enrollment if it is 264 determined that it has a sufficient number of Medicaid 265 participating providers. The agency must allow dispensing 266 practitioners to participate as a part of the Medicaid pharmacy 267 network regardless of the practitioner’s proximity to any other 268 entity that is dispensing prescription drugs under the Medicaid 269 program. A dispensing practitioner must meet all credentialing 270 requirements applicable to his or her practice, as determined by 271 the agency. 272 5. The agency shall develop and implement a program that 273 requires Medicaid practitioners who issue written prescriptions 274 for medicinalprescribedrugs to use a counterfeit-proof 275 prescription pad for Medicaid prescriptions. The agency shall 276 require the use of standardized counterfeit-proof prescription 277 pads byMedicaid-participating prescribers orprescribers who 278 issue writtenwriteprescriptions for Medicaid recipients. The 279 agency may implement the program in targeted geographic areas or 280 statewide. 281 6. The agency may enter into arrangements that require 282 manufacturers of generic drugs prescribed to Medicaid recipients 283 to provide rebates of at least 15.1 percent of the average 284 manufacturer price for the manufacturer’s generic products. 285 These arrangements shall require that if a generic-drug 286 manufacturer pays federal rebates for Medicaid-reimbursed drugs 287 at a level below 15.1 percent, the manufacturer must provide a 288 supplemental rebate to the state in an amount necessary to 289 achieve a 15.1-percent rebate level. 290 7. The agency may establish a preferred drug list as 291 described in this subsection, and, pursuant to the establishment 292 of such preferred drug list, negotiate supplemental rebates from 293 manufacturers that are in addition to those required by Title 294 XIX of the Social Security Act and at no less than 14 percent of 295 the average manufacturer price as defined in 42 U.S.C. s. 1936 296 on the last day of a quarter unless the federal or supplemental 297 rebate, or both, equals or exceeds 29 percent. There is no upper 298 limit on the supplemental rebates the agency may negotiate. The 299 agency may determine that specific products, brand-name or 300 generic, are competitive at lower rebate percentages. Agreement 301 to pay the minimum supplemental rebate percentage guarantees a 302 manufacturer that the Medicaid Pharmaceutical and Therapeutics 303 Committee will consider a product for inclusion on the preferred 304 drug list. However, a pharmaceutical manufacturer is not 305 guaranteed placement on the preferred drug list by simply paying 306 the minimum supplemental rebate. Agency decisions will be made 307 on the clinical efficacy of a drug and recommendations of the 308 Medicaid Pharmaceutical and Therapeutics Committee, as well as 309 the price of competing products minus federal and state rebates. 310 The agency may contract with an outside agency or contractor to 311 conduct negotiations for supplemental rebates. For the purposes 312 of this section, the term “supplemental rebates” means cash 313 rebates. Value-added programs as a substitution for supplemental 314 rebates are prohibited. The agency may seek any federal waivers 315 to implement this initiative. 316 8. The agency shall expand home delivery of pharmacy 317 products. The agency may amend the state plan and issue a 318 procurement, as necessary, in order to implement this program. 319 The procurements must include agreements with a pharmacy or 320 pharmacies located in the state to provide mail order delivery 321 services at no cost to the recipients who elect to receive home 322 delivery of pharmacy products. The procurement must focus on 323 serving recipients with chronic diseases for which pharmacy 324 expenditures represent a significant portion of Medicaid 325 pharmacy expenditures or which impact a significant portion of 326 the Medicaid population. The agency may seek and implement any 327 federal waivers necessary to implement this subparagraph. 328 9. The agency shall limit to one dose per month any drug 329 prescribed to treat erectile dysfunction. 330 10.a. The agency may implement a Medicaid behavioral drug 331 management system. The agency may contract with a vendor that 332 has experience in operating behavioral drug management systems 333 to implement this program. The agency may seek federal waivers 334 to implement this program. 