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Tennessee Nurse Practitioner Association

Weekly Legislative Update

Posted almost 3 years ago by Irene Bean

Week of March 30, 2015

Senate Commerce and Labor committee met on Tuesday of this week to consider its regular calendar of bills including the consideration of Senate Joint Resolution 93, a joint resolution authorizing implementation of Insure Tennessee. After explanation of the resolution by Sen. Doug Overbey, Senator Richard Briggs gave detailed explanation of the amendment adopted by the Senate Health and Welfare committee. As reported, the amendatory language sought to address concerns raised during the Special Session on Insure Tennessee earlier this year. Sen. Briggs stated the amendment; 1) would require an inclusion of a provision in the waiver for a six-month disenrollment period for nonpayment of premiums; 2) the amendment would require the Governor to receive written confirmation of the ability to opt out if the federal funds are not available; and 3) the amendment would specify that the waiver program not be implemented until after the United States Supreme Court decides King v. Burwell (a ruling on health insurance exchanges).

However, after careful and detailed justification for the need of Insure Tennessee, the measure was defeated by members of the Senate Commerce Committee.

6 NO votes include: Sen. Jack Johnson (Chair), Sen. Jim Tracy, Sen. Todd Gardenhire, Sen. Delores Gresham, Sen. Steve Southerland and Sen. Bo Watson.

2 YES votes: Sen. Reginald Tate and Sen. Ken Yager

1 abstained vote: Sen. Mark Green

Please thank Senators Yarbro, Overbey, Briggs, Tate, and Yager for their support of this effort.

Other bills of interest to TNA for this week include the following:

SB72 / HB61 Operation of health insurance exchange by state. -- Sen. Brian K. Kelsey / Rep. Jeremy Durham -- Prohibits the state from operating any American Health Benefit Exchange or any other health insurance exchange under the Patient Protection and Affordable Care Act contingent upon the outcome of King v. Burwell.

04/01/2015 - Taken off notice in House Insurance & Banking Subcommittee.

SB469 / HB395 Helmet exemption for motorcycle riders in funeral procession. -- Sen. Mike Bell / Rep. Tilman Goins -- Exempts drivers and passengers who are 18 or older from wearing a helmet while riding a motorcycle in a funeral procession, memorial ride, or body escort detail.

House Transportation Committee Amendment 1 rewrites the bill. Permits passengers in a parade ride not exceeding 30 miles per hour, and both passengers and drivers in a funeral procession, memorial ride under a police escort, and in a body detail not exceeding 60 miles per hour, to not use a helmet.

Senate Transportation and Safety Committee 1 places speed requirements in all scenarios where a helmet is not lawfully required when operating or riding on a motorcycle at 30 miles per hour or under.

04/01/2015 - Senate Finance, Ways & Means Committee deferred to next week's calendar.

04/01/2015 - House Finance Subcommittee placed behind the budget.

SB615 / HB674 Information required in pamphlet for newborn testing. -- Sen. Joey Hensley / Rep. Courtney Rogers -- Requires information disseminated by the department of health about the confidentiality of the birth defects registry to participating perinatal centers that will be made available to the families shall be made available in a pamphlet. Provides that such information, along with other information on programs provided by the department regarding genetic screening and birth defects, shall be provided to families to review and sign, acknowledging receiving the information. Provides that a newborn screening specimen taken for testing shall be kept for one year for the physicians to request additional testing.

House Health Committee amendment 1 deletes requirement for family to review and sign an acknowledgement of receiving information about newborn testing prior to any testing. Removes requirement that specimen and form with identifying information be kept separate and clarifies that both should be destroyed after one year. Deletes section substituting "person" for "healthcare provider" in existing statute.

04/02/2015 - Set for House Floor on 04/08/15.

