Tennessee Pharmacists Association

Legislative Update

May 26, 2022

On May 25, 2022, Governor Bill Lee signed Senate Bill 2458 / House Bill 2661 into law. Thanks to Lt. Governor Randy McNally and Speaker Cameron Sexton, the many legislators who supported the bill, and the hundreds of Tennessee Pharmacists Association (TPA) members and their patients engaging in grassroots advocacy, this legislation will ensure that patients have access to their pharmacy of choice, pharmacies will receive adequate compensation for medication products and their dispensing, and this law will be enforceable by the Tennessee Department of Commerce and Insurance (TDCI).

With multiple co-prime sponsors in the Senate and the House, the bill passed as amended with an 82-9 vote in the House. Hours later in the Senate, the companion bill passed on a 32-0 vote. With a letter from TPA cosigned by national organization partners, the Governor signed the bill despite pushback by the PBM industry. In order to promulgate rules by the TDCI, the law will take effect immediately. For all other purposes, the law will take effect on January 1, 2023.

Much of this law offers clean-up language to 2021’s Public Chapter 569, yet TPA advocated for key provisions to ensure all provisions can be properly enforced by the TDCI, which align with Arkansas’ law that was defended by the U.S. Supreme Court in Rutledge v. PCMA.

Summary points of the law include:

  • Medication Product Reimbursement
    • Following the proper appeals process, PBMs shall reimburse contracted pharmacies no less than the actual cost for a prescription drug or device.
    • The reimbursement appeals process of a PBM must be approved by the TDCI.
    • If a pharmacy wins an appeal, the PBM must reimburse the proper rate within 7 days and the PBM must pay or waive the cost of any transaction fee to reverse and rebill the claim.
    • If a pharmacy loses an appeal, the PBM must demonstrate where a pharmacy can obtain the product currently in stock at a price that is less than the challenged rate within 7 days. If the PBM cannot produce this information, they must reimburse at the actual cost of the pharmacy.
    • This does not apply to TennCare.
  • Professional Dispensing Fee
    • PBMs shall pay a professional dispensing fee at a rate not less than the current TennCare dispensing fee IF…the pharmacy would qualify for an enhanced dispensing fee for low-volume pharmacies (currently at $11.98), which is currently defined by TennCare standards as less than 65,000 prescriptions per year.
    • The TDCI is authorized to promulgate rules to properly enact this provision. TPA has already been in communication with various third-party payers to determine a proper verification for an enhanced dispensing fee to a pharmacy, which is a question already raised by PBMs.
  • Patient Access to Pharmacy of Choice & Anti-Steerage Provisions
    • PBMs cannot interfere with the right of a patient to choose a contracted pharmacy, nor offer financial or other incentives to utilize a pharmacy owned by or financially beneficial to the PBM or covered entity.
    • PBMs must allow pharmacies the opportunity to be in-network if they are licensed in the state AND are willing to accept the same terms and conditions for at least one of their networks in the state.
    • PBMs cannot prevent a pharmacy from participating in a preferred or non-preferred network of pharmacies.
    • PBMs cannot charge patients different co-payments or provide any inducement or financial incentives for using any pharmacy within a given network.
  • Definitions
    • Clarification for ‘covered entity’ – includes plans governed by the Employee Retirement Income Security Act of 1974 (ERISA), while excluding Medicare Part D plans.
  • Role of the TDCI
    • The TDCI will institute an external appeals process for any appeal denied by a PBM.
    • There is clear determination that this law applies to ERISA plans.
    • Any violations of this law can be clearly enforced by the department.

Over the next several months, TPA will advocate for timely promulgation of rules by the TDCI. In addition, TPA will stay in communication with key stakeholders to ensure that proper implementation and enforcement of the law occur, while offering education across many practice areas to showcase the importance of this law. 

Support TPA Advocacy Efforts

Legislative victories do not happen without hard work and determination as well as your financial support. TPA needs your support of the PharmPAC or the General Advocacy Fund. The PharmPAC has a primary purpose of providing financial assistance to those candidates for public office who are supportive of the profession of pharmacy and recognize the value of quality care and services. The General Advocacy Fund allows for contributions to TPA’s overall advocacy strategy and activities, including our Pharmacy Day on the Hill programming, contract lobbyists, and marketing and advocacy tools. Visit bit.ly/AdvocacySupport to contribute today!


