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Florida HB 607 - APRNs Can Now Admit, Care, Discharge Patients without Physician Oversight

Earlier this month, lawmakers in both chambers of the Florida legislature passed House Bill 607 — legislation which would allow advanced practice registered nurses, or APRNs, to single-handedly admit, care for, and discharge patients from medical facilities.  This would effectively eliminate the need for physician oversight, a costly expense for independent nurse practitioners.

Proponents of House Bill 607 believe that allowing APRNs greater autonomy, as this legislation will do, has the power to fill the gap of much-needed health care services in rural Florida communities.

Although the new law will eliminate the need for an attending physician’s approval and, as such, may arguably increase the potential for treatment mishaps, the bill provides for numerous safety measures to ensure minimal complications including clear education requirements and experience thresholds for APRNs to qualify.

Under the standards, a “qualified nurse practitioner” will have at least 3,000 hours of experience under the supervision of a physician before he/she can qualify to provide services including family medicine, general pediatrics, and general internal medicine.

House Bill 307 also includes a $5 million budget for a loan repayment program for APRNs who work in primary-care health professional shortage areas or county health departments, community health centers, migrant health centers or any other publicly funded health care programs designated by the state.

The legislation, which was signed by Florida Governor Ron DeSantis, will go into effect on July 1, 2020.

For more information, please contact Amanda Waesch at alwaesch@bmdllc.com, or any of the Healthcare & Hospital Law Practice Attorneys at BMD.

Changes to Medicare’s Physician Fee Schedule and Outpatient Prospective Payment System

Come the beginning of 2022, both the Medicare Physician Fee Schedule (“MPFS”) and Outpatient Prospective Payment System (“OPPS”) will look a little different. As a refresher, the MPFS lists the fees associated with reimbursement of services to providers at certain facilities, taking into account geography and costs. By contrast, OPPS sets reimbursement rates for hospitals and community mental health centers for outpatient services, which are determined in advance. A summary of some of the more pertinent changes to each rule will be outlined below.

CMS to Once Again Reprocess Outpatient Clinic Claims

The Hospital Outpatient Prospective Payment System (OPPS) Rule was passed in November 2018, which was intended to prevent the Centers for Medicare and Medicaid Services (CMS) from paying more for services rendered in outpatient settings than what they paid for the same services rendered in physician offices that are simply owned by hospitals or health systems.[1]

New Vaccine Requirement for Select CMS-Participating Facilities

On November 4, 2021, the Centers for Medicare and Medicaid (“CMS”) released a new rule requiring certain healthcare facilities to implement policies requiring employees to be vaccinated against COVID-19. It does not matter if a staff member does not perform patient treatment services, they must still be vaccinated if an employee of an applicable facility.

OSHA COVID-19 EMERGENCY TEMPORARY STANDARD (ETS) Vaccination, Testing, Recordkeeping, and Reporting

The Occupational Safety and Health Administration has issued its long-awaited COVID-19 Emergency Temporary Standard (ETS). Note that the ETS does not apply to employers covered under the Safer Federal Workforce Task Force COVID-19 Workplace Safety: Guidance for Federal Contractors or Subcontractors (see here), or to settings where employees provide healthcare services subject to OSHA’s ETS for the healthcare industry (see here).

Interesting Trends Revealed in 50-State Medicaid Budget Survey

Results of the KFF annual survey of state Medicaid directors reveal some fascinating trends in Medicaid service delivery and benefit coverage. Read on for a summary of the highlights we find most noteworthy. Background As a preliminary matter, many of the trends KFF identifies and that we highlight below are no doubt a result of the Covid-19 pandemic. The pandemic triggered a public health emergency and economic crisis that resulted in increased Medicaid enrollment, service offerings, and flexibility in service delivery, along with a heightened awareness of disparities in access to care and health outcomes.