Noteworthy Health-Related Legislation

·         The Department of Health’s administration bill successfully extended current opioid prescription protections that were put into place in 2018 under the Tennessee Together Act.

·         The Department of Health was extended to June 30, 2027, following an audit and subsequent sunset hearings.

·         Multiple boards administratively attached to the Department of Health were extended by the legislature following audits and subsequent sunset hearings.

Non-Health Related Legislative Activity of Note

·         June 19th is now designated as a state holiday for Juneteenth.

·         State employees are authorized to use sick leave from a sick leave bank to care for a sick minor child of the employee.

·         State employees must be provided six paid weeks of leave for the birth of the employee’s child or because of the employee’s adoption of a child.

·         “Send Me” is now an additional state motto.

·         The legislature passed an extensive transportation modernization act.

·         The legislature passed a teacher paycheck protection act that, among other things, raises the minimum teacher salary to $50,000 by 2026.

·         Law enforcement officers and the district attorney general’s office may extend criminal immunity to persons who are experiencing a drug overdose and who are seeking medical assistance.

Pertinent Public Chapters

*All Public Chapters are hyperlinked to the actual document on the Secretary of State’s website.

Public Chapter No. 1—SB1/HB1—Johnson/Lamberth

This law prohibits a healthcare provider from knowingly performing or offering to perform on a minor, or administer or offer to administer to a minor, a medical procedure if the performance or administration of the procedure is for the purpose of enabling a minor to identify with or live as an identity inconsistent with the minor’s sex. This bill does not prohibit such medical procedure if the performance or administration is to treat a minor’s congenital defect, precocious puberty, disease, or physical injury or the medical procedure began prior to the effective date of this act and concludes on or before March 31, 2024. This law also prohibits a person from knowingly providing a

hormone or puberty blocker by any means to a minor if the provision of the hormone or puberty blocker is not in compliance with this bill. This bill is effective on July 1, 2023.

Public Chapter No. 2—SB3/HB9—Johnson/Todd

This law creates a Class A misdemeanor offense for a person to perform adult cabaret entertainment on public property or in a location where the adult cabaret entertainment could be viewed by a person who is not an adult. Subsequent offenses are Class E felonies. This bill was effective on April 1, 2023.

Public Chapter No. 9—SB51/HB217—Roberts/Ragan

This law extends the professional art therapist advisory committee to June 30, 2024.

Public Chapter No. 10—SB52/HB218—Roberts/Ragan

This law extends the Psychology Interjurisdictional Compact Act to June 30, 2031.

Public Chapter No. 24—SB248/HB66—Johnson/Lamberth

This law authorized the Department of Intellectual and Development Disabilities to provide home health services to outpatients through its administration of the Tennessee Early Intervention System and the home and community-based services provided through such system. This bill was effective on March 10, 2023. This law was a DIDD legislative initiative.

Public Chapter No. 29—SB36/HB202—Roberts/Ragan

This law extends the Controlled Substance Database Committee to June 30, 2027.

Public Chapter No. 31—SB33/HB199—Roberts/Ragan This law extends the Board of Nursing to June 30, 2027.

Public Chapter No. 32—SB34/HB200—Roberts/Ragan This law extends the Board of Pharmacy to June 30, 2027.

Public Chapter No. 33—SB48/HB214—Roberts/Ragan

This law extends the Medical Cannabis Commission to June 30, 2027.

Public Chapter No. 36—SB23/HB17—Massey/Faison

This law designates the month of May as “Silver Alert Awareness Month.” This bill was effective on March 14, 2023.

Public Chapter No. 41—SB256/HB75—Johnson/Lamberth

This law allows law enforcement or the district attorney general’s office to extend criminal immunity from being arrested, charged, or prosecuted to persons who are experiencing a subsequent drug overdose. This bill takes effect on July 1, 2023. This was a Department of Mental Health and Substance Abuse’s legislative initiative.

Public Chapter No. 42—SB266/HB314—Johnson/Lamberth

This law makes changes regarding assignment of benefits to a healthcare provider and the collection of out-of-network charges by healthcare facilities, by removing existing notification requirements and duplicative language within code to adhere to the federal No Surprises Act. This law was effective on March 14, 2023. This was a Department of Commerce and Insurance legislative initiative.

Public Chapter No. 46—SB583/HB339—Pody/Raper

This law allows former municipal judges to solemnize marriages. This law was effective on March 14, 2023.

Public Chapter No. 48—SB11/HB2—Johnson/Zachary

This law extends certain provisions within the code regarding Covid-19 established during the 2021 Special Session. This bill was effective on March 21, 2023.

Public Chapter No. 49—SB94/HB50—Johnson/Lamberth

This law codifies the Acts of the 2022 legislative session. This law was effective on March 21, 2023.

Public Chapter No. 50—SB103/HB611—Gardenhire/Hawk

This law makes it a Class A misdemeanor for a state employee to knowingly violate and willfully fail to remedy a violation of the Tennessee State Employees Uniform Nepotism Act of 1980. This bill also creates a rebuttable presumption that a willful failure or refusal to remove or remedy a violation constitutes an actionable basis to institute ouster proceedings, impeachment proceedings, or quo warranto proceedings. This law will be effective on July 1, 2024.

Public Chapter No. 51—SB0246/HB0064—Johnson/Lamberth

This law amends time requirements set out in current law related to the distribution of funds from the Temporary Assistance for Needy Families Program. Specifically, this law extended dates for the report submission deadline, the pilot programs, the implementation of grants, and the obligation of funds. This law was effective on March 21, 2023. This was a Department of Human Services legislative initiative.

Public Chapter No. 55—SB680/HB895—Reeves/Hurt

This law clarifies that the Medical Assistance Act of 1968 does not require a vendor, healthcare provider, or telehealth provider group that provides healthcare services exclusively via telehealth to have a physical address or site in this state in order to eb eligible to enroll as a vendor, provider, or provider group for that program. This law defines telehealth provider as two or more healthcare providers that share a common employer and provide healthcare services exclusively via telehealth. This law was effective on March 21, 2023.

Public Chapter No. 62—SB486/HB39—Stevens/Bulso

This law states that recoverable costs on appeal include the cost of preparing and transmitting the record, the cost of a transcript of the evidence or proceedings, the cost of producing necessary copies of briefs and the record, premium paid for bonds to preserve the rights pending appeal and costs incurred to obtain such bonds pending appeal, litigation taxes, and other fees of the appellate court or clerk. This law was effective on March 23, 2023.

Public Chapter No. 66.—SB1202/HB808—Rose/Howell

This law clarifies that “nontraditional childcare agency” does not include a person or entity that places children in family boarding homes or foster homes. This law was effective March 23, 2023.

Public Chapter No. 70—SB29/HB195—Roberts/Ragan

This law extends the Board for Professional Counselors, Marital and Family Therapists, and Clinical Pastoral Therapists to June 30, 2027.

Public Chapter No. 71—SB32/HB198—Roberts/Ragan

This law extends the Board of Medical Examiners to June 30, 2027.

Public Chapter No. 79—SB63/HB229—Roberts/Ragan

This law extends the Opioid Abatement council to June 30, 2025.

Public Chapter No. 88—SB334/HB704—Jackson/Doggett

This law authorizes the Tennessee Bureau of Investigation the create new divisions outside of the investigation division, the forensic services division, and the narcotics division. This law also expands the duties of the Medicaid fraud control unit of to investigate and refer for prosecution violations of laws pertaining to misappropriations of funds or property and complaints of abuse, neglect, and financial exploitation of Medicaid recipients. This law was effective eon March 31, 2023.

Public Chapter No. 90—SB450/HB167—Lowe/Butler

This law creates a Class A misdemeanor to sell or distribute tattoo paraphernalia to a person under eighteen or to purchase tattoo paraphernalia on behalf of a person under eighteen. This law also prohibits a person under eighteen from purchasing or accepting receipt of tattoo paraphernalia or from presenting or offering a person purported proof of age that is false, fraudulent, or not that person’s own to purchase such products. This law will be effective on July 1, 2023.

Public Chapter No. 91—SB454/HB609—Watson/Hawk

This law authorizes family leave insurance to be written as an amendment or rider to a group disability income policy or life insurance policy, included in a group disability income police or life insurance policy or a separate group policy purchased by an

employer. Under this law, family leave insurance means an insurance policy issued to an employer related to a benefit program provided to an employee to pay for a percentage or portion of the employee’s income loss due to the birth or adoption of a child by the employee, placement of a child with the employee for foster care, care of a family member of the employee who has a serious health condition, or status of family member of the employee who is a service member on active duty or has been notified of impending duty. This law will be effective on January 1, 2024.

Public Chapter No. 94—SB679/HB803—Reeves/Marsh

This law authorizes certified medical assistants, pursuant to a physician’s or nurses’ delegation, to administer or prepare only medications that have been ordered by authorized healthcare provider and that are consistent with policies and procedures of the applicable licensed facility. This law also amends the current list of authorized medications by requiring intramuscular or subcutaneous medications to continue to be in a single dose and adds rectal medications and medications prepared by the certified medical assistant for administration by the provider. This law also prohibits certified medical assistants from preparing the current list of drugs prohibited from delegation by a physician or nurse. This law was effective on March 31, 2023.

Public Chapter No. 99—SB925/HB1429—Lundberg/Hicks

This law removes the requirement that a provider of home medical equipment services that has a principal placed of business outside this state maintain an office or place of business within this state. This law also requires the board for licensing health care facilities to promulgate rules to identifying contacts for state surveyors and state surveys. This law was effective on March 31, 2023.

Public Chapter No. 101—SB984/HB893—Yager/Reedy

This law extends TennCare’s ground ambulance service annual assessment to June 30, 2024, and makes certain changes to the requirements for the assessment. This law will be effective on July 1, 2024.

Public Chapter No.103—SB1225/HB0556—White/Littleton

This law requires that court clerks notify the health facilities commission, instead of the department of health, when an offender is placed on the registry of persons who have been determined to have abused, neglected, misappropriated, or exploited the property of vulnerable individuals. This law also requires that notice must be provided within 90 days of conviction of the offense. This law became effective on March 31, 2021.

Public Chapter No.107—SB72/HB1195—Watson/Williams

This law authorizes nurse practitioners and physician assistants to refer individuals, either orally or in writing, for physical therapy. This law also removes certain minimum education requirements to engage in the independent practice of physical therapy and allows physical therapists to treat patients without a referral from a physician under

certain circumstances. This bill clarifies the definition of “notified” for purposes of treating a patient without a referral. This act became effective on April 4, 2023.

Public Chapter No.114—SB255/HB74—Johnson/Lamberth

This law changes the terms "general education development credential," "high school equivalency test," and variations of the terms to "high school equivalency credential” as referenced throughout the code. This law also replaces any references in code from GED(R) or HiSET(R) classes, coursework, testing, or services with the phrase “adult education programming to include preparation and testing toward obtaining a high school equivalency credential” throughout the code. This law is effective on July 1, 2023.This was a Department of Labor and Workforce Development legislative initiative.

Public Chapter No.123—SB614/HB1313—Briggs/Kumar

This law requires hospitals that have a certification from a department-approved, nationally recognized certifying body that recognizes the hospital as capable of providing neuroendovascular treatment to report quarterly data that is consistent with nationally recognized stroke consensus measures on the treatment of individuals with confirmed stroke to the East Tennessee State University College of Public Health. This law was effective on April 4, 2023.

