Chapter 1
Division of Health Related Boards

Part 1
General Provisions

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).

NOTES TO DECISIONS

1. Constitutionality.

Any constitutional defects in the enactment of the 1953 amendment were cured by its reenactment by the 1955 Code. Seawell v. Beeler, 199 Tenn. 438, 287 S.W.2d 54, 1956 Tenn. LEXIS 342 (1956)

2. Scope.

Body of act regulating practice of healing arts and prescribing penalty for its violation is not broader than its caption. Short v. State Licensing Board for Healing Arts, 193 Tenn. 389, 246 S.W.2d 56, 1952 Tenn. LEXIS 304 (1952)

3. Treatment of Different Professions.

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)

4. Health Care Practitioners.

A definition of “health care practitioners,” which includes all occupations licensed pursuant to title 63, some of whom cannot be sued for medical malpractice, is too broad; the definition is also too narrow because it omits any health care practitioners who are licensed under a separate title. Mooney v. Sneed, 30 S.W.3d 304, 2000 Tenn. LEXIS 572 (Tenn. 2000)

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.

NOTES TO DECISIONS

1. Diagnosis and Treatment Without License.

Conviction for violating the healing arts act was sustained where the defendant, without a license from the healing arts board, diagnosed the patient and treated her for cancer Reinhart v. State, 193 Tenn. 15, 241 S.W.2d 854, 1951 Tenn. LEXIS 320 (1951)

2. Fitting and Adjusting False Teeth.

A person making impressions, fitting and adjusting false teeth and charging for work and having no license may be enjoined. State Board of Dental Examiners v. Rymer, 202 Tenn. 234, 303 S.W.2d 959, 1957 Tenn. LEXIS 385 (1957)

3. Nurse Acting as Midwife.

Because the legislature has specifically excluded the practice of midwifery from the definition of medicine in § 63-6-204 and because the Nursing Practice Act, chapter 7 of this title, does not deal with midwifery nor is it included within the definition of professional nursing in § 63-7-103, the Tennessee board of nursing did not have jurisdiction over a licensed nurse while she was rendering services as a lay midwife. Leggett v. Tennessee Bd. of Nursing, 612 S.W.2d 476, 1980 Tenn. App. LEXIS 412 (Tenn. Ct. App. 1980)

4. Opticians.

Dispensing opticians were properly subject to regulation under Dispensing Opticians Act, chapter 14 of this title, even though not a profession since such business or calling is related to the public health and field of healing arts. Tennessee Board of Dispensing Opticians v. Eyear Corp., 218 Tenn. 60, 400 S.W.2d 734, 1966 Tenn. LEXIS 550 (1966)

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. 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).
    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.
  1. 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.
  2. 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.

NOTES TO DECISIONS

1. Service.

Tennessee Department of Health properly obtained service by mail under the Rules of Procedure for Contested Cases of the Rules of the Secretary of State because service by certified mail was sufficient despite the Department's failure to obtain a return receipt signed by the doctor. Wyttenbach v. Bd. of Tenn. Med. Examiners, — S.W.3d —, 2016 Tenn. App. LEXIS 192 (Tenn. Ct. App. Mar. 15, 2016), appeal denied, Wyttenbach v. Bd. of TN Med. Examiners, — S.W.3d —, 2016 Tenn. LEXIS 674 (Tenn. Sept. 23, 2016).

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).

NOTES TO DECISIONS

1. Patient Confidentiality Not Violated.

Trial court properly concluded that the physician received adequate notice of the reasons for the request for medical records; however, physicians in Tennessee had no reasonable expectation that they could shield their patients'  records from the Tennessee board of medical examiners'  regulatory oversight and that the board may discipline physicians who willfully refused to comply with lawful requests for patient records that complied with T.C.A. § 63-1-117. McNiel v. Cooper, 241 S.W.3d 886, 2007 Tenn. App. LEXIS 241 (Tenn. Ct. App. Mar. 30, 2007), appeal denied, — S.W.3d —, 2007 Tenn. LEXIS 728 (Tenn. Aug. 13, 2007).

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. 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.
  1. 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).

NOTES TO DECISIONS

1. Constitutionality.

Legislature did not exceed constitutional powers in providing that violation of medical arts statute is not only punishable as misdemeanor, but may be enjoined by chancery court, so that defendant penalized for contempt of court rather than for violation of statute could not complain of double jeopardy. Short v. State Licensing Board for Healing Arts, 193 Tenn. 389, 246 S.W.2d 56, 1952 Tenn. LEXIS 304 (1952).

2. Scope of License.

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 purposes 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).

3. Manner of Enforcement.

Complainants were not entitled to assail the provisions of a statute providing for revocation or suspension of certificates and licenses of optometrists as violating due process without a showing that the manner of enforcement as authorized by this section amounted to a denial of due process. Seawell v. Beeler, 199 Tenn. 438, 287 S.W.2d 54, 1956 Tenn. LEXIS 342 (1956).

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.
      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.
      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.
        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.
  3. 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.
  4. 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.
    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.
  4. 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.
    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.
      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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
    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.
  3. 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. 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.
  1. 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.
    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.
  4. 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.

NOTES TO DECISIONS

1. Notice.

Trial court properly reversed the determination of the Department of Health that a physician assistant (PA) failed to register with the Controlled Substances Monitoring Database (CSMD) and to check the CSMD before prescribing controlled substances because the record did not contain substantial and material evidence to support a finding the PA had notice that she was required to register with the CSMD and check with the CSMD before prescribing controlled substances. Tenn. Dep't of Health v. Sparks, — S.W.3d —, 2019 Tenn. App. LEXIS 439 (Tenn. Ct. App. Sept. 6, 2019), appeal denied, — S.W.3d —, 2020 Tenn. LEXIS 30 (Tenn. Jan. 15, 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. 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.
    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.
      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.
        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.
      6. 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).
  1. 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.

NOTES TO DECISIONS

1. Payment of Additional Costs.

Given the department's success, it was within the commissioner's designee's discretion to order appellants to pay the additional costs incurred on review, which was not unreasonable; there was no clear error or arbitrary or capricious action due to the increase in costs that resulted from the increased violations and increased discipline that resulted from review of the initial order. Ballard v. Tenn. Dep't of Health, — S.W.3d —, 2020 Tenn. App. LEXIS 207 (Tenn. Ct. App. May 8, 2020).

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.
    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.
  4. 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.
  5. 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.
  6. 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.
  7. 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. 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.
  1. 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.
  2. 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).
  3. 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. An individual acting within the scope of a valid license issued pursuant to this title;
      2. Any state-contracted crisis service provider that is employed by a facility licensed under title 33; or
      3. Any alcohol and drug abuse counselor licensed under title 68, chapter 24, part 6; and
    2. Notwithstanding any restriction imposed by §§ 56-7-1002 and 56-7-1003, “telehealth,” “telemedicine,” and “provider-based telemedicine” mean the use of real time audio, video, or other electronic media and telecommunication technology that enables interaction between a healthcare provider and a patient, or also store-and-forward telemedicine services as defined in § 56-7-1002, for the purpose of diagnosis, consultation, or treatment of a patient at a distant site where there may be no in-person exchange between a healthcare provider and a patient.
  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 or treat the patient; or
    2. Affirmatively participates in the diagnosis or treatment.
      1. A healthcare provider who delivers services through the use of telehealth is 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 must be provided in compliance with the guidelines created pursuant to part 4 of this chapter.
    1. 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.
    2. This section does not apply to pain management clinics, as defined in § 63-1-301, chronic nonmalignant pain treatment, or those individuals licensed pursuant to chapter 12 of this title.
  3. Sections 63-6-231 and 63-6-214(b)(21) do not apply to the practice of telemedicine under this section.
  4. This section does not apply to or restrict the requirements of § 63-6-241.
  5. Section 63-6-204(a) also applies to telemedicine.
    1. Except as provided in subdivision (g)(2), to practice under this section a healthcare provider must be licensed to practice in this state under this title.
    2. A physician must 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.

      [Subsection (h) repealed effective April 1, 2022.]

    1. Notwithstanding subsection (a), for the purposes of this section “healthcare provider” means:
      1. Any provider licensed under this title;
      2. Any state-contracted crisis service provider that is employed by a facility licensed under title 33; or
      3. Any alcohol and drug abuse counselor licensed under title 68, chapter 24, part 6.
    2. This subsection (h) is repealed on April 1, 2022.

Acts 2015, ch. 261, § 1; 2020 (2nd Ex. Sess.), ch. 4, § 9.

Compiler's Notes. 2020 (2nd Ex. Sess.), ch. 4, § 10 provided that the act, which amended this section, applies to insurance policies or contracts issued, entered into, renewed, or amended on or after August 20, 2020.

Amendments. The 2020 (2nd Ex. Sess.) amendment by ch. 4, rewrote (a), which read: “(a) For the purposes of this section:“(1) ‘Healthcare provider’ means:“(A) Any provider licensed under this title who is authorized to diagnose and treat humans; or“(B) 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.”; substituted “or” for “and” following “diagnose” or “diagnosis” in (b)(1) and (b)(2); substituted “is held” for “shall be held” in (c)(1)(A); substituted “must” for “shall” in (c)(1)(B); in (c)(3), substituted “does” for “shall”, deleted “and” following “§ 63-1-301,”, and added “, or those individuals licensed pursuant to chapter 12 of this title”; substituted “subdivision 63-6-214(b)(21) do” for “63-6-214(b)(21) shall” in (d); substituted “does” for “shall” in (e); substituted “63-6-204(a) also applies” for “63-6-204(a) shall also apply” in (f); substituted “must” for “shall” in (g)(1) and (g)(2); and added (h).

Effective Dates. Acts 2020 (2nd Ex. Sess.), ch. 4, § 10. August 20, 2020.

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.
    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.
    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).
    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).
    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.
  6. 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).
    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).
    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).
  4. 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.
  5. 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).
  6. 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.
    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.
    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.
    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.
    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.
  2. 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;
      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;
    5. “Morphine milligram equivalent dose” means the morphine milligram equivalent calculation for the amount of a prescribed opioid, multiplied by the days of treatment;
    6. “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
    7. “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.
    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.
      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.
    1. 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.
    2. 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.
    3. 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).
  3. 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.
  4. 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.
  5. This section applies only to the treatment of human patients.
  6. 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

63-1-201. Part definitions.

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

  1. “Free health clinic” means a health care facility operated by a nonprofit private entity that does not receive payment for its services and does not impose any charges on the individuals to whom services are rendered;
  2. “Medical practitioner” means a:
    1. Physician licensed under chapter 6 or 9 of this title;
    2. Dentist or dental hygienist licensed under chapter 5 of this title;
    3. Nurse licensed under chapter 7 of this title;
    4. Chiropractor licensed under chapter 4 of this title;
    5. Psychologist licensed under chapter 11 of this title;
    6. Social worker licensed under chapter 23 of this title; and
    7. Physician assistant licensed under chapter 19 of this title; and
  3. “Special volunteer license” means a license awarded to a medical practitioner whose sole practice is rendering professional services without remuneration in a free health clinic at a specified site or setting. The practitioner must have been previously issued a license to practice in this state or another state and the practitioner must never have been the subject of disciplinary action. The licensing authority shall require an application and relevant documentation before issuing the special volunteer license. No fee may be charged for an application or issuance of the special license.

Acts 2004, ch. 579, § 1.

63-1-202. Exemption from fees and taxes.

Medical practitioners who practice in a free health clinic and who do not receive monetary remuneration for medical care and other services rendered within the statutory scope of practice for such practitioner shall not be subject to:

  1. Any fees for a special volunteer license from the practitioner's licensing board; or
  2. The privilege tax on occupations imposed by title 67, chapter 4, part 17.

Acts 2004, ch. 579, § 1.

63-1-203. Compensation for services prohibited — Donations and gifts permitted.

A medical practitioner or a free health clinic may not receive any compensation for services rendered including, but not limited to, reimbursement from an individual or from any third party payor. Reimbursement may not be accepted from any insurance policy, health plan or federal or state benefits program. A clinic may receive donations and gifts.

Acts 2004, ch. 579, § 1.

Part 3
Pain Management Clinics

63-1-301. Part definitions.

For purposes of this part, unless the context requires otherwise:

  1. “Advanced practice registered nurse” means any person licensed under chapter 7 of this title, who meets the requirements of § 63-7-126;
  2. “Chronic nonmalignant pain treatment” means prescribing or dispensing opioids, benzodiazepines, barbiturates or carisoprodol for ninety (90) days or more in a twelve-month period for pain unrelated to cancer or palliative care;
  3. “Department” means the department of health;
  4. “Medical director” means an individual who:
    1. Is licensed as a physician under chapter 6 or 9 of this title, and who practices in this state with an unrestricted, unencumbered license;
    2. Provides oversight relative to the operations of a pain management clinic; and
    3. Is a pain management specialist on or after July 1, 2016;
  5. “Medical doctor” means any person licensed under chapter 6 of this title;
  6. “Osteopathic physician” means any person licensed under chapter 9 of this title;
    1. “‘Pain management clinic’ or ‘clinic’” means a privately-owned clinic, facility or office in which any health care provider licensed under this title provides chronic nonmalignant pain treatment to a majority of its patients for ninety (90) days or more in a twelve-month period. For purposes of determining if a clinic, facility, or office qualifies as a pain management clinic under this subdivision (8)(A), the entire clinic, facility, or office caseload of patients who received medical care services from all medical doctors, osteopathic physicians, advanced practice registered nurses and physician assistants who serve in the clinic, facility or office shall be counted;
    2. “Pain management clinic” also means a privately-owned clinic, facility or office which advertises in any medium for pain management services of any type.
    3. A pain management clinic does not include any clinic, facility, or office which provides interventional pain management as defined in § 63-6-244 and whose clinic, facility or office does not provide chronic nonmalignant pain treatment to a majority of the patients of a clinic, facility or office for ninety (90) days or more in a twelve-month period;
    4. “Pain management clinic” does not mean a clinic, facility, or office that is wholly owned and operated by a physician multispecialty practice in which one (1) or more board-eligible or board-certified medical specialists who have also completed fellowships in pain medicine or pain management approved by the Accreditation Council for Graduate Medical Education, or who are also board-certified in pain medicine or pain management by the American Board of Pain Medicine or a board approved by the American Board of Medical Specialties, the American Association of Physician Specialists, or the American Osteopathic Association to perform the pain management services for chronic pain patients;
  7. “Pain management specialist” means a physician licensed under chapter 6 or 9 of this title who:
      1. Has a subspecialty certification in pain medicine or pain management as accredited by the Accreditation Council for Graduate Medical Education (ACGME) through either the American Board of Medical Specialties (ABMS) or the American Osteopathic Association (AOA), or is eligible to sit for the board examination offered by ABMS or AOA;
      2. Holds an unencumbered Tennessee license; and
      3. Maintains the minimum number of continuing medical education (CME) hours in pain medicine or pain management to satisfy retention of ABMS or AOA certification. Any exceptions to this requirement shall be approved by the respective regulatory board;
      1. Attains American Board of Pain Medicine (ABPM) diplomate status;
      2. Holds an unencumbered Tennessee license; and
      3. Maintains the minimum number of CME hours in pain management to satisfy retention of ABPM diplomate status. Any exceptions to this requirement shall be approved by the respective regulatory board;
    1. Is board certified by the American Board of Interventional Pain Physicians (ABIPP) by passing exam 1 on or before June 30, 2016, and holds an unencumbered Tennessee license and maintains the minimum number of CME hours in pain management to satisfy retention of ABIPP diplomate status; provided, that on and after July 1, 2016, a new applicant shall only qualify as a pain management specialist under this subdivision (9)(C) if the applicant is board certified by ABIPP by passing parts 1 and 2 of its examination, and holds an unencumbered Tennessee license and maintains the minimum number of CME hours in pain management to satisfy retention of ABIPP diplomate status; or
    2. Has an active pain management practice in a clinic accredited in outpatient interdisciplinary pain rehabilitation by the commission on accreditation of rehabilitation facilities or any successor organization and holds an unencumbered Tennessee license.
  8. “Physician assistant” means any person licensed under chapter 19 of this title.

