Tennessee Pharmacists Association

February 8, 2018

TPA’s TOP LEGISLATIVE PRIORITIES FOR 2018

TPA routinely sends out legislative action alerts during each Tennessee General Assembly legislative session, to request action from members and to facilitate communications between members and legislators regarding key pharmacy advocacy priorities.

TPA utilizes the Tennessee Pharmacists Legislative Action Network (T-PLAN) to make it simple for you to engage on key legislative priorities, by developing automated and customizable e-mail and social media alerts which will go directly to your state and federal legislators.

There are four (4) current federal advocacy campaign opportunities for members. Please visit T-PLAN to get started.

  • Pharmacists As Providers (HR 592 / S 109)
  • Ban on Retroactive DIR Fees (HR 1038 / S 413)
  • Federal “Any Willing Pharmacy” Statute (HR 1939 / S 1044)
  • Prescription Drug Price Transparency Act (HR 1316 / no Senate bill)

At the state level, TPA will be actively advocating for pharmacy and patients as the Tennessee General Assembly considers the following bills in 2018.

Governor Haslam’s TN Together Opioid Reform Legislation

Legislation: House Bill 1831 / Senate Bill 2257
Senate Sponsor(s):
Norris
House Sponsor(s): Hawk
Summary as Introduced:

  • Requires all dispensers (or their delegates) to check the 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
  • Limits the dosage of an opioid prescribed to an opioid naïve patient or acute care patient to not more than a 40 MME daily morphine milligram equivalent dose
  • 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

Other Opioid-Related Legislation:


Mandatory PBM Licensure

Legislation: Senate Bill 1852 / House Bill 1857
Senate Sponsor(s): Haile
House Sponsor(s): Powers
Summary as Introduced:

  • Requires all pharmacy benefits managers (PBM)s 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 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 30 days of any change in PBM information

Professional Privilege Tax Repeal

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). Although the Professional Privilege Tax repeal legislation was not passed in 2017, TPA continues to work in 2018 with the coalition to support and advocate for its passage in 2018.


Medical Cannabis

Legislation: Senate Bill 1710 / House Bill 1749
Senate Sponsor(s): Dickerson
House Sponsor(s): Faison, Ramsey
Summary: Health Care – As introduced, enacts the “Medical Cannabis Act”; establishes a medical cannabis commission for regulation of cannabis-related health care. – Amends TCA Title 4, Chapter 29; Title 39, Chapter 17, Part 4; Title 50; Title 53, Chapter 11; Title 67 and Title 68.

  • Defines “Cannabis product” as cannabis oil, cannabis extract, or a product that is infused with cannabis oil or cannabis extract and intended for use or consumption, and includes capsules, pills, transdermal patches, ointments, lotions, lozenges, tinctures, oils, and liquids
  • Defines “Cardholder” as a qualifying patient or a designated caregiver who has been issued and possesses a valid registry identification card
  • Defines “debilitating medical condition” as (A) cancer; (B) Human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS); (C) Hepatitis C; (D) Amyotrophic lateral sclerosis (ALS); (E) Post-traumatic stress disorder (PTSD); (F) Alzheimer’s disease; (G) Severe arthritis; (H) Inflammatory bowel disease, including Crohn’s disease and ulcerative colitis; (I) Multiple sclerosis; (J) Parkinson’s disease; (K) Schizophrenia; (L) A chronic or debilitating disease or medical condition, with a confirmation of diagnosis, or the treatment of such disease or condition that produces one (1) or more of the following: (i) Cachexia or wasting syndrome; (ii) Peripheral neuropathy; (iii) Severe chronic pain; (iv) Severe nausea; (v) Seizures, including those characteristic of epilepsy; or (vi) Severe or persistent muscle spasms; and (M) any other medical condition approved by the commission in response to a request from a practitioner or potentially qualifying patient or a proposal initiated by a member of the commission
  • Defines “Qualified pharmacist” as a pharmacist licensed pursuant to title 63, chapter 10, who is certified by the commission as competent to consult with cardholders about proper use and dosage of cannabis products
  • Requires dispensaries to ensure that every cardholder consults with a qualified pharmacist prior to the first time cannabis products are dispensed to the cardholder in this state
  • Requires dispensaries to ensure that a cardholder is offered the opportunity to consult with a qualified pharmacist prior to each time cannabis products are dispensed to the cardholder
  • Consultations with qualified pharmacists pursuant to this subsection (d) may be in person or via telephone or other live electronic communication

Other Cannabis Legislation:


Update to MTM Definition

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


Authorization of Partial Fills for Opioids

Legislation: Senate Bill 2025 / House Bill 2440
Senate Sponsor(s): Haile
House Sponsor(s): Terry
Summary: Authorizes partial fill for a prescription of an opioid.


Mandatory Electronic Prescribing of Controlled Substances

Legislation: Senate Bill 2038 / House Bill 1992
Senate Sponsor(s): Gresham
House Sponsor(s): Gant
Summary:  Mandates that health care prescribers issue all prescriptions for Schedule II controlled substances electronically by July 1, 2020.

Other Electronic Prescribing Legislation


Scheduling of Gabapentin as Schedule V Controlled Substance

Legislation: Senate Bill 2258 / House Bill 1832
Senate Sponsor(s): Norris
House Sponsor(s): Hawk
Summary as Introduced: Updates schedules of controlled substances and adds gabapentin to the list of Schedule V controlled substances in Tennessee.


Prescription Authorization in Emergency Situations

Legislation: Senate Bill 1670 / House Bill 1695
Senate Sponsor(s): Green
House Sponsor(s): Pitts
Summary: Permits a pharmacist to honor a valid prescription written by a physician in another state or territory for a person displaced by a disaster who is present in this state.


Student Loan Default

Legislation: Senate Bill 1766 / House Bill 1487
Senate Sponsor(s): Green
House Sponsor(s): McCormick
Summary: Repeals requirements that authorization to engage in regulated professions and occupations be revoked for persons who default on student loans.

OTHER 2018 LEGISLATION BEING MONITORED BY TPA

This list is only a summary of key pharmacy-related bills that have been introduced thus far in 2018. It is not intended to be exhaustive of all healthcare-related legislative proposals. TPA is currently monitoring a large number of legislative proposals and will update members as additional important issues arise.