July 3, 2020

Portions of Florida House Bill 607 went into effect July 1, 2020.  This law expands the scope of practice for Advanced Practice Registered Nurses (APRNs) in a number of areas.  Highlights are below.  Note that the phrase “who is registered to engage in autonomous practice” appears in quite a few provisions to distinguish them from circumstances in which such registration is not required.

The new law:

• provides for the registration of APRNs to engage in autonomous practice
• authorizes APRNs to provide primary health care services and authorizes them to perform specified acts without physician supervision or a supervisory protocol
• revises the definition of the term “practitioner” to include an APRN registered to engage in autonomous practice
• revises the definition of “health care provider” to include ARPNs for the purpose of the Patient’s Bill of Rights and Responsibilities
• authorizes an APRN who is registered to engage in autonomous practice to file a certificate of death or fetal death under certain circumstances
• authorizes an APRN who is registered to engage in autonomous practice to initiate an involuntary examination for mental illness under certain circumstances
• requires AHCA to pay for services provided to Medicaid recipients by an APRN who is registered to engage in autonomous practice
• authorizes an APRN who is registered to engage in autonomous practice to make referrals under certain circumstances
• requires personal injury protection insurance policies to cover a certain percentage of medical services and care provided by an APRN who is registered to engage in autonomous practice
• authorizes an APRN to provide the medical report of a ward in an annual guardianship plan
• authorizes an APRN to provide training in the administration of medication to designated school personnel
• authorizes an APRN who is registered to engage in autonomous practice to medically evaluate a student athlete
• authorizes an APRN who is registered to engage in autonomous practice to receive payments under the Health Care Education Reimbursement and Loan Repayment Program

The attorneys at Turner O’Connor Kozlowski, P.L. are equipped to help you manage all legal aspects of your APRN practice. Call us at (352) 372-4263 for more info.

September 3, 2019

The final version of CMS-1710, “Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2020 and Updates to the IRF Quality Reporting Program,” was published in August and will go into effect October 1, 2019.  The final rule updates the payment rates for IRFs for the year 2020 based on a 2016 base year instead of the previous 2012 base year.  The proposed rule considered using a weighted motor score to assign patients to IRF PPS’s case-mix groups; however, the final rule adopted an unweighted motor score based on public comments and removes one of the items considered in the motor score.

Like the proposed rule, the final rule updates the IRF wage index and amends the regulations at 42 CFR 412.622 to clarify that the determination as to whether a physician qualifies as a rehabilitation physician . . . is made by the IRF.

The CMS website includes helpful info to accompany the rule, including wage index tables and the actual data for each of the 1,122 inpatient rehab facilities used to estimate the policy updates. 

The attorneys at Turner O’Connor Kozlowski, P.L. are equipped to help you manage all legal aspects of your healthcare practice. Call us at (352) 372-4263 for more info.

August 20, 2019

Florida voters passed a constitutional amendment to restore rights to felons. Article VI, Section 4(a) of the Florida Constitution reads:

“No person convicted of a felony, or adjudicated in this or any other state to be mentally incompetent, shall be qualified to vote or hold office until restoration of civil rights or removal of disability. Except as provided in subsection (b) of this section, any disqualification from voting arising from a felony conviction shall terminate and voting rights shall be restored upon completion of all terms of sentence including parole or probation.”

Senate Bill 7066, which was signed into law by Governor DeSantis, defines the phrase “completion of all terms of sentence.” This definition is expansive, containing voluminous subsections. Notably, though, it specifies that all monetary fines must be satisfied to qualify for restoration of rights.

The law further says that if a felon has his outstanding fines converted into a civil lien, that too prevents qualifying for restoration. There is, however, a part of the law that says “A term required to be completed in accordance with this paragraph shall be deemed completed if the court modifies the original sentencing order to no longer require completion of such term.”

This simply means, if there are still outstanding monetary obligations associated with a felony conviction, rights won’t be restored. But, if a judge modifies the underlying obligations and removes them from the sentence, a felon may qualify for restoration of rights without having to pay.

The criminal defense lawyers at Turner O’Connor Kozlowski, P.L. can help if you are seeking to have your rights restored.