Acts 2011, ch. 340, § 1; 2012, ch. 869, § 1; 2013, ch. 336, § 2; 2013, ch. 430, § 7; 2014, ch. 700, § 1; 2015, ch. 475, §§ 1-3; 2016, ch. 829, § 1; 2016, ch. 980, §§ 5-7; 2016, ch. 1033, §§ 6, 7; 2017, ch. 210,  §§ 1-3.

Compiler's Notes. Acts 2013, ch. 336, § 2, effective from July 1, 2013, until October 1, 2013, amended the definition of “pain management clinic” to read: “(5) ‘Pain management clinic’ means a privately-owned facility in which a majority of the facility's patients, seen by any or all of its medical doctors, osteopathic physicians, advanced practice nurses with certificates of fitness to prescribe, or physician assistants, are provided pain management services by being prescribed opioids, benzodiazepines, barbiturates, or carisoprodol, but not suboxone, for more than ninety (90) days in a twelve-month period; and”.

Acts 2013, ch. 430, § 1 provided that the act, which amended the definition of “pain management clinic”, shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.”

Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5), in order to promulgate any rules required by the act.

Amendments. The 2016 amendment by ch. 1033, effective July 1, 2017, deleted the former definition of “certificate holder”, which read: “‘Certificate holder’ means a medical doctor licensed under chapter 6 of this title; an osteopathic physician licensed under chapter 9 of this title; an advanced practice nurse licensed under chapter 7 of this title, who meets the requirements contained in § 63-7-126; or a physician assistant licensed under chapter 19 of this title, who practices in this state with an unrestricted, unencumbered license. Anyone with an ownership interest in a pain management clinic shall be eligible to be the certificate holder;”; and substituted the defined term “‘pain management clinic’ or ‘clinic’” for “pain management clinic”.

The 2017 amendment, in (D) of the definition of “pain management clinic”, substituted “one (1) or more” for “one or more” near the beginning, inserted “or pain management” twice, and substituted “to perform the” for “perform the” near the end; and, in the definition of “pain management specialist”, inserted “or pain management” in (A)(i), and inserted “pain medicine or” in (A)(iii).

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.Acts 2017, ch. 210, § 4.  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).

63-1-302. Exemptions from part.

This part does not apply to:

  1. A medical or dental school, an osteopathic medical school, a nursing school, a physician assistant program or an outpatient clinic associated with any of the foregoing schools or programs, including, but not limited to, clinics that have an agreement to train residents by members of that clinic who are appointed as adjunct faculty of the school or program;
  2. A hospital as defined in § 68-11-201, including any outpatient facility or clinic of a hospital if such outpatient facility or clinic is regulated under title 68;
  3. Hospice services as defined in § 68-11-201;
  4. A nursing home as defined in § 68-11-201;
  5. A facility maintained or operated by this state; or
  6. A hospital or clinic maintained or operated by the federal government.

Acts 2011, ch. 340, § 1; 2012, ch. 869, §§ 2, 3.

63-1-303. Regulation of licensed healthcare practitioners — Rules and regulations.

    1. Each licensed healthcare practitioner who provides services at a pain management clinic shall continue to be regulated only by the board which has issued a license to that practitioner.
    2. A licensed health care practitioner shall notify the board that has licensed the practitioner within ten (10) days of starting or ending work at any pain management clinic.
  1. On or before October 1, 2011, the commissioner of health, in consultation with the board of medical examiners, the board of osteopathic examination, the board of nursing, and the committee on physician assistants, shall promulgate rules necessary to implement this part, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  2. The rules adopted pursuant to subsection (b) shall address the following topics, among others:
    1. The operation of the clinic, including requirements:
      1. That patients have current and valid government issued identification or current health insurance card issued by either a government or private carrier; and
      2. That providers conduct urine drug screening in accordance with a written drug screening compliance plan as required by rules promulgated by the commissioner of health pursuant to subsection (b);
    2. Personnel requirements for the clinic;
    3. Training requirements for clinic providers who are regulated by that board;
    4. Patient records;
    5. Standards to ensure quality of patient care;
    6. Infection control;
    7. Health and safety requirements;
    8. License application and renewal procedures and requirements;
    9. Data collection and reporting requirements;
    10. Inspections and complaint investigations; and
    11. Patient billing procedures.

Acts 2011, ch. 340, § 1; 2013, ch. 430, § 8; 2014, ch. 700, § 2; 2014, ch. 983, § 1; 2016, ch. 1033, § 8.

Compiler's Notes. Acts 2013, ch. 430, § 1 provided that the act, which amended subsection (c), shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.”

Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5), in order to promulgate any rules required by the act.

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.

Amendments. The 2016 amendment by ch. 1033, effective July 1, 2017, deleted the former definition of “certificate holder”, which read: “‘Certificate holder’ means a medical doctor licensed under chapter 6 of this title; an osteopathic physician licensed under chapter 9 of this title; an advanced practice nurse licensed under chapter 7 of this title, who meets the requirements contained in § 63-7-126; or a physician assistant licensed under chapter 19 of this title, who practices in this state with an unrestricted, unencumbered license. Anyone with an ownership interest in a pain management clinic shall be eligible to be the certificate holder;”; and substituted the defined term “‘pain management clinic’ or ‘clinic’” for “pain management clinic”.

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

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).

63-1-304. Inspections.

Each board shall have the authority to inspect a pain management clinic which utilizes the services of a practitioner licensed by that board. During such inspections, the authorized representatives of the board may inspect all necessary documents and medical records to ensure compliance with this part and all other applicable laws and rules.

Acts 2011, ch. 340, § 1.

63-1-305. Investigation of complaints.

Each board shall have the authority to investigate a complaint alleging a violation of this part, or a rule adopted under this part, by a pain management clinic utilizing the services of a healthcare practitioner licensed by that board. Each board shall also have the authority to investigate a complaint alleging that a pain management clinic utilizing the services of a healthcare practitioner licensed by that board is not properly licensed by the department as required by this part.

Acts 2011, ch. 340, § 1; 2016, ch. 1033, § 9.

Amendments.  The 2016 amendment, effective July 1, 2017, substituted “pain management clinic utilizing the services of a healthcare practitioner licensed by that board is not properly licensed” for “facility utilizing the services of a healthcare practitioner licensed by that board is not properly certified” in the second sentence.

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

63-1-306. Medical director — Operation certificate — Disciplinary action.

    1. Each pain management clinic must have a medical director who is a medical doctor or osteopathic physician who practices in this state under an unrestricted and unencumbered license issued pursuant to § 63-6-201 or § 63-9-104.
    2. In addition to the requirements of subdivision (a)(1), each physician serving as a medical director at a pain management clinic shall be a pain management specialist.
      1. All advanced practice registered nurses licensed under chapter 7 of this title, who practice in a licensed pain clinic, shall collaborate with a pain medicine specialist.
      2. All physician assistants licensed under chapter 19 of this title who practice in a licensed pain clinic shall collaborate with a pain medicine specialist.
  1. In the event that the medical director, for whatever reason, no longer meets the requirements of this part, the pain management clinic must notify the department, in writing within ten (10) business days, of the identity of another physician who meets the requirements of this part and will act as medical director and provide all necessary documentation required by the department to establish that the replacement is qualified as required by this part. Any clinic that fails to provide such timely written notice must cease operations until the notice is provided and the department has confirmed in writing that the replacement medical director is duly qualified. Continuation of operations without the timely written notice required by this subsection (b) constitutes grounds for disciplinary action against the clinic under this part.
  2. Any board that assesses any discipline or penalty against a provider that it licenses for a violation of rules promulgated under this part shall inform the department of any penalty or discipline imposed on such a provider for a violation of rules promulgated under this part within thirty (30) days of imposing the discipline or penalty, and the department may consider such discipline or penalty as a basis for disciplinary action against the pain management clinic pursuant to this subsection (c).
  3. The pain management clinic shall post the license in a conspicuous location so as to be clearly visible to patients.
  4. The department shall have the authority to adopt rules, including emergency rules if deemed necessary, to implement this part for which the department has responsibility.

Acts 2011, ch. 340, § 1; 2012, ch. 869, § 4; 2015, ch. 475, §§ 4, 5; 2016, ch. 1033, § 10; 2017, ch. 334, § 1; 2018, ch. 610, § 1.

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

Amendments. The 2016 amendment rewrote the section, which read: “(a)(1)  A pain management clinic, as defined in this part, must have a medical director who is a physician that practices in this state under an unrestricted and unencumbered license issued pursuant to § 63-6-201 or § 63-9-104. “(2)  In addition to the requirements of subdivision (a)(1), each physician serving as a medical director at a pain management clinic shall be a pain management specialist as defined in this part. “(3)  All advanced practice nurses licensed under chapter 7 of this title and physician assistants licensed under chapter 19 of this title, who practice in a certified pain clinic, shall be supervised by a pain medicine specialist as defined in this part.“(b)  In the event that the medical director, for whatever reason, no longer meets the requirements of this part, the pain management clinic must notify the department, within ten (10) business days, of the identity of another physician who meets the requirements of this part and will act as medical director. A change of majority ownership of a certified pain management clinic requires the submission of a new application for a certificate. Failure to notify the department within ten (10) business days may be the basis for a summary suspension of the clinic's certification.“(c)  (1)  Every pain management clinic shall submit an application to the department on a form prescribed by the department for a certificate to operate the clinic. A certificate may be awarded to a certificate holder. The certificate holder shall be one (1) of the owners of the clinic. “(2)  A completed form for a certificate prescribed by the department shall show proof that the clinic has a medical director who is a pain management specialist as defined in this part.“(d)  Each clinic location shall be certified separately regardless of whether the clinic is operated under the same business name, ownership or management as another clinic.“(e)  The department shall issue a certificate if the department finds that the pain management clinic meets the requirements of this part and that the fee required by the department has been paid.“(f)  (1)  If the department finds that a pain management clinic which was issued a certificate no longer meets any requirement of this part, including, but not limited to, any violation of any rule promulgated by the department pursuant to this part, the department may impose lawful disciplinary action against the pain management clinic, including, but not limited to, the revocation or suspension of its certificate, and the imposition of a civil penalty of up to one thousand dollars ($1,000) per day for each day of continued violation. The pain management clinic shall be entitled to a hearing pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Further, the department has the discretion to lift the suspension of a certificate when the clinic demonstrates compliance to the department. “(2)  Any board which assesses any discipline or penalty against a provider that it licenses for a violation of rules promulgated under this part shall inform the department of any penalty or discipline imposed on such a provider for a violation of rules promulgated under this part within thirty (30) days of imposing the discipline or penalty, and the department may consider such discipline or penalty as a basis for disciplinary action against the pain management clinic pursuant to this subsection (f).“(g)  The clinic shall post the certificate in a conspicuous location so as to be clearly visible to patients.“(h)  The department is authorized to charge a fee for the issuance of a certificate.“(i)  The department and each board identified in § 63-1-303(b) shall post on its web site an announcement of the requirement that a pain management clinic obtain a certificate from the department, and each board identified in § 63-1-303(b) shall include information about such requirement in a routine communication sent by each board to its licensees.“(j)  A pain management clinic operating on or before January 1, 2012, may continue to operate as long as an application for certification is timely filed on or before October 1, 2012. This provision shall apply retroactively to applications for certification filed since January 1, 2012.“(k)  The department shall have the authority to adopt rules, including emergency rules if deemed necessary, to implement this part for which the department has responsibility.”The 2017 amendment divided former (a)(3) into present (a)(3)(A) and (B), in present (a)(3)(A), by substituting “under chapter 7 of this title, who practice in a licensed pain clinic, shall collaborate with a pain medicine specialist. (B) All physician assistants” for “under chapter 7 of this title and physician assistants”;  and in present (a)(3)(B), substituted “licensed pain clinic” for “licensed pain management clinic” and substituted “pain medicine specialist” for “pain management specialist.”

The 2018 amendment substituted “shall collaborate with a pain medicine specialist” for “shall be supervised by a pain medicine specialist” at the end of (a)(3)(B).

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

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

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

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).

63-1-307. [Repealed.]

Acts 2011, ch. 340, § 1; repealed by Acts 2016, ch. 1033, § 11, effective July 1, 2017.

Compiler's Notes. Former § 63-1-307, concerned the expiration of a pain management clinic certificate.

63-1-308. [Repealed.]

Acts 2011, ch. 340, § 1; repealed by Acts 2016, ch. 1033, § 12, effective July 1, 2017.

Compiler's Notes. Former § 63-1-308, concerned the renewal of a pain management clinic certificate.

63-1-309. Restrictions on ownership — Documentation of controlled substances dispensed or prescribed — Required medical director hours.

  1. A pain management clinic may not be owned wholly or partly by a person who has been convicted of, pled nolo contendere to, or received deferred adjudication for:
    1. An offense that constitutes a felony; or
    2. An offense that constitutes a misdemeanor, the facts of which relate to the distribution of illegal prescription drugs or a controlled substance or controlled substance analogue as defined in § 39-17-402.
  2. If any practitioner providing services at a pain management clinic prescribes controlled substances for the treatment of chronic nonmalignant pain, the practitioner must document in the patient's record the reason for prescribing that quantity.
  3. A medical director shall be onsite at least twenty percent (20%) of the clinic’s weekly total number of operating hours. A medical director shall serve as medical director and provide services for no more than four (4) pain management clinics.

