If you wish to review any of the following Public Chapters in their entirety, please visit:
Administration of Insulin (SB1445/HB1383)
Board of Nursing Extension (SB1527/HB1604)
Interstate Nurse Licensure Compact Extension (SB1545/HB1600)
Customer Focused Government (SB1629/HB1425)
Controlled Substance Monitoring Database Update (SB1630/HB1426)
Naloxone Rescue Act (SB1631/HB1427)
Professional Privilege Tax (SB1636/HB1432)
Limitations on Scheduled Prescribing (SB1663/HB1512)
Civil Immunity (SB1674/HB1928)
Anti-Meth Production Bill (SB1751/HB1574)
Nurse Depositions (SB1754/HB1556)
Nurse First Assistants (SB1768/HB1656)
Supervising Physician (SB1853/HB2171)
Infant CPR (SB1886/HB1788)
Pain Clinic Update (SB2000/HB1939)
Telehealth as Covered Practice (SB2050/HB1895)
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 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. 63-7 (Nursing).
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).
This law enacts the interstate nurse licensure compact that allows for the mutual recognition of nurses licensed by participating states. The compact sets up a model for nurse licensure that is similar in many ways to the driver's license model. Under the compact, a nurse holds one license-- in the state of residence. The nurse is able to practice nursing in other states that have passed the compact under the authorization of the multistate privilege. If the nurse chooses to move his/her residence to another compact state, the nurse has 30 days to practice while the new home state license is being processed. Once the new license is issued, the original license becomes invalid.
States within the compact (party states) cooperate with each other by sharing licensure, discipline and significant investigative information with each other to protect citizens from nurses who might attempt to evade board disciplinary action by moving to another state. Nurses today frequently practice across state lines through telephone or Internet communication. When those nurses fail to obtain licensure in every state in which they practice, patients are left with no recourse through the regulatory process when violations of the practice act occur.
Until all or most states participate there will not be a financial impact on the board. The compact provides for transition issues such as allowing nurses to hold more than one license when licensed in a party state and a state that is not a party state.
Article 1 sets out the findings and purpose of the compact. Nurse licensure laws protect the public. Nurses are increasingly mobile and frequently use advanced technology to deliver patient care across state lines. A simpler licensure system promotes compliance with licensure laws and cooperation among states. The compact establishes that the nurse is accountable for the licensure law in the state in which the patient is located at the time care is rendered.
Article 2 speaks to definitions used in the compact that must be understood the same by cooperating party states.
Article 3 describes the general provisions and jurisdiction. A license issued by the home state will be mutually recognized by each party state as authorizing a multistate licensure privilege to practice in the party state. Party states may, in accordance with due process laws, limit or revoke the multistate privilege. All licensure actions must be reported promptly to the coordinated licensure information system and this information will be relayed promptly to the home state. Nurses must practice according to the licensure laws of the state where the patient is located and that practice will be subject to the jurisdiction of state licensure board and courts. Nursing practice is defined not only as patient care but also all nursing practice as defined by the state licensing board. This compact does not affect the advanced practice of registered nursing. Individuals who are not a resident of a party state shall still be able to apply for a license in a party state, but that license will not grant them the multistate privilege in other party states.
Article 4 describes the licensure process in a party state. The licensure board in a party state is required to check the coordinated licensure information system to determine if an applicant holds or has held a license in any other state and if there is disciplinary action against the license or privilege. A nurse shall hold a license in only one party state at a time that is issued by the home state. When a nurse changes residence between two party states, the nurse applies for licensure in the new home state and the former home state license is no longer valid. When moving from a non party state to a party state and obtaining licensure, the non party state licensure is not affected and will remain in force. In moving from a party state to a nonparty state, the license issued by the prior home state converts to an individual state license valid only in the former home state without the multistate privilege.
Article 5 addresses adverse actions. The licensing board of a party state is required to promptly notify the administrator of the coordinated licensure information system of any remote state actions and any significant investigative information yet to result in remote state action. The licensing board shall have the authority to complete any pending investigation on a nurse who changes residence during the course of the investigation. A remote state may take action affecting the multistate privilege. Only the home state may take action against the license. The licensing board shall give the same priority and effect to reported conduct received from a remote state as it would if the conduct occurred in the home state and shall apply its own state laws to determine action. Nothing in the compact shall override a party state's decision to allow participation in an alternative program (professional assistance) in lieu of licensure action. Party states must require nurses participating in an alternative program to not practice in any party state during the term of the contract with the alternative program without the prior authorization of the other party state.
Article 6 speaks to additional authorities invested in the party state licensing boards. If permitted by state law, the state may recover the costs of investigation and disposition of cases resulting in adverse action. The state may issue subpoenas, issue cease and desist orders and promulgate uniform rules and regulations.
Article 7 describes the coordinated licensure information system. All party states will cooperate in creating a database for all registered and licensed practical nurses that will contain the disciplinary history of each nurse. All party states will promptly report adverse actions against a nurse's license, actions against a multistate privilege, any current significant investigative information, denials of applications and the reasons for denial. Current significant investigative information will be made available only to party state licensing boards. Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing the information shall be expunged from the coordinated licensure information system.
Article 8 addresses compact administration and interchange of information. The executive director of the state licensure board or his/her designee shall be the administrator of the compact for his/her state. The compact administrator shall provide the compact administrator of each party state information to facilitate administration of the compact. Compact administrators have the authority to develop uniform rules to administer the compact that shall be adopted by the party states.
Article 9 speaks to immunity. The party states shall not be liable on account of any act or omission in good faith while engaged in the performance of their duties under this compact.
