Official Summary Text
Present law requires the department of health ("department") to identify high-risk prescribers based on clinical outcomes, including patient overdoses. Further, the department is required to determine the criteria to make such a determination. This bil
l requires the department to make the criteria for identifying prescribers as high-risk prescribers publicly available on the department's website.
PAIN MANAGEMENT SPECIALISTS
This bill clarifies that the high-risk prescribers determination does not apply to pain management specialists. As used in this bill, a "pain management specialist" means a licensed physician that holds an unencumbered Tennessee license and meets any of
the following requirements:
The physician has a subspecialty certification in pain medicine or pain management as accredited by the Accreditation Council for Graduate Medical Education (ACGME) through either the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA), or is eligible to sit for the board examination offered by ABMS or AOA. Such a physician must maintain the minimum number of continuing medical education hours in pain medicine or pain management to satisfy retention of ABMS or AOA certification.
The physician attains American Board of Pain Medicine (ABPM) diplomate status. Such a physician must maintain the minimum number of continuing medical education hours in pain management to satisfy retention of ABPM diplomate status.
The physician is board certified by the American Board of Interventional Pain Physicians (ABIPP) by passing exam 1 on or before June 30, 2016. After July 1, 2016, new applicants must be board certified by ABIPP by passing parts 1 and 2 of its examination. Such a physician must maintain the minimum number of continuing medical education hours to satisfy retention of ABIPP diplomate status.
The physician has an active pain management practice in a clinic accredited in outpatient interdisciplinary pain rehabilitation by the commission on accreditation of rehabilitation facilities or any successor organization.
Present law requires a pain management clinic to have a medical director who is a medical doctor or osteopathic physician who practices in this state and is a pain management specialist. This bill authorizes a pain management specialist to provide cover
age for and serve as medical director in the place of a medical director who is unable to fulfill the medical director's duties on a temporary basis because of illness, vacation, or unavailability. Such coverage does not require the in-person presence of
t
he pain management specialist who is providing coverage for the medical director, as long as the specialist is immediately available by phone. This bill clarifies that temporary service as a medical director does not count against the four pain managemen
t clinic limit for which a pain management specialist may serve as medical director. Further, the department is prohibited from requiring a medical director to notify the department of the identity of a temporary coverage pain specialist.
INFORMED CONSENT REQUIREMENT
Present law requires the department to submit a high-risk prescriber's information to the board that issued the prescriber's license for appropriate action. The licensing board is required to notify the prescriber, and require the prescriber to, among o
ther things, obtain written consent from any patient who will receive opioid therapy for more than three weeks with daily dosages of at least 60 morphine milligram equivalents. Such an informed consent form must explain the risks of, complications of, me
di
cal and physical alternatives to, and consequences of opioid therapy and addiction. Present law requires the informed consent to be renewed at four-week intervals for patients who continue to receive opioid therapy. This bill, instead, requires the info
rmed consent to be renewed at 30-day intervals for patients who continue to receive opioid therapy.
CONTINUING EDUCATION REQUIREMENT
Present law requires a high-risk prescriber to participate in continuing
education that is designed to inform providers about the risks, complications, and consequences of opioid addiction. This bill requires the department to expunge the identification of a prescriber as a high-risk prescriber upon receiving proof that the p
rescriber has completed such continuing education requirements. Further, the department must notify the prescriber in writing of the expungement.
MISCELLANEOUS CHANGES
Present law requires a medical director of a pain management clinic to be onsite for at least 20% of the clinic's weekly total number of operating hours. This bill, instead, requires the medical director to be onsite for at least 20% of the clinic's qua
rterly total number of operating hours.
Present law provides regulations for pain management clinics, including license requirements, inspection requirements, medical director requirements, restrictions on ownership, reporting requirements, and dispensing requirements, among others. This bil
l authorizes the commissioner to issue advisory private letter rulings to any licensed pain clinic who is affected by such regulations for pain clinics. However, such a private letter ruling only affects the licensed pain clinic making the inquiry and ha
s
no such precedential value for any other inquiry or future contested case.