SB775 / HB2 Required ultrasound prior to abortion. -- Sen. Mae Beavers / Rep. Rick Womick -- Requires an ultrasound be performed not more than 72 hours and not less than 24 hours before the performance of an abortion. Requires the healthcare practitioner to verbally offer the pregnant woman an opportunity to view the ultrasound image and receive a printed copy. If the woman declines, the healthcare practitioner must provide: 1) a verbal explanation of the results, 2) a copy of the ultrasound image to the woman, and 3) an audible real-time heart beat for the woman to hear. Prohibits a provider from accepting any form of payment, deposit, or exchange or make any financial agreement for an abortion or abortion related services other than for payment of the ultrasound. Creates an exception for the ultrasound requirement where there is a medical emergency.

03/31/2015 - House Health Subcommittee deferred to 2016.

SB871 / HB1036 Addiction Treatment Act of 2015. -- Sen. Steven Dickerson / Rep. Ryan A. Haynes -- Enacts the "Addiction Treatment Act of 2015." Prohibits arresting, charging, or prosecuting any individual who, in good faith, seeks medical assistance for a drug overdose themselves, or seeks medical assistance for another person experiencing or believed to be experiencing a drug overdose. Prohibits (1) penalties for a violation of a protective or restraining order, and (2) sanctions for a violation of a condition of pretrial release, probation, parole. Specifies various limitations of the law. Allows certain products containing buprenorphine to be prescribed under various situations and sets limitations for the drug.

House Health Subcommittee amendment 1 provides that the immunity from being arrested, charged or prosecuted applies to the person experiencing a drug overdose only on the person's first such drug overdose.
04/01/2015 - House Health Committee deferred to 04/08/15.

SB885 / HB1018 General assembly approval not needed for governor to expand medicaid. -- Sen. Jeff Yarbro / Rep. Mike Stewart -- Repeals requirement that the general assembly must authorize by joint resolution any expansion of optional enrollment in the medical assistance program, pursuant to the Patient Protection and Affordable Care Act.

03/31/2015 - House Health Subcommittee deferred to 2016.

SB892 / HB1003 Disclosure of protected medical information allowed in certain cases. -- Sen. Brian K. Kelsey / Rep. Jon Lundberg -- Specifies that in a healthcare liability action any healthcare provider's disclosure of protected health or other relevant information, including but not limited to, opinions as to the standard of care, compliance with or breach of the standard, causation of injury, or any other information relevant to the analysis and evaluation of the plaintiff's claim is subject to disclosure.

Senate Judiciary Committee Amendment 1, House Civil Justice Committee Amendment 1 removes language making disclosures of "any other information relevant to the analysis and evaluation of any asserted claim" permissible disclosures.

04/01/2015 - Senate Judiciary Committee recommended with amendment 1. Sent to Senate Calendar Committee.

04/02/2015 - Set for House Floor on 04/09/15.

SB925 / HB700 Revises helmet requirement for riders and passengers of motorcycles. -- Sen. Kerry Roberts / Rep. Jay D. Reedy -- Exempts drivers and passengers over 21 years of age from the requirement to wear a crash helmet while operating or riding in motorcycles, motor-driven cycles, and motorized bicycles. Excludes persons not covered by health or medical insurance other than insurance through TennCare. Establishes a violation of the helmet law as a secondary offense.

03/25/2015 - Failed in Senate Transportation & Safety Committee.

04/01/2015 - House Transportation Subcommittee recommended. Sent to House Transportation Committee.

SB937 / HB963 Healthcare Provider Stability Act. -- Sen. Bo Watson / Rep. Jon Lundberg -- Creates the "Healthcare Provider Stability Act." Establishes requirements regarding material changes in fees or payment methodologies by a third-party payer or healthcare provider. Establishes process for certain third-party payer or healthcare provider to alter material changes regarding previously agreed payment terms.