Public Chapter No.125—SB701/HB729—Crowe/Hulsey

This law clarifies the emergency medical backup requirement for speech language pathologists using endoscopes so that the procedure may be performed when a physician is on the premises or is remotely available regardless of whether the procedure is performed in a community or institutional setting. This act takes effect July 1, 2023.

Public Chapter No.150—SB523/HB495— Jackson/Martin

This bill enacts the "Topical Medical Waste Reduction Act of 2023," which allows facilities, defined as a hospital operating room, hospital emergency room department, or ambulatory surgical treatment center, to offer a patient an unused portion of certain medications required for continuing treatment upon discharge when the medication was ordered at least 24 hours in advance for surgical procedures and is administered to the patient at the facility. If a medication is used in an operating room or emergency department setting, then the prescriber shall counsel the patient on a medications proper use and administration, and the requirement of pharmacist counseling is waived. This law was effective on April 13, 2023.

Public Chapter No.156—SB40/HB206—Roberts/Ragan

This law extends the Department of Health to June 30, 2027. This law was effective on April 17, 2023.

Public Chapter No.157—SB86HB734—Walley/Rudd

This law clarifies that a person requesting public records is not entitled to special or expedited access to those records based on their occupation or association with a profession. This law was effective on April 17, 2023.

Public Chapter No.162—SB401/HB901—Massey/Zachary

This law permanently reenacts the "Proton Therapy Access Act," which was repealed on January 1, 2023. This law requires that state group insurance programs to cover a physician prescribed hypofractionated proton therapy protocol to deliver a biological effective dose by paying the same aggregate amount as would be paid for the delivery of the same biological effective dose with a standard radiation therapy treatment protocol delivered with IMRT for the same indication if certain conditions are satisfied. This law was effective on April 17, 2023, and applies to policies and contracts for insurance executed, renewed, modified, or amended on and after such date.

Public Chapter No. 168—SB600/HB90—Hensley/Moody

This law prohibits counties, municipalities, and metropolitan governments from expending funds for the purpose of assisting a person in obtaining a criminal abortion. This prohibition includes using funds as part of a health benefit plan or for travel to another state for the purpose of obtaining an abortion. This law was effective on April 17, 2023.

Public Chapter No. 173—SB953/HB690—Walley/Martin

This law creates authorizes the Board of Psychology to designate a person who has held a valid license or certificate in another state to practice psychology for at least 10 years within the last 15 years as a “health services provider” if the previous license and certification (1) required training that is generally equivalent to certain licensing standards, (2) has never been the subject of disciplinary action, and (3) allowed the licensee to engage in practice as a health services provider in psychology in the other state. This law authorizes the Board of Psychology to pursue emergency rules during the rule-making process. For the purpose of promulgating rules, this law was effective on April 17, 2023. For all other purposes, this law takes effect January 1, 2024.

Public Chapter No. 188—SB277/HB325—Johnson/Lamberth

This law extends legislation enacted in 2018 to preserve opioid prescription limitations for acute care. In addition, this law exempts individuals who had recent cancer treatment from this prescription limitation. “Recent cancer treatment” is defined as six months following the end of an active cancer treatment. This law creates an exception for informed consent where a healthcare practitioner who issued the initial prescription does not have to obtain and document informed consent, if the subsequent prescription is for the same opioid and for the same episode of treatment. Outside of this exception, informed consent must be updated periodically. This law also requires the Commissioner of the Department of Health to provide a letter, in consultation with the health-related boards, no to certain elected officials that includes information on the

impact and the effects of this legislation in each even-numbered year. This law was effective on April 24, 2023. This law was a Department of Health legislative initiative.

Public Chapter 190—SB350/HB294—Campbell/Freeman

This law creates the “Save Tennessee Students Act” and requires public institutions of higher education to include, among other thing, the telephone number of the suicide and crisis lifeline on student identification cards for students enrolled in the institution. This law takes effect July 1, 2023.

Public Chapter No. 194—SB451/HB165—Lowe/Butler

This law authorizes employees of a public accommodation to ask for certain information about a guide dog in training. A person who utilizes a guide dog is subject to the same liability for damages as a person whose pet causes damage to a place of public accommodation. Fraudulently representing that an animal is a service animal or service animal in training to an employee of a public accommodation is a Class B misdemeanor. A misrepresentation of service animal is a Class B misdemeanor and requires 100 community service hours to be served. This law is effective on July 1, 2023.

Public Chapter No. 196—SB560/HB584—Walley/Grant

This law allows an out of state hospital or an affiliated entity to employ emergency physicians to treat patients at a satellite emergency department, a primary care clinic, or an urgent care clinic, if they are located in this state and owned or controlled by the hospital or affiliated entity. The hospitals must meet certain qualifications and the physicians must be licensed in Tennessee. This law is limited to counties that have a population of less than 27,000 according to the 2020 federal census. This law takes effect July 1, 2023.

Public Chapter No. 199—SB672/HB1051—Reeves/Vaughan

This law authorizes a qualified advance practitioner to issue a certificate of need in support of hospitalization for emergency diagnosis, evaluation, and treatment. A qualified advance practitioner is an individual working in collaboration with a licensed physician and who is a nationally certified psychiatric-mental health advanced practice nurse or physician assistant with additional qualifications in psychiatry. The admitting hospital or treatment resource may rescind the certificate of need if a licensed physician or other qualified professional in examining the patient determines that the patient no longer meets admission criteria. Additionally, this law authorizes a licensed physician who is a board-certified psychiatrist to execute a certificate of need in support of hospitalization for a patient’s admission without a second certificate of need in support of hospitalization. This law takes effect July 1, 2023.

Public Chapter No. 200—SB675/HB667—Reeves/Hicks

This law re-writes the prescription drug donation repository program act. This law creates prescription drug donation repository program where pharmacies may donate prescription drugs that meet certain qualifications. Donation and facilitation of a donation

are not considered wholesale distribution, and a person donating or facilitating a donation does not require licensure as a wholesaler. Drugs will be dispensed based on a property system where indigent persons, a person whose income is below 600% of the federal poverty level, are the first to receive them. This law does not authorize the resale of prescription drugs. This law takes effect January 1, 2024.

Public Chapter No. 201—SB721/HB498—Massey/Martin

This law exempts a patient who is receiving an initial behavioral health evaluation or assessment from the requirement from an in-person encounter between the health care service provider, the healthcare services provider's practice group, or the healthcare system and the patient to be within sixteen months prior to the interactive visit. This law also authorizes a physician assistant who is authorized to prescribe drugs and who provides services solely via telehealth to arrange for chart review by a collaborating physician via HIAA-compliant electronic means. This law was effective on April 24, 2023.

Public Chapter No. 203—SB799/HB859—Yarbro/Jernigan

This law authorizes the Department of Health to disclose de-identified data that is collected from EMS run reports for the purpose of providing opioid overdose response and resources throughout this state. This law was effective on April 24, 2023.

Public Chapter No. 211—SB1451/HB1312—Roberts/Kumar

This law authorizes the Board of Medical Examiners to issue temporary license for two years to international medical school graduates who meet certain criteria. An international medical school graduate must only provide medical services at a healthcare provider that has in place a post-graduate training program accredited by the accreditation council for graduate medical education. The Board must grant a full and unrestricted license to practice medicine to a temporary licensee who is in good standing two years after the date of temporary licensure. The Board of Medical Examiners will need to promulgate rules for this public chapter. For the purpose of promulgating rules, this rule was effective on April 24, 2023. For all other purposes, this law takes effect July 1, 2024.

Public Chapter No. 216—SB276/HB324—Johnson/Lamberth

This law makes various changes to current law pertaining to leave for state employees. Among other things, this law allows an eligible employee to be granted absence from work with pay for a period of time equal to six workweeks because of the birth of the employee’s child or because of the placement of a child with the employee for adoption. This law is effective on July 1, 2023, and applies to eligible employees who qualify for leave on or after July 1, 2023. This was one of Governor Lee’s legislative initiatives.

Public Chapter No. 221—SB678/HB1194— Reeves/Williams

This law makes changes to the Alzheimer's and dementia respite care program. These changes include adding a new definition for “respite care” to mean temporary, substitute support or living arrangements to provide a brief period of relief or rest for informal

caregivers. This law also adds new requirements for which the program must comply. This law was effective on April 25th, 2023.

Public Chapter No. 244—SB1392/HB1213—McNally/Sexton

This law makes changes to the “Tennessee Right to Shop Act” and changes the structure of certain insurance incentives and out of pocket payments. This law takes effect July 1, 2023.

Public Chapter 246—SB1294/HB1309—Kumar/Bailey

This law prohibits a life insurance provider from canceling a life insurance policy based on genetic information, from requesting or requiring genetic testing as a condition of insurability, and from accessing the genetic data of an individual without consent. This law is ultimately effective on January 1, 2024.

Public Chapter No. 252—SB221/HB273—Roberts/Terry

This law requires the division of health-related boards to consult with the Board of Medical Examiners in the hiring of a medical consultant. This law also gives the medical consultant authority to consult on various issues and to work with the board’s attorney on certain portions of the complaint and settlement process. Additionally, the division must provide biannual surveys to the Board for its feedback and review of the consultant. This law authorizes the Board to promulgate rules to effectuate this process. This law was effective on April 28, 2023.

Public Chapter No. 254—SB267/HB315—Johnson/Lamberth

This makes changes to the allowable number of beds in private for-profit and private not-for-private intermediate care facilities for individuals with intellectual disabilities. This law takes was effective on April 28, 2023. This was a Department of Intellectual and Development Disabilities legislative initiative.

Public Chapter No. 256—SB292/HB275—Briggs/Hazlewood

This law makes expands the needle exchange program statewide. Specifically, this law prohibits a needle exchange program from conducting an exchange within 1,000 feet of a school or public park. If a program established pursuant to this section is in a municipality that has a population of no less than 55,440 nor more than 55,450 according to the 2020 federal census or a subsequent federal census, then it shall not conduct an exchange within 2,000 feet of a school or public park. This law takes effect July 1, 2023.

Public Chapter No. 258—SB329/HB514—Haile/Terry

This law requires one of the members appointed by the Governor to the Tennessee Medical Cannabis Commission to be a patient who has been diagnosed with a qualifying medical disease or condition and who can establish the diagnosis for purposes of appointment to and service on the commission with a valid letter of attestation. For purposes of an appointment for a term that begins on July 1, 2023, this law takes effect on April 28, 2023. For all other purposes, this law takes effect July 1, 2023.

Public Chapter No. 265—SB669/HB0981—Reeves/Faison

This law vacates and reconstitutes the Tennessee Emergency Medical Services Board, as of July 1, 2023. This law staggers the initial terms of appointment so that a portion of new members must be appointed in each year for the next four years. Members serving on the Board as of June 30, 2023, may be reappointed to the new Board. After the initial round of appointments, the terms of appointment expand to four years. Additionally, this law also makes various changes to the qualifications for candidates being considered as an appointment for the Board. For purposes of promulgating rules and carrying out administrative duties, this law was effective on April 28, 2023. For all other purposes, this law takes effect on June 30, 2023.

Public Chapter No. 270—SB859/HB982—Reeves/Terry

This law protects a person's statement regarding the use or possession of marijuana to a healthcare provider through the course of a person's medical care for the purpose of obtaining medical advice on the adverse effects of marijuana with other medications or medical treatments. Under this law, such statement is not admissible as evidence in a criminal proceeding in which the person is a defendant unless a person expressly waives this prohibition and requests that the statement be admitted as evidence. This law was effective on April 28, 2023.

