63-1-101. Powers and duties.

The division of health related boards, in the department of health, is responsible for all administrative, fiscal, inspectional, clerical and secretarial functions of the health related boards under § 68-1-101.

Acts 1947, ch. 9, § 1; C. Supp. 1950, § 6907.1 (Williams, § 6917.18); Acts 1953, ch. 113, § 45; 1959, ch. 9, § 15; T.C.A. (orig. ed.), § 63-101; Acts 1984, ch. 937, §§ 3, 54; T.C.A., § 63-1-102.

Compiler's Notes. Former § 63-1-101 was transferred to § 63-1-119 in 1986.

Cross-References. Revocation or denial of professional licenses for child support enforcement, title 36, ch. 5, part 7.

State examining boards, general provisions, title 4, ch. 19.

Textbooks. Tennessee Jurisprudence, 20 Tenn. Juris., Physicians and Surgeons, § 2.

Law Reviews.

Report on Administrative Law to the Tennessee Law Revision Commission, 20 Vand. L. Rev. 777.

The Standard of Care: The Road Not Taken-Using County Size to Determine the Standard of Care, 43 U. Mem. L. Rev. 767 (2013).

Attorney General Opinions. Regulation of the practice of acupuncture, OAG 95-027, 1995 Tenn. AG LEXIS 29 (4/4/95).

Neither the emergency services board nor the division of health related boards have authority to issue administrative subpoenas to compel the attendance of witnesses or the production of documents prior to the commencement of an administrative action, OAG 01-055, 2001 Tenn. AG LEXIS 47 (4/10/01).

63-1-102. Chapter definitions.

For the purposes of this chapter:

1. “Division” means the division of health related boards in the department of health as created by § 68-1-101;
2. “Health care prescriber” means a:
   1. Physician licensed under chapter 6 or 9 of this title;
   2. Dentist licensed under chapter 5 of this title;
   3. Nurse licensed under chapter 7 of this title;
   4. Podiatrist licensed under chapter 3 of this title;
   5. Optometrist licensed under chapter 8 of this title; and
   6. Physician assistant licensed under chapter 19 of this title;
3. “Practice of the healing arts” means offering or undertaking to diagnose, treat, operate on or prescribe for any human pain, injury, disease, deformity or physical or mental condition. The practice of acupuncture is hereby declared to be included within the definition of “practice of the healing arts” as defined by this section; and
4. “Title” means the recognized professional abbreviation or professional designation immediately following or immediately below the person's name that indicates the professional license or certification held by such person.

Acts 1947, ch. 9, § 2; 1947, ch. 107, § 1; C. Supp. 1950, § 6907.2 (Williams, § 6917.19); Acts 1955, ch. 160, § 1; 1969, ch. 338, § 1; 1973, ch. 350, § 1; 1973, ch. 393, § 1; 1975, ch. 355, §§ 1, 2; 1980, ch. 851, § 1; T.C.A. (orig. ed.), § 63-102; Acts 1984, ch. 937, § 55; T.C.A., § 63-1-103; Acts 2005, ch. 467, § 3; 2014, ch. 983, § 4.

Compiler's Notes. Acts 2014, ch. 983, § 5 provided that the commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of the act. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

63-1-103. Application for licenses.

Each application for a license filed with the division shall be on forms prescribed by the division or via online application and shall be accompanied by a fee as set by the division.

Acts 1947, ch. 9, § 4; mod. C. Supp. 1950, § 6907.4 (Williams, § 6917.21); Acts 1953, ch. 113, § 3; T.C.A. (orig. ed.), § 63-108; Acts 1984, ch. 937, § 61; T.C.A., § 63-1-109; Acts 1990, ch. 1026, § 27; 2014, ch. 949, § 1.

Compiler's Notes. Former § 63-1-103 was transferred to §§ 63-1-102 and 63-1-104(c) in 1986.

63-1-104. Issuance of licenses.

1. Upon proper direction by the appropriate licensing board, the division shall forthwith issue to the applicant a license of a size and artistic design to be determined by the board.
2. Every such license issued by the division shall be dated and be numbered in the order of issuance and shall be signed by the executive officer and by the members of the state board charged with the duty by law of issuing the preliminary certificates.
3. No license, examination or certification shall be denied to any person for practice of any of the healing arts under this title because such person is not a citizen of the United States, if such person is legally entitled to live within the United States.
4. Any board, committee, council, or agency created pursuant to this title or title 68 that regulates health professionals shall have the authority to do the following at its discretion:
   1. Issue a limited license of temporary duration to applicants who have been out of clinical practice or inactive in their practice for an extended period of time, or who have been or are at the time of their application engaged exclusively in administrative practice; provided, that the applicant meets all other requirements for licensure;
   2. Restrict the scope of practice under such limited license as deemed appropriate;
   3. Restrict the duration of such limited license as deemed appropriate;
   4. Condition the granting of a full license upon an applicant's completion of any educational measures or supervised practice requirements deemed necessary and appropriate to ensure the applicant's competency to practice the profession for which a license is sought.
5. At the conclusion of the duration of a limited license granted pursuant to subsection (d), an applicant may be eligible for full licensure if the applicant has completed the educational measures or supervised practice requirements the board, committee, council, or agency deemed necessary and appropriate to ensure the applicant's competency to practice. The board, committee, council, or agency may grant a full license before the conclusion of a limited license's duration if an applicant has completed the specified educational measures or practice requirements prior to the expiration of the limited license.
6. A board, committee, council, or agency may promulgate rules establishing other conditions or requirements with respect to the issuance of limited licenses pursuant to this section in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
7. The recipient of a limited license pursuant to this section may engage in the full scope of practice of the applicable profession subject to any limitations or restrictions imposed by the board, committee, council, or agency.

Acts 1947, ch. 9, § 4; C. Supp. 1950, § 6907.4 (Williams, § 6917.21); Acts 1969, ch. 338, § 1; 1980, ch. 851, § 5; T.C.A. (orig. ed.), § 63-109; Acts 1975, ch. 355, § 1; 1984, ch. 937, § 62; T.C.A., §§ 63-1-103, 63-1-110; Acts 2017, ch. 240, § 2.

Compiler's Notes. Former § 63-1-104 (Acts 1947, ch. 9, § 3; mod. C. Supp. 1950, § 6907.3 (Williams, § 6917.20); Acts 1953, ch. 113, § 2; 1973, ch. 393, § 2; 1974, ch. 495, § 6; 1976, ch. 650, § 16; 1980, ch. 851, § 2; T.C.A. (orig. ed.), § 63-103, concerning certificates of fitness for licensing and recommendations for certifying nurse practitioners, was repealed by Acts 1984, ch. 937, § 56.

Amendments. The 2017 amendment added (d)-(g).

Effective Dates. Acts 2017, ch. 240, § 6.  May 2, 2017.

63-1-105. Signing of licenses.

Before issuing any license as provided in this chapter, the division shall cause the license to be signed by the members of the board of the particular branch of the healing arts in which the holder thereof is being licensed.

Acts 1953, ch. 113, § 1 (Williams, § 6917.19); T.C.A. (orig. ed.), § 63-110; Acts 1984, ch. 937, § 63; T.C.A., § 63-1-111.

Compiler's Notes. Former § 63-1-105 was transferred to § 63-1-118 in 1986.

63-1-106. Duplicate licenses — Change of name — Fee.

1. A licensee of any branch of the healing arts whose license has been lost or destroyed may make application to the board of that particular branch of the healing arts for a new license. Such application shall be accompanied by an affidavit setting out the facts concerning the loss or destruction of the license.
2. Any licensee of any branch of the healing arts whose name is changed by marriage or court order may surrender that licensee's license and apply to the board of that particular branch of the healing arts for a new license.
3. The fee for such new license shall be set by the board issuing such certificate.

Acts 1953, ch. 113, § 2 (Williams, § 6917.20); T.C.A. (orig. ed.), § 63-105; Acts 1984, ch. 937, § 58; 1990, ch. 1026, § 28.

63-1-107. License renewals.

1. 1. Every person licensed to practice any branch of the healing arts in this state shall apply to the division for a certificate of registration. Notwithstanding any provision of this title to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board determines that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
   2. No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in subdivision (a)(1).
2. 1. All new licenses issued by the division, upon application and payment of the registration fee provided in this subsection (b), shall be registered by the division at the time of issuance and a certificate of registration shall be issued to the licensee.
   2. Each application shall be made on a form to be furnished by the division. Such application shall give the applicant's name in full, the applicant's address, the date and number of the license issued to such applicant for the practice of the healing arts or any branch thereof, and such other facts as tend to identify the applicant and the applicant's license as the division deems necessary.
   3. Each applicant for registration shall submit with the application a fee as set annually by the division.
3. When any licensee fails to register and pay the annual registration fee within sixty (60) days after the registration becomes due as provided in this section, the license of such person shall be automatically revoked at the expiration of sixty (60) days after the registration was required, without further notice or hearing.
4. Any person whose license is automatically revoked as provided in subsection (c) may make application in writing to the appropriate licensing board for the reinstatement of such license; and, upon good cause being shown, the division and the board in their discretion may reinstate such license upon the payment of the renewal fee as set by the board as well as a late renewal fee set by the board, which may not exceed twice the renewal fee.

Acts 1947, ch. 9, § 5; mod. C. Supp. 1950, § 6907.5 (Williams, § 6917.22); Acts 1953, ch. 113, § 4; 1973, ch. 166, § 1; 1975, ch. 355, § 3; 1976, ch. 406, § 1; 1976, ch. 566, § 1; T.C.A. (orig. ed.), § 63-113; Acts 1984, ch. 937, § 66; T.C.A., § 63-1-114; Acts 1989, ch. 360, §§ 15, 16; 1990, ch. 1026, §§ 29, 30; 2010, ch. 1043, § 1; 2016, ch. 763, § 1.

Compiler's Notes. Former § 63-1-107 (Acts 1947, ch. 9, § 3; mod. C. Supp. 1950, § 6907.3 (Williams, § 6917.20); Acts 1953, ch. 113, § 2; T.C.A. (orig. ed.), § 63-106), concerning failure of branch boards to comply, was repealed by Acts 1984, ch. 937, § 59.

63-1-108. Certificate of registration — Change of address of registrant — Service of process.

1. Upon due application by a licensee of the division and upon the payment of fees required to be paid by this chapter, the division shall issue to such applicant a certificate of registration signed by the executive officer of the division, which certificate shall recite that such person is duly registered for the year specified.
2. Such certificate of registration shall contain the name of the person to whom it is issued, the address of the person, which shall be the address of the licensee deemed sufficient for purposes of service of process, the branch of the healing arts in which the person is licensed to practice, the date and number of the license and such other information as the division deems advisable.
3. If any registrant changes address during the year for which any certificate of registration has been issued by the division, such registrant, within thirty (30) days thereafter, shall notify the division of such change, whereupon the division shall issue to such registrant, without additional fee, a duplicate registration certificate for such new location.
4. For the purpose of effecting service of process upon a licensee, the division may notify the licensee by certified mail, return receipt requested, at the address on file with the division.

Acts 1947, ch. 9, § 6; mod. C. Supp. 1950, § 6907.6 (Williams, § 6917.23); Acts 1975, ch. 355, § 4; T.C.A. (orig. ed.), § 63-114; Acts 1984, ch. 937, § 67; T.C.A., § 63-1-115; Acts 1990, ch. 1026, § 32.

Compiler's Notes. Former § 63-1-108 (Acts 1947, ch. 9, § 3; mod. C. Supp. 1950, § 6907.3 (Williams, § 6917.20); Acts 1953, ch. 113, § 2; T.C.A. (orig. ed.), § 63-107) concerning powers of examining boards, was repealed by Acts 1984, ch. 937, § 60.

63-1-109. Display of license or certificate of registration — Terminology used in signs and written material.

1. Every person licensed or registered to practice one of the healing arts, or any branch thereof, as delineated in this section shall keep an original or copy of the person's license or certificate of registration displayed in the office or place in which the person practices, in a conspicuous place, and shall place and keep placed in a conspicuous place at the entrance of the person's office, a sign in intelligible lettering and not less than one inch (1") in height, containing the name of such person immediately followed by the recognized abbreviation indicating the professional degree, if any, held by such person, and containing immediately below the person's name, in equal size lettering, the word or words:
   1. “Chiropractor,” “chiropractic physician” or “doctor of chiropractic” for practitioners of chiropractic;
   2. “Dentist,” “doctor of dental surgery” or “doctor of dental medicine” for practitioners of dentistry;
   3. “Medical doctor,” “physician,” “medical doctor and surgeon,” “medicine” or “surgeon,” as applicable, for practitioners of medicine and surgery;
   4. “Optometrist,” “doctor of optometry” or “optometric physician” for practitioners of optometry;
   5. “Osteopathic physician,” “osteopathic physician and surgeon,” “doctor of osteopathic medicine” or “doctor of osteopathy” for practitioners of osteopathy;
   6. “Podiatrist,” “podiatric physician,” “doctor of podiatry,” “doctor of podiatric medicine” or “doctor of podiatric medicine and surgery” for practitioners of podiatry;
   7. “Advanced practice registered nurse,” “nurse practitioner,” “nurse anesthetist,” “nurse midwife” or “clinical nurse specialist,” as applicable, for those practicing advanced practice nursing;
   8. “Physician assistant” or “orthopedic physician assistant,” as applicable, for those licensed as a physician assistant;
   9. “Psychologist” or “doctor of psychology” for practitioners of psychology;
   10. “Acupuncturist” for practitioners of acupuncture; and
   11. “Certified professional midwife” for those practitioners of midwifery.
2. Any recognized specialist in any branch of the healing arts, which special field is recognized or approved by the appropriate board licensing that profession, may substitute the specialist designation for the words indicated in subsection (a).
3. A healthcare practitioner listed in subsection (a) shall also affirmatively communicate the practitioner's specific licensure, as defined in this section by one (1) of the following methods:
   1. The healthcare practitioner shall wear a photo identification name tag during all patient encounters that shall include a recent photograph of the licensee, the licensee's full name, and the type of license. The name tag shall be of sufficient size and be worn in a conspicuous manner so as to be visible and apparent; or
   2. After January 1, 2012, the healthcare practitioner shall communicate to a patient the practitioner's full name and type of license in writing at the patient's initial office visit.
4. For purposes of subsection (c), the type of license shall enunciate one (1) or more of the words listed in subsection (a).
5. A healthcare practitioner who practices in more than one (1) office shall be required to comply with the requirements in each practice setting.
6. A healthcare practitioner who does not have an office setting can satisfy the requirements of this section by meeting the conditions set forth in subsection (c).
7. Healthcare practitioners working in facilities licensed pursuant to title 68, chapter 11, or working in facilities licensed pursuant to title 33, chapter 2, are not subject to the requirements of this section.
8. Healthcare practitioners working in no-patient care settings and who have no direct patient care interactions are not subject to the requirements of this section.
9. Any healthcare practitioner who violates this section is guilty of unprofessional conduct and shall be subject to disciplinary action in accordance with the appropriate licensure provisions governing the respective healthcare practitioner. A violation of this section shall not create a private right of action by a patient.
10. Notwithstanding the imposition of any other penalty, the board which has licensed a particular healthcare practitioner may seek injunctive or other relief as appropriate against that practitioner or any entity for a violation of this section.
11. A healthcare practitioner, who provides information regarding healthcare services on an internet website that is directly controlled or administered by the healthcare practitioner or the practitioner's agent, shall prominently display on the internet website the practitioner's full name and type of license using one (1) or more of the words listed in subsection (a).

Acts 1947, ch. 9, § 8; C. Supp. 1950, § 6907.8 (Williams, § 6917.25); Acts 1953, ch. 113, § 5; T.C.A. (orig. ed.), § 63-117; Acts 1984, ch. 937, § 70; T.C.A., § 63-1-118; Acts 1994, ch. 901, § 5; 2005, ch. 467, § 1; 2011, ch. 75, § 1; 2016, ch. 980, § 4.

Compiler's Notes. Acts 2017, ch. 163, § 8 provided that nothing in the act, which amended § 63-1-502,  authorizes a chiropractic physician to use a title other than  the titles recognized in subdivision (a)(1).

63-1-110. Licensees in armed forces or public health service.

1. Any person licensed to practice a healing art or any branch thereof in this state who is an officer in the commissioned medical corps of the army, the navy, the air force or the public health service of the United States shall not be required to register as provided in this chapter.
2. When such person resigns or is honorably discharged from one of the services mentioned in subsection (a) and engages in the practice of a healing art or any branch thereof in this state, such person shall register with the appropriate board licensing that profession.

Acts 1947, ch. 9, § 7; C. Supp. 1950, § 690.7 (Williams, § 6917.24); modified; T.C.A. (orig. ed.), § 63-116; Acts 1984, ch. 937, § 69; T.C.A., § 63-1-117.

63-1-111. Retirement.

1. Any person licensed to practice the healing arts or any branch thereof in this state who has retired or may hereafter retire from such practice shall not be required to register as required by this chapter.
2. Such person shall file with the division an affidavit on a form to be furnished by the division, which affidavit shall state the date on which the person retired from such practice and such other facts as shall tend to verify such retirement as the division shall deem necessary.
3. Any such person who thereafter reengages in the practice of the healing arts or any branch thereof shall register with the division as provided by this chapter.

Acts 1947, ch. 9, § 7; C. Supp. 1950, § 6907.7 (Williams, § 6917.24); T.C.A. (orig. ed.), § 63-115; Acts 1984, ch. 937, § 68; T.C.A., § 63-1-116.

63-1-112. License and registration fees.

1. No fee for the issuance of licenses to practice the healing arts or any branch thereof shall be collected except by the appropriate board licensing that profession.
2. All fees due the boards regulating the various branches of the healing arts shall be collected by the division.

Acts 1947, ch. 9, § 14; C. Supp. 1950, § 6907.14 (Williams, § 6917.31); Acts 1953, ch. 113, § 7; T.C.A. (orig. ed.), § 63-119; Acts 1984, ch. 937, § 71; T.C.A., § 63-1-119; Acts 2010, ch. 1043, § 2.

Compiler's Notes. Former § 63-1-112 (Acts 1947, ch. 9, § 4; C. Supp. 1950, § 6907.4 (Williams, § 6917.21); T.C.A. (orig. ed.), § 63-111), concerning denial of licenses, was repealed by Acts 1984, ch. 937, § 64.

63-1-113. Disbursement of fines and penalties — Operating expenses.

1. All fines and penalties for offenses for the violation of this chapter shall be paid over to the division and shall become a part of the receipts of the division. All money received by the division shall be paid into the state treasury and become a part of the general fund of the state.
2. The commissioner of finance and administration shall make such allotments out of the general fund as the commissioner may deem proper for the necessary expenses of all professional boards for which fees are collected by the division, and no expenditure shall be made by the division unless and until such allotment has been made by the commissioner. Such allotments shall be disbursed under the general budgetary laws of the state.

Acts 1947, ch. 9, § 13; mod. C. Supp. 1950, § 6907.13 (Williams, § 6917.30); Acts 1953, ch. 113, § 6; impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; T.C.A. (orig. ed.), § 63-120; Acts 1984, ch. 937, § 72; T.C.A., § 63-1-120.

63-1-114. Directory of licensees.

The division shall publish a directory listing all persons licensed to practice any branch of the healing arts in Tennessee.

Acts 1947, ch. 9, § 3; mod. C. Supp. 1950, § 6907.3 (Williams, § 6917.20); Acts 1953, ch. 113, § 2; 1972, ch. 834, § 1; T.C.A. (orig. ed.), § 63-112; Acts 1984, ch. 937, § 65; T.C.A., § 63-1-113; Acts 1990, ch. 1024, § 32; 1990, ch. 1026, § 1; 2010, ch. 1043, § 3.

63-1-115. Employment of administrative and enforcement personnel.

The division is authorized to employ investigators, inspectors or agents or to use any other means necessary to bring about and maintain a rigid administration and enforcement of this chapter and all laws regulating the practice of the healing arts and the various branches thereof within this state.

Acts 1947, ch. 9, § 13; C. Supp. 1950, § 6907.13 (Williams, § 6917.30); Acts 1953, ch. 113, § 6; T.C.A. (orig. ed.), § 63-127; Acts 1984, ch. 937, § 78; T.C.A., § 63-1-127.

Law Reviews.

The Tennessee Court Systems — Prosecution,  8 Mem. St. L. Rev. 477.

63-1-116. Criminal background checks for health care providers.

1. Each board, council, committee or other governmental entity created pursuant to this title or title 68 that is attached to the department is authorized to promulgate all rules and regulations necessary for obtaining criminal background information from applicants prior to the issuance of any licenses, certificates, registrations or other authorizations required to practice any of the health related professions regulated by that board, council, committee or other governmental entity. The respective board, council, committee or other governmental entity may utilize, either individually or in combination, any of the following methods in furtherance of the objectives of this section:
   1. Query the Tennessee bureau of investigation's (TBI) Tennessee criminal history records system for any or all of the following information:
      1. Tennessee criminal history records;
      2. Tennessee repository for apprehension of persons (TRAP);
      3. State of Tennessee orders of protection files (STOP); and
      4. Criminal history records of the federal government and other states to which TBI may have access. Criminal history records of the federal bureau of investigation may be obtained for the reasons listed in this subsection (a), only if fingerprints are obtained and submitted through the TBI;
   2. Require applicants to provide any and all information and investigative records to the board, the division or its agent or to any agency that contracts with the state that is necessary for the purpose of verifying whether the applicant has been convicted of a crime;
   3. Require applicants to supply a fingerprint sample and submit to a criminal history records check to be conducted by the TBI, other law enforcement agency or any legally authorized entity; and
   4. Require applicants to supply any sample or release any information required for a criminal background investigation by a professional background screening organization or criminal background check service or registry.
2. All costs associated with the required criminal background checks shall be paid by the applicant. Payments of costs required to be made to the TBI shall be made in accordance with §§ 38-6-103 and 38-6-109.
3. Any board, council, or committee or other governmental entity that denies an application or restricts or conditions any authorization to practice based upon information provided to it under this section shall be immune from suit by or on behalf of that applicant for the denial, restriction or condition.
4. Initial rules promulgated pursuant to this section may be promulgated as emergency rules pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2007, ch. 182, § 1; 2009, ch. 566, § 12.

Compiler's Notes. Former § 63-1-116 (Acts 1975, ch. 355, § 7; 1980, ch. 605, §§ 2, 5; T.C.A., § 63-128; Acts 1984, ch. 937, § 79; T.C.A., § 63-1-128), concerning advertising, was repealed by Acts 2005, ch. 467, § 2, effective July 1, 2005.

Acts 2009, ch. 566, § 12 provided that the Tennessee code commission is directed to change all references to public necessity rules, wherever such references appear in this code, to emergency rules, as sections are amended and volumes are replaced.

63-1-117. Conditions for making medical records available for inspection and copying — No application to records statutorily privileged — Immunity from liability — Compelling production of medical records — Disciplinary action — Confidentiality of disciplinary proceedings — Access to records during public health threat.

1. Notwithstanding §§ 63-2-101(b), 68-11-1502 and 68-11-1503, and regardless of any express or implied contracts, agreements or covenants of confidentiality based upon those sections, health care providers shall make their medical records available for inspection and copying by the department of health or its representatives, designees or employees based on the following conditions:
   1. Upon the presentation of a written authorization for release signed by the patient or the patient's legal representative; or
   2. Upon a written request made by the department of health investigators, inspectors or surveyors who are performing authorized investigations, inspections or surveys of facilities or individuals licensed pursuant to this title or title 68 based on a complaint filed with the department or an inspection or survey required by state or federal law. The written request shall contain the nature of the violation, the applicable laws and rules that may have been violated and the specific date by which production of the records is required. The written request shall be made in good faith and shall be related to the complaint, inspection or survey.
2. This section shall not apply to records that are made statutorily privileged, which shall require for their production a release that specifically identifies the privilege, contains a statement that the privilege is waived and that is signed by the patient or the patient's legal representative.
3. Any health care provider or representative of any health care provider who furnishes records to a duly authorized representative, designee or employee of the department of health shall be immune from liability to any patient, individual or organization for furnishing such information, data, reports or records or for damages resulting from any decision, opinion, action and proceedings rendered, entered or acted upon by the department of health, if the information or other records or documents provided were provided or created in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
4. In the event that a health care provider does not comply with the written request for medical records issued in compliance with subdivision (a)(2), the state may file a petition in the chancery court of Davidson County to compel production of the medical records within fifteen (15) days following the date specified for the production of the medical records contained in the written request.
5. A health care provider's willful disregard of the request for medical records pursuant to this section is grounds for disciplinary action by the licensing board that regulates the health care provider.
6. The following materials, documents, and other matters related to, or compiled or created pursuant to, an investigation conducted by or on behalf of the department are confidential and not a public record or subject to subpoena, except for subpoenas from law enforcement agencies, before formal disciplinary charges are filed against the provider:
   1. Allegations against the health care provider;
   2. Complainant's identifying information;
   3. Identifying information of a witness who requests anonymity;
   4. Patient's identifying information;
   5. Patient's medical record; and
   6. Any report or documents prepared by or on behalf of the department as a part of an investigation.
7. After the filing of formal disciplinary charges against the provider, only the materials and documents upon which the charges are based may be disclosed as a public record, but not the complainant's identifying information, identifying information of a witness who requests anonymity, patient's identifying information, patient's medical record or investigator's report.
8. Department annual health care facility and pharmacy survey inspection reports shall be available to the public pursuant to subsections (f) and (g).
9. Pursuant to § 68-1-104, the commissioner or the commissioner's designee, upon request, shall obtain access to records maintained by any facility, entity, or individual licensed under this title. Access shall be given in the most efficient and expedient means possible, including remote electronic access, to facilitate investigations and inquiries while responding to an immediate threat to the public health, welfare, or general good. Electronic access shall be limited to the minimum necessary for the duration of the outbreak, event, or time in which the public health is under immediate threat as determined by the commissioner.
10. This section does not modify or limit the prehearing discovery provisions set forth in the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
11. As used in this section:
    1. “Health care provider” means health care professionals, establishments or facilities licensed, registered, certified or permitted pursuant to this title or title 68 and regulated either under the authority of the department of health or any agency, board, council or committee attached to the department; and
    2. “Medical record” means any and all documents maintained by a health care provider relating to a patient's diagnosis, care and treatment, including, but not limited to, notes, reports, memos, emails, facsimile transmissions, laboratory tests, billing documents and medication orders.
12. The commissioner of health is authorized to promulgate rules and regulations to effectuate this part.

Acts 1985, ch. 120, § 1; T.C.A., § 63-1-130; Acts 2003, ch. 281, § 1; 2004, ch. 575, §§ 1-3; 2005, ch. 118, §§ 1, 2; 2009, ch. 188, § 1; 2014, ch. 949, § 2; 2015, ch. 154, § 1; 2017, ch. 240, § 3; 2019, ch. 447, § 1.

Amendments. The 2017 amendment, in (f), substituted “, and other matters related to, or compiled or created pursuant to, an investigation conducted by or on behalf of the department shall be confidential and shall not be a public record or subject to subpoena” for “and other matters related to, compiled or created pursuant to an investigation, conducted by or on behalf of the department shall not be a public record” in the introductory language, and inserted “or documents” in (6).

The 2019 amendment, in (f), substituted “are” for “shall be”, substituted “and not a public” for “and shall not be a public”, and inserted “, except for subpoenas from law enforcement agencies,”.

Effective Dates. Acts 2017, ch. 240, § 6. May 2, 2017.

Acts 2019, ch. 447, § 2. May 22, 2019.

Cross-References. Confidentiality of public records, § 10-7-504.

Attorney General Opinions. Information obtained pursuant to an administrative/investigative subpoena is confidential pending the introduction of the information at the administrative hearing to the extent that such information is obtained during an investigation by the division of health related boards or the board of medical examiners, OAG 01-055, 2001 Tenn. AG LEXIS 47 (4/10/01).

63-1-118. Certification of fitness for license in other state.

1. A licensee of any branch of the healing arts who seeks to be licensed in another state by reciprocity on the basis of the licensee's Tennessee license shall have the application for the license certified by the board of the particular branch of the healing arts in which the licensee is licensed.
2. The fee for this certificate shall be set by and paid to the board of the particular branch of the healing arts in which the applicant is licensed.

Acts 1947, ch. 9, § 3; mod. C. Supp. 1950, § 6907.3 (Williams, § 6917.20); Acts 1953, ch. 113, § 2; T.C.A. (orig. ed.), § 63-104; Acts 1984, ch. 937, § 57; T.C.A., § 63-1-105; Acts 1990, ch. 1026, § 31.

63-1-119. Effect of chapter on other law.

No provision of this chapter shall be construed as repealing any other law with reference to the requirements regulating the practice of the healing arts or any branch thereof, except insofar as the same may conflict with this chapter.

Acts 1947, ch. 9, § 9; C. Supp. 1950, § 6907.9 (Williams, § 6917.26); modified; T.C.A. (orig. ed.), § 63-118; Acts 1984, ch. 937, § 53; T.C.A., § 63-1-101.

63-1-120. Denial, withholding, suspending, limiting or restricting licensure, certification, permit, or authorization or otherwise disciplining holder of license, certificate, permit, or authorization — Disciplinary actions.

1. 1. With respect to any person required to be licensed, permitted, certified or authorized by any board, council, committee, agency, or regulatory program created pursuant to chapters 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 16, 17, 18, 19, 22, 23, 24, 25, 26, 27, 28, 29, 30, and 31 of this title and to title 68, chapter 140 attached to the division of health related boards, such board, council, committee or agency may:
      1. Deny an application for licensure, certification, permit or authorization;
      2. Permanently withhold issuance of licensure, certification, permit or authorization;
      3. Suspend, limit or restrict previously issued licensure, certification, permit or authorization; or
      4. Otherwise discipline a holder of a license, certificate, permit or authorization, if the applicant, licensee or certificate or permit holder has been disciplined by another state of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed, certified, permitted or authorized in this state.
   2. A certified copy of the initial order, final order or other equivalent document memorializing the disciplinary action from the disciplining state shall constitute prima facie evidence of a violation of this section and shall be sufficient grounds upon which to deny, restrict or condition the license, permit or certificate renewal or application, and/or otherwise to discipline a licensee licensed in this state.
2. In disciplinary actions against individuals holding a license, certificate, permit or authorization in this state at the time of a disciplinary action in another reporting state, in the absence of justifying evidence to the contrary, there shall be a rebuttable presumption that the sanction proposed in any such proceeding will be comparable to that in the reporting state; however, no such presumption shall exist for those who are applying for licensure, certification, permit or authorization in this state during or after the time the disciplinary action in the other state is pending or has become final. If a board, council, committee, agency, or regulatory program created pursuant to chapters 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 16, 17, 18, 19, 22, 23, 24, 25, 26, 27, 28, 29, 30, and 31 of this title or title 68, chapter 140 denies, restricts or conditions a licensure, certification, permit or authorization based on a disciplinary action in another state, the applicant shall, upon written request, filed within thirty (30) days of the date of the action on the application, be entitled to a contested case hearing.

Acts 1947, ch. 9, § 11; mod. C. Supp. 1950, § 6907.11 (Williams, § 6917.28); Acts 1955, ch. 57, § 1; 1975, ch. 355, §§ 5, 6; 1980, ch. 605, § 1; T.C.A. (orig. ed.), § 63-123; Acts 1984, ch. 937, § 75; T.C.A., § 63-1-123; Acts 2001, ch. 286, §§ 1, 2; 2010, ch. 1043, § 4; 2020, ch. 594, § 5.

Amendments. The 2020 amendment substituted “board, council, committee, agency, or regulatory program created pursuant to chapters 3, 4, 5, 6, 7, 8, 9, 10, 11,  12,  13, 14,  16, 17, 18, 19, 22, 23,  24,  25,  26, 27, 28,  29, 30, and 31” for “board, council, committee or agency created pursuant to chapters 4, 5, 7, 9, 11 and 12” in the introductory paragraph of (a)(1) and the second sentence of (b).

Effective Dates. Acts 2020, ch. 594, § 9. March 20, 2020.

Cross-References. Ambulatory surgical care centers terminating pregnancies, licensing, § 68-11-223.

Parental consent for abortions by minors, title 37, ch. 10, part 3.

Textbooks. Tennessee Jurisprudence, 15 Tenn. Juris., Injunctions, § 15.

Law Reviews.

Tennessee Civil Disabilities: A Systemic Approach (Neil P. Cohen), 41 Tenn. L. Rev. 253 (1974).

Attorney General Opinions. A proposed amendment to T.C.A. § 63-1-120, which would add a new subdivision regarding health care professionals who fail to comply either with any federal or state direct or guaranteed loan or with service requirements of any federal or state loan allowing forgiveness of debt in exchange for a period of service, would not violate the equal protection clauses of the United States or Tennessee constitutions, OAG 02-059, 2002 Tenn. AG LEXIS 64 (5/6/02).

