Legislative Issues & Updates

A central part of TMA’s advocacy mission is state-level government relations, and the advocacy team works with state lawmakers and other organizations to achieve members’ legislative priorities as defined by the Legislative Committee, Board of Trustees and House of Delegates. In 2019, TMA was named the most influential advocacy organization on Capitol Hill. Our lobbyists review hundreds of bills each year to identify measures that promote or threaten good healthcare policies, and then organize member physicians and organizations to help carry TMA’s support or opposition.

 

2024 Legislative Priorities

SCOPE OF PRACTICE 
For years, TMA has worked to preserve the formal professional relationship between physicians and advance practice providers, such as advance practice registered nurses and physician assistants, to ensure patients receive the highest quality of care possible. Unfortunately, these same professionals have actively lobbied to practice medicine without the collaboration of a physician, potentially putting patients at risk. TMA, along with its multi-specialty partners in the Coalition for Collaborative Care, will continue to promote the team-based care model as the most effective solution for Tennesseans to have access to high-quality, comprehensive health care no matter where they live. 

Update: TMA introduced and passed legislation updating the state’s team-based care model to allow “endorsed” physician assistants with more than 6000 hours of post-graduate clinical experience to practice under less prescriptive protocols and formularies, as approved by their employer. The bill does not apply to PAs with less than 6000 hours of post-graduate clinical experience or to APRNs. 

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PHYSICIAN WELLNESS 
Career fatigue among physicians has risen dramatically since the COVID-19 pandemic, with nearly 63% reporting at least one symptom of burnout in 2021, according to a recent survey. These feelings have been linked to lower productivity and patient satisfaction, increased risk for medical errors, and even suicidal ideation. TMA is working to prioritize physician well-being by removing stigmatizing questions on licensure, renewal, and credentialing applications which may serve as barriers to seeking routine mental health treatment.

Update: TMA worked to support physician wellness by making certain communications with a therapist confidential for purposes of licensure, credentialing, and employment. The new law offers protections for physicians seeking help with career fatigue which is defined as a “work-related, psychological disorder that manifests itself in emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment.”

 

INSURER CLAWBACKS
Health insurers often attempt to recover payments made to physician practices well after a service is rendered. Recoupments for these inaccurate payments can occur years after the claim was duly adjudicated by the health plan and initial payment was received. Recoupments require physicians and their staff to revisit claims that should have been paid correctly the first time, often because the health plan failed to identify the incorrect payments in the first place. These recovery efforts greatly increase administrative costs incurred by the physician while unjustly enriching health plans through free care provided to the enrollee. TMA will work to reform audit and overpayment protocols to prohibit health plans from recouping 100% of improperly adjudicated claims and place specific requirements on overpayment recovery processes, including advance overpayment notification, payment transparency, due process rights, and clawback time limits.

Update: TMA passed legislation reforming the state’s health insurance recoupment statute to make the process fairer and more transparent for physician practices. This includes requiring insurers to give advance notice (30 days) of the intent to recoup and provide detailed information on the basis of recoupment; prohibiting insurers from recouping any monies before all appeals are exhausted; and prohibiting insurers from collecting the entire contested claim amount versus just the overpayment amount.

 

DR. BENJAMIN MAUCK ACT
Since the onset of the Covid-19 pandemic, medical professionals have experienced a sharp increase in workplace violence which has resulted in assault and even death in some cases. Not only does this aggression cause physical and psychological injury for health care workers, but it creates an unsafe environment that makes it far more difficult for doctors and other clinical staff to provide quality patient care. While Tennessee currently has legal protections for assaults committed against first responders and nurses, TMA would like to see these protections extended to physicians as well. Ensuring that offenders are appropriately punished for violent behavior will help keep our health care heroes safe from harm so they can continue to deliver high-quality care.

Update: In honor of murdered Collierville physician, Dr. Benjamin Mauck, TMA introduced and passed legislation that increases the penalty for knowingly committing assault within a healthcare facility. The law aligns Tennessee with 40 other states that have already established laws creating or increasing penalties for violence against healthcare workers.