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Florida’s “Live Healthy” Initiative Provides Foreign Trained Physicians a Path to Licensure

Florida Senate Bill 7016

In early 2024, the Florida Senate passed Senate Bill 7016 in an effort to expand the residents’ access to healthcare as the state’s population continues to grow. The law attempts to increase the number of doctors in the state through ways such as expanding medical residency programs in Florida and establishing ways to retain Florida medical students leading into their years of practicing.

According to the bill, part of the solution to retaining Florida medical students is removing certain barriers for foreign-trained physicians to practice in Florida. The Association of American Medical Colleges notes that one of the difficulties Florida medical students face when attempting to secure a residency in Florida is competition from overseas medical schools that pay to place their students in Florida clinicals.

Additionally, foreign-trained physicians must bear the burden of completing another residency in Florida before they are qualified to practice, despite already having a license elsewhere. With the bill, removing the barriers is meant to benefit Florida medical students and foreign-trained physicians alike.

Changes Under the New Law

Under the previous law, foreign-trained physicians were subjected to a residency requirement which was typically set for a minimum of one year. Under the new law, foreign-trained physicians are exempt from the previous residency requirement, barring that they qualify for the new criteria set forth under the law.

Section 458.311(8)(e) of the bill is amended to state that graduates of a foreign medical school who have not completed residency may bypass the requirement by meeting the following criteria:

  1. Has an active, unencumbered license to practice medicine in a foreign country; 2.
  2. Has actively practiced medicine during the entire 4-year period preceding the date of the submission of a licensure application;
  3.  Has completed a residency or substantially similar postgraduate medical training in a country recognized by his or her licensing jurisdiction which is substantially similar to a residency program accredited by the Accreditation Council for Graduate Medical Education, as determined by the board;
  4. Has had his or her medical credentials evaluated by the Educational Commission for Foreign Medical Graduates, holds an active, valid certificate issued by that commission, and has passed the examination used by that commission; and
  5. Has an offer for full-time employment as a physician from a health care provider that operates in this state. For the purposes of this paragraph, the term “health care provider” means a health care professional, health care facility, or entity licensed or certified to provide health services in this state as recognized by the board.

In addition to the barriers removed for foreign-trained physicians during the residency process, the bill has also removed some challenges that foreign-trained physicians may face in the hiring process of Florida medical schools. The bill removes statutory limits that were placed on hiring experienced foreign-trained physicians for the medical school’s faculty.

Further, the Board of Medicine may certify the licensure of a foreign-trained physician who has held an active medical faculty certificate and has taught at a Florida medical school full-time for at least three consecutive years.

Future Impacts

With the residency requirement removed for qualified foreign-trained physicians and the ability to receive licensure through teaching, there may be quite a few individuals who want to use the opportunity to become a licensed physician in Florida. As of May, of this year, the law is expected to benefit over 30,000 Cuban physicians and other foreign-trained healthcare professionals who can qualify under the new requirements. Although the law was only passed early this year, it is possible that it may have a significant impact on the status of our healthcare system for years to come.

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It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services, please contact me using the contact information listed above.

All information and references made to laws, rules, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.

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

Overview of the Ban

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 final rule’s effective date is 120 days after publication in the Federal Registrar. To conform to the final rule, employers will have to provide notice to workers who are bound to existing non-compete agreements, that their non-compete agreement will not be enforced against them in the future. As a guide, the FTC has provided model language that employers may use to communicate the change to employees.

Although existing non-compete agreements will not be enforceable after the effective date, there is an exception for senior executives. Senior executives’ existing non-compete agreements will remain in force but the ban against any new non-compete agreements will still apply. The role of a senior executive applies to any worker who was in a policy-making position and received a compensation of more than $151,164 annually.

Who Does the Rule Apply to?

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. 

Generally, the rule will not affect employment agreements entered into by nonprofit organization employees because the FTC’s authority only extends to for-profit businesses. However, the FTC stated that both judicial decisions and FTC precedent recognize that not all entities claiming tax-exempt status as nonprofits fall outside the Commission’s jurisdiction.

To determine whether a corporation is organized for profit and therefore within the FTC’s jurisdiction, a two-part test is applied. The FTC explains that “[t]he not-for-profit jurisdictional exemption under Section 4 requires both that there be an adequate nexus between an organization’s activities and its alleged public purposes and that its net proceeds be properly devoted to recognized public, rather than private, interests.” Any entity that satisfies the two-prong test falls within the FTC’s jurisdiction and is thus bound by the final rule.

Challenges to the Ruling

Following the enforcement of the rule is expected to have significant impacts on employers who use non-compete agreements to protect certain interests of the company. The FTC has stated that employers may use alternatives to protect their company investments without having to enforce a non-compete agreement. The FTC provides the use of trade secret laws and non-disclosure agreements as a feasible alternative to protect sensitive information. The FTC also encourages employers to improve wages and working conditions to retain employees rather than non-compete agreements.