63-1-121. Enjoining violations.

1. The division, in addition to the powers and duties expressed in this chapter with respect to the denial of a license, denial of certificate of registration and suspension or revocation of a license, is empowered to petition any circuit or chancery court having jurisdiction of any person within this state who is practicing without a license or to whom a license has been denied, or to whom a certificate of registration has been denied or whose license has been suspended or revoked by action of the division, to enjoin such person from continuing to practice the healing arts, or any branch thereof, within this state.
2. Jurisdiction is conferred upon the circuit and chancery courts of this state to hear and determine all such causes as equity causes and exercise full and complete jurisdiction in such injunctive proceedings; but nothing in this section shall be construed as conferring criminal jurisdiction upon any court not now possessing such criminal jurisdiction, nor shall any such court, as an incident to the injunctive proceedings authorized in this section, have the power to assess the criminal penalties set out in this chapter.

Acts 1947, ch. 9, § 12; C. Supp. 1950, § 6907.12 (Williams, § 6917.29); T.C.A. (orig. ed.), § 63-125; Acts 1984, ch. 937, § 77; T.C.A., § 63-1-125.

Compiler's Notes. Former § 63-1-121 (Acts 1947, ch. 9, § 15; C. Supp. 1950, § 6907.15 (Williams, § 6917.32); Acts 1953, ch. 113, § 8; 1976, ch. 806, § 1 (99); T.C.A. (orig. ed.), § 63-121), concerning compensation of board members and payment of expenses, was repealed by Acts 1984, ch. 937, § 73.

63-1-122. Standard of care.

For purposes of any action before any board, committee, council, or other agency created pursuant to this title or title 68, in which the standard of care is at issue, members of such a board, committee, council, or agency are entitled to rely upon their own expertise in making determinations concerning the standard of care and are not subject to voir dire concerning such expertise. The standard of care for such actions is a statewide standard of minimal competency and practice; provided, however, that to sustain actions based upon a violation of this standard of care, the board, committee, council, or other agency must, absent admissions or other testimony to the effect that the standard of care was violated, articulate the standard of care in its deliberations. The provisions of title 29, chapter 26, and specifically § 29-26-115(a), concerning the locality rule, do not apply to actions taken pursuant to this title or title 68.

Acts 2017, ch. 240, § 4.

Compiler's Notes. Former § 63-1-122 (Acts 1947, ch. 9, § 10; C. Supp. 1950, § 6907.10 (Williams, § 6917.27); T.C.A. (orig. ed.), § 63-122; Acts 1984, ch. 937, § 74; T.C.A. § 63-1-122), concerning the enforcement of regulatory laws designed to prevent unlawful practices of the healing arts, was repealed by Acts 2010, ch. 1043, § 5, effective June 11, 2010.

Effective Dates. Acts 2017, ch. 240, § 6.  May 2, 2017.

63-1-123. Penalties.

1. Any person, except those expressly exempted from this chapter by § 63-1-110 or § 63-1-111 who practices the healing arts as defined in this chapter, or any branch thereof, without first complying with this chapter, including all laws now in force regulating the practice of the various branches of the healing arts, and any person who violates this chapter commits a Class B misdemeanor.
2. Each time any person practices the healing arts, or any branch thereof, without meeting all the requirements of laws now in force and of this chapter constitutes a separate offense. Any person filing or attempting to file as that person's own a diploma or license of another or a forged affidavit of identification commits a felony and is subject to the punishment prescribed by law for the crime of forgery.

Acts 1947, ch. 9, § 13; C. Supp. 1950, § 6907.13 (Williams, § 6917.30); T.C.A. (orig. ed.), § 63-126; T.C.A. § 63-1-126; Acts 1989, ch. 591, § 112.

Cross-References. Forgery, §§ 39-14-114, 39-14-115.

Penalty for Class B misdemeanor, § 40-35-111.

63-1-124. Citizen member.

The governor shall appoint one (1) citizen member to each health-related board that does not have a citizen as a part of its membership. The term of each such citizen member shall be the same as other members of the respective board to which such person is appointed. As used in this section, “citizen member” means a person who is appointed to serve on a board and who does not engage in any profession, business or activity subject to regulation by the board.

Acts 1993, ch. 181, § 1.

Compiler's Notes. Former § 63-1-124 (Acts 1947, ch. 9, § 11; C. Supp. 1950, § 6907.11 (Williams, § 6917.28); T.C.A. (orig. ed.), § 63-124), concerning procedure for suspension or revocation, and judicial review, was repealed by Acts 1984, ch. 937, § 76.

63-1-125. Kenneth and Madge Tullis, MD, Suicide Prevention Training Act.

1. This section shall be known and may be cited as the “Kenneth and Madge Tullis, MD, Suicide Prevention Training Act.”
2. As used in this section:
   1. “Board” means a health-related board created in this title or title 68 and includes the:
      1. Board for professional counselors, marital and family therapists, and clinical pastoral therapists, created by § 63-22-101;
      2. Board of social work licensure, created by § 63-23-101;
      3. Board of alcohol and drug abuse counselors, created by § 68-24-601; and
      4. Board of occupational therapy, created by § 63-13-216; and
   2. “Training program” means an empirically supported training program that covers the following elements:
      1. Suicide prevention;
      2. Suicide assessment and screening;
      3. Suicide treatment;
      4. Suicide management; and
      5. Suicide postvention.
3. The department of mental health and substance abuse services shall:
   1. Develop, in collaboration with the Tennessee Suicide Prevention Network, a model list of training programs;
   2. When developing the model list, consider training programs of at least two (2) hours in length that are based on expert consensus and adhere to high standards of suicide prevention;
   3. When developing the model list, consult with the boards; public and private institutions of higher education; experts in suicide prevention, assessment, treatment, management, and postvention; and affected professional associations; and
   4. Report, in collaboration with the Tennessee Suicide Prevention Network, the model list of training programs to the department of health no later than December 15, 2017.
4. A board may approve a training program that excludes an element described in the definition of training program if the element is inappropriate for the profession in question or inappropriate for the level of licensure or credentialing of that profession based on the profession's scope of practice.
5. Beginning January 1, 2020, each of the following professionals certified or licensed under this title or title 68 shall, at least once every four (4) years, complete a training program that is approved by rule by the respective boards:
   1. A social worker licensed under chapter 23 of this title;
   2. A marriage and family therapist, professional counselor, or pastoral counselor certified or licensed under chapter 22 of this title;
   3. An alcohol and drug abuse counselor certified under title 68, chapter 24; and
   4. An occupational therapist licensed under chapter 13 of this title.
6. A professional listed in subsection (e) applying for initial licensure or certification on or after January 1, 2020, is not required to complete the training program required by this section for two (2) years after initial licensure or certification if the professional can demonstrate successful completion of a two-hour academic training program that meets criteria established by the profession's board and that was completed no more than two (2) years prior to the application for initial licensure or certification.
7. The hours spent completing the training program under this section count toward meeting any applicable continuing education requirements for each profession.
8. Nothing in this section expands or limits the scope of practice of any profession regulated under this title or title 68.

Acts 2017, ch. 396, § 1; 2019, ch. 131, § 1.

Code Commission Notes.

Acts 2017, ch. 396, § 1 enacted this section as § 63-1-122 but the section has been redesignated as § 63-1-125 by the authority of the code commission.

Compiler's Notes. Acts 2017, ch. 396, § 2, which enacted this section, provided that the department of health, the department of mental health and substance abuse services, and each board that governs professionals subject to the act are authorized to promulgate rules to effectuate the purposes of this act. All rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5.

For the Preamble to the act concerning training health professionals in suicide prevention, please refer to Acts 2017, ch. 396.

Amendments. The 2019 amendment substituted “at least once every four (4) years,” for “at least once every five (5) years,” in (e).

Effective Dates. Acts 2017, ch. 396, § 3. May 18, 2017.

Acts 2019, ch. 131, § 2. April 9,  2019.

63-1-126. Refusal to submit to drug test or testing positive for any drug violation of practitioner's practice act.

1. As used in this section:
   1. “Confirmed drug test” means a confirmed test as defined in § 50-9-103;
   2. “Drug” means a drug as defined in § 50-9-103;
   3. “Employer” means a covered employer, as defined in § 50-9-103, that is a healthcare facility licensed under title 68, chapter 11, part 2, or any other healthcare employer that employs healthcare practitioners; and
   4. “Healthcare practitioner” or “practitioner” means any person required to be licensed, permitted, certified, or authorized:
      1. Under this title by a board or committee under the division of health-related boards specified in § 68-1-101(a)(8), who has humans for patients; or
      2. Under title 68, chapter 24, part 6; or
      3. Under title 68, chapter 140.
2. A healthcare practitioner violates the practitioner's practice act by refusing to submit to a drug test or testing positive for any drug on any government or private sector preemployment or employer-ordered confirmed drug test for an employer when the practitioner does not have a lawful prescription for using the drug or a valid medical reason for using the drug.
3. 1. 1. If a healthcare practitioner refuses to submit to a drug test or tests positive for any drug on any government or private sector preemployment or employer-ordered confirmed drug test for a covered employer, then this section shall apply to the practitioner.
      2. The practitioner shall be given three (3) business days from the time of notification to the practitioner of the confirmed test result to:
         1. Produce a lawful prescription for the drug or a valid medical reason for using the drug to the employer; or
         2. Report to the substance abuse peer assistance or treatment program of the appropriate board for the practitioner.
      3. So long as the practitioner obtains and maintains the advocacy of the substance abuse peer assistance or treatment program, unless otherwise required by law, the employer is not required to notify the appropriate board for the practitioner of the violation of the practitioner's practice act.
   2. 1. Whenever a healthcare practitioner who has been referred by the practitioner's employer or who has self-reported to the substance abuse peer assistance or treatment program of the appropriate board pursuant to subdivision (c)(1) fails to obtain or maintain the advocacy of the program, the program shall report the practitioner to the appropriate board concerning the violation of the practitioner's practice act.
      2. 1. So long as the practitioner complies with the terms and conditions of a referral to a substance abuse peer assistance or treatment program, the practitioner's license or certificate shall not be suspended or revoked by the appropriate board for a positive result on a confirmed drug test or a refusal to submit to a drug test.
         2. The board shall suspend the license, certificate, permit, or authorization of a healthcare practitioner who has been referred to the substance abuse peer assistance or treatment program pursuant to this subsection (c) when the practitioner fails to comply with the terms and conditions of the program.
         3. The board is not prohibited from taking any other disciplinary action authorized by law for conduct other than a positive result on a confirmed drug test or a refusal to submit to a drug test.
         4. A substance abuse peer assistance or treatment program shall promptly report any failure of a practitioner who has reported to the program pursuant to this subsection (c) to maintain compliance with the terms and conditions of the program to the appropriate licensing board.
4. Any drug test used for action pursuant to this section shall comply with the requirements of title 50, chapter 9. The employer of the healthcare practitioner shall promptly report, as determined by rule and subject to subsection (c), a practitioner who tests positive for any drug on a confirmed drug test, or who refuses to submit to a drug test, to the department.
5. The commissioner of health is authorized to promulgate rules to effectuate the purposes of this section. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2017, ch. 481, § 1.

Compiler's Notes. Former § 63-1-126 was transferred to § 63-1-123 in 1986.

Effective Dates. Acts 2017, ch. 481, § 5. July 1, 2017.

63-1-127. Sharing of information concerning substance abuse by healthcare practitioner with other quality improvement committees.

A quality improvement committee, as defined in § 63-1-150, may share information concerning substance abuse by a healthcare practitioner licensed or certified under this title with another quality improvement committee pursuant to § 63-1-150(d)(3) or § 68-11-272(c)(3) in furtherance of the functions of the committees.

Acts 2017, ch. 481, § 2.

Compiler's Notes. Former § 63-1-127 was transferred to § 63-1-115 in 1986.

Effective Dates. Acts 2017, ch. 481, § 5. July 1, 2017.

63-1-128. Emergency action not requiring prior approval of attorney general and reporter.

Notwithstanding any law, rule, or policy of a board or the department of health, emergency action by the department or the board under § 4-5-320(c) shall not require the prior approval of the attorney general and reporter.

Acts 2017, ch. 481, § 3.

Compiler's Notes. Former § 63-1-128 was transferred to § 63-1-116 in 1986.

Effective Dates. Acts 2017, ch. 481, § 5. July 1, 2017.

63-1-129. Solicitation of accident and disaster victims by health care prescribers prohibited — Exceptions.

1. Health care prescribers, their employees, agents, or independent contractors shall not conduct in-person solicitation, telemarketing, or telephonic solicitation of victims of an accident or disaster, for the purpose of marketing services of the healing arts related to the accident or disaster, unless:
   1. The health care prescriber has a family or prior professional relationship with the victim; or
   2. The solicitation is carried out more than thirty (30) days after the date of the accident or disaster.
2. Health care prescribers shall maintain:
   1. Telemarketing transcripts for a period of two (2) years following their utilization; and
   2. A log of contacts for a period of two (2) years following a telemarketing encounter.
3. This section does not prohibit solicitation by targeted direct-mail advertising or other forms of written, radio, or television advertising, as long as the advertising does not involve coercion, duress, or harassment and is not false, deceptive, or misleading.
4. 1. Any agreement to pay a health care prescriber for services that were rendered by the health care prescriber as a direct result of a violation of this section is void and unenforceable. No person may collect or pursue collection for any debt arising from such an agreement.
   2. A patient or person who paid on behalf of a patient is entitled to a complete refund of any money paid for services that were rendered by a health care prescriber as a direct result of a violation of this section.
5. The division is authorized to petition any circuit or chancery court having jurisdiction to enjoin any person who is violating this section. No injunction bond shall be required of the division in such proceedings, and jurisdiction is conferred upon the circuit and chancery courts of this state to hear such cases.

Acts 2018, ch. 638, § 1.

Compiler's Notes. Former § 63-1-129 (Acts 1980, ch. 851, §§ 7, 12; 1980, ch. 858, § 2; T.C.A., § 63-129), concerning nurse practitioners, was repealed by Acts 1984, ch. 937, § 80.

Acts 2018, ch. 638, § 2 provided that the act, which enacted this section, shall apply to violations occurring on or after July 1, 2018.

Effective Dates. Acts 2018, ch. 638, § 2. July 1, 2018.

63-1-130. Denial of license for prior criminal prosecution prohibited.

1. As used in this section, “licensing authority” means any state department, board, commission, or agency that issues any license, certificate, or registration for an individual to engage in an occupation, profession, business, or trade in this state, including to those licensing authorities that have statutory authority to deny, suspend, or revoke a license for felonies or misdemeanors of moral turpitude.
2. 1. Subject to the exemptions in this section and unless prohibited by federal law, a licensing authority shall not deny an application for a license, certificate, or registration, or refuse to renew a license, certificate, or registration due to a prior criminal conviction that does not directly relate to the applicable occupation, profession, business, or trade.
   2. Prior to denying an application for a license, certificate, or registration on the basis of a criminal conviction, or prior to the refusal to renew a license, certificate, or registration on the basis of a criminal conviction, the licensing authority shall notify the applicant, licensee, certificate holder, or registrant of the licensing authority's determination in writing via certified mail, facsimile transmission, or email. The written notification shall include the licensing authority's justification for denial or refusal to renew in accordance to subdivision (b)(4)(A). The determination must state the earliest date upon which the applicant is eligible to reapply for the license, certificate, or registration.
   3. Prior to submitting the application necessary to obtain a license, certification, or registration an individual may request written notice from the licensing authority from which they seek to obtain a license, certification, or registration concerning the individual's qualification to obtain the license, certificate, or registration, based on the individual's criminal history. If the licensing authority determines that an individual is disqualified due to the individual's criminal history, the licensing authority must provide the individual with a written notification that sets forth the reasons for its determination and its justification in accordance with subdivision (b)(4)(A). The written notice as to the individual's qualifications to obtain a license, certificate, or registration must be limited to the individual's criminal history and should not be construed as prohibiting the licensing authority from denying an application on other grounds. This determination shall apply exclusively to the individual and shall not be construed as an advisory or formal opinion of the licensing authority.
   4. 1. In considering whether to deny an application for a license, certificate, or registration to an applicant, or whether to refuse to renew a license, certificate, or registration, on the basis of a criminal conviction, the licensing authority must consider:
         1. The nature and seriousness of the crime for which the individual was convicted;
         2. The length of time since the commission of the crime;
         3. The relationship between the nature of the crime and the purposes of regulating the occupation, profession, business, or trade for which the license, certificate, or registration is sought;
         4. The relationship between the crime and the ability, capacity, and fitness required to perform the duties and discharge the responsibilities of the occupation, profession, business, or trade;
         5. Any evidence of rehabilitation or treatment undertaken by the individual that might mitigate against the relationship of crime to the occupation, profession, business, or trade; and
         6. Any applicable federal laws regarding an individual's participation in the occupation, profession, business, or trade.
      2. If an applicant, licensee, certificate holder, or registrant's prior conviction was for a Class A felony, Class B felony, or Class C felony not defined under title 39, chapter 17, part 4, or if the felony conviction is for an offense for which the offender is required to register under the Tennessee Animal Abuser Registration Act, compiled in title 40, chapter 39, part 1; the Tennessee Sexual Offender and Violent Sexual Offender Registration, Verification and Tracking Act of 2004, compiled in title 40, chapter 39, part 2; or title 40, chapter 39, part 3, there shall be a rebuttable presumption that the conviction relates to the fitness of the applicant, licensee, certificate holder, or registrant engaged in the applicable occupation, profession, business, or trade.
3. An individual, applicant, licensee, certificate holder, or registrant who receives written notice pursuant to subdivision (b)(2) or (b)(3) may file a petition within thirty (30) business days of the receipt of the notice in Davidson County chancery court. The licensing authority must demonstrate by a preponderance of the evidence that the individual, applicant, licensee, certificate holder, or registrant's conviction is related to the applicable occupation, profession, business, or trade.
4. Nothing in this section shall be construed to prohibit a licensing authority created by this title from issuing a restricted or conditional license, if otherwise authorized to do so under law.
5. Nothing in this section shall be construed to create a separate right to a contested case hearing that does not otherwise exist relative to the denial of the license, certificate, or registration under the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
6. Nothing in this section applies to:
   1. The board of law examiners, created under § 23-1-101;
   2. The board of judicial conduct, created under § 17-5-201;
   3. The licensure of services and facilities operated pursuant to title 33, chapter 2, part 4, for the provision of mental health services, alcohol, and drug abuse prevention or treatment; for the provision of services for intellectual and developmental disabilities; and for personal support services;
   4. The certification of police officers under title 38, chapter 8;
   5. Any licensing authority created under titles 41, 48, 49, 56, and 71;
   6. The department of financial institutions, when acting as a licensing authority pursuant to title 45;
   7. Any license, certificate, or registration issued pursuant to the rules of the supreme court;
   8. The licensure of pain management clinics licensed pursuant to chapter 1, part 3 of this title; and
   9. The licensure of physicians under chapter 6 or 9 of this title.

Acts 2018, ch. 793, § 3.

Compiler's Notes. Acts 2018, ch. 793, § 1 provided that the act, which enacted this section, shall be known and may be cited as the “Fresh Start Act.”

Former § 63-1-130 was transferred to § 63-1-117 in 1986.

Effective Dates. Acts 2018, ch. 793, § 4. July 1, 2018.

63-1-131. Director — Appointment.

The commissioner of health shall appoint a director of the division of health related boards provided for in this section and §§ 63-1-132, 63-1-133, and 68-1-101.

Acts 1971, ch. 81, § 5; T.C.A., §§ 53-121, 68-1-601; Acts 2010, ch. 1043, § 6.

63-1-132. Director — Powers and duties.

1. The director of the division of health related boards has the power, duty, and responsibility to:
   1. Employ all staff assigned or performing duties for the agencies attached to the division;
   2. Promulgate rules and regulations for all administrative functions and activities of the agencies attached to the division as well as all matters that affect more than one (1) of the agencies attached to the division with the approval of the agencies affected. In cases where multiple agencies are authorized to promulgate similar rules that apply to each of the agencies, the director is authorized to hold one (1) public rulemaking hearing and promulgate a single rule or a single chapter of rules, but only after receiving prior approval of the agencies affected;
   3. Employ, with the consent of the regulatory board concerned, all executive directors and consultants; the director may employ all other personnel necessary to carry out the function of all of the agencies attached to the division;
   4. Maintain a central filing system for official records and documents of all agencies attached to the division;
   5. Provide office space and necessary quarters for the agencies attached to the division;
   6. Assign personnel to staff such agencies in order to ensure the most efficient use of personnel; and
   7. Perform such other duties as the commissioner may prescribe, or as may be prescribed by law.
2. Any employment of personnel or consultants by the division shall be in accordance with the rules, regulations and standards of the departments of human resources and finance and administration.

Acts 1971, ch. 81, § 6; T.C.A., § 53-122; Acts 1985, ch. 120, § 16; T.C.A., § 68-1-602; Acts 1994, ch. 569, § 1; 1996, ch. 659, § 1; 1996, ch. 754, § 3; 2010, ch. 1043, § 7.

Compiler's Notes. Acts 1996, ch. 754, § 3 purported to insert “or § 63-9-113” following “§ 63-6-204” near the middle of (c); however, as rewritten by Acts 1996, ch. 659, “§ 63-6-204” does not appear in (c). The amendment by ch. 754 is therefore deemed to be of no effect.

Attorney General Opinions. The division of health related boards of the Tennessee department of health does not have authority, absent specific legislation, to use screening panels for the various boards to assist with the processing and disposition of disciplinary cases, OAG 01-055, 2001 Tenn. AG LEXIS 47 (4/10/01).

Hiring of executive director of the board of pharmacy.  OAG 11-47, 2011 Tenn. AG LEXIS 49 (5/19/11).

63-1-133. Director — Member of agencies.

1. The director of the division or the director's duly authorized representative shall be an ex officio, nonvoting member of each agency attached to this division and shall be entitled to attend all meetings of such agencies.
2. All agencies attached to this division shall advise the director of any meeting at which official action will be taken at least forty-eight (48) hours prior to such meeting unless the director expressly waives such requirement.

Acts 1971, ch. 81, § 7; T.C.A., §§ 53-123, 68-1-603.

63-1-134. Penalty for violation of statute, rule or order — Recovery.

1. With respect to any person required to be licensed, permitted or authorized by any board, commission or agency attached to the division of health related boards, each respective board, commission or agency may assess a civil penalty against such person in an amount not to exceed one thousand dollars ($1,000) for each separate violation of a statute, rule or order pertaining to such board, commission or agency. Each day of continued violation constitutes a separate violation.
2. Each board, commission or agency shall by rule establish a schedule designating the minimum and maximum civil penalties that may be assessed under this section. In assessing civil penalties, the following factors may be considered:
   1. Whether the amount imposed will be a substantial economic deterrent to the violator;
   2. The circumstances leading to the violation;
   3. The severity of the violation and the risk of harm to the public;
   4. The economic benefits gained by the violator as a result of noncompliance; and
   5. The interest of the public.
3. 1. Civil penalties assessed pursuant to this section or any other section authorizing the assessment of civil penalties by any board, council or committee established in this title or title 68 that is attached to the department, unless otherwise provided by law, shall become final, due and payable on the date the order in which they are assessed becomes final pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5; provided however, that the boards, councils, committees or the department is authorized to order or enter into agreements for the payment of assessed civil penalties in installments that are due and payable beyond the date on which the assessment becomes final.
   2. If the violator fails to pay an assessment when it becomes final or fails to pay according to the terms of an installment payment plan, the department, in addition to taking further action against the violator's license, may apply to the appropriate court for a judgment and seek execution of the judgment.
   3. Jurisdiction for recovery of such penalties shall be in the chancery court of Davidson County or the chancery court of the county in which all or part of the violations occurred.
4. All sums recovered pursuant to this section shall be paid into the state treasury.

Acts 1989, ch. 389, § 2; 2007, ch. 196, § 1.

63-1-135. Expenditure estimates — Improvement recommendations.

1. 1. Before submitting an estimate of its expenditure requirements as provided in § 9-4-5103, the department of health shall consult with each board, commission or agency that is attached to the division of health related boards created under § 68-1-101 and is authorized or required to collect any fees.
   2. Any such board, commission or agency shall timely submit to the commissioner of health an itemized list of any improvements recommended for inclusion in the department's expenditure estimate.
   3. In the preparation of such estimate, the department shall clearly indicate the disposition of each improvement recommendation received under this section.
2. The department shall transmit with its expenditure estimate a copy of each list of recommended improvements received under this section to the commissioner of finance and administration.

Acts 1989, ch. 523, § 181.

63-1-136. Additional powers and duties — Assistance to impaired health practitioners.

1. Regulatory boards, commissions and agencies attached to the division of health related boards, in addition to other enumerated powers and duties, have as their purpose assistance in the rehabilitation of impaired health practitioners who are licensed, certified or registered by the respective regulatory boards, commissions and agencies.
2. Regulatory boards, commissions and agencies attached to the division of health related boards, in addition to other enumerated powers and duties, have the power to enter into agreements, provide grants and make other arrangements with statewide nonprofit professional associations or their affiliated foundations to identify and assist impaired professionals who are licensed, registered or certified by the respective regulatory boards, commissions and agencies.
3. Regulatory boards, commissions and agencies attached to the division of health related boards have the authority to accept and designate grants, public or private financial assistance and licensure fees to fund programs authorized in subsection (b) to assist impaired professionals. The provision of such grants shall not deem recipient peer assistance programs to be the functional equivalent of the state.
4. All information, interviews, reports, statements, memoranda and other data furnished to a nonprofit professional association or its affiliated foundation and any findings, conclusions or recommendations resulting from the proceedings of such professional association or its affiliated foundation are privileged and confidential. The records of such proceedings of the affiliated foundation or association shall be used only in the exercise of proper functions of the regulatory board, commission or agency attached to the division of health related boards and shall not become public record nor be made available for court subpoena or discovery proceedings.
5. If a regulatory board, commission or agency attached to the division of health related boards determines that an association or its affiliated foundation is not providing adequate services under this section, then the board, commission or agency may contract with another nonprofit organization in order to assist impaired professionals.
6. Organizations that directly provide alcohol and drug treatment services or behavioral health services on an inpatient or outpatient basis for remuneration shall be prohibited from contracting with such board, commission or agency to provide a professional assistance program.

Acts 1992, ch. 541, § 1; 2003, ch. 388, §§ 1, 3.

Compiler's Notes. Acts 2003, ch. 388, § 2 provided that nothing in the act, which amended subsections (b), (c) and (d) and added subsection (e) and (f), shall interfere with any existing contract.

Cross-References. Confidentiality of public records, § 10-7-504.

Attorney General Opinions. Applicability of procurement requirements when providing grants and entering into agreements to assist impaired professionals pursuant to T.C.A. § 63-1-136; applicability to grant contracts for peer assistance issued by health-related regulatory boards under T.C.A. § 63-1-136. OAG 14-98, 2014 Tenn. AG LEXIS 101 (10/30/14).

63-1-137. Funds — Deposits and disbursements.

1. Notwithstanding any provision of law to the contrary, all moneys other than the state regulatory fee as provided for in § 9-4-5117 collected by any board attached to the division of health related boards shall be deposited in the state general fund and credited to a separate account for each such board.
2. Disbursements from such accounts shall be made solely for the purpose of defraying expenses incurred in the implementation and enforcement of the board's area of regulation, including defraying costs to implement the Health Care Consumer Right-to-Know Act of 1998, compiled in chapter 51 of this title.
3. No such expenses shall be paid from any other state funds other than provided for in § 9-4-5117.
4. Funds remaining in board accounts at the end of any fiscal year shall not revert to the general fund but shall remain available for expenditure in accordance with law.

Acts 1992, ch. 830, § 1; 1995, ch. 446, § 3; 1999, ch. 373, § 1.

Code Commission Notes.

Former subsection (e), concerning amounts remaining in board accounts on June 30, 1994, was deemed obsolete and was deleted by the code commission in 2004.

Compiler's Notes. Section 4-3-1011, referred to in (a) and (c), was transferred to § 9-4-5117 by Acts 2013, ch. 454, § 13, effective May 16, 2013.

Acts 2012, ch. 880, § 28 provided that, notwithstanding any provision of the law to the contrary, no funds maintained in any of the accounts created pursuant to § 63-1-137 shall be used to pay any of the expenses incurred in acquiring hardware, software, or contracted services or employing personnel needed to implement and enhance the operation of the controlled substance monitoring database pursuant to the provisions of Acts 2012, ch. 880.

63-1-138. Screening panels.

1. The division and each board, committee or council established in this title that does not already have authority to utilize screening panels and the medical laboratory board, the board of alcohol and drug counselors and the Tennessee emergency medical services board as established in title 68 may utilize one (1) or more screening panels in their investigative and disciplinary process to assure that complaints filed and investigations conducted are meritorious and to act as a mechanism for diversion to professional peer review organizations and/or impaired professionals associations or foundations of those cases that the boards, through established guidelines, deem appropriate.
2. The activities of the screening panels and any mediation or arbitration sessions shall not be construed as meetings of an agency for purposes of the open meetings law, compiled in title 8, chapter 44, and shall remain confidential. The members of the screening panels, mediators and arbitrators have a deliberative privilege and the same immunity as provided by law for the boards and are not subject to deposition or subpoena to testify regarding any matter or issue raised in any contested case, criminal prosecution or civil lawsuit that may result from or be incident to cases processed before them.
3. The screening panel has the authority to administer oaths to witnesses. Any documents or records produced at the screening panel shall be exempt from the public records law, compiled in title 10, chapter 7, until there is a filing of a notice of charges and such documents or records form the basis for such filing of a notice of charges.
4. Members of a screening panel may be drawn from among the membership of the relevant board, or members may be appointed by the relevant board. Nonboard members shall meet the requirements of membership for the relevant board and may include a consumer member. A board member serving on a panel shall not participate in a contested case involving any matter heard by the panel.
5. Each screening panel shall be instructed as to the statutes, rules, regulations and philosophies of the relevant board as it pertains to disciplinary action and to the procedures to be followed by the panels. Each screening panel shall be provided a copy of Rule 31 of the Rules of the Tennessee Supreme Court for review by members of the screening panel for general guidance as to the principles of mediation and alternative dispute resolution.
6. A board does not have authority to compel any party to participate in a screening panel, and no prejudice will be incurred if the party chooses not to participate or to accept the offer of the screening panel.

Acts 2001, ch. 322, § 1; 2005, ch. 234, § 1.

Compiler's Notes. Former § 63-1-138 (Acts 1994, ch. 803, § 1), concerning games of the XXVIth Olympiad and the Xth Paralympiad, was repealed by Acts 1994, ch. 803, § 1, effective December 31, 1996.

Cross-References. Confidentiality of public records, § 10-7-504.

63-1-139. Rules and regulations.

1. Each board, commission, committee, agency or other governmental entity created pursuant to this title, title 68, chapter 24, and title 68, chapter 140, part 3 shall notify each applicant for a license, certification or registration from such board, commission, committee, agency or other governmental entity where to obtain a copy of any statutes, rules, policies and guidelines setting forth the prerequisites for such license, certification or registration and shall, upon request, make available to the applicant a copy of such statutes, rules, policies and guidelines.
2. Each board, commission, committee, agency or other governmental entity created pursuant to this title, title 68, chapter 24 and title 68, chapter 140, part 3 shall notify each holder of a license, certification or registration from the board, commission, committee, agency or other governmental entity of changes in state law that impact the holder and are implemented or enforced by the entity, including newly promulgated or amended statutes, rules, policies and guidelines. The notification required by this subsection (b) may be satisfied by the board, commission, committee, agency, or other governmental entity posting on its website changes in state law that impact the holder and are implemented or enforced by the entity, including newly promulgated or amended statutes, rules, policies, and guidelines. The website posting must be made within thirty (30) days of the effective date of the change and maintained on the website until at least two (2) years after the effective date of the change.
3. Each board, commission, committee, agency or other governmental entity created pursuant to this title, title 68, chapter 24 and title 68, chapter 140, part 3 shall establish and maintain a link or links on the entity's website to the statutes, rules, policies and guidelines that are implemented or enforced by the entity and that impact an applicant for, or a holder of, a license, certification or registration from the entity.
4. 1. Each board, commission, committee, agency or other governmental entity created pursuant to this title, title 68, chapter 24 and title 68, chapter 140, part 3 shall allow each holder of a license, certification or registration from the board, commission, committee, agency or other governmental entity to have the option of being notified by electronic mail of:
      1. Renewals of the holder’s license, certification or registration;
      2. Any fee increases;
      3. [Deleted by 2020 amendment.]
      4. Any meeting where changes in rules or fees are on the agenda. For purposes of this subdivision (d)(1)(D), the electronic notice shall be at least forty-five (45) days in advance of the meeting, unless it is an emergency meeting then the notice shall be sent as soon as is practicable.
   2. Each board, commission, agency or other governmental entity created pursuant to this title, title 68, chapter 24 and title 68, chapter 140, part 3 shall notify each holder of a license, certification or registration of the availability of receiving electronic notices pursuant to subdivision (d)(1) upon issuance or renewal of the holder’s license, certification or registration.
5. Each board, commission, committee, agency or other governmental entity created pursuant to this title, title 68, chapter 24 and title 68, chapter 140, part 3 shall have the authority to accept license applications and renewals electronically as if the same were submitted in hard copy format.