Weekly Summary — April 29, 2022

On Wednesday morning, the House approved PBM bill HB 2661 (Sexton) as amended with an 82-9 vote. Hours later in the Senate, the companion bill, SB 2458 (McNally), passed on a 32-0 vote. The bill now moves to the Governor’s office for signature. While TPA anticipates the bill will be signed, a letter from TPA cosigned by national association partners will formally request the Governor’s signature.

TPA would like to thank the hundreds of TPA members and their patients who contacted their state legislators to support this bill! Without this strong grassroots effort, this bill would not have passed. Be sure to thank your legislators for their support of the bill for enforceable PBM reform in Tennessee!

A few key highlights of this bill, include:

  • Medication Reimbursement
    • PBMs shall reimburse pharmacies no less than the actual cost for a prescription drug or device.
    • PBMs’ appeal process should be approved by TDCI.
    • If a pharmacy loses an appeal, the PBM must demonstrate where a pharmacy can obtain the product at the challenged rate within 7 days. If the PBM cannot produce this information, they must reimburse at the actual cost of the pharmacy.
  • Dispensing Fee
    • PBMs shall pay a current TennCare dispensing fee for low-volume pharmacies ($11.98), only if the pharmacy would qualify as a low-volume pharmacy per TennCare standards (less than 65,000 prescriptions per year).
  • Patient Access/Anti-Steerage
    • PBMs must allow pharmacies the opportunity to be in-network if they accept the same terms and conditions for at least one of their networks in the state.
    • PBMs cannot prevent a pharmacy from participating in a preferred or non-preferred network of pharmacies.
    • PBMs cannot charge patients different co-payments or provide any inducement or financial incentives for using any pharmacy within a given network.
  • Role of TDCI
    • TDCI will institute an external appeals process for any appeal denied by a PBM.
    • Clear determination that this law also applies to ERISA plans
    • Violations of this law can be clearly enforced by TDCI.
  • Implementation
    • For purposes of TDCI’s ability to promulgate rules for enforcement, the law is effective upon bill signing.
    • For all other aspects (including dispensing fee adjustments), the law takes effect on January 1, 2023.

A more thorough summary of the law and its impact on Tennessee pharmacy will be forthcoming, including an educational webinar for members and another webinar for other stakeholders. Watch for more details.

Click here to review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.

You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — April 22, 2022

With the approved state budget moving to the Governor’s Office, SB 2458 (McNally)/HB 2661 (Sexton), which was placed behind the budget, will be discussed by the legislature early next week (likely Tuesday). Over the past week, TPA worked with Senate and House leadership to harmonize amendments to the original bill to allow for one finalized bill. The final bill will provide for enforceable language around anti-steerage provisions, price transparency and fair reimbursement of drug product and dispensing fee, and give clear enforcement authority to the Tennessee Department of Commerce and Insurance.

All Tennessee pharmacists, pharmacy technicians, and students in pharmacy need to contact their state legislators before it’s too late! Contact your state legislators to urge their support of this important bill by next week.

If you need additional talking points with your legislators, utilize this new TPA flyer or this flyer from NCPA to share with them. You can specifically reference data from the Kaiser Family Foundation related to the effect that PBM reform has on health premiums. In the state of Arkansas (which deployed similar PBM reform in 2015), health premiums did not increase as much as the national average (even when factoring in healthcare inflation rates). Arkansas’ health premiums ($387) are actually far less now than the national average ($438), while Tennessee’s average health premiums ($445) are above the national average.

You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — April 15, 2022

It is projected that there will be a final budget approved in the next week. Therefore, SB 2458 (McNally)/HB 2661 (Sexton), which was placed behind the budget, will be discussed by the legislature very soon. Regardless of where you live or work, your state legislators need to hear your voice before it’s too late! Please contact your state legislators to urge their support of this important bill by next week.

TPA has provided updated information that you can use to refute claims by PBMs and businesses about the impact of this bill on health premiums. You can utilize this new TPA flyer or this flyer from NCPA to share with your legislators.

You can specifically reference data from the Kaiser Family Foundation related to the effect that PBM reform has on health premiums. In the state of Arkansas (which deployed similar PBM reform in 2015), health premiums did not increase as much as the national average (even when factoring in healthcare inflation rates). Arkansas’ health premiums ($387) are actually far less now than the national average ($438), while Tennessee’s average health premiums ($445) are above the national average.

TPA is asking members to utilize this patient leave-behind/bag stuffer to help educate your patients on the need for enforceable PBM reform. Before printing, you may add your pharmacy’s logo to the document, as well as your individual state legislators’ names.