Joint Council on Pensions and Insurance amendment 1 deletes all language after the enacting clause. Prohibits a health insurance entity from making a change to a provider's fee schedule except for one-time during any 12-month period or if a health insurance entity and a hospital agree in writing to a change in the fee schedule. This prohibition does not apply to changes effected by federal or state government; certain reimbursements for drugs, immunizations, or injectables; changes due to the provider's chargemaster under certain circumstances; any changes or additions to the list of Current Procedural Terminology (CPT) codes or Healthcare Common Procedure Coding System; and any changes or additions to revenue codes established by the National Uniform Billing Committee. Authorizes a health insurance entity to effect a change only to any policies, procedures, or methodologies on two dates, April 1 and October 1, of a given year except for limited exclusions included within the bill. These provisions of the bill do not apply to the state employee, local education, and local government insurance plans or the health plans administered by the Division of Health Care Finance and Administration, including TennCare, Cover Kids, and AccessTN. Establishes requirements between health insurance entities and healthcare providers and provider network contract amendments, including fee schedule disclosures and possible terminations of other network agreements based on a provider's decision. Creates reporting of alleged noncompliance procedures between the two parties. Requires health insurance entities to contract with independent reviewers to implement dispute resolution and the timeframes in which dispute procedures must be completed. Creates the Selection Panel for Health Insurance Reviewers and requires the Commissioner of Commerce and Insurance to appoint five individuals and a designee from the department. The panel will not be paid and will meet twice a year. The Commissioner will annually publish a report that includes the number of requests for independent reviews filed for each health insurance entity during the prior calendar year and generally report the outcome of these independent review requests. Requires health insurance entities to provide the payment or fee schedules and all other information sufficient to enable the healthcare provider to determine the manner and amount of payments under the contract prior to the final execution or renewal of the contract. The health insurance entity shall make available to the healthcare provider access, free of charge, to that provider's individual fee schedule in a format readily adaptable to the provider's practice management system. Requires health insurance entities to provide notice of any change to the provider's fee schedule within 90 days prior to the effective date of the change. Requires health insurance entities to maintain detailed descriptions and copies of coding guidelines, policies, methodologies, and processes that would impact coverage or payment of items and services that are expected to be applied to claims; information that will enable the provider to determine what effect the application of claims edits and payment rules will have on payment prior to the provider's providing an item or services or submitting a claim; and information that will enable the provider to determine the potential basis for the health insurance entity's claim denial, reduction, or delay; any additional documentation needed by the health insurance entity that is necessary for payment; and any patient data or Senate Committee Commerce and Labor Committee Amendment 1 rewrites Section 3 of the amended bill to exclude TennCare and the state, local education or local government health insurance programs.

03/31/2015 - Senate Commerce & Labor Committee recommended with amendment 1. Sent to Senate Finance.

04/01/2015 - House Insurance & Banking Subcommittee recommended with amendment 1. Sent to House Insurance & Banking Committee.

SB961 / HB1324 Waiver to extend TennCare eligibility to veterans. -- Sen. Sara Kyle / Rep. Joe E. Armstrong -- Directs the commissioner of finance and administration to request an appropriate waiver to extend TennCare eligibility to veterans under the federal Patient Protection and Affordable Care Act on the basis of income

04/01/2015 - Taken off notice in House Insurance & Banking Subcommittee.

SB984 / HB572 Definition of biological product for TN Affordable Drug Act. -- Sen. Mark S. Norris / Rep. Cameron Sexton -- Defines a "biological product" and an "interchangeable biological product" in the Tennessee Affordable Drug Act of 2005. Requires a prescriber to allow for the substitution of a prescribed biological product for an interchangeable biological product, except in cases where the prescriber determines the medical necessity of a prescribed biological product due to certain conditions or an interchangeable biological product is unavailable. Specifies that a pharmacist who selects an interchangeable biological product for substitution has the same responsibilities for that product as the pharmacist would have for dispensing a prescription. Requires the board of pharmacy to maintain a link on its website to the current list of all biological products determined by the FDA to be interchangeable biological products.

House Health Committee Amendment 1 rewrites the bills. Defines "biological product" and "interchangeable biological product." Requires prescriber to allow for substitutions with an interchangeable biological product of a prescribed biological product except in certain circumstances.

House Health Committee Amendment 2 changes effective date of the bill to July 1, 2015.

House Health Committee Amendment 3 clarifies the bill as amended does not apply to prescriptions administered to patients in a hospital, nursing home, or assisted living facility.