Acts 1998, ch. 1088, § 2; 2008, ch. 1070, §§ 3-5; 2012, ch. 952, § 2; 2014, ch. 949, § 3; 2020, ch. 594, §§ 6-8.

Compiler's Notes. Acts 2008, ch. 1070, § 13 provided that each entity subject to the act, which amended subsection (a) and added subsections (b) and (c), shall promulgate rules to effectuate the purposes of the act. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Amendments. The 2020 amendment, in (b), deleted “, upon the issuance and upon each renewal of the holder's license, certification or registration” following “policies and guidelines” at the end of the first sentence and added the second and third sentences; and deleted (d)(1)(C), which read: “Any changes in state law that impact the holder and are implemented or enforced by the entity, including newly promulgated or amended statutes, rules, policies and guidelines; and”.

Effective Dates. Acts 2020, ch. 594, § 9. March 20, 2020.

63-1-140. State citizenship of all board members.

All members of any board, commission or council that licenses, certifies or regulates any profession or occupation shall, during the time of their respective appointments, be citizens of this state. The appointment of any member of any board, commission or council that licenses or certifies any profession or occupation shall terminate when Tennessee is no longer the domicile of such member.

Acts 1998, ch. 1088, § 4.

63-1-141. Default on student loans by members of the healing arts profession.

1. 1. Upon receiving a copy of a final order as provided in subsection (b) from the Tennessee student assistance corporation (TSAC) or a guarantee agency that has an agreement with the United States secretary of education (guarantee agency), each board, commission, committee, agency or other governmental entity (licensing authority) created pursuant to this title shall suspend, deny or revoke the license of, or take other such appropriate disciplinary action, against any person (also referred to as the debtor), who has defaulted on a repayment or service obligation under any federal family education loan program, the federal Higher Education Act of 1965, a student loan guaranteed or administered by the Tennessee student assistance corporation or any other state or federal educational loan or service-conditional scholarship program.
   2. Notwithstanding subdivision (a)(1), a licensing authority may elect not to suspend, deny, or revoke the license of a person if the default or delinquency is the result of a medical hardship that prevented the person from working in the person's licensed field and the medical hardship significantly contributed to the default or delinquency.
2. 1. Each board, commission, committee, agency or other governmental entity created pursuant to this title shall accept any determination of default from TSAC or a guarantee agency, after TSAC or the guarantee agency has afforded a debtor an opportunity to be heard in accordance with subdivision (b)(2); and such board, commission, committee, agency or other governmental entity shall rescind any disciplinary action and restore any license or certificate upon receiving notice from such corporation or guarantee agency that the person has agreed to serve such person's obligation or is in compliance with an approved repayment plan.
   2. 1. Unless a debtor has made satisfactory arrangements according to the lender, TSAC or the guarantee agency, which may include administrative wage garnishment, voluntary payment arrangements or deferment/forbearance, then the debtor shall be regarded as delinquent or in default. If a debtor is delinquent or in default on a repayment or service obligation under a guaranteed student loan identified in subsection (a) or such debtor has failed to enter into a payment plan or comply with a payment plan previously approved by TSAC or the guarantee agency, then TSAC or the guarantee agency shall issue to such debtor a notice of intent to file an order with the appropriate licensing authority to suspend, deny or revoke the debtor's license or certificate. The notice must:
         1. Be served upon the debtor personally or by certified mail with return receipt requested; and
         2. State that the debtor's license or certificate will be suspended, denied or revoked ninety (90) days after service, unless within that time the debtor:
            1. Pays the entire debt stated in the notice;
            2. Enters into a payment plan or complies with a payment plan previously entered into and approved by TSAC or the guarantee agency; or
            3. Requests a hearing before TSAC or the guarantee agency.
      2. Any such hearing request by the debtor shall be made in writing and must be received by TSAC or the guarantee agency within twenty (20) days of the date the notice is served.
      3. TSAC, or the guarantee agency, upon receipt of a request for a hearing from the debtor, shall schedule a hearing to determine whether suspension, denial or revocation of the debtor's license or certificate is appropriate. The debtor's license or certificate may not be suspended, denied or revoked until a determination is reached following the hearing. The only issues that may be determined in such hearing are:
         1. The amount of the debt, if any;
         2. Whether the debtor is delinquent or in default;
         3. Whether the debtor has entered into a payment plan or the debtor is willing to enter into a payment plan or to comply with a payment plan previously entered into and approved by TSAC or the guarantee agency; and
         4. Whether the debtor's default or delinquency is the result of a medical hardship that prevented the debtor from working in the debtor's licensed field and the medical hardship significantly contributed to the default or delinquency.
      4. If a debtor fails to respond to such notice of intent, fails to timely request a hearing or fails to appear at a regularly scheduled hearing, the debtor's defenses, objections or request for a payment plan or compliance with a payment plan may be determined to be without merit, and TSAC or the guarantee agency shall enter a final decision and order, requesting suspension, denial or revocation of the debtor's license or certificate and further requesting the licensing authority to order the debtor to refrain from engaging in the licensed activity or activity for which a certificate has been issued. TSAC or the guarantee agency shall send a copy of such order to the licensing authority and the debtor.
      5. All such administrative hearings shall be conducted in the same manner as those conducted pursuant to §§ 36-5-703 and 36-5-704.
      6. 1. When TSAC or the guarantee agency determines that the debt is paid in full or the debtor has entered into a payment plan or complied with a payment plan previously approved by TSAC or the guarantee agency, TSAC or the guarantee agency shall terminate the order suspending, denying or revoking the license or certificate. TSAC or the guarantee agency shall send a copy of the order terminating the suspension, denial or revocation to the licensing authority and the debtor. Notwithstanding any other provision of law, rule or regulation to the contrary, when the license or certificate is reinstated, the licensing authority shall not impose a reinstatement fee that exceeds fifty dollars ($50.00).
         2. Entry of an order terminating suspension, denial or revocation of a license or certificate does not limit the ability of TSAC or the guarantee agency to issue a new order suspending, denying or revoking the license or certificate of the same debtor in the event of another delinquency or default.
      7. TSAC is authorized to promulgate necessary rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this subsection (b).
3. Each board, commission, committee, agency or other governmental entity created pursuant to this title shall promulgate rules and regulations to effectuate the purposes of this section.

Acts 1999, ch. 476, § 1; 2018, ch. 744, §§ 11, 12.

Compiler's Notes. The federal Higher Education Act of 1965, referred to in this section, is compiled primarily at 20 U.S.C. § 1001 et seq.

Amendments. The 2018 amendment, effective January 1, 2019, added (a)(2) and (b)(2)(C)(iv).

Effective Dates. Acts 2018, ch. 744, § 13. January 1, 2019; provided that for purposes of promulgating rules, the act took effect April 18, 2018.

63-1-142. Temporary authorization to practice.

1. Any board regulated by this title may authorize any of its members or its designee to conduct a review of the qualifications of an applicant for a license to practice such profession in this state and to make an initial determination as to whether the applicant has met all the requirements for licensure. If the board member or board designee determines that the applicant has met all the requirements for a license, the board member or board designee has the authority to issue to such applicant a temporary authorization to practice, and, once the temporary authorization is issued, the applicant is then authorized to practice such profession in this state until the board makes a final decision on the application for a license. Such temporary authorization, once issued, shall be deemed to be a valid license for all purposes, granting to the applicant all rights that would attach if the person had been issued a permanent license at that time. The board may authorize the use of this procedure with respect to an applicant for an initial license, temporary permit, temporary license, renewal of license and license reinstatement if the issuance of temporary permits, temporary licenses, renewal of license and license reinstatement is otherwise authorized by such board's practice statutes. In no event shall the temporary authorization issued pursuant to an initial determination made by a board member or a board designee be effective for longer than a six-month period measured from the date of issuance. The applicant shall not utilize this process for the same reason more than once.
2. If temporary authorization, pursuant to subsection (a), is issued to an applicant and if the subsequent decision of the board is to deny the application based upon a determination that the applicant has not complied with all the requirements for licensure, then the initial approval from that point forward shall immediately become null and void, and the applicant shall be notified immediately. In this event, the doctrine of estoppel shall not apply against the state based upon its issuance of temporary authorization and its subsequent denial of licensure.

Acts 1999, ch. 518, § 1.

63-1-143. Notification of vacancy — Termination due to vacancy.

1. Each board, commission, committee, agency or other governmental entity created pursuant to this title incurring a vacancy shall notify the appointing authority in writing within ninety (90) days after the vacancy. All vacancies, other than ex officio members, on any board, commission, committee, agency or other governmental entity created pursuant to this title shall be filled by the appointing authority within ninety (90) days of receiving written notice of the vacancy and sufficient information is provided for the appointing authority to make an informed decision in regard to filling such vacancy. If sufficient information has been provided and a board, commission, committee, agency or other governmental entity created pursuant to this title has more than one (1) vacancy that is more than one hundred eighty (180) days in duration, such board, commissioner, committee, agency or other governmental entity shall report to the house and senate government operations committees why such vacancies have not been filled.
2. If more than one-half (½) of the positions on any board, commission, committee, agency or other governmental entity created pursuant to this title are vacant for more than one hundred eighty (180) consecutive days, such board, commission, committee, agency or other governmental entity shall terminate. Such board, commission, committee, agency or other governmental entity shall wind up its affairs pursuant to § 4-29-112. If a board, commission, committee, agency or other governmental entity created pursuant to this title is terminated pursuant to this subsection (b), it shall be reviewed by the evaluation committees pursuant to the Uniform Administrative Procedures Act, compiled at title 4, chapter 5, before ceasing all its activities. Nothing in this section shall prohibit the general assembly from continuing, restructuring, or reestablishing a board, commission, committee, agency or other governmental entity created pursuant to this title.

Acts 2000, ch. 835, § 2.

Compiler's Notes. Acts 2000, ch. 835, § 7 provided that the act, which enacted this section, shall not change any procedure, manner, or time which members of the Tennessee motor vehicle commission who are selected from a list of qualified persons submitted by motor vehicle manufacturers licensed in Tennessee or their consumer replacements are appointed pursuant to § 55-17-103.

63-1-144. Payment of costs of investigation and prosecution.

1. In addition to any existing authority regarding the requirement to pay costs in disciplinary proceedings, when the division or any board, council or committee created pursuant to this title and/or title 68, chapters 24 and 29 and regulated under the authority of the department of health imposes sanctions on a license or certificate holder in any disciplinary contested case proceeding, the license or certificate holder may, at the discretion of the division, board, council or committee before which the contested case proceeding was held be required to pay the actual and reasonable costs of the investigation and prosecution of the case, which shall include, but not be limited to, the following:
   1. All costs absorbed by the division or attributed to and assessed against the board, council or committee by the division's bureau of investigations in connection with the prosecution of the matter including all investigator time, travel and lodging incurred during the prosecution;
   2. All costs absorbed by the division or assessed against the board, council or committee by the division for the use of the division facilities and personnel for prosecution of the matter;
   3. All costs assessed against the division, board, council or committee for the appearance fees, transcripts, time, travel and lodging of administrative law judges and court reporters and witnesses required in the prosecution of the matter; and
   4. All costs attributed to and assessed against the division, board, council or committee by the department's office of general counsel in connection with the prosecution of the matter, including all attorney and paralegal time, travel and lodging incurred during the prosecution of the matter.
2. The division, board or committee shall include in any order in which the payment of costs has been assessed an amount that is the maximum amount owed by the license or certificate holder at the time the order is entered. Prior to the expiration of sixty (60) days from the effective date of the order, the division, council, board or committee shall send to the license or certificate holder, by certified mail, return receipt requested, and by regular United States mail, a final costs assessment that does not exceed the maximum amount in the order.

Acts 2003, ch. 102, § 1; 2007, ch. 265, § 1.

63-1-145. Rules and regulations regarding advertisement pertaining to board certification and specialty.

Consistent with this title, the boards of the respective branches of the healing arts shall promulgate rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and this title to regulate the nature, manner, content and extent of advertising and the use of titles by practitioners of such healing arts who are under the jurisdiction of such boards, including advertising pertaining to board certification and specialty. Those boards that have already adopted such rules and regulations are not required to adopt additional rules and regulations, unless and until deemed necessary and appropriate by those boards.

Acts 2005, ch. 467, § 4.

63-1-146. Rules and regulations regarding sanctions for violations.

Consistent with this title, the boards of the respective branches of the healing arts are hereby authorized to promulgate rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, which establish sanctions for violations of this chapter by members of the professions the boards regulate. Such sanctions may include civil penalties, suspension or revocation of license.

Acts 2005, ch. 467, § 5.

63-1-147. Authority to enter into arrangements for evaluating and guiding the development of the health care workforce to improve delivery of quality health care.

Any board of an allied health care profession, for allied health professionals as defined by United States Code, title 42, chapter 6A, subchapter V, part F, § 295p (42 U.S.C. § 295p), within the division of health related boards as set out in § 68-1-101, is authorized to enter into grants, agreements, scholarships or other arrangements with statewide nonprofit agencies or other state agencies for the purpose of evaluating and guiding the development of the education, distribution and availability of the allied health care workforce under the regulation of that board to provide a basis for improving the delivery of quality health care.

Acts 2006, ch. 558, § 1.

63-1-148. Covenants not to compete signed by healthcare providers.

1. A restriction on the right of an employed or contracted healthcare provider to practice the healthcare provider's profession upon termination or conclusion of the employment or contractual relationship shall be deemed reasonable if:
   1. The restriction is set forth in an employment agreement or other written document signed by the healthcare provider and the employing or contracting entity; and
   2. The duration of the restriction is two (2) years or less and either:
      1. The maximum allowable geographic restriction is the greater of:
         1. A ten-mile radius from the primary practice site of the healthcare provider while employed or contracted; or
         2. The county in which the primary practice of the healthcare provider while employed or contracted is located; or
      2. There is no geographic restriction, but the healthcare provider is restricted from practicing the healthcare provider's profession at any facility at which the employing or contracting entity provided services while the healthcare provider was employed or contracted with the employing or contracting entity.
2. An agreement entered into in conjunction with the purchase or sale of a healthcare provider's practice, or all or substantially all of the assets of the healthcare provider's practice, may restrict the healthcare provider's right to practice the healthcare provider's profession; provided, that the duration of the restriction and the allowable area of the restriction are reasonable under the circumstances. There shall be a rebuttable presumption that the duration and area of restriction agreed upon by the parties in such an agreement are reasonable.
3. This section shall apply to healthcare providers licensed under chapters 3, 4, 5, 6, 8, 9 and 11 of this title.
4. This section shall not apply to physicians who specialize in the practice of emergency medicine.

Acts 2007, ch. 487, § 1; 2008, ch. 891, § 1; 2010, ch. 851, § 1; 2011, ch. 218, §§ 1, 2.

Law Reviews.

Covenants Not to Compete: The Real Question for Enforcement, 47 U. Mem. L. Rev. 855 (2017).

Physician Non-Compete Agreements Revisited and Revived (Josh A. McCreary), 43 Tenn. B.J. 17 (2007).

Tax Subsidies, Third-Party-Payments, and Cross-Subsidization: America's Distorted Health Care Markets (William P. Kratzke), 40 U. Mem. L. Rev. 279 (2009).

63-1-149. Registry check.

1. On and after October 1, 2010, before employing or contracting with any person who would be providing direct patient care, for whom a background check has not been completed, a health care professional licensed under any chapter of this title or title 68, chapters 24 and 140, shall initiate and perform a “registry check” which for the purposes of this section is defined as:
   1. A state-by-state look in any state in which the person has lived in the previous seven (7) years of the national sex offender public registry website coordinated by the United States department of justice, including, but not limited to, the sexual offender registry maintained by the Tennessee bureau of investigation pursuant to title 40, chapter 39, part 2; and
   2. Any adult abuse registry maintained for any state in which the person has lived in the previous seven (7) years; and
   3. The department of health's elder abuse registry established pursuant to title 68, chapter 11, part 10.
2. Should an applicant be listed on any of the registries listed in subdivisions (a)(1)-(3), the health care professional shall not employ or contract with the person if the person would be providing direct patient care.
3. A health care professional who complies with the requirements to perform registry checks under subsection (a), or relies on a documented representation provided by an entity with which the health care professional contracts that the person who will work in the office is not on any of these registries, shall not be subject to civil or criminal liability solely based upon the information provided through a registry check under this section. This immunity shall extend to a claim related to the professional's refusal to employ or contract with a person based on information obtained from a registry check.
4. This section is not intended to apply to contracted, external staff who provide such services as cleaning services, maintenance of office or medical equipment or other services where direct patient contact is not intended.
5. This section shall not apply to health care professionals licensed chapter 12 of this title.
6. The department of health shall post no later than October 1, 2010, in a conspicuous location on its website as well as the website of each applicable licensing board a link to all potential databases the health care professional would be required to check pursuant to subsection (a). In addition, each applicable licensing board shall notify all of its licensees at least annually through board newsletters of their obligations under this section.

Acts 2010, ch. 1084, § 1.

63-1-150. Patient safety and quality improvement.

1. This section shall not apply to §§ 63-4-118, 63-5-131, 63-10-402 — 63-10-405, 63-11-220, 63-12-138 and 68-11-272.
2. It is the policy of this state to encourage the improvement of patient safety and quality and the evaluation of the quality, safety, cost, processes and necessity of healthcare services by healthcare providers and by other entities. This state further recognizes that certain protections must be available to these providers and entities to ensure that they are able to effectively pursue these measures.
3. As used in this section:
   1. “Healthcare organization” means any:
      1. State or local health professional association or society;
      2. Professional assistance program providing, or attempting to provide, intervention, counseling, referral or other assistance to any healthcare provider or family of a healthcare provider directly related to and including the alcohol or drug impairment of a healthcare provider;
      3. Healthcare provider malpractice support group;
      4. Group practice that is engaged in the provision of healthcare services;
      5. Entity engaged in the provision of healthcare provider services or healthcare provider staffing to licensed healthcare entities, including hospitals;
      6. Professional healthcare foundation;
      7. Individual practice association made up of practices the members of which are engaged in the provision of health care;
      8. Health maintenance organization, preferred provider organization, hospital and medical service corporation, or accountable care organization as defined by § 3022 of the federal Patient Protection and Affordable Care Act, P.L. 111-148, as amended;
      9. Entity that contracts with a healthcare organization to perform any of the functions of a quality improvement committee;
      10. Any patient safety organization listed as such by the federal secretary of health and human services pursuant to § 924 of the Patient Safety and Quality Improvement Act of 2005, P.L. 109-41, as amended;
      11. University medical school or health science center; or
      12. Community mental health center as defined in § 33-1-101;
   2. “Healthcare provider” means any healthcare professional licensed, authorized, certified or regulated under this title, including, but not limited to, medical resident physicians, interns, and fellows participating in a training program of one (1) of the accredited medical schools or of one (1) of such medical school's affiliated teaching hospitals in this state, or any other clinical staff of a healthcare organization;
   3. “Quality improvement committee” or “QIC” means a committee formed or retained by a healthcare organization, an activity of a healthcare organization, or one (1) or more individuals employed by a healthcare organization performing the types of functions listed in subdivisions (c)(3)(A)-(P), the purpose of which, or one (1) of the purposes of which is to evaluate the safety, quality, processes, costs, appropriateness, or necessity of healthcare services by performing functions, including, but not limited to:
      1. Evaluation and improvement of the quality of healthcare services rendered;
      2. Determination that health services rendered were professionally indicated or were performed in compliance with applicable standards of care;
      3. Determination that the cost of health care rendered was considered reasonable;
      4. Evaluation of the qualifications, credentials, competence and performance of healthcare providers or action upon matters relating to the discipline of any individual healthcare provider;
      5. Reduction of morbidity or mortality;
      6. Establishment and enforcement of guidelines designed to keep the cost of health care within reasonable bounds;
      7. Research;
      8. Evaluation of whether facilities are being properly utilized;
      9. Supervision, education, discipline, admission, and the determination of privileges of healthcare providers;
      10. Review of professional qualifications or activities of healthcare providers;
      11. Evaluation of the quantity, quality and timeliness of healthcare services rendered to patients;
      12. Evaluation, review or improvement of methods, procedures or treatments being utilized;
      13. Intervention, support or rehabilitative referrals or services to healthcare providers;
      14. Evaluation as to whether to report an unusual incident pursuant to § 63-6-221 or § 63-9-117 or to evaluate and improve the quality of health care rendered by healthcare providers related to the submission of an unusual incident report;
      15. Activities to determine the healthcare organization's compliance with state or federal regulations; or
      16. Participation in utilization review activities, including participation in review activities within the healthcare organization and activities in conjunction with an insurer or utilization review agent under title 56, chapter 6, part 7; and
   4. “Records” means records of interviews and all reports, incident reports, statements, minutes, memoranda, charts, statistics, evaluations, critiques, test results, corrective actions, disciplinary actions and any and all other documentation generated in connection with the activities of a QIC.
4. 1. Records of a QIC and testimony or statements by a healthcare organization's officers or directors, trustees, healthcare providers, administrative staff, employees or other committee members or attendees relating to activities of the QIC shall be confidential and privileged and shall be protected from direct or indirect means of discovery, subpoena or admission into evidence in any judicial or administrative proceeding. Any person who supplies information, testifies or makes statements as part of a QIC may not be required to provide information as to the information, testimony or statements provided to or made before such a committee or opinions formed by such person as a result of committee participation.
   2. Any information, documents or records, which are not produced for use by a QIC or which are not produced by persons acting on behalf of a QIC, and are otherwise available from original sources, shall not be construed as immune from discovery or use in any judicial or administrative proceedings merely because such information, documents or records were presented during proceedings of such committee.
   3. A QIC may share information and documents, including complaints, incident reports, and testimony and statements by any person to the QIC, with one (1) or more other QICs as defined under this section or under § 68-11-272. Information and documents disclosed by one (1) QIC to another QIC, and any information and documents created or maintained as a result of the sharing of such information and documents, shall be confidential, privileged and protected from direct or indirect means of discovery, subpoena or admission into evidence, to the same extent as provided in subdivision (d)(1). The QIC sharing such information with another QIC shall determine the manner and process by which it will share such information and documents, which process may include requiring a written agreement between QICs regarding the sharing of practitioner information. The QIC and its sponsoring healthcare organization shall not be held liable and are immune from suit for any disclosure or sharing of information in compliance with this section.
5. No healthcare organization or its officers, trustees, directors, healthcare providers, administrative staff, employees, other committee members or attendees, or any person providing information to a QIC shall be held liable:
   1. In any action for damages or other relief and is immune from liability arising from the provision of information to a QIC or in any judicial or administrative proceeding if the information is provided to the QIC in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist; or
   2. In any action for damages or other relief and is immune from liability resulting from any decisions, opinions, actions, and proceedings rendered, entered or acted upon by a QIC undertaken or performed within the scope or function of the duties of such committees or in any judicial or administrative proceeding, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
6. A professional assistance program also advocates for healthcare professionals before other QICs, healthcare entities, private and governmental insurance carriers, national or local certification and accreditation bodies, and the state health-related boards of this or any other state. The disclosure of confidential, privileged QIC information to such entities during advocacy or as a report to the health-related boards, or to the affected healthcare provider under review, does not constitute either a waiver of confidentiality or privilege.
7. Any person providing information to a QIC is presumed to have acted in good faith and without malice. Any person alleging lack of good faith has the burden of proving bad faith and malice.
8. All decisions, opinions, actions and proceedings rendered, entered or acted upon by a QIC are presumed to have been completed in good faith and without malice. Any person alleging lack of good faith has the burden of proving bad faith and malice.

Acts 2011, ch. 67, § 4; 2014, ch. 651, §§ 1-3; 2017, ch. 4, § 1; 2018, ch. 593, § 1.

Compiler's Notes. Acts 2011, ch. 67, § 2 provided that the act, which enacted this section, shall be known and may be cited as the “Tennessee Patient Safety and Quality Improvement Act of 2011.”

Amendments. The 2017 amendment deleted “63-9-114,” following “63-5-131,” in (a).

The 2018 amendment added (c)(1)(L).

Effective Dates. Acts 2017, ch. 4, § 11. March 15, 2017.

Acts 2018, ch. 593, § 3. March 22, 2018.

63-1-151. Report by practitioner to licensing board of indictment for offense involving sale or dispensing of controlled substances.

1. 1. Notwithstanding any other provision of this chapter or of chapter 3, chapters 5-9 or chapter 19 of this title, when a practitioner licensed under any of such chapters is under state or federal indictment in this state for an offense involving the sale or dispensing of controlled substances under state or federal law, the practitioner shall report the indictment to the practitioner's licensing board in writing within seven (7) calendar days of acquiring actual knowledge of the indictment. Such report shall include the jurisdiction in which the indictment is pending, if known, and shall also be accompanied by a copy of the indictment, if the practitioner has one.
   2. A district attorney general and appropriate attorneys for the federal government are strongly encouraged, when appropriate, to promptly notify a practitioner's licensing board when a practitioner covered under subdivision (a)(1) is indicted in this state for an offense involving the sale or dispensing of controlled substances under state or federal law.
2. The knowing failure of a practitioner to submit the report required in subdivision (a)(1) to the licensing board shall be considered unprofessional, dishonorable or unethical conduct and may be grounds for such licensing board to take disciplinary action against the practitioner's license. The fact an indictment was sealed and the practitioner could not have actual knowledge of its existence excuses the practitioner from discipline based on the failure of the practitioner to submit a report. However, the claim that the practitioner was not aware of the obligation required in subdivision (a)(1) may not excuse the practitioner from discipline based on the failure of the practitioner to submit a report.
3. Upon receiving a report of an indictment pursuant to subdivision (a)(1), (a)(2) or from any other source, the practitioner's licensing board, through the board's consultant or other person designated by the board, shall within fifteen (15) calendar days, conduct an expedited review of the practitioner's conduct alleged in the indictment. The purpose of such expedited review shall be to determine if the matter merits an expedited investigation by the board. If so, such a directive shall be given to the department of health's office of investigations. All review activity under this subsection (c) shall be confidential pursuant to § 63-1-117(f).
4. For the purposes of this section, “controlled substances” means substances regulated as controlled substances under title 39, chapter 17, part 4, or title 53, chapters 10 and 11, or the federal Controlled Substances Act, (21 U.S.C. § 801, et seq.).

Acts 2013, ch. 232, § 1.

Cross-References. Confidentiality of public records, § 10-7-504.

63-1-152. Prescription, dispensation, and administration of opioid antagonists — Immunity of certain individuals — Training of first responders.

1. As used in this section:
   1. “Drug-related overdose” means an acute condition, including mania, hysteria, extreme physical illness, coma, or death resulting from the consumption or use of a controlled substance, or another substance with which a controlled substance was combined, and that a layperson would reasonably believe to be an opioid related drug overdose that requires medical assistance;
   2. “Opioid antagonist” means naloxone hydrochloride which is approved by the federal food and drug administration for the treatment of a drug overdose.
2. A licensed healthcare practitioner otherwise authorized to prescribe an opioid antagonist acting in good faith and exercising reasonable care may, directly or by standing order, prescribe an opioid antagonist to the following persons:
   1. A person at risk of experiencing an opiate related overdose; or
   2. A family member, friend, or other person in a position to assist a person at risk of experiencing an opiate-related overdose.
3. In order to establish good faith under subsection (b), a licensed healthcare practitioner, prior to prescribing an opioid antagonist, may require receipt of a written communication that provides a factual basis for a reasonable conclusion that:
   1. The person seeking the opioid antagonist is at risk of experiencing an opiate-related overdose; or
   2. The person seeking the opioid antagonist other than the person who is at risk of experiencing an opiate-related overdose, and who is seeking the opioid antagonist, is a family member, friend, or other person in a position to assist the person at risk of experiencing an opiate-related overdose.
4. A person who receives an opioid antagonist that was prescribed pursuant to subsection (b) may administer an opioid antagonist to another person if:
   1. The person has a good faith belief that the other person is experiencing an opioid related drug overdose; and
   2. The person exercises reasonable care in administering the drug to the other person.
5. Evidence of the use of reasonable care in administering the drug shall include the receipt of basic instruction and information on how to administer the opioid antagonist, including successful completion of the online overdose prevention education program offered by the department of health.
6. The commissioner of health or the commissioner's designee, in consultation with other state, federal or local government personnel, including contractors, shall create and maintain an online education program with the goal of educating laypersons and the general public on the administration of opioid antagonists and appropriate techniques and follow-up procedures for dealing with opioid related drug overdose.
7. The following individuals are immune from civil liability in the absence of gross negligence or willful misconduct for actions authorized by this section:
   1. Any licensed healthcare practitioner who prescribes or dispenses an opioid antagonist pursuant to subsection (b); and
   2. Any person who administers an opioid antagonist pursuant to subsection (d).
8. A licensed healthcare practitioner acting in good faith and with reasonable care, who prescribes, dispenses, or administers an opioid antagonist to a person the healthcare provider believes to be experiencing or is at risk of experiencing a drug-related overdose or prescribes an opioid antagonist to a family member, friend, or other person in a position to assist a person experiencing or at risk of experiencing a drug-related overdose is immune from disciplinary or adverse administrative actions under this title for acts or omissions during the administration, prescription, or dispensation of an opioid antagonist.
9. The commissioner of health or the commissioner's designee shall make available recommendations for training of first responders, as defined in § 29-34-203, in the appropriate use of opioid antagonists. The recommendations shall include a provision concerning the appropriate supply of opioid antagonists to first responders to administer consistent with the requirements of this section.
10. Any person treated for a drug-related overdose with an opioid antagonist by a first responder shall be taken to a medical facility by emergency medical services for evaluation, unless the person is competent to refuse medical treatment and chooses to refuse treatment.

Acts 2014, ch. 623, § 1; 2015, ch. 396, § 5; 2017, ch. 484, §§ 1, 2.

Code Commission Notes.

Acts 2017, ch. 484, § 1 and § 2  enacted two new subdivisions. However, since the subdivision added by § 1 contained the same language as the subdivision added by § 2, only the subdivision added by § 2 was retained since it had additional language not in conflict with the subdivsion added by § 1.

Compiler's Notes. Acts 2014, ch. 909, § 2 purported to enact § 63-1-152. Section 63-1-152 was previously enacted by Acts 2014, ch. 623, § 1, therefore, the enactment by Acts 2014, ch. 909, § 2 was designated as § 63-1-153 by the authority of the code commission.

Acts 2015, ch. 396, § 1 provided that the act, which added (i), shall be known and may be cited as the “Addiction Treatment Act of 2015”.

Amendments. The 2017 amendment added (j).

Effective Dates. Acts 2017, ch. 484, § 3. July 1, 2017.

Law Reviews.

Defining the Opioid Crisis and the Limited Role of the Criminal Justice System Resolving It, 48 U. Mem. L. Rev. 1206 (Summer 2018).

63-1-153. Signage of medical spas to display name and certification status of supervising medical director or physician.

1. As used in this section:
   1. “Cosmetic medical service” means any service that uses a biologic or synthetic material, a chemical application, a mechanical device, or a displaced energy form of any kind that alters or damages, or is capable of altering or damaging, living tissue to improve the patient's appearance or achieve an enhanced aesthetic result;
   2. “Media” or “advertising” means oral, written and other types of communication disseminated for the purpose of soliciting medical services. These communications include, but are not limited to, newspaper or magazine advertisement, telephone directory displays, printed brochures or leaflets, websites, email correspondence, and television or radio announcements;
   3. “Medical director” or “supervising physician” means a physician who:
      1. Holds an active medical license under chapter 6 or 9 of this title in this state;
      2. Has an active medical practice in this state; and
      3. Is responsible for the provision of or supervises the provision of cosmetic medical services; and
   4. “Medical spa” means any entity, however named or organized, which offers or performs cosmetic medical services; provided, that a medical spa shall not include an individual physician's office or practice owned by a physician.
2. Any entity doing business as or advertised as a medical spa shall display the name of the medical director or supervising physician and shall indicate one of the following by signage at its practice site and in its media and advertising:
   1. Whether the medical director or supervising physician is certified or eligible for certification by a private or public board, parent association, multidisciplinary board or association that is a member of the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA);
   2. Whether the medical director or supervising physician is certified by a board or association with equivalent requirements to the ABMS or AOA as approved and recognized by the board of medical examiners or the board of osteopathic examination, as appropriate; or
   3. Whether the medical director or supervising physician is certified by a board or association requiring an Accreditation Council for Graduate Medical Education (ACGME) or AOA approved training program that provides complete training in the specialty or subspecialty certified, followed by prerequisite certification by a certifying board of the ABMS or AOA in that training field and successful completion of an additional examination in the specialty or subspecialty certified.
3. If the medical director or supervising physician is not certified by any of the entities identified in subsection (b), then the lack of certification shall be displayed by signage at its practice site and in its media and advertising.