While some medical organizations have favored the ban of non-compete agreements, stating they are exploitative for professions such as physicians who require state licenses, credentials, and insurance, making relocation even more difficult, other organizations have been opposed to the ban.

The American Hospital Association released a press statement vehemently opposing the ban stating the rule is “bad law, bad policy, and a clear sign of an agency run amok.” The Federation of American Hospitals CEO also joined the discontent with the rule stating that the ban will make it more difficult to recruit and retain caregivers to care for patients and create an anti-competitive and unlevel playing field between tax-paying and tax-exempt hospitals.

As of now, there is uncertainty about whether the rule will survive the legal challenges that are sure to come. The U.S. Chamber of Commerce president and CEO, Suzanne P. Clark, has issued a statement explaining that the Chamber will sue the FTC to block the rule which she describes as a blatant power grab that will undermine American businesses’ ability to remain competitive.

Conclusion

Although the future of the FTC’s ruling is still up in the air amid legal challenges, the effective date for the ban of non-compete agreements is set for 120 days after publication in the Federal Registrar.

The rule will affect all new non-compete agreements and most existing non-compete agreements. Employees who are working in non-profit organizations may advise an attorney as to whether the two-prong test would satisfy the FTC’s jurisdiction or not. 

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It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services, please contact me using the contact information listed above.

All information and references made to laws, rules, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.

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

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.

General Licensing Requirements

Although consumers may buy and use hemp-based products within the legalized concentration range without a license, those who wish to grow, sell, and distribute hemp-based products have obligations before they can legally do so. The licensing requirements are regulated under § 581.217 of the state hemp program within the Florida Department of Agricultural and Consumer Services (FDACS).

Hemp Cultivation

Any person who seeks to cultivate hemp must apply to the FDACS for a license and submit fingerprints along with the form. After obtaining the license, the licensee has multiple obligations including but not limited to 1) complying with the licensee’s environmental containment plan, 2) complying with the Hemp Waste Disposal Manual, 3) only cultivating on lands that are primarily for bona fide agricultural purposes, and 4) posting signage at every cultivation access point with the department issued license number and cultivation location. Further requirements are outlined in 5B-57.014(5).

Home growing is generally not permitted, with exceptions to a small number of registered nurseries on residential properties.

Distribution and Retail Sale of Hemp Extract

Food establishments that prepare and/or sell prepacked food containing hemp extract must have a hemp food establishment permit from the Division of Food Safety within the FDACS. Establishments that manufacture, process, pack, hold, or prepare food containing hemp extract intended for human ingestion must also have a hemp food establishment permit from the Division of Food Safety within the FDACS.

The distribution and retail sale of hemp extract in the state is authorized according to § 581.217(7) if the product:

  1. Has a certificate of analysis prepared by an independent testing laboratory that states:
    1. The hemp extract is the product of a batch tested by the independent testing laboratory;
    2. The batch contained a total delta-9-tetrahydrocannabinol concentration that did not exceed 0.3 percent pursuant to the testing of a random sample of the batch;
    3. The batch does not contain contaminants unsafe for human consumption; and
    4. The batch was processed in a facility that holds a current and valid permit issued by a human health or food safety regulatory entity with authority over the facility, and that facility meets the human health or food safety sanitization requirements of the regulatory entity. Such compliance must be documented by a report from the regulatory entity confirming that the facility meets such requirements.
  2. Is distributed or sold in a container that includes:
    1. A scannable barcode or quick response code linked to the certificate of analysis of the hemp extract batch by an independent testing laboratory;
    2. The batch number;
    3. The Internet address of a website where batch information may be obtained;
    4. The expiration date; and
    5. The number of milligrams of each marketed cannabinoid per serving.
  3. Is distributed or sold in a container that:
    1. Is suitable to contain products for human consumption;
    2. Is composed of materials designed to minimize exposure to light;
    3. Mitigates exposure to high temperatures;
    4. Is not attractive to children; and
    5. Is compliant with the United States Poison Prevention Packaging Act of 1970, 15 U.S.C. ss. 1471 et seq., without regard to provided exemptions.

The statute defines hemp extract as a substance or compound containing more than a trace amount of a cannabinoid intended for ingestion, or a substance deriving from or containing hemp meant for inhalation. This does not include synthetic cannabidiol or seeds/seed-derived ingredients that are generally recognized as safe by the U.S. Food and Drug Administration (FDA).

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.

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It should be noted that I am not your lawyer (unless you have presently retained my services through a retainer agreement). This post is not intended as legal advice, it is purely educational and informational, and no attorney-client relationship shall result after reading it. Please consult your own attorney for legal advice. If you do not have one and would like to retain my legal services, please contact me using the contact information listed above.

All information and references made to laws, rules, regulations, and advisory opinions were accurate based on the law as it existed at this time, but laws are constantly evolving. Please contact me to be sure that the law which will govern your business is current. Thank you.