Public Chapter No. 285—SB1237/HB306—Hensley/Bulso

This law requires, in connection with an interscholastic athletic activity or event where membership in the TSSAA (Tennessee Secondary Athletic Association) is required, a student enrolled in a private school in this state to participate in an athletic activity or event only in accordance with the student’s sex as defined in code. This does not prohibit a student whose sex is female from participating on a team designated for male students if the school does not offer a separate team for female students in that sport. This law was effective on April 28, 2023.

Public Chapter No. 296—SB644/HB252—Hensley/Barrett

This law removes the requirement that a parent-teacher of a home school student provide proof of the student's immunizations and receipt of health services or examinations required by law generally for children in this state to the local education agency. Under this law, if a home school student participates in an LEA-sponsored interscholastic activity or event or an LEA-sponsored extracurricular activity, then the LEA may request and receive proof that the school received a health service or examination that is required for the LEA’s students to participate in the activity or event. This law was effective on April 28, 2023

Public Chapter No. 300—SB551/HB448—Lowe/Davis

This law requires governmental entities to provide a period of public comment for public meetings but authorizes the governmental entities to place reasonable restrictions on the period for public comment. This does not apply to a meeting of a governing body, or a portion thereof, where the governing body is conducting a disciplinary hearing or a

meeting for which there are no actionable items on the agenda. This takes effect July 1, 2023.

Public Chapter No. 306—SB924/HB577—Rose/Parkinson

This law adds as an enhancement factor that can be considered during sentencing if a defendant has been convicted of aggravated assault or attempted first degree murder on the grounds or premises of a healthcare facility. Healthcare facility is defined as a hospital licensed under title 33 or 68. This law takes effect July 1, 2023.

Public Chapter 313—SB745/HB883—Helton-Haynes/Briggs

This law specifies that terminating an ectopic or molar pregnancy does not constitute a criminal abortion. This law removes the current affirmative defense in law and instead provides that it is not an offense of criminal abortion if the abortion is performed or attempted by a licensed physician in a licensed hospital or ambulatory surgical treatment center and certain conditions are met. This law also requires the Department of Health to collect reports submitted under this law and report quarterly the number of abortions performed in this state to certain individuals in the executive and legislative branches no later than January 1, April 1, July 1, and October 1 of each year. This law is effective April 28, 2023.

Public Chapter No. 316—SB1426/HB1004—Roberts/Darby

This law requires an appointed member of a governing body for a state entity to serve in such capacity until the member's successor is duly appointed and qualified. Under this, an appointed member of a board, commission, or other governing body for a state governmental entity may be removed by the member's appointing authority with or without cause. A vacancy created by the removal of a member must be filled by the appointing authority in the same manner as the original appointment. This law also creates an advisory council on state procurement. This law was effective on April 28, 2023.

Public Chapter No. 325—SB1191/HB1388—Bailey/Ragan

This law terminates the Radiologic Imaging and Radiation Therapy Board of Examiners with no wind down period. This law authorizes the Board of Medical Examiners to establish and issue limited and full X-ray certifications. This law was effective on April 28, 2023.

Public Chapter No. 327—SB0004/HB0435—Massey/White

This law establishes a deaf mentor and parent advisor program to assist families in implementing bilingual and bicultural home-based programming for young children who are deaf, hard of hearing, or deaf-blind at the Tennessee Schools for the Deaf and the West Tennessee School for the Deaf. This law makes a pilot program established in 2019 for the West Tennessee School for the Deaf permanent and applicable statewide to Schools for the Deaf. This law is effective on July 1, 2023.

Public Chapter No. 332—SB0068/HB0234—Roberts/Ragan

This law makes permanent rules filed with the Secretary of State on or after January 1, 2022, which are set to expire on June 30, 2023, remain in effect until repealed, amended or superseded by legislative enactment. This law was effective on May 5, 2023.

Public Chapter No. 335—SB3195/HB472—Lundberg/Crawford

This law establishes standards for shelters that must be provided specifically to dogs under animal cruelty laws. This law takes effect on July 1, 2023.

Public Chapter No. 337—SB269/HB317—Johnson/Lamberth

This law designates June 19th as as a new official state holiday for Juneteenth. This law was effective on May 5, 2023, and applies to June 19, 2023. This was one of Governor Lee’s legislative initiatives.

Public Chapter No. 352—SB1345/HB1503—Watson/Vaughan

This law creates the “No Surprise Billing Consumer Protection Act.” This act outlines how an insurer provides benefits to covered persons with respect to both emergency and non-emergency medical services, and outlines how the insurer must reimburse for such services. This act also allows an insurer to dispute claims with the Department of Commerce and Insurance as well as requires the Department to maintain an all-payer health claims database. This law has different effective dates for different portions of the law. However, all purposes will be effective on January 1, 2024.

Public Chapter No. 353—SB1443/HB727—Roberts/Fritts

This law requires an LEA to obtain the written, informed, and voluntary signed consent of a student’s parent or legal guardian, or the student if they are 18 years of age or older, before the student participates in a survey, analysis, or evaluation. A parent or legal guardian who wishes to excuse the student from participating in health screenings as part of a coordinate school health program must submit a request in writing to the school’s nurse, instructor, school, counselor, or principal. As used in this law, “health screening” means vision, dental, blood pressure, and hearing screenings. This law makes other changes regarding a student’s receiving of instruction of sexual orientation curriculum or gender identity curriculum or a student’s membership of a club or organization. This law is effective July 1, 2023.

Public Chapter No. 372—SB0457/HB0155—Watson/Hicks

This law requires the Board of Emergency Medical Services to pay a supplement of

$800 to a licensed Tennessee ambulance service with full-time employed EMS personnel for each personnel who successfully complete annually an in-service training course of at least 40 hours duration at a training center. For the purpose of rulemaking, this law was effective May 11, 2023. For everything else, this law will be effective on January 1, 2024.

Public Chapter No. 379—SB0365/HB0355—Massey/Alexander

This law requires that a health benefit plan that provides coverage for a screening mammogram must provide coverage for diagnostic imaging and supplemental breast

screening without imposing a cost-sharing requirement on the patient. This law is effective 90 days after May 11, 2023.

Public Chapter 380—SB123/HB394—Niceley/Reedy

This law makes various changes to the Tennessee Meat and Poultry Inspection Act and establishes a state meat inspection program within the Department of Agriculture. This law has multiple effective dates.

Public Chapter 382—SB773/HB457—Lamar/Hakeem

This law requires that each LEA and public charter school to encourage all coaches, whether employed or volunteer, to annually complete training in physical conditioning and in the use of training equipment to the extent such training is available. This law also encourages cities, counties, businesses, and nonprofit organizations that organize community based athletic activities to comply with the safety standards outlined in this law and requires the aforementioned agencies to ensure that at least one individual who is involved has completed and is in compliance with the safety standards applicable to coaches and volunteers. This law is effective on July 1, 2023.

Public Chapter 386—SB193/HB702—Lundberg/Doggett

This law adds fentanyl, carfentanil, remifentanil, alfentanil, and thiafentanil to what constitutes a qualifying controlled substance for purposes of certain felony offenses. This law is on July 1, 2023, and applies to offenses after that date.

Public Chapter No. 390—SB0907/HB0814—Niceley/Davis

This law requires the state fire marshal to create a state fire permit that mobile food units may obtain annually to demonstrate fire safety and electrical code competency to local governments. Additionally, this law requires local governments to recognize such permit in its jurisdiction and prohibits the local government from requiring a mobile food unit with a state fire permit to hold a local fire permit or pass a local fire inspection. This law was effective May 11, 2023.

Public Chapter No. 395—SB0666/HB0885—Reeves/Hawk

This law creates the Prior Authorization Fairness Act and, among other things, establishes processes for prior authorization requests and appeals of adverse determinations. For purposes of rulemaking, this law was effective May 11, 2023. For all other purposes, this law is effective January 1, 2025, unless otherwise specified within the Act.

Public Chapter No. 399—SB1458/HB0983—White/Sexton

This law requires local education agencies (LEAs) to provide licensed employees of the LEA 6 paid workweeks after a birth or stillbirth of the employee's child or employee's adoption of a newly placed minor child. This law is effective May 11, 2023, and applies to leave taken on or after that date.

Public Chapter No. 412—SB1398/HB1242—Reeves/Powers

This law makes it a Class A misdemeanor to knowingly possess xylazine and makes it a Class C felony to knowingly manufacture, deliver, or sell xylazine, or to knowingly possess xylazine with intent to manufacture, deliver, or sell xylazine. This law exempts veterinarians. This law is effective July 1, 2023.

Public Chapter No. 413—SB1120/HB1280—Jackson/Keisling

This law expands the offense of aggravated stalking to include a person who commits stalking against a victim who is at least 65 or older. This law takes effect on July 1, 2023.

Public Chapter No. 414—SB0781/HB1281—Crowe/Holsclaw

This law establishes a family medicine student loan repayment grant program to incentivize physicians in residency training to provide medical health services in health resource shortage areas following completion of their training. This law is effective July 1, 2023.

Public Chapter No. 420—SB1533/HB1543—Johnson/Lamberth

This law increases, for Fiscal Year 23-24, the state employer match to 200 percent of the amount contributed by each state employee to the state's 401(k) plan per month, up to a maximum of $100 per month. This law was effective May 11, 2023.

Public Chapter No. 423—SB0378/HB0403—Briggs/Lamberth

This law creates the regulation of the production and sale of hemp-derived cannabinoids, including products known as delta-8 and delta-10 under the Department of Agriculture and the Department of Revenue. The sections of this law have varying effective dates, but this law is ultimately effective July 1, 2024.

Public Chapter No. 424—SB0394/HB0734—Lamar/Love

This law creates the doula services advisory committee, which is administratively attached to the Department of Health, to advise the Department by establishing core competencies and standards for the provision of doula services in this state and to recommend reimbursement rates and fee schedules for TennCare reimbursement for doula services. The committee consists of five members, one of which is the Commissioner of the Department of Health or his designee with certain experience requirements. This law is effective July 1, 2023.

Public Chapter No. 426—SB0458/HB0496—Watson/Martin

This law requires certain health related boards to either render a decision on the application or inform the applicant of the need to appear before such board within 60 days from the date the respective board receives a completed application for licensure from either an initial applicant or an applicant who is licensed in another state or territory

of the United States or in the District of Columbia. This law was effective on May 11, 2023, and applies to applications submitted on or after that date.

Public Chapter No. 431—SB698/HB1358—Crowe/Farmer

This law directs the Department of Health to officially request the United States Department of Health and Human Services to add newborn screening for metachromatic leukodystrophy to the recommended uniform screening panel. This law took effect on May 11, 2023.

Public Chapter No. 432—SB702/HB1095—Crowe/Boyd

This law places requirements for registration of a temporary healthcare staffing agency. This law requires a temporary healthcare staffing agency to submit a biannual report to the Health Facilities Commission. This law lays out penalties and disciplinary proceedings for temporary healthcare staffing agency, such as revoking registration, under certain circumstances. Sections of this law have differing effective dates.

