FL H0865

Revises the definition of "institutional formulary system" to clarify it applies to Class I, Class II, and Class III institutional pharmacies.

Authorizes Class I institutional pharmacies to adopt an institutional formulary system with medical staff approval to identify medicinal drugs, biologics, biosimilars, and biosimilar interchangeables that may be dispensed.

Establishes nine specific requirements for Class I institutional pharmacy formulary system policies and procedures, including medical staff approval, detailed selection criteria, continuous drug review, and compliance monitoring.

Requires mechanisms to inform prescribers prior to drug substitutions using the prescriber's designated communication method, with notation in the patient's chart.

Allows prescribers to opt out of the formulary system entirely or on a per-patient basis, and prohibits penalizing practitioners for prescribing medically necessary nonformulary drugs.

Takes effect July 1, 2019.