Acts 2011, ch. 340, § 1; 2012, ch. 848, § 65; 2012, ch. 869, § 5; 2012, ch. 880, § 24; 2013, ch. 336, §§ 3, 4; 2013, ch. 430, § 9; 2016, ch. 1002, § 13; 2016, ch. 1033, § 13.

Compiler's Notes. Acts 2012, ch. 880, § 1 provided that the act, which amended subsection (c), shall be known and may be cited as the “Tennessee Prescription Safety Act of 2012.”

Acts 2012, ch. 880, § 25, provided that this section shall be interpreted to be consistent with all state and federal laws addressing privacy of patient records.

Acts 2013, ch. 430, § 1 provided that the act, which amended subsection (d), shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.”

Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5), in order to promulgate any rules required by the act.

Acts 2016, ch. 1002, § 13, deleted the provisions of Acts 2012, ch. 880, § 29 that provided for the expiration of the amendments by Acts 2012, ch. 880,  § 24.  Therefore, those amendments remain in effect.

63-1-310. Payments.

  1. A pain management clinic may accept only a check or credit card in payment for services provided at the clinic, except as provided in subsection (b).
  2. A payment may be made in cash for a co-pay, coinsurance or deductible when the remainder of the charge for the services will be submitted to the patient's insurance plan for reimbursement.

Acts 2011, ch. 340, § 1; 2013, ch. 430, § 10.

Compiler's Notes. Acts 2013, ch. 430, § 1 provided that the act, which amended subsection (a), shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.”

Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5), in order to promulgate any rules required by the act.

NOTES TO DECISIONS

1. Violation.

Clinic continued to accept money orders and a sign posted in the office confirmed that the clinic would accept only money orders for self-pay for office visits; this practice conflicted with the statute to only allow cash payments in limited circumstances, and as appellants admitted to several billing violations and at least one improper practice continued when charges were filed, substantial and material evidence existed for the finding of a failure to maintain adequate billing records. Ballard v. Tenn. Dep't of Health, — S.W.3d —, 2020 Tenn. App. LEXIS 207 (Tenn. Ct. App. May 8, 2020).

63-1-311. Violations — Penalties.

  1. A violation of this part, or a rule adopted under this part, is grounds for disciplinary action against a practitioner providing services at a pain management clinic licensed under this part by the board that licensed that practitioner.
  2. A practitioner who provides pain management services at an unlicensed pain management clinic is subject to disciplinary action against the practitioner's license, up to and including revocation, as well as an administrative penalty of no less than one thousand dollars ($1,000) per day of unlicensed operation and not exceeding five thousand dollars ($5,000) per day of unlicensed operation, imposed by the board that licensed that practitioner, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Before such a penalty may be assessed by the board, the board shall give at least thirty (30) days' notice to the practitioner of the alleged violation of this part.
  3. Any owner of an unlicensed pain management clinic is subject to disciplinary action against the practitioner's license, up to and including revocation, as well as an administrative penalty of no less than one thousand dollars ($1,000) per day of unlicensed operation and not exceeding five thousand dollars ($5,000) per day of unlicensed operation, imposed by the department of health, in accordance with the Uniform Administrative Procedures Act. Any owner may also be charged the costs of any inspection or investigation pursuant to this part, as well as the costs of prosecution and other costs permitted under § 63-1-144 and that formed the basis of disciplinary action provided for in this part. Before such a penalty may be assessed by the department, the department shall give at least thirty (30) days' notice to the owners of the alleged violation of this part.

Acts 2011, ch. 340, § 1; 2013, ch. 430, §§ 12, 13; 2016, ch. 1033, § 14.

Compiler's Notes. Acts 2013, ch. 430, § 1 provided that the act, which amended subsection (b) and added subsection (c), shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.”

Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5), in order to promulgate any rules required by the act.

Amendments. The 2016 amendment, effective July 1, 2017, rewrote the section, which read: “(a)  A violation of this part, or a rule adopted under this part, is grounds for disciplinary action against a practitioner providing services at a pain management clinic certified under this part by the board which licensed that practitioner.”“(b)  A practitioner who provides pain management services at an uncertified pain management clinic is subject to an administrative penalty of no less than one thousand dollars ($1,000) per day and which shall not exceed five thousand dollars ($5,000) per day, imposed by the board which licensed that practitioner, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Before such a penalty may be assessed by the board, the board shall give at least thirty (30) days' notice to the practitioner of the alleged violation of this part.“(c)  An owner, co-owner, or operator of an uncertified pain management clinic is subject to an administrative penalty of no less than one thousand dollars ($1,000) per day and which shall not exceed five thousand dollars ($5,000) per day, imposed by the department of health, in accordance with the Uniform Administrative Procedures Act. Before such a penalty may be assessed by the department, the department shall give at least thirty (30) days' notice to the owner, co-owner, or operator of the alleged violation of this part.”

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

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).

63-1-312. [Repealed.]

Acts 2012, ch. 869, § 6; repealed by Acts 2016, ch. 1033, § 15, effective July 1, 2017.

Compiler's Notes. Former § 63-1-312, concerned the involuntary inactivation of a pain management clinic certificate.

63-1-313. Dispensing of controlled substances by pain management clinics or medical personnel working at pain management clinics.

  1. Notwithstanding any provision of this title or title 53, chapters 10 and 11 to the contrary, no pain management clinic or medical doctor, osteopathic physician, advanced practice registered nurse with certificates of fitness to prescribe, or physician assistant working at a pain management clinic shall be permitted to dispense controlled substances; provided, however, that this subsection (a) shall not prohibit a medical doctor, osteopathic physician, advanced practice registered nurse with certificates of fitness to prescribe, or physician assistant working at a pain management clinic from providing to that practitioner's patient, without charge, a sample of a schedule IV or schedule V controlled substance in a quantity limited to an amount that is adequate to treat the patient for a maximum of seventy-two (72) hours or a sample of a non-narcotic schedule V controlled substance in a quantity limited to an amount that is adequate to treat the patient for a maximum of fourteen (14) days.
  2. For the purposes of this section, “controlled substance” has the meaning given in § 39-17-402.

Acts 2013, ch. 336, § 1; 2014, ch. 842, § 1; 2016, ch. 980, § 8.

Code Commission Notes.

Acts 2013, ch. 430, § 14 purported to enact § 63-1-313. Section 63-1-313 was previously enacted by Acts 2013, ch. 336, § 1; therefore, the enactment by Acts 2013, ch. 430, § 14 was designated as § 63-1-314 by the authority of the code commission.

Compiler's Notes. Pursuant to Article III, Section 18 of the Constitution of Tennessee, Acts 2014, ch. 842 took effect on April 28, 2014.

Cross-References. Criteria for schedule IV drugs, § 39-17-411.

Criteria for schedule V drugs, § 39-17-413.

NOTES TO DECISIONS

1. Violation.

Doctor admitted to repackaging controlled substances from some patients and giving them to others, and while he attempted to minimize his violations of T.C.A. § 63-1-313(a), substantial and material evidence was presented to establish the finding that controlled substances were distributed by him in violation of statutes applicable to pain clinics. Ballard v. Tenn. Dep't of Health, — S.W.3d —, 2020 Tenn. App. LEXIS 207 (Tenn. Ct. App. May 8, 2020).

63-1-314. Reporting on prescription drug abuse and pain management clinics

The commissioner of health and each appropriate occupational professional licensing board governing licensees who may legally prescribe or dispense controlled substances shall prepare a comprehensive report on actions relative to prescription drug abuse and pain management clinics to the general assembly no later than January 31 for actions in the prior calendar year. This report shall summarize the number of complaints received, frequent findings, and actions taken.

Acts 2013, ch. 430, § 14.

Code Commission Notes.

Acts 2013, ch. 430, § 14 purported to enact § 63-1-313. Section 63-1-313 was previously enacted by Acts 2013, ch. 336, § 1; therefore, the enactment by Acts 2013, ch. 430, § 14 was designated as § 63-1-314 by the authority of the code commission.

Compiler's Notes. Acts 2013, ch. 430, § 1 provided that the act, which enacted this section, shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.”

Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5), in order to promulgate any rules required by the act.

63-1-315. Inspection of office suspected of operating as unlicensed pain management clinic — Prohibited admission of new patients.

  1. Notwithstanding this title or title 68, for the purposes of determining if a health care provider's office is operating as a pain management clinic, the department of health is authorized to conduct an unannounced inspection process, which may include, but not be limited to, review of business and medical records, when the department has reasonable suspicion that the office is operating as an unlicensed pain management clinic. As part of this inspection process, the health care provider's office shall be required to produce evidence that the majority of its patient population is not receiving chronic nonmalignant pain treatment.
  2. If the health care provider's office is unable during the inspection process to provide satisfactory evidence that the office does not meet the definition of a pain management clinic, there shall be a rebuttable presumption that the provider's office was operating as a pain management clinic in any administrative proceeding arising from such inspection process.
  3. The requirements for evidence under this section shall be established by rule.
  4. Any health care provider's office rebuttably presumed to be operating an unlicensed pain management clinic shall be prohibited from admitting any new patients to the practice immediately upon receipt of written notice to any provider at the clinic and all owners and providers at such clinic shall be subject to a hearing upon thirty (30) days' notice before the licensee's licensing board to consider whether the individual's license to practice should be revoked or otherwise disciplined. Pursuant to this part, the commissioner may promulgate rules providing for an informal advisory administrative hearing by a panel appointed by the commissioner to review the department's determination regarding the unlicensed operation of the clinic and to provide nonbinding recommendations to the commissioner concerning those determinations. The informal administrative hearing shall not be subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Individuals appointed to any panel pursuant to this part shall be considered “state employees” for purposes of title 8, chapter 42, and § 9-8-307.

Acts 2016, ch. 1033, § 1.

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

63-1-316. Pain management clinic license.

  1. On or after July 1, 2017, no person shall own or operate a pain management clinic unless the medical director obtains a license from the department. No license shall be issued unless the pain management clinic has been inspected and found to be in compliance with this part by the department. The department is authorized to charge a reasonable fee for any application for a license.
    1. Every medical director of a pain management clinic in this state shall receive from the department a pain management clinic license. Notwithstanding any provision of this title to the contrary, the department shall establish a system of license renewals at intervals that will allow for the distribution of the license workload as uniformly as is practicable throughout the calendar year. Licenses issued under this section 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 department 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 this section for a period of other than twenty-four (24) months shall be proportional 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. In order to transition regulation of pain management clinics to a system of licensure, the department is authorized to require the licensure of a clinic with a certificate holder under this part on the date of the expiration of the certificate. The pain management clinic may continue to operate until the certificate expires, and the certificate shall be deemed to be a license under this part until it expires. On the expiration of the certificate, the clinic may seek an initial licensure under this section.
  2. The department shall inspect each pain management clinic a minimum of once every two (2) years to ensure compliance with this part. The department shall not refuse license renewal based solely upon failure of the department to inspect a pain management clinic as required by this subsection (c).
  3. Any medical director, in order to lawfully establish, conduct, operate, or maintain a pain management clinic shall obtain a license from the department in the following manner:
    1. The medical director shall submit an application on a form to be prepared by the department, showing that the medical director is of good moral character and able to comply with the minimum standards for a pain management clinic and with rules lawfully promulgated under this part. The medical director shall also submit any required fees. The application shall contain the following additional information:
      1. The name or names of all owners;
      2. The location of the pain management clinic;
      3. The name of the medical director, and the identification of any other license or application related to a pain management clinic with which the medical director is associated;
      4. The names and Tennessee license numbers for any employees of the clinics or other persons with whom the clinic has contracted for services;
      5. Whether any owner, employee, or person with whom the clinic contracts has been convicted of any felony; is under indictment for any offense involving the sale, diversion, or dispensing of controlled substances under state or federal law; or has had any license issued by any jurisdiction, under which the person may prescribe, dispense, administer, supply, or sell a controlled substance, restricted, disciplined, or denied; and
      6. Other information as the department may reasonably require;
    2. If the commissioner determines that a license for any pain management clinic will not be granted in accordance with this section, the commissioner shall notify the applicant; and
    3. If the commissioner finds that the applicant complies with this part and the rules promulgated under this part, then the commissioner may recommend and approve the issuance of a license, and a license may be issued by the department licensing the applicant to operate the pain management clinic.
    1. The commissioner shall promulgate by rule additional licensure requirements that define appropriate health and safety standards necessary to protect the health and welfare of residents.
    2. The commissioner shall promulgate by rule additional financial requirements, such as bonds or liability insurance, to be required of pain management clinics.
  4. Each license to operate a pain management clinic shall expire as provided in subsection (b) and shall become invalid on that date unless renewed. A licensee may renew its license within sixty (60) days following the license expiration date upon payment of the renewal fee in addition to a late penalty established by the commissioner for each month or fraction of a month that payment for renewal is late. A late penalty shall not exceed twice the renewal fee. If a licensee fails to renew its license within sixty (60) days following the license expiration date, the licensee shall reapply for licensure in accordance with the rules established by the commissioner and shall cease operation of the clinic until such time as the clinic is duly licensed. A license shall not be assignable or transferable, shall be issued only for the location named in the application, shall be posted in a conspicuous place in the pain management clinic, and may be renewed as provided in this part.
    1. The commissioner may deny, suspend, revoke, or otherwise discipline or restrict the license issued under this part on any of the following grounds:
      1. A violation of this part or of the rules promulgated pursuant to this part;
      2. The permitting, aiding, or abetting the commission of any illegal act in the pain management clinic;
      3. A license issued in error;
      4. Any conduct or practice found by the commissioner to be detrimental to the welfare of the patients in the pain management clinic;
      5. A conviction of any employee of the clinic for an offense involving the sale, diversion, or dispensing of controlled substances under state or federal law related to the operation of the clinic;
      6. Any owner has been convicted of, pled nolo contendere to, or received deferred adjudication for an offense that constitutes a felony;
      7. Any owner or employee or person who otherwise provides services in the clinic or contracts with the clinic has ever been denied, by any jurisdiction, a license under which the person may prescribe, dispense, administer, supply, or sell a controlled substance;
      8. Any owner or employee or person who otherwise provides services in the clinic or contracts with the clinic has ever held a license issued by any jurisdiction, under which the person may prescribe, dispense, administer, supply, or sell a controlled substance, that has been restricted; and
      9. Any owner or employee or person who otherwise provides services in the clinic or contracts with the clinic has ever been subject to disciplinary action by any licensing entity for conduct that was the result of inappropriately prescribing, dispensing, administering, supplying, or selling a controlled substance.
    2. The commissioner may, after a hearing, hold the case under advisement and make a recommendation as to requirements to be met by the pain management clinic in order to avoid suspension, revocation, or other discipline of a license or suspension of admissions.
    3. The commissioner may promulgate rules defining the sanction structure and associated penalties.
    4. The hearing to deny a license, suspend a license, revoke a license, place a pain management clinic on probation, or impose any other sanction, and judicial review of the commissioner's decision, shall be in accordance with the Uniform Administrative Procedures Act (UAPA), compiled in title 4, chapter 5, and shall include the right to appeal and judicial review under the UAPA.
  5. On or after July 1, 2017, no owner of a pain management clinic shall locate or participate in locating a pharmacy, as defined in § 63-10-204, in which any owner has an ownership interest, in a location that is adjacent to the location of the clinic. Locating a pharmacy in which any owner of a pain management clinic has an ownership interest adjacent to the clinic shall result in the revocation of the license to operate the pain management clinic.
  6. The commissioner is authorized to promulgate, in accordance with the Uniform Administrative Procedures Act rules as are necessary to set fees for licensure, renewal of licensure, late renewal fees, and other fees.
  7. Any licensee or applicant for a license aggrieved by a decision or action of the department or commissioner pursuant to this part may request a hearing before the commissioner.

