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Medical Laboratory Board

Legislative Updates


Legislative Updates:Current through July 01, 2014

If you wish to review any of the following Public Chapters in their entirety, please visit:
http://www.tennessee.gov/sos/acts/index.htm.


Board Specific Updates

Public Chapter 213-Esoteric Testing Effective July 01, 2013

Public Chapter 717-Board Member Nominations Effective July 01, 2012 Continues Medical Laboratory Board until June 30, 2016 T.C.A. 4-29-237 (a)(49)

Public Chapter 952-Electronic Notices for Certain Licenses, Certifications and Registrations Effective January 01, 2013


Updates Applicable to All Boards

Public Chapter 340 -

This bill extends the interstate nurse licensure compact through June 30, 2018

Public Chapter 575 -

This act extends civil immunity to health care providers providing services at clinics that charge patients based on a sliding scale to health care providers offering services at a clinic that does not charge a patient for services.

Public Chapter 585 -

This legislation allows the Commissioner of Health to set the pharmacy formulary for medications that are issued from local health departments. It allows input from the Board of Pharmacy on the medications to be listed. This will streamline the process and allow for more prompt changes to the formulary.

Public Chapter 590 -

This legislation adds advanced practice nurses to individuals exempt from subpoena to trial. Advanced practice nurses, like physicians assistants, are still subject to subpoena to deposition.

Public Chapter 594 -

The act requires certain entities to make available information and instruction of infant CPR to at least one future parent or caregiver.

Public Chapter 602 -

This bill extends the Board of Nursing through June 30, 2018.

Public Chapter 614 -

This legislation authorizes (not mandates) LEA’s to allow school personnel trained by a registered nurse to administer insulin to a student. It requires the Tennessee Department of Health and the Tennessee Department of Education to jointly draft guidelines governing appropriate procedures for RN’s to use in training personnel, but it also requires the Board of Nursing to review the guidelines before they take effect. Training to administer glucagon and insulin shall take place annually and competencies shall be demonstrated twice a year. Registered nurses providing the training and trained personnel shall have immunity.

Public Chapter 622 -

Current law requires that, prior to writing a script for an opiate or benzodiazepine; a practitioner must check the database for their patient. This act allows that patient’s profile to be placed in their medical record, which is subject to HIPAA. This further allows the Department of Health to make available upon request aggregate, de-identified data from the CSMD.

Public Chapter 623 -

Naloxone is an opioid antagonist designed to stop the effects of an opiate related overdose. This act allows a licensed healthcare practitioner to prescribe naloxone to a person at risk of having an opiate related overdose, or a family member or friend of the at-risk individual. It further requires training in administration of naloxone prior to the drug being prescribed. Civil immunity is provided for both the prescribing practitioner and the individual administering naloxone.

Public Chapter 638 -

This act allows optometrists to use local anesthetics in conjunction with the primary care of an eyelid lesion. It requires optometrists to follow board promulgated rules governing the care of eyelid lesions and they must be CPR certified and show proof of certification to the board in order to use such anesthesia. It further prohibits reconstructive surgery from being performed.

Public Chapter 651 -

The act allows Quality Improvement Committees (QIC’s) to share information with their counterparts and keeps this information confidential, privileged and protected from subpoena, discovery or trial evidence. It removes liability surrounding those who give information to QIC’s and removes liability solely on actions taken by the QIC.

Public Chapter 675 -

The act allows telehealth providers to contract with insurance companies to have their services covered in offered plans. Insurance providers cannot deny payment solely because the encounter was not in person.

Public Chapter 700 -

The act defines chronic non-malignant pain treatment as “prescribing or dispensing opioids, benzodiazepines, barbiturates or carisoprodol for ninety (90) days or more in a twelve (12) month period for pain unrelated to cancer or palliative care.” A pain clinic has been redefined in statute.

Public Chapter 763 -

This act revises delinquent privilege tax provisions that would require the Department of Revenue to notify the licensee that failure to cure the delinquency or deficiency prior to their licensure renewal date can result in renewal abeyance. For purposes of the bill, “cure” means payment in full, entering into an agreed payment plan, or abatement of tax liability. Licensing boards will be provided monthly with list of licensees who are delinquent 90 days or more and boards may not process licensure renewal.

Public Chapter 791 -

This act creates a pilot program where three drug courts will have the ability to retrieve data from the controlled substance monitoring database. The pilot programs will be in rural, semi-urban, and urban counties and the retrieval process will mirror the current manner in which law enforcement is able to access data. The drug courts must show a need for the data, as their retrieval ability is very limited in scope.

Public Chapter 809 -

This act deletes superfluous language in the existing practice act statute. It adds forensic evaluation and parent coordination to the scope of practice. Further, this bill authorizes the board to promulgate rules regarding the practice of telepsychology.

