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.
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.
In another article, we provided an update to the autonomous practice law for Nurse Practitioners in Florida. For NP’s that qualify, that means they can open a primary care practice without a supervising physician. For most, that means learning about opening and operating a company. Here’s what that entails:
Florida is the latest state to expand the practice of Advanced Practice Registered Nurses. In March 2020, autonomous practice was passed and signed into law, with the law going into effect in July. In October, the Board of Nursing promulgated rules and provided the application for NP’s seeking to practice autonomously.
Before qualifying for autonomous practice, however, an NP must meet the following requirements:
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:
Access to telehealth for Medicare beneficiaries was further increased by the Trump Administration April 30, 2020. These new changes allows all health care professionals eligible to bill Medicare for services to provide services via telehealth communications and to bill the Medicare program for such services. Additionally, certain services may now be provided using audio technology only.
For a list of services eligible for reimbursement by the Medicare Program, including services requiring audio technology only, download here. There are approximately 180 different codes reimbursable by Medicare if provided via telehealth communications.
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.
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