Due to the holiday weekend, TPA does not have this week’s general legislative summary from Harris Frazier. You may review last week’s current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — April 8, 2022

Priority #1: Enforceable PBM Reform

As the state awaits the legislature’s approval of a budget, which would help to move SB 2458 (McNally)/HB 2661 (Sexton) forward, TPA is seeing growing opposition to this bill from the business community over fear that the bill will raise healthcare premiums. TPA encourages all members to stay in close contact with your legislators to provide education and support of this legislation.

TPA is working to create updated talking points that include data from the Kaiser Family Foundation, to refute these concerns. In the state of Arkansas (which deployed PBM reform in 2015), employer health premiums did not increase as much as the national average (even when factoring in healthcare inflation rates). Arkansas’ health premiums ($387) are actually far less now than the national average ($438), while Tennessee’s average employer health premiums ($445) are above the national average.

You can utilize our current talking points on PBM reform, talking points from NCPA, and/or this patient leaflet/bag stuffer to engage in grassroots advocacy. Before printing, your pharmacy can add its logo onto the patient leaflet, as well as your local legislators’ names.

Priority #2: Codifying PREP Act

Today, April 8, 2022, Governor Lee signed SB 2446 (Haile)/HB 2131 (Marsh). TPA is excited to see a modernized definition of pharmacy technicians that now clearly allows a pharmacist to delegate tasks to a technician based on their education, training, and support. Allowing all members of the pharmacy team to practice at the top of their education and training ultimately improves the health of all Tennesseans.

If you haven’t already, TPA encourages you to reach out to your legislators to thank them for their unanimous support of this bill.

Other Issues:

  • SB 2188 (Niceley)/HB 2746 (Lynn): The issue of ivermectin access has evolved over this legislation session. The bill, which now has support in the Senate and House, will codify the ability for a pharmacist and prescriber to enter into a non-patient-specific collaborative practice agreement if they so choose. The Board of Pharmacy will have to adopt rules to establish standard procedures for such a collaborative practice agreement. TPA advocated with legislative leadership for the best-case resolution for ivermectin access, which did not mandate participation or removal of a pharmacist’s clinical judgment, while specifically seeking administrative and civil liability immunity for any such participation by a pharmacist.
  • SB 1859 (Massey)/HB 1999 (Jernigan): Accessible Prescription Labels. TPA has worked with sponsors of this bill to express early concerns about the initial bill language, while showcasing ways that pharmacies can provide accessible prescription labels to the visually impaired. The latest amendment to this bill would have the Board of Pharmacy promulgate rules as needed to address labels for the visually impaired.
  • SB 980 (Campbell)/ HB 686 (Beck): Statewide Collaborative Agreement for EpiPens. This bill is a holdover from 2021 but would offer the opportunity for pharmacists to provide epinephrine in a broader way, to improve access to those in need.

You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills that TPA is following on behalf of our members.


Weekly Summary — April 1, 2022

Priority #1: Enforceable PBM Reform

SB 2458 (McNally)/HB 2661 (Sexton) is holding steady this week as we await the state’s process of approving the budget. At this point, TPA encourages all members to stay in close contact with your legislators to provide education and support of this legislation.

You can utilize these TPA talking points on PBM reform, talking points from NCPA, and/or this patient leaflet/bag stuffer to engage in grassroots advocacy. Before printing, your pharmacy can add its logo onto the patient leaflet, as well as your local legislators’ names.

Priority #2: Codifying PREP Act

This week, SB 2446 (Haile)/HB 2131 (Marsh) passed in the Senate and was signed by the House and Senate Speaker on Wednesday, March 30. This bill now moves to the Governor for his signature!

TPA encourages you to reach out to your legislators to thank them for their unanimous support of this bill. TPA is excited to see a modernized definition of pharmacy technicians that now clearly allows a pharmacist to delegate tasks to a technician based on their education, training, and support. Allowing all members of the pharmacy team to practice at the top of their education and training ultimately improves the health of all Tennesseans.

You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills that TPA is following on behalf of our members.


Weekly Summary — March 25, 2022

TPA’s legislative focus on enforceable PBM reform continues into week 11 of the 2022 General Assembly.

Priority #1: Enforceable PBM Reform

On Wednesday, HB 2661 (Sexton) was placed behind the budget by the House Finance, Ways, and Means Subcommittee. At this point, this is a procedural matter in which we will have to wait until a budget is agreed upon by the House and Senate before the bill moves forward.

On Friday, Speaker Sexton visited Phipps Pharmacy in Jackson. He was greeted by TPA President-Elect Jay Phipps and his pharmacy staff to discuss the impact of PBMs on his practice. They thanked the Speaker for his support in bringing forward enforceable PBM legislation.