Public Chapter No.433—SB1038/HB1365—Stevens/Farmer

This law revises provisions relating to background checks for persons considered for appointment to or employment in various positions in state government and for administrators and employees of childcare agencies. Under this law the Governor, Speaker of the Senate, Speaker of the House of Representatives, and Chief Justice are authorized to request the director of TBI to conduct a background investigation on a person who has asked or agreed to be considered for an appointment to a position of trust and responsibility. This law took effect May 11, 2023.

Public Chapter No. 438—SB102/HB158—Gardenhire/Zachary

This law prohibits an LEA, public charter school, or public institution of higher education from requiring an educator or other employee of the LEA or public charter school to complete or participate in implicit bias training or take an adverse employment action against them for failure or refusal to complete or participate in implicit bias training. "Implicit bias training" means a training or other educational program designed to expose an individual to biases that the training's or educational program's developer or designer presumes the individual to unconsciously, subconsciously, or unintentionally possess that predispose the individual to be unfairly prejudiced in favor of or against a thing, person, or group to adjust the individual's patterns of thinking in order to eliminate the individual's unconscious bias or prejudice. This law took effect May 17, 2023.

Public Chapter No. 442—SB219/HB271—Jackson/Hicks

This law adds and additional level of practice under the Board of Examiners in Psychology to include certified psychological testing technician. A person practices as a "certified psychological testing technician" within the meaning of this chapter when the person claims to be a certified psychological testing technician or renders to individuals or the public for remuneration any service involving the application of recognized principles, methods, and procedures of the science and profession of psychology and only under the supervision of either the psychologist or senior psychological examiner employing the certified psychological testing technician or the employing community

mental health center or state governmental agency. Any and all work performed by a certified psychological testing technician is supervised by a psychologist or senior psychological examiner as determined by the board. This law details the requirements for licensure for a certified psychological testing technician. The Board is authorized to promulgate rules, effective immediately. This law takes effect January 1, 2024.

Public Chapter No. 443—SB296/HB779—Gardenhire/Helton-Haynes

This law requires the Board of Medical Examiners, the Board of Osteopathic Examination, the Board of Nursing, the Board of Physician Assistants, and the Alcohol and Drug Abuse Counselors Board to, upon the receipt of a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, render a decision on the application or inform the applicant of the need to appear before the board within 45 days from the date the board receives the application. This law requires the Board of Athletic Trainers to, upon the receipt of a completed application for licensure from an applicant who is licensed in another state or territory of the United States or in the District of Columbia, render a decision on the application or inform the applicant of the need to appear before the board within 60 days from the date the board receives the application. "Completed application" means an application that satisfies all statutory and board rule requirements. This law takes effect May 17, 2023.

Public Chapter No. 446—SB361/HB942—Massey/Alexander

This law creates the dentist and dental hygienist compact. The compact details licensure requirements and other provisions related to the practice of dentists and dental hygienists who participate in the compact. While this law has been enacted in Tennessee, it will not take effect until the date the seventh compact state enacts the same legislation. This legislation has been enacted in three states as of the date of this publication: Tennessee, Washington, and Iowa. Four states have this legislation: Texas, Kansas, Minnesota, and Ohio.

Public Chapter No. 447—SB460/HB607—Watson/Hale

This law makes changes relative to the coverage of complex rehabilitation technology (CRT) by health insurance entities and managed care organizations. This law prohibits a health insurance entity that offers health insurance coverage of complex rehabilitation technology (CRT) or manual wheelchairs from requiring a prior authorization for repairs of such technology or equipment unless certain conditions exist. Additionally, a managed care organization must not require a participant in a TennCare program to obtain and submit a prior authorization for repairing complex rehabilitation technology (CRT) or manual wheelchairs unless certain conditions apply. This law takes effect July 1, 2023.

Public Chapter No. 448—SB466/HB1269—Rose/Cochran

This law provides that a teacher or other employee of a public school or LEA is not required to use a student's preferred pronoun when referring to the student if the preferred pronoun is not consistent with the student's biological sex. Under this law, a teacher or other employee of a public school or LEA is not civilly liable for using a

pronoun that is consistent with the biological sex of the student to whom the teacher or employee is referring, even if the pronoun is not the student's preferred pronoun. Under this law, a teacher or other employee of a public school or LEA are not subject to adverse employment action for not using a student's preferred pronoun if the student's preferred pronoun is inconsistent with the student's biological sex. This law took effect May 17, 2023.

Public Chapter No. 452—SB543/HB634—Jackson/Moody

This law creates a childcare improvement pilot program, administered by the Department of Human Services, to provide grants to nonprofit organizations to be used for establishing a new child care agency in this state or making improvements to, or assisting with staffing, recruitment, or salary gaps, at an existing child care agency in this state. The program must be operated from July 1, 2023, to June 30, 2026. This law was effective on May 17, 2023.

Public Chapter No. 457—SB753/HB1317—Haile/Kumar

This law changes the composition and number of members of the Board of Pharmacy by adding two members to the Board and adding a residency requirement of no less than five years for pharmacist members of the board. This law authorizes the Board of Pharmacy to issue advisory opinions. This law also specifies that the current board members must serve on July 1, 2023, through the end of the members’ existing terms. This law was effective May 17, 2023.

Public Chapter No. 466—SB858/HB952—Reeves/Boyd

This law makes several changes concerning the powers and authorities of the Health Facilities Commission, including but not limited to authorizing the Commission to license facilities also licensed by the Department of Mental Health and Substance Abuse Services for the purpose of provide acute care services, authorizes the licensing and regulating of assisted-care facility administrators, amends the duties and responsibilities of the board for licensing health care facilities, authorizes the recovery and collection of civil monetary penalties under certain circumstances, and cleans up references to the Department of Health. This law has multiple effective dates. However, the law in its entirety will become effective on July 1, 2024.

Public Chapter No. 469—SB469/HB1484—Lundberg/Hulsey

This law authorizes county jails to utilize federal or state funds, if available, for the payment of medication for HIV positive patients. Additionally, this law authorizes the Department of Health to pay for HIV medication for inmates subject to availability of federal or state funds. This law was effective on May 17, 2020.

Public Chapter No. 470—SB937/HB1311—Briggs/Kumar

This law creates the "Graduate Physicians Act." This act allows medical students who have graduated from medical school and have passed Step 1 and Step 2 of the USMLE, or equivalent, but have not completed an approved postgraduate residency, to practice under a collaborative practice arrangement with a licensed physician under certain parameters. The graduate physician collaborative practice arrangement must

limit the graduate physician to providing primary care services in a medically underserved rural area of the state, a pilot project area established for graduate physicians to practice, or a rural health clinic. This law establishes guidelines for the reviewing of graduate physicians’ charts by physicians who have entered into a graduate physician collaborative practice agreement. A graduate physician’s license is only valid for 2 years and cannot be renewed. For the purposes of promulgating rules, this act was effective May 17, 2023. For all other purposes, this act takes effect July 1, 2025.

Public Chapter No. 475—SB1049/HB1077—Yarbro/Thompson

This law creates a farmer’s market food unit permit for qualified applicants who pay a

$300 permit fee and who have successfully completed a pre-operational inspection to determine compliance with applicable rules. Additionally, this law exempts vendors from the requirement to obtain a license or permit to offer samples for consumption on the premises of the farmer’s market. For the purposes of promulgating rules, this law is effective May 17, 2023. For all other purposes, this law will be effective on July 1, 2024. This requires the Department of Health to promulgate rules.

Public Chapter No. 477—SB1111/HB1380—Bowling/Ragan

This law creates the “Mature Minor Doctrine Clarification Act.” This act prohibits a healthcare provider from providing a vaccination to a minor unless the healthcare provider first receives informed consent from a parent or legal guardian of the minor. The healthcare provider must document receipt of and include in the minor's medical record proof of prior parental or guardian informed consent. This law also requires written consent from a parent or legal guardian before providing a minor with a COVID- 19 vaccine. Additionally, this law prohibits an employee or agent of the state to provide, request, or facilitate the vaccination of a minor child in state custody except when certain situations apply. This law was effective May 17, 2023.

Public Chapter No. 483—SB1274/HB1270—Jackson/Farmer

This law establishes a mechanism for using state funds to contract with local governments and qualified private entities to develop community-based alternatives to incarceration that provide a treatment-centered pathway and community-based supervision for offenders. The department of correction or another state agency shall not penalize, financially or otherwise, the organization for providing such service. This law takes effect July 30, 2023.

Public Chapter No. 484—SB1275/HB874—Briggs/Lafferty

The law prohibits a health insurance issuer or a managed health insurance issuer from

(1) denying a licensed medical laboratory the right to participate as a participating provider in a policy, contact, or plan on the same terms and conditions as offered to another medical laboratory under the same circumstances and (2) preventing a person who is a party to or beneficiary of a policy, contract, or plan from selecting a licensed medical laboratory of a person’s choice to furnish services under the contract, policy, or plan. This law becomes effective July 1, 2023.

Public Chapter No. 486—SB1440/HB239—Roberts/Bulso

This law defines “sex” in code to mean a person's immutable biological sex as determined by anatomy and genetics existing at the time of birth and evidence of a person's biological sex. “Evidence of a person’s biological sex” includes, but is not limited to, a government-issued identification document that accurately reflects a person's sex listed on the person's original birth certificate. This law takes effect on July 1, 2023.

Please note that these are high-level overviews of each public chapter. They do not include every detail or provide all bill information. Please review the text of the bill in its entirety at your own discretion. If you have any questions or need further clarity, please reach out to your attorney.

Non-Health Related Legislative Activity of Note

·         The legislature addressed legislative and Congressional redistricting.

·         The “Truth in Sentencing” Act made mandatory sentences for certain criminal offenses.

·         The “Tennessee Investment in Student Achievement (TISA) Act” reformed the school funding approach.

Highlights and Noteworthy Health-Related Legislation

·         The Department had two successful legislative initiatives that became law relating to local county health departments and the Controlled Substance Monitoring Database, respectively.

·         Healthcare Facilities will move to the Health Services and Development Agency (HSDA)/Health Facility Commission on July 1, 2022.

·         Healthcare providers can continue to utilize telehealth and receive reimbursement for telehealth services.

·         The Board of Pharmacy and the Board of Nursing will now hire and fire the Executive Director of the Board.

·         A registry within the Tennessee Commission on Aging and Disability was created to combat the operation of unlicensed facilities.

Pertinent Public Chapters

*All Public Chapters are Hyperlinked to the Document on the Secretary of State’s Website*

Public Chapter 644—SB1823/HB1867—Johnson/Zachary

Re: Covid-19 Vaccine Exemptions. This public chapter requires that an employer grant certain exemptions to requirements of proof/receipt of vaccinations if the request for exemption is either

(1) supported by signed/date statement by a licensed physician that the staff member has a condition recognized under generally accepted medical standards as a basis for the medical exemption or (2) the staff member attests in writing (including electronic means) that the staff member has a sincerely held religious believe that prevents the staff member from complying the requirement in accordance with guidance from Medicare and Medicaid services. This public chapter creates a civil penalty of $10,000 for violation of this statute.

Effective as of March 11, 2022.

Public Chapter 664—SB1248/HB1195—Reeves/Garrett

Re Insurance Prior Authorization Notifications. This public chapter requires a healthcare facility to notify a patient of communication between the healthcare facility and a health insurance entity or provider concerning additional information needed to process a prior authorization request for

the patient within five business days after the communication has occurred. This requirement does not apply to the TennCare program or a successor program. This public chapter also includes requirements for utilization review agents if needed more information to determine a request for prior authorization.

