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Tennessee Nurse Practitioner Association

Legislation in the House - Pain Management Clinics

Posted over 2 years ago by Irene Bean

I am receiving this message today:

TN Advocates,

SPPAN is scheduling a strategy call to talk about plans around SB 1466, which we currently oppose, and thought you might be interested. This bill, which concerns pain management clinics, appears to be moving quickly and there are some serious concerns that many of us share. We would like to hear what others may be doing and consider how we can best work together to support good pain care.
Thursday, Jan. 14
3:00-4:00 CST
641-715-3272, 647214#

For some more detailed background: As currently written, the bill would (among other things):
Require a certificate of need in order to establish and operate a pain management clinic, which could severely impact patient access to care by reducing the number of pain management clinics that may operate in a given location. Further, no certificates of need for new pain management clinics shall be issued until the state health planning division has made recommendations with respect to the appropriate criteria that are consistent with the state health plan, and until the agency has adopted the appropriate criteria. There is no deadline for finalizing these recommendations specified in the bill, meaning the process could take a significant amount of time while still complying with the law.

Require a special license for every pain clinic after January 1, 2017. It is unclear how and/or why this is different from the certificate of need. Further, the commissioner may refuse a license to any application and the decision of the commissioner will be final. There will be no opportunity for appeal.

Would allow for the suspension or revocation of a clinic's licensure due to the conviction of any employee of the clinic for any offense involving the sale or dispensation of controlled substances. The commissioner shall also have the ability to place a facility on probation, but there is no guidance as to what would trigger such a probation.

Impose criminal charges in the form of a Class A Misdemeanor for operating a pain clinic without a license. This would mean fines of $1000 per day (and potential jail time, as a Class A Misdemeanor is punishable by 11 months in jail in Tennessee) and no grace period is specified. Given that pain management clinic status is triggered in Tennessee when 50% or more patients are being treated for "chronic non-malignant pain treatment," a clinic could inadvertently fall in violation of this provision, with no time to take corrective action, by agreeing to see just one patient too many in need of pain management services.

Require the medical director of each pain clinic to report to the Department of Health each year, among other things, the number of patient's treated at the clinic who have overdosed, the number of patient's being treated for pain of the clinic who have died during the year, and the number of morphine equivalents per patient per clinic.

Disallow pharmacies within, or adjacent to, pain management clinics.

In the interest of not re-writing the entire bill in this email, we have only listed some of the most bothersome provisions, but there are more. If passed, this bill will have severe consequences for pain management clinicians and those living with pain in Tennessee.
We hope you can make this time, but if you aren't available but are interested in the collective discussion, please let us know if you have a few minutes to touch base about it this week.

All the best,
Amy & Katie
Amy Goldstein, MSW
Director, State Pain Policy Advocacy Network (SPPAN)
American Academy of Pain Management
913-484-2120 (mobile)
Katie Duensing, JD
Researcher and Policy Analyst
American Academy of Pain Management

We cannot allow this bill to move forward. This is taking one piece of the physician led bill and chopping it, one slice at a time. If you can call your legislators NOW, please act on this immediately.

This will affect those NPs who are owners of pain management clinics, now, but will eventually come to those owning family practices and weight loss clinics, next. We have to unite.
If you require more information, please contact Brett Brett Badgley Snodgrass, Irene Bean, or Thomas Cooper. I am asking for you to repost and call today. Timing is CRUCIAL!!