Article 10 addresses entry into force, withdrawal and amendment. The compact shall become effective when it has been enacted into law. A party state may withdraw from the compact by enacting a statute and providing six months notice of the withdrawal to the executive heads of all other party states. Withdrawal shall not affect the validity of states remaining in the compact. This compact will not invalidate or prevent a party state from any nurse licensure agreement with a non party state. The compact may be amended by the party states, but will not become effective and binding unless and until it is enacted into the laws of all party states.
Article 11 speaks to construction and severability. The provisions of the compact shall be severable if any part is declared to be contrary to the constitution of any party state or of the United States. In the event of settling disputes arising under the compact, the party state may submit the issues to an arbitration panel composed of the administrator in the home state, the compact administrator of the remote state involved and a compact administrator agreed upon by all the party states involved. The decision of the majority will be binding.
The Tennessee General Assembly enacted the Nurse Licensure Compact in 2002. As of July 1, 2008, the following states belong to this mutual recognition model of multistate nursing regulation: Arizona, Arkansas, Colorado, Delaware, Idaho, Iowa, Kentucky, Maine, Maryland, Mississippi, Nebraska, New Hampshire, New Mexico, North Carolina, North Dakota, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and Wisconsin. Nurses who reside in other compact states who hold a multistate license “have the “multistate privilege” to practice in Tennessee without the requirement for a license issued by the Tennessee Board of Nursing. The following questions and answers provide information about the Nurse Licensure Compact and how it will affect employment of nurses from other compact (party) states that have enacted the Compact.
Q: What does a ‘multistate privilege to practice’ mean?
A: Similar to the driver’s license model, this is the mechanism in the Nurse Licensure Compact that allows a nurse who is licensed in one compact state (home state) to legally practice in another compact state (remote state). It is important to understand that the Nurse Licensure Compact requires the nurse to adhere to the practice laws and rules of the state in which the client(s) receives care.
Q: Where will nurses obtain/renew their license under this mutual recognition model of licensure?
A: Nurses must meet the requirements to obtain and renew their license in their primary state of residence. Primary state of residence as defined in the Compact means “the person’s fixed permanent and principal home for legal purposes; domicile”.
Q: How will the Nurse Licensure Compact affect nurses who live in Compact states?
A: As of July 1, 2003, a nurse who resides in Tennessee and holds an unencumbered Tennessee multistate nursing license will have the ‘multistate privilege to practice’ in any of the other compact states. Likewise, a nurse who resides in and is licensed by another compact state and holds a multistate license will have the ‘multistate privilege to practice’ in Tennessee. When a nurse changes his/her primary state of residence to another compact state he/she will be required to apply for and obtain a nursing license in that state. A nurse who lives in a compact state no longer must obtain (or renew) a license in any of the other states that have enacted the Nurse Licensure Compact.
Q: Will the nurse who lives in a non-compact state and practices in Tennessee still need to have a license to practice in Tennessee?
A: Yes. Nurses who practice nursing in Tennessee but live in a non-compact state, such as California or Georgia, must continue to hold a license issued by the Tennessee Board of Nursing. The Nurse Licensure Compact will not change how they obtain or renew their Tennessee license. However, the Tennessee nursing license will be a single state license for non-compact state residents. It will not include the multistate licensure privilege to practice in other compact states. This privilege is extended only to those nurses who reside in Tennessee.
Q: How will employers verify licensure status of nurses under this mutual recognition model?
A: For nurses who holds a license issued by the Tennessee Board of Nursing, employers will continue to verify licensure status via the internet (www.tennessee.gov/health) or through our automated telephone verification system at 888-778-4123. Please note that verification via internet will include the multistate privilege to practice for those nurses who reside in Tennessee and hold an unencumbered license.
For those nurses who are licensed in another compact state and are seeking employment in Tennessee, employers are asked to access the nationally coordinated licensure information system called NURSYS. Basic licensure information as well as disciplinary history for a licensee will be provided through this system at www.nursys.com, or contact the website/office of the state of licensure.
Q: How will employers be informed of new states joining the Nurse Licensure Compact?
A: This information will be available on the website of the National Council of State Boards of Nursing (www.ncsbn.org). It is most important that employers remain informed as other states join the Compact. Please note that there may be a lag time between enactment of the Nurse Licensure Compact and implementation.
Q: How will complaints about nurses be handled within this mutual recognition model?
A: The compact authorizes the nurse licensing board of any compact state (home or remote) to investigate allegations of unsafe practice by any nurse practicing in that state. Based upon the outcome of the investigation, a remote state licensing board may deny the nurse’s multistate privilege to practice in that state. Only the nurse’s home state (state of residence) licensing board may take action against the nurse’s license. States will continue to apply the same administrative and due process procedures for imposing discipline as they have always done. However, compact states will have more timely access to information, including current significant investigative information and the disciplinary history of nurses, through the coordinated licensure information system (NURSYS). Should you have a complaint to report about a nurse practicing in Tennessee, submit it to the Health Related Boards Investigative Division (1-800-852-2187).
Q: How do I get more information about mutual recognition and the Nurse Licensure Compact?
A: The Nurse Licensure Compact and other information related to the mutual recognition of nursing regulation are available on the Board website. The National Council of State Boards of Nursing (NCSBN) website (www.ncsbn.org) lists the states that have enacted the Nurse Licensure Compact and provides in-depth information on the mutual recognition model. NCSBN may be accessed directly or through a link on the Tennessee Board of Nursing’s website. If you have specific questions about this new model of nursing regulation please contact the Board office.