For the purposes of rulemaking by the Commissioner of Commerce and Insurance, effective as of March 18, 2022. For all other purposes, effective on January 1, 2023 and applies to communications made pursuant to insurance policies entered into, issued, renewed, or amended on or after that date.

Public Chapter 680—SB1909/HB1904—Johnson/Faison

Re Autoclave Requirements. This public chapter exempts autoclaves from the clearance requirements of the Board of Boilers Rules if the autoclave sterilizes reusable medical or dental equipment used by an individual licensed under title 68 or 63, is installed in accordance with the manufacturer’s recommendations, contains a boiler, and is regulated by the FDA.

Effective as of March 28, 2022. The Governor did not sign this public chapter.

Public Chapter 722—SB1697/HB1778—Roberts/Ragan

Re Board Extension. This public chapter extends the Board of Examiners for Nursing Home Administrators to June 30, 2027.

Public Chapter 749—SB2572/HB2465—Crowe/Leatherwood

Re Naloxone Standing Order. This public chapter allows licensed healthcare workers to prescribe, directly or through standing order, naloxone or other similarly acting and equally safe drugs approved by the FDA to an organization or municipal or county entity, including but not limited to a recovery organization, hospital, school, or county jail. This public chapter also allows an individual or entity under a standing order to receive and store an opioid antagonist and provide an opioid antagonist directly or indirectly to an individual. Additionally, this public chapter authorizes a first responder acting under a standing order to receive and store an opioid antagonist and to provide an opioid antagonist to an individual at risk of experiencing a drug-related overdose or to a family member friend or other individual in a position to assist an at-risk individual. This public chapter includes “unresponsiveness, decreased level of consciousness, and respiratory depression” to be included within the definition of drug related overdose.

Effective on July 1, 2022.

Public Chapter 756—SB1789/HB2858—Briggs/Kumar

Re Conditions of Participation. This public chapter removes the requirement that a healthcare provider enrolled in Medicare or Medicaid be subject to conditions of participation to be exempt from the definition of “private business” or “governmental entity” for purposes of the Title 14/Covid-19 state laws.

Effective as of March 31, 2022.

Public Chapter 764—SB2427/HB2177—Johnson/Lamberth

Drug Paraphernalia. This public chapter excludes narcotic testing equipment used to determine whether a controlled substance contains a synthetic opioid from the definition of “drug paraphernalia” as used within the criminal code unless the narcotic testing equipment is possessed for purposes of the defendant’s commission of certain drug related offenses. This public chapter will be repealed on July 1, 2025.

Effective as of March 31, 2022.

Public Chapter 766—SB2453/HB2655—Yager/Hawk

Re Telehealth. This public chapter extends the ability for healthcare providers to receive reimbursement for healthcare services provided during a telehealth encounter. This public chapter also clarifies that a healthcare provider acting within the scope of a valid license is not prohibited from delivering services through telehealth. Lastly, this public chapter adds that the requirement of an in-person encounter between the healthcare services provider, the provider’s practice group, or the healthcare system and patient within sixteen months prior to the interactive visit is tolled for the duration of a state of emergency declared by the Governor provided that healthcare services provider or patient, or both, are located in the geographical area covered by the state of emergency. Effective as of April 1, 2022 and applies to insurance policies or contracts issued, entered into, renewed, or amended on or after that date.

Public Chapter 769—SB568/HB702—Johnson/Lamberth

Re Anatomical Gifts. This public chapter prohibits a healthcare provider, a hospital, an ambulatory surgical treatment center, a home care organization or any other entity responsible for matching anatomical gifts or organ donors to potential recipients from, solely on the basis of whether an individual has received or will receive a Covid-19 vaccine, (1) consider an individual ineligible for transplant or receipt of an anatomical gift, (2) deny medical or other services related to transplantation, (3) refuse to refer an individual to a transplant center or specialist, (4) refuse to place an individual on an organ or tissue waiting list, or (5) place an individual at a position on an organ or tissue waiting list lower than the position the person at which the individual would have been placed if not for the individual’s vaccine status.

Effective as of April 8, 2022.

Public Chapter 833—HB1997/SB1936—Cochran/Jackson

Re UAPA. Clarifies that the ALJ shall decide a procedural questions of law. Allows the director of the administrative procedures division of the secretary of state’s office to issue subpoenas. Allows electronic participation in hearings, by agreement of the parties. The hearing officer may allow electronic testimony if the absence of the witness would otherwise cause of delay of the hearing. Requires that a final orders be issued within 90 days. Allows that a petition for reconsideration be filed within 15 days of the entry of the final order or initial order.

Effective as of April 19, 2022.

Public Chapter 854—HB2733/SB2879—Windle/Bailey

Re Veteran’s Day Holiday. Requires that private businesses provide a veteran with Veteran’s Day as a non-paid holiday if the veteran provides proof of status, notice to the employer and the employee’s absence will not cause the employer significant issue.

Effective as of April 20, 2022.

Public Chapter 881—SB2240/HB2335—Haile/Vaughn

Re Buprenorphine. Prohibits prescribing of buprenorphine via telehealth unless the healthcare provider is employed by a licensed non-residential opioid treatment facility, a community mental health center, an FQHC, a hospital, or through TennCare.

Effective as of April 14, 2022.

Public Chapter 883—SB2285/HB1749—Bell/Ragan

Re UAPA and Judicial Review Standards. Requires that a judge over a contested case not defer to an agency’s interpretation of the statue or rule and shall interpret it de novo. Remaining ambiguity shall be resolved against the agency.

Effective as of April 14, 2022.

Public Chapter 896—SB896/HB1960—Bowling/Hulsey

Re Title 14. Eliminates the sunset provisions in Title 14 for the definitions section and for the section that prohibits government entities from mandating vaccinations. Deletes a variety of definitions from the Title.

For the deletion of definitions, effective July 1, 2022 at 12:01 AM. For all other purposes, effective as of April 19, 2022.

Public Chapter 911—HB2309/SB2464—Freeman/Reeves

Re Professional License Requirements. Mandates that a person seeking a professional license have US citizenship or be authorized under federal law to work in the US as verified by the SAVE Program (allows DACA children who are now adults to obtain professional licensure if not otherwise prevented by the license).

Effective July 1, 2022.

Public Chapter 930—HB1871/SB1982—Hulsey/Hensley

Re Covid Vaccinations and Acquired Immunity. Amends Title 14 to mandate that acquired immunity from a previous Covid-19 infection be treated the same as a Covid-19 vaccination by a governmental entity, school, or local education authority. Mandates that private businesses who require vaccinations also include recognition for acquired immunity for Covid-19.

Effective as of April 11, 2022—This was not signed by Governor.

Public Chapter 949—HB2537/SB2511—Gant/Massey

Re Nurse Practitioners & FQHCs. Extends NPs the ability to write prescriptions at FQHCs. Allows APRNS to collaborate on up to 10 sites with a physician and the physician’s reviews may be done electronically. Allows PAs to collaborate on up to 10 sites with a physician and the

physician’s reviews may be done electronically. There shall be an annual review in-person between the physician and the APRN/PA.

Effective as of April 29, 2022.

Public Chapter 954—HB2667/SB2550—Sexton, C./Jackson

Re Workforce Flexibility for Nurses. Allows the Commissioner to promulgate rules so that during a workforce crisis a nurse from out-of-state can practice on a temporary basis. Allows certain professions to do tasks outside of their scope of practice if approved by the rules. Permits students in respiratory care programs to practice without licensure during a healthcare workforce crisis. The commissioner determines if there is a workforce crisis and shall notify the governor, the Lt. governor, and the Speaker of the House. Flexibility rules also apply to graduate professional nurses.

Effective as of April 29, 2022.

Public Chapter 997—HB2649/SB2162—Williams/Watson

Re Law Enforcement at Healthcare Facilities. Permits a healthcare facility to establish policies to allow for the employment of POST-certified peace and police officers. Provides the manner in which to do this and provides civil liability immunity for the police department, if separate from the healthcare facility. Additional minimum standards may be adopted for security guard personnel.

Effective as of May 5, 2022.

Public Chapter 1049—HB1686/SB1749—Williams/Reeves

Re Alzheimer’s Patients and Payments for Caregivers. “Colonel Thomas G. Bowden Act” Creates a pilot program to provide grants for the purposes of developing payment to caregivers of Alzheimer’s and dementia patients. An agency can use its current infrastructure to develop this program but must report the costs. This program runs from July 1, 2022 through June 30, 2025, and creates an income-based fee structure. Each agency shall provide a report on January 15 of each year of the program.

Effective as of May 25, 2022.

Public Chapter 1061—HB2228/S2465—Ramsey/Reeves

Re Opioid Antagonists. Requires that a prescriber offer a prescription for an opioid antagonist when issuing a prescription for an opioid if the prescription is for longer than 3 days and there is a history of or suspicion of abuse. This does not apply in palliative care or veterinarian settings. Penalties are included for failure to comply.

Effective on July 1, 2022 and applies to opioid prescriptions issued after that date.

Public Chapter 1068—HB2544/SB2711—Alexander/White

Re Mammograms for Women at 35 Years Old. Requires that a health benefit plan provide access to annual low-dose mammograms and other breast cancer screenings for women between the ages of 35 and 40 if risk factors exist and for those over 40.

Effective as of May 25, 2022.

Public Chapter 1073—HB2665/SB2449—Sexton, McNally

Re Covid Visitation Policies and Limitations on Covid Treatment Exemptions. Clarifies that a prescriber can be disciplined for prescribing controlled substances and/or narcotics for treatment of Covid, if appropriate. In addition, creates a patient advocate process that hospitals must follow during times of covid concern. Allows that person to enter a facility if they agree to follow procedures but provides certain exceptions to access to locations within the hospital.

Effective as of May 25, 2022.

Public Chapter 1081—SB439/HB630—Rose/Gillespie

Re Unlicensed Facility Registry. Creates a registry for unlicensed facilities where vulnerable and/or elderly adults are mistreated. Creates criminal punishment for facilities who continue to operate after being published as a facility.

Effective as of May 27, 2022.

Public Chapter 1094—SB1891/HB1905—Hulsey/Doggett

Re Mandatory Reporting of Fatal Drug Overdoses. Requires that a fatal overdose be reported to law enforcement, including by doctors and nurses.

Effective July 1, 2022.

Public Chapter 1112—SB2295/HB2545—Bell/Alexander

Re Medication Aides. Expands those eligible to receive medication aide certification to include nursing aides and OT assistants, subject to other restrictions. Requires that the Board permit either in-person or distance learning it its clinical and instruction hours. Mandates that rules be promulgated no later than January 1, 2023.

For medication aide certification, effective on January 1, 2023. For all other purposes, effective as of June 1, 2022.

ACTION ITEM: Board of Nursing Rule-making.

Public Chapter 1117—SB2448/HB2671—White/Farmer

Re: Extended Liability Protection Against Covid Claims. Extends the liability protection against claims based on Covid exposure until July 1, 2023.

Effective as of June 1, 2022.

Public Chapter 1118—SB2463/HB2347—Reeves/Boyd

Re Staffing Flexibility Study. Requires that the comptroller, in conjunction with TennCare and TDH, study the impact of temporary staffing by healthcare staffing agencies at long-term care facilities. Comptroller’s office required to deliver a report.

Effective as of June 1, 2022.