Acts 2016, ch. 1033, § 2.

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

63-1-317. Unlawful operation of pain management clinic — Investigation — Injunctive relief — Civil penalty.

  1. An entity or person who operates a pain management clinic without obtaining a license pursuant to this part commits a Class A misdemeanor. Each day of operation without a license constitutes a separate offense.
  2. The commissioner of health may authorize an investigation of any person or entity to the extent necessary to determine if the person or entity is engaged in the unlawful operation of a pain management clinic.
  3. The commissioner may, through the office of the attorney general and reporter, apply for injunctive relief in any court of competent jurisdiction to enjoin any person from committing an act in violation of this part. Injunctive proceedings are in addition to, and not in lieu of, all penalties and other remedies prescribed in this part.
  4. A person who aids or requires another person to violate this part or rules promulgated pursuant to this part, who permits a license issued by the commissioner to be used by any person other than the licensee, or who acts to violate or evade this part or rules promulgated pursuant to this part is subject to a civil penalty of not more than five thousand dollars ($5,000) for each violation. Each day in violation of this part constitutes a separate violation.

Acts 2016, ch. 1033, § 3.

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

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

63-1-318. Suspension of treatment — Transition plan — Notice — Corrective action plan — Special monitor.

    1. In those cases where the conditions of any pain management clinic are, or are likely to be, detrimental to the health, safety, or welfare of any patient, the commissioner of health has the authority to suspend treatment of any new or existing patients to the clinic pending a prompt hearing before an administrative judge.
    2. In the event a suspension under this section affects existing patients, the pain management clinic shall provide written notice and other appropriate notice to patients. The pain management clinic shall develop a transition plan to maintain continuity of care for the patients and to minimize the impact of transition to alternative care arrangements. The plan shall be developed in conjunction with the department. The pain management clinic shall assist each patient in locating an alternative placement or treatment resource, which shall be specified in the transition plan. The transition plan shall also include the most recent version of the patient's plan of care. The commissioner may promulgate rules specifying additional components of the transition plan in accordance with this part.
  1. The commissioner is authorized to withdraw the suspension of treatment at any time prior to a hearing, based on information presented to the commissioner showing that such conditions have been and will continue to remain corrected.
  2. Whenever the commissioner suspends the treatment of any new patients, the commissioner shall detail, in a notice to the clinic, the specific violations causing the suspension. The notice shall be prominently posted at the clinic so as to be readily available to the public.
  3. The notice shall detail what conditions are considered detrimental to the health, safety, or welfare of the patients.
  4. Within ten (10) days of receiving the notice described in subsection (d), a pain management clinic shall submit a corrective action plan to the commissioner delineating the measures to be taken to address violations and associated time frames. If it is deemed by the commissioner to be necessary to ensure the health, safety, and welfare of clinic patients, the commissioner may require the clinic to take all necessary actions to correct violations immediately.
  5. If the clinic complies with the conditions described in subsection (e), the commissioner may lift the suspension, unless other conditions exist that warrant an additional suspension or continuation of the suspension. The commissioner has the authority to:
    1. Continue or modify the suspension of treatment;
    2. Withdraw the suspension of treatment;
    3. Suspend or condition the license of the clinic; and
    4. Enter other orders as the commissioner deems necessary.
  6. During a suspension of treatment pursuant to this section, the commissioner may appoint one (1) or more special monitors, if the deficiency threatens serious harm to the patients of the clinic. The commissioner may appoint a special monitor or monitors at any other time, if the commissioner has reason to believe that deficiencies exist in a clinic that are detrimental to the direct care of the patients. Whenever the appointment of monitors is utilized pursuant to this section, the commissioner shall appoint a sufficient number of monitors to ensure their presence in the clinic for a minimum of twenty (20) hours per week. The monitors shall observe the operation of the clinic and shall submit written reports periodically to the commissioner on the operation of the clinic. Persons appointed as monitors shall be duly qualified to discharge their responsibilities. While employed as monitors, they shall represent the department with the power to observe and review all of the clinic's operation, with attention to those aspects for which the suspension of admission was imposed. When appointment of a monitor or monitors is mandated by this section, the clinic shall be liable for the costs of the special monitors, until it has been determined that the deficiencies have been corrected. The commissioner may retain a monitor in a clinic after acceptance of a correction plan and issuance of compliance to evaluate the clinic's continued compliance, but such continued monitoring shall be at the expense of the department. The costs of the monitors for which a clinic is responsible shall be recoverable as follows:
    1. Addition of such costs to the clinic's licensing fee, the renewal of the clinic's license to be contingent upon the prior payment of the costs; or
    2. By suit of the department in the circuit or chancery court of competent jurisdiction to recover the costs.
  7. Judicial review shall be available pursuant to § 4-5-322.

Acts 2016, ch. 1033, § 4.

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

63-1-319. Annual report by medical director of pain management clinic.

  1. The medical director of each pain management clinic shall report annually to the department of health, on a form promulgated by the department, the following:
    1. The number of physicians, physician assistants, and advanced practice registered nurses who are working in the clinic for each month;
    2. The number of patients seen by the clinic for each month and the number receiving treatment for chronic nonmalignant pain;
    3. Whether the pain management clinic is part of or associated with a hospital; and
    4. Any other information requested by the department.
  2. The department is authorized to promulgate a reporting form concerning such information as the commissioner may reasonably require, and establish the reporting period and dates for submission.

Acts 2016, ch. 1033, § 5.

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

63-1-320. Providing rules to health committee and health and welfare committee.

Notwithstanding this part or the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any rule promulgated to implement this part 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.

Acts 2016, ch. 1033, § 17.

Effective Dates. Acts 2016, ch. 1033, § 18. July 1, 2017; provided that for the purposes of rulemaking, the act took effect on April 28, 2016.

Part 4
Treatment Guidelines

63-1-401. Part definitions — Development of recommended treatment guidelines for prescribing opioids — Development of pain clinic guidelines — Study of co-prescription of naloxone with opioid — Review of guidelines — Notification of licensees.

  1. As used in this part:
    1. “Commissioner” means the commissioner of health;
    2. “Pain clinic guidelines” means systematically developed standards to assist healthcare providers and pain clinic certificate holders in making decisions concerning the appropriate medical care for chronic nonmalignant pain treatment, as defined in § 63-1-301; and
    3. “Treatment guidelines” means systematically developed statements to assist healthcare providers in making patient decisions concerning appropriate medical care for specific clinical circumstances and settings.
  2. By January 1, 2016, the commissioner shall develop recommended treatment guidelines for prescribing opioids that can be used by prescribers in this state as a guide for caring for patients. This subsection (b) shall not apply to veterinarians.
  3. By January 1, 2017, the commissioner shall develop recommended pain clinic standards for the operation of a pain management clinic, as defined in § 63-1-301, that can be used by certified pain clinics in this state as a guide for operating a pain clinic. This subsection (c) shall not apply to veterinarians.
  4. By January 1, 2020, the commissioner shall:
    1. Study instances when co-prescribing of naloxone with an opioid is beneficial and publish the results to each prescribing board that licenses healthcare professionals who can legally prescribe controlled substances and to the board of pharmacy; and
    2. Include the findings in the treatment guidelines for prescribing opioids developed pursuant to subsection (b).
  5. The commissioner shall review treatment guidelines and the pain clinic guidelines by September 30 of each year and shall cause these guidelines to be posted on the department's website.
  6. The treatment guidelines shall be submitted to each prescribing board that licenses health professionals who can legally prescribe controlled substances and to the board of pharmacy. Each board shall be charged with reviewing the treatment guidelines and determining how the treatment guidelines should be used by that board's licensees.
  7. The pain clinic guidelines shall be submitted to each board that licenses individuals eligible to hold a pain clinic certificate for review and concurrence.
  8. Each board shall notify all of its licensees through routine bulletins or newsletters of the existence of the guidelines and standards.

Acts 2013, ch. 430, § 2; 2015, ch. 475, § 6; 2019, ch. 327, § 1.

Compiler's Notes. Acts 2013, ch. 430, § 1 provided that the act, which enacted this part, shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.”

Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5), in order to promulgate any rules required by the act.

Amendments. The 2019 amendment added (d) and redesignated former (d) through (g) as present (e) through (h), respectively.

Effective Dates. Acts 2019, ch. 327, § 2. May 8, 2019.

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).

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

63-1-402. Prescribers required to hold a current federal DEA license and to complete continuing education — Exceptions to application of part.

  1. On or after July 1, 2014, all prescribers who hold a current federal drug enforcement administration (DEA) license and who prescribe controlled substances shall be required to complete a minimum of two (2) hours of continuing education related to controlled substance prescribing biennially to count toward the licensees' mandatory continuing education.
  2. The continuing education must include instruction in the department's treatment guidelines on opioids, benzodiazepines, barbiturates, and carisoprodol, and may include such other topics as medicine addiction, risk management tools, and other topics as approved by the respective licensing boards.
  3. This section shall not apply to veterinarians, providers practicing at a registered pain management clinic as defined in § 63-1-301 or to medical doctors or osteopathic physicians board certified by the American Board of Medical Specialties (ABMS), or American Osteopathic Association (AOA), or the American Board of Physician Specialties (ABPS) in one (1) or more of the following specialties or subspecialties:
    1. Pain management;
    2. Anesthesiology;
    3. Physical medicine and rehabilitation;
    4. Neurology; or
    5. Rheumatology.

Acts 2013, ch. 430, § 2.

Compiler's Notes. Acts 2013, ch. 430, § 1 provided that the act, which enacted this part, shall be known and may be cited as the “Addison Sharp Prescription Regulatory Act of 2013.”

Acts 2013, ch. 430, § 11 provided that the department of health, the board of pharmacy or any board operating under title 63, is authorized to use emergency rules under § 4-5-208(a)(5), in order to promulgate any rules required by the act.

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).

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

63-1-403. Nonresidential buprenorphine treatment guidelines.

  1. As used in this section:
    1. “Commissioners” means the commissioner of mental health and substance abuse services and the commissioner of health; and
    2. “Nonresidential buprenorphine treatment guidelines” means systematically developed standards to assist any practitioners authorized by the state to prescribe buprenorphine-containing products for the treatment of opioid use disorder as defined in the latest version of the Diagnostic and Statistical Manual of Mental Disorders.
    1. By January 1, 2018, the commissioner of mental health and substance abuse services, in collaboration with the commissioner of health, shall develop recommended nonresidential treatment guidelines for the use of buprenorphine that can be used by prescribers in this state as a guide for caring for patients. This subsection (b) shall only apply to practitioners prescribing buprenorphine-containing products for the treatment of opioid use disorder in a nonresidential setting. The guidelines must be consistent with applicable state and federal laws.
    2. Guidelines from nationally recognized organizations, such as the American Society of Addiction Medicine, Substance Abuse and Mental Health Services Administration, and the American Board of Preventative Medicine, must serve as resources in the development of guidelines under this section.
    3. The commissioner of mental health and substance abuse services shall consult with appropriate physicians, alcohol and substance abuse counselors, and other experts to serve as resources in the development of guidelines under this section.
  2. By July 1, 2019, the commissioner of mental health and substance abuse services, in collaboration with the commissioner of health, shall revise the nonresidential buprenorphine treatment guidelines to be consistent with state and federal law and establish protocols for initiating periodic prescriber-initiated-and-led discussions with patients regarding patient readiness to taper down or taper off opioids employed in treatment. The commissioner of mental health and substance abuse services shall consult with appropriate physicians, alcohol and substance abuse counselors, and other experts to serve as resources in the development of guidelines under this subsection (c).
  3. Beginning in 2019, the commissioners shall review the nonresidential buprenorphine treatment guidelines by September 30 of each year and shall cause these guidelines to be posted on both the department of mental health and substance abuse services and the department of health's websites.
    1. The commissioner of mental health and substance abuse services shall submit the nonresidential buprenorphine treatment guidelines to each health-related board that licenses any practitioner authorized by the state to prescribe buprenorphine-containing products for the treatment of an opioid use disorder as defined in the Diagnostic and Statistical Manual of Mental Disorders and to the board of pharmacy.
    2. Each board shall review the nonresidential buprenorphine treatment guidelines and determine how the nonresidential buprenorphine treatment guidelines should be used by that board's licensees.
    3. Each board shall post the nonresidential buprenorphine guidelines and standards on the licensing board's website.
  4. The commissioner of mental health and substance abuse services shall provide a copy of any guidelines developed pursuant to this section and any revision to those guidelines developed pursuant to this section to the chairs of the health committee of the house of representatives and the health and welfare committee of the senate at the time the guidelines or the revisions are posted on websites of the department of mental health and substance abuse services and the department of health.

Acts 2017, ch. 112, § 1; 2018, ch. 978, § 5.

Amendments. The 2018 amendment added present (c) and redesignated former (c)-(e) as present (d)-(f), respectively.

Effective Dates. Acts 2017, ch. 112, § 2. April 7, 2017.

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

Part 5
Health Care Empowerment Act

63-1-501. Short title.

This part shall be known and may be cited as the “Health Care Empowerment Act.”

Acts 2016, ch. 996, § 1; 2020, ch. 739, §  1.

Amendments. The 2020 amendment purported to amend this section, but no changes were made.

Effective Dates. Acts 2020, ch. 739, § 3. July 1, 2020.

63-1-502. Part definitions.

