TNA legislative updates
TNA Response to Senator Ophelia Ford, February 14, 2012
Please note a print verson of this week’s 2012 TNA Legislative Update can be accessed by clicking HERE
To access the list of TNA’s Position on Legislation for 2012 click HERE.
Legislative Update Archive – Members Only Area
TNA Legislative Update and Weekly Bills Calendar, April 30, 2012
by Wilhelmina Davis, Manager, Government Affairs
The following is an update of bills considered during the week of April 23, 2012.
On Wednesday, April 25, the Senate amended and passed SB 1935, Interventional Pain Management Legislation. The bill was transmitted to the House for consideration and was calendared for and debated on Friday, April 27. Rep. Joey Hensley substituted HB 1896 for SB 1935 as amended. After much debate and discussion, the bill passed the House without additional amendments proposed by House members.
A special thanks to TNA members for your diligence and the valiant efforts put forth as we worked over the years to defeat this legislation.
Listed below you will find the bill summary, amendments on the bill and final Senate and House votes:
This bill specifies that an advanced practice nurse or physician assistant may only perform invasive procedures involving any portion of the spine, spinal cord, sympathetic nerves or block of major peripheral nerves in any setting not licensed as a health facility under the direct supervision of a licensed physician or osteopathic physician who is actively practicing spinal injections and has current privileges to do so at a licensed health facility. Such direct supervision would only be offered by a physician or osteopathic physician who meets the qualifications described below in (1) or (3). “Direct supervision” means being physically present in the same building as the advanced practice nurse or physician assistant at the time the invasive procedure is performed. This direct supervision requirement would not apply to an advanced practice nurse or physician assistant performing major joint injections except sacroiliac injections, soft tissue injections or epidurals for surgical anesthesia or labor analgesia in unlicensed settings.
This bill specifies that a licensed physician or osteopathic physician may only practice interventional pain management if the physician is either:
(1) Board certified through the American Board of Medical Specialties (ABMS), or in the case of osteopathic physicians the American Osteopathic Association (AOA), in:
(A) Anesthesiology; neurological surgery; orthopedic surgery; or physical medicine and rehabilitation; or
(B) Any other board certified physician who has completed a subspecialty board in pain medicine or completed an ACGME-accredited pain fellowship;
(2) A recent graduate in a medical specialty listed in (1) not yet eligible to apply for board certification, as long as there is a practice relationship with a physician or osteopathic physician who meets the requirements of (1); or
(3) A licensee who is not board certified in one of the specialties listed in (1) but is board certified in a different specialty and has completed a post-graduate training program in interventional pain management approved by the appropriate board.
“Interventional pain management” is the practice of performing invasive procedures involving any portion of the spine, spinal cord, sympathetic nerves or block of major peripheral nerves in any setting not licensed as a health facility.
A physician or osteopathic physician who violates the requirements described above in (1) – (3) would be subject to disciplinary action by the board of medical examiners or the board of osteopathic examination, including civil penalties of up to $1,000 for every day such requirements are violated.
Senate Amendment 1 — changes the effective date to July 1, 2013, clarifies that the provisions of this bill concerning sympathetic nerves and major peripheral nerves applies to sympathetic nerves of the spine and major peripheral nerves of the spine, specifies that the requirements of this bill concerning advanced practice nurses and physician assistants does not apply to such health care providers when performing major joint injections except sacroiliac injections or to performing soft tissue injections or epidurals for surgical anesthesia or labor anesthesia in unlicensed settings, and adds that physicians who meet any of the following will also be authorized to practice interventional pain management:
(1) A licensee who is board certified in radiology;
(2) A licensee who serves as a clinical instructor in pain medicine at an accredited Tennessee medical training program; or
(3) A licensee who 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.
This amendment also clarifies that osteopathic physicians may apply either AOA or the ABMS board certification in order to qualify to practice interventional pain management.
Senate Amendment 3 — extends authorization to practice interventional pain management base on certification by American Board of Physician Specialties (ABPS)/American Association of Physician Specialists (AAPS).
Senate Amendment 4 — restores authorization, which was removed by Senate Amendment #3, for physicians who meet any of the following to also be authorized to practice interventional pain management:
(1) A licensee who is board certified in radiology;
(2) A licensee who serves as a clinical instructor in pain medicine at an accredited Tennessee medical training program; or
(3) A licensee who 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.
Senate floor vote on SB 1935 as amended:
Ayes………………………………………20
Noes……………………………………..10
Present and not voting………………2
Not voting……………………………………1
Senators aye were: Beavers, Bell, Berke, Burks, Crowe, Ford, Gresham, Haynes, Henry, Johnson, Ketron, Kyle, Massey, McNally, Norris, Summerville, Tracy, Watson, Yager and Speaker Ramsey — 20.
Senators voting no were: Barnes, Campfield, Faulk, Finney, Harper, Herron, Kelsey, Marrero, Overby and Stewart– 10.
Representatives present and not voting were: Roberts and Southerland — 2.
Senator not voting: Tate—1.
