July 25, 2019

The 2019 session was an active one for the Florida Legislature.  Here’s a quick rundown of what you need to know that affects your practice.

HB 19:  Prescription Drug Importation Programs

Two new programs were created to establish a safe method of importing Rx drugs into the state.  First, the Canadian Importation Program requires AHCA to contract with a vendor to identify compliant Canadian suppliers who have agreed to export particular drugs at prices that will save the state money.  Among the excluded classes of drugs are controlled substances; biological products; infused drugs; IV drugs; inhalants; and parenterals.

The International Prescription Drug Importation Program requires foreign pharmacies to maintain active licenses in their home countries and to apply for an international export pharmacy permit.  Both programs include bond requirements and are contingent upon federal approval.  Fees are set under new section 465.0157(4).

HB 451:  Nonopioid Alternatives

DOH will be required to create and host on its website a pamphlet providing information on alternatives to opioids for the management of pain, including the pros and cons of those alternatives.  Additionally, you must now inform your patients before administering anesthesia or opioids (except in emergency situations) that opioid alternatives are available and must discuss the pros and cons with them, including their personal risk factors, and hand them a copy of the pamphlet.  When that pamphlet is available, we’ll post an update here.

HB 851:  Human Trafficking

If you hold your license under Florida Statutes chapter 457, 458, 459, 460, 461, 463, 465, 466, parts of 468, 480, or 486, you must now take a 1-hour continuing ed course on human trafficking. 

If you are a massage therapist and own a clinic or establishment, you must appoint a manager to be responsible for compliance.  DOH must now deny establishment licensing if the owner or manager has been convicted of a prostitution-related offense.  There are a few other requirements relating specifically to massage therapists, so check it out here.

SB 182:  Medical Marijuana

This bill contains a lot of important information; call us if you certify patients in your practice and need more detailed information.  Perhaps most importantly, the term “medical use” now includes smoking.  However, there are restrictions on where it can be smoked, and the consent form must include reference to the negative health risks of smoking marijuana.  You are limited in the amount you can certify (no more than three 70-day supply limits or six 35-day supply limits in smokable form).  You can request an exception if warranted.

SB 732:  Surgery Centers

DOH must issue ESOs (emergency suspension or restriction orders) if probable cause is found that an office or physician is not compliant with office-surgery standards.  With regard to liposuction, you must register your office if you conduct procedures in which more than 1,000 cc’s of supernatant fat is removed.

SB 1418:  Mental Health

Mental health providers, listen up:  If a patient communicates to you a specific threat to cause serious bodily injury or death to someone, and if you reasonably believe (or should reasonably believe) that the patient has the apparent intent and ability to carry out that threat, your clinical records must be released to the extent necessary to give law enforcement sufficient information to take action.

May 1, 2019

Only a signature from Gov. Ron DeSantis is needed before it becomes a primary offense in Florida to text while driving. Right now, you can be ticketed for texting if you are caught violating another traffic law. If the governor signs a bill that now has passed the legislature, that will change.

In anticipation of the bill becoming law, the Tampa Bay Times has published a list of what you need to know about the texting and driving prohibition. You can read it here: https://www.tampabay.com/florida/2019/04/25/five-things-to-know-about-texting-while-driving-legislation-in-florida/

The Gainesville criminal defense lawyers at Turner O’Connor Kozlowski have more than 75 years combined experience helping residents of north central Florida charged with traffic violations, misdemeanors, and felonies. Contact us if you find yourself accused of a crime.

April, 30, 2019

Dr. David R. Nelson, who has served as interim senior vice president for health affairs at UF for almost a year, was given the permanent position Tuesday. Nelson, who is a professor of medicine, will lead a massive organization that stretches throughout the state and includes six health science colleges, nine interdisciplinary research centers, two hospital systems, and dozens of physician practices.

According to a release from the university, Nelson has spent more than 25 years working at UF’s academic health center and generated more than $80 million in grants. An expert in liver disease, Nelson has authored more than 200 publications and won multiple awards for research.

UF President Kent Fuchs said the appointment is effective immediately.

The lawyers at Turner O’Connor Kozlowski assist many UF doctors and other health care professionals with licensing issues, discipline at work or by the state, and with questions about contracts and compliance.

April 15, 2019

On March 18, 2019 Governor Ron DeSantis signed into law Senate Bill 182, which allows a qualified physician to determine that smoking is an appropriate route of administration for medical marijuana. As a qualified physician, here’s what you need to know:

First, you must revise your informed-consent form to advise patients of the negative health risks associated with smoking marijuana.

Second, you must submit specified documentation to your board (Board of Medicine or Board of Osteopathic Medicine) once you determine that smoking is an appropriate route of administration for a patient. The documentation must include:

• A list of other routes of administration, if any, certified by a qualified physician that the patient has tried,the length of time the patient used such routes of administration, and an assessment of the effectiveness of those routes of administration in treating the qualified patient’s qualifying condition. 
• Research documenting the effectiveness of smoking as a route of administration to treat similarly situated patients with the same qualifying condition as the qualified patient.
• A statement signed by you documenting your opinion that the benefits of smoking marijuana for medical use outweigh the risks for the qualified patient.

Additionally, you may not issue a physician certification for marijuana in a form for smoking to a patient under 18 years of age unless the patient is diagnosed with a terminal condition; you determine that smoking is the most effective route of administration for the patient; and a second physician who is a board-certified pediatrician concurs with such determination. That determination and concurrence must be documented in the patient’s medical record and in the medical marijuana use registry.

Lastly, you must also obtain written informed consent of the minor patient’s parent or legal guardian before issuing a physician certification to the patient for marijuana in a form for smoking. The Board of Medicine and the Board of Osteopathic Medicine have adopted a standardized consent form which includes information concerning the negative health effects of smoking marijuana on persons under 18 years of age and an acknowledgement that you have sufficiently explained the contents of the form.

The bill also does a few other things. It:

• establishes a supply limit for your physician certification, viz., no more than three 70-day supply limits or six 35-day supply limits unless you request an exception to the daily dose limit;

• authorizes more than one caregiver to assist with a qualified patient’s medical use of marijuana if the patient is participating in a certain research program in a teaching nursing home; 

• authorizes a caregiver to be listed in the medical marijuana use registry as a designated caregiver for qualified patients who are participating in a certain research program in a teaching nursing home; and 

• requires DOH to adopt rules regulating the types, appearance, and labeling of marijuana delivery devices.

If you have questions about the implementation of SB 182, we can help. The lawyers at Turner O’Connor Kozlowski assist doctors and other health care professionals with a host of issues, ranging from compliance and contracts to investigations by the Department of Health.

Florida will spend $375 million this year on health care for prisoners, and next year’s budget anticipates a rise to just short of $500 million. Sen. Jeff Brandes, R-St. Petersburg, is trying to do something about it.

Brandes has proposed allowing some prisoners with terminal or debilitating diseases to qualify for early release, potentially saving millions in the process. A bill to that effect is being considered, and Brandes says it would primarily affect very old, sick, and infirm prisoners who are unlikely to reoffend.

Medicare and Medicaid do not cover people who are incarcerated, so the full cost falls on the state prison system. Once released, those programs would become responsible for health coverage. 

Under the proposed law, released prisoners would have to wear ankle monitors.

In Florida, a quarter of prisoners are older than 50, and more than 1,600 are 70 or older. Brandes acknowledges that this proposal would mean the release of just about 200 inmates, and he also is promoting other prison reform measures, such as changes to sentencing laws.