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In the end, pill-mill bill passes unanimously

The pill-mill crackdown, which passed both the Senate and House unanimously on Friday, includes a ban on doctors dispensing the most dangerous narcotics, with only a few exceptions.

Since the House and Senate negotiators agreed only hours ago, no copies of the bill were immediately available. However, the staff of Sen. Mike Fasano, R-New Port Richey, provided an outline that sums up the agreement. (Fasano was the one who persisted in pushing the plan through over great opposition).

So what's in it? One thing that is NOT in it, according to the outline, is the 5,000-pill limit that each retail pharmacy could receive each month. Some concerns had been raised that this could lead to shortages of pain medicine for legitimate patients.

Instead, the Department of Health will conduct a study on the distribution of addictive drugs in Florida and submit it to the Legislature by November.

What IS in the bill, according to Fasano's outline:

--Enhanced administrative and criminal penalties for doctors who overprescribe narcotics and violate standards of care.

--Most of the regulations and standards of care for pain management clinics that were passed last year, with a sunset review in 2016.

--The prescription drug monitoring program -- often called the "drug database" -- that doctors and pharmacists can check to protect against addicts and drug dealers posing as patients. Posting will be required within seven days (it had originally been set at 15 days).

--Criminal background checks, including fingerprinting, for staff members of doctors and pharmacies who have access to the database.

--Bars physicians from dispensing the most abused narcotics from their offices, with exceptions for surgical procedures, clinical trials, methadone clinics and hospice. An effort by workers' comp doctors to get an exemption failed.

-- Requirements that practitioners who prescribe controlled substances register with the Department of Health, comply with specific standards of care, and use DOH-approved forms or electronic prescribing.

--A new permitting system for pharmacies that dispense the most addictive narcotics, including onsite inspections, financial disclosures and exclusion for those with criminal histories.

--Heightened responsibility for wholesale drug distributors to report to the state on where narcotics are going and to check credentials of pharmacies that order them.

--A mandatory buy-back program in which physicians have to send unused narcotics back to distributors.

--Declaration of a state of emergency by DOH.

Carol Gentry, founder and special correspondent of Health News Florida, has four decades of experience covering health finance and policy, with an emphasis on consumer education and protection.