Acts 2014, ch. 909, § 2.

Code Commission Notes.

Acts 2014, ch. 909, § 2 purported to enact § 63-1-152. Section 63-1-152 was previously enacted by Acts 2014, ch. 623, § 1, therefore, the enactment by Acts 2014, ch. 909, § 2 was designated as § 63-1-153 by the authority of the code commission.

Compiler's Notes. Acts 2014, ch. 909, § 1 provided that the act, which enacted this section, shall be known and may be referred to as the “Tennessee Patient Safety Cosmetic Medical Procedures Act.”

Attorney General Opinions. An aesthetician licensed by the Board of Cosmetology and Barber Examiners may not perform microblading and/or microneedling in a cosmetology shop or at a medical spa.  A person not licensed by the Board of Cosmetology and Barber Examiners may perform microneedling only if that person satisfies an exemption found in T.C.A. § 62-4-109.  A person not licensed by the Board of Cosmetology and Barber Examiners may perform microblading only if that person satisfies an exemption found in T.C.A. § 62-4-109 and either is a licensed tattoo artist under T.C.A. § 62-38-204 or is exempt from tattooing laws and regulations under T.C.A. § 62-38-210(b).  The marks created by microblading constitute a tattoo.  An individual may perform microblading only if that person satisfies an exemption found in T.C.A. § 62-4-109 and is a licensed tattoo artist under T.C.A. § 62-38-204 or is exempt from tattooing laws and regulations under T.C.A. § 62-38-210(b).  OAG 17-31, 2017 Tenn. AG LEXIS 30 (4/20/2017).

63-1-154. Health care prescriber prohibited from dispensing an opioid or benzodiazepine — Exceptions — Disposition of undispensed inventory.

1. Except as provided in § 63-1-313, a health care prescriber licensed under this title may not dispense an opioid or benzodiazepine. This section shall not apply to:
   1. The dispensing of complimentary packages of medicinal drugs that are labeled as a drug sample or complimentary drug to the practitioner's own patients in the regular course of practice without the payment of a fee or remuneration of any kind;
   2. The dispensing of opioids or benzodiazepines in the health care system of the department of correction;
   3. The dispensing of opioids or benzodiazepines in connection with the performance of a surgical procedure performed at a licensed health care facility. The amount dispensed pursuant to this subdivision (a)(3) may not exceed a seven-day supply. This exception does not allow for the dispensing of an opioid or benzodiazepine more than seven (7) days after the performance of the surgical procedure;
   4. The dispensing of opioids or benzodiazepines pursuant to an approved clinical trial. For purposes of this subsection (a), the term “approved clinical trial” means a clinical research study or clinical investigation that, in whole or in part, is state or federally funded or is conducted under an investigational new drug application that is reviewed by the United States food and drug administration;
   5. The dispensing of an opioid drug in a nonresidential substitution-based treatment center for opiate addiction, as defined in § 68-11-1602;
   6. The dispensing of an opioid or benzodiazepine to a patient of a facility that is licensed by the board for licensing health care facilities pursuant to § 68-11-202;
   7. The dispensing of an opioid or benzodiazepine to a patient of a facility licensed under title 33;
   8. The dispensing of an opioid or benzodiazepine by a physician practice that provides healthcare services that:
      1. Dispenses opioids and benzodiazepines, as directed by the patient's prescription, in safety-sealed, prepackaged containers stamped with the manufacturer's national drug code (NDC) number;
      2. Administers and records pill-counts for opioids or benzodiazepines in order to ensure patient compliance with the prescription;
      3. Dispenses noncontrolled substances which amount to at least fifty percent (50%) of the prescriptions filled annually from the practice; and
      4. Submits controlled substance dispensing information to the controlled substances monitoring database under title 53, chapter 10, part 3, according to the requirements of state law; or
   9. The dispensing of an opioid or benzodiazepine by a veterinarian in the course of the veterinarian's practice.
2. Within ten (10) days after January 1, 2015, each medical practitioner licensed under this title, unless the practitioner meets one (1) of the exceptions listed in subsection (a), shall ensure that the undispensed inventory of opioids and benzodiazepines purchased under the prescriber's drug enforcement administration number for dispensing is:
   1. Returned in compliance with this section to a licensed third party reverse distributor; or
   2. Turned in to local law enforcement agencies and abandoned.
3. Wholesalers shall buy back the undispensed inventory of opioids and benzodiazepines, which are in the manufacturer's original packing, unopened, and in date, in accordance with the established policies of the wholesaler or the contractual terms between the wholesaler and the practitioner concerning returns.

Acts 2014, ch. 983, § 3; 2016, ch. 973, § 1.

Compiler's Notes. Acts 2014, ch. 983, § 5 provided that the commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of the act. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Law Reviews.

The Right Hammer for the Right Nail: Public Health Tools in the Struggle Between Pain and Addiction, 48 U. Mem. L. Rev. 1300 (Summer 2018).

63-1-155. Telehealth services — Establishment of provider-patient relationship — Standard of practice — Applicability.

1. For the purposes of this section:
   1. “Healthcare provider” means:
      1. Any provider licensed under this title who is authorized to diagnose and treat humans; or
      2. Any state-contracted crisis service provider employed by a facility licensed under title 33; and
   2. “Telehealth” or “telemedicine” means, notwithstanding any restriction imposed by § 56-7-1002, the use of real-time audio, video, or other electronic media and telecommunications technologies that enable interaction between the healthcare provider and the patient, or also store-and-forward telemedicine services, as defined by § 56-7-1002(a), for the purpose of diagnosis, consultation, or treatment of a patient in another location where there may be no in-person exchange.
2. For the purposes of this section, a healthcare provider-patient relationship with respect to telemedicine or telehealth is created by mutual consent and mutual communication, except in an emergency, between the patient and the provider. The consent by the patient may be expressed or implied consent; however, the provider-patient relationship is not created simply by the receipt of patient health information by a provider unless a prior provider-patient relationship exists. The duties and obligations created by the relationship do not arise until the healthcare provider:
   1. Affirmatively undertakes to diagnose and treat the patient; or
   2. Affirmatively participates in the diagnosis and treatment.
3. 1. 1. A healthcare provider who delivers services through the use of telehealth shall be held to the same standard of professional practice as a similar licensee of the same practice area or specialty that is providing the same healthcare services through in-person encounters, and nothing in this section is intended to create any new standards of care.
      2. Notwithstanding subdivision (c)(1)(A), telehealth services shall be provided in compliance with the guidelines created pursuant to part 4 of this chapter.
   2. The board or licensing entity governing any healthcare provider covered by this section shall not establish a more restrictive standard of professional practice for the practice of telehealth than that specifically authorized by the provider's practice act or other specifically applicable statute, including this chapter or title 53, chapter 10 or 11.
   3. This section shall not apply to pain management clinics, as defined in § 63-1-301, and chronic nonmalignant pain treatment.
4. Sections 63-6-231 and 63-6-214(b)(21) shall not apply to the practice of telemedicine under this section.
5. This section shall not apply to or restrict the requirements of § 63-6-241.
6. Section 63-6-204(a) shall also apply to telemedicine.
7. 1. Except as provided in subdivision (g)(2), to practice under this section a healthcare provider shall be licensed to practice in this state under this title.
   2. A physician shall be licensed to practice under chapter 6 or 9 of this title in order to practice telemedicine pursuant to § 63-6-209(b), except as otherwise authorized by law or rule.

Acts 2015, ch. 261, § 1.

63-1-156. Immunity from prosecution when seeking medical assistance for drug overdose — Providing first aid or other medical assistance as mitigating factor — Effect on admissibility of evidence.

1. As used in this section:
   1. “Controlled substance” means a drug, substance, or immediate precursor identified, defined, or listed in title 39, chapter 17, part 4 and title 53, chapter 11;
   2. “Drug overdose” means an acute condition, including, but not limited to, extreme physical illness, decreased level of consciousness, respiratory depression, coma, mania, or death, resulting from the consumption or use of a controlled substance, or other substance inhaled, ingested, injected, or otherwise introduced into the body by the distressed individual that a reasonable person would believe to be resulting from the consumption or use of a controlled substance or other substance by the distressed individual;
   3. “Drug violation” means:
      1. A violation of § 39-17-418; or
      2. A violation of § 39-17-425;
   4. “Medical assistance” means aid provided to a person by a healthcare professional licensed, registered, or certified under the laws of this state who, acting within the person's lawful scope of practice, may provide diagnosis, treatment, or emergency medical services; and
   5. “Seeks medical assistance” means:
      1. Accesses or assists in accessing medical assistance or the 911 system;
      2. Contacts or assists in contacting law enforcement or a poison control center; or
      3. Provides care or contacts or assists in contacting any person or entity to provide care while awaiting the arrival of medical assistance to aid a person who is experiencing or believed to be experiencing a drug overdose.
2. Any person who in good faith seeks medical assistance for a person experiencing or believed to be experiencing a drug overdose shall not be arrested, charged, or prosecuted for a drug violation if the evidence for the arrest, charge, or prosecution of the drug violation resulted from seeking such medical assistance. Any person who is experiencing a drug overdose and who in good faith seeks medical assistance for or is the subject of a request for medical assistance shall not be arrested, charged, or prosecuted for a drug violation if the evidence for the arrest, charge, or prosecution of the drug violation resulted from seeking such medical assistance. This immunity from being arrested, charged, or prosecuted shall apply to the person experiencing a drug overdose only on the person's first such drug overdose. Any such person shall also not be subject to the following, if related to the seeking of medical assistance:
   1. Penalties for a violation of a permanent or temporary protective order or restraining order; or
   2. Sanctions for a violation of a condition of pretrial release, condition of probation, or condition of parole based on a drug violation.
3. 1. The act of providing first aid or other medical assistance to someone who is experiencing a drug overdose may be used as a mitigating factor in a criminal prosecution for which immunity, set out in subsection (b), is not provided.
   2. Nothing in this section shall limit the admissibility of any evidence in connection with the investigation or prosecution of a crime with regard to a defendant who does not qualify for the protections of subsection (b) or with regard to other crimes committed by a person who otherwise qualifies for the protections of subsection (b).
   3. Nothing in this section shall limit any seizure of evidence or contraband otherwise permitted by law.
   4. Nothing in this section shall limit or abridge the authority of a law enforcement officer to detain or take into custody a person in the course of an investigation or to effectuate an arrest for any offense except as provided in subsection (b).

Acts 2015, ch. 396, § 2.

Compiler's Notes. Acts 2015, ch. 396, § 1 provided that the act which enacted this section shall be known and may be cited as the “Addiction Treatment Act of 2015”.

Law Reviews.

Defining the Opioid Crisis and the Limited Role of the Criminal Justice System Resolving It, 48 U. Mem. L. Rev. 1206 (Summer 2018).

63-1-157. Statewide collaborative pharmacy practice.

1. As used in this section:
   1. “Chief medical officer” means the chief medical officer for the department of health;
   2. “Opioid antagonist” means a drug that binds to opioid receptors and blocks or inhibits the effect of opioids acting on those receptors, including, but not limited to, naloxone hydrochloride or any other similarly acting and equally safe drug approved by the United States food and drug administration for the treatment of drug overdose;
   3. “Opioid antagonist training program” means a training program approved by the department of health related to opioid antagonist therapy. The training program shall include, but not be limited to, proper administration techniques, use, documentation, and quality assurance.
2. 1. The chief medical officer is authorized to implement a statewide collaborative pharmacy practice agreement specific to opioid antagonist therapy with any pharmacist licensed in, and practicing in, this state.
   2. A pharmacist licensed in, and practicing in, this state is authorized to dispense an opioid antagonist, in good faith, pursuant to a valid statewide collaborative pharmacy practice agreement executed by the chief medical officer.
   3. Under a valid statewide collaborative pharmacy practice agreement authorized by the chief medical officer, an authorized pharmacist may dispense an opioid antagonist to:
      1. A person at risk of experiencing an opiate-related overdose;
      2. A family member, friend, or other person in a position to assist a person at risk of experiencing an opiate-related overdose.
   4. Before a pharmacist enters into a statewide collaborative pharmacy practice agreement with the chief medical officer for the dispensing of an opioid antagonist, the pharmacist shall be able to provide documentation of completion of an opioid antagonist training program within the previous two (2) years.
   5. The pharmacist shall maintain the collaborative pharmacy practice agreement in accordance with the requirements set forth in § 63-10-217, and this agreement must be made available to the department of health upon request.
   6. Any licensed pharmacist acting in good faith and with reasonable care, who dispenses an opioid antagonist to a person the pharmacist believes to be experiencing or at risk of experiencing a drug-related overdose, or who dispenses an opioid antagonist to a family member, friend, or other person in a position to assist a person experiencing or at risk of experiencing a drug-related overdose, is immune from disciplinary or adverse administrative actions under this title for acts or omissions during the dispensation of an opioid antagonist.
   7. Any licensed pharmacist who dispenses an opioid antagonist pursuant to subdivision (b)(2) is immune from civil liability in the absence of gross negligence or willful misconduct for actions authorized by this section.
   8. The chief medical officer shall be immune from disciplinary or adverse administrative actions under this title, as well as civil liability in the absence of gross negligence or willful misconduct, for acts or omissions during the dispensing of an opioid antagonist by a pharmacist acting pursuant to a collaborative agreement established pursuant to this section.

Acts 2016, ch. 596, § 1.

Compiler's Notes. For the preamble to the act relative to collaborative pharmacy practice agreements for opioid antagonist therapy, please refer to Acts 2016, ch. 596.

Law Reviews.

Defining the Opioid Crisis and the Limited Role of the Criminal Justice System Resolving It, 48 U. Mem. L. Rev. 1206 (Summer 2018).

63-1-158. Epinephrine-administration protocol — Definitions — Possession of epinephrine kits by law enforcement officers — Liability — Record requirement.

1. As used in this section:
   1. “Epinephrine kit” means a dose of epinephrine and a device for administering the dose of epinephrine;
   2. “Law enforcement agency” has the same meaning as in § 39-13-519;
   3. “Law enforcement officer” has the same meaning as in § 39-11-106; and
   4. “Pharmacist” has the same meaning as in § 63-10-204.
2. A law enforcement agency may develop an epinephrine-administration protocol in accordance with this section. The epinephrine-administration protocol shall be developed by a physician licensed under chapter 6 or 9 of this title.
3. For any law enforcement agency that has developed a epinephrine-administration protocol in accordance with subsection (b), a health care prescriber may prescribe epinephrine kits in the name of the law enforcement agency and a pharmacist may dispense epinephrine kits to the law enforcement agency pursuant to a prescription issued in the name of the law enforcement agency.
4. In coordination with the appropriate local emergency medical services providers and in accordance with this section, a law enforcement officer may possess an epinephrine kit prescribed to the law enforcement officer's law enforcement agency for the purpose of administering epinephrine in an emergency situation to treat anaphylactic reactions if authorized to do so by the officer's law enforcement agency.
5. A law enforcement officer may administer epinephrine to treat an anaphylactic reaction if the law enforcement officer is authorized to administer epinephrine by the officer's law enforcement agency, has completed the training required by subsection (f) within the past twelve (12) months, and administers the epinephrine in accordance with a protocol adopted by the officer's law enforcement agency in accordance with subsection (b).
6. 1. A law enforcement agency shall require that each officer that is authorized to administer epinephrine receive training from qualified medical personnel at least annually. The training shall include:
      1. Patient assessment, including signs and symptoms of anaphylactic shock;
      2. Universal precautions;
      3. Rescue breathing;
      4. Seeking medical attention; and
      5. The use of intramuscular epinephrine as detailed in the protocol described in subsection (b).
   2. A law enforcement agency shall keep a record of each officer's participation in training pursuant to this subsection (f).
7. 1. A physician shall not be held liable for any injury to an individual who is harmed by the administration of the epinephrine prescribed by the physician pursuant to this section unless the physician acted with reckless disregard for safety.
   2. A law enforcement officer shall not be held liable for any injury to an individual who is harmed by the administration of epinephrine by the law enforcement officer pursuant to this section unless the law enforcement officer acted with reckless disregard for safety.
   3. A law enforcement agency shall not be held liable for any injury to an individual who is harmed by the administration of epinephrine by a law enforcement officer employed by the law enforcement agency pursuant to this section unless the law enforcement agency acted with reckless disregard for safety.
   4. A pharmacist shall not be held liable for any injury to an individual who is harmed by the administration of the epinephrine dispensed by the pharmacist and prescribed by a physician pursuant to this section unless the pharmacist acted with reckless disregard for safety.
8. A law enforcement officer that administers epinephrine in accordance with this section shall file a record of the event with the appropriate local emergency medical services agency. The record shall include the signs, symptoms, therapies, response, and disposition of the event.

Acts 2016, ch. 801, § 1.

Compiler's Notes. For the preamble to the act concerning administration of epinephrine in emergency circumstances, please refer to Acts 2016, ch. 801.

63-1-159. Prohibited offer or payment, or offer or solicitation, of commission for referral of patient or patronage with respect to alcohol or drug services.

1. A healthcare provider licensed under this title, with respect to alcohol and drug services, as defined in § 33-2-402, shall not knowingly:
   1. Offer or pay a commission, benefit, rebate, kickback, or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, to induce the referral of a patient or patronage to or from a licensee or facility licensed under title 33, chapter 2, part 4;
   2. Solicit or receive a commission, benefit, rebate, kickback, or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, in return for referring a patient or patronage to or from a licensee or facility licensed under title 33, chapter 2, part 4;
   3. Solicit or receive a commission, benefit, rebate, kickback, or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, in return for the acceptance or acknowledgment of treatment from a licensee or facility licensed under title 33, chapter 2, part 4; or
   4. Aid, abet, advise, or otherwise participate in the conduct prohibited under subdivision (a)(1), (a)(2), or (a)(3).
2. Any healthcare provider licensed under this title, with respect to alcohol and drug services, that violates this section is subject to suspension or revocation of the healthcare provider's license by the appropriate healthcare licensing board and the imposition of civil penalties as authorized under this title.

Acts 2018, ch. 855, § 2.

Effective Dates. Acts 2018, ch. 855, § 4. July 1, 2018.

63-1-160. Prescription for Schedule ll controlled substance — Electronic prescription for Schedule ll, lll, lV, or V controlled substance — Exceptions.

1. As used in this section, “electronic prescription” means a written prescription that is generated on an electronic application and is transmitted in accordance with 21 CFR Part 1311.
2. All written, printed, or electronic prescription orders for a Schedule II controlled substance must contain all information otherwise required by law. The healthcare prescriber must sign the written, printed, or electronic prescription order on the day it is issued. Nothing in this section prevents a healthcare prescriber from issuing a verbal prescription order.
3. Subject to subsection (d), on or after January 1, 2021, any prescription for a Schedule II, III, IV, or V controlled substance issued by a prescriber who is authorized by law to prescribe the drug must be issued as an electronic prescription from the person issuing the prescription to a pharmacy. The name, address, and telephone number of the collaborating physician of an advanced practice registered nurse or physician assistant must be included on electronic prescriptions issued by an advance practice registered nurse or physician assistant.
4. Subsection (c) does not apply to prescriptions:
   1. Issued by veterinarians;
   2. Issued in circumstances where electronic prescribing is not available due to technological or electrical failure, as set forth in rule;
   3. Issued by a health care prescriber to be dispensed by a pharmacy located outside the state, as set forth in rule;
   4. Issued when the health care prescriber and dispenser are the same entity;
   5. Issued while including elements that are not supported by the most recently implemented version of the National Council for Prescription Drug Programs Prescriber/Pharmacist Interface SCRIPT Standard;
   6. Issued by a health care prescriber for a drug that the federal food and drug administration (FDA) requires the prescription to contain certain elements that are not able to be accomplished with electronic prescribing;
   7. Issued by a health care prescriber allowing for the dispensing of a non-patient-specific prescription pursuant to a standing order, approved protocol for drug therapy, collaborative pharmacy practice agreement in response to a public health emergency, or in other circumstances where the health care prescriber may issue a non-patient-specific prescription;
   8. Issued by a health care prescriber prescribing a drug under a research protocol;
   9. Issued by a health care prescriber who has received a waiver or a renewed waiver for a specified period determined by the commissioner of health, not to exceed one (1) year without renewal by the commissioner, from the requirement to use electronic prescribing, pursuant to a process established in rule by the commissioner, due to economic hardship, technological limitations that are not reasonably within the control of the health care prescriber, or other exceptional circumstance demonstrated by the health care prescriber;
   10. Issued by a health care prescriber under circumstances where, notwithstanding the health care prescriber's present ability to make an electronic prescription as required by this subsection (a), the health care prescriber reasonably determines that it would be impractical for the patient to obtain substances prescribed by electronic prescription in a timely manner, and such delay would adversely impact the patient's medical condition;
   11. Issued by a health care prescriber who issues fifty (50) or fewer prescriptions for Schedule II controlled substances per year.
5. A pharmacist who receives a written, oral, or faxed prescription is not required to verify with the health care prescriber that the prescription properly falls under one (1) of the exceptions from the requirement to electronically prescribe in subsection (d). Pharmacists may continue to dispense medications from otherwise valid written, oral, or fax prescriptions that are consistent with § 53-11-308.
6. The commissioner of health shall refer individual health care prescribers who violate this section to the health care prescriber's licensing board, and for such violation in this section, the health care prescriber is subject to penalties under § 63-1-134.
7. Any health-related board under § 68-1-101(a)(8) that is affected by this section, shall report to the general assembly by January 1, 2019, on issues related to the implementation of this section.

Acts 2018, ch. 883, § 1; 2019, ch. 124, §§ 3, 4.

Compiler's Notes. Acts 2018, ch. 883, § 10 provided that the commissioner of health is authorized to promulgate rules to effectuate the purposes of the act. All rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, title 4, chapter 5.

Amendments. The 2019 amendment rewrote (b) and (c) which read: “(b)  Subject to subsection (c), any written, printed, or electronic prescription order for a Schedule II controlled substance prepared by a health care prescriber who is authorized by law to prescribe a drug must be legibly printed, entered, or typed as a separate prescription order. The written, printed, or electronic prescription order must contain all information otherwise required by law. The health care prescriber must sign the written, printed, or electronic prescription order on the day it is issued. Nothing in this section shall be construed to prevent a health care prescriber from issuing a verbal prescription order.“(c)  Subject to subsection (d) of this section, on or after January 1, 2020, any prescription for a Schedule II controlled substance shall be issued as an electronic prescription from the person issuing the prescription to a pharmacy. The name, address, and telephone number of the collaborating physician of an advanced practice registered nurse or physician assistant shall be included on the electronic prescription.”

Effective Dates. Acts 2018, ch. 883, § 12. January 1, 2019; provided that for rulemaking purposes, the act took effect May 3, 2018.

Acts 2019, ch. 124, § 16. April 9,  2019.

63-1-161. Waiver of initial licensure fees for low-income persons.

1. As used in this section:
   1. “Licensing” means the procedure through which the privilege to engage in a specific profession regulated under this title is granted by a licensing authority;
   2. “Licensing authority” means any state agency with the authority to impose training, education, or licensure fees to practice in a profession;
   3. “Licensure fee” means a fee imposed by a licensing authority on persons licensed to practice a profession for the privilege of providing goods or services;
   4. “Low-income persons” means persons who are enrolled in a state or federal public assistance program, including, but not limited to, temporary assistance for needy families (TANF), medicaid, or supplemental nutrition assistance program (SNAP); and
   5. “State agency” means a state board, agency, or commission attached to the division of health related boards, as listed in § 68-1-101(a)(8).
2. 1. Any licensing authority that requires a license for persons to practice in a profession shall waive all initial licensure fees for low-income persons.
   2. Persons seeking a waiver of initial licensure fee requirements shall apply to the appropriate licensing authority in a format prescribed by the authority.
   3. All licensing authorities to which this section applies shall promulgate rules to effectuate the purposes of this section. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2018, ch. 954, § 2.

Effective Dates. Acts 2018, ch. 954, § 4. January 1, 2019; provided, that for purposes, of promulgating rules, the act took effect May 18, 2018.

63-1-162. Task force to create minimum disciplinary action for healthcare practitioner who deviates from sound medical judgment in treatment of patient with an opioid. [Effective until July 1, 2023.]

1. If a healthcare practitioner treats a human patient with an opioid and that healthcare practitioner's licensing board or agency finds that the healthcare practitioner engaged in a significant deviation or pattern of deviation from sound medical judgment, the minimum disciplinary action that a healthcare practitioner's licensing board or committee must take shall be established and promulgated by rule by a task force composed of representatives from:
   1. The board of medical examiners;
   2. The board of osteopathic examination;
   3. The board of dentistry;
   4. The board of podiatric medical examiners;
   5. The board of optometry;
   6. The board of nursing; and
   7. The board of medical examiners' committee on physician assistants.
2. The task force must create a uniform minimum disciplinary action pursuant to this section, which shall be binding on each board and committee listed in subsection (a).
3. The task force is authorized to establish minimum disciplinary actions pursuant to this section by emergency rule in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rule promulgated by the task force shall be codified and published by the secretary of state in each of the chapters for the boards and committee listed in subsection (a).
4. 1. Each board and committee listed in subsection (a) must select and appoint by majority vote one (1) member of their respective board or committee to serve on the task force before September 1, 2018.
   2. The task force shall select and appoint a member to serve as chair of the task force.
   3. A majority of the task force shall constitute a quorum, and a majority vote of the task force members present is required for any action.
   4. Notwithstanding any provision of the Uniform Administrative Procedures Act to the contrary, the task force shall hear public comment at any required hearing on behalf of all boards listed in subsection (a) when a hearing is required. The task force is authorized to vote to promulgate the rule to establish the uniform minimum disciplinary action for each board and committee listed in subsection (a).
5. In the event that the task force has not promulgated uniform minimum disciplinary actions by April 1, 2019, then the minimum disciplinary action that a healthcare practitioner's licensing board or agency must take is a removal of the healthcare practitioner's right to prescribe controlled substances for no less than five (5) years.
6. The task force shall terminate upon the later of July 1, 2019, or the effective date of a permanent rule establishing the uniform minimum disciplinary action pursuant to this section. The procedures of this section must be followed to amend, repeal, or otherwise revise the uniform minimum disciplinary action established pursuant to this section. In such case, the task force may be reconvened by the commissioner of health or a majority of the boards and committees listed in subsection (a).
7. Nothing in this part shall be construed to prohibit the licensing boards and committee listed in subsection (a) from promulgating rules regarding other minimum disciplinary actions that will be taken against their licensees.

Acts 2018, ch. 978, § 13.

Compiler's Notes. Acts 2018, ch. 978, § 14 provided that this section shall terminate on July 1, 2023 and law in effect prior to this act shall be restored.

Effective Dates. Acts 2018, ch. 978, § 15. July 1, 2018; provided, that for rulemaking purposes, the act took effect May 21, 2018.

63-1-163. Partial fill for prescription for controlled substance — Partial fill for opioid.

1. As used in this section:
   1. “Original prescription” means a prescription for a controlled substance from an authorized prescriber that is presented by the patient to the pharmacist or submitted electronically to the pharmacy; and
   2. “Partial fill” means a prescription filled in a lesser quantity than the amount specified on the prescription for the patient.
2. 1. A prescription for a controlled substance may be partially filled if:
      1. The partial fill is requested by the patient or the practitioner who wrote the prescription; and
      2. The total quantity dispensed through partial fills pursuant to subdivision (b)(1)(A) does not exceed the total quantity prescribed for the original prescription.
   2. If a partial fill is made, the pharmacist shall retain the original prescription at the pharmacy where the prescription was first presented and the partial fill dispensed.
   3. Any subsequent fill must occur at the pharmacy that initially dispensed the partial fill. Any subsequent fill must be filled within six (6) months from issuance of the original prescription, unless federal law requires it to be filled within a shorter timeframe.
3. 1. If a partial fill is dispensed, the pharmacist shall only record in the controlled substance database the partial fill amount actually dispensed.
   2. If a partial fill is dispensed, the pharmacist shall notify the prescribing practitioner of the partial fill and of the amount actually dispensed:
      1. Through a notation in the interoperable electronic health record of the patient;
      2. Through submission of information to the controlled substance database;
      3. By electronic or facsimile transmission; or
      4. Through a notation in the patient's record that is maintained by the pharmacy, and that is accessible to the practitioner upon request.
   3. Nothing in this section shall be construed to conflict with or supersede any other requirement established in this part or title 53, chapter 10 or 11, for a prescription of a controlled substance.
4. 1. [Deleted by 2019 amendment.]
   2. A pharmacist or pharmacy is authorized to charge a dispensing fee to cover the actual supply and labor costs associated with the dispensing of the original prescription of an opioid and each partial fill associated with the original prescription.
   3. Any cost sharing, copayment, dispensing fee, or any portion thereof, made to a pharmacist or pharmacy for the dispensing of a partial fill of an opioid shall not be considered an overpayment.
   4. A health insurance issuer or pharmacy benefits manager shall not utilize partial fills of an opioid to reduce payments to a pharmacist or pharmacy for dispensing multiple partial fills.
5. 1. [Deleted by 2019 amendment.]
   2. A pharmacist or pharmacy is authorized to charge a dispensing fee to cover the actual supply and labor costs associated with the dispensing of the original prescription of a controlled substance other than an opioid and each partial fill associated with the original prescription.
   3. Any cost sharing, copayment, dispensing fee, or any portion thereof, made to a pharmacist or pharmacy for the dispensing of a partial fill of a controlled substance other than an opioid shall not be considered an overpayment.
   4. A health insurance issuer or pharmacy benefits manager shall not utilize partial fills of a controlled substance other than an opioid to reduce payments to a pharmacist or pharmacy for dispensing multiple partial fills.
6. By January 1, 2021, all pharmacy dispensing software vendors operating in this state shall update their dispensing software systems to allow for partial filling of controlled substances pursuant to this section.

Acts 2018, ch. 1007, § 1; 2019, ch. 124, §§ 5, 6, 14, 15.

Compiler's Notes. Acts 2018, ch. 1007, § 2 provided that subsection (d) of this section shall take effect January 1, 2019, and, as amended by Acts 2019, ch. 124, § 15, that  subsection (e) of this section shall take effect July 1, 2019.

Amendments. The 2019 amendment, in (b)(3), substituted both occurrences of “must” for “shall”, substituted “six (6) months” for thirty (30) days”, and added “, unless federal law requires it to be filled within a shorter timeframe” at the end; deleted former (d)(1) which read: “A person who presents a prescription for a partial fill for an opioid pursuant to this section is required to pay the prorated portion of cost sharing and copayments.”; deleted former (e)(1) (which never took effect); and added (f). See Compiler’s Notes.

Effective Dates. Acts 2018, ch. 1007, § 2. May 1, 2019; January 1, 2019; July 1, 2019.

Acts 2019, ch. 124, § 16. April 9,  2019.

63-1-164. Restrictions and limitations on treating patient with opioids. [Effective until July 1, 2023.]