Public Chapter 1119—SB2466/HB2500—Reeves/Boyd

Re Health Facilities Commission Creation. Creates the Health Facilities Commission from the division of health licensure and regulation within TDH. The commission is empowered to issue

licenses and regulate hospitals, recuperation centers, nursing homes, homes for the ages, residential HIV facilities, assisted living facilities, home care organizations, hospices, birthing centers, prescribed childcare centers, renal dialysis clinics, ambulatory surgical centers, outpatient diagnostic centers, adult care homes, and TBI residential homes. Clarifies that the Health Facilities Commission also handles the certificate of need process.

Effective July 1, 2022.

Public Chapter 1123—SB2574/HB2535—Crowe/Alexander

Re: End-of-Life Visitation at Nursing Homes and Assisted Living Facilities. Requires that nursing homes and assisted living facilities allow for visitation during a disaster, emergency, or public health emergency for Covid-19. Provides an exemption if the visitation would violate federal or state law.

Effective July 1, 2022.

** Please note that these are high-level overviews of each public chapter. Speak with the Board Attorney for any specific questions or concerns. **

Public Chapter 37

This act prohibits agencies subject to sunset review from promulgating rules or adopting policies to exempt members solely by virtue of their status as members.

This act took effect March 23, 2021.

Public Chapter 148

This act requires the board of licensed healthcare facilities to promulgate emergency rules no later than July 1, 2021, relative to permitting qualified temporary nursing aides in nursing homes to become certified nursing assistants in Tennessee to assist with the ongoing pandemic response in healthcare facilities. This act also clarifies that they would be added to the nurse aid registry.

This act took effect April 13, 2021.

Public Chapter 242

This act authorizes records custodians to petition a court for injunctive relief from individuals making frequent public records requests with the intent of disrupting government operations, following a fifth (5^th) public records request. A records custodian can only petition a court if they notify the person in writing stating the specific conduct may constitute intent to disrupt government operations, and that the person continues to do so. The individual upon a court enjoinment would not be able to make public requests at the agency for up to one (1) year.

This chapter took effect April 28^th, 2021 and will sunset July 1, 2025.

Public Chapter 291

This act requires the attorney general and reporter to not approve an emergency rule if the emergency rule does not meet the statutory criteria for adoption of the rule.

This act took effect July 1, 2021.

Public Chapter 328

This act requires that starting December 1, 2023, state agencies submit a report of their effective rules to the chairs of the government operations committee every eight (8) years. The report is required to include a brief description of the department’s operations that each chapter affects, as well as each rule and its administrative history, which would include the original promulgated date and the dates the rule was last amended, if applicable. Additionally, the report would include a determination of each rule on whether it is adheres to current state or federal law or court rulings, should be amended or repealed, reviewed further, or continue in effect without amendment. Lastly, if there are any intentionally false statements in the report, the government operations committee would have the ability to vote to request the general assembly to remove a rule or suspend the department’s rulemaking authority for any reasonable period of time.

This act took effect July 1, 2021

Public Chapter 453

This act requires public or private entities or businesses that operate a building open to the general public to post signage regarding public restroom access in certain situations. Specifically, this applies to entities or businesses that have restroom policies allowing either biological sex to use any public restroom within their building. The act includes requirements for language, size, location, and even color for the signage. The act excludes unisex, single occupant restrooms or family restrooms intended for use by either sex.

This act took effect July 1, 2021.

Public Chapter 458

This act adds nurses to the list of victims warranting enhanced penalties under the crime of assault against first responders (a Class A misdemeanor), as well aggravated assault of first responder (a Class C felony).

This act takes effect July 1, 2021.

Public Chapter 461

This act requires TDH licensing authorities, upon learning a healthcare prescriber was indicted of certain criminal offenses (controlled substance violations or sexual offenses), to automatically restrict the prescriber’s ability to prescribe Schedule II controlled substances until the case reaches a final disposition. The restriction shall be removed upon sufficient proof of acquittal or dismissal/nolle prosequi. The act further requires licensing authorities to automatically revoke the license of a practitioner that is convicted of those same criminal offenses. A new license shall be granted if the conviction is overturned or reversed (but shall be restricted related to prescribing if the case has not reached final disposition). In addition, the act requires the licensing authority to suspend the license of midlevel practitioner (APRN/PA) upon finding the healthcare professional failed to comply with physician collaboration requirements. Finally, this act requires

facility administrators to report certain disciplinary actions concerning licensed personnel to the professionals’ respective boards.

This act took effect May 18, 2021.

Public Chapter 464

This act recreates the elder abuse task force, which was originally created in 2019 and was terminated January 15, 2021. The task force will consist of ten (10) members, including the Commissioner of Health or their designee. The task force will hold public meetings and utilize technological means to gather feedback on the recommendations from the general public and from persons and families affected by poverty. The commission on aging and disability will provide necessary administrative support for the task force. Lastly, this act requires the task force to submit its findings and recommendations to the governor and the general assembly to combat the abuse of elder persons and other vulnerable adults no later than January 15, 2022, at which time the task force will terminate.

This act took effect May 18, 2021.

Public Chapter 530

This act grants extends the TennCare annual nursing home assessment fee to June 30, 2022. Additionally, this act clarifies that provisions in existing code relative to late fees also applies to quarterly assessment fees by TennCare and adds a five-percent (5%) penalty of the quarterly assessment fee balance for each month that the balance is unpaid to TennCare.

This act took effect July 1, 2021.

Public Chapter 531

This act limits an agency’s authority to promulgate rules without a public hearing. There are exceptions to the public hearing requirement. These exceptions include emergency rules, rules that are nonsubstantive modifications to existing rules (like clerical updates), rules that repeal existing rule, or rules that eliminate or reduce a fee described by an existing rule.

This act took effect July 1, 2021.

Public Chapter 532

This act authorizes the joint government operations committee to stay an agency’s rule from going into effect for a period of time not to exceed ninety (90) days. If the government operations committee determines that subsequent stays are necessary, then the joint committee may issue consecutive stays, each for an additional ninety (90) day period, so long as such stays do not extend beyond the fifth legislative day of the year following the year in which the rule is filed with the secretary of state. The initial stay may be done by either the house or senate government operations committee, but subsequent stays must be by agreement by the committees of both chambers. A stay is effective when the respective committee files written notice with the secretary of state, and the respective committee shall specify the length of effectiveness of the stay.

This act took effect May 25, 2021.

Public Chapter 557

This thirty-page act does a complete overhaul of the certificate of need process through the health services and development agency. Among the changes are adjustments to various population thresholds, modifications to the fee schedule, and changes in bed numbers. One of the components of the bill requires the executive director of HSDA to submit a plan to consolidate into a health facilities commission, the powers and duties of HSDA and the board for licensing health

care facilities. The plan is to be submitted to the chairs of senate and house health by January 1, 2023.

Some portions of this act took effect May 26, 2021. The rest of the act will take effect October 1, 2021.

**These are general summaries of legislation. For more detailed information and all specifics/requirements, please review the links to each public chapter**

Public Chapter 4 (second extraordinary session)

This public chapter deals with telehealth and reimbursement.  The majority of the legislation is focused on provisions related to insurance and reimbursement for telehealth services.  Section 9 of the public chapter, however, focuses on the definition of telehealth and what health practitioners are authorized to do telehealth.

Section 9 of the bill defines "telehealth," "telemedicine," and "provider-based telemedicine" as the use of real time audio, video, or other electronic media and telecommunication technology that enables interaction between a healthcare provider and a patient for the purpose of diagnosis, consultation, or treatment of a patient at a distant site where there may be no in-person exchange between a healthcare provider and a patient. The definition also includes store-and-forward telemedicine services.

Until April 1, 2022, all licensed providers under title 63 (as well as licensed alcohol and drug abuse counselors under title 68, or any state-contracted crisis service provider that is employed by a facility licensed under title 33) are defined as healthcare providers under the telehealth bill.  After April 1, 2022, the definition of a healthcare provider eligible to perform telehealth services will change to an individual acting within the scope of a valid license issued pursuant to title 63 (as well as licensed alcohol and drug abuse counselors under title 68, or any state-contracted crisis service provider that is employed by a facility licensed under title 33).  Telehealth is not authorized for use at pain management clinics or for the treatment of chronic nonmalignant pain.  It is also not available for veterinarians. 

A patient-provider relationship in regard to telehealth is created by mutual consent and communication.  No new standards of care are created, and the provider will be held to the same standard of care as if the case was in person.  Finally, the board shall not establish a more restrictive standard of practice for telehealth than what is specifically authorized by the provider's practice act or other applicable statutes.

This act took effect August 20, 2020.

Public Chapter 594

This act was the Department of Health’s Licensure Accountability Act.  The bill allows all health related boards to take action against a licensee that has been disciplined by another state for any acts or omissions that would constitute grounds for discipline in Tennessee.  The law also expands available emergency actions, allowing actions beyond simply a summary suspension.  Finally, the act establishes that the notification of law changes to health practitioners can be satisfied by the online posting of law changes by the respective boards.  Notice must be maintained online for at least 2 years following the change. 

This act took effect March 20, 2020.

Public Chapter 644

This act extends the nursing home annual assessment to June 30, 2021.

This act took effect April 1, 2020.

Public Chapter 738

This act prohibits a governmental entity from authorizing destruction of public records if the governmental entity knows the records are subject to a pending public record request.  Prior to authorizing destruction of public records an entity must contact the public record request coordinator to ensure the records are not subject to any pending public record requests.  Records may still be disposed of in accordance with an established records retention schedule/policy as part of an ordinary course of business as long as the records custodian is without knowledge the records are subject to a pending request. 

This act took effect on June 22, 2020.

Legislative Update 2019: Nursing Home Administrators Board

Public Chapter 61

This act states that an entity responsible for an AED program is immune from civil liability for personal injury caused by maintenance or use of an AED if such conduct does not rise to the level of willful or wanton misconduct or gross negligence.

This act took effect on March 28, 2019. 

Public Chapter 124

This act makes a variety of small changes and additions to the TN Together opioid initiative put in place in 2018.  One addition is allowing access to CSMD data to a healthcare practitioner under review by a quality improvement committee (QIC), as well as to the QIC, if the information is furnished by a healthcare practitioner who is the subject of the review by the QIC.  

The requirement for e-prescribing of all schedule II substances by January 1, 2020 has been delayed to January 1, 2021 and is modified to require all schedule II through V prescriptions to be e-prescribed except under certain circumstances.  The law also requires all pharmacy dispensing software vendors operating in the state to update their systems to allow for partial filling of controlled substances.

Definitions are given by this act to the terms palliative care, severe burn and major physical trauma.  Along with its new definition, palliative care has now joined severe burn and major physical trauma as an exception to the opioid dosage limits otherwise required under TN Together.  

An unintended consequence of last year’s Public Chapter 1039 was on cough syrup.  This act establishes that the law does not apply to opioids approved by the FDA to treat upper respiratory symptoms or cough, but limits such cough syrup to a 14 day supply.

Also changed from last year’s act is the requirement to partial fill.  Partial filling of opioids is now permissive.

Finally, the opioid limits under have been simplified from the previous year’s act.  The twenty day supply and morphine milligram equivalent limit has been eliminated.  Three day and ten day requirements remain the same.  Instances such as more than minimally invasive surgery, which previously fell under the twenty day provision, now can be treated under the limits of the thirty day category.

This act took effect on April 9, 2019. 

