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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.


Did You Receive More than $750,000 in Provider Relief Funds?

The Provider Relief Funds (“PRF”) - authorized under the CARES Act - has been a vital tool for health care providers during the COVID-19 public health emergency. These funds have allowed providers to stay open and continue to offer care during these pressing times. While helpful, these funds do come with several important obligations. First, fund recipients are required to comply with certain record-keeping requirements as well as comply with certain balance billing prohibitions. See our Client Alert. Second, fund recipients are required to report their intent, use of funds, and other data elements, which helps promote transparency to the federal government. Please see our Client Alert on provider relief fund reporting requirements. Third, and perhaps a new concept for many providers, fund recipients of more than $750,000 must undergo a “single audit” to ensure program compliance and appropriate use of funds.

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PPP Update: Loan Necessity Questionnaires

On October 26, 2020, the Small Business Administration (“SBA”) published a notice in the Federal Register which foreshadowed the release of two new forms seeking information from for-profit and nonprofit organizations that received Paycheck Protection Program (“PPP”) loans of $2 million or more. If approved, the SBA would use information from these forms to evaluate and determine whether economic uncertainty made a PPP loan request necessary.

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Lessons Learned: Five Tips for Buying or Selling a Practice

If you are anticipating buying or selling a practice during the coming months, you are not alone. The healthcare industry is experiencing a wave of integration. In fact, it has been occurring for several years. Many transactional healthcare attorneys have negotiated and closed dozens of these transactions for clients. They have negotiated on behalf of the sellers in some cases and the buyers in others.