1. As used in this section:
   1. “Alternative treatments” includes, but is not limited to, treatments such as chiropractic care, physical therapy, nonopioid medicinal drugs or drug products, occupational therapy, acupuncture, interventional procedures or treatments, and other such treatments that relieve pain without the use of opioids;
   2. “Encounter” means a single visit where an opioid is administered or an opioid prescription is issued or dispensed;
   3. “Healthcare practitioner” means a person licensed under this title who has the authority to prescribe or dispense controlled substances in the course of professional practice;
   4. “ICD-10 code” means the code established in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) adopted by the federal centers for medicare and medicaid services, or the code used in any successor classification system adopted by the federal centers for medicare and medicaid services, that corresponds to the diagnosis of the condition being treated;
   5. 1. “Informed consent” means consent voluntarily given in writing by the patient or the patient's legal representative after sufficient explanation and disclosure by the healthcare practitioner of the subject matter involved to enable the person whose consent is sought to make a knowing and willful decision. This explanation and disclosure by the healthcare practitioner to the patient or the patient's legal representative before consent may be obtained must include, at a minimum:
         1. Adequate information to allow the patient or the patient's legal representative to understand:
            1. The risks, effects, and characteristics of opioids, including the risks of physical dependency and addiction, misuse, and diversion;
            2. What to expect when taking an opioid and how opioids should be used; and
            3. Reasonable alternatives to opioids for treating or managing the patient's condition or symptoms and the benefits and risks of the alternative treatments;
         2. A reasonable opportunity for questions by the patient or patient's legal representative;
         3. Discussion and consideration by the patient or the patient's legal representative and the healthcare practitioner of whether the patient should take an opioid medication; and
         4. If the patient is a woman of childbearing age and ability, information regarding neonatal abstinence syndrome and specific information regarding how to access contraceptive services in the community. For purposes of this section, childbearing age is between the ages of fifteen (15) and forty-four (44);
      2. Nothing in subdivision (a)(5)(A) limits other requirements imposed on healthcare practitioners by law or applicable licensing authority;
   6. “Morphine milligram equivalent dose” means the morphine milligram equivalent calculation for the amount of a prescribed opioid, multiplied by the days of treatment;
   7. “Palliative care” means specialized treatment for patients facing serious illness, which focuses on providing relief of suffering through a multidisciplinary approach in order to maximize quality of life for the patient. As used in this subdivision (a)(7), “serious illness” means a health condition that carries a high risk of mortality and negatively impacts a patient's daily bodily functions; and
   8. “Treat” means prescribe, dispense, or administer.
2. Except as provided in this section, a healthcare practitioner shall not treat a patient with more than a three-day supply of an opioid and shall not treat a patient with an opioid dosage that exceeds a total of one hundred eighty (180) morphine milligram equivalent dose. A healthcare practitioner shall not be required to include an ICD-10 code on any prescription for an opioid of a three-day supply or less and an opioid dosage of less than one hundred eighty (180) morphine milligram equivalent.
3. 1. A patient shall not be treated with an opioid more frequently than every ten (10) days; provided, however, that if the patient has an adverse reaction to an opioid, a healthcare practitioner may treat a patient with a different opioid within a ten-day period under the following circumstances:
      1. The healthcare practitioner is employed by the same practice that initially treated the patient with the opioid that caused the adverse reaction;
      2. The healthcare practitioner personally evaluates the patient, assesses the patient's adverse reaction, and determines a different course of treatment is more medically appropriate;
      3. The healthcare practitioner confirms with the dispenser that the remainder of the initial prescription has been cancelled by the dispenser;
      4. The healthcare practitioner counsels the patient to appropriately destroy any remaining opioids that were previously dispensed to the patient; and
      5. The healthcare practitioner's treatment of the patient conforms to the requirements of this section.
   2. Notwithstanding subdivision (c)(1), where the treatment provided by a healthcare practitioner is prescribing an opioid, the healthcare practitioner may authorize the prescription to be dispensed by partial fill by placing “partial fill” or “PF” on the prescription.
4. 1. 1. A healthcare practitioner may treat a patient with more than a three-day supply of an opioid if the healthcare practitioner treats the patient with no more than one (1) prescription for an opioid per encounter and:
         1. Personally conducts a thorough evaluation of the patient;
         2. Documents consideration of non-opioid and non-pharmacologic pain management strategies and why the strategies failed or were not attempted;
         3. Includes the ICD-10 code for the primary disease in the patient's chart, and on the prescription when a prescription is issued; and
         4. Obtains informed consent and documents the reason for treating with an opioid in the chart.
      2. A healthcare practitioner who is dispensing pursuant to a prescription written by another healthcare practitioner for more than a three-day supply of an opioid is not required to satisfy subdivisions (d)(1)(A)(i)-(iv) when filling a prescription that contains an ICD-10 code; provided, that the healthcare practitioner shall not dispense more than one (1) prescription for an opioid to a patient per encounter.
   2. If a healthcare practitioner treats a patient with more than a three-day supply of an opioid, the healthcare practitioner may treat the patient with no more than a ten-day supply and with a dosage that does not exceed a total of a five hundred (500) morphine milligram equivalent dose.
   3. Notwithstanding subdivision (d)(2), in rare cases where the patient has a condition that will be treated by a procedure that is more than minimally invasive and sound medical judgment would determine the risk of adverse effects from the pain exceeds the risk of the development of a substance use disorder or overdose event, a healthcare practitioner may treat a patient with up to a thirty-day supply of an opioid and with a dosage that does not exceed a total of a twelve hundred (1200) morphine milligram equivalent dose.
   4. Notwithstanding subdivision (d)(2), in rare cases after trial and failure of reasonable, appropriate, and available non-opioid treatments for the pain condition or documenting the contraindication, inefficacy, or intolerance of non-opioid treatments, where medical necessity and sound medical judgment would determine the risk of adverse effects from the pain exceeds the risk of the development of a substance use disorder or overdose event, a healthcare practitioner may treat a patient with up to a thirty-day supply of an opioid and with a dosage that does not exceed a total of a one thousand two hundred (1,200) morphine milligram equivalent dose. The healthcare practitioner must include the phrase “medical necessity” on the prescription for any prescription issued pursuant to this subdivision (d)(4).
5. The restrictions of this section do not apply to the following; provided, that where a prescription is issued pursuant to this subsection (e), the prescription contains the ICD-10 code for the primary disease documented in the patient's chart and the word “exempt”:
   1. The treatment of patients who are undergoing active cancer treatment, undergoing palliative care treatment, or are receiving hospice care;
   2. The treatment of patients with a diagnosis of sickle cell disease;
   3. The administration of opioids directly to a patient during the patient's treatment at any facility licensed under title 68, chapter 11, or any hospital licensed under title 33, chapter 2, part 4;
   4. Prescriptions issued by healthcare practitioners who are:
      1. Pain management specialists, as that term is defined in § 63-1-301, or who are collaborating with a pain management specialist in accordance with § 63-1-306(a)(3); provided, that the patient receiving the prescription is personally assessed by the pain management specialist, or by the advanced practice registered nurse or physician assistant collaborating with the pain management specialist; or
      2. Treating patients in an outpatient setting of a hospital exempt under § 63-1-302(2) that holds itself out to the public as a pain management clinic.
   5. The treatment of patients who have been treated with an opioid daily for ninety (90) days or more during the three hundred sixty-five (365) days prior to April 15, 2018, or those who are subsequently treated for ninety (90) days or more under one (1) of the exceptions listed in subdivision (d)(4) or this subsection (e);
   6. The direct administration of, or dispensing of, methadone for the treatment of an opioid use disorder to a patient who is receiving treatment from a healthcare practitioner practicing under 21 U.S.C. § 823(g)(1);
   7. The treatment of a patient for opioid use disorder with products that are approved by the U.S. food and drug administration for opioid use disorder by a healthcare practitioner under 21 U.S.C. § 823(g)(2);
   8. The treatment of a patient with a product that is an opioid antagonist and does not contain an opioid agonist; or
   9. The treatment of a patient who has suffered a severe burn or major physical trauma and for whom sound medical judgment would determine the risk of adverse effects from the pain exceeds the risk of the development of a substance use disorder or overdose event. As used in this subdivision (e)(9), “severe burn” means an injury sustained from thermal or chemical causes resulting in second degree or third degree burns. As used in this subdivision (e)(9), “major physical trauma” means a serious injury sustained due to blunt or penetrating force which results in serious blood loss, fracture, significant temporary or permanent impairment, or disability.
6. The commissioner of health, in consultation with the regulatory boards created pursuant to this title that license healthcare practitioners, shall study and analyze the impact and effects of the restrictions and limitations set forth in this section. No later than November 1, 2021, the commissioner shall issue a report relative to the impact and effects of the restrictions and limitations to the governor, the health and welfare committee of the senate, and the health committee of the house of representatives. The report may include recommendations for revisions to the restrictions on the prescription of opioids.
7. This section applies only to the treatment of human patients.
8. This section does not apply to opioids approved by the food and drug administration to treat upper respiratory symptoms or cough. However, a healthcare practitioner shall not treat a patient with more than a fourteen-day supply of such an opioid.

Acts 2018, ch. 1039, § 6; 2019, ch. 117, § 1; 2019, ch. 124, §§ 7-13; 2020, ch. 573, § 1.

Compiler's Notes. Acts 2018, ch. 1039, § 9 provided that sections 1 and 6 of the act, which enacted this section and amended § 53-10-303, shall terminate on July 1, 2023, and the law in effect prior to July 1, 2018 shall be restored.

Amendments. The 2019 amendment by ch. 117 added the definition of “alternative treatments” in (a).

The 2019 amendment by ch. 124, effective April 9, 2019, added the definition of “palliative care” in (a); rewrote (c)(2) which read: “(2)  (A)  Notwithstanding subdivision (c)(1), where the treatment provided by a healthcare practitioner is dispensing an opioid, the healthcare practitioner may treat a patient more than once within ten (10) days; provided, that the healthcare practitioner shall not dispense an opioid in an amount that exceeds the greater of:“(i)  A five-day supply per encounter; or“(ii)  Half of the total prescribed amount.“(B)  The healthcare practitioner may dispense the remainder in a subsequent encounter.“(C)  The partial fill requirements of this subdivision (c)(2) shall not be mandatory prior to January 1, 2019, for a dispenser who has not updated the dispenser's software system.”; substituted “thirty-day supply of an opioid and with a dosage that does not exceed a total of a twelve hundred (1200) morphine milligram equivalent dose” for “twenty-day supply of an opioid and with a dosage that does not exceed a total of an eight hundred fifty (850) morphine milligram equivalent dose” at the end of (d)(3); rewrote (e)(1) which read: “The treatment of patients who are undergoing active or palliative cancer treatment or who are receiving hospice care;”; in (e)(9), substituted “for whom sound medical judgment” for “, as those terms are defined by the controlled substance database committee by rule and adopted by the licensing boards created pursuant to title 63, and sound medical judgment” in the first sentence and added the last two sentences; and added (h); and, effective July 1, 2019, added the last sentence in (b).

The 2020 amendment substituted “nonopioid medicinal drugs or drug products, occupational therapy, acupuncture, interventional procedures or treatments, and other such treatments” for “acupuncture, and other such treatments” in the definition of “alternative treatments”.

Effective Dates. Acts 2018, ch. 1039, § 10. July 1, 2018; provided that for rulemaking purposes, the act took effect on May 21, 2018.

Acts 2019, ch. 117, § 2. April 9,  2019.

Acts 2019, ch. 124, § 16. April 9,  2019; July 1, 2019.

Acts 2020, ch. 573, § 2. March 19, 2020.

63-1-165. [Repealed.]

Acts 2018, ch. 1054, § 1; repealed by Acts 2019, ch. 222, § 1, effective April 30, 2019.

Compiler's Notes. Former § 63-1-165 concerned requirements for person practicing ultrasound sonography in nonclinical 3D/4D ultrasound boutique setting.

63-1-166. Acceptance of barter as payment for healthcare services.

1. Notwithstanding any law to the contrary, a healthcare professional may accept goods or services as payment in a direct exchange of barter for healthcare services provided by the healthcare professional if the patient to whom the healthcare services are provided is not covered by health insurance coverage, as defined by § 56-7-109. A healthcare professional who accepts barter as payment in accordance with this section shall annually submit a copy of the relevant federal tax form disclosing the healthcare professional's income from barter to the healthcare professional's licensing board. This section does not apply to any healthcare services provided at a pain management clinic as defined in § 63-1-301.
2. For purposes of this section, “healthcare professional” means a physician or other healthcare practitioner licensed, registered, accredited, or certified to perform specified healthcare services pursuant to this title or title 68 and regulated under the authority of the department of health or any agency, board, council, or committee attached to the department.

Acts 2019, ch. 229, § 1.

Effective Dates. Acts 2019, ch. 229, § 3. April 30, 2019.

63-1-167. Exemption from licensing requirements for medical professionals participating in federal lnnovative Readiness Training programs.

1. Notwithstanding any requirement for the licensure of a medical professional by a health related board listed in § 68-1-101, a medical professional who has a current license to practice from another state, commonwealth, territory, or the District of Columbia is exempt from the licensure requirements of such boards, if:
   1. The medical professional is an active or reserve member of the armed forces of the United States, a member of the national guard, a civilian employee of the United States department of defense, an authorized personal services contractor under 10 U.S.C. § 1091, or a healthcare professional otherwise authorized by the department of defense; and
   2. The medical professional is engaged in the practice of a medical profession listed in § 68-1-101 through a program in partnership with the federal Innovative Readiness Training.
2. The exemption provided by this section only applies while:
   1. The medical professional's practice is required by the program pursuant to military orders; and
   2. The services provided by the medical professional are within the scope of practice for the individual's respective profession in this state.
3. This section does not permit a medical professional exempt by this section to engage in the practice of a medical profession listed in § 68-1-101, except as part of federal Innovative Readiness Training as described in this section.
4. The respective health related board may promulgate rules to effectuate this section. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2019, ch. 255, § 1.

Compiler's Notes. The federal Innovative Readiness Training, referred to in this section, is codified at 10 U.S.C. § 2012.

Effective Dates. Acts 2019, ch. 255, § 2. July 1, 2019; provided that for purposes of promulgating rules, the act took effect April 30, 2019.

Part 2
Medical Practitioners Practicing in Free Health Clinics

63-3-101. “Podiatrist” defined — Performance of ankle surgery.

1. Within this chapter, “podiatrist” means one who examines, diagnoses or treats, medically mechanically or surgically, the ailments of the human foot, ankle and soft tissue structures extending no higher than the distal tibial metaphyseal flair, including the use and prescribing of drugs and medications, but excluding the direct applications of general anesthesia by a podiatrist and the amputation of the foot. A podiatrist may perform Achilles tendon repair, subject to subsection (b), but may not perform surgery on Pilon fractures or tibial fractures that do not enter the ankle joint.
2. A licensed podiatrist may perform ankle surgery only when that podiatrist meets the requirements of either subdivision (b)(1) or (b)(2):
   1. Was, prior to October 2, 1995, credentialed to perform ankle surgery by a JCAHO accredited hospital in Tennessee or JCAHO accredited ambulatory surgical treatment center in Tennessee; provided, that a podiatrist who qualifies to perform ankle surgery under this subdivision (b)(1) must, if the podiatrist wishes to continue to perform ankle surgery:
      1. Notify the board as to the hospital or ambulatory surgical treatment center at which the podiatrist was credentialed to perform ankle surgery prior to October 2, 1995;
      2. Obtain and maintain evidence of obtaining at least ten (10) hours of approved continuing education related to ankle surgery annually; and
      3. Comply with any other requirements established by the board to ensure continued proficiency in performing ankle surgery; or
   2. Has completed a surgical residency program at least twenty-four (24) months in length that has been approved by the council on podiatric medical education and is currently eligible for certification to perform reconstructive rearfoot/ankle surgery by the American Board of Podiatric Surgery; provided, that a podiatrist who qualifies to perform ankle surgery under this subdivision (b)(2) must obtain certification to perform reconstructive rearfoot/ankle surgery from the American Board of Podiatric Surgery within six (6) years of May 24, 2000, or within six (6) years of first becoming eligible for certification, whichever date is later, and may not continue to perform ankle surgery if that podiatrist has not obtained certification by the end of the six-year period.
3. A licensed podiatrist may perform ankle surgery only in an accredited hospital or ambulatory surgical treatment center licensed under title 68 at which the podiatrist has surgical privileges to perform ankle surgery. For purposes of this subsection (c), an accredited hospital is one that is accredited by joint commission or the American Osteopathic Association, and an accredited ambulatory surgical treatment center is one that is accredited by joint commission, Accreditation Association for Ambulatory Health Care or American Association for Accreditation of Ambulatory Surgical Facilities. A podiatrist who performs ankle surgery in an ambulatory surgical treatment center must first have surgical privileges to perform ankle surgery at a local hospital. A licensed podiatrist who performs ankle surgery must meet the same standard of care applicable to orthopedic surgeons who perform ankle surgery.
4. Licensed podiatrists may perform nonsurgical care on the ankle without meeting the requirements of subsection (b).
5. A licensed podiatrist may collaborate with a physician assistant or an orthopedic physician assistant licensed pursuant to chapter 19 of this title. A podiatrist collaborating with a physician assistant pursuant to this subsection (e) shall comply with the requirements of and any rules adopted pursuant to §§ 63-19-106 and 63-19-107 governing collaboration with a physician assistant. A podiatrist collaborating with an orthopedic physician assistant pursuant to this subsection (e) shall comply with the requirements of and any rules adopted pursuant to §§ 63-19-203 — 63-19-205 governing collaboration with an orthopedic physician assistant.

Acts 1931, ch. 31, § 1; C. Supp. 1950, § 7182.1; Acts 1963, ch. 290, § 1; 1971, ch. 188, § 2; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-301; Acts 2000, ch. 828, § 1; 2004, ch. 668, § 1; 2009, ch. 422, § 11; 2016, ch. 946, § 1; 2018, ch. 610, § 2.

Compiler's Notes. JCAHO, referred to in this section, is the Joint Commission on Accreditation of Healthcare Organizations.”

Amendments. The 2018 amendment, in (e), substituted “may collaborate with” for “may supervise” in the first sentence, substituted “A podiatrist collaborating with” for “A podiatrist supervising” at the beginning of the second and third sentences, substituted “collaboration with a physician assistant” for “the supervision of a physician assistant” at the end of the second sentence, and substituted “collaboration with” for “the supervision” of in  the last sentence.

Effective Dates. Acts 2018, ch. 610, § 42. July 1, 2018.

Cross-References. Assignment of insurance benefits to health care provider, § 56-7-120.

Liability of professional societies, title 62, ch. 50, part 1.

Occupation tax on podiatrists, title 67, ch. 4, part 17.

State examining boards, general provisions, title 4, ch. 19, part 1.

Law Reviews.

Report on Administrative Law to the Tennessee Law Revision Commission, 20 Vand. L. Rev. 777.

63-3-102. Chapter definitions.

As used in this chapter, unless the context otherwise requires:

1. “Board” means the board of podiatric medical examiners; and
2. “Division” means the division of health related boards of the department of health.

Acts 1931, ch. 31, § 3; C. Supp. 1950, § 7182.15 (Williams, § 7182.16); Acts 1971, ch. 188, § 1; T.C.A. (orig. ed.), § 63-302; Acts 1984, ch. 937, § 4; 2005, ch. 228, § 1.

63-3-103. Board of podiatric medical examiners — Members.

1. A board of examiners is established, to be known by the name and title of “board of podiatric medical examiners.”
2. The governor shall appoint four (4) persons who have been licensed podiatrists for a period of at least two (2) years in this state as members of this board. The terms of office shall be for four (4) years. In making appointments to the board of podiatric medical examiners, the governor shall strive to ensure that at least one (1) person serving on the board is sixty (60) years of age or older and that at least one (1) person serving on the board is a member of a racial minority.
3. Upon the expiration of the term of a member, the governor shall appoint the member's successor for a term of four (4) years.
4. The governor has the power to remove from office members of the board for neglect of duties as required by this chapter, or for malfeasance in office and incompetency or for unprofessional conduct. The governor has the authority to fill any vacancy caused by the removal of any member of the board by the member's resignation or death, from a list of all licensed podiatrists who have practiced not less than two (2) years in this state.

Acts 1931, ch. 31, § 3; mod. C. Supp. 1950, § 7182.13 (Williams, § 7182.14); Acts 1971, ch. 188, § 1; T.C.A. (orig. ed.), § 63-303; Acts 1988, ch. 1013, § 40; 1993, ch. 181, § 2; 2005, ch. 228, § 2; 2009, ch. 422, §§ 1, 2, 12.

Compiler's Notes. The regulatory board created by this section is attached to the division of health related boards in the department of health.

The board of podiatric medical examiners, created by this section, terminates June 30, 2021. See §§ 4-29-112, 4-29-242.

Cross-References. Prevention of HIV transmission, rulemaking authority, § 68-11-222.

63-3-104. Organization, meetings and compensation of board.

1. The board shall elect a chair and a secretary from its own members.
2. The board shall hold one (1) regular meeting in each year and such additional meetings at such times and places as it may determine.
3. Each member of the board shall receive one hundred dollars ($100) per diem when actually engaged in the discharge of official duties and, in addition, shall be reimbursed for all travel and other necessary expenses. All expenses shall be claimed and paid in accordance with prevailing travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 1931, ch. 31, § 3; C. Supp. 1950, § 7182.13 (Williams, § 7182.14); Acts 1971, ch. 188, § 1; 1973, ch. 393, § 3; 1976, ch. 796, § 1; 1976, ch. 806, § 1(111); T.C.A., § 63-304; Acts 2009, ch. 422, § 3.

63-3-105. Disposition of fees — Expenditures.

1. All fees and moneys from whatever source coming into the hands of the board shall be paid by the board to the state treasurer and become a part of the general fund.
2. The commissioner of finance and administration shall make allotments out of the general fund for the proper expenditures of the board, and no expenditure may be made by the board until allotment therefor has been made by the commissioner. The allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.

Acts 1931, ch. 31, § 3; C. Supp. 1950, § 7182.13 (Williams, § 7182.14); modified; impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; Acts 1971, ch. 188, §§ 1-3; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-305.

63-3-106. General powers of board.

The board has the powers and duties, in addition to powers and duties granted to or imposed upon it by the other sections of this chapter, to:

1. Adopt and promulgate rules and regulations as may be necessary to govern its proceedings and carry into effect the purpose of this chapter;
2. Conduct examinations to ascertain the qualifications and fitness of applicants for a license to practice podiatry in this state;
3. Provide standards by which podiatry schools and colleges shall be approved;
4. Direct the division to issue a license for applicants who successfully pass the examination for the practice of podiatry;
5. Conduct hearings, to revoke or suspend any license or certificate under the authority of this chapter or any previous laws authorizing the holder thereof to practice podiatry for violations by a licensee of any of the provisions of this chapter or any rule or regulation of the board properly adopted and promulgated by the board; and
6. Sponsor, conduct or approve such educational programs as are necessary to carry out and make effective this chapter.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.2; impl. am. Acts 1971, ch. 161, § 3; Acts 1971, ch. 188, §§ 1, 5; 1973, ch. 393, § 5; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-306; Acts 1984, ch. 937, § 5.

63-3-107. Unlawful practice.

1. It is unlawful for any person to practice or attempt to practice podiatry in this state unless such person has been issued a valid and current license to practice podiatry by this board as provided by this chapter.
2. If any person uses any name or title that would designate that person as a podiatrist or imply that that person was or is qualified to practice podiatry under this chapter, it is deemed prima facie evidence of practicing within the meaning of this chapter.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.2; impl. am. Acts 1971, ch. 161, § 3; Acts 1971, ch. 188, §§ 1, 5; 1973, ch. 393, § 5; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-307; Acts 1984, ch. 937, § 6.

63-3-108. Exemptions.

This chapter shall not apply to the commissioned physicians and surgeons of the United States army, navy, air force or marine hospital service in the actual performance of their official duties, nor to physicians and surgeons or to osteopathic physicians and surgeons regularly licensed under the laws of this state, nor to visiting podiatrists called into consultation in this state from another state where they are duly qualified under the laws of that state to practice podiatry.

Acts 1931, ch. 31, § 2; 1949, ch. 152, § 1; C. Supp. 1950, § 7182.3 (Williams, § 7182.4); modified; Acts 1973, ch. 393, § 6; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-308.

63-3-109. Academic license — License to practice — Requirements — Podiatrists licensed in other states.

1. Any person desiring an academic license to participate in a residency program shall:
   1. Apply on a form prescribed by the board or via online application for an academic license;
   2. Pay a fee as determined by the board; and
   3. Have a residency program accepted by the board certify that the applicant has been accepted for its program.
2. The academic license shall terminate upon the applicant leaving the residency program.
3. Any person desiring to become licensed to practice podiatry in this state must:
   1. Make application to the secretary of the board on a form prescribed by the board;
   2. Pay an application fee as determined by the board;
   3. Pass the examination conducted or accepted by the board; and
   4. Successfully complete at least a one-year residency program approved by the Council on Podiatric Medical Education or its successor organization.
4. The board shall have the authority to issue locum tenens licenses to podiatrists licensed in another state who wish to practice podiatry in this state for a limited period of time and who meet all the requirements established by the board by rule for a locum tenens license.

Acts 1976, ch. 796, § 1; T.C.A., § 63-309; Acts 1984, ch. 937, § 7; 1986, ch. 675, § 14; 1990, ch. 886, § 1; 2009, ch. 422, §§ 4-7; 2014, ch. 949, § 4.

63-3-110. Qualifications of applicants — Educational standards.

No person shall be entitled to take any examination for a license unless that person furnishes the board with satisfactory proof that the person is at least eighteen (18) years of age, is of good moral character and has graduated from a college of podiatric medicine which is accredited by the Council on Podiatric Medical Education or its successor organization.

Acts 1931, ch. 31, § 2; 1935, ch. 60, § 1; 1949, ch. 152, § 1; C. Supp. 1950, § 7182.3 (Williams, § 7182.4); Acts 1971, ch. 161, § 2; 1971, ch. 188, §§ 1, 6; 1973, ch. 393, § 8; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-310; Acts 1984, ch. 937, § 8; 2009, ch. 422, § 8.

Law Reviews.

Tennessee Civil Disabilities: A Systemic Approach (Neil P. Cohen), 41 Tenn. L. Rev. 253 (1974).

63-3-111. Contents of examination — Grade requirement — Fee.

1. 1. The board may conduct examinations at such times and places as it may designate.
   2. Examinations shall be in the English language, written and clinical, and shall include subjects of histology, surgery, hygiene, dermatology, anatomy, physiology, chemistry, bacteriology, pathology, diagnosis and treatment, materia medica and therapeutics, and clinical podiatry and such additional subjects as are pertinent to podiatry; but such examinations shall be so limited in their scope as to cover only the requirements for podiatry education as provided in this chapter.
   3. The board may accept the report of the National Board of Podiatric Medical Examiners on any examinee.
2. The board shall establish the minimum passing grade by regulation.
3. The board may set an examination fee.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.5 (Williams, § 7182.6); Acts 1971, ch. 188, § 1; 1973, ch. 393, § 9; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-311; Acts 1984, ch. 937, § 9; 1990, ch. 886, § 2; 2009, ch. 422, § 9.

63-3-112. Reexamination.

An applicant who fails to pass an examination satisfactory to the board, and is therefore refused a license, is entitled, within six (6) months after such refusal, to a reexamination upon payment of an additional fee as set annually by the board for each such reexamination.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.7 (Williams, § 7182.8); Acts 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-312; Acts 1984, ch. 937, § 10; 1986, ch. 675, § 15; 1989, ch. 523, § 65.

63-3-113. Issuance of licenses.

If an applicant successfully passes the examination provided by this chapter and meets all of the requirements of this chapter, the board shall direct the division to issue the applicable license.

Acts 1931, ch. 31, § 2; 1949, ch. 152, § 1; C. Supp. 1950, § 7182.3 (Williams, § 7182.4); Acts 1971, ch. 188, § 7; 1973, ch. 393, § 10; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-313; Acts 1984, ch. 937, § 11.

63-3-114. Reciprocity.

The board, in its discretion, may waive the examination required by § 63-3-109(c)(3) and may issue a license to any applicant who holds or possesses a valid license to practice podiatry in another state; provided, that the requirements for licensure in such state are, in the opinion of the board, at least equivalent to the requirements for licensure provided by this chapter and that such applicant pays a fee as set by the board.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.4 (Williams, § 7182.5); Acts 1971, ch. 188, § 8; 1973, ch. 393, § 11; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-314; Acts 1984, ch. 937, § 12; 1989, ch. 523, § 66.

63-3-115. Renewal of license.

1. Each person licensed to practice as a podiatrist in this state shall biennially apply to the board for renewal of the person's license and shall pay a renewal fee set by the board. A podiatrist who fails to renew the license by the date of expiration of the license shall not continue to practice as a podiatrist in this state.
2. A podiatrist who fails to timely renew the license may seek reinstatement from the board. The board may reinstate the license upon good cause shown, upon payment of all past due renewal fees and a late renewal fee and upon compliance with any other reasonable conditions imposed by the board.
3. The board may utilize the renewal system described in § 63-1-107.
4. Any licensed podiatrist who has retired from practice in this state shall not be required to renew the license if the person retired from practice files with the board an affidavit of retirement on a form furnished by the board. The affidavit shall state the date on which the person retired from practice and such other facts as the board deems necessary to verify retirement. If the person thereafter wishes to reenter practice in this state, the person shall apply for license reactivation, pay the reactivation fee set by the board and meet such other reasonable requirements deemed necessary by the board.

Acts 1931, ch. 31, § 4; C. Supp. 1950, § 7182.16 (Williams, § 7182.17); Acts 1973, ch. 393, § 12; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-315; Acts 1984, ch. 937, § 13; 1986, ch. 675, § 16; 1989, ch. 523, §§ 67, 68; 2005, ch. 228, § 4.

63-3-116. Continuing medical education — Exemptions.

1. As a condition of the biennial renewal of a podiatrist license, every licensed podiatrist must obtain at least fifteen (15) hours of continuing medical education each calendar year in programs approved by the board. The only basis upon which a podiatrist may seek an exemption from this requirement or an extension of time for meeting this requirement is illness or disability.
2. Podiatrists who have properly retired their licenses pursuant to § 63-3-115(d) are exempt from the requirement of subsection (a).

Acts 1931, ch. 31, § 5; 1949, ch. 152, § 3; C. Supp. 1950, § 7182.17 (Williams, § 7182.18); Acts 1971, ch. 188, § 9; 1974, ch. 495, § 7; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-316; Acts 1984, ch. 937, § 14; 1986, ch. 675, §§ 3, 17; 1988, ch. 600, § 1; 1989, ch. 360, § 17; 1989, ch. 523, §§ 69, 70; 2005, ch. 228, § 5.

63-3-117. Application of health laws.

Licensed podiatrists shall observe and be subject to all state and municipal regulations relating to the control of contagious and infectious diseases and all matters pertaining to public health, making reports to proper health officers in the same manner as other practitioners of the healing arts are required to make.

Acts 1931, ch. 31, § 8; C. Supp. 1950, § 7182.20 (Williams, § 7182.21); Acts 1971, ch. 188, § 1; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-317.

63-3-118. Services provided by physician assistant or orthopedic physician assistant collaborating with podiatrist.

A physician assistant collaborating with a licensed podiatrist shall not provide services that are outside of the scope of practice of a podiatrist as set forth in § 63-3-101 and may prescribe only drugs that are rational to the practice of podiatry. An orthopedic physician assistant collaborating with a licensed podiatrist shall not provide services that are outside of the scope of practice of a podiatrist as set forth in § 63-3-101.

Acts 2016, ch. 946, § 2; 2018, ch. 610, § 3.

Compiler's Notes. Former § 63-3-118 (Acts 1931, ch. 31, § 9; C. Supp. 1950, § 7182.21 (Williams, § 7182.22); Acts 1971, ch. 188, § 1; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-318), concerning jury duty exemption for licensed podiatrists, was repealed by Acts 2008, ch. 1159, § 6, effective January 1, 2009.

Amendments. The 2018 amendment substituted “collaborating with” for “supervised by” in the first and second sentences.

Effective Dates. Acts 2018, ch. 610, § 42. July 1, 2018.

63-3-119. Suspension or revocation of license — Enforcement.