As used in this part:

  1. “Direct medical care agreement” means a written contractual agreement between a direct medical care provider and an individual patient, or the patient's legal representative, in which:
    1. The direct medical care provider agrees to provide medical care services to the individual patient for an agreed fee over an agreed period of time;
    2. The direct medical care provider will not bill third parties on a fee-for-service basis;
    3. Any per-visit charges under the agreement will be less than the monthly equivalent of the periodic fee;
    4. The agreement describes the scope of the medical care service that is covered by the periodic fee;
    5. The agreement contains the following disclosures, or substantially similar disclosures, that are conspicuously visible in the agreement in bold font:
      1. The agreement does not constitute health insurance under the laws of this state;
      2. An uninsured patient that enters into a direct medical care agreement may be subject to tax penalties under the Patient Protection and Affordable Care Act, Public Law 111-148, for failing to obtain insurance;
      3. Patients insured by health insurance plans that are compliant with the Patient Protection and Affordable Care Act already have coverage for certain preventative care benefits at no cost to the patient;
      4. Payments made by a patient for services rendered under a direct medical care agreement may not count towards the patient's health insurance deductibles and maximum out-of-pocket expenses;
      5. A patient is encouraged to consult with the patient's health insurance plan before entering into the agreement and receiving care; and
      6. A direct medical care provider who breaches the agreement may be liable for damages and subject to discipline by the appropriate licensing board;
    6. The agreement specifies the duration of the agreement, including automatic renewal periods; and
    7. The patient is not required to pay more than twelve (12) months of the fee in advance. However, the contracted fee may be paid on a payment schedule agreed to by the direct medical care provider and patient that may be due on a monthly, quarterly, or yearly basis;
  2. “Direct medical care provider”:
    1. Means an individual or legal entity that is licensed, registered, or otherwise authorized to provide medical care services in this state under this title, and who chooses to enter into a direct medical care agreement; and
    2. Includes an individual medical care provider or other legal entity, alone or with others professionally associated with the provider or other legal entity;
  3. “Medical care service” includes the screening, assessment, diagnosis, and treatment for the purpose of promotion of health or the detection and management of disease or injury within the competency and training of the direct medical care provider; and
  4. “Medical products” include medical drugs and pharmaceuticals.

Acts 2016, ch. 996, § 1; 2017, ch. 163, §§ 1-7; 2020, ch. 739, §  1.

Compiler's Notes. Acts 2017, ch. 163, § 8 provided that nothing in the act, which amended this section, authorizes a chiropractic physician to use a title other than  the titles recognized in § 63-1-109(a)(1).

Amendments. The 2017 amendment, in the definition of “direct primary care agreement”, substituted “between a direct primary care physician” for “between a primary care physician” in the introductory language; substituted “direct primary care physician” for “physician” in (A), (E)(vi) and (G); substituted “discipline by the appropriate licensing board;” for “professional discipline by the board of medical examiners;” in (E)(vi); substituted “‘Primary care physician’ or ‘physician’” for “‘Physician’” and “chapters 4, 6, or 9” for “chapter 6 or 9” in the definition of “physician”; and added “ or, if applicable, within the scope of practice of a chiropractic physician” after “within the competency and training of the direct primary care physician” at the end of the definition of “primary care service.”

The 2020 amendment substituted “medical” for “primary” and “provider” for “physician” throughout the section;  substituted “the medical care service” for “primary service” in (1)(D); substituted “may be subject” for “may still be subject” in (1)(E)(ii); deleted “may be” preceding “subject to” in (1)(E)(vi); in (1)(G), substituted “. However, the” for “; provided, that the” and inserted “the” preceding “direct”; substituted the present definition of “Direct medical care provider” for the former definition of “Direct primary care physician” which read: “Direct primary care physician” means an individual or legal entity that is licensed, registered, or otherwise authorized to provide primary care services in this state under this title, and who chooses to enter into a direct primary care agreement. A direct primary care physician includes an individual primary care physician or other legal entity, alone or with others professionally associated with the physician or other legal entity”; redesignated the definition of “Medical products”; deleted the former definitions of “Primary care physician” or “physician” which read: “‘Primary care physician’ or ‘physician’ means a physician licensed under chapters 4, 6, or 9 of this title; and”; deleted the former definition of “Primary care service” which read: “‘Primary care service’ includes the screening, assessment, diagnosis, and treatment for the purpose of promotion of health or the detection and management of disease or injury within the competency and training of the direct primary care physician or, if applicable, within the scope of practice of a chiropractic physician.”; and added the definition of “Medical care service”.

Effective Dates. Acts 2017, ch. 163, § 9. April 24, 2017.

Acts 2020, ch. 739, § 3. July 1, 2020.

63-1-503. Purchase and payment of medical services or products outside of insurance plan or outside of TennCare or medicare program not prohibited.

    1. Nothing in state law prohibits a patient or a legal representative of a patient from seeking care outside of an insurance plan, or outside of the TennCare or Medicare program, and paying for that care.
    2. Nothing in state law prohibits a medical care provider licensed under this title, or a healthcare facility, licensed under title 33 or 68, from accepting payment for services or medical products outside of an insurance plan.
    3. Nothing in state law prohibits a medical care provider licensed under this title, or a healthcare facility, licensed under title 33 or 68, from accepting payment for services or medical products provided to a TennCare or Medicare beneficiary.
  1. A patient or legal representative does not forfeit insurance benefits, TennCare benefits, or Medicare benefits by purchasing medical services or medical products outside the system.
  2. The offer and provision of medical services or medical products purchased and provided under this part is not an offer of insurance and is not regulated by the insurance laws of this state.

Acts 2016, ch. 996, § 1; 2020, ch. 739, §  1.

Amendments. The 2020 amendment substituted “prohibits” for “shall be construed as prohibiting” in (a)(1); redesignated the former first sentence of (b) as (a)(2) and rewrote the sentence, which read: “Nothing in the law of this state shall be construed as prohibiting a physician, other medical professional licensed under this title, or a healthcare facility, licensed under title 33 or 68, from accepting payment for services or medical products outside of an insurance plan.”; redesignated the former second sentence of (b) as (a)(3) and rewrote the sentence, which read: “Nothing in the law of this state shall prohibit a physician, other medical professional, or a medical facility from accepting payment for services or medical products provided to a TennCare or medicare beneficiary.”; redesignated former (c) as present (b) and former (d) as present (c); substituted “does” for “shall” in present (b); and in present (c), substituted “is not an offer” for “shall not be deemed an offer”,  “is not regulated” for “nor regulated” and “this state” for “the state”.

Effective Dates. Acts 2020, ch. 739, § 3. July 1, 2020.

63-1-504. Direct medical care agreement.

  1. A direct medical care agreement is not insurance and is not subject to regulation by the department of commerce and insurance.
  2. Entering into a direct medical care agreement is not the business of insurance and is not subject to regulation under title 56.
  3. A direct medical care provider, or the agent of a direct medical care provider, is not required to obtain a certification of authority or license under the Tennessee Insurance Producer Licensing Act of 2002, compiled in title 56, chapter 6, to market, sell, or offer to sell a direct medical care agreement.
  4. A direct medical care agreement is not a discount medical plan.
  5. A direct medical care agreement must:
    1. Allow either party to terminate the agreement upon written notice to the other party;
    2. Provide that fees are not earned by the direct medical care provider until the month paid by the periodic fee has been completed; and
    3. Provide that, upon termination of this agreement by the individual patient, all unearned fees are to be returned to the patient.

Acts 2016, ch. 996, § 1; 2020, ch. 739, §  1.

Amendments. The 2020 amendment substituted “medical” for “primary” in the section heading and throughout the section; substituted “provider” for “physician” in (c) twice, and in (e)(2); and substituted “must” for “shall” in the introductory paragraph of (e).

Effective Dates. Acts 2020, ch. 739, § 3. July 1, 2020.

Part 6
Opiod Abuse or Diversion

63-1-601. Reporting suspected opiod abuse or diversion.

  1. The department of health shall accept allegations of opioid abuse or diversion. The department shall publicize a means of reporting allegations of opioid abuse or diversion.
  2. Any entity that prescribes, dispenses, or handles opioids shall provide information to employees about reporting suspected opioid abuse or diversion. The information may be provided to each employee individually in writing, documented by the employing entity, or by posting, in a conspicuous location in a non-public area regularly used by employees, a sign at least eleven inches (11") in height and seventeen inches (17") in width stating:

    NOTICE: PLEASE REPORT ANY SUSPECTED ABUSE OR DIVERSION OF OPIOIDS, OR ANY OTHER IMPROPER BEHAVIOR WITH RESPECT TO OPIOIDS, TO THE DEPARTMENT OF HEALTH'S COMPLAINT INTAKE LINE:

    [NUMBER OF INTAKE LINE]

  3. The department shall refer reports received to the appropriate health-related board or law enforcement official.

Acts 2018, ch. 675, § 1.

Effective Dates. Acts 2018, ch. 675, § 2. January 1, 2019.

63-1-602. Protection of employees or persons who report information relative to opiod abuse or diversion.

  1. No employee of an entity that prescribes, dispenses, or handles opioids shall be discharged or terminated solely for reporting information in good faith to the department of health.
  2. No person licensed under this title shall suffer an adverse licensure action solely for reporting information in good faith to the department of health.
  3. A person who reports information in good faith to the department of health is immune from civil liability related to the report.

Acts 2018, ch. 675, § 1.

Effective Dates. Acts 2018, ch. 675, § 2. January 1, 2019.

Chapter 2
Medical Records

63-2-101. Release of medical records — Definitions.

    1. Notwithstanding any other provision of law to the contrary, a health care provider shall furnish to a patient or a patient's authorized representative a copy or summary of such patient's medical records, at the option of the health care provider, within ten (10) working days upon request in writing by the patient or such representative.
    2. If a provider fails to comply with subdivision (a)(1), proper notice shall be given to the provider's licensing board or boards, and the provider may be subject to disciplinary actions that include sanctions and a monetary fine.
      1. Except as otherwise provided by law, such patient's medical records shall not constitute public records, and nothing contained in this part shall be deemed to impair any privilege of confidentiality conferred by law on patients, their personal representatives or heirs. Nothing in this subsection (b) shall impair or abridge the right of the patient or the patient's authorized representative to obtain copies of the patient's hospital records in the manner provided in § 68-11-304. Nothing in this subsection (b) shall be construed as prohibiting a patient's medical records from being subpoenaed by a court of competent jurisdiction.
      2. As used in subdivision (b)(1)(A), “medical records” includes any list of patients that is compiled or maintained by or for such patient's health care provider.
    1. Except for any statutorily required reporting to health or government authorities and except for access by an interested third-party payer or their designee for the purpose of utilization review, case management, peer reviews or other administrative functions, the name and address and other identifying information of a patient shall not be divulged. The name and address and other identifying information shall not be sold for any purpose. Any violation of this subdivision (b)(2) shall be an invasion of the patient's right to privacy.
    2. Except as otherwise authorized in this section, title 38, chapter 7, part 1, title 68, chapter 11, part 3 and title 68, chapter 11, part 15, a health care provider shall have in place a policy to protect the dignity of a patient, even if the patient dies or becomes incapacitated, by limiting the use and disclosure of medical records, images, videos or pictures intended to be used for appropriate medical educational purposes, even if the patient's information is de-identified. The policy shall include when and to whom it is appropriate to use and disclose the patient's information, and when a written authorization from the patient or their authorized representative is required, whenever it is reasonably possible to obtain it, prior to use or disclosure. If the patient becomes incapacitated or dies, and there is no legal representative for the patient, the patient's next of kin will be considered to be an authorized representative for the patient. When required the written authorization will include the core elements required by 45 CFR Parts 160 and 164, “Standards for Privacy of Individually Identifiable Health Information.”
  1. As used in this chapter:
    1. “De-identified” means there is no reasonable basis to believe that the information can be used to identify an individual and there is compliance with the requirements for de-identification outlined in 45 CFR Part 164, § 164.514 “Other requirements relating to uses and disclosures of protected health information”;
    2. “Health care provider” means any person required to be licensed under this title;
    3. “Incapacitated” means that a patient is in a physical or mental condition such that the patient is incapable of granting or denying informed consent; and
    4. “Medical records” means all medical histories, records, reports and summaries, diagnoses, prognoses, records of treatment and medication ordered and given, X-ray and radiology interpretations, physical therapy charts and notes and lab reports.
  2. Nothing in this chapter shall be construed to prevent a true, correct and complete copy of the medical records from being subject to a subpoena duces tecum.
  3. To further the effectiveness of the immunization program of the department of health, a physician or any third party payor or health insurance entity regulated by the department of commerce and insurance doing business in Tennessee, or any entity that has elected, organized and qualified as a self-insured entity that provides information to the department regarding a child's immunization status for any of the following purposes shall not be subject to liability or cause of action or a claim of any nature, including any licensing board disciplinary action, arising solely from the disclosure of information concerning such child's immunization status:
    1. Compliance with the laws regarding child care and school attendance;
    2. Ensuring that a child receives such immunization as is medically appropriate or assisting in efforts to ensure a child is appropriately immunized;
    3. Providing immunization information to the immunization registry maintained by the department;
    4. Insuring compliance with the Families First Act, compiled in title 71, chapter 3, part 1; or
    5. Providing information that will allow the department to determine immunization levels in Tennessee.
  4. All information received by the department pursuant to this part from any source shall be confidential and unavailable to the public. Contact of a parent or guardian of a child by the department regarding the child's immunization status as the result of the department's contact with the physician shall not be held to be a breach of confidentiality by the reporting physician.
  5. The names of all children shall be included on the immunization registry established by title 37, chapter 10, part 4, unless such child's custodial parent or guardian objects to the inclusion of the child's name on the immunization registry to the department. The department shall notify the child's custodial parent or guardian in writing within six (6) months of the child's birth that inclusion on the immunization registry is not mandatory. Upon such written or oral request of exclusion by the child's custodial parent or guardian, the department shall either remove the child's name from the immunization registry or refrain from adding the child's name to the immunization registry and confirm in writing to the child's custodial parent or guardian that the child's name has been excluded from the immunization registry.
  6. Notwithstanding this part or any other law to the contrary, it shall not be unlawful to disclose, nor shall there be any liability for disclosing, medical information in response to a subpoena, court order or request authorized by state or federal law.
  7. Providers, as defined in § 71-5-2503, shall make available for inspection and copying to the office of inspector general and the medicaid fraud control unit, upon request, no later than by the close of business on the next business day, a complete set of all medical records requested in connection with an investigation being pursued by the agency or shall provide a compelling reason why the requested records cannot be produced; provided, that no such records shall be removed from the grounds of the provider's office without the provider's consent, unless the office of inspector general or the medicaid fraud control unit reasonably believes that the requested documents are about to be altered or destroyed.
  8. On request of a provider, a duly authorized agent of the requesting agency shall sign a document acknowledging receipt of records produced pursuant to this section. On request of a duly authorized agent of the requesting agency, a duly authorized agent of the provider shall sign a document acknowledging the return of specific records to the provider.
  9. No person or entity shall be subject to any civil or criminal liability for releasing patient information in response to a request from the office of inspector general or the medicaid fraud control unit.

