Tennessee Pharmacists Association

Tennessee State Capitol

February 23, 2018

TPA Needs Your Help TODAY! 

Below are several important pieces of pharmacy-related legislation being considered by the Tennessee General Assembly. Please take a few minutes to contact your state legislators about the specific bills listed below!

Click the individual  buttons below to send an email to your state legislators through TPA’s Tennessee Pharmacists Legislative Action Network (T-PLAN) system, or CLICK HERE to look up the contact information for your elected state Representative and state Senator. (If you use T-PLAN to email your legislators, the system will automatically insert the correct addresses.)

PBM Licensing Through TN Dept of Commerce and Insurance

Action Needed: Please contact your state legislators TODAY and ask them to SUPPORT this important pharmacy initiative!

This legislation is currently being considered by the House Insurance and Banking Subcommittee and the Senate Commerce and Labor Committee

Legislation: Senate Bill 1852 / House Bill 1857Senate Sponsor(s): Haile, Crowe, BellHouse Sponsor(s): Powers

Summary:
  • Requires all pharmacy benefits managers (PBMs) to obtain licensure and renew biennially through the Tennessee Department of Commerce and Insurance (TDCI)
  • Requires PBMs to demonstrate that they are able to transact in this state, are financially responsible, and have not had a prior license denied or revoked within five (5) years of the date the license is sought
  • Requires PBMs to provide TDCI with the person or entity’s name, address, telephone number, and website address
  • Requires PBMs to notify TDCI within 60 days of any change in PBM information

Governor Haslam’s TN Together Opioid Reform

Action Needed: Contact your state legislators and ask them to AMEND the Governor’s TN Together legislation with changes supported by TPA and many other professional associations and health care organizations. TPA has significant concerns about the legislation as introduced (see summary below), and amendments are needed to ensure that the Governor’s TN Together legislation achieves a patient-centered and practical legislative solution.

This legislation is currently being considered by the Tennessee General Assembly

Legislation: House Bill 1831 / Senate Bill 2257
Senate Sponsor(s): Norris, Haile, Yager
House Sponsor(s): Hawk, Casada, Kumar

Summary as Introduced:
  • Requires all dispensers (or their delegates) to check the Controlled Substance Monitoring Database (CSMD) prior to dispensing an opioid or a benzodiazepine the first time that human patient is dispensed a controlled substance at that practice site
  • Requires all dispensers (or their delegates) to check the CSMD again at least once every six (6) months for that human patient after the initial dispensing, for the duration of time the controlled substance is dispensed to that patient
  • Requires all dispensers (or their delegates) to check the CSMD prior to dispensing pursuant to any prescription with written instructions indicating the earliest date on which the prescription can be filled
  • Creates new definitions for “Acute Care Patient” and “Opioid Naïve”
  • Establishes practitioner documentation requirements, including informed consent and reasons for prescribing opioids
  • Limits initial opioid prescriptions for opioid naïve patients (patients who have not been treated with an opioid in the 30-day period prior to the date of treatment by a healthcare practitioner) to a 5-day supply
  • Allows a practitioner to issue an opioid naïve patient a second opioid prescription simultaneous to the issuance of an initial prescription, with written instructions on the prescription stating that the earliest date on which a prescription may be filled is five (5) days from issuance and the latest date is ten (10) days from issuance
  • Dispensers must check the CSMD for any opioid prescription with a “dispense on or after” date
  • Limits the dosage of an opioid prescribed to an opioid naïve patient or acute care patient to not more than 40 morphine milligram equivalents (MME) per day
  • Exceptions: malignant pain, cancer treatment, hospice care, administration in a licensed health care facility, prescriptions from pain management specialists, methadone treatment facilities, treatment for opioid use disorder, and treatment with opioid antagonists

Professional Privilege Tax Repeal

Action Needed: Contact your state legislators today and ask them to SUPPORT this important initiative!

This legislation is currently being considered by the Tennessee General Assembly.

Legislation: Multiple Bills Filed 
Summary: For several years, TPA has participated as a member of a coalition of affected professionals and has actively advocated for a repeal of the Professional Privilege Tax. In 2016, the coalition’s efforts produced a Tennessee Advisory Commission on Intergovernmental Relations (TACIR) study, which outlined the tax and also provided more detail about the tax relative to other states. The coalition worked with legislators to introduce legislation that would phase out the tax over a 5-year period (similar to the recent Hall Tax repeal strategy). TPA continues to work with the coalition to support and advocate for its passage in 2018.


