Good Morning Florida. Besides double crossing Trump DeSantis and the Florida RINO legislation has given voters another reason to distrust them:
023 Florida Statutes
SECTION 1865 Collaborative pharmacy practice for chronic health conditions.
(1) For purposes of this section, the term:
(a) “Collaborative pharmacy practice agreement” means a written agreement between a pharmacist who meets the qualifications of this section and a physician licensed under chapter 458 or chapter 459 in which a collaborating physician authorizes a pharmacist to provide specified patient care services to the collaborating physician’s patients.
(b) “Chronic health condition” means:
1. Arthritis;
2. Asthma;
3. Chronic obstructive pulmonary diseases;
4. Type 2 diabetes;
5. Human immunodeficiency virus or acquired immune deficiency syndrome;
6. Obesity; or
7. Any other chronic condition adopted in rule by the board, in consultation with the Board of Medicine and the Board of Osteopathic Medicine.
(2) To provide services under a collaborative pharmacy practice agreement, a pharmacist must be certified by the board, according to the rules adopted by the board in consultation with the Board of Medicine and the Board of Osteopathic Medicine. To be certified, a pharmacist must, at a minimum:
(a) Hold an active and unencumbered license to practice pharmacy in this state.
(b) Have earned a degree of doctor of pharmacy or have completed 5 years of experience as a licensed pharmacist.
(c) Have completed an initial 20-hour course approved by the board, in consultation with the Board of Medicine and the Board of Osteopathic Medicine, that includes, at a minimum, instruction on the following:
1. Performance of patient assessments.
2. Ordering, performing, and interpreting clinical and laboratory tests related to collaborative pharmacy practice.
3. Evaluating and managing diseases and health conditions in collaboration with other health care practitioners.
4. Any other area required by the board.
(d) Maintain at least $250,000 of professional liability insurance coverage. However, a pharmacist who maintains professional liability insurance coverage pursuant to s. 465.1895 satisfies this requirement.
(e) Have established a system to maintain records of all patients receiving services under a collaborative pharmacy practice agreement for a period of 5 years from each patient’s most recent provision of service.
(3) The terms and conditions of the collaborative pharmacy practice agreement must be appropriate to the pharmacist’s training, and the services delegated to the pharmacist must be within the collaborating physician’s scope of practice. A copy of the certification issued under subsection (2) must be included as an attachment to the collaborative pharmacy practice agreement.
(a) A collaborative pharmacy practice agreement must include the following:
1. Name of the collaborating physician’s patient or patients for whom a pharmacist may provide services.
2. Each chronic health condition to be collaboratively managed.
3. Specific medicinal drug or drugs to be managed by the pharmacist for each patient.
4. Circumstances under which the pharmacist may order or perform and evaluate laboratory or clinical tests.
5. Conditions and events upon which the pharmacist must notify the collaborating physician and the manner and timeframe in which such notification must occur.
6. Beginning and ending dates for the collaborative pharmacy practice agreement and termination procedures, including procedures for patient notification and medical records transfers.
7. A statement that the collaborative pharmacy practice agreement may be terminated, in writing, by either party at any time.
(b) A collaborative pharmacy practice agreement shall automatically terminate 2 years after execution if not renewed.
(c) The pharmacist, along with the collaborating physician, must maintain on file the collaborative pharmacy practice agreement at his or her practice location, and must make such agreement available to the department or board upon request or inspection.
(d) A pharmacist who enters into a collaborative pharmacy practice agreement must submit a copy of the signed agreement to the board before the agreement may be implemented.
(4) A pharmacist may not:
(a) Modify or discontinue medicinal drugs prescribed by a health care practitioner with whom he or she does not have a collaborative pharmacy practice agreement.
(b) Enter into a collaborative pharmacy practice agreement while acting as an employee without the written approval of the owner of the pharmacy.
(5) A physician may not delegate the authority to initiate or prescribe a controlled substance as described in s. 893.03 or 21 U.S.C. s. 812 to a pharmacist.
(6) A pharmacist who practices under a collaborative pharmacy practice agreement must complete an 8-hour continuing education course approved by the board that addresses issues related to collaborative pharmacy practice each biennial licensure renewal in addition to the continuing education requirements under s. 465.009. A pharmacist must submit confirmation of having completed such course when applying for licensure renewal. A pharmacist who fails to comply with this subsection shall be prohibited from practicing under a collaborative pharmacy practice agreement under this section.
(7) The board, in consultation with the Board of Medicine and the Board of Osteopathic Medicine, shall adopt rules pursuant to ss. 120.536(1) and 120.54 to implement this section. History.—s. 3, ch. 2020-7.
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IMO legislation like this destroys what little patient-physician relationship is left after the Covid hoax, especially if you have Obamacare insurance. Why? If a physician agrees to accept an insurance say Aetna. Aetna can have the physician agree that their designated pharmacist has a CPA relationship with the physician and his patients who have Aetna. This allows an Aetna ‘corporate’ pharmacist to approve or reject scripts for medication or medical supplies for patients that fall into the legislation’s categories. Example: Aetna policy holder is an insulin dependent diabetic, aka Type 1, and has been using Dexcom to keep blood sugar within range. Now with the new legislation when patient’s file is reviewed by Aetna the corporate pharmacist can reject future scripts for Dexcom saying the patient has to prove x,y,z or why Dexcom is better option than Freestyle Libre or patient has to show Freestyle Libre doesn’t work before the Dexcom script can be approved. Even though Aetna has in the past approved the patient’s Dexcom scripts. Aetna is wanting to go the cheapest route patient’s health be damned.