Acts 1990, ch. 1067, § 1; 1996, ch. 862, §§ 1, 2; 1996, ch. 881, § 2; 1997, ch. 420, §§ 1, 2; 1999, ch. 386, § 1; 2003, ch. 40, § 1; 2005, ch. 113, § 1; 2005, ch. 474, § 12; 2010, ch. 862, §§ 2, 3.

Compiler's Notes. Acts 2010, ch. 862, § 1 provided that the act shall be known and may be cited as the “Colby Stansberry Act.”

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

Hospital records, access, § 68-11-304.

Law Reviews.

Can We Talk? (Jerry Potter), 38 No. 11 Tenn. B.J. 14 (2002).

Can We Talk? The Rest of the Story or Why Defense Attorneys Should Not Talk to the Plaintiff's Doctors (Bobby Russ), 39 No. 2 Tenn. B.J. 29 (2003).

HIPAA Violations on Social Media: Will HHS Continue to Ignore?, 45 U. Mem. L. Rev. 633 (2015).

Physician-Patient Confidentiality in Health Care Liability Actions: HIPAA's Preemption of Ex Parte Interviews with Treating Physicians Through the Obstacle Test, 44 U. Mem. L. Rev. 97 (2013).

Attorney General Opinions. Release of medical records by dentists, OAG 97-030, 1997 Tenn. AG LEXIS 29 (3/31/97).

63-2-102. Costs of reproduction, copying or mailing of records.

  1. The party requesting the patient's records is responsible to the provider for the reasonable costs of copying and mailing such patient's records. For other than records involving workers' compensation cases, such reasonable costs shall not exceed twenty dollars ($20.00) for medical records five (5) pages or less in length and fifty cents (50¢) per page for each page copied after the first five (5) pages and the actual cost of mailing. Any third-party provider of record copying and related services shall be subject to the reasonable cost limits contained in this section and shall not impose any charge or fee for such services in excess of such cost limits. The costs charged for reproducing records of patients involved in a workers' compensation claim shall be as defined in § 50-6-204. A health care provider shall not charge a fee for copying or notarizing a medical record when requested by the department pursuant to a complaint, inspection or survey as set forth in § 63-1-117.
  2. Any increase in charges for copying and certifying medical records permitted by this section that is above those charges established by this section as it existed on January 1, 2010, shall not apply to requests for medical records made by the department of human services, and charges for copying and certifying medical records requests made by the department of human services shall remain the same as existed under this section as of January 1, 2010.
    1. Upon request, the provider shall submit a notarized affidavit by the custodian of records certifying that the records provided in response to the request:
      1. Are true and correct copies of records in the custody of the affiant;
      2. Were made at or near the time of the occurrence of the matters set forth by, or from information transmitted by, a person with knowledge of and a business duty to record or transmit those matters;
      3. Were kept in the course of regularly conducted activity; and
      4. Were made by the regularly conducted activity as a regular practice.
    2. In addition to the charge for the copies of the record, the provider may charge up to twenty dollars ($20.00) for the affidavit described in this subsection (c), and the records submitted with that affidavit, and the affidavit shall qualify for the business records exception to the hearsay rule.
  3. Nothing in this chapter shall be construed as superseding any provision of law that establishes specific costs for the reproduction, copying or mailing of records.
  4. Payment of such costs may be required by the provider prior to the records being furnished. Upon payment of the costs described in this section, the patient or a patient's authorized representative shall have the right to receive the medical records without delay.
  5. In workers' compensation cases, a request for medical records shall include a medical or anatomical impairment rating as required by § 50-6-246 [See the Compiler’s Notes].

Acts 1990, ch. 1067, § 1; 1996, ch. 881, § 3; 1997, ch. 425, §§ 1, 2; 2000, ch. 825, § 1; 2002, ch. 523, § 2; 2010, ch. 865, § 1.

Compiler's Notes. Acts 2013, ch. 289, § 92, effective July 1, 2014, amends § 50-6-246, referred to in (f), by deleting it in its entirety.  However, pursuant to § 50-6-101, as amended by Acts 2013, ch. 289, § 3, effective July 1, 2014, all claims having a date of injury prior to July 1, 2014, shall be governed by prior law. Thus, this section remains in effect as to injuries occurring prior to July 1, 2014.

Law Reviews.

Obtaining medical records for mental health evaluations (David L. Raybin), 37 No. 7 Tenn. B.J. 27 (2001).

63-2-103. Authority to promulgate regulations regarding retention of physician medical records — Limit on retention of mammography records.

  1. The board of medical examiners is authorized to promulgate regulations regarding the retention of physician medical records as defined in § 63-2-101(c).
  2. Notwithstanding any law or rule to the contrary, such retention of mammography records shall not exceed ten (10) years.

Acts 2013, ch. 113, § 2.

Chapter 3
Podiatrists

Part 1
General Provisions

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.

NOTES TO DECISIONS

1. Ankle Injury.

Determination of the board of podiatry that the treatment of soft tissue involved in an ankle sprain fell within the definition of podiatrist was not supported by the evidence. Tennessee Medical Ass'n v. Board of Registration in Podiatry, 907 S.W.2d 820, 1995 Tenn. App. LEXIS 377 (Tenn. Ct. App. 1995).

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. 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.
  1. The board shall establish the minimum passing grade by regulation.
  2. 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.

NOTES TO DECISIONS

1. Construction.

Provision in an agreement between the Tennessee board of registration in podiatry and the podiatrist that precluded the podiatrist from reactivating his license in Tennessee was upheld, because the podiatrist made a knowing and voluntary waiver of his rights to apply for the license in exchange for settlement of numerous claims asserted against him; the fact that the podiatrist later learned that he was precluded from receiving federal healthcare payments was no reason to set aside the provision, which was within the full authority of the board. Bacardi v. Tenn. Bd. of Registration in Podiatry, 124 S.W.3d 553, 2003 Tenn. App. LEXIS 402 (Tenn. Ct. App. 2003), appeal denied, Bacardi v. Tn. Bd. of Registration in Podiatry, — S.W.3d —, 2003 Tenn. LEXIS 872 (Tenn. 2003).

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.
    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.
  3. 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. 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.
  1. 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. 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.
  1. 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.
    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.
      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.
    3. 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.
    4. 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.
    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

63-3-201. Part definitions.

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

  1. “Board” means the board that licenses and regulates podiatrists in Tennessee in part 1 of this chapter;
  2. “Commissioner” means the commissioner of health;
  3. “Custom fabricated and fitted device” means an orthosis, prosthesis or pedorthic device that is fabricated to original measurements or to a mold for use by a patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions and that requires substantial clinical and technical judgment in its design and fitting;
  4. “Custom fitted device” means a prefabricated orthosis, prosthesis or pedorthic device sized or modified for use by the patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions that requires substantial clinical judgment and substantive alteration for appropriate use;
  5. “Department” means the department of health;
  6. “Director” means the director of the division of health related boards;
  7. “Division” means the division of health related boards;
  8. “Facility” means the business location where orthotic, prosthetic or pedorthic care is provided. In the case of an orthotic/prosthetic facility, the orthotic/prosthetic facility has the appropriate clinical and laboratory space and equipment to provide comprehensive orthotic or prosthetic care; and, in the case of a pedorthic facility, the pedorthic facility has the appropriate clinical space and equipment to provide pedorthic care. Licensed orthotists, prosthetists and pedorthists must be available to either provide care or to supervise the provision of care by nonlicensed staff;
  9. “Licensed orthotist” means a person who is licensed under this part to practice orthotics and who represents the person to the public by title or description of services that includes the term “orthotic,” “orthotist,” “brace” or a similar title or description of services;
  10. “Licensed pedorthist” means a person who is licensed under this part to practice pedorthics and who represents the person to the public by the title or description of services that includes the term “pedorthic,” “pedorthist” or a similar title or description of services;
  11. “Licensed prosthetist” means a person who is licensed under this part to practice prosthetics and who represents the person to the public by title or description of services that includes the term “prosthetic,” “prosthetist,” “artificial limb” or a similar title or description of services;
  12. “Off-the-shelf device” means a prefabricated prosthesis or orthosis sized or modified for use by the patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions that does not require substantial clinical judgment and substantive alteration for appropriate use;
  13. “Orthosis” means a custom designed, fabricated, fitted or modified device to correct, support or compensate for a neuro-musculoskeletal disorder or acquired condition. “Orthosis” does not include fabric or elastic supports, corsets, arch supports, low-temperature plastic splints, trusses, elastic hoses, canes, crutches, soft cervical collars, dental appliances or other similar devices that are carried in stock and sold without modification as over-the-counter items by a drug store, department store, corset shop or surgical supply facility;
  14. “Orthotic and prosthetic education program” means a course of instruction accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), consisting of:
    1. An adequate curriculum of college level training and instruction in math, physics, biology, chemistry and psychology; and
    2. A specific curriculum in orthotic or prosthetic courses, including:
      1. Lectures covering pertinent anatomy, biomechanics, pathomechanics, prosthetic-orthotic components and materials, training and functional capabilities, prosthetic or orthotic performance evaluation, prescription considerations, etiology of amputations and disease processes necessitating prosthetic or orthotic use and medical management;
      2. Subject matter related to pediatric and geriatric problems;
      3. Instruction in acute care techniques, such as immediate and early post-surgical prosthetics and fracture bracing techniques; and
      4. Lectures, demonstrations and laboratory experiences related to the entire process of measuring, casting, fitting, fabricating, aligning and completing prostheses or orthoses;
  15. “Orthotics” means the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting or servicing an orthosis, under an order from a licensed health care practitioner authorized by law to issue such an order, for the correction or alleviation of neuromuscular or musculoskeletal dysfunction, disease, injury or deformity;
  16. “Orthotist” means an allied health professional who is specifically trained and educated to provide or manage the provision of a custom-designed, fabricated, modified and fitted external orthosis to an orthotic patient, based on a clinical assessment and a prescription from a health care practitioner authorized by law to write such prescriptions, to restore physiological function or cosmesis;
  17. “Over-the-counter device” means a prefabricated, mass-produced device that is prepackaged and requires no professional advice or judgment in either size selection or use, including fabric or elastic supports, corsets, generic arch supports and elastic hose;
  18. “Pedorthic device” means therapeutic footwear, foot orthoses for use at the ankle or below and modified footwear made for therapeutic purposes, as prescribed by a licensed health care practitioner authorized by law to issue such prescription. “Pedorthic device” does not include nontherapeutic accommodative inlays or nontherapeutic accommodative footwear, regardless of method of manufacture, shoe modifications made for nontherapeutic purposes, unmodified, over-the-counter shoes or prefabricated foot care products;
  19. “Pedorthic education program” means a course of instruction accredited by the Board for Certification in Pedorthics, consisting of:
    1. A basic curriculum of instruction in foot-related pathology of diseases, anatomy and biomechanics;
    2. A specific curriculum in pedorthic courses, including lectures covering shoes, foot orthoses and shoe modifications, pedorthic components and materials, training and functional capabilities, pedorthic performance evaluation, prescription considerations, etiology of disease processes necessitating use of pedorthic devices, medical management and subject matter related to pediatric and geriatric problems; and
    3. Lectures, demonstrations, and laboratory experiences related to the entire process of measuring and casting, fitting, fabricating, aligning and completing pedorthic devices;
  20. “Pedorthics” means the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting or servicing a pedorthic device, under an order from a licensed health care practitioner authorized by law to issue such order for the correction or alleviation of neuromuscular or musculoskeletal dysfunction, disease, injury or deformity;
  21. “Pedorthist” means a person who measures, designs, fabricates, fits or services pedorthic devices and assists in the formulation of the order of pedorthic devices, as ordered by a licensed health care practitioner authorized by law to issue such order for the support or correction of disabilities caused by neuro-musculoskeletal diseases, injuries or deformities;
  22. “Person” means a natural person;
  23. “Prosthesis” means a custom designed, fabricated, fitted or modified device to replace an absent external limb, for the purpose of restoring physiological function or cosmesis. “Prosthesis” does not include artificial eyes, ears or dental appliances, cosmetic devices such as artificial breasts, eyelashes or wigs or other devices that do not have a significant impact on the musculoskeletal functions of the body;
  24. “Prosthetics” means the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting or servicing a prosthesis, under an order from a licensed health care practitioner authorized by law to issue such order;
  25. “Prosthetist” means an allied health professional who is specifically trained and educated to provide or manage the provision of a custom designed, fabricated, modified and fitted external limb prosthesis to a prosthetic patient, based on a clinical assessment and a prescription from a health care practitioner authorized to write such prescriptions, to restore physiological function or cosmesis;
  26. “Prosthetist/Orthotist” means a person who practices both disciplines of prosthetics and orthotics and who represents the person to the public by title or by description of services; and
  27. “Resident” means a person who has completed an education program in either orthotics or prosthetics and is continuing such person's clinical education in a residency program approved by the board.

Acts 2005, ch. 380, § 1.

63-3-202. Rules and regulations — Authority of the board.