TPA encourages all members to stay in contact with your legislators to provide the foundation for support of this legislation. Use TPA’s talking points on PBM reform, the talking points from NCPA, and this patient leaflet/bag stuffer to engage our grassroots advocacy. Before printing, your pharmacy can add its logo onto the patient leaflet, as well as your local legislators’ names.

Priority #2: Codifying PREP Act

TPA’s other priority, to codify provisions of the PREP Act in Tennessee, continues to move forward. While HB 2131 (Marsh) passed in the House on First Consideration a few weeks ago, we have finally seen movement in the Senate. This week, the Senate Health & Welfare Committee recommended it for passage, and it has been placed on the Senate Consent Calendar for Monday, March 28. At this point, we do not recommend any form of advocacy action until after the bill passes.

Other Issues:

TPA continues to monitor various proposed bills of interest, including:

  • SB 1859 (Massey)/HB 1999 (Jernigan): Accessible Prescription Labels. TPA has worked with sponsors of this bill to express concerns on the bill language, while showcasing ways that pharmacies can provide accessible prescription labels to the visually impaired. The latest amendment to this proposed bill would have the Board of Pharmacy promulgate rules as needed to address labels for the visually impaired.
  • SB 980 (Campbell)/ HB 686 (Beck): Statewide Collaborative Agreement for EpiPens. This bill is a holdover from 2021 but would offer the opportunity for pharmacists to provide epinephrine in a broader way to improve access to those in need.

You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills that TPA is following on behalf of our members.


Weekly Summary — March 18, 2022

TPA’s legislative focus on enforceable PBM reform continues into week 10 of the 2022 General Assembly.

Priority #1: Enforceable PBM Reform

SB 2458 (McNally)/HB 2661 (Sexton) was voted out of the House Government Operations Committee on Monday, and the Senate Commerce and Labor Committee on Tuesday. Each bill will move forward to its respective finance committee. During Tuesday’s committee meeting, TPA member Beth Bryan of Surgionsville Pharmacy testified on the struggle that PBMs place on pharmacy practice across the state. You can view the testimony here.

TPA is encouraging all members to contact their legislators to lay the foundation for support of this legislation. Use TPA’s talking points on PBM reform, the talking points from NCPA, and this patient leaflet/bag stuffer to engage our grassroots advocacy. Before printing, your pharmacy can drop its logo onto the patient leaflet, as well as add your local legislators’ names.

ACTION ALERT: TPA is asking members to contact their Representative if they serve on the House Finance, Ways and Means Subcommittee, to ask for their support of HB 2661 before the committee meets next Wednesday. Here are TPA talking points on PBM reform, and additional talking points from NCPA.

Priority #2: Codifying PREP Act

TPA’s other priority, to codify provisions of the PREP Act in Tennessee, continues to move forward. HB 2131 (Marsh) passed in the House on First Consideration and now needs movement to occur in the Senate. The Senate Health & Welfare Committee should discuss the companion bill, SB 2446 (Haile), on Wednesday, March 23.

Other Issues:

Other proposed bills of interest to TPA continue movement in the legislature. At this point, many of those bills are moving in a way of minimal concern, yet TPA’s advocacy team continues to closely monitor the 50+ bills on our tracker document.

You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills that TPA is following on behalf of our members.


Weekly Summary — March 11, 2022

TPA’s legislative advocacy, including its grassroots network, have been on full display this week! Thank you to those TPA members who answered the call, yet there is still work that needs to be done.

Priority #1: Enforceable PBM Reform

HB 2661 (Sexton)/SB 2458 (McNally) was voted out of the House Insurance Committee on Tuesday, March 8. The House Bill now moves to the Government Operations Committee on Monday, March 14. In the Senate, SB 2458 couldn’t be discussed in committee this week and will be heard by the Senate Commerce & Labor Committee on Tuesday, March 15. TPA has requested pharmacist testimony for this Senate committee meeting.

TPA has created this patient leaflet/bag stuffer for pharmacies to begin using to seek grassroots advocacy from their patients. Before printing, your pharmacy can drop its logo on this document, as well as add your local legislators’ names.

ACTION ALERT: TPA is asking members to contact their Senators if they serve on the Senate Commerce & Labor Committee, to ask for their support of SB 2458 over the weekend. before next Tuesday. Here are TPA talking points on PBM reform, and additional talking points from NCPA.