335 b. The agency, in conjunction with the Department of 336 Children and Families, may implement the Medicaid behavioral 337 drug management system that is designed to improve the quality 338 of care and behavioral health prescribing practices based on 339 best practice guidelines, improve patient adherence to 340 medication plans, reduce clinical risk, and lower prescribed 341 drug costs and the rate of inappropriate spending on Medicaid 342 behavioral drugs. The program may include the following 343 elements: 344 (I) Provide for the development and adoption of best 345 practice guidelines for behavioral health-related drugs such as 346 antipsychotics, antidepressants, and medications for treating 347 bipolar disorders and other behavioral conditions; translate 348 them into practice; review behavioral health prescribers and 349 compare their prescribing patterns to a number of indicators 350 that are based on national standards; and determine deviations 351 from best practice guidelines. 352 (II) Implement processes for providing feedback to and 353 educating prescribers using best practice educational materials 354 and peer-to-peer consultation. 355 (III) Assess Medicaid beneficiaries who are outliers in 356 their use of behavioral health drugs with regard to the numbers 357 and types of drugs taken, drug dosages, combination drug 358 therapies, and other indicators of improper use of behavioral 359 health drugs. 360 (IV) Alert prescribers to patients who fail to refill 361 prescriptions in a timely fashion, are prescribed multiple same 362 class behavioral health drugs, and may have other potential 363 medication problems. 364 (V) Track spending trends for behavioral health drugs and 365 deviation from best practice guidelines. 366 (VI) Use educational and technological approaches to 367 promote best practices, educate consumers, and train prescribers 368 in the use of practice guidelines. 369 (VII) Disseminate electronic and published materials. 370 (VIII) Hold statewide and regional conferences. 371 (IX) Implement a disease management program with a model 372 quality-based medication component for severely mentally ill 373 individuals and emotionally disturbed children who are high 374 users of care. 375 11. The agency shall implement a Medicaid prescription drug 376 management system. 377 a. The agency may contract with a vendor that has 378 experience in operating prescription drug management systems in 379 order to implement this system. Any management system that is 380 implemented in accordance with this subparagraph must rely on 381 cooperation between physicians and pharmacists to determine 382 appropriate practice patterns and clinical guidelines to improve 383 the prescribing, dispensing, and use of drugs in the Medicaid 384 program. The agency may seek federal waivers to implement this 385 program. 386 b. The drug management system must be designed to improve 387 the quality of care and prescribing practices based on best 388 practice guidelines, improve patient adherence to medication 389 plans, reduce clinical risk, and lower prescribed drug costs and 390 the rate of inappropriate spending on Medicaid prescription 391 drugs. The program must: 392 (I) Provide for the adoption of best practice guidelines 393 for the prescribing and use of drugs in the Medicaid program, 394 including translating best practice guidelines into practice; 395 reviewing prescriber patterns and comparing them to indicators 396 that are based on national standards and practice patterns of 397 clinical peers in their community, statewide, and nationally; 398 and determine deviations from best practice guidelines. 399 (II) Implement processes for providing feedback to and 400 educating prescribers using best practice educational materials 401 and peer-to-peer consultation. 402 (III) Assess Medicaid recipients who are outliers in their 403 use of a single or multiple prescription drugs with regard to 404 the numbers and types of drugs taken, drug dosages, combination 405 drug therapies, and other indicators of improper use of 406 prescription drugs. 407 (IV) Alert prescribers to recipients who fail to refill 408 prescriptions in a timely fashion, are prescribed multiple drugs 409 that may be redundant or contraindicated, or may have other 410 potential medication problems. 411 12. The agency may contract for drug rebate administration, 412 including, but not limited to, calculating rebate amounts, 413 invoicing manufacturers, negotiating disputes with 414 manufacturers, and maintaining a database of rebate collections. 415 13. The agency may specify the preferred daily dosing form 416 or strength for the purpose of promoting best practices with 417 regard to the prescribing of certain drugs as specified in the 418 General Appropriations Act and ensuring cost-effective 419 prescribing practices. 