1. The board has the duty and authority to suspend for a specified time, within the discretion of the board or to revoke any license to practice podiatry or to otherwise discipline any licensee or refuse to grant any certificate of fitness whenever the licensee or applicant is found guilty of any of the following acts or offenses:
   1. Fraud in procuring a license or certificate;
   2. Conviction of a felony, conviction of any offense under state or federal drug laws or conviction of any offense involving moral turpitude;
   3. Habitual intoxication or personal misuse of any drugs;
   4. Immoral, unethical, unprofessional or dishonorable conduct;
   5. Solicitation by agents or persons or profiting by the acts of those representing themselves to be agents of the licensee or the certificate holder;
   6. Division of fees or agreeing to split or divide fees received for professional services with any person for bringing or referring a patient;
   7. Professional connection or association with any person, firm or corporation in any manner in an effort to avoid and circumvent this chapter or lending one's name to another for the illegal practice of podiatry by such person;
   8. Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate this chapter or any lawful order of the board; issued pursuant thereto, or any criminal statute of this state;
   9. Giving of testimonials, directly or indirectly, concerning the supposed virtue of secret therapeutic agents or proprietary preparations, such as remedies, vaccines or other articles or materials that are offered to the public, claiming radical cure or prevention of disease by their use;
   10. Any other unprofessional or unethical conduct that may be specified by the board from time to time by means of rules and regulations duly published and promulgated by the board or the violation of any provision of this chapter;
   11. Making false statements or representations or being guilty of fraud or deceit in the practice of podiatry;
   12. Invasion of a field of practice in which the licensee is not licensed to practice or is not within the limits of the licensee's respective callings;
   13. Dispensing, prescribing or otherwise distributing any controlled substance or any other drug not in the course of professional practice or not in good faith to relieve pain and suffering, or not to cure an ailment, physical infirmity or disease;
   14. Dispensing, prescribing or otherwise distributing any controlled substance, controlled substance analogue or any other drug to any person in violation of any law of the state or of the United States;
   15. Practicing podiatry under any trade name or a name designating a given location or the name of another podiatrist or any name other than that which appears on the practitioner's license or using any title other than “podiatrist”; provided, that “foot specialist” may be used as an explanatory term of the title “podiatrist” and not alone or as a substitute for the title “podiatrist”;
   16. Willful violation of the rules and regulations that may be promulgated by the board of podiatric medical examiners to regulate advertising by practitioners who are under the jurisdiction of the board;
   17. Making or signing in one's professional capacity any certificate that is known to be false at the time one makes or signs such certificate;
   18. Engaging in the practice of podiatry when mentally or physically unable to safely do so; or
   19. Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of the practice of podiatry.
2. The board of podiatric medical examiners may adopt rules and regulations to regulate the nature, manner, content and extent of advertising by practitioners who are under the jurisdiction of the board. All methods must be allowed such as: newspaper, radio and television.
3. 1. For purposes of enforcement of this section, the board shall, upon probable cause, have authority to compel an applicant or licensee to submit to a mental and/or physical examination by a designated committee of at least three (3) practicing physicians, including a psychiatrist where a question of mental condition may be involved.
   2. The applicant or licensee shall have the right to have an independent medical practitioner present during such examination and to have an independent physical or mental examination, the report of which shall be filed with the board for consideration.
   3. The committee will submit a report of its findings to the board, which will then hold a hearing as provided in § 63-3-120.
4. An action taken under this section shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.8 (Williams, § 7182.9); Acts 1971, ch. 188, §§ 1, 10; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-319; Acts 1985, ch. 120, §§ 2-6; 2005, ch. 228, § 3; 2009, ch. 422, § 10; 2012, ch. 798, § 34; 2012, ch. 848, § 66; 2018, ch. 745, § 22.

Amendments. The 2018 amendment added (d).

Effective Dates. Acts 2018, ch. 745, § 46. July 1, 2018.

Cross-References. Grounds for license denial, suspension or revocations, § 63-6-214.

63-3-120. Administrative procedure.

All proceedings for disciplinary action against a licensee under this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.9 (Williams, § 7182.10); Acts 1971, ch. 188, § 1; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-320; Acts 1985, ch. 120, § 7.

Cross-References. Review of quasi-judicial bodies generally, title 27, ch. 9.

63-3-121. Enjoining violations.

1. The board, in addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license and in the matter of the refusal to issue a certificate, is authorized and empowered to petition any circuit or chancery court, having jurisdiction, to enjoin any person who is practicing or attempting to practice podiatry without possessing a valid license to so practice and to enjoin any person, firm or corporation from performing any act or rendering any service that constitutes the practice of podiatry as defined by this chapter. No injunction bond shall be required of the board.
2. Jurisdiction is conferred upon the circuit and chancery courts of the state to hear and determine such causes as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.10 (Williams, § 7182.11); Acts 1971, ch. 188, § 1; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-321.

Cross-References. Enjoining violations, § 63-1-121.

Law Reviews.

The Tennessee Court System — Chancery Court (Frederic S. Le Clercq), 8 Mem. St. U.L. Rev. 281.

The Tennessee Court System — Circuit Court (Frederic S. Le Clercq), 8 Mem. St. U.L. Rev. 241.

63-3-122. District attorneys to assist board.

1. The board at all times has the power to call upon the district attorneys general for the state in the various districts to assist the board.
2. It is hereby declared to be the duty of all district attorneys general throughout the state to assist the board, upon its request, in any suit for injunction or prosecution instituted by the board without charge or additional compensation to the district attorneys general.

Acts 1931, ch. 31, § 2; 1949, ch. 152, § 2; mod. C. Supp. 1950, § 7182.11 (Williams, § 7182.12); Acts 1971, ch. 188, § 1; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-322.

63-3-123. Criminal penalties.

1. 1. Any person who violates any provision of this chapter commits a Class B misdemeanor.
   2. Upon being convicted of any violation of any provision of this chapter, any person who again violates any of the provisions of this chapter commits a Class E felony.
2. Any person who has been enjoined by a court of competent jurisdiction from performing any acts or rendering any services that constitute the practice of podiatry as defined by this chapter who thereafter willfully violates the terms of the injunction by again performing such acts or rendering such services commits a Class E felony.

Acts 1931, ch. 31, § 2; C. Supp. 1950, § 7182.12 (Williams, § 7182.13); Acts 1971, ch. 188, § 1; 1976, ch. 796, § 1; T.C.A. (orig. ed.), § 63-323; Acts 1989, ch. 591, §§ 79, 80, 112.

Cross-References. Penalty for Class B misdemeanor, § 40-35-111.

Penalty for Class E felony, § 40-35-111.

63-3-124. Retail sales of foot appliances and shoes.

No part or portion of this chapter shall be deemed to prohibit the usual and customary commercial sale and adjustment of foot appliances and remedies or shoes in retail stores.

Acts 1931, ch. 31, § 10; C. Supp. 1950, § 7182.22 (Williams, § 7182.23); T.C.A. (orig. ed.), § 63-326.

63-3-125. Regulations relating to X-ray procedures.

1. 1. The board shall adopt rules and regulations that establish minimum educational standards and criteria for persons operating X-ray equipment for diagnostic purposes in podiatrist offices.
   2. These regulations may include, but not be limited to, provisions for grandfathering, waiver, reciprocity, renewal, continuing education, fees, examination and hardship cases.
2. After the effective date of the rules and regulations, no person shall perform X-ray procedures in a podiatrist office who does not meet these standards and who has not received a certificate of proficiency from the board.

Acts 1990, ch. 886, § 3.

63-3-126. Cost of prosecution — Administering oaths.

1. The board shall promulgate rules governing the assessment of costs against a licensee or other person found by the board to have violated any provision of this chapter. The costs assessed by the board may include only those costs directly related to the prosecution of the charges against the licensee or other person, including investigatory costs where appropriate. The board shall determine the appropriate amount of costs, if any, to be assessed in a contested case. These costs shall be reasonable and proportionate in light of the violation committed by the licensee or other person.
2. 1. Any elected officer of the board, or any duly appointed or elected chair has the authority to administer oaths to witnesses. Upon probable cause being established, the board, by a vote of two thirds (2/3) of the members to which the board is entitled, may issue subpoenas for the attendance of witnesses and the production of documents and records.
   2. Service of a subpoena issued by the board shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
   3. 1. A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the board for the sole purpose of making a special appearance to quash or modify the subpoena. The subpoena for attendance of the person or the production of books and records shall be stayed until the board votes upon the request to quash or modify the subpoena. A majority vote of the members to which the board is entitled shall be required to quash or modify a subpoena.
      2. A motion to appeal from a decision by the board regarding a request to quash or modify a subpoena shall be made to the chancery court in Davidson County within fifteen (15) days of such decision.
   4. If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides; and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered. Any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
   5. Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.

Acts 1999, ch. 437, § 3.

Cross-References. Payment of costs of investigation and prosecution, § 63-1-144.

Attorney General Opinions. The board of registration in podiatry has authority to issue administrative subpoenas to compel the attendance of witnesses or the production of documents prior to the commencement of an administrative action, OAG 01-055, 2001 Tenn. AG LEXIS (4/10/01).

63-3-127. Drug prescriptions.

1. Any handwritten prescription order for a drug prepared by a podiatrist who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing podiatrist, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing podiatrist must sign the handwritten prescription order on the day it is issued, unless it is a standing order issued in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201.
2. Any typed or computer-generated prescription order for a drug issued by a podiatrist who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer-generated prescription order must contain the name of the prescribing podiatrist, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug, and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing podiatrist must sign the typed or computer-generated prescription order on the day it is issued, unless it is a standing order issued in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201.
3. Nothing in this section shall be construed to prevent a podiatrist from issuing a verbal prescription order.
4. 1. All handwritten, typed or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the United States Troop Readiness, Veterans' Care, Katrina Recovery, and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions.
   2. Subdivision (d)(1) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.

Acts 2004, ch. 678, § 3; 2005, ch. 12, § 1; 2008, ch. 1035, §§ 2, 9; 2010, ch. 795, § 13; 2013, ch. 74, § 2.

Compiler's Notes. Acts 2004, ch. 678, § 1 provided that the title of the act is and may be cited as the “Medication Error Reduction Act of 2004.”

Acts 2004, ch. 678, § 2 provided that it is the intent of the general assembly to create a uniform standard that health care providers must follow in issuing written or electronic prescription orders. This standard is intended to reduce medication related errors, which represent a major source of medical errors in the health care system. The general assembly finds that reducing medical errors will result in greater safety for patients as well as cost savings for the health care system in this state. By adopting these standards, the general assembly intends to promote medical safety for all patients who are issued drug prescriptions in this state.

Acts 2004, ch. 678, § 11 provided that nothing in the act shall be construed as limiting any practitioner's or pharmacist's ability to order the use of or distribute nonprescription drugs or devices otherwise in accordance with applicable law.

Acts 2004, ch. 678, § 12 provided that nothing in the act shall be construed as limiting any professional nurse's ability to issue drugs in accordance with the provisions of § 63-7-124.

Acts 2004, ch. 678, § 13 provided that the department of health, division of health related boards and the board of pharmacy, are authorized to promulgate uniform rules to effect the purposes of this act in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The power and duty to enforce those rules shall be vested in the various boards that regulate health care providers affected by the act, in accordance with § 63-1-122 [repealed].

Acts 2004, ch. 678, § 14 provided that the act shall not affect rights and duties that matured, penalties that were incurred, or proceedings that were begun before July 1, 2004.

Acts 2010, ch. 795, § 8 provided that nothing in the act shall be construed as limiting any practitioner's or pharmacist's ability to order the use of or distribute non-prescription drugs or devices otherwise in accordance with applicable law.

Acts 2010, ch. 795, § 10 provided that nothing in the act shall be construed as limiting any professional nurse's ability to issue drugs in accordance with the provisions of § 63-7-124.

Acts 2010, ch. 795, § 11 provided that the department of health, division of health related boards and the board of pharmacy, are authorized to promulgate uniform rules to effect the purposes of the act in accordance with title 4, chapter 5. The power and duty to enforce those rules shall be vested in the various boards that regulate healthcare providers affected by the act, in accordance with § 63-1-122 [repealed].

Acts 2010, ch. 795, § 19 provided that the act shall not affect rights and duties that matured, penalties that were incurred, or proceedings that were begun before January 1, 2011.

63-3-128. [Repealed.]

Acts 2010, ch. 795, § 1, repealed by Acts 2018, ch. 883, § 3, effective January 1, 2019.

Compiler's Notes. Section 63-1-128, concerning prescriptions for Schedule II controlled substances, is repealed by Acts 2018, ch. 883, § 3, effective January 1, 2019.

Acts 2018, ch. 883, § 10 provided that the commissioner of health is authorized to promulgate rules to effectuate the purposes of the act. All rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, title 4, chapter 5.

Former § 63-1-128, concerned prescriptions for Schedule II controlled substances.

Part 2
Tennessee Orthotics, Prosthetics, and Pedorthics Practice Act of 2005

NOTES TO DECISIONS

1. Diagnosis.

The field of chiropractic is limited to the treatment of those illnesses and diseases of the human body which doctors of chiropractic reasonably believe can be aided by manual manipulation of the spine. Ison v. McFall, 55 Tenn. App. 326, 400 S.W.2d 243, 1964 Tenn. App. LEXIS 170 (Tenn. Ct. App. 1964), superseded by statute as stated in, Johnson v. Lawrence, 720 S.W.2d 50, 1986 Tenn. App. LEXIS 2842, 77 A.L.R.4th 251 (Tenn. Ct. App. 1986); Spunt v. Fowinkle, 572 S.W.2d 259, 1978 Tenn. App. LEXIS 306 (Tenn. Ct. App. 1978).

There is nothing in this section which would prohibit a chiropractor from treating a patient afflicted with paralysis so long as he in good faith believes that a manipulation of the spine will benefit the patient. Ison v. McFall, 55 Tenn. App. 326, 400 S.W.2d 243, 1964 Tenn. App. LEXIS 170 (Tenn. Ct. App. 1964), superseded by statute as stated in, Johnson v. Lawrence, 720 S.W.2d 50, 1986 Tenn. App. LEXIS 2842, 77 A.L.R.4th 251 (Tenn. Ct. App. 1986).

2. Expert Witness.

Chiropractor was competent to testify as to nerve interference in patient's spine the subluxations of his vertebrae and the abnormal curvature of the spine, and to express an opinion as to the probable causes and effects of these injuries but he was not competent to testify as an expert as to occupational diseases or as to whether patient had silicosis. Ward v. North American Rayon Corp., 211 Tenn. 535, 366 S.W.2d 134, 1963 Tenn. LEXIS 378 (1963).

Chiropractor not competent to testify in workers' compensation proceeding as to medical matters outside the scope of his profession. Tom Still Transfer Co. v. Way, 482 S.W.2d 775, 1972 Tenn. LEXIS 358 (Tenn. 1972).

The fact that a chiropractor admitted that treatment of a fractured collar bone was beyond the scope of his profession did not affect the admissibility or relevance of his testimony with respect to the condition of employee's spine and the cause and effect of such condition. Smith v. Hale, 528 S.W.2d 543, 1975 Tenn. LEXIS 626 (Tenn. 1975).

3. Practice.

Any licensed chiropractor who, in the practice of his profession, engages in activities beyond the scope of those authorized in § 63-1-105 may be found to have invaded the field of medicine as defined in § 63-6-204 and may be disciplined by the state licensing board for the healing arts pursuant to § 63-1-123. Spunt v. Fowinkle, 572 S.W.2d 259, 1978 Tenn. App. LEXIS 306 (Tenn. Ct. App. 1978).

There was material and substantial evidence to support the findings of the state licensing board for the healing arts that a chiropractor exceeded the scope of his license and invaded the field of medicine by making pap smears and by drawing blood for the purpose of diagnosing various human diseases and ailments which were unrelated to chiropractic practice. Spunt v. Fowinkle, 572 S.W.2d 259, 1978 Tenn. App. LEXIS 306 (Tenn. Ct. App. 1978).

4. Sufficiency of Evidence.

There was substantial evidence in a workers' compensation case to support chancellor's finding of 50% permanent partial disability where a chiropractor testified his opinion to be that there was between 55% and 60% disability to employee's spine and where employee and his parents testified as to the employee's inability to do any heavy work. Smith v. Hale, 528 S.W.2d 543, 1975 Tenn. LEXIS 626 (Tenn. 1975).

NOTES TO DECISIONS

1. Deception and Fraud in Practice of Chiropractic.

A chiropractor who purports to engage in the practice of medicine and even of surgery and exacts a fee for such “services” has been guilty of deception and fraud in the practice of chiropractic. Janeway v. State Board of Chiropractic Examiners, 33 Tenn. App. 280, 231 S.W.2d 584, 1950 Tenn. App. LEXIS 107 (Tenn. Ct. App. 1950)

Where practitioner used his license in another field, and the title of “doctor,” such conduct amounted to a fraud and deception in the practice of the art for which a license had been issued. Janeway v. State Board of Chiropractic Examiners, 33 Tenn. App. 280, 231 S.W.2d 584, 1950 Tenn. App. LEXIS 107 (Tenn. Ct. App. 1950)

2. Power of Board.

The legislature, after laying down specific grounds for the guidance of the board of chiropractic examiners, intended to confer upon it also the power to revoke the license of a chiropractor whose activities were found to be unprofessional or subversive to the public interest or welfare. Janeway v. State Board of Chiropractic Examiners, 33 Tenn. App. 280, 231 S.W.2d 584, 1950 Tenn. App. LEXIS 107 (Tenn. Ct. App. 1950)

3. Solicitation.

The solicitation clause of T.C.A. § 63-4-114(a)(5) is unconstitutionally broad as it clearly proscribes both personal and telephonic solicitation. Although the state has a substantial interest in prohibiting the telemarketing of chiropractic services to accident victims, the blanket ban on in-person as well as telephone solicitation is too broad to pass constitutional muster (decided prior to 2015 amendment). Silverman v. Walkup, 21 F. Supp. 2d 775, 1998 U.S. Dist. LEXIS 15823 (E.D. Tenn. 1998).

Chiropractor's license was properly revoked under T.C.A. § 63-4-114 for violating Tenn. Comp. R. & Regs. § 0260-02-.20(6)(a) as the chiropractor admitted that the chiropractor violated the regulation by contacting an accident victim just two days after an accident, even if the chiropractor did so at the request of a family member; it was not arbitrary or capricious to discipline the chiropractor for the incident of solicitation, which occurred in 2000, even though the final order imposing the discipline was entered eight years later. Byrd v. Tenn. Bd. of Chiropractic Examiners, — S.W.3d —, 2011 Tenn. App. LEXIS 440 (Tenn. Ct. App. Aug. 11, 2011), appeal denied, — S.W.3d —, 2011 Tenn. LEXIS 1178 (Tenn. Dec. 13, 2011), cert. denied, Byrd v. Tenn. Bd of Chiropractic Exam’rs, 182 L. Ed. 2d 869, 132 S. Ct. 2109, 566 U.S. 975, 2012 U.S. LEXIS 3329.

Tennessee Board of Chiropractic Examiners had authority to revoke a chiropractor's license under T.C.A. § 63-4-114(4) as under T.C.A. § 48-101-610(d), a chiropractor could not conduct a practice in a manner that was contrary to the standards of ethics applicable to the profession simply by using the shield of a professional corporation; the chiropractor could not circumvent Tenn. Comp. R. & Regs. § 0260-02-.20(6)(a) by having a medical professional corporation's employees or agents conduct telemarketing that would otherwise be prohibited. Byrd v. Tenn. Bd. of Chiropractic Examiners, — S.W.3d —, 2011 Tenn. App. LEXIS 440 (Tenn. Ct. App. Aug. 11, 2011), appeal denied, — S.W.3d —, 2011 Tenn. LEXIS 1178 (Tenn. Dec. 13, 2011), cert. denied, Byrd v. Tenn. Bd of Chiropractic Exam’rs, 182 L. Ed. 2d 869, 132 S. Ct. 2109, 566 U.S. 975, 2012 U.S. LEXIS 3329.

4. Sufficiency of Notice.

Sufficiency of the notice was waived by holder of certificate suspended by board when he went to trial before board without raising that question. Janeway v. State Board of Chiropractic Examiners, 33 Tenn. App. 280, 231 S.W.2d 584, 1950 Tenn. App. LEXIS 107 (Tenn. Ct. App. 1950).

NOTES TO DECISIONS

1. Evidence.

In prosecution for practicing dentistry without a license, trial court did not err in permitting secretary of healing arts board to testify as to what his records contained. Hooper v. State, 205 Tenn. 126, 325 S.W.2d 561, 1959 Tenn. LEXIS 347 (1959).

2. Finding of Fact.

In prosecution for practicing dentistry without a license, it was error for trial court to charge jury that defendant did not have a license and such error was not cured by instructions that it was province of jury to find the facts and that jury was not to imagine that court had any opinion as to what the facts were. Hooper v. State, 205 Tenn. 126, 325 S.W.2d 561, 1959 Tenn. LEXIS 347 (1959).

3. Injunction.

Injunction restraining person from unlawfully practicing dentistry was in furtherance of criminal laws and contempt of such injunction was criminal rather than civil. Hooper v. State ex rel. Nichol, 205 Tenn. 134, 325 S.W.2d 565, 1959 Tenn. LEXIS 348 (1959).

Criminal court has jurisdiction of proceeding for contempt of injunction prohibiting unlawful practice of dentistry. Hooper v. State ex rel. Nichol, 205 Tenn. 134, 325 S.W.2d 565, 1959 Tenn. LEXIS 348 (1959).

Contempt proceedings against defendant who violated injunction against unlawful practice of dentistry were proper even though judgment finding guilty of unlawful practice was reversed since such judgment was voidable only rather than void. Hooper v. State ex rel. Nichol, 205 Tenn. 134, 325 S.W.2d 565, 1959 Tenn. LEXIS 348 (1959).

NOTES TO DECISIONS

1. Constitutionality.

A statute regulating the practice of dentistry and defining such practice was not unconstitutional. Hooper v. State, 206 Tenn. 489, 334 S.W.2d 730, 1960 Tenn. LEXIS 386 (1960).

2. False Teeth.

Where a person made impressions, fitted and adjusted false teeth and charged for the work without a license, an injunction was properly issued. State Board of Dental Examiners v. Rymer, 202 Tenn. 234, 303 S.W.2d 959, 1957 Tenn. LEXIS 385 (1957).

NOTES TO DECISIONS

1. Advertising.

Rule of the board of dentistry that required a general dentist who practiced orthodontics but was not specially certified as an orthodontist to include in advertisements of his practice that he was performing the services as a general dentist did not violate constitutional free speech provisions. Douglas v. State, 921 S.W.2d 180, 1996 Tenn. LEXIS 253 (Tenn. 1996).

NOTES TO DECISIONS

1. Constitutionality.

Imposition of fine of $550 and imprisonment of 110 days for violation of injunction prohibiting defendant from illegally practicing dentistry did not violate Tenn. Const. art. VI, § 14, where consent decree signed by defendant and his attorney stipulated that 11 separate violations of injunction were involved and that defendant was fined $50.00 and sentenced ten days for each violation thereof. State Board of Dental Examiners v. Talley, 185 Tenn. 83, 203 S.W.2d 364, 1947 Tenn. LEXIS 303 (1947).

2. Violation of Injunction as Contempt.

Injunction restraining person from unlawfully practicing dentistry was in furtherance of criminal laws and contempt of such injunction was criminal rather than civil. Hooper v. State ex rel. Nichol, 205 Tenn. 134, 325 S.W.2d 565, 1959 Tenn. LEXIS 348 (1959).

Criminal court has jurisdiction of proceeding for contempt of injunction prohibiting unlawful practice of dentistry. Hooper v. State ex rel. Nichol, 205 Tenn. 134, 325 S.W.2d 565, 1959 Tenn. LEXIS 348 (1959).

Contempt proceedings against defendant who violated injunction against unlawful practice of dentistry were proper even though judgment finding guilty of unlawful practice was reversed since such judgment was voidable only rather than void. Hooper v. State ex rel. Nichol, 205 Tenn. 134, 325 S.W.2d 565, 1959 Tenn. LEXIS 348 (1959).

NOTES TO DECISIONS

1. Constitutionality.

Appellee's contention that he has been deprived of equal protection of the laws or of due process simply because the criminal sanctions prescribed for violation of the particular licensing laws regulating him as a dentist differ in some respects from penalties provided for other professional groups was without merit. State v. Blockman, 615 S.W.2d 672, 1981 Tenn. LEXIS 430 (Tenn. 1981).

Podiatrists, chiropractors, optometrists, osteopaths, psychologists, veterinarians, physical therapists, dispensing opticians, nursing home administrators and speech pathologists are not all members of the same class and thus there is no requirement that they receive identical treatment, either civilly or criminally, under the licensure laws, even though all are generally subject to the regulation and supervision of the board for the healing arts. State v. Blockman, 615 S.W.2d 672, 1981 Tenn. LEXIS 430 (Tenn. 1981).

63-6-101. Creation — Composition — Administrative support.

1. 1. There shall be a board to be known as the board of medical examiners, referred to in this chapter as the “board,” to consist of twelve (12) members. Nine (9) members shall be duly licensed physicians, each of whom must meet the following qualifications:
      1. Graduation from a medical school whose curriculum is substantially similar to, and whose educational standards are as high as that of, the medical department of the University of Tennessee, as published at the time of its extant catalogue; and
      2. Not less than six (6) years experience in the practice of either medicine or surgery or both.
   2. Three (3) members shall be nonphysicians who are consumers of health care and who neither own nor have any financial or other interest in any health care facility or business or school of medicine or other allied health care practitioner educational program and who shall represent the public at large.
   3. It shall be the board's duty to examine the qualifications of all applicants for certification of fitness to practice medicine or surgery in this state, to conduct disciplinary hearings, and to make such rules and regulations as are necessary to carry out and make effective this chapter. Any rules and regulations promulgated by the board shall comply with all requirements of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. No member shall be employed by or be a member of the governing body of, or have a financial interest in, any medical school, college or university of the state or of any school, college or university in which allied health care practitioners who are under the regulation of the board receive their qualifying education.
   4. The board is authorized to issue advisory private letter rulings to any affected licensee who makes such a request regarding any matters within the board's primary jurisdiction. Such private letter ruling shall only affect the licensee making such inquiry and shall have no precedential value for any other inquiry or future contested case to come before the board. Any dispute regarding a private letter ruling may, if the board chooses to do so, be resolved pursuant to the declaratory order provisions of § 4-5-223.
2. The board shall receive administrative support from the division of health related boards in the department of health, referred to as the “division” in this chapter.

Acts 1901, ch. 78, § 2; Shan., § 3096a14; Code 1932, § 6919; Acts 1945, ch. 181, § 1; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; mod. C. Supp. 1950, § 6919; T.C.A. (orig. ed.), § 63-601; Acts 1982, ch. 905, § 1; 1984, ch. 937, § 26; 1993, ch. 404, § 1; 1996, ch. 1043, § 1.

Compiler's Notes. The regulatory board created by this section is attached to the division of health related boards in the department of health. See §§ 63-1-131 — 63-1-133 and 68-1-101.

The board of medical examiners, created by this section, terminates June 30, 2023. See §§ 4-29-112, 4-29-244.

Cross-References. Abortion, title 39, ch. 15, part 2.

Health maintenance organizations exempt from chapter, § 56-32-121.

Liability of professional societies, title 62, ch. 50, part 1.

Prevention of HIV transmission, rulemaking authority, § 68-11-222.

Regulation of health and related facilities, title 68, ch. 11, part 2.

State examining boards, general provisions, title 4, ch. 19.

Law Reviews.

Report on Administrative Law to the Tennessee Law Revision Commission, 20 Vand. L. Rev. 777.

Uncovering the Silent Victims of the American Medical Liability System, 67 Vand. L. Rev. 151 (2014).

United States v. Caronia: How True Does “Truthful” Have to Be?, 67 Vand. L. Rev. En Banc 157 (2014).

Attorney General Opinions. Even though the Tennessee Medical Practice Act contains no express language authorizing the Board of Medical Examiners to regulate the facilities at which physicians practice, unless provided otherwise by law or Board regulation, individual physician practice requirements and standards apply to a physician's practice of medicine in any setting, including a medical clinic, OAG 04-128 (8/11/04).

63-6-102. Appointment — Terms — Vacancies — Removal.

1. 1. 1. The members of the board shall be appointed by the governor for terms of five (5) years' duration, which terms shall commence on May 1 and expire on April 30, five (5) years thereafter. All board members subsequently added to the board after May 2, 1993, shall be appointed so as to serve staggered terms of from one (1) to four (4) years, with one (1) member appointed to a one-year term, the second member appointed to a two-year term, the third member appointed to a three-year term, and the fourth member appointed to serve a four-year term.
      2. The members appointed by the governor in 1988 shall be appointed as follows:
         1. One (1) member shall be appointed to a one-year term expiring on April 30, 1989;
         2. One (1) member shall be appointed to a two-year term expiring on April 30, 1990;
         3. One (1) member shall be appointed to a three-year term expiring on April 30, 1991;
         4. One (1) member shall be appointed to a four-year term expiring on April 30, 1992; and
         5. One (1) member shall be appointed to a five-year term expiring on April 30, 1993.
   2. Members of the board shall, upon expiration of their terms of office, be eligible for reappointment to successive terms.
   3. In making appointments to the board, the governor shall give due regard to the geographic distribution of the membership of the board to assure, to the extent feasible, that all grand divisions of the state are adequately represented on the board.
   4. Board members may be selected from lists of qualified persons submitted to the governor by interested medical groups including, but not limited to, the Tennessee Medical Association. The governor shall consult with such groups to determine qualified persons to fill the positions on the board.
2. All vacancies occurring on the board by reason of death or resignation shall be filled by the board itself for the unexpired term.
3. In making appointments to the board, the governor shall, to the extent feasible, strive to ensure the full twelve-member board is composed of at least one (1) person who is sixty (60) years of age or older, one (1) person who is female and one (1) person who is an African-American.
4. When a board member is absent without excuse from the board business portion of three (3) meetings within any twelve-month period of time, that member shall, after formal action by the board, be removed from office by the governor. A new member shall be appointed by the governor to serve out the remaining term of the member being replaced. An absence shall be deemed excused if it is caused by a health problem or condition verified in writing by a physician or by an accident or similar unforeseen tragedy or event immediately prior to or during the board meeting.

Acts 1901, ch. 78, § 3; Shan., § 3609a15; Code 1932, § 6920; T.C.A. (orig. ed.), § 63-602; Acts 1988, ch. 790, § 1; 1988, ch. 1013, § 43; 1993, ch. 404, §§ 2, 3; 2006, ch. 531, § 1; 2012, ch. 650, § 3.

Cross-References. Grand divisions, title 4, ch. 1, part 2.

63-6-103. Officers — Quorum.

1. The board is authorized to elect from its own members a president and secretary and to create such other officers as may be necessary for its efficient operations.
2. For purposes of conducting administrative business and promulgating rules and regulations, seven (7) members shall constitute a quorum, and the board shall meet at least twice a year to conduct such administrative business. A majority vote of the members present at the business meetings shall be required to authorize board action on any board business. For purposes of contested case hearings and disciplinary matters, three (3) or more members shall constitute a quorum; and the board president is authorized, when it is deemed necessary, to split the board into panels of three (3) or more, each to conduct contested case hearings or disciplinary matters. A majority vote of the members present on any duly constituted panel shall be required to authorize board action in disciplinary matters and contested case hearings. The board president shall have the authority to appoint board members to serve, as necessary, on the panels regardless of the grand division from which the appointed member was chosen or the member's status as a physician or nonphysician member. The existence of a nonphysician board member creates no rights in any individual concerning the composition of any panel in any disciplinary matter or contested case hearing. Notwithstanding § 4-5-314(e) to the contrary, unavailability of a member of any panel before rendition of a final order shall not require substitution of another member unless the unavailability results in there being less than the quorum required by this section for contested case hearings or disciplinary matters. Any substitute required shall use any existing record and may conduct any further proceedings as is necessary in the interest of justice.

Acts 1901, ch. 78, § 4; Shan., § 3609a16; Code 1932, § 6921; Acts 1978, ch. 628, §§ 1, 2; T.C.A. (orig. ed.), § 63-603; Acts 1982, ch. 905, § 2; 1993, ch. 404, § 4; 1995, ch. 329, § 2; 2004, ch. 677, § 3.

Cross-References. Grand divisions, title 4, ch. 1, part 2.

63-6-104. Meetings — Compensation — Disposition of receipts — Operating expenses.

1. All regular meetings of the board shall be held upon the call of the president.
2. 1. The members of the board shall be entitled to a per diem of one hundred dollars ($100) for each day's service in attending meetings of the board, as provided in this section, and for conducting examinations for professional certificates and other administrative functions of the board and necessary expenses for traveling and subsistence while attending such meetings. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
   2. The board shall pay all money received by it into the state treasury and the commissioner of finance and administration shall make such allotments out of the general fund as the commissioner may deem proper for the necessary and proper expenses of the board, and no expenditure shall be made by the board unless and until such allotment has been made by the commissioner. Such allotment shall be disbursed under the general budgetary laws of this state.

Acts 1901, ch. 78, § 5; Shan., § 3609a17; mod. Code 1932, § 6922; Acts 1945, ch. 181, § 2; C. Supp. 1950, § 6922; Acts 1953, ch. 113, § 13; impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; Acts 1975, ch. 355, § 13; 1976, ch. 806, § 1(113); T.C.A. (orig. ed.), § 63-604; Acts 1993, ch. 404, § 5.

63-6-105. Online registry for medical spas — Annual fee authorized.

1. The board of medical examiners, in consultation with the board of osteopathic examination, shall establish and maintain an online registry for medical spas as defined in § 63-1-153, and, notwithstanding § 63-1-153, the registry shall include any physician-owned practice that advertises or holds itself out as a medical spa or a physician-owned practice that primarily engages in the performance of elective cosmetic medical services. The online registry shall include, at a minimum, the following information:
   1. The name and physical address of the medical spa;
   2. The name of the medical director or supervising physician, the medical license number of the director or supervising physician, and the designation as a medical doctor or doctor of osteopathy; and
   3. Certification information of the medical director or supervising physician as required by § 63-1-153(b) and (c).
2. Any medical director or supervising physician who is responsible for or supervises a medical spa shall provide the board of medical examiners or the board of osteopathic examination with the information described in subsection (a); provided, that the medical director or supervising physician for a medical spa in existence prior to January 1, 2017, shall submit the required information to the appropriate board prior to that date.
3. The board of medical examiners and the board of osteopathic examination shall post, in conspicuous size and type, notice of the requirements of this section on the website of each board.
4. In order to offset the cost of implementing this section, the board of medical examiners, in consultation with the board of osteopathic examination, is authorized to promulgate rules to set an annual fee to be assessed on medical spas that are listed on the online registry.

