Legislation seeking to bar physicians from asking patients about guns in their homes failed in the Senate Health and Welfare Committee this week. SB474/HB387 by Sen. Janice Bowling (R-Tullahoma) and Rep. Ed Butler (R-Rickman), would have prohibited a healthcare provider from inquiring as to a patient's ownership, possession of, or access to firearms, ammunition, or accessories. It also would have subjected violators to disciplinary action and a fine of $1,000 for making such inquiries.

TMA opposed the legislation over concerns that it would have inhibited a physician’s ability to protect children from preventable firearm injury and educate parents about safe gun storage, an issue on which TMA has House of Delegates policy.

During the hearing, Sen. Ferrell Haile (R-Gallatin) asked to hear from TMA. Julie Griffin testified that “TMA has grave concerns about this piece of legislation. Doctors ask about guns because they are trying to take care of patients.” The bill only received one yes vote from the Committee so it is finished for the session.

GOVERNOR’S SCOPE OF PRACTICE LEGISLATIVE AGENDA

As part of the Federal Rural Healthcare Transformation Grant, the Governor’s office has several proposals to increase scopes of practice for psychologists and pharmacists, and proposals to create pathways for Advanced Practice Registered Nurses (APRNs) and Physician Assistants (PAs) to practice without a formal physician collaboration agreement.

TMA worked with its multi-specialty partners in the Coalition for Collaborative Care (CCC) to defeat two of the proposed scope expansions this week and testified on another.

Both SB2245/HB2554, Independent Practice for APRNs, and SB2243/HB2555, Independent Practice for PAs, were taken off notice this week, shelving them for the session.

Despite our opposition, the bill allowing Test and Treat for Pharmacists (SB2242/HB2557) successfully moved out of Senate Health and Welfare Committee this week. TMA Member and Tennessee Academy of Family Physicians Vice Chair, Dr. William “Trae” Bates, testified to the inherent dangers in giving pharmacists such wide-ranging treating ability without performing a physical examination and taking a patient’s clinical history. TMA and the CCC will continue to work to get the bill amended, discussing with legislators the potential for patient harm.

TMA LEGISLATION

One of TMA’s priority bills, the medical necessity determination bill, advanced unanimously out of the House Health Committee on Wednesday and will be heard on the House floor on Monday. It already passed in the Senate. As amended, SB1753/HB1770 by Sen. Ferrell Haile (R-Gallatin) and Rep. Brock Martin (R-Huntingdon) updates Tennessee statute governing medical practice to keep pace with emerging technologies and healthcare delivery models. First, the proposal formally recognizes three newly identified specialties within the practice of medicine:

• Clinical Informatics - medical practice incorporating mathematics, statistics, databases, software technology, etc. to improve patient outcomes and system efficiency
• Lifestyle Medicine - medical practice focused on the prevention and long-term management of chronic diseases like diabetes, obesity and cardiovascular conditions
• Medical Virtualist - medical practice that utilizes cutting edge telehealth delivery systems to reach patients who may have limited or no access to specialty care

Second, the bill clarifies that both medical doctors and osteopathic physicians may determine the appropriateness of treatments or procedures for patient conditions and that all doctors making medical necessity decisions be governed by their respective medical boards.

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