Priority #2: Codifying PREP Act

TPA’s other priority, to codify provisions of the PREP Act in Tennessee, continues to move forward. HB 2131 (Marsh) passed in the House on First Consideration, and we will now need movement to occur in the Senate. The Senate House & Welfare Committee deferred discussion this week on the companion bill, SB 2446 (Haile), so we should see it discussed next week.

Other Issues:

TPA met with members and various PSAO stakeholders to address SB 2844 (Bailey)/HB 2351 (Hall), which would have limited the operations of PSAOs (Pharmacy Services Administrative Organizations) in Tennessee. TPA engaged members to contact the House sponsor to express the opposition to the bill. TPA has been made aware that the House Bill will lose its sponsor.

TPA met with advocacy groups this week regarding SB 2465 (Reeves)/HB 2228 (Ramsey), which would require a prescriber to offer opioid antagonist medications for patients receiving certain types of opioid medications. TPA reviewed the potential impact of this bill on pharmacy inventory, as well as best practices on ensuring that patients at risk for opioid overdose receive naloxone.

TPA continues to work with Meagan Frazier and the team at Harris Frazier to carry out our legislative priorities and response to the urgent issues impacting the profession at the state legislative level. You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — March 4, 2022

The pharmacy profession was on full display this week as more than 150+ TPA members crowded the halls of the capitol for TPA’s Pharmacy Day on the Hill. Thank you to all of the attendees who helped make the day a massive success. The feedback received from legislators regarding the passion and intelligence of our group has been overwhelming.

Priority #1: Enforceable PBM Reform

HB 2661 (Sexton)/SB 2458 (McNally) was voted out of the House Insurance Subcommittee on Tuesday, March 1. Both Senate and House versions of this PBM ‘clean-up’ bill will be presented in front of full committees next Tuesday, March 8.

ACTION ALERT: TPA is asking for members to contact their legislators if they serve on the House Insurance Committee or the Senate Commerce & Labor Committee, to ask for their support of HB 2661/SB 2458 before next Tuesday. Here are TPA talking points on PBM reform, as well as additional talking points from NCPA.

Priority #2: Codifying PREP Act

TPA’s other priority, to codify provisions of the PREP Act in Tennessee, continues to move forward. HB 2131 (Marsh) has been placed on the House Consent Calendar, which should allow the House version of this bill to be approved quickly. The Senate House & Welfare Committee has not yet discussed the companion bill, SB 2446 (Haile), but it is now placed on their calendar for Wednesday, March 9.

Other Issues:

TPA continues to monitor various bills tied to the dispensing of ivermectin in the state, with concern over each bill limiting a pharmacist’s clinical judgment. These include: SB 2188 (Niceley), which reclassifies off-label treatments as OTC status; and SB 2630 (Niceley), which requires pharmacists to dispense ivermectin or hydroxychloroquine. TPA is working with Senate leadership to find a resolution to the needs of the bill sponsor.

TPA continues to work with Senator Massey to express concerns over SB 1859 (Massey)/HB 1999 (Jernigan) regarding requirements for audible label readers, large print, or Braille on prescriptions for the visually-impaired. At this time, TPA is seeking opportunities through the Board of Pharmacy to assist in meeting the needs of this bill.

TPA continues to work with Meagan Frazier and the team at Harris Frazier to carry out our legislative priorities and response to the urgent issues impacting the profession at the state legislative level. You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — February 25, 2022

Priority #1: Enforceable PBM Reform

TPA continued its work with state leadership to advance TPA’s top priority, to see meaningful enforcement of Public Chapter 569. This week, TPA continued to lend its expertise to the state for clean-up language on Public Chapter 569. The clean-up bill has been labeled HB 2661 (Sexton)/SB 2458 (McNally), which will be discussed by the House Insurance Subcommittee on Tuesday, March 1, at 1:30pm (CT). If you are not attending Pharmacy Day on the Hill, you can watch the discussion live here. ACTION ALERT: TPA is asking for members to contact their legislators if they serve on this subcommittee, to ask for their support of HB 2661 by next Tuesday. Here are TPA talking points on PBM reform. 

TPA has also been closely monitoring a lawsuit in Chattanooga filed by McKee Foods against TPA member Thrifty MedPlus Pharmacy. This week, the State of Tennessee released a motion to intervene, which signifies that the Attorney General may now play a clearer role in helping to enforce Public Chapter 569.

Priority #2: Codifying PREP Act

TPA’s other priority, to codify provisions of the PREP Act in Tennessee, continues to move forward. This week, the House Health Committee voted to move HB 2131, which will amend the current definition of a pharmacy technician to permit a pharmacy technician to perform tasks delegated by the pharmacist, including helping with drug, dietary supplement and device selection, storage, distribution and administration so long as the delegated tasks are consistent with the pharmacy technician’s education, training and experience. The Senate version, SB 2446, was placed on the Senate Health and Welfare Committee calendar for March 2.  

