The Tennessee General Assembly was back in action this week after lawmakers canceled legislative meetings due to a sweeping winter storm that covered much of Tennessee in a blanket of snow. Despite the unexpected interruption legislators swiftly resumed business on Monday, filing over 700 bills in just five days. TMA’s government affairs team spent the week identifying and securing sponsors for the association’s four priority issues ahead of the Jan. 31 deadline, which include:

SCOPE OF PRACTICE

Sen. Shane Reeves (R-Murfreesboro) | Rep. Ryan Williams (R-Cookeville)
After nearly a decade of fending off inappropriate scope of practice expansions by APRNs and PAs, TMA will be carrying a bill approved collectively by the Coalition for Collaborative Care (CCC) that modernizes the physician-led, team-based care model to give experienced mid-level providers more autonomy in diagnosing and treating patients while ensuring the collaborative agreement remains in place. The proposal draws on several points of agreement between the CCC and the Tennessee Academy of Physician Assistants (TAPA) amid ongoing negotiations, while incorporating safeguards that protect patients from expansive practice authority and misleading use of specialty designation. Specifically, the bill establishes a hybrid team-based care model wherein APRNs and PAs with over 6000 hours of post-graduate clinical experience can be endorsed by their respective licensing board after demonstrating competency. The endorsed status would enable them to diagnose and treat patients in collaboration with a physician, including ordering tests and durable medical equipment, in addition to performing minor medical procedures and signing death certificates. Nothing in statute would change for providers who have less than 6000 hours of post-graduate clinical experience.

PHYSICIAN WELLNESS

Sen. Richard Briggs, MD (R-Knoxville) | Rep. Tom Leatherwood (R-Arlington)
TMA is reviving its physician wellness proposal from last session but making it narrower to apply only to workplace burnout (as opposed to substance abuse and mental illness). The bill aims to enact confidentiality protections for physicians by implementing policies for records concerning mental health and wellness treatment, thereby ensuring physicians will not be required to disclose past treatment as a condition for licensure, credentialing, and pre-employment interviews. Due to opposition from various stakeholders last session the measure had been unsuccessful, but months of negotiations over the fall has yielded a suitable agreement among all parties.

DR. BENJAMIN MAUCK ACT

Sen. Joey Hensley, MD (R-Hohenwald) | Rep. Scott Cepicky (R-Culleoka)*
On July 11, 2023, Tennessee’s medical community tragically lost the life of beloved orthopedic surgeon, Dr. Benjamin Mauck, in a senseless act of violence in Collierville. Around the country, healthcare professionals are five times more likely to be injured in the workplace compared with their counterparts in other industries. TMA is working to mitigate violence in the healthcare setting by increasing the criminal penalty for assaults occurring in hospitals and physician offices. Statute already provides enhanced penalties for assaults committed against nurses and first responders.

*Note: TMA's previous sponsors for this legislation, Sen. Paul Rose (R-Covington) and Rep. Kevin Vaughan (R-Collierville), have agreed to sign on to this bill which was carried over from the 2023 legislative session.

INSURER CLAWBACKS

Sen. Ken Yager (R-Kingston) | Rep. Brock Martin (R-Huntingdon)
Many practices across Tennessee have struggled with insurance contracts that permit payers to recover alleged overpayments by reducing or “offsetting” overpaid amounts from pending or future claims payments with few restrictions or transparency requirements. Current statute, which has not been updated in more than two decades, allows this type of recoupment to go back up to 18 months. TMA is working to reform this process by limiting the timeframe in which health plans may recoup overpayment for improperly adjudicated claims while making the process more transparent by requiring detailed notice of the basis of recoupment, including the specific CPT, billing, or modifier codes under question and a citation of the relevant policy. Under the proposal, health plans would be prohibited from recouping any monies until all appeals are exhausted.

2024 DOCTOR OF THE DAY VOLUNTEERS

Each Tuesday during the legislative session, TMA members have the opportunity to volunteer their time to serve the needs of lawmakers and staff, observe the legislative process, and advocate for regulatory or policy issues they are passionate about. Volunteers for the 2024 Doctor of the Day program are as follows: 

Jan. 30: Jonathan Hughes, MD – Anesthesiology, Sullivan County Medical Society

Feb. 6: Katrina Green, MD – Emergency Medicine, Nashville Academy of Medicine

Feb. 13: Roger Sherman – Preventive Medicine, Nashville Academy of Medicine

Feb. 20: Daniel Sumrok, MD – Addiction Medicine, Blount County Medical Society

Feb. 27: Kaylin Craig, MD – Internal Medicine, Nashville Academy of Medicine

March 12: David Arehart, MD – Pain Medicine, Upper Cumberland Medical Society 

March 19: Elise Denneny, MD – Otolaryngology and Randal Dabbs, MD – Emergency Medicine, Knoxville Academy of Medicine

March 26: Elly Riley, DO – Family Medicine, Consolidated Medical Assembly of West Tennessee

April 2: Michael Mabry, DO – Family Medicine, Washington-Unicoi-Johnson Medical Society

April 9: VACANT*

April 16: Brian Bingham, MD – Radiation Oncology, Bradley County Medical Society 

*Interested in serving as Doctor of the Day on April 9? Contact TMA’s Grassroots & Legislative Affairs Associate, Joey Alongi, at joey.alongi@tnmed.org.