Acts 2015, ch. 494, § 1; 2016, ch. 956, §§ 1, 2.

Part 2
General Provisions

63-7-101. Purpose of chapter.

The purpose of this chapter is to safeguard life and health by requiring each person who is practicing or is offering to practice nursing to submit evidence that the person is qualified to practice and to be licensed as provided in this chapter. Such evidence of qualifications shall be submitted to the state board of nursing, which is the regulatory body authorized to enforce this chapter.

Acts 1967, ch. 78, § 1; T.C.A., § 63-729; Acts 1990, ch. 651, § 1; 2005, ch. 387, § 1.

Cross-References. Duties of nurses regarding known or suspected child sexual abuse, §§ 37-1-403, 37-1-605.

Liability of professional societies, title 62, ch. 50, part 1.

Loan-scholarship program for graduate students in professional nursing, § 49-4-702.

Prevention of HIV transmission, rulemaking authority, § 68-11-222.

Training of nurses to include courses in detection and treatment of child sexual abuse, § 49-7-117.

Textbooks. Tennessee Jurisprudence, 20 Tenn. Juris., Physicians and Surgeons, § 6.

Law Reviews.

Report on Administrative Law to the Tennessee Law Revision Commission, 20 Vand. L. Rev. 777.

Attorney General Opinions. Authority to set standards for public school nurses, OAG 98-073, 1998 Tenn. AG LEXIS 73 (3/31/98).

63-7-102. Exemptions.

Nothing in this chapter shall be construed as applying to:

1. The domestic administration of family remedies or the furnishing of assistance in the case of an emergency;
2. Persons employed in the office of a licensed physician or dentist, assisting in the nursing care of patients where adequate medical or nursing supervision, or both, is provided;
3. The practice of nursing incidental to a program of study by students enrolled in nursing education programs approved by the board;
4. Persons belonging to a recognized church or religious denomination having religious teachings and beliefs in regard to the care of the sick by prayer;
5. Care of persons in their homes by domestic servants, housekeepers, attendants or household aides of any type, whether employed regularly or because of an emergency or illness if such persons are not initially employed in a nursing capacity;
6. The practice of any lawfully qualified nurse of another state who is employed by the United States government or any bureau, division or agency thereof while in the discharge of the nurse's official duties in this state;
7. The practice of any currently licensed nurse of another state who is presenting educational programs or consultative services within this state for a period not to exceed fourteen (14) days in a calendar year;
8. The practice of any currently licensed nurse of another state whose responsibilities include transporting patients into, out of or through this state. Such exemption shall be limited to a period not to exceed forty-eight (48) hours for each transport;
9. The practice of nursing by students who are enrolled in board-approved refresher programs or comprehensive orientation programs;
10. Persons trained in accordance with § 68-1-904(c) who are:
    1. Providing personal support services to clients living in their own home or private residence pursuant to a contract or agreement under any medicaid waiver or other program of the department of intellectual and developmental disabilities;
    2. Employed by agencies that are both licensed under title 33 and under contract to provide residential or adult day programs for people with intellectual disabilities and persons trained in accordance with § 68-1-904(c); or
    3. Employed by community-based licensed intermediate care facilities for people with intellectual disabilities who will administer medication only at a location other than the community-based facility. The employees of the community-based licensed intermediate care facilities for people with intellectual disabilities may additionally receive medication administration training specific to the person served. For the purposes of this subdivision (10)(C), when administered by employees of the intermediate care facilities, medications shall be packaged in individual doses labeled with the name of the individual patient, the time of administration and the drug name and dosage;
11. Except for those persons covered under subdivision (10)(A), a person employed by an agency licensed under title 33, chapter 2, part 4 providing personal support services to clients living in their own home or private residence may assist the client with medication, except for injections, upon a written authorization by the client or the client's authorized representative. For the purpose of this section, assistance is limited to opening medication packaging and providing medication reminders and does not permit giving the client any form of medication. Before any such person is authorized to assist the client with medication as provided in this subdivision (11), the person shall receive and be able to document training in medication assistance performed by or under the general supervision of a registered nurse and consistent with the state's home and community-based services (HCBS) training in assisting with medications. For the purposes of this subdivision (11), assisting with medications is not to be interpreted in any manner or fashion to include, or to be the same as, medication administration that would be only appropriate and acceptable for persons who are authorized so to do by specific professional acts under this title or by rules or regulations;
12. 1. Persons trained in accordance with § 68-1-904(c)(2), who are employed by agencies that are both licensed under title 37 and under contract with the department of children's services to provide services, can assist children and youth with the self-administration of medication in a group home setting. Before that person is authorized to assist the child or youth with self-administration of medication, that person must have received and be able to document six (6) hours of training in medication administration from a registered nurse licensed pursuant to this chapter;
    2. For the purposes of subdivision (12)(A), assisting with self-administration of medications is not to be interpreted in any manner or fashion to include, or to be the same as, medication administration that would be only appropriate and acceptable for persons who are authorized to do so by specific professional acts under this title or by rules or regulations; and
13. Except to the extent that it applies to the administration of medication, an individual who holds a valid medication technician certificate issued under this chapter, if the medication is administered in accordance with this chapter.

Acts 1967, ch. 78, § 11; T.C.A., § 63-739; Acts 1982, ch. 712, § 2; 1985, ch. 39, § 1; 1993, ch. 357, § 1; 2000, ch. 947, § 6; 2004, ch. 577, § 1; 2005, ch. 210, § 2; 2005, ch. 387, § 2; 2006, ch. 846, § 1; 2007, ch. 364, § 3; 2007, ch. 399, § 1; 2008, ch. 850, §§ 1, 2; 2009, ch. 403, § 1; 2009, ch. 477, § 1; 2010, ch. 1100, § 99; 2011, ch. 158, §§ 31, 32.

Compiler's Notes. Acts 2009, ch. 477, § 1, directed the code commission to change all references from “division of mental retardation services” to “division of intellectual disabilities services” and to include the changes in supplements and replacement volumes for the Tennessee Code Annotated.

Acts 2010, ch. 1100, § 153 provided that the commissioner of mental health and developmental disabilities, the commissioner of mental health, the commissioner of intellectual and developmental disabilities, and the commissioner of finance and administration are authorized to promulgate rules and regulations to effectuate the purposes of the act. All such rules and regulations shall be promulgated in accordance with the provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

63-7-103. “Practice of professional nursing” and “professional nursing” defined.

1. 1. “Practice of professional nursing” means the performance for compensation of any act requiring substantial specialized judgment and skill based on knowledge of the natural, behavioral and nursing sciences and the humanities as the basis for application of the nursing process in wellness and illness care.
   2. “Professional nursing” includes:
      1. Responsible supervision of a patient requiring skill and observation of symptoms and reactions and accurate recording of the facts;
      2. Promotion, restoration and maintenance of health or prevention of illness of others;
      3. Counseling, managing, supervising and teaching of others;
      4. Administration of medications and treatments as prescribed by a licensed physician, dentist, podiatrist, or nurse authorized to prescribe pursuant to § 63-7-123, or selected, ordered, or administered by an advanced practice registered nurse specializing as a certified registered nurse anesthetist (CRNA) during services ordered by a physician, dentist, or podiatrist and provided by a CRNA in collaboration with the ordering physician, dentist, or podiatrist that are within the scope of practice of the CRNA and authorized by clinical privileges granted by the medical staff of the facility. A CRNA shall collaborate in a cooperative working relationship with the ordering physician, dentist, or podiatrist in the provision of patient care, which includes consultation regarding patient treatment and cooperation in the management and delivery of health care;
      5. Application of such nursing procedures as involve understanding of cause and effect; and
      6. Nursing management of illness, injury or infirmity including identification of patient problems.
2. Notwithstanding subsection (a), the practice of professional nursing does not include acts of medical diagnosis or the development of a medical plan of care and therapeutics for a patient, except to the extent such acts may be authorized by §§ 63-1-132, 63-7-123 and 63-7-207.
3. 1. This section does not preclude a qualified registered nurse from determining whether a patient presenting to a hospital has an emergency medical condition if the determination is pursuant to:
      1. A cooperative working relationship with a physician; and
      2. Protocols jointly developed by the hospital's medical and nursing leadership and adopted by the hospital's medical staff and governing body.
   2. The protocols described in subdivision (c)(1) must include a requirement that the qualified registered nurse obtain the concurrence of a physician when making a determination authorized under subdivision (c)(1).
   3. As used in this subsection (c):
      1. “Emergency medical condition” means:
         1. A medical condition manifesting itself by acute symptoms of sufficient severity, including severe pain, such that the absence of immediate medical attention could reasonably be expected to result in:
            1. Placing the health of the individual or, with respect to a pregnant woman, the health of the woman or the woman's unborn child, in serious jeopardy;
            2. Serious impairment to bodily functions; or
            3. Serious dysfunction of any bodily organ or part; and
         2. With respect to a pregnant woman who is having contractions:
            1. That there is inadequate time to effect a safe transfer to another hospital before delivery; or
            2. That transfer may pose a threat to the health or safety of the woman or the woman's unborn child; and
      2. “Qualified registered nurse” means a registered nurse who has been approved by the hospital governing body, based on the recommendation of hospital nursing leadership, as possessing the skills and competency to make a determination of the existence of a specified emergency medical condition of a patient presenting to a hospital.

Acts 1967, ch. 78, § 12; 1972, ch. 523, § 1; T.C.A., § 63-740; Acts 1990, ch. 651, § 2; 2015, ch. 513, § 2; 2016, ch. 980, § 11; 2019, ch. 12, § 1.

Amendments. The 2019 amendment added (c).

Effective Dates. Acts 2019, ch. 12, § 2. March 20, 2019.

63-7-104. Registered nurse qualifications.

An applicant for a license to practice professional nursing shall submit to the board evidence in such form as the board may prescribe that such applicant:

1. Is in good physical and mental health;
2. Holds a diploma from a four-year accredited high school, or the equivalent thereof, as determined by the board; and
3. Has successfully completed a course of study in an approved school of nursing, as defined by the board, and the applicant holds a diploma or degree from an approved school of nursing or the approved school has certified to the board that the applicant has met all requirements for a diploma or degree.

Acts 1967, ch. 78, § 13; T.C.A., § 63-741; Acts 1984, ch. 848, § 1.

63-7-105. Registered nurse licensure.

1. By Examination.  An applicant for a license to practice professional nursing shall be required to pass an examination in such subjects as the board may determine. The board shall issue a license to practice professional nursing to an applicant who successfully completes the examination.
2. Without Examination.  The board may issue a license to practice professional nursing to a professional or registered nurse who has been duly licensed in another state or territory if, in the opinion of the board, the individual meets the professional nurse qualifications that, at the time of the applicant's graduation, were in effect in this state.
3. Temporary Permits.  The board may issue a temporary permit to a professional or registered nurse duly licensed according to the laws of another state and who has made application for permanent licensure in Tennessee. A permit issued under this subsection (c) shall be valid for a single period of six (6) months.

Acts 1967, ch. 78, § 14; 1976, ch. 501, §§ 3, 13; 1978, ch. 678, § 1; 1981, ch. 462, § 2; T.C.A., § 63-742; Acts 1982, ch. 712, § 3; 1985, ch. 39, § 11; 2005, ch. 387, § 3.

63-7-106. Registered nurse fees — Certification to other states.

1. 1. The applicant for a license to practice as a professional or registered nurse by examination must pay a fee as set by the board and the board may direct, by regulation, that a part of the fee shall be paid directly to a testing service by the applicant.
   2. An unsuccessful applicant for licensure by examination may rewrite the examination upon payment of a fee as set by the board, and the board may direct, by regulation, that a part of the fee shall be paid directly to a testing service by the applicant.
   3. The applicant for a license to practice as a professional or registered nurse without examination under § 63-7-105(b) shall pay a fee as set by the board.
2. The applicant for a temporary permit shall pay a fee as set by the board.
3. Any person who holds a license to practice professional nursing under this chapter, and who seeks to be licensed in another state by endorsement on the basis of the person's Tennessee license, shall have the license certified by the board for a fee as set by the board.
4. The applicant for a duplicate original license or a duplicate renewal certificate shall pay a fee as set by the board.
5. The applicant for a school transcript shall pay a fee as set by the board.
6. The applicant for a change in name shall pay a fee as set by the board.
7. An applicant for a certificate of fitness or a temporary certificate of fitness pursuant to § 63-7-123 shall pay a fee as set by the board.

Acts 1967, ch. 78, § 15; 1976, ch. 501, §§ 4, 5; 1981, ch. 462, §§ 3-5; T.C.A., § 63-743; Acts 1982, ch. 712, § 4; 1985, ch. 39, §§ 2-4; 1989, ch. 523, §§ 194-200; 1992, ch. 822, § 2; 2005, ch. 387, § 4.

Law Reviews.

Health Professionals' Access to Hospitals: A Retrospective and Prospective Analysis, 34 Vand. L. Rev. 1161 (1981).

63-7-107. Use of “registered nurse” title.

Any person who holds a license to practice professional nursing under this chapter shall, during the effective period of such license, be entitled to use the title “nurse,” “registered nurse,” or the abbreviation “R.N.” No other person shall assume such titles or use such abbreviation or any other words, letters or signs to indicate that the person using the same is a professional or registered nurse.

Acts 1967, ch. 78, § 16; T.C.A., § 63-744; Acts 2004, ch. 573, § 1.

63-7-108. “Practice of practical nursing” defined.

The “practice of practical nursing” means the performance for compensation of selected acts required in the nursing care of the ill, injured or infirm and/or carrying out medical orders prescribed by a licensed physician or dentist under the direction of a licensed physician, dentist or professional registered nurse. The licensed practical nurse shall have preparation in and understanding of nursing, but shall not be required to have the same degree of education and preparation as required of a registered nurse.

Acts 1967, ch. 78, § 17; T.C.A., § 63-745.

63-7-109. Practical nurse qualifications.

An applicant for a license to practice as a licensed practical nurse shall submit to the board evidence in such form as the board may prescribe that the applicant:

1. Is in good physical and mental health;
2. Has completed the twelfth grade or its equivalent or has successfully passed the test for and has received a general equivalency diploma and such other preliminary qualifications and requirements as the board may prescribe; and
3. Has successfully completed a course of study in an approved school for practical nurses, as defined by the board, and the applicant holds a certificate therefrom, or the approved school has certified to the board that the applicant has met all requirements for a certificate.

Acts 1967, ch. 78, § 18; 1981, ch. 462, §§ 6, 7; T.C.A., § 63-746; Acts 1984, ch. 848, § 2.

63-7-110. Practical nurse licensure.

1. By Examination.  An applicant for a license to practice practical nursing shall be required to pass a written examination as prescribed by the board. The board shall issue a license to practice practical nursing to an applicant who successfully completes the examination.
2. Without Examination.  The board may issue a license to a licensed practical nurse who has been duly licensed in another state or territory if, in the opinion of the board, the individual meets the practical nurse qualifications that, at the time of the applicant's graduation, were in effect in this state.
3. Temporary Permits.  The board may issue a temporary permit to a practical nurse duly licensed according to the laws of another state and who has made application for a permanent license in Tennessee. A permit issued under the provisions of this subsection (c) shall be valid for a single period of six (6) months.

Acts 1967, ch. 78, § 19; 1976, ch. 501, § 6; 1978, ch. 678, § 2; 1981, ch. 462, § 8; T.C.A., § 63-747; Acts 1982, ch. 712, § 5; 2005, ch. 387, § 5.

63-7-111. Practical nurse fees — Certification to other states.

1. 1. The applicant for a license to practice as a licensed practical nurse shall pay an examination fee as set by the board, and the board may direct, by regulation, that a part of the fee shall be paid directly to a testing service by the applicant.
   2. An applicant to rewrite an examination shall pay an examination fee as set by the board, and the board may direct, by regulation, that a part of the fee shall be paid directly to a testing service by the applicant.
2. The applicant to practice as a licensed practical nurse without examination under § 63-7-110(b) shall pay a fee as set by the board.
3. The applicant for a permit shall pay a fee as set by the board.
4. Any person who holds a license to practice as a practical nurse under this chapter and who seeks to be licensed in another state by endorsement on the basis of the person's Tennessee license shall have the license certified by the board for a fee as set by the board.
5. The applicant for a duplicate original license or a duplicate renewal certificate shall pay a fee as set by the board.
6. The applicant for a school transcript shall pay a fee as set by the board.
7. The applicant for a change in name shall pay a fee as set by the board.

Acts 1967, ch. 78, § 20; 1976, ch. 501, § 7; 1981, ch. 462, §§ 9-12; T.C.A., § 63-748; Acts 1982, ch. 712, § 6; 1985, ch. 39, §§ 5-7; 1989, ch. 523, §§ 201-208; 2005, ch. 387, § 6.

Law Reviews.

Health Professionals' Access to Hospitals: A Retrospective and Prospective Analysis, 34 Vand. L. Rev. 1161 (1981).

63-7-112. Use of “licensed practical nurse” title.

Any person who holds a license to practice practical nursing under this chapter shall, during the effective period of such license, be entitled to use the title “nurse,” “licensed practical nurse” or the abbreviation “L.P.N.” No other person shall assume such titles or use such abbreviation or any other words, letters or signs to indicate that the person using the same is a licensed practical nurse.

Acts 1967, ch. 78, § 21; T.C.A., § 63-749; Acts 2004, ch. 573, § 2.

63-7-113. Examinations.

1. An examination for both the professional and practical nurses shall be held at least once each year at such time and place as the board may determine and additional examinations as the board may deem necessary.
2. The board shall appoint the number of nurses and proctors necessary to administer the examination in each place designated and make such rules and regulations in regard to the examinations as are essential to efficient service. Each nurse or proctor shall receive fifty dollars ($50.00) per day for each day of service, and in addition thereto, shall be reimbursed for travel and other necessary expenses. Such expenses shall be claimed and paid in accordance with the prevailing travel regulations of the state government.

Acts 1967, ch. 78, § 22; 1976, ch. 501, § 8; T.C.A., § 63-750; Acts 2005, ch. 387, § 7.

63-7-114. Renewal of license.

1. All licensed professional or registered nurses shall submit an application for renewal of licensure registration to the board of nursing with a biennial renewal fee as set by the board.
2. Each licensed practical nurse shall submit an application for the renewal of licensure registration to the board with a biennial renewal fee as set by the board.
3. 1. Notwithstanding this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license renewals at alternative intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under the alternative method are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period. However, during a transition period, or at any time thereafter when the board shall determine that the volume of work for any given interval is unduly burdensome or costly, either the licenses or renewals, or both of them, may be issued for terms of not less than six (6) months nor more than eighteen (18) months. The fee imposed for any license under the alternative interval method for a period of other than twenty-four (24) months shall be proportionate to the annual fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢).
   2. No renewal application will be accepted after the last day of the month following the license expiration date under the alternative method authorized in this subsection (c).
4. The executive director of the board shall notify each person holding a current licensure registration to practice as a professional or registered nurse or as a practical nurse at least sixty (60) days prior to the due date of the renewal fee that the fee is due. Failure of any licensee to receive such notice shall not relieve or exempt such licensee from the requirements of this section.
5. The license of any nurse who fails to renew the licensure registration, provide any information requested by the board to perform its duties or pay any fees required by this chapter shall be automatically revoked unless registration is made within sixty (60) days. Reinstatement may be obtained upon good cause being shown to the board, payment of all past due fees and upon payment of a reinstatement fee as set by the board. The board may request evidence of nursing competence prior to renewal of the nursing license.
6. Any nurse who has not been engaged in the practice of nursing for five (5) years or more shall be issued an inactive license. If such nurse desires to resume practice, notice in writing shall be given to the board and evidence of nursing competence may be required prior to license renewal. The board shall evaluate, on an individual basis, evidence of nursing competence, which may include, but is not limited to, continuing education, a refresher program, comprehensive orientation program, employment in a health-related policy position or nursing educational program.

Acts 1967, ch. 78, § 23; 1972, ch. 523, § 2; 1976, ch. 501, § 9; 1981, ch. 462, § 13; T.C.A., § 63-751; Acts 1982, ch. 712, § 7; 1989, ch. 360, §§ 27-29; 1989, ch. 523, §§ 209-211; 2005, ch. 387, §§ 8, 9.

63-7-115. Grounds for denial, revocation or suspension of certificate or license.

1. 1. The board has the power to deny, revoke or suspend any certificate or license to practice nursing or to otherwise discipline a licensee upon proof that the person:
      1. Is guilty of fraud or deceit in procuring or attempting to procure a license to practice nursing;
      2. Is guilty of a crime;
      3. Is unfit or incompetent by reason of negligence, habits or other cause;
      4. Is addicted to alcohol or drugs to the degree of interfering with nursing duties;
      5. Is mentally incompetent;
      6. Is guilty of unprofessional conduct; or
      7. Has violated or attempted to violate, directly or indirectly, or assisted in or abetted the violation of or conspired to violate any provision of this chapter or any lawful order of the board issued pursuant thereto.
   2. This section shall also apply to members of the board.
2. The board shall have concurrent enforcement power, pursuant to § 63-1-122 [repealed], with the division to revoke or suspend any certificate of fitness of a nurse practitioner who has been issued a certificate of fitness pursuant to § 63-1-104 or to otherwise discipline such person in accordance with this section.
3. 1. The board may utilize one (1) or more screening panels in its investigative and disciplinary process to assure that complaints filed and investigations conducted are meritorious and to act as a mechanism for diversion to professional peer review organizations and/or impaired professionals associations or foundations those cases that the board, through established guidelines, deems appropriate. Upon diversion, such entities shall retain the same immunity as provided by law for the board.
   2. The screening panels shall consist of as many members as the board directs, but shall include at least one (1) but no more than three (3) licensed nurses, who may be members of the board or may serve either voluntarily or through employment by or under contract with the board.
   3. The activities of the screening panels and any mediation or arbitration sessions shall not be construed as meetings of an agency for purposes of the open meetings law, compiled in title 8, chapter 44, and shall remain confidential. The members of the screening panels, mediators and arbitrators have a deliberative privilege and the same immunity as provided by law for the board and are not subject to deposition or subpoena to testify regarding any matter or issue raised in any contested case, criminal prosecution or civil lawsuit that may result from or be incident to cases processed before them.
4. The board retains jurisdiction to modify or refuse to modify, upon request of any party, any of its orders issued pursuant to this section in compliance with procedures established by the board. The board, pursuant to duly promulgated rules, may, whenever a final order is issued after a disciplinary contested case hearing that contains findings that a licensee or other person has violated any provision of this chapter, assess the costs directly related to the prosecution of the case against the licensee or person.
5. Any elected officer of the board or any duly appointed or elected chair of any panel of the board or any screening panel and any hearing officer, arbitrator or mediator has the authority to administer oaths to witnesses and, upon probable cause being established, issue subpoenas for the attendance of witnesses and the production of documents and records.

Acts 1967, ch. 78, § 24; 1976, ch. 501, § 10; 1980, ch. 851, § 6; T.C.A., § 63-752; Acts 1982, ch. 712, § 8; 1998, ch. 1047, § 1.

Compiler's Notes. Former section 63-1-122, referred to in this section, was repealed by Acts 2010, ch. 1043, § 5, effective June 11, 2010.

Cross-References. Confidentiality of public records, § 10-7-504.

Law Reviews.

Tennessee Civil Disabilities: A Systemic Approach (Neil P. Cohen), 41 Tenn. L. Rev. 253 (1974).

Attorney General Opinions. The emergency services board does not have authority to develop and use screening panels to assist with the processing and disposition of disciplinary cases; however, the board of chiropractic examiners, board of medical examiners, and board of nursing are authorized by statute to use screening panels in their investigative and disciplinary processes, OAG 01-055, 2001 Tenn. AG LEXIS 47 (4/10/01).

The board of nursing has authority to issue administrative subpoenas to compel the attendance of witnesses or the production of documents prior to the commencement of an administrative action, OAG 01-055, 2001 Tenn. AG LEXIS 47 (4/10/01).

63-7-116. License revocation or suspension procedure — Reissuance — Contested case hearings.

1. Any person may prefer charges against a nurse for violation of any grounds of discipline mentioned in § 63-7-115. The charges shall be in writing and submitted to the board unless they originate with the board or a member thereof.
2. Unless the charges are dismissed without a hearing by the board as unfounded or not warranting further investigation, the board shall, within ninety (90) days from the date on which the charges are preferred, set a time, date and place for a hearing on the charges. The date set for the hearing shall not be more than six (6) months from the date on which the charges are preferred.
3. A copy of the charges, together with the notice of the time and place of the hearing, shall be furnished to the accused, which may be done by registered mail directed to the address furnished to the board at the time of registration, at least thirty (30) days before the date fixed for the hearing.
4. 1. The chair or the vice chair of the board has the power to administer oaths, issue subpoenas and enforce the attendance of witnesses and the production of books, records and papers at any hearing on any matter that the board has power to investigate.
   2. If any witness fails or refuses to obey a subpoena issued by it, the board is authorized to make application to any court of record in this state within the jurisdiction of which the witness is found or resides; and the court shall have power to attach the body of the witness and compel the witness to appear before the board and give testimony or produce books, records or papers as ordered. Any failure to obey the court order may be punished by the court issuing the order as a contempt.
   3. Each witness who appears before the board by order of the board shall receive for attendance the compensation provided by law for attendance of witnesses in a court of record, which shall be paid from the funds of the board in the same manner as all other expenses of the board are paid.
5. At the hearing, the accused shall have the right to appear personally and by counsel to cross-examine witnesses to produce evidence and witnesses, and shall also have the right to have subpoenas issued by the board to compel the attendance of all witnesses considered by the parties to be necessary to a full and complete hearing.
6. After the hearing, if a majority of the members of the board present vote in favor of finding the accused guilty of any of the charges, the board shall suspend or revoke the certificate of registration of the accused as in its judgment the offense deserves.
7. Review of the action of the board in suspending or revoking any license shall be pursuant to title 27, chapter 9.
8. The board may reissue any license that it has revoked if a majority of the members of the board present vote in favor of the reissuance of the license for reasons the board may consider sufficient.
9. Notwithstanding any other law to the contrary, for purposes of contested case hearings and disciplinary matters, three (3) or more members shall constitute a quorum and the board chair is authorized, when it is deemed necessary, to split the board into panels of three (3) or more members, each to conduct contested case hearings or disciplinary matters. A majority vote of the members present on any duly constituted panel shall be required to authorize board action in disciplinary matters and contested case hearings. The board chair shall have the authority to appoint board members to serve, as necessary, on the panels regardless of the grand division from which the appointed member was chosen or the member's status as a nurse or non-nurse member. The participation of a non-nurse board member creates no rights in any individual concerning the composition of any panel in any disciplinary matter or contested case hearing. The unavailability of a member of any panel before rendition of a final order shall not require substitution of another member unless the unavailability results in there being less than the quorum required by this section for contested case hearings or disciplinary matters. Any substitute required shall use any existing record and may conduct any further proceedings as are necessary in the interest of justice. A decision by the panel shall be deemed an order of the board.

Acts 1967, ch. 78, § 25; 1972, ch. 523, § 3; T.C.A., § 63-753; Acts 1984, ch. 755, § 7; 1985, ch. 39, §§ 8, 9, 12; 2008, ch. 849, § 1.

Cross-References. Certified mail in lieu of registered mail, § 1-3-111.

Grand divisions, title 4, ch. 1, part 2.

Law Reviews.

Review of Administrative Decisions by Writ of Certiorari in Tennessee (Ben. H. Cantrell), 4 Mem. St. U.L. Rev. 19.

63-7-117. Application for school accreditation.

An institution desiring to conduct a school of professional nursing or a school of practical nursing on ground, distance, online or via other electronic means must apply to the board for approval, and submit evidence that it is prepared to:

1. Carry out the prescribed basic professional nursing curriculum or the prescribed curriculum for practical nursing, as the case may be; and
2. Meet other standards established by this chapter or by the board.

Acts 1967, ch. 78, § 26; T.C.A., § 63-754; Acts 2005, ch. 387, § 10.

63-7-118. Investigation of applicants for accreditation.

A survey of the institution or institutions and agencies with which the school is to be affiliated shall be made by the executive director or by a qualified nurse appointed for this purpose by the board. The school shall submit a written report to the board. If, in the opinion of the board, the requirements for an approved school are found to be met, the board shall approve such school and designate it as an approved school of nursing.

Acts 1967, ch. 78, § 27; T.C.A., § 63-755; Acts 2005, ch. 387, § 11.

63-7-119. Survey of schools and report — Loss of accreditation.

At least once every eight (8) years, the executive director or other authorized employee shall survey each school of nursing in Tennessee and submit a written report to the board. If the board determines that a school of nursing previously approved is not maintaining the required standards, written notice shall be furnished the school with a specification of the deficiencies claimed to exist by the board. After a hearing, which shall be afforded if demanded, a school that fails to correct the deficiencies written in such notice within the time specified shall be removed from the list of approved schools of nursing.

Acts 1967, ch. 78, § 28; T.C.A., § 63-756; Acts 1985, ch. 39, § 10; 2005, ch. 387, § 12.

63-7-120. Violations and penalties.

1. It is a Class B misdemeanor for any person, corporation or association to:
   1. Sell or fraudulently obtain or furnish any nursing diploma, license or record, or aid or abet therein;
   2. Practice nursing as defined by this chapter under cover of any diploma, license or record illegally or fraudulently obtained or assigned or issued unlawfully or under fraudulent representation;
   3. Practice nursing as defined by this chapter unless duly licensed to do so under this chapter;
   4. Use in connection with the person's name any designation tending to imply that the person is a registered nurse or a licensed practical nurse unless duly licensed so to practice under this chapter;
   5. Practice nursing during the time the person's license issued under this chapter is suspended or revoked;
   6. Conduct a school of nursing or a program for the training of practical nurses unless the school or program has been approved by the board; or
   7. Otherwise violate any provisions of this chapter.
2. Legal procedure in prosecution of violations of this section shall be in accordance with general statutes.

Acts 1967, ch. 78, § 29; 1976, ch. 501, § 11; T.C.A., § 63-757; Acts 1989, ch. 591, § 112.

Cross-References. Penalty for Class B misdemeanor, § 40-35-111.

Law Reviews.

Tennessee Civil Disabilities: A Systemic Approach (Neil P. Cohen), 41 Tenn. L. Rev. 253 (1974).

63-7-121. Validity of license issued on or before September 1, 1967.

Any person holding a license to practice as a registered or professional nurse or licensed practical nurse issued by the board that is valid on September 1, 1967, shall thereafter be considered to be licensed under this chapter.

Acts 1967, ch. 78, § 30; T.C.A., § 63-758.

63-7-122. Enjoining violations.

1. The board of nursing, in addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license, is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin:
   1. Any person from practicing or from attempting to practice as a professional or registered nurse, as described in § 63-7-103, or as a licensed practical nurse, as described in § 63-7-108, without possessing a valid license;
   2. Any licensee from practicing who has been found guilty of the acts enumerated in § 63-7-115; or
   3. Any person from using the title “nurse” or from using any other title, abbreviation, or designation in connection with the person's name, occupation, or profession that indicates or implies that the person is a practicing nurse, but who does not possess a valid license or certificate from the board of nursing.
2. No injunction bond shall be required of the board.
3. Jurisdiction is conferred upon the circuit and chancery courts to hear and determine such causes as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.

Acts 1976, ch. 501, § 12; T.C.A., § 63-759; Acts 2019, ch. 245, § 2.

Amendments. The 2019 amendment, in (a), divided the former subsection into the present introductory language and (a)(1) and (a)(2) by substituting “to enjoin: (1) Any person from practicing or from attempting” for “to enjoin from practicing any person who is practicing or attempting”, and substituting “a valid license; (2) Any licensee” for “a valid license or to enjoin any licensee”, substituted “described” for “defined” twice in (a)(1), added “or” at the end of (a)(2), and added (a)(3).

Effective Dates. Acts 2019, ch. 245, § 3. May 2, 2019.

Cross-References. Enjoining violations, § 63-1-121.

Law Reviews.

The Tennessee Court System — Chancery Court (Frederic S. Le Clercq),8 Mem. St. L. Rev. 281.

63-7-123. Certified nurse practitioners — Drug prescriptions — Temporary certificate — Rules and regulations.