Other Issues: 

ACTION ALERT: TPA is asking members to contact members of the Senate Health and Welfare Committee to express concerns over 2 bills to be discussed next Wednesday, March 2 at 1:00 pm (CT). First, SB 2188 (Niceley) reclassifies off-label treatments as OTC status. States do not have the authority to reclassify prescription-only drugs as OTC products. Second, SB 2630 (Niceley) requires pharmacists to dispense ivermectin or hydroxychloroquine. TPA urges you to utilize this one-pager to demonstrate pharmacists’ core responsibilities for patient safety. 

TPA has been in contact with the Department of Health to express concerns over SB 2421 (Johnson)/HB 2171 (Lamberth) regarding the impact of this bill’s changes to the controlled substance monitoring database (CSMD) and the need for inpatient reporting to the CSMD. 

TPA has also been in communication with Senator Massey to express concerns over SB 1859 (Massey)/HB 1999 (Jernigan) regarding requirements for audible label readers, large print, or Braille on prescriptions for the visually-impaired. 

Don’t forget to register for TPA Winter Meetings! Please work now to schedule a meeting with your legislators for Pharmacy Day on the Hill (March 1, 2022). If you do not know who your legislators are, use the legislator finder tool. TPA is excited to have a special guest, Antonio Ciaccia of 3 Axis Advisors, to speak on PBM reform at the PharmPAC breakfast on Tuesday, March 1. Get your tickets today!  

TPA continues to work with Meagan Frazier and the team at Harris Frazier to carry out our legislative priorities and response to the urgent issues impacting the profession at the state legislative level. You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — February 18, 2022

Priority #1: Enforceable PBM Reform 

On Tuesday, the Tennessee House Standing Committee on Insurance hosted a second discussion on PBMs, but this time, they heard from the Tennessee Department of Commerce and Insurance (TDCI) and the PBMs via their trade organization, PCMA. It is clear that Tennessee legislators are upset that PBMs are not complying with the law, and they want to see meaningful resolution for the complaints of pharmacists. This week, TPA submitted clean-up language for Public Chapter 569 to Legislative Legal Services. This clean-up bill has been labeled HB 2661 (Sexton)/SB 2458 (McNally). Final talking points are being drafted to guide our members as you begin to have conversations with your legislators about enforcement of PBM reform.

Priority #2: Codifying PREP Act

TPA’s other priority, to codify provisions of the PREP Act in Tennessee, continues to move forward. On Tuesday, the Tennessee House Health Subcommittee voted to move HB 2131, which will amend the current definition of a pharmacy technician to permit a pharmacy technician to perform tasks delegated by the pharmacist, including helping with drug, dietary supplement and device selection, storage, distribution and administration, so long as the delegated tasks are consistent with the pharmacy technician’s education, training and experience. Thank you to all TPA members who contacted members on this subcommittee!

TPA continues to work with Senator Reeves and Representative Baum, who will sponsor a bill to expand pharmacists’ scope of practice to mirror authorities in the PREP Act related to pharmacists’ authority to prescribe and administer vaccinations as well as provide medications based on the results of a CLIA-waived test for conditions aligned with public health needs in the state, all without the need for a collaborative practice agreement.

Other Issues: 

TPA continues to monitor other proposed bills that impact the profession, including requiring dispensing of off-label treatments in Tennessee or requiring QR codes on prescription labels for visually-impaired patients. 

If you are planning to attend TPA Winter Meetings, please work now to schedule a meeting with your legislators for Pharmacy Day on the Hill (March 1, 2022). If you do not know who your legislators are, use the legislator finder tool.  TPA is excited to have a special guest, Antonio Ciaccia of 3 Axis Advisors, to speak on PBM reform at the PharmPAC breakfast on Tuesday, March 1. Get your tickets today!  

TPA continues to work with Meagan Frazier and the team at Harris Frazier to carry out our legislative priorities and response to the urgent issues impacting the profession at the state legislative level. You may review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — February 11, 2022

Priority #1: Enforceable PBM Reform 

On Tuesday, February 8, the Tennessee House Standing Committee on Insurance hosted a discussion on PBMs. The Committee members heard from TPA leaders, as well as other representatives from the Tennessee healthcare community, about the limited enforcement of Tennessee’s PBM laws. A recording of the hearing is available here. Next Tuesday, February 15, the Committee will hear from representatives from the PBM industry and the Tennessee Department of Commerce and Insurance. To view a live stream, click here 

This week, TPA’s drafted clean-up language to Public Chapter 569 was provided to Legislative Legal Services, which should be assigned for committee discussion soon enough. Additional talking points are being drafted to guide our members as you begin to have conversations with your legislators about enforcement of PBM reform.