August 1, 2019

Hemp is legal in Florida as of July 1. Because of the plant’s close relationship to marijuana, law enforcement agencies and prosecutors throughout Florida are declining to arrest or prosecute marijuana possession. Gainesville is the latest area to formally decline marijuana cases.

The only practical way to distinguish legal hemp from illicit marijuana is through testing to determine the level of THC. Because such testing equipment is difficult to obtain, and not necessarily accepted by courts, prosecutors believe they cannot obtain convictions. Without that confidence, there is no point in filing charges or even arresting a possible offender.

A secondary and probably unanticipated effect of hemp legalization is that a time-worn law enforcement tool for obtaining evidence may no longer be valid. For years, courts have permitted searches based on the odor of cannabis. Searches based on that odor sometimes lead to stolen credit cards, firearms, or other drugs. Now, because that odor could well be hemp, officers are being told they can use smell as a basis for a warrantless search only if there is another indicator of illegal activity present. This change has the potential to tie an officer’s hands when there is a strong suspicion of a crime but nothing in particular to point to.

Not every agency or jurisdiction has adopted these new policies, and the courts eventually will have to sort out the requirements under the changing law. But for now, people arrested after July 1 may have new avenues of defense.

The criminal defense lawyers at Turner O’Connor Kozlowski, P.L. can help if you have been arrested for a marijuana charge or a different crime that involved a search based on marijuana odor.

July 25, 2019

The 2019 session was an active one for the Florida Legislature.  Here’s a quick rundown of what you need to know that affects your practice.

HB 19:  Prescription Drug Importation Programs

Two new programs were created to establish a safe method of importing Rx drugs into the state.  First, the Canadian Importation Program requires AHCA to contract with a vendor to identify compliant Canadian suppliers who have agreed to export particular drugs at prices that will save the state money.  Among the excluded classes of drugs are controlled substances; biological products; infused drugs; IV drugs; inhalants; and parenterals.

The International Prescription Drug Importation Program requires foreign pharmacies to maintain active licenses in their home countries and to apply for an international export pharmacy permit.  Both programs include bond requirements and are contingent upon federal approval.  Fees are set under new section 465.0157(4).

HB 451:  Nonopioid Alternatives

DOH will be required to create and host on its website a pamphlet providing information on alternatives to opioids for the management of pain, including the pros and cons of those alternatives.  Additionally, you must now inform your patients before administering anesthesia or opioids (except in emergency situations) that opioid alternatives are available and must discuss the pros and cons with them, including their personal risk factors, and hand them a copy of the pamphlet.  When that pamphlet is available, we’ll post an update here.

HB 851:  Human Trafficking

If you hold your license under Florida Statutes chapter 457, 458, 459, 460, 461, 463, 465, 466, parts of 468, 480, or 486, you must now take a 1-hour continuing ed course on human trafficking. 

If you are a massage therapist and own a clinic or establishment, you must appoint a manager to be responsible for compliance.  DOH must now deny establishment licensing if the owner or manager has been convicted of a prostitution-related offense.  There are a few other requirements relating specifically to massage therapists, so check it out here.

SB 182:  Medical Marijuana

This bill contains a lot of important information; call us if you certify patients in your practice and need more detailed information.  Perhaps most importantly, the term “medical use” now includes smoking.  However, there are restrictions on where it can be smoked, and the consent form must include reference to the negative health risks of smoking marijuana.  You are limited in the amount you can certify (no more than three 70-day supply limits or six 35-day supply limits in smokable form).  You can request an exception if warranted.

SB 732:  Surgery Centers

DOH must issue ESOs (emergency suspension or restriction orders) if probable cause is found that an office or physician is not compliant with office-surgery standards.  With regard to liposuction, you must register your office if you conduct procedures in which more than 1,000 cc’s of supernatant fat is removed.

SB 1418:  Mental Health

Mental health providers, listen up:  If a patient communicates to you a specific threat to cause serious bodily injury or death to someone, and if you reasonably believe (or should reasonably believe) that the patient has the apparent intent and ability to carry out that threat, your clinical records must be released to the extent necessary to give law enforcement sufficient information to take action.