420 14. The agency may require prior authorization for 421 Medicaid-covered prescribed drugs. The agency may prior 422 authorize the use of a product: 423 a. For an indication not approved in labeling; 424 b. To comply with certain clinical guidelines; or 425 c. If the product has the potential for overuse, misuse, or 426 abuse. 427 428 The agency may require the prescribing professional to provide 429 information about the rationale and supporting medical evidence 430 for the use of a drug. The agency shall post prior 431 authorization, step-edit criteria and protocol, and updates to 432 the list of drugs that are subject to prior authorization on the 433 agency’s Internet website within 21 days after the prior 434 authorization and step-edit criteria and protocol and updates 435 are approved by the agency. For purposes of this subparagraph, 436 the term “step-edit” means an automatic electronic review of 437 certain medications subject to prior authorization. 438 15. The agency, in conjunction with the Pharmaceutical and 439 Therapeutics Committee, may require age-related prior 440 authorizations for certain prescribed drugs. The agency may 441 preauthorize the use of a drug for a recipient who may not meet 442 the age requirement or may exceed the length of therapy for use 443 of this product as recommended by the manufacturer and approved 444 by the Food and Drug Administration. Prior authorization may 445 require the prescribing professional to provide information 446 about the rationale and supporting medical evidence for the use 447 of a drug. 448 16. The agency shall implement a step-therapy prior 449 authorization approval process for medications excluded from the 450 preferred drug list. Medications listed on the preferred drug 451 list must be used within the previous 12 months before the 452 alternative medications that are not listed. The step-therapy 453 prior authorization may require the prescriber to use the 454 medications of a similar drug class or for a similar medical 455 indication unless contraindicated in the Food and Drug 456 Administration labeling. The trial period between the specified 457 steps may vary according to the medical indication. The step 458 therapy approval process shall be developed in accordance with 459 the committee as stated in s. 409.91195(7) and (8). A drug 460 product may be approved without meeting the step-therapy prior 461 authorization criteria if the prescribing physician provides the 462 agency with additional written medical or clinical documentation 463 that the product is medically necessary because: 464 a. There is not a drug on the preferred drug list to treat 465 the disease or medical condition which is an acceptable clinical 466 alternative; 467 b. The alternatives have been ineffective in the treatment 468 of the beneficiary’s disease; or 469 c. Based on historic evidence and known characteristics of 470 the patient and the drug, the drug is likely to be ineffective, 471 or the number of doses have been ineffective. 472 473 The agency shall work with the physician to determine the best 474 alternative for the patient. The agency may adopt rules waiving 475 the requirements for written clinical documentation for specific 476 drugs in limited clinical situations. 477 17. The agency shall implement a return and reuse program 478 for drugs dispensed by pharmacies to institutional recipients, 479 which includes payment of a $5 restocking fee for the 480 implementation and operation of the program. The return and 481 reuse program shall be implemented electronically and in a 482 manner that promotes efficiency. The program must permit a 483 pharmacy to exclude drugs from the program if it is not 484 practical or cost-effective for the drug to be included and must 485 provide for the return to inventory of drugs that cannot be 486 credited or returned in a cost-effective manner. The agency 487 shall determine if the program has reduced the amount of 488 Medicaid prescription drugs which are destroyed on an annual 489 basis and if there are additional ways to ensure more 490 prescription drugs are not destroyed which could safely be 491 reused. 492 Section 4. Section 456.0392, Florida Statutes, is amended 493 to read: 494 456.0392 Prescription labeling.— 495 (1) A prescription issuedwrittenby a practitioner who is 496 authorized under the laws of this state to prescribewrite497prescriptions fordrugs that are not listed as controlled 498 substances in chapter 893 but who is not eligible for a federal 499 Drug Enforcement Administration number shall include that 500 practitioner’s name and professional license number. The 501 pharmacist or dispensing practitioner must include the 502 practitioner’s name on the container of the drug that is 503 dispensed. A pharmacist shall be permitted, upon verification by 504 the prescriber, to document any information required by this 505 section. 