14509568, 64B8ER14-1 - Florida Administrative Rules, Law, Code, Register

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Notice: 14509568

Notice of Emergency Rule

Department:

DEPARTMENT OF HEALTH

Division:

Board of Medicine

Overview

RULE:

64B8ER14-1

Standards for Telemedicine Practice

SPECIFIC REASONS FOR FINDING AN IMMEDIATE DANGER TO THE PUBLIC HEALTH, SAFETY OR WELFARE:

The Board of Medicine (hereinafter "the Board") has statutory authority to set standards of practice in various medical practice settings.  Pursuant to this aforementioned authority, the Board recently promulgated rules setting forth standards for telemedicine practice.  Rule 64B8-9.0141 went into effect on March 12, 2014.  Shortly thereafter, the Board began to receive reports from physicians and hospital representatives that expressed concern that the Board's standards for telemedicine practice rule precluded physicians from ordering controlled substances through the use of telemedicine for their hospitalized patients.  In fact, interested parties reported to the Board that in some instances hospital pharmacists have expressed their reluctance to dispense controlled substances ordered via telemedicine because they believe it is precluded by Rule 64B8-9.0141(4).
	Rule 64B8-9.0141(4) currently precludes the prescribing of controlled substances through the use of telemedicine.  While the rule does not preclude the ordering of controlled substances to hospitalized patients, the current prescribing prohibition has created doubt amongst licensees and pharmacist because of the ambiguity of the definition of term "prescribing" as set forth in sections 465.003(14) and 893.02(22), Florida Statutes.
	Through its promulgation of Rule 64B8-9.0141, the Board has inadvertently created doubt as to whether it is legal to order controlled substances for hospitalized patients through the use of telemedicine.  Therefore, the Board believes that this current situation presents an immediate danger to the public health, safety and welfare because it may prevent critically ill hospital patients from obtaining necessary controlled substances on a timely basis.  This scenario presents a particular problem for those hospitals that staff intensive care units (ICUs) after hours through the use of telemedicine technology.   
	The Board believes that the filing of a narrowly tailored emergency rule amending Rule 64B8-9.0141 to clarify that the ordering of controlled substances for hospitalized patients through the use of telemedicine is not precluded by Rule 64B8-9.0141(4) is justified.  It will prevent unnecessary patient harm in an expeditious manner and will not harm licensees or any health care practitioners in any way.

REASON FOR CONCLUDING THAT THE PROCEDURE IS FAIR UNDER THE CIRCUMSTANCES:

The procedures employed for adopting this emergency rule are fair under the circumstances.   The emergency rule amendment in question does not prescribe the behavior or actions of any regulated entity or licensee but rather clarifies that physicians can indeed order controlled substances for hospitalized patients through the use of telemedicine.  In addition, upon filing of the emergency rule the Agency for Health Care Administration (AHCA) will notify all Florida licensed hospitals of the new rule and the Department of Health will publish notices of the emergency rule on the Board of Medicine's and the Board of Pharmacy's official websites. 
	The Board acknowledges that in promulgating this emergency rule it has acted with limited prior notice.  However, the Board believes that exigent circumstances and the rule's limited scope and design mitigates any perceived notice shortcomings.

SUMMARY:

The emergency rule clarifies the existing rule by stating that the ordering of controlled substances for hospitalized patients through the use of telemedicine is not precluded by Rule 64B8-9.0141(4), F.A.C.

THE PERSON TO BE CONTACTED REGARDING THE EMERGENCY RULE IS:

Allison M. Dudley, J.D., Executive Director, Board of Medicine, 4052 Bald Cypress Way, Bin #C03, Tallahassee, Florida 43499-3053.

PRINT PUBLISH DATE:

5/1/2014 Vol. 40/85

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://www.flrules.org/gateway/ruleno.asp?id=64B8ER14-1&PDate=5/1/2014&Section=4

REFERENCE MATERIALS:

No reference(s).

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