House Health Committee Amendment 5 adds language specifying that if the state mandates electronic medical records between a pharmacist and prescriber, then the pharmacist will only be required to communicate the biological dispensed through an electronic medical records system when such system is in place and the information is accessible to the prescribers.

Senate Health and Welfare Committee Amendment 1 rewrites the bills. Defines "biological product" and "interchangeable biological product." Requires prescriber to allow for substitutions with an interchangeable biological product of a prescribed biological product except in certain circumstances. Specifies that a pharmacist must notify a prescriber within five business days of dispensing a biological product, rather than within a reasonable time. Specifies the methods of electronic communication that a pharmacist can use to communicate with prescribers. Specifies that a pharmacist is only required to communicate the biological product dispensed through an electronic medical records system when such a system is in place and the information is accessible by the prescriber.

Senate Health and Welfare Committee Amendment 3 substitutes the language "that is electronically accessible" in section 2 with the language "that can be accessed electronically."
04/02/2015 - Senate deferred to 04/06/15.

04/02/2015 - Set for House Floor on 04/08/15.

SB1124 / HB1209 State health insurance exchange. -- Sen. Jeff Yarbro / Rep. Harold Love Jr. -- Requires the state to establish a health insurance exchange under the federal Patient Protection and Affordable Care Act if King v. Burwell is decided by the United States supreme court in a certain manner.

04/01/2015 - Taken off notice in House Insurance & Banking Subcommittee.

SB1266 / HB1157 Pain management clinic requirements for medical directors and others. -- Sen. Ken Yager / Rep. Bob Ramsey -- Defines the terms certificate holder, medical director, and pain management specialist as they relate to pain management clinics. Revises qualifications for medical directors of pain management clinics and increases the time medical directors have to spend on site. Requires pain management clinics to obtain a certificate to operate which are only granted to an owner of a clinic who is also a certificate holder. Broadly captioned.

Senate Health & Welfare Committee Amendment 1, House Health Subcommittee Amendment 1 rewrites the bill. Provides that anyone with an ownership interest in a pain management clinic shall be eligible to be the certificate holder. Redefines "medical director" to include an individual who is a pain management specialist on or after July 1, 2016. Redefines "pain management specialist" to provide further qualifications to be eligible. Establishes that all advanced practice nurses and physician assistants who practice in a certified pain clinic shall be supervised by a pain medicine specialist. Requires the commissioner of health, by January 1, 2016, to develop recommended treatment guidelines for prescribing opioids that can be used by prescribers as a guide for caring for patients, and to develop, by January 1, 2017, recommended pain clinic standards for the operation of a pain management clinic. Provides that the guidelines shall be submitted to the appropriate prescribing boards and the board of pharmacy, and each board shall notify its licensees of the existence of the standards.

House Health Subcommittee Amendment 2 requires that there be board certification for certain clinics. Requires clinics to pass certain examinations.

House Health Subcommittee Amendment 1 to 2 extends the enacting date from July 1, 2016 to July 1, 2017 that physicians must be certified specialists.

04/02/2015 - Senate deferred to 04/06/15.

SB1287 / HB1216 Explanations justifying amount of drugs prescribed. -- Sen. Joey Hensley / Rep. Barry Doss -- Extends the time in which the top 50 prescribers of controlled substances must provide an explanation to the department of health justifying the amount of controlled substances they prescribed from 15 business days to 30 business days.

04/01/2015 - House Criminal Justice Committee recommended with amendment. Sent to House Health Committee.

HJR85 Commends Governor Haslam for his efforts on Insure TN. -- Rep. Craig Fitzhugh -- Commends Governor Haslam for his efforts concerning the Insure Tennessee proposal, and encourages him to continue negotiations with CMS to obtain a written agreement concerning TennCare Demonstration Amendment #25.

04/01/2015 - Failed in House Insurance & Banking Subcommittee.

HJR90 Authorizes implementation of Insure Tennessee. -- Rep. Larry J. Miller -- Authorizes the Governor to do all that is necessary and appropriate to implement Insure Tennessee substantially as described in TennCare Demonstration Amendment #25.

04/01/2015 - House Insurance & Banking Subcommittee deferred to summer study.