The Florida Boards of Osteopathy, Medicine [Allopathy], and Pharmacy have all also addressed the issue of internet pharmacy. The Boards of Osteopathy and Medicine [Allopathy] have promulgated regulations proscribing the practice of prescribing medication for patients whom the physician has not personally examined, although they have also specified that theseregulations should not interfere with interstate consultation betweenphysicians. The Board of Pharmacy, inline with the legislature, requires pharmacies operating within the state to be licensed in some manner.
Board Actions
64B15-14.008 Standards for Telemedicine Practice. [Osteopathic]
(1) Prescribing medications based solely on an electronic medical questionnaire constitutes the failure to practice osteopathic medicine with that level of care, skill, and treatment which is recognized by reasonably prudent osteopathic physicians as being acceptable under similar conditions and circumstances, as well as prescribing legend drugs other than in the course of an osteopathic physician’s professional practice. Such practice shall constitute grounds for disciplinary action pursuant to Sections459.015(1)(x) and (t), F.S.
(2) Osteopathic Physicians shall not providetreatment recommendations, including issuing a prescription, via electronic orother means, unless the following elements have been met:
(a) A documented patient evaluation, includinghistory and physical examination, adequate to establish the diagnosis for which any drug is prescribed.
(b) Sufficient dialogue between the osteopathic physician and the patient regarding treatment options and the risks and benefits of treatment.
(c) Maintenance of contemporaneous medical records meeting the requirements of Rule 64B15-15.004, F.A.C.
(3) The provisions of this rule are not applicable in an emergency situation. For purposes of this rule an emergency situation means those situations in which the prescribing physician determines that the immediate administration of the medication is necessary for the proper treatment of the patient, and that it is not reasonably possible for the prescribing physician to comply with the provision of this rule prior to providing such prescription.
(4) The provisions of this rule shall not be construed to prohibit patient care in consultation with another physician who has an ongoing relationship with the patient, and who has agreed to supervise the patient’s treatment, including the use of any prescribed medications, nor on-call or cross-coverage situations in which the physician has access to patient records.
Specific Authority 459.005, 459.015(1)(z) FS.Law Implemented 459.015(1)(x), (t) FS. History–New10-16-01.
(Up-to-date from theBoard)
64B8-9.014 Standards for Telemedicine Prescribing Practice.[Allopathic]
(1)Prescribing medications based solely on an electronic medical questionnaire constitutes the failure to practice medicine with that level of care, skill, and treatment which is recognized by reasonably prudent physiciansas being acceptable under similar conditions and circumstances, as well as prescribing legend drugs other than in the course of a physician’s professional practice.
(2)Physicians and physician assistants shall not provide treatment recommendations, including issuing a prescription, via electronic or other means, unless the following elements have been met:
(a)A documented patient evaluation, including history and physical examination to establish the diagnosis for which any legend drug is prescribed.
(b)Discussion between the physician or the physician assistant and the patient regarding treatment options and the risks and benefits of treatment.
(c)Maintenance of contemporaneous medical records meeting the requirements of Rule 64B8-9.003, F.A.C.
(3)The provisions of this rule are not applicable in an emergency situation. For purposes of this rule an emergency situation means those situations in which the prescribing physician or physician assistant determines that the immediate administration of the medication is necessary for the proper treatment of the patient, and that it is not reasonably possible for the prescribing physician or physician assistant to comply with the provision of this rule prior to providing such prescription.
(4)The provisions of this rule shall not be construed to prohibit patient care in consultation with another physician who has an ongoing relationship with the patient, and who has agreed to supervise the patient’s treatment, including the use of any prescribed medications, nor on-call or cross-coverage situations in which the physician has access to patient records.
(5)For purposes of this rule, the term “telemedicine” shall include, but is not limited to, prescribing legend drugs to patients through thefollowing modes of communication:
(a)Internet;
(b)Telephone; and
(c)Facsimile.
Specific Authority 458.309,458.331(1)(v) FS. Law Implemented 458.331(1)(q), (t), (v) FS. History–New9-14-03.
Osteopathy Board Survey Response
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FLORIDA |
osteopathy |
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ResponseFrom: |
Pamela King, ExecutiveDirector
Florida Board of Osteopathic Medicine
4052 BaldCypress Way, BIN #C06
Tallahassee,FL 32399-1753
Pamela_King@doh.state.fl.us
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Typeof Response: |
Written |
Date: |
August7, 2006 |
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1.Has the Board of Medicine issued statements that might affect the remotedelivery of health care by physicians? |
The requirements regarding licensure and practicing medicine as an osteopathic physician in Florida can be found in chapter 459, Florida Statutes and in 64B15, Florida Administrative Code. General provisions for all healthcare providers in Florida can be found in Chapter 456, Florida Statutes.
Specific requirements relating to the practice of telemedicine can be found in 64B15-14.008, Florida Administrative Code. I am attaching a copy of this rule for your perusal. The Board has had cases brought before them for violation of the requirements inthis particular rule.
We will have to do someresearch on the cases -- very few -- it may take awhile
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2.Are there other statute, regulations, or guidance for:
a. requirements forphysicians
b. Consulting physicians
c. physicians in another state deliveringdirect care to patients.
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Seeabove |
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3.Ability to write prescriptions for patients that may not be seen inperson:
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Seeabove |
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4.Pending or anticipated legislation, regulation, or policies affecting remotedelivery of healthcare in [state].
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I am not aware of any pending legislation. |
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Pharmacy Board Policy on Internet Pharmacies
The Florida Board of Pharmacy in a policy opinion has stated that out-of-state individuals practicing as defined in our state statute 465.003(13) Florida Statutes should be appropriately licensed in that jurisdiction, but not necessarily in Florida. Pharmacies providing dispensed medication to patients in this state must be licensed under the provisions of 465.0156, Florida Statutes. Again, Florida licensure of individual pharmacists of the facility is not required