506 (2) A prescription for a drug that is not listed as a 507 controlled substance in chapter 893 which is issuedwrittenby 508 an advanced practice registered nurse licensed under s. 464.012 509 is presumed, subject to rebuttal, to be valid and within the 510 parameters of the prescriptive authority delegated by a 511 practitioner licensed under chapter 458, chapter 459, or chapter 512 466. 513 (3) A prescription for a drug that is not listed as a 514 controlled substance in chapter 893 which is issuedwrittenby a 515 physician assistant licensed under chapter 458 or chapter 459 is 516 presumed, subject to rebuttal, to be valid and within the 517 parameters of the prescriptive authority delegated by the 518 physician assistant’s supervising physician. 519 Section 5. Paragraph (d) of subsection (3) of section 520 458.3265, Florida Statutes, is amended to read: 521 458.3265 Pain-management clinics.— 522 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities 523 apply to any physician who provides professional services in a 524 pain-management clinic that is required to be registered in 525 subsection (1). 526 (d) A physician authorized to prescribe controlled 527 substances who practices at a pain-management clinic is 528 responsible for maintaining the control and security of his or 529 her prescription blanks or electronic prescribing softwareand530any other methodused for prescribing controlled substance pain 531 medication. AThephysician who issues written prescriptions 532 shall comply with the requirements for counterfeit-resistant 533 prescription blanks in s. 893.065 and the rules adopted pursuant 534 to that section. AThephysician shall notify, in writing, the 535 department within 24 hours afterfollowingany theft or loss of 536 a prescription blank or breach of his or her electronic 537 prescribing software usedany other methodfor prescribing pain 538 medication. 539 Section 6. Paragraph (qq) of subsection (1) of section 540 458.331, Florida Statutes, is amended to read: 541 458.331 Grounds for disciplinary action; action by the 542 board and department.— 543 (1) The following acts constitute grounds for denial of a 544 license or disciplinary action, as specified in s. 456.072(2): 545 (qq) Failing to timely notify the department of the theft 546 of prescription blanks from a pain-management clinic or a breach 547 of a physician’s electronic prescribing softwareother methods548for prescribingwithin 24 hours as required by s. 458.3265(3). 549 Section 7. Paragraph (d) of subsection (3) of section 550 459.0137, Florida Statutes, is amended to read: 551 459.0137 Pain-management clinics.— 552 (3) PHYSICIAN RESPONSIBILITIES.—These responsibilities 553 apply to any osteopathic physician who provides professional 554 services in a pain-management clinic that is required to be 555 registered in subsection (1). 556 (d) An osteopathic physician authorized to prescribe 557 controlled substances who practices at a pain-management clinic 558 is responsible for maintaining the control and security of his 559 or her prescription blanks or electronic prescribing software 560and any other methodused for prescribing controlled substance 561 pain medication. AnTheosteopathic physician who issues written 562 prescriptions shall comply with the requirements for 563 counterfeit-resistant prescription blanks in s. 893.065 and the 564 rules adopted pursuant to that section. AnTheosteopathic 565 physician shall notify, in writing, the department within 24 566 hours afterfollowingany theft or loss of a prescription blank 567 or breach of his or her electronic prescribing software usedany568other methodfor prescribing pain medication. 569 Section 8. Paragraph (ss) of subsection (1) of section 570 459.015, Florida Statutes, is amended to read: 571 459.015 Grounds for disciplinary action; action by the 572 board and department.— 573 (1) The following acts constitute grounds for denial of a 574 license or disciplinary action, as specified in s. 456.072(2): 575 (ss) Failing to timely notify the department of the theft 576 of prescription blanks from a pain-management clinic or a breach 577 of an osteopathic physician’s electronic prescribing software 578other methods for prescribingwithin 24 hours as required by s. 579 459.0137(3). 580 Section 9. This act shall take effect January 1, 2020.