Resources

Client Alerts, News Articles, Blog Posts, & Multimedia

Everything you need to know about BMD and the industry.

Primary Care Practice Officially Defined in Florida for APRNs Practicing Autonomously

Client Alert

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.


Multi-340B Contract Pharmacy Locations on the Brink? The Third Circuit’s Ruling Gives a Hint.

The 340B drug discount program requires pharmaceutical manufacturers to offer to sell their products at significant discounts to safety net providers called “covered entities.” In 1996, the Health Resources and Services Administration (HRSA) issued guidance authorizing covered entities to enter into a contract pharmacy arrangement with a single third-party contract pharmacy, to which the manufacturer would ship 340B medications but bill the covered entity. In 2010, HRSA issued revised guidance permitting covered entities to enter into an unlimited number of contract pharmacy arrangements.

Five Opportunities for Operations and Compliance Excellence in 2023

With the holidays behind us and the rest of the year ahead, now is the perfect time to get your operational/compliance house in order! Though your list might be a mile (or an inch) long, here are five places to start.

The Pregnant Workers Fairness Act - What Employers Need to Know

Effective June 27, 2023, the Pregnant Workers Fairness Act (PWFA) will require employers with at least 15 employees to provide reasonable accommodations for qualified employees with pregnancy-related restrictions unless doing so would impose an undue hardship on the employer.

Valley National Bank/Trulieve Loan: A Big Step Out of the Shadows

In a late December press release, Trulieve announced that it had secured a $71.5 million commercial bank loan. In addition to the amount of the loan, which may be the largest commercial bank loan to date to a cannabis company, the release prominently identified Valley Bank and featured both a quote from Valley’s Senior Vice President, John Myers, and a description of the Bank’s service platform and commitment to the cannabis industry.

The End of Non-Competes? The Impact It Will Have on the Healthcare Industry

On January 5, 2023, the Federal Trade Commission (“FTC”) announced a proposed rule that, if enacted, will ban employers from entering into non-compete clauses with workers (the “Rule”), and the Rule would void existing non-compete agreements. In their Notice, the FTC stated that if the Rule were to go into effect, they estimate the overall earnings of employees in the United States could increase by $250 billion to $296 billion per year. The Rule would also require employers to rescind non-competes that they had already entered into with their workers. For purposes of the Rule, the FTC has defined “worker” to also include any employees, interns, volunteers, and contractors.”