HB 2572

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 other 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 fo rm must explain the risks of, complications of, medical 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 op io id therapy. This bill, instead, requires the informed 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 prescriber 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."