  1. The board shall adopt rules and regulations, promulgated in compliance with all requirements of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to:
    1. Establish licensure categories and issue licenses for prosthetists, orthotists and pedorthists;
    2. Establish the qualifications, educational courses, curriculum, hours and standards that are prerequisite to issuance of all levels and types of licensure established pursuant to subdivision (a)(1); provided, however, that such qualifications shall include the following:
      1. To qualify for a license to practice orthotics or prosthetics, a person shall:
        1. Possess a baccalaureate degree or semester hours equivalent to four (4) years of study at a four-year college or university;
        2. Complete the amount of formal training, including, but not limited to, any necessary hours of classroom education and clinical practice required by the board;
        3. Complete a clinical residency in the professional area for which a license is sought, in accordance with standards, guidelines, or procedures for residencies inside or outside this state established and approved by the board. The majority of training shall be devoted to services performed under the supervision of a licensed practitioner of orthotics or prosthetics or a person who has obtained certification from the American Board for Certification in Orthotics and Prosthetics, Inc. or the Board for Orthotist/Prosthetist Certification;
        4. Pass all written, practical and oral examinations that are required and approved by the board; and
        5. Be qualified to practice in accordance with commonly accepted standards of orthotic and prosthetic care acceptable to the board;
      2. To qualify for a license to practice pedorthics, a person shall:
        1. Possess a high school diploma or comparable credential approved by the board;
        2. Complete the amount of formal training, including, but not limited to, any necessary hours of classroom education and clinical practice required by the board;
        3. Pass all examinations that are required and approved by the board;
        4. Complete a qualified work experience program or internship in pedorthics, in accordance with standards and procedures established by the board; and
        5. Be qualified to practice in accordance with commonly accepted standards of pedorthic care acceptable to the board; and
      3. A person may be licensed in more than one (1) discipline;
    3. Establish the circumstances or conditions, if any, under which persons shall be entitled to exemption from licensure during training, while waiting to take or receive the results of any required examination or upon meeting specified minimum educational and clinical qualifications;
    4. Select the examination or examinations to be utilized as the board's licensure examination or examinations and the prerequisites, if any, for admission to the examination or examinations. The board is authorized to enter into a contract or agreement with the chosen examination service or services or select an intermediary between the board and the examination service or services to process applicants for the examination or examinations;
    5. Establish any other criteria for issuance of licensure that are reasonably related to the safe and competent performance of prosthetics, orthotics and pedorthics;
    6. Accredit continuing education courses;
      1. Establish the fees to be paid for each of the following:
        1. Application for licensure;
        2. Renewal or reinstatement of licensure;
        3. Late renewal of licensure;
        4. Application for continuing education course accreditation; and
        5. Duplicate or replacement license;
      2. The fees shall be set at a level that is adequate to pay all of the expenses of implementing and administering this part. All deposits and disbursements shall be handled in accordance with § 63-1-137;
    7. Establish the continuing education requirements for license holders, which shall include the frequency of reporting, number of hours, types of courses, approval of courses, methods of proving compliance, penalties for violation and all fees necessary for implementation of the continuing education process;
    8. Regulate the nature, manner, content and extent of advertising by persons licensed under this part;
    9. Delineate the actions relative to therapeutic footwear and medical devices for the foot and ankle that must be performed by licensed health care practitioners; and
    10. Establish a registration process for residents as prescribed in § 63-3-209(2)(B).
  2. The board shall have the authority to:
    1. Conduct disciplinary hearings, in accordance with the Uniform Administrative Procedures Act; and
    2. Issue advisory private letter rulings to any affected person licensed under this part who makes such a request regarding any matters within the board's primary jurisdiction. Such private letter ruling shall affect only the person making such inquiry and shall have no precedential value for any other inquiry or future contested case that might 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.

Acts 2005, ch. 380, § 1; 2017, ch. 167, § 2.

Amendments. The 2017 amendment added (a)(11).

Effective Dates. Acts 2017, ch. 167, § 4. July 1, 2017.

63-3-203. Licensing.

  1. Licenses shall be issued and renewed by the board pursuant to the division's biennial issuance and renewal system.
  2. Any person who has been issued a license to practice under this part and who wishes to retire that license shall file with the board an affidavit, on a form to be furnished by the board, stating the date on which the person retired from such practice and such other facts that tend to verify such retirement, as the board deems necessary. Any person who wishes to reenter practice after retiring such person's license must request reinstatement of licensure.
  3. Any license issued by the board shall contain the name of the person to whom it is issued, the address of the person, the date and number of the license and such other information as the board deems necessary. The address contained on the license shall be the address where all correspondence and renewal forms from the board shall be sent. Any person whose address changes shall, within thirty (30) days after the address change, notify the board of the address change. The most recent address contained in the board's records for each license holder shall be the address deemed sufficient for purposes of service of process.
  4. Every person issued a license pursuant to this part shall either keep such license prominently displayed in the office or place in which such person practices or have it stored in a place from which it can be immediately produced upon request of a patient or a representative of the department.
  5. Any person whose license has been lost or destroyed may make application to the board for a replacement. Such application shall be accompanied by an affidavit setting out the facts concerning the loss or destruction of the original license.
  6. Any person whose name is changed by marriage or court order may surrender the person's license and apply to the board for a replacement license.

Acts 2005, ch. 380, § 1.

Cross-References. Licenses, §§ 63-1-10363-1-107.

63-3-204. Powers of the board.

  1. The board shall have the power to:
    1. Deny, restrict or condition a license;
    2. Permanently or temporarily withhold issuance of a license;
    3. Suspend, limit or restrict a previously issued license, for such time and in such manner as the board may determine;
    4. Reprimand, suspend, revoke or take such other disciplinary action in relation to an applicant or license holder as the board, in its discretion, may deem proper; or
    5. Permanently revoke a license.
  2. The grounds upon which the board shall exercise such power include, but are not limited to, circumstances in which the person:
    1. Is guilty of fraud or deceit in the procurement or holding of the license;
    2. Has been convicted of a felony in a court of competent jurisdiction, either within or outside of this state, unless the conviction has been reversed and the holder of the license discharged or acquitted or if the holder has been pardoned with full restoration of civil rights, in which case the license shall be restored;
    3. Is or has been afflicted with any medical problem, disability or addiction that, in the opinion of the board, would impair professional competence;
    4. Has knowingly aided and abetted a person who is not a license holder or is not otherwise authorized pursuant to this chapter to perform the duties of a license holder under this chapter;
    5. Has undertaken or engaged in any practice beyond the scope of duties permitted a license holder under this chapter;
    6. Has impersonated a license holder or former license holder or is under an assumed name performing the duties authorized to be performed only by a licensed person;
    7. Has been found guilty of violations of a code of ethics, which the board shall establish by regulation;
    8. Is or has been found guilty of incompetence or negligence in performance as a license holder;
    9. Acts in a manner unprofessional, dishonorable or unethical or has been found guilty of unprofessional, dishonorable or unethical conduct;
    10. Violates, or attempts to violate, directly or indirectly, or assists or aids in the violation of, or conspires to violate, any provision of this chapter or any lawful order of the board issued pursuant to this chapter or any of the rules or regulations promulgated pursuant to this chapter, or any criminal statute of the state;
    11. Is habitually intoxicated or engages in personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice; or
    12. Has received disciplinary action from another state or territory of the United States that has licensed or certified the person to practice in that state for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order, or other equivalent document memorializing the disciplinary action from the disciplining state or territory, shall constitute prima facie evidence of violation of this section and shall be sufficient grounds upon which to deny, restrict or condition licensure or renewal or to discipline a person licensed in this state.
  3. 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 2005, ch. 380, § 1; 2012, ch. 848, § 67; 2018, ch. 745, § 23.

Amendments. The 2018 amendment added (c).

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

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

63-3-205. Application.

  1. On and after January 1, 2008, no person shall practice orthotics, prosthetics or pedorthics in this state, or hold out as being able to practice either profession, or dispense an orthosis, prosthesis or pedorthic device, unless such person is licensed in accordance with the requirements of this part.
  2. Until January 1, 2008, a person certified by the American Board for Certification in Orthotics and Prosthetics, Inc., with the title of Certified Orthotist (CO), Certified Prosthetist (CP) or Certified Orthotist-Prosthetist (CPO), or by the Board for Orthotist/Prosthetist Certification with the title of Board of Orthotic Certification — Orthotist (BOCO) or Board of Certification — Prosthetist (BOCP), or holding similar certifications from other accrediting bodies with equivalent educational requirements and examination standards, may apply for and may be granted orthotic or prosthetic licensure under this part, upon payment of the required fee. After January 1, 2008, any applicant for initial licensure as an orthotist or a prosthetist shall meet the requirements of this part regarding license.
  3. Until January 1, 2008, a person certified as a Certified Pedorthist (CPED) by the Board of Certification in Pedorthics, Inc., or a person certified as a CO, CP or CPO by the American Board for Certification in Orthotics and Prosthetics, Inc., or certified as a BOCO or BOCP by the Board for Orthotist/Prosthetist Certification, or holding similar certifications from other accrediting bodies with equivalent educational requirements and examination standards, may apply for and may be granted pedorthic licensure under this part, upon payment of the required fee. After that date, any applicant for initial licensure as a pedorthist shall meet the requirements of this part regarding licensure.
  4. Notwithstanding any other provision of this part to the contrary, a person who has practiced full time for a minimum of the past five (5) years in a prosthetic/orthotic facility as an orthotist or prosthetist or in a pedorthic facility as a pedorthist may file an application with the board before January 1, 2007, in order to continue to practice orthotics, prosthetics or pedorthics and may be issued a license to practice orthotics, prosthetics or pedorthics under this part without examination, upon receipt by the division of payment of the licensing fee required and after the board has completed an investigation of the applicant's work history. The investigation may include, but is not limited to, completion by the applicant of a questionnaire regarding the applicant's work history and scope of practice.

Acts 2005, ch. 380, § 1.

63-3-206. Order from licensed health care provider required to provide care or services.

A licensed orthotist, prosthetist or pedorthist may provide care or services only if the care or services are provided pursuant to an order from a licensed health care practitioner authorized to issue such an order.

Acts 2005, ch. 380, § 1.

63-3-207. Scope of practice.

  1. The scope of practice of a licensed orthotist, prosthetist or pedorthist shall not include the right to diagnose a medical problem or condition or the right to give medical advice as to the nature, cause or treatment for the problem or condition for which the orthotic, prosthetic or pedorthic device is being dispensed; however, the scope of practice of a licensed orthotist, prosthetist or pedorthist does include the right to provide information or demonstration regarding the proper use and care of the device and to make adjustments to the device as needed.
  2. No person shall dispense or sell an over-the-counter or off-the-shelf device based upon an image of the customer's limb captured by the person through a mold, cast, scanning device, digital appliance, or pressure sensitive device, unless the customer has first presented to that person a written prescription for that device from a health care practitioner authorized by law to write such a prescription.

Acts 2005, ch. 380, § 1.

Attorney General Opinions. Sale of diabetic shoes.  OAG 13-105, 2013 Tenn. AG LEXIS 109 (12/19/13).

63-3-208. Interpretation of part.

  1. Nothing in this part or in the rules adopted by the board pursuant to this part shall be interpreted to limit or restrict a health care practitioner licensed under this title from engaging in the full scope of practice of such person's profession, training or services. Nothing in this part or in the rules adopted by the board pursuant to this part shall be interpreted or permitted to limit or restrict individuals acting under the supervision and control of a pharmacist or pharmacy licensed under this title or home medical equipment provider licensed under title 68 from measuring, fitting or adjusting any non-custom-fabricated and fitted device, including, but not limited to, over-the-counter or off-the-shelf devices, so long as such individual does not create a cast, mold or scan of a part of the human body for the purpose of constructing a medical device to treat a patient's medical condition and so long as such individual meets one (1) of the following criteria for such device:
    1. Documented training from a manufacturer or training from a licensed or certified orthotist, prosthetist or pedorthist;
    2. Certification or registration as a fitter of orthotic, prosthetic or pedorthic devices from a nationally recognized board or association such as the Board for Orthotist/Prosthetist Certification (BOC), the Board of Certification for Pedorthists, the National Community Pharmacists Association (NCPA) or the American Board for Certification in Orthotics and Prosthetics (ABC); or
    3. Direct supervision by a trained and experienced, or certified or registered, fitter of orthotic, prosthetic or pedorthic devices.
  2. Nothing in this part or in the rules adopted by the board pursuant to this part shall be interpreted or permitted to limit or restrict individuals acting under the supervision and control of a pharmacist or pharmacy licensed under this title or home medical equipment provider licensed under title 68 from measuring, fitting or adjusting any non-custom-fabricated and fitted pedorthic devices, including, but not limited to, diabetic shoes, so long as such individual meets the criteria of either subdivision (a)(2) or (a)(3) and so long as the individual does not create a cast, mold or scan of a part of the human body for the purpose of constructing a medical device to treat a patient's medical problem.

Acts 2005, ch. 380, § 1.

Attorney General Opinions. Sale of diabetic shoes.  OAG 13-105, 2013 Tenn. AG LEXIS 109 (12/19/13).

63-3-209. Construction of part.

Nothing in this part shall be construed to restrict:

  1. The practice of orthotics, prosthetics or pedorthics by a person who is employed by the federal government or any bureau, division or agency of the federal government while in the discharge of the employee's official duties;
  2. The practice of orthotics, prosthetics or pedorthics by:
    1. A student enrolled in a school of orthotics, prosthetics or pedorthics;
    2. A resident continuing such resident's clinical education in a residency accredited by the National Commission on Orthotic and Prosthetic Education; provided, that such person has first registered as a resident with the board; or
    3. A student in a qualified work experience program or internship in pedorthics; or
  3. The measuring, fitting or adjusting of an orthotic device by an employee or authorized representative of an orthosis manufacturer registered with the federal food and drug administration, when such employee or representative is supervised by a licensed health care professional authorized by law to prescribe, measure or fit such device, and the measuring, fitting or adjusting of such device occurs in the office of such licensed health care professional or in a health care facility.

Acts 2005, ch. 380, § 1; 2017, ch. 167, § 1.

Amendments. The 2017 amendment added the proviso at the end of (2)(B).

Effective Dates. Acts 2017, ch. 167, § 4. July 1, 2017.

63-3-210. Violation of part.

  1. Any person who practices in this state without having first complied with this part commits a Class C misdemeanor; provided, however, that, for a period of one (1) year after January 1, 2006, an offense under this section shall only result in a warning and such person shall have thirty (30) days to comply with this part.
  2. The board of registration in podiatry shall inform persons to be regulated by this part of the regulations to be imposed by this part.

Acts 2005, ch. 380, § 1.

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

63-3-211. Injunction — Jurisdiction.

  1. The board is authorized to petition any circuit or chancery court having jurisdiction over any person who is practicing without a license, or to whom a license has been denied or whose license has been suspended or revoked by action of the board to enjoin such person from continuing to practice within this state.
  2. Jurisdiction is conferred upon the circuit and chancery courts of this state to hear and determine all such causes and to exercise full and complete jurisdiction in such injunctive proceedings.

Acts 2005, ch. 380, § 1.

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

63-3-212. Screening panels in investigative and disciplinary process.

  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 resolution of complaints or diversion to professional peer review organizations or impaired professionals' associations or foundations of those cases that the board, through established guidelines, deems appropriate.
  2. The screening panel has the authority to administer oaths to witnesses.
  3. Members of a screening panel may be drawn from the membership of the board or may be appointed by the board. Nonboard members shall meet the requirements of membership on the 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.

Acts 2005, ch. 380, § 1.

Cross-References. Screening panels, § 63-1-138.

63-3-213. Appointments to the board.

  1. To assist in the implementation and administration of this part, the governor shall initially appoint to the board one (1) person who is eligible for licensure as an orthotist, or prosthetist or pedorthist.
  2. That person's term of office on the board shall be three (3) years. Upon expiration of that person's term, the governor shall appoint a person licensed under this part to fill this position on the board.
  3. A person may serve more than one (1) term in this position on the board.
  4. The governor may remove this member of the board from office for neglect of duties, malfeasance in office, incompetence or professional misconduct.
  5. The governor may fill a vacancy in this position upon the member's resignation or death.
  6. In making appointments to this position on the board, the governor shall consider persons recommended by the professional organization of orthotists, prosthetists and pedorthists in Tennessee.
  7. The person filling this position on the board shall receive the same per diem and reimbursement for travel and other necessary expenses that is received by other members of the board.
  8. The person filling this position shall have the right to vote on all matters considered by the board.

