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Everything you need to know about BMD and the industry.

Changes to Physician Assistant Statutes in Florida

In the last year, there have been many changes to the scope of practice and collaboration/supervision requirements for advanced practice providers such as APRNs and physician assistants in the state of Florida.  In a previous Client Alert we discussed House Bill 607, which expanded the autonomous practice of APRNs providing primary care services in Florida.

This Client Alert focuses on Florida House Bill 431 (the “Bill”), which went into effect on July 1, 2021 and amended Florida Statutes 458.347 and 459.022. The Bill essentially gives Florida PAs more autonomy in certain aspects of their practice, and changes the number of PAs that physicians are permitted to supervise from four (4) to ten (10).

The Florida Board of Medicine published the comprehensive list of all of the changes made, and among those, PAs are no longer required to notify patients that they have the right to see a physician before prescribing or dispensing prescriptions, and they are able to authenticate any document that may also be authenticated by physicians, with the exception of physician certifications (which includes, but is not limited to, death certificates, school physical exams, and medical examinations for workers’ compensation claims).

Additionally, PAs are no longer required to notify the Department of Health in writing when any changes are made to their supervising physician or within thirty (30) days of employment, and are permitted to supervise medical assistants.

As for changes in prescribing, PAs no longer need to include a prescribing number on prescriptions, but instead must include their name, address, and phone number, along with the name of each of their supervising physicians. Additionally, a formulary that lists prescriptions PAs are not allowed to prescribe will be published, and PAs can now prescribe 14-day supplies of Schedule II psychotropic drugs to minors, provided they are supervised by a pediatrician, family practice physician, internal medicine physician, or psychiatrist.

The Board of Medicine also noted the following changes from the Bill:

  • Amends provisions related to program approval for the education and training of PAs and allows trainees to perform medical services rendered within the scope of an approved program;
  • Amends the licensure requirements for PAs based on the date a PA graduated from an approved program as defined in the bill by specifying which PA education and training programs are approved for PA licensure;
  • Authorizes a PA to satisfy the continuing education requirement on controlled substance prescribing through a designated course; and
  • Removes the requirement that PA licensure applicants seeking prescribing authority provide course transcripts.

If you have any questions about any of the specific changes or additions to Florida Statutes 458.347 and 459.022, and how they are applicable to you and your practice, please contact Amanda Waesch at alwaesch@bmdllc.com.

New York, Kansas, Massachusetts, and Delaware Become the latest States to Adopt Full Practice Authority for Nurse Practitioners

While the COVID-19 pandemic certainly created many obstacles and hardships, it also created many opportunities to try doing things differently. This can be seen in the instant rise of remote work opportunities, telehealth visits, and virtual meetings. Many States took the challenges of the pandemic and turned them into an opportunity to adjust the regulations governing licensed professionals, including for advanced practice registered nurses (APRNs).

Explosive Growth in Pot of Gold Opportunity for Bank (and Other) Cannabis Lenders Driving Erosion of the Barriers

Our original article on bank lending to the cannabis industry anticipated that the convergence of interest between banks and the cannabis industry would draw more and larger banks to the industry. Banks were awash in liquidity with limited deployment options, while bankable cannabis businesses had rapidly growing needs for more and lower cost credit. Since then, the pot of gold opportunity for banks to lend into the cannabis industry has grown exponentially due to a combination of market constraints on equity causing a dramatic shift to debt and the ever-increasing capital needs of one of the country’s fastest growing industries. At the same time, hurdles to entry of new banks are being systematically cleared as the yellow brick road to the cannabis industry’s access to the financial markets is being paved, brick by brick, by the progressively increasing number and size of banks that are now entering the market.

2021 EEOC Charge Statistics: Retaliation & Impact of Remote Work

The U.S. Equal Employment Opportunity Commission (EEOC) released its detailed information on workplace discrimination charges it received in 2021. Unsurprisingly, for the second year in a row, the total number of charges decreased as COVID-19 either shut down workplaces or disconnected employees from each other. In 2021, the agency received a total of approximately 61,000 workplace discrimination charges - the fewest in 25 years by a wide margin. For reference, the agency received over 67,000 charges in 2020, and averaged almost 90,000 charges per year over the previous 10 years.

Ohio’s Managed Care Overhaul Delayed – New Implementation Timeline

At the direction of Governor Mike DeWine, the Ohio Department of Medicaid (ODM) launched the Medicaid Managed Care Procurement process in 2019. ODM’s stated vision for the procurement was to focus on people and not just the business of managed care. This is the first structural change to Ohio’s managed care system since the Centers for Medicare & Medicaid Services' (CMS) approval of Ohio’s Medicaid program in 2005. Initially, all of the new managed care programs were supposed to be implemented starting on July 1, 2022. However, ODM Director Maureen Corcoran recently confirmed that this date will be pushed back for several managed care-related programs.

Laboratory Specimen Collection Arrangements with Contract Hospitals - OIG Advisory Opinion 22-09

On April 28, 2022, the Department of Health and Human Services, Office of Inspector General (“OIG”) published an Advisory Opinion[1] in which it evaluated a proposed arrangement where a network of clinical laboratories (the “Requestor”) would compensate hospitals (each a “Contract Hospital”) for specimen collection, processing, and handling services (“Collection Services”) for laboratory tests furnished by the Requestor (the “Proposed Arrangement”). The OIG concluded that the Proposed Arrangement would generate prohibited remuneration under the federal Anti-Kickback Statute (“AKS”) if the requisite intent were present. This is due to both the possibility that the proposed per-patient-encounter fee would be used to induce or reward referrals to Requestor and the associated risk of improperly steering patients to Requestor.