The second session of the 114th Tennessee General Assembly adjourned after 8:00pm on Thursday. Lawmakers were holding a slew of conference committees and shooting bills between the chambers in the final days to try to wrap up their business.

In terms of healthcare, TMA and the House of Medicine endured a tough session, battling bills that increased prohibitions on physicians, the practice of medicine, and tried to expand scope of practice for non-physicians. The government affairs team spent a lot of its energy lobbying against harmful legislation and successfully fended off many measures that would have impeded physicians’ ability to practice evidence-based medicine and patient-centered care.

One of TMA’s priority bills, the medical necessity determination bill, was signed into law by the Governor. As amended, SB1753/HB1770 by Sen. Ferrell Haile (R-Gallatin) and Rep. Brock Martin (R-Huntingdon) updates Tennessee statute governing medical practice to keep pace with emerging technologies and healthcare delivery models and clarifies that medical doctors and osteopathic physicians may determine the appropriateness of treatments or procedures for patient conditions. This bill will ensure that ALL physicians, including insurance company medical directors, are governed by the same standard of care criteria when making medical necessity determinations. As the practice of medicine, the Board of Medical Examiners and Board of Osteopathic Examination interpret the laws, rules, and regulations to determine the appropriate standards of practice to ensure the highest degree of professional conduct. The Boards will be responsible for the investigation of alleged violations. This is a groundbreaking new law, the first in the country, which gives providers one more tool in the arsenal to fight against insurance companies if they practice medicine without a license.

Wins for Stem Cells, Biomarker Testing, Newborn Screening, Step Therapy Exemptions

Last week, SB2586/HB224, the TMA-supported Tennessee Stem Cell Bill was sent to the Governor. Championed by TMA Member Dr. Ethan Kellum, the bill establishes that a physician may perform stem cell therapy or regenerative medicine therapy that is not approved by the federal Food and Drug Administration (FDA) if the therapy is used for a treatment or procedure that is within the physician's scope of practice.

Dr. Kellum is a sports medicine fellowship-trained orthopedic surgeon leading the advancement of interventional and regenerative orthopedics. He also serves as a team physician for the Tennessee Titans and USA Basketball.

Bill sponsor Senator Ed Jackson (R-Jackson) read from the Senate floor, “For a decade, Dr. Kellum has quietly transformed lives — offering hope to patients who had exhausted every other option and building a foundation of care and credibility in our community that made moments like today possible. He didn't just treat patients. He pioneered a movement in Tennessee. And when the time came to put that experience into law, Dr. Kellum didn't step back — he stepped up. He brought his firsthand clinical knowledge to the table and helped us draft the very bill we are voting on today. His fingerprints are on this legislation, and Tennessee patients will be better for it for generations to come.” Senator Jackson also thanked the Tennessee Medical Association for their assistance with the bill.

SB435/HB484 by Senator Shane Reeves (R-Murfreesboro) and Representative Brock Martin (R-Huntingdon) awaits the Governor’s signature. This bill requires group insurance plans for public employees and TennCare to provide coverage for biomarker testing for the purposes of diagnosis, treatment, appropriate management, or ongoing monitoring of an enrollee's disease or condition when the test is supported by medical and scientific evidence. Since the bill was amended to remove commercial insurance plans, the bill also requires a report on the usage of covered biomarker testing and cost savings generated by TennCare to the Legislature by February 2029 setting the stage for future expansion.

SB1697/HB1944 by Senator Raumesh Akbari (D-Memphis) and Representative Harold Love (D-Nashville) was signed into law. This bill requires the Department of Health to test for the presence of sickle cell trait as part of the newborn screening program and notify the parent if the results are positive. Individuals with sickle cell trait are carriers and can pass the sickle hemoglobin gene to their children but typically will not show symptoms of sickle cell disease.

SB2081/HB1956 by Senator Bo Watson (R-Hixson) and Representative Rebecca Alexander (R-Jonesborough) awaits the Governor’s signature. This bill updates health insurance step therapy rules by barring health benefit plans from requiring step therapy before covering an approved prescription drug for an enrollee diagnosed with cancer expanding prior, more limited protections.