Medical Spa Industry Is Booming But is Regulation Keeping Up?

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medical spa lawMedical Spas nationwide, but specifically in Florida, have been opening up at a staggering pace. For many reasons, including new services, technological advances, and lax regulations, the opportunities for medical spa businesses are endless.

In 2010, there were about 1,600 medspas operating in the United States generating about $1.1 billion in revenue (about $700,000 per medspa on average). By 2018, these numbers increased to over 5,000 medspas generating about $7 billion-$8 billion in revenue (about $1.4 million per medspa on average). The number is expected to grow to over 10,000 medspas by 2023 with about $18 billion-$20.7 billion in revenue.

While medical spa owners have taken advantage of these opportunities, state authorities have yet to keep up. The medical spa industry is largely unregulated, whether that be due to the nature of the services provided, or the explosive growth in this alternative type of medical clinic. On top of that, there’s been a expansion in scope of practice and supervision requirements for certain providers, including nurse practitioners.Continue reading

Autonomous Nurse Practitioners in Private Practices

By: Chase Howard

The new autonomous practice regulations allow certain Nurse Practitioners to practice independent of physicians, without supervision, in certain settings. While we’re awaiting further declarations and definitions from the Board of Nursing as to what is including in primary care, there is already an opportunity for autonomous practice nurse practitioners to establish concierge and direct primary care offices.

The concierge practice model and the direct primary care model, however, are still regulated depending on the way patients pay.Continue reading

How Autonomous Practice Is The Biggest Business Opportunity for 2021

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fhlf nurse practitioner lawBy: Chase Howard

With the passage of autonomous practice ability for nurse practitioners in Florida this year, many are wondering how this will affect the healthcare industry in Florida. In a traditional sense, rural and underserved areas should have the opportunity for growth in healthcare providers. The autonomous practice law removes restrictions on certain nurse practitioners, granting them the ability to practice in primary care practice settings without worrying about supervision restrictions. Outside of that, the application of the new law can expand healthcare business offerings and abilities. Continue reading

Florida APRN Independent Practice Update

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APRN independent practiceBy: Chase Howard

In March, the Florida Legislature passed multiple bills that would allow advanced practice registered nurses (APRN) to practice independently of physicians in the delivery of primary care practice. The law, however, went into full effect on July 1. Still, the law did not automatically grant autonomous practice to all nurse practitioners. Rather, an application process is still needed, as well as final regulations governing the new law.

In June, the Florida Board of Nursing voted to move forward with the drafting of rules and the application process to be designated as an independent practice Nurse Practitioner. This process usually takes three months to complete before it is open for practitioners to apply. The Board also voted to define “primary care practice” to include “health promotion, disease prevention, health maintenance, counseling, patient education, and diagnosis and treatment of acute and chronic illnesses in a variety of healthcare settings.”

Until final rules are decided, a nurse practitioner will at least need to meet the following requirements:Continue reading

What Nurse Practitioner Practice Expansion Means for Doctors

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nurse practitioner practiceBy: Jeff Cohen

The issue of scope of practice is front and center in Florida right now with the expansion of what nurse practitioners (and nurse midwives) are legally permitted to do.  The newly enacted 464.0123 allows for qualified APRNs (there is specific criteria) to practice independent of a supervising physician in the following areas of medicine–primary care, family medicine, general pediatrics, and general internal medicine.

Even more, assuming they meet the membership criteria for admission to a healthcare facility medical staff, they may admit patients, manage patient care, and discharge patients.  One of the only preserved connections with a physician established by the law is if the APRN practices at a healthcare facility, a transfer agreement including a physician is required.  Additionally, the new law establishes a Council On Advanced Practice Registered Nurse Autonomous Practice, two members of which are appointed by the Board of Medicine and an additional two appointed by the Board of Osteopathic Medicine.       Continue reading

Solution or Problem? Depends Who You Ask. New Changes to Supervision Laws Guaranteed to Make Waves In Healthcare Industry.

New changes to supervision laws for APRNs advanced practice registered nurse

New changes to supervision laws for APRNs advanced practice registered nurseBy: Chase Howard

After more than a year of debate, edits, tabling and lobbying, the Florida Legislature passed multiple bills that would allow advanced practice registered nurses (APRN) to practice independently of physicians, as well as authorize certain pharmacists to test and treat patients for the flu and strep throat, among other conditions.

Prior to passage of these bills, APRNs were required to have some level of physician supervision in order to practice. While in many cases direct supervision is not required, Florida law required that an APRN enter into a supervisory relationship with a Florida licensed physician. Specifically, the providers must draft written protocols regarding scope of practice, as well as provide certain notices to their governing boards and patients. While the requirements vary based on the type of practice, they aren’t difficult to comply with in most cases. Finding a supervising physician outside of that physician’s primary practice, however, might prove to be more difficult than it seems. The requirements also carry certain mileage restrictions, prohibiting supervision outside mile limits based on the level and type of supervision.

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Florida Physician Supervision for Non-Physician Providers

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florida physician supervisionBy: Chase Howard

In Florida, a licensed physician can provide supervision of healthcare providers that are not physicians under certain circumstances. Understanding who a physician can cover and under what circumstances can help protect your license and avoid receiving a complaint by the Florida Department of Health.

In every case, when a physician agrees to supervise another provider, Florida law requires certain documentation and notice to be filed.Continue reading

Med Spa Compliance: Are you Operating Within the Law?

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med spa complianceBy: Jacqueline Bain

On May 19, 2018, Delray Beach medical spa owner Jennifer Aspen was booked into the Palm Beach County Jail and charged with practicing medicine without a license. Ms. Aspen is the manager of Mermaid’s Skin & Wellness, a medical spa located in Delray Beach, Florida. The charges against Ms. Aspen stem from the fact that a Delray Beach police officer presented to Mermaid’s Skin & Wellness for a testosterone shot. Ms. Aspen stated to the officer that she would perform the injection. Ms. Aspen is a certified nursing assistant in the State of Florida. Her license is currently listed as “delinquent” on the Department of Health’s website, meaning that (as of today) she failed to renew her license after its May 30, 2018 expiration date. Certified nursing assistants are not generally allowed to administer testosterone in the State of Florida.

One of the legal issues that presents frequently in our office is med spa compliance; who can open and operate a medical spa if it is just a cash business, meaning that it does not submit claims for reimbursement to any government or commercial payor. Misunderstandings run rampant in the medical spa industry and many times patients are administered treatment from persons who are not supposed to be providing it.Continue reading