Establishing MTM as a Pharmacist-Provided Benefit

Action Needed: Contact your state Representative today and ask them to SUPPORT this important pharmacy initiative!

The Senate version of this legislation passed 29-0 earlier this week. This legislation is scheduled in the House Health Committee next week. 

Legislation: Senate Bill 1774 / House Bill 1874
Senate Sponsor(s): Crowe
House Sponsor(s): Kumar
Summary: This legislation specifies that a medication therapy management program involves pharmacist-provided services.


Required Notifications Prior to Vaccine Administration

Action Needed: Contact your state legislators today and ask them to OPPOSE this unnecessary and burdensome anti-vaccination legislation!

This legislation is currently being considered by the House Health Subcommittee and the Senate Health and Welfare Committee

Legislation: Senate Bill 2482 / House Bill 2488
Senate Sponsor(s): Niceley
House Sponsor(s): Holt, 
Faison, Goins, Hawk, Calfee, Hicks, Moody, Casada, Ragan, Weaver

Summary: This legislation would place additional requirements for immunizing pharmacists to provide patients with a list of vaccine ingredients, potential side effects on the vaccine manufacturer’s insert, and information about the purpose and availability of the federal vaccine adverse event reporting system (VAERS), prior to administration of every vaccine.


National-Level Pharmacy Legislative Priorities

Action Needed: Please contact your US Representative and US Senators TODAY and ask them to SUPPORT these important pharmacy initiatives!

TPA greatly appreciates your continued pharmacy advocacy and thanks you for your action in response to these specific legislative initiatives! For a more complete list of 2018 TPA Pharmacy-Related Legislative Priorities, CLICK HERE.  Even better, come to Nashville to participate in the TPA Legislative and Regulatory Policy Forum, Legislative Reception, and Pharmacy Day on the Hill, THIS MONDAY AND TUESDAY (Feb. 26-27, 2018) at the TPA Winter Meeting. You can register on Monday when you arrive!

You Have a Voice: TPA

IMPORTANT VOTES THIS WEEK:
CONTACT YOUR LEGISLATORS TODAY!

A number of initiatives impacting pharmacy are being heard in the Tennessee General Assembly this week. Please contact your state legislators TODAY, and let them know where you stand on the important issues described below. TPA encourages you to use the new TPA Tennessee Pharmacists Legislative Action Network (T‑PLAN) web-based email tool to quickly send an email to your state Representative and state Senator, or simply CLICK HERE to find the phone number and other contact information for your state Representative and state Senator.

To visit the TPA T‑PLAN site and to look up your elected officials, please CLICK HERE or enter the following address into your browser: https://tnpharm.org/get-involved/legislative-advocacy-center/advocacy-in-action/. T-PLAN simplifies the legislative contact process by using the zip code you provide to automatically identify your elected officials and generate an email to them asking for support, using a pre-written sample letter which is specific to the legislative issue being considered. PLEASE DON’T FORGET TO CUSTOMIZE THE LETTER for your pharmacy practice before you send it!


MEDICATION THERAPY MANAGEMENT IN MEDICAID
In 2016, TPA has worked with bill sponsors to introduce legislation which requires TennCare, in collaboration with the various Managed Care Organizations administering the medical benefits on behalf of TennCare, to develop and incorporate a Medication Therapy Management (MTM) program.
Legislation: 
HB 2398 by Littleton, Shepard, Sexton C. / SB 1882 by McNally, Crowe, Overbey, HaileNext Action:
  • Senate: Referred to Senate Finance, Ways, and Means Committee
  • House: Referred to House Health Subcommittee
Talking Points: CLICK HERE
Take Action Button

