Tennessee Board of Medical Examiners
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12/01/01
The Board of Medical Examiners met on November 28 to consider the proposed rules. They had been given copies of all written testimony, and they heard additional testimony in opposition to the rule regarding physician employment and contracting. After discussion, the Board voted to form a Joint Task Force composed of members of the Medical Board, the Nursing Board, the Tennessee Medical Association, the Tennessee Nurses Association, state government staff attorneys, Medical Board and Nursing Board staff, the Director of Health Related Boards, Vanderbilt University Nursing and Medicine representatives, and other interested parties. Louise Browning, TNA Executive Director, will serve on the task force, along with an advanced practice nurse who is a TNA member in active practice. No date has been set for the first meeting.
10/31/01
The BME hearing went very well! Twenty people (NPs, MDs, attorneys) spoke in opposition to the rule, and no one spoke in support. Close to 50 people attended, and more than 50 letters have been received. TNA’s special appreciation goes to those who drove in from out of town (Upper East, East and West TN)!
The Board of Medical Examiners will meet on Wednesday, November 28, and will discuss and vote on the proposed rule at 9:00 a.m. At that meeting they could vote to withdraw the rule, revise and approve the rule, approve the rule in its current form, or postpone the action on the rule. Board meetings are open to the public, and this will be an interesting meeting. Please attend if possible. Click HERE for the meeting location.
Proposed Rules
Department of Health
Notice of Rulemaking Hearing
Board of Medical Examiners
Division of Health Related Boards
There will be a hearing before the Board of Medical Examiners to consider the promulgation of new rules and amendments to rules pursuant to T.C.A. §§ 4-3-1011, 4-5-202, 4-5-204, 63-6-101, 63-6-201, 63-6-207, 63-6-208, 63-6-210, 63-6-211, 63-6-214, 63-6-216, 63-6-224, 63-24-102, 63-24-103, 63-24-105, 63-24-106, 63-24-107, and Public Chapter 320, Public Acts of 2001. The hearing will be conducted in the manner prescribed by the Uniform Administrative Procedures Act, Tennessee Code Annotated, Section 4-5-204 and will take place in the Cumberland Room on the Ground Floor of theCordell Hull Buildinglocated at 425 5th Avenue North, Nashville, Tennessee at 2:30 p.m. (CDT)on the 22nd day of October, 2001.
For a copy of the entire text of this notice of rulemaking hearing contact: [Letters of testimony can be mailed prior to October 22 to] Jerry Kosten, Regulations Manager, Division of Health Related Boards, 1st Floor, Cordell Hull Building, 425 5th Avenue North, Nashville, TN, 37247-1010, (615) 532-4397, [[email protected]].
Substance of Proposed Rule
New Rules
[This proposed rule inserts a new #9 in Section 0880-2-.14 of the current Rules.]
0880-2-.14 Specifically Regulated Areas and Aspects of Medical Practice
(9) Employment of Physicians –
(a) Medical Orders, Referrals or Providing Supervision, Responsibility and/or Control – Throughout Tennessee Code Annotated, Title 63 and 68 there are provisions of the law requiring that identified health care practitioners may provide services or practice only upon the order of, or pursuant to referrals from, or under the supervision, control and/or responsibility of a licensed physician.
1. A physician cannot issue effective and ethical medical orders, or make effective and ethical referrals, or exercise effective and ethical supervision, responsibility and/or control as an employee of, or incident to any contract of employment for the purposes of issuing medical orders to, or making referrals to, or providing supervision, responsibility and/or control with any health care professional, or group, company, corporation or other such entity comprised thereof whose practice is required to be performed, or whose services are required to be rendered, pursuant to the order of, or pursuant to referrals from, or under the supervision, or responsibility and/or control of a physician.
2. It shall be a prima facie violation of T.C.A. § 63-6-214 (b) (1) for a physician to:
(i) Be an employee of such health care professionals, or group, company, corporation or other such entity comprised thereof who provide their services to persons who are not clearly identifiable as patients of the physician for the purpose of issuing orders, providing referrals or providing supervision, or responsibility and/or control.
(ii) Enter into a contract for the issuance of orders to, or the making of referrals to, or the provision of supervision, responsibility and/or control for such health care professionals, or group, company, corporation or other such entity comprised thereof, who provide their services to persons who are not clearly identifiable as patients of the physician.
(b) Nothing in this rule shall be construed as
1. Affecting the employment or contract provisions, or services incident thereto, of T.C.A. §§ 63-6-204 (d) or (e) or 68-11-205 (b) or (c); or
2. Affecting contracts entered into by physicians for the employment of other health care practitioners for the provision of their health care services to the patients of the employing physician.
Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-6-101, 63-6-204, 63-6-214, and Public Chapter 327 the Public Acts of 2001.
*Tennessee Nurses Association notes enclosed in brackets