Public Chapter 820 -

This act allows for prosecution, up to a class A misdemeanor, of a woman who gives birth to a child with neonatal abstinence syndrome, if the mother was illegally using narcotics. It is an affirmative defense for the mother if she was enrolled in a recovery program prior to the birth and successfully completes the program. (link to FAQ’s for PC 820 – coming soon)

Public Chapter 828 -

This requires a pharmacy to submit a data entry error correction to the NPLEx, upon learning of a data entry error. It prohibits the NPLEx from generating a stop sale alert where quantity limit is exceeded due to data entry error for which a correction was submitted.

Public Chapter 832 -

This authorizes collaborative pharmacy practice agreements (CPPAs) and sets out the legal parameters for CPPAs involving pharmacists and health care practitioners with prescriptive authority. It prohibits a retail pharmacy from employing an individual with prescribing authority for the purpose of maintaining, establishing or entering into a collaborative practice agreement with a patient. Further, it specifies that nothing shall prevent a pharmacy or pharmacist or group of pharmacists from employing or entering into a professional contract with a physician or licensed medical practitioner for the purpose of conducting quality assurance reviews of its pharmacists that are engaged in the practice of collaborative drug therapy.

Public Chapter 842 -

This act expands the provisions for dispensing in pain clinics to allow prescribers at a pain clinic to dispense complimentary samples of non-narcotic schedule V controlled substances for up to a 14-day supply.

Public Chapter 857 -

This act defines maximum allowable cost (MAC) and maximum allowable cost list for pharmacy benefits managers (PBM) and covered entities and requires PBM to find that a drug is generally available for purchase by pharmacies in the state from a national or regional wholesaler, prior to that drug being placed on MAC list. If a drug on the MAC list no longer meets these qualifications, it must be removed from list within 5 business days after discovery. This act does not prohibit a PBM from reimbursing claims for generics at a previously determined MAC, even if a PBM reimburses brand name at contracted rate after drug is determined generally unavailable. PBM’s must make available to each pharmacy contracted with or included in their network, at the beginning of the contract and upon renewal, the following: sources used to determine MAC for drugs and devices on MAC list; every MAC for individual drugs used by PBM for patients served by that pharmacy; and, upon request, every MAC list used by that PBM for patients served by that pharmacy. PBM’s shall: update the MAC list at least every 3 business days; make updated lists available to each pharmacy contracted with or included in network, online; and, utilize updated MACs to calculate payments made to pharmacies within 5 business days. PBM’s shall define how a pharmacy may contest the MAC of a particular drug or device. Pharmacies may appeal if the MAC established is below the cost of that drug or product is generally available and/or the PBM has placed the drug on list without determining that the drug is generally available for purchase by pharmacies in the state from a national or regional wholesaler. The appeal must be filed within 7 business days of submission of initial claim for reimbursement. A PBM must make its final determination of appeal within 7 business days of PBM receiving the appeal. Any denial of appeal requires the PBM to state the reason for denial and provide national drug code of equivalent drug that is generally available for purchase at a price which is equal to or less that MAC for drug. Successful appeals require the PBM to adjust MAC of drug or device for appealing pharmacy, effective from the date the appeal was filed, and within 3 business days to apply to claims submitted by other network pharmacies for the next payment cycle. PBM’s shall make information regarding the appeals process available online. Medical products and devices are limited to those included as pharmacy benefit under the contract. Violations of this law may subject PBM’s to current penalties in law. Pharmacies shall not disclose to any third party any MAC lists or other related information it receives from a PBM except that pharmacies may share such lists and information with pharmacy services administrative organizations or similar entities which the pharmacy contracts with to provide administrative services. Organizations that receive such information from pharmacies shall not disclose the information to any third party. This act takes effect January 1, 2015 and applies to all contracts entered into or renewed on or after that date.

Public Chapter 859 -

This act transfers the collection of the nursing home assessment from the Department of Health to the Bureau of TennCare. It restructures the assessment from a per-bed tax to a per-resident-day basis, excluding Medicare patients. It creates a trust fund of the collections from nursing homes, investment earnings and penalties. Payments are due on the 15th of each month for the previous month’s assessment and are due to TennCare starting on August 15, 2014.

Public Chapter 872 -

This act requires an individual picking up prescription of a schedule II-IV opioid, benzodiazepine, zolpidem, barbiturate, or carisoprodol to show identification. The individual picking up the prescription is not required to be the person for whom the script is written for. Several exemptions apply to this law such as: it is only applicable to prescriptions longer than a 7-day period; dispenser is not required to check ID if the person is personally known by dispenser; minors or homeless individuals that do not have ID may receive prescription based upon dispenser’s personal judgment; does not apply to veterinarians; does not apply to samples dispensed by healthcare professionals. Additionally, this act does not apply to scripts written for: inpatients in a hospital; outpatients of a hospital where prescriber writes order in medical chart and order is given directly to hospital pharmacy; residents of a nursing home or assisted living facility; inpatients or residents of licensed MH facility; inpatients or residents of a DEA registered narcotic treatment program; patients in correctional facilities; mail order patients; pharmacy home delivery patients. Violations of this act are only subject to civil penalty assessed by the licensing board, which is authorized to promulgate rules to effectuate this act.