STATE-WIDE COLLABORATIVE PHARMACY PRACTICE AGREEMENT FOR THE DISPENSING OF OPIOID ANTAGONISTS BY PHARMACISTS – PASSED!
This legislation is sponsored by TPA and seeks to increase patient access to life-saving opioid antagonist therapy through a state-wide Collaborative Pharmacy Practice Agreement (CPPA) with the Chief Medical Officer for the Tennessee Department of Health. If enacted, pharmacists can enter into a CPPA to dispense opioid antagonists, effectively reducing barriers to this important medication, effectively reducing the number of opioid overdose deaths and saving the lives of many Tennesseans.
Legislation: HB 2225 by Terry, Williams, Sexton C, Doss, Dunlap, Howell, Hazlewood, Brooks K, Ramsey / SB 2403 by Overbey, Haile
Next Action:
  • Senate: Scheduled for consideration on the Senate Floor February 24, 2016
  • House: Scheduled for consideration on the House Floor  February 25, 2016
  • UPDATE! Passed by the Senate and House and sent to Governor Haslam for his signature!
Talking Points:  CLICK HERE
Take Action Button

AUTHORIZATION OF PHARMACY SERVICES ADMINISTRATIVE ORGANIZATIONS TO FILE MAC APPEALS ON BEHALF OF CONTRACTED PHARMACIES
This legislation is a joint effort between TPA, Southern Pharmacy Cooperative, and other pharmacy organizations. It seeks to clear up language regarding the role of Pharmacy Services Administrative Organizations (PSAO’s) operating in Tennessee by authorizing their participation in the Maximum Allowable Cost (MAC) appeal process.Legislation: HB 1697 by Shepard / SB 1789 by Overbey, McNally
Next Action:
  • Senate: Scheduled for consideration on the Senate Floor February 24, 2016
  • House: Scheduled for consideration by House Insurance and Banking Subcommittee February 24, 2016
Talking Points: CLICK HERE
Take Action Button

RESTORATION OF PROPOSED AWP-BASED CUTS TO THE TENNCARE PHARMACY PROGRAM

TPA successfully worked with members of the Tennessee General Assembly, in collaboration with several other pharmacy-related organizations, to restore funding for the proposed Average Wholesale Price (AWP) cuts to the TennCare pharmacy program for FY 2015 – 2016. These cuts would have reduced AWP-based reimbursements to pharmacies by over $17.4 million (total state and federal funding) for brand, generic, and specialty medications. If implemented, these AWP-based cuts would have affected all pharmacy providers that currently accept TennCare patients, so this is a win for our patients and the entire profession of pharmacy. However, funding was not allocated for fiscal year 2016-2017, so TPA continues to work with key members in the House and Senate to restore the proposed AWP cuts to the pharmacy program for FY2016-2017, and prevent these pharmacy-based reductions from going into place.

OTHER KEY PHARMACY-RELATED ISSUES BEING CONSIDERED DURING THIS SESSION: 
  • AUTHORIZATION FOR MAINTENANCE DISPENSING BY PHARMACISTS(HB 1768 by Sexton C / SB 1786 by Overbey)
  • RENEWAL OF THE PRESCRIPTION SAFETY ACT (HB 2571 by McCormick, Brooks K, Hawk, Farmer / SB 2552 by Norris, Yager)
  • ENHANCING PENALTIES FOR PHARMACY ROBBERIES (HB 0587 by Shepard / SB 0593 by Haile)
  • REPEAL OF THE PROFESSIONAL PRIVILEGE TAX (HB 0678 by VanHuss, Matheny, Butt, Hill M, Keisling, Holt, Womick / SB 0556 by Bowling)
  • PHARMACIST-PROVIDED CONTRACEPTIVE THERAPY (HB 1823 by Hazlewood / SB 1677 by Dickerson and HB 1847 by Jernigan / SB 1958 by Yarbro)
  • ORAL CHEMOTHERAPY PARITY (HB 2239 by Lamberth, Casada, Littleton, Powers, Kumar, Brooks K, Terry, Powell, McCormick, White M, Butt, Farmer, Towns, Beck, Doss, Akbari, Camper, Kane, Fitzhugh, Johnson, Shepard, Hill M / SB 2091 by Ketron, Green, Beavers, Jackson)
  • REGULATION OF PHYSICIAN DISPENSING OF OPIOIDS AND BENZODIAZEPINES (HB 2126 by Terry / SB 2060 by Briggs)

TPA continues to work to protect and advance the profession of pharmacy through advocacy and legislative initiatives, and we appreciate your support! Updates will be provided to TPA members as developments unfold. For questions, please contact the TPA office at 615-256-3023.