Priority #2: Codifying PREP Act 

TPA’s other priority, to codify provisions of the PREP Act in Tennessee, is moving forward as well. On Tuesday, February 15, the Tennessee House Health Subcommittee will discuss HB 2131, which will amend the current definition of a pharmacy technician to permit a pharmacy technician to perform tasks delegated by the pharmacist, including helping with drug, dietary supplement and device selection, storage, distribution and administration, so long as the delegated tasks are consistent with the pharmacy technician’s education, training and experience. An advocacy action alert was sent to TPA members to contact their legislators before Tuesday, if their representative serves on this House subcommittee 

TPA continues to work with Senator Reeves and Representative Baum, who will sponsor a bill to expand pharmacists’ scope of practice to mirror authorities in the PREP Act related to pharmacists’ authority to prescribe and administer vaccinations as well as provide medications based on the results of a CLIA-waived test for conditions aligned with public health needs in the state, all without the need for a collaborative practice agreement. This bill language is currently being finalized and reviewed by legal services.  

Other Issues: 

TPA has seen proposed bills to require dispensing of off-label treatments in Tennessee, which have also been seen across the country. We continue to actively monitor committee activity on this topic, and we are working to provide a unified front against forced prescribing and dispensing bills with other pharmacy, hospital, and provider organizations.  

If you are planning to attend TPA Winter Meetings, please work now to schedule a meeting with your legislators for Pharmacy Day on the Hill (March 1, 2022). If you do not know who your legislators are, use the legislator finder tool.  

TPA continues to work with Meagan Frazier and the team at Harris Frazier to carry out our legislative priorities and response to the urgent issues impacting the profession at the state legislative level. You may review the current bill tracker, listing all bills TPA is following on behalf of our members.   


Weekly Summary — February 4, 2022

This week, the Governor delivered his State of the State address. Here is a thorough review from our colleagues at Harris Frazier. While pharmacy issues were not specifically mentioned, understanding the Governor’s priorities is helpful as TPA pushes its priorities forward.

TPA’s PBM clean-up bill inches closer towards its final draft. We await final input from the Tennessee Department of Commerce and Insurance on our suggested language, while looking for their commitment to enforcing regulation of PBMs. Next Tuesday, February 8th at 9:00 a.m., the House Insurance Committee will hold an open hearing on PBMs. TPA has been invited to testify. You will be able to watch the hearing at this link. Watch for a recap of the hearing in next week’s legislative summary.

TPA’s other priority—to codify provisions of the PREP Act—is moving forward as well. HB2131 and SB2446 were introduced this week and moved forward on first consideration. This bill would amend the definition of a pharmacy technician to allow technicians to be delegated tasks by a pharmacist for all aspects of selection, storage, distribution, and administration of medications, consistent with the technician’s education, training, and experience. The bill would allow pharmacy technicians to administer vaccinations and other injectables, if delegated by a pharmacist.

TPA is finalizing language on a second bill to codify provisions of the PREP Act focused on addressing pharmacists’ authority to prescribe and administer vaccinations, as well as provide medications based on the results of a CLIA-waived test for conditions aligned with public health needs in the state, all without the need for a collaborative practice agreement.

TPA continues to encourage you to reach out to your elected officials and introduce yourself as a resource on pharmacy and healthcare issues. If you do not know who your legislators are, use the legislator finder tool. TPA’s Pharmacy Day on the Hill (March 1), which is held in tandem with the TPA Winter Meetings, is also a great opportunity to hear from legislators and experts on the issues impacting pharmacy. You, and your relationship with your legislators, are the profession’s most important advocacy asset.

TPA continues to work with Meagan Frazier and the team at Harris Frazier to carry out our legislative priorities and response to the urgent issues impacting the profession at the state legislative level. Click here to review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — January 28, 2022

This week, TPA has worked to move our priorities forward, as well as be responsive to other proposed legislation impacting the profession.