1. The board shall issue a certificate of fitness to nurse practitioners who meet the qualifications, competencies, training, education and experience, pursuant to § 63-7-207(14), sufficient to prepare such persons to write and sign prescriptions and/or issue drugs within the limitations and provisions of § 63-1-132.
2. 1. A nurse who has been issued a certificate of fitness as a nurse practitioner pursuant to § 63-7-207 and this section shall file a notice with the board, containing the name of the nurse practitioner, the name of the licensed physician collaborating with the nurse practitioner who has control and responsibility for prescriptive services rendered by the nurse practitioner, and a copy of the formulary describing the categories of legend drugs to be prescribed and/or issued by the nurse practitioner. The nurse practitioner shall be responsible for updating this information.
   2. 1. The nurse practitioner who holds a certificate of fitness shall be authorized to prescribe and/or issue controlled substances listed in Schedules II, III, IV, and V of title 39, chapter 17, part 4, upon joint adoption of physician collaboration rules concerning controlled substances pursuant to subsection (d).
      2. Notwithstanding subdivision (b)(2)(A), a nurse practitioner shall not prescribe Schedules II, III, and IV controlled substances unless such prescription is specifically authorized by the formulary or expressly approved after consultation with the collaborating physician before the initial issuance of the prescription or dispensing of the medication.
      3. A nurse practitioner who had been issued a certificate of fitness may only prescribe or issue a Schedule II or III opioid listed on the formulary for a maximum of a non-refillable, thirty-day course of treatment unless specifically approved after consultation with the collaborating physician before the initial issuance of the prescription or dispensing of the medication. This subdivision (b)(2)(C) shall not apply to prescriptions issued in a hospital, a nursing home licensed under title 68, or inpatient facilities licensed under title 33.
   3. 1. Any prescription written and signed or drug issued by a nurse practitioner under collaboration with and the control of a collaborating physician shall be deemed to be that of the nurse practitioner. Every prescription issued by a nurse practitioner pursuant to this section shall be entered in the medical records of the patient and shall be written on a preprinted prescription pad bearing the name, address, and telephone number of the collaborating physician and of the nurse practitioner, and the nurse practitioner shall sign each prescription so written. Where the preprinted prescription pad contains the names of more than one (1) physician, the nurse practitioner shall indicate on the prescription which of those physicians is the nurse practitioner's primary collaborating physician by placing a checkmark beside or a circle around the name of that physician.
      2. Any handwritten prescription order for a drug prepared by a nurse practitioner who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription. The handwritten prescription order must contain the name of the prescribing nurse practitioner, the name and strength of the drug prescribed, the quantity of the drug prescribed, handwritten in letters or in numerals, instructions for the proper use of the drug and the month and day that the prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing nurse practitioner must sign the handwritten prescription order on the day it is issued, unless the prescription order is:
         1. Issued as a standing order in a hospital, a nursing home or an assisted care living facility as defined in § 68-11-201; or
         2. Prescribed by a nurse practitioner in the department of health or local health departments or dispensed by the department of health or a local health department as stipulated in § 63-10-205.
      3. Any typed or computer-generated prescription order for a drug issued by a nurse practitioner who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the prescription order. The typed or computer-generated prescription order must contain the name of the prescribing nurse practitioner, the name and strength of the drug prescribed, the quantity of the drug prescribed, recorded in letters or in numerals, instructions for the proper use of the drug and the month and day that the typed or computer-generated prescription order was issued, recorded in letters or in numerals or a combination thereof. The prescribing nurse practitioner must sign the typed or computer-generated prescription order on the day it is issued, unless the prescription order is:
         1. Issued as a standing order in a hospital, nursing home or an assisted care living facility as defined in § 68-11-201; or
         2. Prescribed by a nurse practitioner in the department of health or local health departments or dispensed by the department of health or a local health department as stipulated in § 63-10-205.
      4. Nothing in this section shall be construed to prevent a nurse practitioner from issuing a verbal prescription order.
      5. 1. All handwritten, typed or computer-generated prescription orders must be issued on either tamper-resistant prescription paper or printed utilizing a technology that results in a tamper-resistant prescription that meets the current centers for medicare and medicaid service guidance to state medicaid directors regarding § 7002(b) of the United States Troop Readiness, Veterans' Care, Katrina Recovery and Iraq Accountability Appropriations Act of 2007, P.L. 110-28, and meets or exceeds specific TennCare requirements for tamper-resistant prescriptions.
         2. Subdivision (b)(3)(E)(i) shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the doctor or other person authorized to write prescriptions writes the order into the hospital medical record and then the order is given directly to the hospital pharmacy and the patient never has the opportunity to handle the written order, a nursing home or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.
      6. [Deleted by 2018 amendment.]
   4. The nurse practitioner shall maintain a copy of the protocol the nurse practitioner is using at the nurse practitioner's practice location and shall make the protocol available upon request by the board of nursing, the board of medical examiners or authorized agents of either board.
   5. An advanced practice registered nurse with a certificate of fitness issued pursuant to this chapter, who provides services in a free clinic as defined in § 63-6-703 or engages in the voluntary provision of healthcare services as defined in § 63-6-703, may arrange for required personal review of the nurse's charts by a collaborating physician in the office or practice site of the physician or remotely via HIPAA-compliant electronic means rather than at the site of the clinic. For purposes of this subdivision (b)(5), “HIPAA-compliant” means that the entity has implemented technical policies and procedures for electronic information systems that meet the requirements of 45 CFR 164.312.
   6. An advanced practice registered nurse with a certificate of fitness issued pursuant to this chapter, who provides services in a community mental health center as defined in § 33-1-101, may arrange for the required personal review of the advanced practice registered nurse's charts by a collaborating physician, with the same authority to render prescriptive services that the nurse practitioner is authorized to render, in the office or practice site of the physician, or the required visit by a collaborating physician to any remote site, or both, via HIPAA-compliant electronic means rather than at the site of the clinic. For purposes of this subdivision (b)(6), “HIPAA-compliant” means that the entity has implemented technical policies and procedures for electronic information systems that meet the requirements of 45 C.F.R. § 164.312.
3. 1. The board may issue a temporary certificate of fitness to a registered nurse who:
      1. Is licensed to practice in Tennessee;
      2. Has a master's degree in a nursing clinical specialty area with preparation in specialized practitioner skills that includes three (3) quarter hours of pharmacology instruction or its equivalent; and
      3. Has applied for examination and/or is awaiting examination results for national certification as a first-time examinee in an appropriate nursing specialty area.
   2. Such temporary certificate shall remain valid until the examination results are obtained. The holder of a temporary certificate issued under this subsection (c) who has not received the results of the examination shall work only under the supervision and control of a certified nurse practitioner or physician.
4. Any rules that purport to regulate the collaboration of nurse practitioners with physicians shall be jointly adopted by the board of medical examiners and the board of nursing.

Acts 1980, ch. 851, § 4; T.C.A., § 63-760; Acts 1985, ch. 120, § 9; 1992, ch. 822, § 1; 1994, ch. 569, § 2; 1995, ch. 358, § 1; 1996, ch. 659, § 2; 1997, ch. 507, § 2; 1998, ch. 842, §§ 2, 3; 2003, ch. 259, § 1; 2004, ch. 678, § 9; 2005, ch. 12, § 4; 2008, ch. 1035, §§ 5, 9; 2010, ch. 795, §§ 6, 17; 2013, ch. 74, § 5; 2013, ch. 396, § 1; 2016, ch. 769, § 1; 2016, ch. 980, § 12; 2017, ch. 334, §§ 2-5; 2018, ch. 883, § 6; 2019, ch. 183, § 1.

Compiler's Notes. Acts 1997, ch. 507, § 4 provides that nothing in (b)(2) shall apply to the practice of nurse anesthesia.

Acts 2004, ch. 678, § 1 provided that the title of the act is and may be cited as the “Medication Error Reduction Act of 2004.”

Acts 2004, ch. 678, § 2 provided that it is the intent of the general assembly to create a uniform standard that health care providers must follow in issuing written or electronic prescription orders. This standard is intended to reduce medication related errors, which represent a major source of medical errors in the health care system. The general assembly finds that reducing medical errors will result in greater safety for patients as well as cost savings for the health care system in this state. By adopting these standards, the general assembly intends to promote medical safety for all patients who are issued drug prescriptions in this state.

Acts 2004, ch. 678, § 11 provided that nothing in the act shall be construed as limiting any practitioner's or pharmacist's ability to order the use of or distribute nonprescription drugs or devices otherwise in accordance with applicable law.

Acts 2004, ch. 678, § 12 provided that nothing in the act shall be construed as limiting any professional nurse's ability to issue drugs in accordance with the provisions of § 63-7-124.

Acts 2004, ch. 678, § 13 provided that the department of health, division of health related boards and the board of pharmacy, are authorized to promulgate uniform rules to effect the purposes of this act in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The power and duty to enforce those rules shall be vested in the various boards that regulate health care providers affected by the act, in accordance with § 63-1-122 [repealed].

Acts 2004, ch. 678, § 14 provided that the act shall not affect rights and duties that matured, penalties that were incurred, or proceedings that were begun before July 1, 2004.

Acts 2010, ch. 795, § 8 provided that nothing in the act shall be construed as limiting any practitioner's or pharmacist's ability to order the use of or distribute non-prescription drugs or devices otherwise in accordance with applicable law.

Acts 2010, ch. 795, § 9 provided that §§ 1-7 of the act shall not apply to prescriptions written for inpatients of a hospital, outpatients of a hospital where the physician or other person authorized to write prescriptions, writes the order into the hospital medical record and the patient or patient's agent or representative never has the opportunity to handle the written order, a nursing home, or an assisted care living facility as defined in § 68-11-201 or inpatients or residents of a mental health hospital or residential facility licensed under title 33 or individuals incarcerated in a local, state or federal correctional facility.

Acts 2010, ch. 795, § 10 provided that nothing in the act shall be construed as limiting any professional nurse's ability to issue drugs in accordance with the provisions of § 63-7-124.

Acts 2010, ch. 795, § 11 provided that the department of health, division of health related boards and the board of pharmacy, are authorized to promulgate uniform rules to effect the purposes of the act in accordance with title 4, chapter 5. The power and duty to enforce those rules shall be vested in the various boards that regulate healthcare providers affected by the act, in accordance with § 63-1-122 [repealed].

Acts 2010, ch. 795, § 19 provided that the act shall not affect rights and duties that matured, penalties that were incurred, or proceedings that were begun before January 1, 2011.

For the Preamble to the act  relative to the relationship between physicians and advanced practice registered nurses, please refer to Acts 2017, ch. 334.

Acts 2018, ch. 883, § 10 provided that the commissioner of health is authorized to promulgate rules to effectuate the purposes of the act. All rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5.

Amendments. The 2017 amendment, in (b), substituted “collaborating physician” for “supervising physician” throughout, substituted “licensed physician collaborating with the nurse practitioner who has control” for “licensed physician having supervision, control” in (1), substituted “physician collaboration rules” for “physician supervisory rules” in (2)(A), and substituted “nurse practitioner under collaboration with and the control of a collaborating physician” for “nurse practitioner under the supervision and control of a supervising physician” in (3)(A); and substituted “regulate the collaboration of nurse practitioners with physicians” for “regulate the supervision of nurse practitioners by physicians” in (d).

The 2018 amendment, effective January 1, 2019, deleted former (b)(3)(F) which read: “Any written, printed or computer-generated prescription order for a Schedule II controlled substance prepared by an advanced practice registered nurse who is authorized by law to prescribe a drug must be printed or typed as a separate prescription order. The written, printed or computer-generated prescription order must contain all information otherwise required by law. The prescribing advanced practice registered nurse must sign the written, printed or computer-generated prescription order on the day it is issued.”

The 2019 amendment added (b)(6).

Effective Dates. Acts 2017, ch. 334, § 15. July 1, 2017.

Acts 2018, ch. 883, § 12. January 1, 2019; provided that for rulemaking purposes the act took effect May 3, 2018.

Acts 2019, ch. 183, § 3. April 23, 2019.

Cross-References. Certified nurse practitioners' prescription and drug authorization powers, § 63-7-207.

Issuance of oral contraceptives and drugs relating to sexually transmitted diseases, by professional nurse, § 63-7-124.

Law Reviews.

Health Professionals' Access to Hospitals: A Retrospective and Prospective Analysis, 34 Vand. L. Rev. 1161 (1981).

Defining the Opioid Crisis and the Limited Role of the Criminal Justice System Resolving It, 48 U. Mem. L. Rev. 1206 (Summer 2018).

Attorney General Opinions. Prescriptions by nurse anesthetist, nurse midwife, or clinical nurse specialist; applicability of prescribing privileges to all categories of advanced practice nurse.  OAG 10-22, 2010 Tenn. AG LEXIS 17 (3/1/10).

63-7-124. Authority to issue oral contraceptives and drugs relating to sexually transmitted diseases.

1. Notwithstanding former §§ 63-1-132(c) [repealed] and 63-7-123, a professional nurse, licensed pursuant to §§ 63-7-104 — 63-7-107, who is employed by a primary health care center established under § 68-1-701, that receives fifty percent (50%) or more of its family planning funds from funds distributed by the department of health, has the authority to issue, in the same manner as is currently permitted the department or local health departments under § 63-10-205:
   1. Oral contraceptives, excluding abortifacients; and
   2. Drugs relating to sexually transmitted diseases.
2. A drug issued under this section shall be issued in accordance with any protocols or standards established by the department for the use of such drug.
3. No drugs as provided in this section shall be issued unless a physician has examined the patient for the condition for which such drugs are issued; provided, that this requirement does not supersede any protocol under which a nurse practitioner is rendering service to a patient pursuant to § 63-6-204 or § 63-7-123.

Acts 1990, ch. 858, § 1.

Compiler's Notes. Former § 63-1-132(c), referred to in this section, was repealed by Acts 2010, ch. 1043, § 7, effective June 11, 2010.

63-7-125. Confidentiality.

1. The confidential communications between a client and a registered nurse who is nationally certified as a specialist in psychiatric and mental health nursing and who is practicing in that specialty are considered equivalent to the confidential communications between a patient and a licensed physician practicing as a psychiatrist, under laws addressing privilege and confidentiality and shall have the same protections accorded to patient-psychiatrist communications under § 24-1-207.
2. Nothing in this section shall be construed to prevent disclosure of confidential communications in proceedings arising under title 37, chapter 1, part 4, concerning mandatory child abuse reports, or in proceedings arising under title 71, chapter 6, part 1, concerning mandatory adult abuse reports.

Acts 1995, ch. 271, § 1.

Cross-References. Confidentiality of public records, § 10-7-504.

63-7-126. Advanced practice registered nurses.

1. “Advanced practice registered nurse” means a registered nurse with a master's degree or higher in a nursing specialty and national specialty certification as a nurse practitioner, nurse anesthetist, nurse midwife or clinical nurse specialist.
2. Nurse practitioners, nurse anesthetists, nurse midwives and clinical nurse specialists holding such education and practice credentials shall apply to the board for a certificate to practice as an advanced practice registered nurse, including authorization to use the title “advanced practice registered nurse” or the abbreviation “APRN.” No other person shall assume such title or use such abbreviation or any other words, letters or signs to indicate that the person using the same is an advanced practice registered nurse.
3. An applicant for a certificate to practice as an advanced practice registered nurse shall pay an initial fee as set by the board as well as a biennial renewal fee as set by the board.
4. A nurse practitioner, nurse anesthetist, nurse midwife or clinical nurse specialist who holds a Tennessee registered nurse license in good standing and current national specialty certification in the advanced practice specialty shall be eligible for a certificate to practice as an advanced practice registered nurse on May 22, 2002, and shall be exempt from the requirement of a master's degree or higher in the nursing specialty if licensed in Tennessee and holding national specialty certification prior to July 1, 2005. Notwithstanding the previous requirements, a nurse anesthetist shall be eligible for a certificate to practice as an advanced practice registered nurse if the nurse anesthetist graduated prior to January 1, 1999, from a nurse anesthesia educational program approved by the American Association of Nurse Anesthetists Council on Accreditation.
5. With the exception of subsection (f), nothing in this section shall be interpreted to alter or change the current law as it existed on May 22, 2002, regarding prescriptive rights, supervision or scope of practice for nurse anesthetists regulated under this title, nurse midwives as described in § 56-7-2407, clinical nurse specialists or certified nurse practitioners as defined in § 63-7-123. Nor shall anything in this section be interpreted to allow any board or other entity to promulgate rules that would alter or change the law as it existed on May 22, 2002, regarding such prescriptive rights, supervision or scope of practice.
6. An advanced practice registered nurse shall only perform invasive procedures involving any portion of the spine, spinal cord, sympathetic nerves of the spine or block of major peripheral nerves of the spine in any setting not licensed under title 68, chapter 11 under the direct supervision of a Tennessee physician licensed pursuant to chapter 6 or 9 of this title who is actively practicing spinal injections and has current privileges to do so at a facility licensed pursuant to title 68, chapter 11. The direct supervision provided by a physician in this subsection (f) shall only be offered by a physician who meets the qualifications established in § 63-6-244(a)(1) or (a)(3) or § 63-9-121(a)(1) or (a)(3). For purposes of this subsection (f), “direct supervision” is defined as being physically present in the same building as the advanced practice registered nurse at the time the invasive procedure is performed. This subsection (f) shall not apply to an advanced practice registered nurse performing major joint injections except sacroiliac injections, or to performing soft tissue injections or epidurals for surgical anesthesia or labor analgesia in unlicensed settings.

Acts 2002, ch. 768, § 1; 2003, ch. 111, § 1; 2008, ch. 782, § 1; 2012, ch. 961, §§ 1, 2; 2016, ch. 980, §§ 13-15.

Attorney General Opinions. Prescriptions by nurse anesthetist, nurse midwife, or clinical nurse specialist; applicability of prescribing privileges to all categories of advanced practice nurse.  OAG 10-22, 2010 Tenn. AG LEXIS 17 (3/1/10).

63-7-127. Medication aides.

1. As used in this section, “medication aide” means an individual who administers medications under the general supervision of a licensed registered or practical nurse pursuant to this section. During the course of administering medication, a medication aide shall not be assigned any other nonmedication administration duties. A medication aide shall not be prohibited from responding, as appropriate, to an emergency.
2. Any nursing home or assisted care living facility licensed pursuant to title 68 or a Program for All-Inclusive Care for the Elderly (PACE) as defined in § 56-2-121(b) may use one (1) or more medication aides to administer medications, as set forth in this section, to its patients; provided, that each and every individual used as a medication aide shall hold a current, valid medication aide certificate issued by the board of nursing under this section.
3. When carrying out their responsibilities under this section, medication aides shall wear a name tag visible to others that displays the designation “Medication Aide.”
4. An individual seeking certification as a medication aide shall apply to the board of nursing on a form prescribed and provided by the board in writing or via online application. The individual shall also pay the applicable certification fee established by the board.
5. To be eligible to receive a medication aide certificate, an applicant shall:
   1. Be at least eighteen (18) years of age;
   2. Have completed the twelfth grade or its equivalent, or have successfully passed the test for and received a general equivalency diploma;
   3. Be a nurse aide, duly certified under the standards established under federal law and title 68, chapter 11, part 2, who has practiced as a certified nurse aide in a nursing home or assisted care living facility or a PACE as defined in § 56-2-121 for a minimum of one (1) year at the time the applicant submits an application for certification as a medication aide;
   4. Have successfully completed the course of instruction provided by a training program approved by the board under subsection (i); and
   5. Have passed a standardized examination.
6. If an applicant meets the requirements of subsection (e), the board shall issue a medication aide certificate to the applicant.
7. A medication aide certificate is valid for two (2) years, unless it is earlier suspended or revoked. The certificate may be renewed in accordance with procedures specified in rules promulgated by the board under this section. To be eligible for renewal, an applicant shall pay a renewal fee established by the board and shall:
   1. Have completed all continuing education or continued competency requirements, or both, necessary to maintain nurse aide certification under title 68, chapter 11, part 2, and the rules promulgated pursuant to title 68, chapter 11, part 2; and
   2. Have completed a total of six (6) contact hours per year of continuing education; provided, that five (5) hours of the continuing education shall be in pharmacology provided by a licensed pharmacist or registered nurse.
8. 1. The board has the power to deny, revoke, or suspend any certificate to practice as a medication aide or to otherwise discipline a certificate holder, including imposing civil monetary penalties, upon proof that the medication aide:
      1. Is guilty of fraud or deceit in procuring or attempting to procure a certificate as a medication aide;
      2. Is guilty of a crime;
      3. Is addicted to alcohol or drugs to the degree of interfering with the medication aide's professional duties;
      4. Is mentally incompetent;
      5. Is unfit or incompetent by reason of negligence, habits, or other cause, including the following:
9. Intentionally or negligently causing physical or emotional injury to a patient;
10. 1. The board shall provide or contract for the provision of standardized medication aide examination services by:
       1. Publishing an annual schedule of examination schedules and sites;
       2. Scheduling tests to be administered, except when no individual is scheduled to test at a particular test site;
       3. Publishing the number of individuals passing and failing the exam on at least a quarterly basis;
       4. Requiring the minimum passing grade to be eighty-five percent (85%) for the examination; and
       5. Requiring individuals who fail any portion of the examination two (2) consecutive times to repeat the course of training as set forth in subsection (i) prior to taking the examination again.
    2. In accordance with the Uniform Administrative Procedures Act, the board shall have rulemaking authority to establish any necessary rules for the administration of this subsection (j).
11. 1. 1. Except for the prohibited medications and the methods of medication administration specified in subdivision (k)(3), a medication aide, who holds a current, valid medication aide certificate issued under this section, may administer medications to the residents of nursing homes or assisted care living facilities or to the participants of PACE that use medication aides pursuant to this section. A medication aide shall administer medications only pursuant to delegation by a licensed nurse.
       2. A delegation of medication administration to a medication aide shall be carried out in accordance with the rules for nursing delegation adopted under this chapter by the board of nursing.
       3. A medication aide may only administer medication after:
          1. Each resident is evaluated by a licensed nurse on admission and after any change in status, acuity, or medication; and
          2. The licensed nurse makes a determination that it is appropriate for the resident to receive medication by a medication aide.
    2. In exercising the authority to administer medications pursuant to a nursing delegation, a medication aide may administer medications in any of the following categories:
       1. Oral medications;
       2. Topical medications; and
       3. Any medications set forth in subdivision (k)(2)(A) or (k)(2)(B) prescribed with a designation authorizing or requiring administration on an as-needed basis, but only if a nursing assessment of the patient is completed by a nurse licensed under this title before the medication is administered.
    3. A medication aide shall not:
       1. Administer medications when administration would require a dosage decision or calculation;
       2. Directly receive orders from a physician or other medication prescriber;
       3. Administer barium or other contrast media;
       4. Administer chemotherapeutic agents;
       5. Administer rectal and vaginal medications;
       6. Apply topical medications ordered for the treatment of pressure ulcers or skin grafts;
       7. Change a dosage amount to adhere to a change in a physician's order;
       8. Administer medications delivered by aerosol / nebulizers; or
       9. Administer medications delivered by metered hand-held inhalers without a spacer.
    4. A medication aide shall not, under any circumstances, administer medications by certain methods or routes, or both, as determined by rule. These methods or routes include, but are not limited to, the following:
       1. Injection;
       2. Intravenous;
       3. Central lines;
       4. Intrathecal;
       5. Colostomy;
       6. A surgically placed feeding tube, such as gastrostomy or jejunostomy;
       7. Nasogastric;
       8. Intradermal;
       9. Urethral;
       10. Epidural;
       11. Endotracheal;
       12. Intramuscular;
       13. Subcutaneous; or
       14. Nonmetered inhaler.
12. 1. The board of nursing shall adopt rules to implement this section. These rules shall take effect no later than January 1, 2017. All rules shall be promulgated in accordance with the Uniform Administrative Procedures Act.
    2. The rules adopted to implement this section shall at a minimum establish or specify the following:
       1. Fees, in an amount sufficient to cover the costs the board incurs in implementing this section;
       2. Procedures for renewal of medication aide certificates;
       3. Grounds for discipline of applicants or certificate holders, or both;
       4. Standards for approval of peer support programs for the holders of medication aide certificates; and
       5. Procedures for approval or denial of medication aide training programs.
13. A licensed nurse for the purpose of this section shall include a registered nurse, a licensed practical nurse, or either one.
14. 1. Any nursing home or assisted care living facility licensed pursuant to title 68 or a PACE that uses one (1) or more medication aides to administer medications shall implement as part of its facility policy a plan for the tracking and recording of:
       1. Any medication error; and
       2. Any incident of opioid or benzodiazepine diversion.
    2. The incidents of medication error and diversion of opioids and benzodiazepines shall be made available to duly appointed representatives of the department of health pursuant to § 68-11-210.

Failing to assist in maintaining a facility record for each patient that accurately reflects the medication administration by the medication aide or failure to maintain a record for each patient that accurately reflects the name and title of the aide providing care, or both;

Using or removing without authorization drugs, supplies, or equipment from any licensed nursing home, assisted care living facility, or Program for All-Inclusive Care for the Elderly (PACE) as defined in § 56-2-121;

Using any intoxicating beverage or illegally using any narcotic or dangerous drug while on duty in any licensed nursing home, assisted care living facility, or PACE;

Being under the influence of alcoholic beverages, or under the influence of drugs that impair judgment while on duty in any licensed nursing home, assisted care living facility, or PACE;

Impersonating another licensed or certified healthcare provider;

Having received a revocation, suspension, probation, or other discipline of a certificate to practice as a medication aide, or its equivalent, or as a certified nurse aide, by another state for any act or omission that would constitute grounds for the revocation, suspension, probation, or other discipline of a certificate in this state;

Practicing as a medication aide certified in this state on a lapsed certificate;

Aiding, abetting, or assisting an individual to violate or circumvent any law or duly promulgated rule intended to guide the conduct of any certified or licensed healthcare provider;

Exercising undue influence on a patient, including the promotion or sale of services, goods, appliances, or drugs in such a manner as to exploit the patient for financial gain of the medication aide or of a third party;

Discriminating in the rendering of services as it relates to race, age, sex, religion, national origin, or the condition of the patient;

Violating confidentiality of information or knowledge concerning the patient, except when required to do so by a court of law;

Failing to take appropriate action in safeguarding the patient from incompetent healthcare practices;

Failing to report, through proper channels, facts known to the individual regarding incompetent, unethical, or illegal practices of any healthcare provider;

Performing healthcare techniques or procedures without proper education and practice; or

Engaging in acts of dishonesty that relate to the practice of a medication aide;

Is convicted of any one (1) of the following crimes:

First degree murder, § 39-13-202;

Second degree murder, § 39-13-210;

Kidnapping, § 39-13-303;

Aggravated kidnapping, § 39-13-304;

Especially aggravated kidnapping, § 39-13-305;

Aggravated robbery, § 39-13-402;

Especially aggravated robbery, § 39-13-403;

Aggravated rape, § 39-13-502;

Rape, § 39-13-503;

Exploitation of an adult under § 39-14-111 [repealed]; or

Abuse, neglect, or exploitation of an adult under § 71-6-117;

Furnished or otherwise provided the board with false or incomplete information on an application for a certificate regarding the individual's criminal conviction record; or

Has violated or attempted to violate, or assisted in or abetted the violation of, or conspired to violate, this chapter, any duly promulgated rule, or any lawful order of the board issued pursuant to this chapter.

All disciplinary actions taken by the board under this section shall conform to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, part 3, and may be heard by a screening panel pursuant to § 63-7-115(c).

(1)  A qualified entity seeking approval to provide a medication aide training program shall apply to the board of nursing on a form prescribed and provided by the board, along with the applicable fee established by the board.

The board shall approve the applicant described in subdivision (i)(1) if the applicant is a qualified entity, or a combination of qualified entities, and if the content of the course of instruction to be provided by the program meets the standards, specified by the board in rules promulgated under this section, and includes:

At least sixty (60) hours of instruction, consisting of forty (40) classroom hours and twenty (20) clinical hours. The standard minimum curriculum shall be determined by the board of nursing and shall include appropriate instruction to enable communication, attention to safety, knowledge of medications, and other factors as determined necessary by the board; and

A supervised clinical practice component that includes an approved medication aide training program sufficient to assure that students are prepared to administer medications as a medication aide in a safe and effective manner and that:

Consists of twenty (20) hours, including experience in tasks related to the administration of medication, and that is conducted under the direction and supervision of a licensed nurse;

Requires any licensed nursing home, assisted care living facility, or PACE participating in the training program to have a written agreement to provide licensed nurse supervision of the student; and

Requires supervision of a student engaged in medication administration by a licensed nurse.

The board may deny, suspend, or revoke the approval granted to the qualified entity of a medication aide training program for reasons specified in rules promulgated under this subsection (i). All actions taken by the board to deny, suspend, or revoke the approval of a training program shall conform to the Uniform Administrative Procedures Act.

Acts 2009, ch. 403, § 2; 2010, ch. 926, § 1; 2014, ch. 949, § 7; 2016, ch. 1051, § 1.

Compiler's Notes. Acts 2016, ch. 1051, § 2 provided that notwithstanding the act or the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any rule promulgated to implement the provisions of the act shall be provided to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate by the secretary of state, after approval by the attorney general and reporter, at the same time the text of the rule is made available to the government operations committees of the senate and the house of representatives for purposes of conducting the review required by § 4-5-226 in order for the health committee of the house of representatives and the health and welfare committee of the senate to be afforded the opportunity to comment on the rule.

§ 39-14-111, referred to in this section, was repealed by Acts 2017, ch. 466, § 3, effective July 1, 2017. Similar provisions can be found in title 39, chapter 15, part 5.

Cross-References. Confidentiality of public records, § 10-7-504.

Attorney General Opinions. 2010 amendment adding subsection (m) clarifying that a licensed nurse for purposes of the section includes a registered nurse, a licensed practical nurse or either one does not create a conflict with T.C.A. § 63-7-108 by creating an impermissible chain of supervision.  OAG 10-65, 2010 Tenn. AG LEXIS 71 (5/10/10).

63-7-128. Certificate to practice as a registered nurse first assistant.

1. As used in this section, “registered nurse first assistant” means a person who:
   1. Is licensed as a registered nurse in this state;
   2. 1. Is certified in perioperative nursing; or
      2. 1. Is certified as an advanced practice registered nurse; and
         2. Is qualified by education and training to perform tasks involved in perioperative nursing, as determined by the board; and
   3. Has successfully completed a registered nurse first assistant education program that meets the education standard of the Association of periOperative Registered Nurses for a registered nurse first assistant.
2. Registered nurses holding the education and practice credentials of a registered nurse first assistant may apply to the board of nursing for a certificate to practice as a registered nurse first assistant, including authorization to use the title “registered nurse first assistant” or the abbreviation “RNFA.” No other person shall assume such title or use such abbreviation or any other words, letters or signs to indicate that the person using the same is a registered nurse first assistant.
3. An applicant for a certificate to practice as a registered nurse first assistant shall pay an initial fee as set by the board as well as a biennial renewal fee as set by the board.

Acts 2014, ch. 953, § 1; 2019, ch. 326, § 1.

Amendments. The 2019 amendment, effective July 1, 2020, added (a)(2)(B).

Effective Dates. Acts 2019, ch. 326, § 2. July 1, 2020; provided, that for purposes of promulgating rules, the act took effect May 8, 2019.

63-7-129. Use of title “nurse”.

Notwithstanding any provision of any title to the contrary, a person shall not use the title “nurse” or any other title, abbreviation, or designation in connection with the person's name, occupation, or profession to indicate or imply that the person is a practicing nurse unless the person is actively licensed or certified by the board of nursing.

Acts 2019, ch. 245, § 1.

Effective Dates. Acts 2019, ch. 245, § 3. May 2, 2019.

Part 2
Board of Nursing

NOTES TO DECISIONS

1. Constitutionality.

The statute is not unconstitutional as arbitrary class legislation. Saunders v. Swann, 155 Tenn. 310, 292 S.W. 458, 1926 Tenn. LEXIS 49 (1927).

This chapter is not invalid in that it excludes oculists and ophthalmologists since such professions may be classified separately without violating the constitution. Seawell v. Beeler, 199 Tenn. 438, 287 S.W.2d 54, 1956 Tenn. LEXIS 342 (1956).

This chapter makes no distinction between members of the class of individuals known as optometrists, and does not violate the due process and equal protection clauses of U.S. Const. amend. 14. State v. Sowder, 826 S.W.2d 924, 1991 Tenn. Crim. App. LEXIS 798 (Tenn. Crim. App. 1991), cert. denied, Sowder v. Tennessee, 510 U.S. 883, 114 S. Ct. 229, 126 L. Ed. 2d 184, 1993 U.S. LEXIS 5939 (1993).