UPDATE: Florida Independent Practice Bill Becomes Law, but with Restrictions

Posted By American Med Spa Association, Thursday, March 12, 2020

In a flurry of activity, Florida House Bill 607 (HB 607), which would allow nurse practitioners (NPs) to practice without the need for physician supervision, has become law, although with substantial changes from prior versions that limit the scope of practice for NPs. We briefly discussed the some of the prior changes to the bill here, and you can read the official final version and history here. After passing both the House and Senate in the last week, it was signed into law by Governor Ron DeSantis.
The final version of HB 607 differs substantially from the prior versions. Earlier versions would have provided for physician assistants (PAs) and NPs to practice without a physician. The final version no longer includes any changes to the practice requirements for PAs, and instead addresses NPs in a very limited scope of practice and home health workers. In the present version of HB 607, NPs can register to practice without physician supervision—known as “autonomous practice”—in certain circumstances. In order to be eligible, the NP must:
Additionally, the NP would need to maintain minimum levels of financial responsibility, typically through professional liability insurance.
Once registered for autonomous practice, the NP would be able to render primary care services only; the specific scope of “primary care services” may be defined in future council rules, but include family medicine, general pediatrics and general internal medicine. NPs in autonomous practice may not perform any surgical procedures, aside from subcutaneous ones. Because of these restrictions, it is unlikely that common medical spa procedures would be considered “primary care” services. Therefore, it is unlikely this law will substantially affect how NPs currently practice in medical spas.
HB 607 allows for rules to be adopted to better define the scope, so it is possible this may change in the future. The bill also creates an advanced practice registered nursing (APRN) council and adopts professional ethics for APRNs to include prohibitions on fee-splitting and patient solicitation.
There is a broad national trend for APRNs to be able to practice independently. Currently, 26 states allow for some sort of independent practice. By passing HB 607, Florida joins that group, albeit with a somewhat restricted scope of practice.