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Primary Care Practice Officially Defined in Florida for APRNs Practicing Autonomously

Overview

As many providers in Florida are aware, House Bill 607 (the “Bill”), which was passed in February of last year, gives certain APRNs in Florida the ability to practice autonomously. The only catch is that they must work in primary practice. When the Bill was initially passed, there was question as to what was exactly considered primary care, absent a definition from the Florida Board of Nursing. However, as of February 25, 2021, “primary care practice” has officially been defined.

Florida Administrative Code 64B9-4.001

Florida Statute 464.0123, which sets forth the requirements for APRN autonomous practice, states, “[a]n advanced practice registered nurse who is registered under this section may engage in autonomous practice only in primary care practice, including family medicine, general pediatrics, and general internal medicine, as defined by board rule.”

However, the Board of Nursing had not yet provided such a definition when the statute was passed, leaving APRN's confused as to whether they qualified for an autonomous practice license. In February, primary care was defined in Florida Administrative Code 64B9-4.001(12) as including, “physical and mental health promotion, assessment, evaluation, disease prevention, health maintenance, counseling, patient education, diagnosis and treatment of acute and chronic illnesses, inclusive of behavioral and mental health conditions.” While this definition also encompasses mental health treatment, in addition to family medicine and general medicine, anything involving specialty care will still require a collaborative agreement.[1]

In Practice

The Florida Association of Nurse Practitioners further explains when an APRN’s practice is considered primary care and when it is not. For example, administering Botox may be considered primary care if the provider is using it for migraines in a primary care setting, while administering it in a MedSpa or using it for wrinkle treatment outside of a primary care setting would not be considered primary care and would require the APRN to practice pursuant to a collaboration agreement.[2]

Conclusion

It is important to note that even if an APRN is working in a primary care setting and offering primary care to their patients, they may not practice autonomously until they have applied for an autonomous license and have been approved.

If you have any questions about whether you qualify for an autonomous license in Florida, or have any other questions about the application process and requirements, please contact Amanda Waesch at alwaesch@bmdllc.com.

[1] Florida Association of Nurse Practitioners, Autonomous Practice Q&A, (Feb. 22, 2021) https://www.flanp.org/page/AutonomousPractice.

[2] Id.

Is Your Bonus System Creating Wage and Hour Violations? A Hidden Impact of the Labor Shortages

As employers struggle with attracting and retaining talent, many have turned to incentives such as Signing Bonuses and Retention Bonuses. In doing so, employers may be inadvertently exposing themselves to overtime law violations. Employers with non-exempt employees know that the Fair Labor Standards Act (FLSA) requires an overtime premium to non-exempt for work in excess of 40 hours per week. However, all too often, employers miscalculate the “regular rate” of pay, which is used for calculating the “overtime rate.” The miscalculation is becoming more prevalent in today’s market when employers fail to include supplemental compensation, such as certain Signing Bonuses and Retention Bonuses into the regular rate of pay. An example: A non-exempt employee is hired at a rate of $20 per hour, and also receives a retention bonus of $1,200 after working for 12 weeks. In her 11th week of work, employee works 50 hours. In her 14th week of work, employee works 50 hours. What is her paycheck in week 11? What is her paycheck in week 14?

No Surprises Act – Notice Requirements

On July 1, 2021, the Biden Administration passed an interim final rule: Part 1 of the “Requirements Related to Surprise Billing Act,” in an attempt to curb excessive costs patients are required to pay in relation to surprise billing. The rule is set to take affect January 1, 2022, and will only affect those who are enrolled in insurance via their employers, as federal healthcare programs already prohibit this type of billing.[1]

El Contrato Escrito: La Herramienta Predilecta

No existe mejor herramienta a una disputa contractual que un documento firmado por las partes en el cual se expongan las obligaciones y acuerdos entre éstas.

New State Budget Institutes Licensure Requirement for Ohio’s Hospitals

On July 1, 2021, Governor Mike DeWine signed Ohio’s final budget codified at Ohio Revised Code 3722.01 et seq., which includes a new licensing requirement for Ohio’s hospitals. For years, Ohio was the only state in the country that did not license its hospitals. This approach will now be replaced with new, detailed requirements that will require careful review and compliance. Here are some of the highlights concerning these new changes:

Healthcare Provisions in the Ohio FY 22-23 Budget

Governor Mike DeWine signed Ohio’s Fiscal Year 2022-2023 budget bill (HB 110) into law on July 1, 2021. At almost 1,000 pages and 74.1 billion dollars, the budget lays out the State’s spending for the next two years. Below are a few highlighted provisions from the budget that will be important for the healthcare industry in Ohio