Say patient has arthritis and is on ENBREL. Aetna’s corporate pharmacist can reject ENBREL for the patient and say they have to use a less costly med like Tylenol the health of the patient be damned.
This legislation is going to bite many people due to the obesity epidemic. Obesity is classified as a chronic illness and the legislation gives the pharmacist power to be involved with the care of patient’s beyond dispensing medicine. Many of the latest fad wonder drugs for obesity won’t be approved by the pharmacist due to cost.
I have a good friend going through the Dexcom issue now which brought the legislation to my attention. I can understand why policy holders milk the insurance for everything due to the insurance trying to cut corners on chronic illness to save money. They are betting that most patients won’t fight their decisions or that any worsening of the patient’s chronic condition won’t occur until the patient is on Medicare so passing the problem off.
Very few pharmacist today work in a small mom/pop type pharmacy, where this legislation would make sense. Most insurance companies have the big corporate pharmacies like CVS or Walmart in their network and the pharmacist knows very little about any of the patient’s whose scripts are being filled.
And finally notice the last part of the legislative definition of a chronic illness ....any other chronic condition adopted in rule by the board in consultation with the Board of Medicine and the Board of Osteopathic Medicine. This leaves the door open giving pharmacists way too much leeway in overriding physicians decisions due to cost or other factors not related to patient health.
Good post! I couldn’t believe the attitude I got from my long-time CVS pharmacist when I showed up with a 12-month prescription for HCQ three years ago. He refused to fill it at first and snarled at me in disdain. He finally filled it, after I argued with him and made him fill it for six months. When I went back for the final six months of pills, I got no flak. People had fought back by then and he didn’t say a word.
My question was: how did he know what I wanted it for at the very beginning of the pandemic? It was as though a bulletin went out to pharmacists.
Sonora Court Denies Ovidio Guzman His Amparo
https://zetatijuana.com/2023/08/juzgado-de-sonora-niega-amparo-a-ovidio-guzman/
Translated excerpt:
A District Judge from the State of Sonora denied the amparo and protection of federal justice to alleged drug trafficker Ovidio Guzmán López, El Ratón, against the agreement of a Control Judge of Hermosillo who refused to set a time and date for the initial hearing in a criminal case against the Sinaloan.
The son of Joaquin “El Chapo” Guzman, former leader of the Sinaloa Cartel, claimed that, despite being imprisoned in the maximum security prison “Altiplano”, he has not been served with an arrest warrant issued in criminal case 15/2023 for crimes against health.
Despite this, through his lawyers, Ovidio Guzmán demanded the federal judge in Sonora to hold the initial hearing of the case.
On May 8, 2023, the District Judge, Temporary Commissioner to the Federal Criminal Justice Center in the State of Sonora, acting as Control Judge, concluded “no basis” for the request from the leader of the criminal cell Los Menores or Los Chapitos.
Dissatisfied with the ruling, Guzmán López filed an amparo lawsuit, and the responsible authority admitted the existence of the challenged act.
Upon rendering his justified report, the judge answered that although there is an arrest warrant against the complainant, he has not been placed at his disposal, and, “as long as this does not occur, the Public Prosecutor’s Office may request the first hearing from this indictment”.
The amparo judge legally agreed with the judge of the case, since article 145, first and second paragraphs of the National Code of Criminal Procedures establishes that the exercise of the criminal action corresponds exclusively to the agent of the Public Prosecutor’s Office. Therefore, the judicial authority is in a position to set a date and time for the initial hearing when requested by the prosecution.
“The decision of the responsible authority did not violate the right of access to justice. Once the initial hearing is held, Ovidio Guzmán López will have the opportunity to know the terms of the accusation against him”, highlights the resolution that denies the amparo.
And it adds that El Ratón will also have access to the content of evidence contained in the investigation file “. And thus be able to implement the defense strategy that best favors his interests. As well as to make the petitions that are convenient to his right”.
Ovidio Guzmán López, brother of alleged drug traffickers Iván Archivaldo, Jesús Alfredo and Joaquín Guzmán, was arrested by the Mexican Armed Forces in the early morning of January 5, 2023, in the Jesús María township, municipality of Culiacán, Sinaloa.
3rd party payers destroyed the doc/pt relationship. This is just another step on the path to govt run healthcare.
Speaking of additional insurance affectations, coming to you soon, and Poltico goes there. 😳
https://www.politico.com/news/2023/08/31/california-wildfires-insurance-risk-00113563
Politico Title:
” A secret recording. Boasts of late-session ‘jam.’ Insurance fight bursts into the open.
A consumer advocate and a building lobbyist walk onto a Southwest flight from Los Angeles to Sacramento.... “