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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.


Mandatory Filings Under CFIUS New Rules

On September 15, 2020, the Committee on Foreign Investment in the United States (“CFIUS”) promulgated a final rule modifying its mandatory declaration requirements for certain foreign investment transactions involving “TID US businesses” (sensitive U.S. businesses dealing in critical technologies, critical infrastructure and sensitive personal data) dealing in “critical technologies” – i.e., U.S. businesses that produce, design, test, manufacture, fabricate, or develop one or more critical technologies. The new rule also makes amendments to the definition of the term “substantial interest” (used to determine whether a foreign government has a substantial interest in an entity). The final rule became effective on October 15, 2020.

IRS Guidance on Employee Retention Credit

The Employee Retention Credit created under Section 2302 of the Coronavirus Aid, Relief, and Economic Security (“CARES”) Act is a refundable tax credit against certain employment taxes equal to 50 percent of the qualified wages an eligible employer pays to employees after March 12, 2020, and before January 1, 2021. Since the adoption of the CARES Act, employers have expressed concern that if one employer acquires another employer that previously received a PPP loan, the acquirer’s entire aggregated group may no longer be eligible to claim the Employee Retention Credit.

International Sales Contracts - COVID-19 Pandemic and Force Majeure

Identity Protection PIN Available to ALL Taxpayers in January

Beginning in January 2021, the IRS will allow all taxpayers who can properly verify his/her identity to obtain an Identity Protection PIN. An Identity Protection PIN (“IP PIN”) is a six digit number assigned to a specific taxpayer to assist in preventing the misuse of a taxpayer’s social security number on fraudulent federal tax returns. Previously, only confirmed victims of identity theft who resolved his/her tax issues with the IRS were eligible for an IP PIN.

Updates for Employers Regarding Medical Marijuana

In 2020, the momentum for marijuana legalization and decriminalization continued. In the November elections, five more states legalized either medical marijuana, recreational marijuana, or both. Although marijuana remains illegal in any form under federal law, just last week, the U.S. House of Representatives voted to decriminalize marijuana usage at the federal level. It's unlikely that the Senate will approve of that, but it is another milestone in what has been a rapidly shifting landscape over the last decade. Given the patchwork of state laws regarding medical and recreational marijuana, widely varied approaches for workplace protections, and the total federal ban, it can be difficult for employers to know how to deal with this issue.