Public Chapter 144

This act amends the Prevention of Youth Access to Tobacco and Vapor Products Act by limiting the places in which one may use vapor products.  The act defines vapor products and prohibits the use of such products in a number of locations including child care centers, group care homes, healthcare facilities (excluding nursing homes), residential treatment facilities, school grounds, and several other areas.  Several locations have specific exceptions set forth in the statute.

This act took effect on April 17, 2019.

Public Chapter 195

The majority of this act pertains to boards governed by the Department of Commerce and Insurance.  One small section applies to the health related boards. Currently, the health related boards have an expedited licensure process for military members and their spouses.  Previously, a spouse of an active military member had to leave active employment to be eligible for this expedited process.  This act removes that requirement.  This section applies to all health related boards.  The Commissioner of Health is permitted to promulgate rules, but rules are not needed to implement the act.

This act takes effect July 1, 2019. 

Public Chapter 229

This act allows healthcare professionals to accept goods or services as payment in direct exchange of barter for healthcare services. Bartering is only permissible if the patient to whom services are provided is not covered by health insurance. All barters accepted by a healthcare professional must be submitted to the IRS annually. This act does not apply to healthcare services provided at a pain management clinic.

This act took effect April 30, 2019.

Public Chapter 243

This act mandates that an agency that requires a person applying for a license to engage in an occupation, trade, or profession in this state to take an examination must provide appropriate accommodations in accordance with the Americans with Disabilities Act (ADA). Any state agency that administers a required examination for licensure (except for examinations required by federal law) shall promulgate rules in regard to eligibility criteria. This legislation was introduced to assist individuals with dyslexia.

 This act took effect May 2, 2019 for the purpose of promulgating rules, and for all other purposes, takes effect July 1, 2020. 

Public Chapter 245

This act prohibits any person who is not licensed or certified by the Board of Nursing from using the title “nurse” or any other title that implies that the person is a practicing nurse. The Board is empowered to petition any circuit or chancery court having jurisdiction to enjoin: (1) a person attempting to practice or practicing nursing without a valid license; (2) a licensee found guilty of any of the acts listed in 63-7-115; or (3) any person using the title “nurse” who does not possess valid license or certificate from the Board.  

This act took effect May 2, 2019.

Public Chapter 324

This act authorizes any existing licensed and operating nursing home to relocate 62 or fewer of its licensed beds to a new separate licensed nursing home if certain conditions are satisfied, including obtaining a certificate of need through the Health Services and Development Agency.

There is only one nursing home that currently meets these conditions (in East Tennessee).  

This act takes effect July 1, 2019.

Public Chapter 423

This act extends the nursing home assessment fee through June 30, 2020. The act will assess

4.75% of each included nursing facility’s annual coverage assessment base for fiscal year 2020.

This act will take effect July 1, 2019.

Public Chapter 447

This act permits law enforcement agencies to subpoena materials and documents pertaining to an investigation conducted by the Department of Health prior to formal disciplinary charges being filed against the provider. This bill was brought by the Tennessee Bureau of Investigation.

This act went into effect May 22, 2019. 

Public Chapter 474

This act is known as the “Elderly and Vulnerable Adult Protection Act of 2019.” The act adds definitions of abuse, sexual exploitation, financial exploitation, and neglect. Convictions for the preceding offences are required to be reported to the Abuse Registry. Penalties for these offenses are also increased for aggravated abuse of an elderly or vulnerable adult. In addition, this act requires any relative conservator, agent, employee of the Tennessee Commission on Aging and Disability, or guardian ad litem to be mandatory reporters if they have knowledge that an elderly or vulnerable adult is a victim of any of the offenses listed above.

This act became effective May 24, 2019 for the purpose of promulgating rules. For all other purposes, this act will go into effect January 1, 2020.

*Insurance Legislation*

Multiple acts were passed during the 2019 legislative session that affect healthcare plans and insurance and create certain obligations on providers and facilities.  A few pieces of legislation include Public Chapter 407 and Public Chapter 239.  Healthcare providers and facilities are encouraged to review these to make sure they meet their statutory obligations.  

Nursing Home Administrators Wraps – 2018

Public Chapter 611

This law requires an agency holding a public hearing as part of its rulemaking process, to make copies of the rule available in “redline form” to people attending the hearing. 

This act takes effect July 1, 2018.

Public Chapter 655

This is the department of health (TDH) administration bill CORE.  This act makes a variety of changes to existing law regarding nursing homes, assisted care facilities and the abuse registry. 

This act establishes that the TDH commissioner has the authority to suspend admission of any new patients or residents to any facility or licensee in those cases where there is a factual basis that the conditions are, or are likely to be, detrimental to the health, safety, or welfare of a patient or resident.

The act lays out the suspension process, appeals process, and time windows required.  It also establishes that the board has the authority to continue, revoke, or modify the suspension of admissions and enter other such orders as it deems necessary.

The act also creates a requirement on homes for the aged, traumatic brain injury residential homes, assisted care living facilities, and adult care homes to notify residents of their right to file a complaint and the process to do so.  The legislation also prohibits facilities from retaliatory actions against residents for filing a complaint.  Those filing complaints in good faith are immune from civil liability.

The CORE act also establishes TDH’s ability to act in regard to entities operating unlicensed facilities and establishes the penalties that TDH may pursue or assess.

Finally the act makes clarifications of those individuals that TDH will list on the abuse registry and the requirements of the disposition order from TBI.

This act takes effect July 1, 2018.

Public Chapter 671

This act redefines “trauma service codes.”

Previously it was defined as “the ICDA-9-CM discharge codes designated as trauma service codes by the American College of Surgeons committee on trauma.”

The new definition will be “a subset of the ICD-10-CM diagnosis codes, or the most relevant versions of the lnternational Classification of Diseases and Related Health Problems (lCD) required by the centers for medicare and medicaid services, for coding hospital discharges designated as trauma service codes by the American College of Surgeons committee on trauma.”

This act took effect April 12, 2018.

Public Chapter 675

This act requires the department of health to accept allegations of opioid abuse or diversion and for the department to publicize a means of reporting allegations.  

Any entity that prescribes, dispenses, OR handles opioids is required to provide information to employees about reporting suspected opioid abuse/diversion.  That notice is to either be provided individually to the employee in writing and documented by the employer OR by posting a sign in a conspicuous, non-public area of minimum height and width stating: “NOTICE: PLEASE REPORT ANY SUSPECTED ABUSE OR DIVERSION OF OPIOIDS, OR ANY OTHER IMPROPER BEHAVIOR WITH RESPECT TO OPIOIDS, TO THE DEPARTMENT OF HEALTH'S COMPLAINT INTAKE LINE: 800-852-2187.”

Whistleblower protections are also established.  An individual who makes a report in good faith may not be terminated or suffer adverse licensure action solely based on the report.  The individual also is immune from any civil liability related to a good faith report. 

This act takes effect January 1, 2019.

Public Chapter 744

This statute allows a licensing entity the discretion to not suspend/deny/revoke a license in cases where the licensee has defaulted or become delinquent on student loans IF a medical hardship significantly contributed to the default or delinquency.

This act took effect January 1, 2019.

Public Chapter 745 and Public Chapter 793

These public chapters work together to create and implement the “Fresh Start Act.”  Licensing authorities are prohibited from denying an application or renewal for a license/certificate/registration due to a prior criminal conviction that does not directly relate to the applicable occupation.  Lays out the requirements on the licensing authorities as well as the exceptions to the law (ex: rebuttable presumption regarding A and B level felonies). 

These acts take effect July 1, 2018.

Public Chapter 754

This chapter prevents any board, commission, committee, etc. created by statute from promulgating rules, issuing statements, or issuing intra-agency memoranda that infringe on an entity member’s freedom of speech. 

Freedom of speech includes, but is not limited to, a member’s freedom to express an opinion concerning any matter relating to that governmental entity, excluding matters deemed to be confidential under TCA 10-7-504.

Violations as determined by a joint evaluation committee may result in recommendations to the general assembly concerning the entity’s sunset status, rulemaking authority and funding.

This act took effect April 18, 2018.

Public Chapter 883

This act lays the framework for e-prescribing practices in the state and the exceptions from electronic prescriptions. Requires that all Schedule II prescriptions be e-prescribed by January 1, 2020 except under certain circumstances.  Any health-related board under TCA 68-1-101(a)(8) that is affected by this act shall report to the general assembly by January 1, 2019 on issues related to the implementation of this section.  The commissioner of health is authorized to promulgate rules to effectuate the purposes of this act. 

This act took effect May 3, 2018 for rule purposes.

The act takes effect January 1, 2019 for all other purposes.

Public Chapter 929

This act redefines policy and rule and requires each agency to submit a list of all policies, with certain exceptions, that have been adopted or changed in the previous year to the chairs of the government operations committees on July 1 of each year.  The submission shall include a summary of the policy and the justification for adopting a policy instead of a rule.

This act also prohibits any policy or rule by any agency that infringes upon an agency member’s freedom of speech. 

Finally, this act establishes that an agency’s appointing authority shall have the sole power to remove a member from a board, committee, etc.

This act takes effect July 1, 2018 and applies to policies adopted on or after that date.

Public Chapter 954

This legislation requires the initial licensure fee for low-income persons to be waived.  Low income individuals per the statute are defined as persons who are enrolled in a state or federal public assistance program including but not limited to TANF, Medicaid, and SNAP.  All licensing authorities are required to promulgate rules to effectuate the purposes of this act. 

This act takes effect January 1, 2019.

Public Chapter 1007

This act allows for a prescription for a controlled substance to be partial filled if requested by the patient or the practitioner who wrote the prescription AND the total quantity dispensed through partial fills does not exceed the total quantity prescribed for the original prescription.  The act lays out the requirements on the pharmacists and gives details regarding payments.

This act takes effect January 1, 2019.

Public Chapter 1021

This act allows for appeals of contested case hearings to be in the chancery court nearest the residence of the person contesting the agency action or at that person’s discretion, in the chancery court nearest the place the action arose, or in the chancery court of Davidson County.  Petitions seeking review must be filed within 60 days after entry of the agency’s final order. 

This act takes effect July 1, 2018.

Public Chapter 1039

This legislation places limits and requirements on the amount of opioids prescribed and dispensed.  It limits opioid prescriptions to up to a three day supply with a total of 180 MME (morphine milligram equivalents) for those three days.  This limitation is subject to a number of exceptions under certain circumstances.  These exceptions include up to a ten day supply with a total of 500 MME, up to a twenty day supply with a total of 850 MME for a procedure that is more than minimally invasive, and up to a thirty day supply with a total of 1200 MME when other reasonable and appropriate non-opioid treatments have been attempted and failed and the risk of adverse effects from the pain exceeds the risk of the patient developing an addiction or overdose.  Prescribing under these exceptions requires the prescriber to check the controlled substance monitoring database, personally conduct a physical exam of the patient, consider non-opioid alternatives, obtain informed consent including counseling about neonatal abstinence syndrome and contraception for women of childbearing age, and document the ICD-10 code for the patient’s primary disease (as well as the term “medical necessity” on thirty day prescriptions).  These ten, twenty, and thirty day opioid prescriptions will only be filled by dispensers in an amount that is half of the full prescription at a time, requiring patients and pharmacists to consider whether the patient requires the full amount prescribed.  There are still further exceptions for those patients undergoing active or palliative cancer treatment, receiving hospice care, diagnosed with sickle cell disease, administered to in a hospital, being treated by a pain management specialist or collaborating provider in a pain management clinic, who have received ninety days or more in the year prior to April 2018 or subsequently do so under one of the exceptions, receiving treatment for medication-assisted treatment, or suffering severe burns or major physical trauma. 