ON APRIL 2, 2026, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 2279, AS AMENDED.
AMENDMENT #1 requires the department to receive proof that the prescriber has completed course requirements and that either (i) none of the patient overdoses that formed the basis for the prescriber's identification as a high-risk prescriber involved a s
ubstance prescribed by the prescriber; or (ii) the department does not identify the prescriber as a high-risk prescriber for the next two consecutive years prior to expunging a prescriber's identification as a high-risk prescriber.
Current Bill Text
Read the full stored bill text
HOUSE BILL 2572
By Kumar
SENATE BILL 2279
By Briggs
SB2279
012218
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AN ACT to amend Tennessee Code Annotated, Title 63
and Title 68, relative to pain management.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 68-1-128(c)(1), is amended by
deleting the subdivision and substituting:
(1) In addition to identifying prescribers pursuant to subsections (a) and (b),
beginning July 1, 2017, and annually thereafter, the department shall identify high-risk
prescribers based on clinical outcomes, including patient overdoses. The department
shall determine which providers are high-risk prescribers and the criteria to make such
determination. The department shall make the criteria for identifying prescribers as high-
risk prescribers publicly available on the department's website. Providers determined to
be high-risk prescribers pursuant to this subdivision (c)(1) are subject to selected chart
review and investigation by the department.
SECTION 2. Tennessee Code Annotated, Section 68-1-128(c)(3)(D), is amended by
deleting "four-week" and substituting "thirty-day".
SECTION 3. Tennessee Code Annotated, Section 68-1-128, is amended by adding the
following as new subdivisions:
(7) Subdivision (c)(1) does not apply to pain management specialists, as defined
in § 63-1-301.
(8) The department shall expunge the identification of a prescriber as a high-risk
prescriber pursuant to subdivision (c)(1) upon receiving proof that the prescriber has
completed the course requirements of subdivision (c)(3)(A), and shall notify the
prescriber in writing of the expungement.
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SECTION 4. Tennessee Code Annotated, Section 63-1-306, is amended by inserting
the following as a new subsection (c), and redesignating the existing subsection (c) and
remaining subsections accordingly:
(c)
(1) A pain management specialist may provide coverage for and serve as
medical director in the place of a medical director who is unable to fulfill the
medical director's duties on a temporary basis because of illness, vacation, or
unavailability. Such coverage may be provided on a temporary, short-term basis
and does not require the in-person presence of the pain management specialist
who is providing coverage for the medical director, as long as that pain
management specialist is immediately available by phone.
(2) Temporary service in the capacity of a medical director pursuant to
subdivision (c)(1) does not count against the limit of four (4) pain management
clinics at which a pain management specialist may serve as medical director
under § 63-1-309(c).
(3) The department shall not require a medical director to notify the
department of the identity of another pain management specialist who serves as
medical director pursuant to subdivision (c)(1) during the medical director's
absence.
SECTION 5. Tennessee Code Annotated, Section 63-1-309(c), is amended by deleting
"weekly" and substituting "quarterly".
SECTION 6. Tennessee Code Annotated, Section 63-1-316, is amended by adding the
following as a new subsection:
(k) The commissioner or the commissioner's designee is authorized to issue
advisory private letter rulings to any affected licensee who makes such a request
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regarding any matters within this part. Such private letter ruling only affects the licensee
making such inquiry and has no precedential value for any other inquiry or future
contested case. Any dispute regarding a private letter ruling may, if the commissioner or
the commissioner's designee chooses to do so, be resolved pursuant to the declaratory
order provisions of § 4-5-223.
SECTION 7. Tennessee Code Annotated, Section 63-1-316(c), is amended by adding
the following to the end of the subsection:
The department shall make available to the public on its website all inspection criteria
required for compliance by pain management clinics.
SECTION 8. This act takes effect upon becoming a law, the public welfare requiring it.