EDUCATION: Florida Bill Bans Storage of Health Records Outside the Continental United States, its Territories, or Canada

EDUCATION: What Does the FTC Ban of Non-Compete Agreements Mean for Healthcare Providers?

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On April 23, the Federal Trade Commission (FTC) issued a final rule, banning new non-compete agreements with all workers. It is estimated that around thirty million workers are subject to non-compete agreements, nationwide. The Commission’s final ruling states that non-compete agreements give rise to an unfair method of competition and banning non-compete agreements will result in reduced healthcare costs, new business formation, increased innovation, and higher worker earnings. The rule applies to anyone who works for a for-profit employer, despite being paid or unpaid and independent contractors. Additionally, limited use of non-compete agreements between franchises and franchisors is permitted. The rule also does not apply to non-compete agreements entered into by a person pursuant to a bona fide sale of a business entity.

EDUCATION: Do I Need a Permit to Sell CBD Products in Florida?

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In 2018, the Agricultural Improvement Act of 2018 was signed into law, authorizing the production of hemp and removing hemp and hemp seeds from the Drug Enforcement Agency’s (DEA) list of controlled substances. The act also allowed the U.S. Department of Agriculture (USDA) to provide guidance to implement a program that would help establish the regulatory framework regarding the production of hemp throughout the United States.

Following the Agricultural Improvement Act of 2018, Senate Bill 1020 in Florida was signed. This bill provided a state plan for the regulation of cultivating hemp within Florida. Under the bill, hemp-derived cannabinoids are not controlled substances so long as the hemp derivates do not exceed a total delta-9 tetrahydro cannibal (THC) concentration of 0.3 percent on a dry weight basis. Any product with a THC concentration over 0.3 percent is considered a controlled substance.

It is important to note that the sale of topical CBD products is not required to be licensed by the FDACS and is rather regulated by the Florida Division of Business and Professional Regulation. Additionally, there may be further requirements for CBD products that contain dairy or frozen ingredients.

EDUCATION: Regulation of Unlicensed Activity by the Florida Department of Health

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In the State of Florida, the Department of Health regulates the unlicensed practices of health care professionals. Florida Statute § 456.065 states that any practice, performance, or delivery of health care services by an individual without a valid and active license to practice that profession is strictly prohibited.

Not only can practicing without a valid license accumulate hefty fines for an offender, but it can also impose criminal penalties and/or sentences. The Unlicensed Activity Unit works with law enforcement and the state attorney’s offices to prosecute any individuals practicing without a license.

The unlicensed practice of health care can have serious impositions on the administrative side and criminal side. An individual practicing without a valid license may be delivered a cease-and-desist notice to halt their practice which can have further implications if the notice is not abided by. Furthermore, individuals practicing unlicensed may be subject to citations and criminal proceedings that include fines and imprisonment.

EDUCATION: What are Work Relative Value Units (wRVUs) in Physician Employment Agreements

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When a physician provides a service, the reimbursement amount for that work is often measured through a metric referred to as work relative value units (wRVU). Although not every physician may be subject to wRVUs, such as physicians who have their own private practice, many physicians who work in large healthcare organizations may be required to meet a minimum amount of wRVUs.

The goal of the wRVU model is for physicians’ compensation to be directly correlated to the amount of work they perform, regardless of the patient’s insurance plan or the revenue generated during the services. Focusing on the amount of work performed has proven to be more effective than the previous method of tracking a physician’s productivity by the number of patients seen and number of services performed. Additionally, calculating reimbursement simply off the amount charged to the patient can be ineffective as well because the amount does not necessarily reflect the underlying value of the work provided. As such, the current wRVU model is the standard compensation model that many physicians and employers use in the healthcare industry.

EDUCATION: Guidelines for Closing or Relocating a Florida Medical Practice

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Record Keeping

Fla. Stat. §456.057(13) of the Florida statutes states that “records owners shall notify the appropriate board office when they are terminating practice, retiring, or relocating, and no longer available to patients, specifying who the new records owner is and where medical records can be found.”

As defined in the statute, a records owner means:

• Any health care practitioner who administers treatment, dispenses drugs, or generates a medical record after making a physical or mental examination of any person.
• A health care practitioner to whom records are transferred by a previous record’s owner.
• Any health care practitioner’s employer provided that the agreement designates the practitioner’s employer as the records owner.

Notification of Changes

In addition to notifying the appropriate board office when retiring, closing, or relocating their practice, a record’s owner must also place an advertisement in the local newspaper or notify the patients in writing of the change, pursuant to Fla. Stat. §456.057(12). The patients of the practitioner must have the opportunity to request a copy of their medical record. According to Fla. Stat. §456.057(14), when a new records owner has been appointed, the new owner is responsible for providing a copy of the complete medical record to a patient or a patient’s legal representative who has requested the record.

Outside of notifying the appropriate board office and patients, practitioners may need to notify the Centers for Medicare & Medicaid Services and the U.S. Drug Enforcement Agency to comply with the appropriate disposal of the drugs within the practice. If the practitioner holds a license from the Department of Health for their use of medical equipment, they must notify the department and keep a record of the transfer or disposal of the equipment. Other establishments that may need to be notified include the Florida Agency for Health Care Administration, the hospital where the practitioner worked if applicable, other vendors whom the practitioner may have received supplies or equipment from, and the practitioner’s medical malpractice insurance carrier.