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.
When new healthcare regs come out, we all get excited. “What sort of nuggets will I find that could be useful?” Sometimes the regs have useful things and sometimes, they’re just disappointing and frustrating. The proposed changes to the 2016 Medicare Physician Fee Schedule are a mixed bag. Allow me to illustrate:
The incident to rules may be changed to require only the ordering physician to supervise the performance of the service. Currently, any physician in a group practice could supervise the performance of an incident to service (which allows the practice to bill for the service as though it had been performed by the ordering physician);
Qualified telemedicine services that are furnished via an interactive telecom system can be furnished by a physician or authorized practitioner for an additional list of services, including CRNAs. This is a big change that expands the list of authorized providers;
The feds propose to characterize certain Stark Law violations as “technical,” which means they pose no financial risk to the Medicare program. Examples include unsigned or expired agreements;
The scope of Physician Assistants’ practice is a dynamic and hotly debated area of law which shares many similarities with the nurse supervision issues we covered in a recent article (available here). House Bill 1275 would have also allowed for an expansion in the PA field and was included on the “Health Train” compilation of bills introduced during the Florida legislature’s recent session. As we know nothing on the Train passed before the session ended and though it may gain forward momentum next time, here’ how the laws stand today:
Nearly half of U.S. States have already expanded the scope of nursing practice and several more are analyzing whether it is appropriate. The debate between physicians and nurses regarding how much autonomy a nurse should be given is a political hotbed that will likely be revisited by the legislature in the near future. Until that time, the Board of Medicine and the Board of Nursing will quietly continue to enforce the present requirements. Here’s how they stand today:
Under Florida’s current laws, in addition to the practice of professional nursing, an advanced registered nurse practitioner (“ARNP”) may perform acts of medical diagnosis, treatment and prescription. However, for the most part, such acts must be performed under the general supervision of a physician. The nature of such a supervisory relationship should be identified in a protocol which identifies the medical acts to be performed and the conditions for their performance.
Health law is the federal, state, and local law, rules, regulations and other jurisprudence among providers, payers and vendors to the healthcare industry and its patient and delivery of health care services; all with an emphasis on operations, regulatory and transactional legal issues.