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Ohio S.B. 310 Loosens Practice Barrier for Advanced Practice Providers

S.B. 310, signed by Ohio Governor DeWine on and effective from December 29, 2020 until May 1, 2021, provides flexibility regarding the regulatorily mandated supervision and collaboration agreements for physician assistants, certified nurse-midwives, clinical nurse specialists and certified nurse practitioners working in a hospital or other health care facility. Originally drafted as a bill to distribute federal COVID funding to local subdivisions, the healthcare related provisions were added to help relieve some of the stresses hospitals and other healthcare facilities are facing during the COVID-19 pandemic.

FAQ:  When may an APRN practice without a standard care arrangement or a physician assistant practice without a supervision agreement under SB 310?

By temporarily relaxing certain requirements from Chapters 4730, 4731, and 4723 of the Revised Code, S.B. 310 allows certified nurse-midwives, clinical nurse specialists, and certified nurse practitioners (“APRNs”) who are employed by or under contract with a hospital or other health care facility to “practice with a physician or podiatrist without having entered into a standard care arrangement with that physician or podiatrist, as long as the physician or podiatrist is continuously available to communicate with the nurse either in person or by electronic communication.” Any services performed by an APRN who has not entered into a SCA with a physician must be authorized by the hospital or health care facility within which the nurse is practicing.

Furthermore, S.B. 310 permits a physician assistant to practice without a supervision agreement if the if the physician assistant is employed by or under contract with a hospital or other health care facility and the services are authorized by a physician or podiatrist and by the hospital or other health care facility within which the physician assistant is practicing

These provisions are in effect until May 1, 2021.   

FAQ:  What qualifies as a “health care facility” under S.B. 310?

The term “health care facility” is not defined in S.B. 310.  However, the statutes and regulations governing physician assistant practice already defines “health care facility.”  Unfortunately, there is no such definition for APRNs.  

As an initial note, the term “health care facility” is defined in numerous other places in Ohio law.  The most common bond between the various definitions of “health care facility” in other Ohio statutes and regulations, appears to be the concept that a “health care facility” is a facility providing health care services and is not a practitioner’s office.  Each location will need to be evaluated on a case by case basis to determine whether it can be considered a “health care facility.” 

Under the statute governing physician assistant practice, ORC 4730.01(B), "Health care facility" means any of the following:

(1) A hospital registered with the department of health under section 3701.07 of the Revised Code;

(2) A health care facility licensed by the department of health under section 3702.30 of the Revised Code;

(3) Any other facility designated by the state medical board in rules adopted pursuant to division (B) of section 4730.08 of the Revised Code.

It is possible that the APRN definition of “health care facility” could be construed broadly by the Ohio Board of Nursing.  However, lacking further guidance from the Ohio Board of Nursing, it seems reasonable that APRNs could use an interpretation of “health care facility” that is similar to the definition found in physician assistant practice.

FAQ:  What else does S.B. 310 do?

In addition to the suspension of standard care arrangement and supervision agreement requirements in certain circumstances, S.B. 310 also permits emergency medical technicians to administer a test for COVID-19, respiratory care professionals to direct the practice of a licensed practical nurse, and retired or inactive health care professionals including nurses, pharmacists, physician assistants, physicians, podiatrists, respiratory therapists or EMTs to practice under a temporary license.

FAQ:  What are the requirements under S.B. 310 for a retired or inactive health care professional to practice under a temporary license?

To practice temporarily, a health care professional: (1) must have held a license or certificate to practice issued by a licensing board in the five-year period immediately preceding December 29, 2020 and (2) within that five years, the professional’s license or certificate expired or became inactive, which may have occurred because the professional retired from practice. A temporary license will not be extended to any professional whose license was revoked or suspended or who surrendered their license in order to avoid disciplinary action.

FAQ:  Does S.B. 310 change an APRN’s or physician assistant’s scope of practice?

No. The language in S.B. 310 does not change the scope of practice of an APRN or a physician assistant. For example, S.B. 310 does not limit the authority of an APRN or physician assistant to administer, deliver, or distribute drugs pursuant to a protocol implemented under section 3701.048 of the Revised Code following the declaration of an emergency that affects the public health. However, S.B. 310 also does not expand an APRN’s or physician assistant’s scope of practice beyond the services and procedures they have the knowledge, skill, and ability to perform.

FAQ:  When do the S.B. 310 changes expire?

As stated above, the changes provided by S.B. 310 are only temporary and will expire on May 1, 2021.

For questions regarding S.B. 310 or other matters affecting advanced practice providers, please contact BMD Healthcare and Hospital Law Member Jeana M. Singleton at jmsingleton@bmdllc.com or 330-253-2001, Attorney Ashley Watson at abwatson@bmdllc.com, or any member of the BMD Healthcare and Hospital Law group.

Surprise! A Cautionary Tale for Out-Of-Network Billing: The No Surprises Act and the Impact on Healthcare Providers

SURPRISE! Congress passed The No Surprises Act at the end of 2020. Providers, particularly those billing as out-of-network providers, should start thinking about strategies to comply with this new law, set to take effect on January 1, 2022. In its most basic sense, the new law prohibits providers from billing patients for more than the in-network cost-sharing amount in most situations where surprise bills happen. It specifically applies to non-government payers and the amounts will be set through a process described in the new law. In particular, the established in-network cost-sharing amount must be billed for the following services:

Ohio Enacts Substantial Changes to Employment Discrimination Laws

In January, Governor Mike DeWine signed into law the Employment Law Uniformity Act, amending the employment protections in the Ohio Civil Rights Act in several significant ways. Such changes to the state’s anti-discrimination and anti-harassment laws have been considered and debated for years and finally made their way into Ohio law. What has changed for employment claims under the amended Ohio Civil Rights Act?

OHIO ADOPTS THE SERIES LLC: Implementation of Ohio’s Revised Limited Liability Company Act is Coming

On January 7, 2021, Ohio adopted S.B. 276. The new legislation establishes the Ohio Revised Limited Liability Company Act (“ORLLCA”) which effectively replaces the current Ohio LLC Act. ORLLCA will be fully effective as of January 2022. While the new law contains numerous changes to the existing LLC landscape, below is an overview of some of the key differences under the ORLLCA.

Will Federal Legislation Open Cannabis Acquisition Floodgate?

Are potential buyers quietly lobbying at federal and state levels to kick open the door to launch a new round of strategic acquisitions? Will presently pending federal legislation, the SAFE and MORE Acts, providing safe harbor for banks and re- or de-scheduling marijuana, be sufficient to mobilize into action major non-cannabis companies that previously shunned the cannabis industry due to the unknown implications of owning businesses whose activities are illegal under federal law?

The Future of the Families First Coronavirus Response Act

Over the last year we all have had to adjust to the new normal ushered in by the coronavirus pandemic. Schools and daycares closed, businesses transitioned from in-office work to work from home, bars and restaurants have closed their doors...all to slow the spread and try to prevent this pandemic from spiraling out of control. The start of the pandemic was utter pandemonium. Working parents trying to balance both caring for their now at-home children and their livelihood. Businesses trying to decide how to implement leave policies with limited information. Employees determining if they could financially afford to take time off. We were all flying by the seat of our pants trying to adjust to our new normal.