TCEP’s 2020 Legislative / Regulatory Summary

John Proctor, MD, FACEP

1. There were no attempts to reverse the Tennessee College of Emergency Physicians (TCEP) successful 2019 effort to preserve the following exclusion to the mandatory check of the Controlled Substance Monitoring Database (CSMD):
The quantity of the controlled substance which is prescribed or dispensed does not exceed an amount which is adequate for a single, three-day treatment period (emphasis added) and does not allow a refill.

TCEP’s 2019 effort relieved all Tennessee physicians of the burden of interrupting workflow and patient care to log in to the CSMD for short-term, non-refillable controlled substance prescriptions.

The entire Tennessee Code Annotated 53-10-310 section containing this language may be found at: http://www.tsc.state.tn.us/Tennessee%20Code
Click on “View Tennessee Code” then enter 53-10-310 into the search bar.

2. The Tennessee Supreme Court, in an opinion published February 26, 2020, upheld Tennessee’s statutory cap on noneconomic damages in civil cases, codified at Tennessee Code Annotated 29-39-102, which generally limits noneconomic damages, including pain and suffering, permanent injury, and loss of enjoyment of life, to $750,000.

The Tennessee punitive damages cap was part of the Tennessee Civil Justice Act, passed by the state legislature in 2011. The Supreme Court ruling in 2020 lends substantive judicial support for this damages cap law.

3. No legislative action on balance billing has emerged from House or Senate committee in 2020. TCEP supports the caption bill submitted by Senator Bo Watson and Representative Timothy Hill. This bill is based on the independent dispute resolution model from New York. TCEP will continue to advocate for removing the patient from balance bill dispute resolution and the application of an independent, third party database–such as FAIR Health—to determine fair market value for physician services.

4. TCEP supports the full repeal of the Tennessee Professional Privilege Tax. A bill sponsored by Senator Jack Johnson and Representative William Lamberth (SB 2201/HB 2268) would reduce the professional privilege tax from $400 to $200.

5. TCEP supports the telehealth bill sponsored by Senator Art Swann and Representative Robin Smith (SB 1892/HB 1699). This bill seeks to increase access to telehealth-rendered care in rural areas of Tennessee.

For many years, TCEP physicians have sought to improve the healthcare provided to some of our most needy citizens—those with behavioral health and substance abuse issues. Due to an inadequate system to support their needs, these patients often languish in emergency departments across the state. The mental health system often usurps the independent medical judgement of emergency physicians by demanding expensive and medically unnecessary diagnostic studies for these patients as part of “medical clearance.”

In September 2019, the Tennessee Department of Mental Health and Substance Abuse (TDMHSAS) named Sanford (Sandy) Herman, MD, MS, FACEP as Community Behavioral Health Medical Director at the TDMHSAS. This is a true “win” for Tennessee behavioral health and substance abuse patients and for emergency physicians across the state. Sandy is the current TCEP Secretary-Treasurer and TCEP Past-President. Sandy has held numerous leadership positions within the American College of Emergency Physicians (ACEP) and is the recipient of one of ACEP’s highest individual awards, the John A. Rupke Legacy Award. We wish Sandy all the best in his new role.