Public Chapter 898 -

This act revises the way Advanced Practice Nurse and Physicians Assistants profiles are maintained on the Consumer Right to Know Database. It does this by making the database searchable by APN, PA or physician name. It further requires notification to the Department within 30 days of any change in supervising relationship by all providers so it can be changed in the database for the public.

Public Chapter 906 -

This is the Methamphetamine Production Reduction Act. The law caps the sale/purchase of ephedrine or pseudoephedrine products at 5.76 g/month or 28.8 g/year, per person requiring prescription. The caps shall not apply with respect to a valid prescription from a practitioner authorized to prescribe. No person under the age of 18 may purchase the products except pursuant to a valid prescription from a practitioner or from a pharmacist generated prescription.

Public Chapter 909 -

The act defines cosmetic medical service as any “service that uses a biologic or synthetic material, a chemical application, a mechanical device, or a displaced energy form of any kind that alters or damages, or is capable of altering or damaging, living tissue to improve the patient’s appearance or achieve an enhanced aesthetic result”. The act further requires any business advertising as a medical spa to display the medical director or supervising physician of the practice on a sign at the practice including board certification.

Public Chapter 918 -

This legislation creates the Applied Behavior Analyst Licensing Committee under the Board of Examiners in Psychology. The committee shall consist of five members appointed by the governor, three of which shall be licensed behavior analysts, one assistant behavior analyst and one consumer member of the public. The law sets forth procedures for obtaining and maintaining licensure for behavior analysts and assistant behavior analysts. It adds the chair of the committee as an ex-officio voting member to the Board of Examiners in Psychology. Further, it sets a minimum quorum for the board at six members and also requires any board action to receive at least six alike votes.

Public Chapter 936 -

This act allows for cannabidiol to be dispensed and administered as part of clinic research trials for treatment of intractable seizures in certain hospitals. The act requires the trials to be supervised by a physician practicing at a hospital or associated clinic that are affiliated with a university with a college or school of medicine. Any physician conducting a trial must report the results to the standing health committees of the Tennessee House and Tennessee Senate as well as both the Speakers of the Senate and House by January 15, 2018.

Public Chapter 949 -

This act allows for initial licensure applications to be accepted online. Currently, renewing licenses is already available online. This also makes available to the public annual inspections of health care facilities and pharmacies, similar to how nursing home inspections are already available.

Public Chapter 953 -

This legislation adds the certification of “Registered Nurse First Assistant” to the purview of the Board of Nursing. It allows a licensed registered nurse, certified in perioperative nursing, and has completed a RNFA educational program, to apply to the board for a RNFA certificate. It authorizes the board to promulgate rules and set fees associated with RNFA certification.

Public Chapter 983 -

This is a pain clinic revision act that requires all healthcare practitioners to notify their appropriate licensing board within 10 days of starting or ending employment at a pain clinic. It prevents health care prescribers from dispensing an opioid or benzodiazepine except under certain conditions. Requires all opioids and benzodiazepine’s not falling under the exemptions to be returned to a reverse distributor or to local law enforcement by Jan. 11, 2015. The act requires pharmacy wholesalers to notify the Board of Pharmacy and other prescribing boards when suspicious orders (unusual size, deviations from normal pattern, and unusual frequency) are discovered. Wholesalers must report a theft or significant loss of controlled substances to the Controlled Substance Monitoring Committee and local law enforcement within one business day of discovery.

Public Chapter 1011 -

The act requires submissions to the Controlled Substance Monitoring Database be made at the close of each business day for all controlled substances dispensed the prior business day. The act does provide good faith effort exemption and gives the Board of Pharmacy the ability to make rules implementing this exemption. This act does not go into effect until January 1, 2016. Veterinary Medical Examiners are exempt from this provision.


Statutes and Rules

Statutes

Statutes are proposed and made law by the Tennessee State General Assembly (Legislature). The Board, following specific notice requirements and hearings, adopts rules. Both have the force of law and may be used in the regulation of a profession. The statutes pertaining to this Board are found at
T.C.A. 63-1 (Division of Health Related Boards) and T.C.A. 68-29 (Medical Laboratories).

Click here to review the Tennessee Code Annotated. (This link will take you to a website that is not maintained by the Tennessee Department of Health).

 

 

Rules

Click here for Rules and Regulations pertaining to the Tennessee Medical Laboratory Board