House floor vote on SB 1935 as amended:
Ayes………………………………………68
Noes……………………………………..16
Present and not voting………………4
Not voting……………………………………11
Representatives voting aye were: Brooks H, Brooks K, Brown, Butt, Campbell, Carr, Casada, Cobb, Coley, Curtiss, Dean, DeBerry J, DeBerry L, Dunn, Elam, Eldridge, Faison, Favors, Floyd, Forgety, Gilmore, Halford, Hall, Harrison, Hawk, Hensley, Holt, Johnson C, Johnson P, Keisling, Lollar, Lundberg, Maggart, Marsh, Matheny, Matlock, McCormick, McDaniel, McManus, Miller D, Miller L, Montgomery, Moore, Niceley, Pody, Powers, Ragan, Ramsey, Richardson, Roach, Sargent, Sexton, Shaw, Shepard, Shipley, Sontany, Sparks, Stewart, Swann, Todd, Towns, Turner J, Turner M, White, Williams K, Williams R, Wirgau, Madam Speaker Harwell — 68.
Representatives voting no were: Alexander, Armstrong, Dennis, Evans, Fitzhugh, Hardaway, Hill, Hurley, Jones, Kernell, Parkinson, Pitts, Pruitt, Weaver, Windle, Womick — 16.
Representatives present and not voting were: Bass, Camper, Rich, Sanderson — 4.
Representatives not voting were: Cooper, Ford, Gotto, Harmon, Haynes, McDonald, Naifeh, Odom, Tidwell, Tindell and Watson–11
Calendar for Monday, April 30, 2012
9:15 a.m. – LP 16 – House General Subcommittee of Finance – Bills Behind the Budget 2011 — MEMBERS: Chair Rep. M. Harrison (R), Vice Chair Rep. C. Johnson (R), Rep. K. Brooks (R), Rep. L. DeBerry (D), Rep. C. Fitzhugh (D), Rep. J. Matheny (R), Rep. G. McCormick (R), Rep. S. McDaniel (R), Rep. J. Naifeh (D), Rep. G. Odom (D), Rep. D. Roach (R), Rep. C. Sargent (R), Rep. J. Shaw (D), Rep. H. Tindell (D)
*HB76 G. Hardaway— Public Finance: Prohibits transfer of certain funds to the general fund. Requires that the Division of Regulatory Boards Fund under the Department of Commerce and Insurance and Health Related Boards Fund under the Department of Health be kept separate and apart from all other funds.
*SB898 – B. Watson – 02/25/2011 – Referred to Senate Finance, Ways & Means.
Senate Status: 02/25/2011 – Referred to Senate Finance, Ways & Means.
House Status: 04/27/2012 – Set for House General Subcommittee of Finance – Bills Behind the Budget 2011 04/30/12.
11:00 a.m. – TBA – House Finance Calendar 2 — MEMBERS: Chair Rep. C. Sargent (R), Vice Chair Rep. M. Harrison (R), Secretary Rep. C. Johnson (R), Rep. D. Alexander (R), Rep. J. Armstrong (D), Rep. H. Brooks (R), Rep. K. Brooks (R), Rep. T. Brown (D), Rep. S. Campbell (R), Rep. J. Carr (R), Rep. J. Coley (R), Rep. L. DeBerry (D), Rep. J. Eldridge (R), Rep. C. Fitzhugh (D), Rep. S. Hall (R), Rep. D. Hawk (R), Rep. J. Matheny (R), Rep. G. McCormick (R), Rep. S. McDaniel (R), Rep. L. Miller (D), Rep. J. Naifeh (D), Rep. G. Odom (D), Rep. D. Roach (R), Rep. J. Shaw (D), Rep. H. Tindell (D)
*HB369 M. Pody — Health Care: Health Care Compact. Enacts health care compact, declaring that member states have the primary responsibility to regulate health care policy within their states. Makes effective upon adoption by the member states and consent of the federal congress. Declares that member states have the right to federal funding according to mandatory spending formula. Creates an interstate advisory health care commission.
*SB326 – M. Beavers – 05/18/2011 – Senate passed with previously adopted amendments 1, 2, 3 and 4.
SENATE AMENDMENT 1- deletes the language of the original bill. Requires Tennessee to join a health care compact with other states to retain regulatory authority over health care in member states. Requires member states to seek the consent of Congress to this compact. Consent would authorize states to enact laws that supersede all federal laws regarding health care within member states. Permits member states to receive federal funding for health care, unconditioned on any action or policy by the member states. The funding would be based on the actual federal spending on health care in the member state during federal fiscal year 2010, adjusted for population changes in the state and inflation. Creates an Interstate Advisory Health Care Commission empowered to study health care regulatory issues and make nonbinding recommendations to the legislatures of the member states. Prohibits the Commission from taking any actions within a member state that contravene any laws of that state.
SENATE AMENDMENT 2 – sunsets the Health care compact on June 30, 2013.
SENATE AMENDMENT 3 (00481818) makes a typographical error by changing Title 69 to Title 68.
SENATE AMENDMENT 4 (00759773) specifies that the funds necessary for the state of Tennessee to perform the duties as a member state to the Interstate Advisory Health Care Commission shall be earmarked from the administrative fees from Federal monies received by the state. Specifies that the funds necessary for the state to perform the duties as a member of the Interstate Advisory Health Care Commission shall be earmarked from the administrative fees from federal monies received by the state. Specifies that the state retains the authority to decline to participate in the Interstate Advisory Health Care Commission and may pay for the costs of administering health care in the state in lieu of administration costs of the commission by use of the administrative fees received from federal monies.
Legislative Update Archive – Members Only Area