TPA held additional meetings with stakeholders this week to finalize a clean-up bill to Public Chapter 569, in order to ensure PBMs are held accountable to the law. At this point, TPA has focused our primary concerns on Section 2 (any willing provider/patient steering) and Section 3 (fair pricing) of the current law. TPA continues to work with legislative leadership to look at best mechanisms to ensure that all concerns of TPA, including concerns with white-bagging, are addressed in the clean-up bill. Next week, TPA will be meeting with lead sponsors in the House and Senate, as we aim to finalize the language needed in our final proposed bill. Also stay tuned, as TPA is working with House leadership to participate in a legislative hearing focused on enforcement of PBM laws on Tuesday, February 8.

As TPA looks to codify provisions of the PREP Act in Tennessee law, we have developed a strategy to address this priority across two bills. The first bill will focus on amending the definition of a pharmacy technician in the Practice Act, to allow for pharmacists to delegate tasks consistent with the technician’s training and expertise, including medication administration. The second bill will focus on addressing pharmacists’ authority to prescribe and administer vaccinations, as well as provide medications based on the results of a CLIA-waived test for conditions aligned with public health needs in the state, all without the need for a collaborative practice agreement.

TPA continues to encourage you to reach out to your elected officials and introduce yourself as a resource on pharmacy and healthcare issues. If you do not know who your legislators are, use the legislator finder tool. TPA’s Pharmacy Day on the Hill (March 1), which is held in tandem with the TPA Winter Meetings, is also a great opportunity to hear from legislators and experts on the issues impacting pharmacy. You, and your relationship with your legislators, are the profession’s most important advocacy asset. 

TPA continues to work with Meagan Frazier and the team at Harris Frazier to carry out our legislative priorities and response to the urgent issues impacting the profession at the state legislative level. Click here to review a general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members. 


Weekly Summary — January 21, 2022

This week, legislators continue to concentrate on hearing from advocates about bills that didn’t pass from last year’s session, as well as many bills that will continue to be released for this year.

TPA continues to meet with legislative sponsors and other stakeholders to address a clean-up bill to Public Chapter 569. As many TPA members know, the Tennessee Department of Commerce and Insurance has had limited enforcement of last year’s PBM legislation. TPA has collected insight to help frame the language to be used in the clean-up, and we expect to have final language in the coming weeks.

In addition, TPA has met with key supporters for our other legislative priority – codifying provisions of the PREP Act. The language of this proposal is currently coming together to help finalize the talking points for other legislators, as the bill filing deadline approaches (February 3, 2022).

TPA continues to encourage you to reach out to your elected officials and introduce yourself as a resource on pharmacy and healthcare issues. If you do not know who your legislators are, use the legislator finder tool. TPA’s Pharmacy Day on the Hill (March 1), which is held in tandem with the TPA Winter Meetings, is also a great opportunity to hear from legislators and experts on the issues impacting pharmacy. You, and your relationship with your legislators, are the profession’s most important advocacy asset.

TPA continues to work with Meagan Frazier and the team at Harris Frazier to carry out our legislative priorities and response to the urgent issues impacting the profession at the state legislative level. Please review the general legislative summary from Harris Frazier and the current bill tracker, listing all bills TPA is following on behalf of our members.


Weekly Summary — January 14, 2022

The 2nd session of the 112th Tennessee General Assembly began this week, with legislators returning to the Tennessee State Capitol on Tuesday.

This week also begins TPA’s legislative advocacy efforts at the capitol. With a new contract lobbyist team from Harris Frazier, TPA has focused our attention this week on crafting our legislation for our two primary priorities – enforcement of PBM laws and codifying the pharmacy provisions of the PREP Act in the state. With the meetings this week with the Tennessee Department of Commerce and Insurance, TPA has a clearer strategy on what will be included in a clean-up bill to Public Chapter 569. TPA has also held meetings with colleagues at the Tennessee Hospital Association to discuss white-bagging legislation for 2022.

We strongly encourage all of our members to reach out to your elected officials and introduce yourself as a resource on pharmacy and healthcare issues. If you do not know who your legislators are, use the legislator finder tool. TPA’s Pharmacy Day on the Hill (March 1), which is held in tandem with the TPA Winter Meetings, is also a great opportunity to hear from legislators and experts on the issues impacting pharmacy. You, and your relationship with your legislators, are the profession’s most important advocacy asset.

Each week throughout the session, TPA will provide updates through the 10 for Tenn e-newsletter, as well as a general legislative summary from Harris Frazier. TPA also provides a bill tracker, listing all bills TPA is following on behalf of our members.  In addition, watch your inbox for Advocacy Alerts from TPA asking you to take part in a grassroots effort on particular legislation, telling you who to contact and what you need to say. These grassroots efforts are critical to our advocacy efforts.