This act took effect for rule purposes on May 21, 2018, and for all other purposes shall take effect July 1, 2018.

Public Chapter 392

This legislation authorizes the Department of Health, in cooperation with the Board of Pharmacy, to establish a prescription drug donation repository program under which a person or organization may donate prescription drugs and supplies for use by an eligible nonprofit organization.  The law requires these nonprofit organizations to report data to the department about the number of donors, donations, types of prescriptions and other data.  The law allows donated drugs to be dispensed at no cost if they are in their original sealed packaging, are inspected by a pharmacist, and are prescribed by a healthcare practitioner and dispensed by a pharmacist.  Additionally, the law provides for limited civil and criminal liability for matters related to the donation, acceptance, or dispensing of drugs pursuant to this repository program.  Finally, the law allows the department of health, in consultation with the Board of Pharmacy, to promulgate rules to effectuate the purposes of this part.  This act will take effect on January 1, 2018.   

Public Chapter 355

This Act allows nursing homes to participate in the drug donation repository program.  Furthermore, it directs the board for licensing health care facilities to use emergency rulemaking to permit facilities to dispose of drugs by any DEA permitted manner including disposal by donation to a drug donation repository program.  This legislation took effect on May 11, 2017.

Public Chapter 350

This legislation will allow healthcare providers to satisfy one hour of continuing education requirements through the performance of one hour of voluntary provision of healthcare services.  The maximum amount of annual hours of continuing education that a provider can receive through providing volunteer healthcare services is the lesser of 8 hours or 20% of the provider’s annual continuing education requirement.  The legislation allows for rulemaking by the division of health related boards in order to administer this section.  This took effect on May 12, 2017.

Public Chapter 215

This legislation requires state governmental entities that establish or adopt guides to practice to do so through the promulgation of rules, rather than policy.  The rules so promulgated must specify all provisions included in and relating to the guide to practice.  Any changes to guides to practice made after the guides are adopted must also be promulgated by rule in order to be effective.   For purposes of this part, guides to practice includes codes of ethics and other quality standards, but does not include tests, examinations, building codes, safety codes, or drug standards.  This legislation took effect on April 28, 2017.

Public Chapter 240

This legislation authorizes entities that regulate health professionals to issue limited licenses and makes various changes related to reporting of disciplinary matters to licensure entities. This legislation will:

Insure the integrity of licensure examinations by making examination questions, answer sheets, scoring keys, and other examination data confidential and closed to public inspection.

Allow the issuance of limited licenses to applicants who have been out of clinical practice or inactive, or who are engaged in administrative practice.Limited licenses may be of restricted scope, restricted duration, and have additional conditions placed upon them in order to obtain full licensure.

Clarify that other documents prepared by or on behalf of the Department with regard to an investigation are confidential until such time as formal disciplinary charges are filed against the provider.

Eliminate the “locality rule” for administrative law.

Require the chief administrative official for each health care facility to report within 60 days any disciplinary action taken against an employee for matters related to ethics, incompetence or negligence, moral turpitude, or substance abuse, to the employee’s respective licensing board.All records pertaining to the disciplinary action shall be made available for examination to the licensing board.

This act became effective on May 2, 2017.

Public Chapter 481

This legislation creates a new violation of a healthcare practitioner’s practice act if that practitioner refuses to submit to or tests positive for any drug the practitioner does not have a lawful prescription for or a valid medical reason for using the drug.  It is the duty of the employer to report any violation to the Department of Health.  If the practitioner fails a drug test, the practitioner has 3 business days to either produce the requisite prescription or medical reason, or report to their board approved peer assistance program.  If the practitioner does not comply with any of these measures, it is the duty of the employer to report this violation of the practice act to the employee’s licensing board for investigation and action.  If the practitioner reports to the peer assistance program and obtains and maintains advocacy of the program, the employer is not required to notify the board. 

As long as a practitioner obtains, maintains and complies with the terms of a peer assistance program, the board shall not take action on the licensee for the sole reason of a failed or refused drug test.  If a practitioner fails to obtain or maintain advocacy from the peer assistance program, the program is required to report that information to the appropriate licensing board.  The board SHALL suspend the license of a practitioner who fails to comply with the terms of the program.  Employer drug testing must be compliant with the Drug-free Workplace requirements.  This legislation allows a quality improvement committee to share information regarding substance abuse by a practitioner with other quality improvement committees.  Additionally, this legislation specifies that the Department of Health is not required to obtain prior approval from the Attorney General in order to take any emergency action on a licensee. This legislation took effect on July 1, 2017.

Public Chapter 230

This legislation authorizes commissioners or supervising officials of departments to evaluate certain actions by a regulatory board to determine whether the action may constitute a potentially unreasonable restraint of trade.  Supervising officials must ensure that the actions of regulatory boards that displace competition are consistent with a clearly articulated state policy.  If a board action constitutes a potentially unreasonably restraint of free trade, the supervising official must conduct a further review of the action and either approve, remand or veto the action.  The supervising official may not be licensed by, participate in, or have a financial interest in the occupation, business or trade regulated by the board who is subject to further review, nor be a voting or ex officio member of the board.  The supervising official must provide written notice of any vetoed actions to the senate and house government operations committees. 

Prior to filing a regulatory board's rule with the secretary of state, the commissioner or chief executive officer of the administrative department under which a regulatory board operates or to which a regulatory board is administratively attached, or a designee to the extent a conflict of interest may exist with respect to the commissioner or chief executive officer, must remand a rule that may constitute a potentially unreasonable restraint of trade to the regulatory board for additional information, further proceedings, or modification, if the rule is not consistent with a clearly articulated state policy or law established by the general assembly with respect to the regulatory board.  This act took effect on April 24, 2017.    

Public Chapter 377

This is annual legislation regarding nursing home assessments and took effect on July 1, 2017. 

Public Chapter 349

This legislation allows disabled adults to hire paid personal aides to perform health maintenance tasks for them in the adult’s home.  “Home” is defined as the dwelling in which the person resides, whether the person owns, leases or rents the residence or whether the person resides in a dwelling owned, leased or rented by someone else.  “Health maintenance task” is defined as a healthcare task that a person without a disability would customarily and personally perform without assistance, the disabled person is unable to perform on their own, the licensed healthcare provider has determined can be safely performed by the aide, and can include tasks like: administration of glucometer tests, administration of eye or ear drops, nebulizer treatment, and ostomy care.  This act will take effect on January 1, 2018.    

Public Chapter 611

This extends the board of examiners for nursing home administrators six years to June 30, 2022.  It also establishes minimum attendance requirements for board members and requires the removal of members who do not meet the requirement of attending at least 50% of the scheduled meetings in a calendar year.

Public Chapter 763

Permits licensees whose licenses have expired due to non-payment to obtain reinstatement when payment of past due renewal fees, which are capped at twice the annual renewal fee, and unattained continuing education are completed.   This replaces the current requirement of payment of all past due fees before reinstatement. This act will take effect on July 1, 2016.

Public Chapter 990

This legislation requires an insurer to reimburse and provide coverage for telehealth services provided by a practitioner licensed in Tennessee, regardless of the patient’s location.  This act will take effect on January 1, 2017.

Public Chapter 1051

This legislation makes changes to the current requirements for medication aides.  Specifically, this legislation:

Reduces from 75 to 60 the number of required hours of instruction in a medication aide training program, consisting of 40 classroom hours and 20 clinical hours.

Establishes that a medication aide may not administer medications delivered by aerosol or nebulizers, or administer medications by metered hand-held inhalers without a spacer or a non-metered inhaler.

Authorizes the use of medication aides in any Program for All-Inclusive Care for the Elderly (PACE)

Adds language to require any nursing home, assisted-care living facility, or PACE program that utilizes one or more medication aides to administer medications, to implement a policy to track and record any incidents of medication errors and opioid or benzodiazepine diversions, and requires such incidents be made available to the Department of Health.

Public Chapter 154

This act allows the Commissioner of Health or his designee to have electronic access to medical records in order to facilitate investigations when responding to an immediate threat to public health. Today the Commissioner of Health or his designee already has this authority but must go to the facility to review the medical records.

Public Chapter 94

This act defines “abuse” and “neglect” for purposes of placing a person on the registry of persons who have abused, neglected, or misappropriated the property of vulnerable individuals specifically within the statutes that govern the Dept. of Health. It does not impact the definitions within the statutes that govern the Dept. of Intellectual and Developmental Disabilities nor the Dept. of Human Services.  It also increases the time within which placement on the registry may be appealed from 30 to 60 days.

Public Chapter 153

As enacted, this authorizes the board for licensing healthcare facilities and the departments of mental health and substance abuse services, human services, and intellectual and developmental disabilities to amend licensure rules to be consistent with the federal home-based and community-based settings final rule, but it prohibits the use of emergency rulemaking to promulgate such rules. 

Public Chapter 502

This act allows the Joint Government Operations Committee (the legislative committee that reviews all rules) to stay a rule up to 75 days instead of 60 days.  Present law authorizes the Joint Government Operations Committee to consider the following factors when reviewing rules: authority, clarity, consistency, justification, necessity and reference. This act adds arbitrariness and capriciousness as two new considerations.

Public Chapter 376

This creates the “Tennessee Right to Try Act.” It authorizes eligible patients to utilize investigational drugs, biological products or devices that have completed phase 1 of a clinical trial, but has not yet been approved for general us by the FDA. The clinical trial must be documented by the National Institutes of Health.  An eligible patient is:

·         someone with an advanced illness that is attested to by the patient’s treating physician and confirmed by a second physician

·         has considered all other FDA-approved treatment options

·         has received a recommendation from the patient’s physician for an investigational drug, biological product, or device

·         has given written, informed consent for the use of an investigational drug, biological product, or device

·         has documentation from such physician that the patient meets all the aforementioned requirements.

All expenses related to the use of investigational treatment will be borne by the patient.  Manufacturers are authorized to make investigational products available to patients with or without compensation.  This bill specifically prohibits Medicare or any licensing board from taking any adverse action against a licensee based solely on a recommendation for treatment with an investigational product and holds manufacturers and providers harmless if operating in good faith.  This act takes effect on July 1, 2015.

Public Chapter 268

This act makes disclosures of protected healthcare information permissible in medical malpractice lawsuits.

Public Chapter 411

This act requires any healthcare facility providing care with regards to dementia with Lewy bodies and frontotemporal dementia to provide written disclosure of the form of care, treatment, and activities provided to individuals receiving such care.  

Public Chapter 230-  Provides that each health-related board shall establish a procedure to expedite the issuance of a license, certificate, or permit for an applicant who is certified or licensed in another state to perform the same profession that is the subject of the application; whose spouse is a member of the armed forces; whose spouse is the subject of a military transfer to Tennessee; and who has left employment to accompany the person’s spouse to Tennessee.  The procedure shall include issuing the applicant a license, certificate, or permit if the licensure requirements in the other state are substantially equivalent to Tennessee’s requirements or developing a method to authorize the applicant to practice in Tennessee with a temporary permit in accordance with current law (T.C.A. §63-1-142). 

Public Chapter 358- Continues the Board for Nursing Home Administrators until June 30, 2011.

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.