Acts 2005, ch. 380, § 1.

63-3-214. Use of non-licensed persons.

A licensed orthotist or prosthetist may utilize one (1) or more non-licensed persons to assist in:

  1. The performance of minor repairs on devices which have been previously dispensed to patients; and
  2. The performance of other tasks approved by the board of podiatric medical examiners.

Acts 2017, ch. 167, § 3.

Effective Dates. Acts 2017, ch. 167, § 4. July 1, 2017.

Chapter 4
Chiropractors

63-4-101. Practice of chiropractic — Education and clinical training — Scope of practice.

    1. As used in this chapter, unless the context otherwise requires:
      1. “Differential diagnosis” means the examination of body systems and structures of a patient to determine the source, nature, and extent of a disease or other physical condition for the purpose of establishing an appropriate plan of care for the patient, which may include referral to another provider for care that is outside the scope of practice of a chiropractic physician;
      2. “Diagnosis” means:
        1. The differential diagnosis of human ailments through examination and evaluation of patients and through diagnostic procedures necessary to clinically correlate a physical examination to a diagnostic impression;
        2. The ordering of X-rays, advanced diagnostic imaging, and other diagnostic procedures;
        3. The performance of X-rays and other non-invasive diagnostic procedures, as well as minimally invasive procedures for which the chiropractic physician has received training by an institution accredited by the Council on Chiropractic Education or its successor and which have been approved by the board of chiropractic examiners after consultation with the board of medical examiners; and
        4. The collection of blood, urine, saliva, and hair for analysis; provided, however, venipuncture shall only be done by a phlebotomist or other person who is properly trained to draw blood;
      3. “Practice of chiropractic” means the diagnosis and treatment of patients, as defined in subdivisions (a)(1)(B) and (D); and
      4. “Treatment” means:
        1. The treatment of neuromuscular, musculoskeletal, and related conditions through the use of chiropractic adjustment and manipulation; physical agent modalities; manual, rehabilitative, and other therapeutic care; and mechanical, chemical, electrical, and thermal methods;
        2. The use of acupuncture by a chiropractic physician who has completed two hundred fifty (250) hours of an accredited acupuncture course and has passed the National Board of Chiropractic Examiners Acupuncture Exam;
        3. The location and removal of interference with nerve transmission and nerve function;
        4. The making of appropriate referrals to other healthcare professionals for conditions that are outside the scope of practice of a chiropractic physician;
        5. The ordering of durable medical equipment for patients who need such equipment to assist in the restoration of their health under the plan of care for treatment of their neuromuscular, musculoskeletal, and related conditions; and
        6. The provision of supportive care with due regard for nutrition, hygiene, sanitation, and rehabilitation designed to assist in the restoration and maintenance of a patient's health.
    2. Nothing in this chapter authorizes a chiropractic physician to engage in the practice of medicine and surgery or osteopathy, as defined in chapters 6 and 9 of this title, or to prescribe legend drugs or controlled substances.
  1. As used in this chapter, “chiropractic physician” means a person who is a graduate of a chiropractic college accredited by the Council on Chiropractic Education or its successor, or is a graduate of an international chiropractic college approved by the board of chiropractic examiners, and who has received a license issued by the board of chiropractic examiners.
    1. No person licensed under this title may perform a spinal manipulation or spinal adjustment without first having the legal authority to differentially diagnose and having received a minimum of four hundred (400) hours of classroom instruction in spinal manipulation or spinal adjustment and a minimum of eight hundred (800) hours of supervised clinical training at a facility where spinal manipulation or spinal adjustment is a primary method of treatment. “Spinal manipulation” and “spinal adjustment” are interchangeable terms that identify a method of skillful and beneficial treatment where a person uses direct thrust to move a joint of the patient's spine beyond its normal range of motion, but without exceeding the limits of anatomical integrity. A violation of this section is an unlawful practice of chiropractic and is grounds for the offending health care provider's licensing board to suspend, revoke or refuse to renew such provider's license or take other disciplinary action allowed by law.
    2. Nothing in this subsection (c) shall in any way apply to the scope of practice of:
      1. An osteopathic physician licensed under chapter 9 of this title; or
      2. Any person who practices medicine or surgery who is licensed under chapter 6 of this title.

Acts 1923, ch. 9, § 5; Shan. Supp., § 3654a120; Code 1932, § 7013; Acts 1941, ch. 29, § 2; C. Supp. 1950, § 7013; Acts 1980, ch. 673, § 1; T.C.A. (orig. ed.), § 63-401; Acts 1999, ch. 323, § 1; 2003, ch. 166, § 1; 2006, ch. 775, § 1; 2017, ch. 455, §§ 1, 2.

Amendments. The 2017 amendment rewrote (a) and (b) which read: “(a) The term ‘chiropractic’ where used in this chapter is defined as the science and art of locating and removing interference with nerve transmission and nerve function. A chiropractic physician diagnoses and treats neuromuscular and musculoskeletal conditions through physical agent modalities and manipulative therapies. The adjustment, manipulation or treatment shall be directed toward restoring and maintaining the normal neuromuscular and musculoskeletal function and health of the patient. A chiropractic physician will also make appropriate health referrals for conditions that may not be treated by physical agent modalities and manipulative therapies. Patient care shall be conducted with due regard for nutrition, environment, hygiene, sanitation and rehabilitation designed to assist in the restoration and maintenance of the patient's health. Nothing in this chapter shall be construed to authorize the chiropractic physician to practice any branch of medicine osteopathy, as defined in chapters 6 and 9 of this title, or surgery, including venipuncture or the prescribing of medication, acupuncture being the exception. “(b) As used in this chapter, ‘chiropractic physician’ means a graduate of an accredited chiropractic college authorized to confer upon graduates the degree of doctor of chiropractic (D.C.), who is duly licensed in this state.”

Effective Dates. Acts 2017, ch. 455, § 8. July 1, 2017.

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

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

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

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

Reimbursable services within scope of practice of chiropractor, discrimination prohibited, § 56-7-2404.

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. Doctors of chiropractic may not order and receive the results of diagnostic testing from licensed medical laboratories, including urinalysis, arthritis panel, urine count, glucose tolerance test, male-female endocrine profile, standard blood profile (CBC with differential), and pregnancy testing, OAG 00-131, 200 Tenn. AG LEXIS 132 (8/15/00).

Chiropractors may not practice a treatment modality that involves the insertion of needles with the intent bring about the same result as the needle insertion techniques applied in the practice of acupuncture, without first obtaining a certification to practice acupuncture, OAG 05-020, 2005 Tenn. AG LEXIS 20 (3/08/05).

A licensed physical therapist may not perform or hold himself or herself out as performing “spinal manipulation,” as that term is used in former T.C.A. § 63-4-101(c)(1) (now T.C.A. § 63-4-101(b)(1)), without first having fulfilled the requirements of that section, OAG 07-055 (4/23/07).

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).

63-4-102. Board — Members and officers — Terms of appointment — Quorum — Administrative support.

  1. There shall be a board of chiropractic examiners, referred to as “board” in this chapter, consisting of five (5) chiropractic physicians, residents in Tennessee who have been actively engaged in the practice of their profession in Tennessee for a period of at least five (5) years, and two (2) consumer members who are not affiliated with the practice of chiropractic. The members of the board shall be appointed by the governor and shall hold office for a term of five (5) years commencing on May 1 and expiring on April 30, five (5) years thereafter.
  2. All vacancies occurring on the board by reason of death or resignation shall be filled by the governor for the unexpired term.
  3. In making appointments to the board, 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.
  4. In order to stagger the terms of office, for the year 2000 the governor shall appoint the board members for transition terms in the following manner:
    1. One (1) chiropractic physician and one (1) consumer member for one (1) year with the term to expire on April 30, 2001;
    2. One (1) chiropractic physician for a two-year term to expire on April 30, 2002;
    3. One (1) chiropractic physician for a three-year term to expire on April 30, 2003;
    4. One (1) chiropractic physician and one (1) consumer member for a four-year term to expire April 30, 2004; and
    5. One (1) chiropractic physician for a five-year term to expire April 30, 2005.
  5. Any person appointed shall be eligible for successive appointments, in the discretion of the governor, and all members shall hold office until the appointment of their successors.
  6. No chiropractor shall be eligible for appointment unless such chiropractor is actively engaged in the practice of the profession of chiropractic within this state.
  7. Further, no persons shall be eligible for appointment on the board who at the time are actively engaged in the practice, or holding themselves out as practitioners, of any other branch of the healing arts.
  8. The governor has the discretion to seek recommendations and nominations from the Tennessee Chiropractic Association in making appointments to the board.
  9. The board is authorized to annually elect from among its members a president, vice president and secretary and to create such officers it deems necessary for its efficient operations. Four (4) members of the board shall constitute a quorum, and a majority of those present shall be necessary to pass or reject any official business.
  10. The board shall be provided administrative support by the division of health related boards, referred to as the “division” in this chapter.

Acts 1923, ch. 9, § 1; Shan. Supp., § 3654a116; mod. Code 1932, § 7009; Acts 1939, ch. 116, § 1; C. Supp. 1950, § 7009; Acts 1976, ch. 781, § 1; T.C.A. (orig. ed.), § 63-402; Acts 1984, ch. 937, § 15; 1988, ch. 1013, § 41; 1992, ch. 817, § 3; 1993, ch. 463, § 1; 2000, ch. 618, § 1; 2017, ch. 455, § 3.

Compiler's Notes. The board of chiropractic examiners, created by this section, terminates June 30, 2021. See §§ 4-29-112, 4-29-242.

Amendments. The 2017 amendment added “within this state” at the end of (f).

Effective Dates. Acts 2017, ch. 455, § 8. July 1, 2017.

Cross-References. Division of health related boards, title 63, ch. 1.

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

63-4-103. Powers and duties of board.

It is the duty of the board to:

  1. Examine applicants and have licenses issued to practice chiropractic to all applicants who have successfully passed the examination approved by the board or whose applications for license by reciprocity have been acted upon favorably by the board;
  2. Conduct hearings to revoke or suspend any license or certificate under the authority of this or any previous laws authorizing the holder thereof to practice chiropractic for violations by the licensee of any of the provisions of this chapter;
  3. Sponsor, conduct or approve such educational programs as are necessary to carry out and make effective this chapter; and
  4. 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.

Acts 1923, ch. 9, § 1; Shan. Supp., § 3654a116; mod. Code 1932, § 7009; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7009; Acts 1953, ch. 113, § 31; 1976, ch. 781, § 3; T.C.A. (orig. ed.), § 63-404; Acts 1984, ch. 937, § 16; 1998, ch. 973, § 1; 2017, ch. 455, § 4.

Amendments. The 2017 amendment substituted “approved” for “given” following “examination” in (1).

Effective Dates. Acts 2017, ch. 455, § 8. July 1, 2017.

63-4-104. Meetings of board.

The board shall hold one (1) regular meeting in each year and such additional meetings at such times and places as it may determine.

Acts 1923, ch. 9, § 2; Shan. Supp., § 3654a117; Code 1932, § 7010; Acts 1939, ch. 116, § 2; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7010; impl. am. Acts 1953, ch. 113, § 36; Acts 1976, ch. 781, § 4; T.C.A. (orig. ed.), § 63-405.

63-4-105. Disposition of fees — Operating expenses — Compensation.

  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 the allotment for the expenditure 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.
  3. Each member of the board shall receive one hundred dollars ($100) per diem when actually engaged in the discharge of that member's official duties and, in addition, be reimbursed for all travel and other necessary expenses. The secretary of the board shall, in lieu of the per diem provided by this section, receive a salary not to exceed one hundred dollars ($100) per month as set annually by the board. 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.

Acts 1923, ch. 9, § 15; impl. am. Acts 1925, ch. 115, § 32; Shan. Supp., § 3654a129; Code 1932, § 7023; Acts 1939, ch. 116, § 8; C. Supp. 1950, § 7023; Acts 1953, ch. 113, § 36; impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; 1976, ch. 781, § 5; 1976, ch. 806, § 1(27); T.C.A. (orig. ed.), § 63-406; Acts 2017, ch. 455, § 5.

Amendments. The 2017 amendment substituted “one hundred dollars ($100)” for “fifty dollars ($50.00)” in the first sentence of (c).

Effective Dates. Acts 2017, ch. 455, § 8. July 1, 2017.

63-4-106. Rules and regulations.

The board is authorized to adopt such rules and regulations as are necessary to carry out and enforce this chapter and that are consistent with this chapter. Rules and regulations of the board shall be subject to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1923, ch. 9, § 16; Shan. Supp., § 3654a130; Code 1932, § 7024; Acts 1976, ch. 781, §§ 6, 7; T.C.A. (orig. ed.), § 63-407.

63-4-107. License requirement.

It is unlawful for any person to practice chiropractic within this state without having procured a license.

Acts 1923, ch. 9, § 12; Shan. Supp., § 3654a126; Code 1932, § 7020; mod. C. Supp. 1950, § 7020; T.C.A. (orig. ed.), § 63-408.

Cross-References. Exemption from licensing requirements for practice of medicine, § 63-6-204.

Licensure, §§ 63-1-10363-1-107.

63-4-108. Eligibility for licensure.

Any person of good moral character is eligible for licensure, if that person:

  1. Is a graduate of a chiropractic college having status with the commission on accreditation of the Council on Chiropractic Education, or its successor, or graduated from an international chiropractic college approved by the board;
  2. Has attended a chiropractic college for four (4) school years of not less than nine (9) months each; and
  3. Submits to the board proof of additional parachiropractic education as follows:
    1. For applicants matriculating in a chiropractic college prior to year 2000, the applicant must provide a transcript of grades showing a minimum of two (2) full academic years of college or university work of at least sixty (60) semester hours or its equivalent from an accredited institution; or
    2. For applicants matriculating in a chiropractic college in year 2000 and beyond, proof that a bachelor's level education or its equivalent has been obtained from an accredited college or university.

Acts 1923, ch. 9, § 4; Shan. Supp., § 3654a119; Code 1932, § 7012; Acts 1939, ch. 116, § 3; 1941, ch. 29, § 1; C. Supp. 1950, § 7012; Acts 1975, ch. 229, § 1; T.C.A. (orig. ed.), § 63-409; Acts 2000, ch. 618, § 2.

Law Reviews.

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

63-4-109. Application for licensure.

  1. Application for licensure shall be made to the board in writing or via online application.
  2. The application shall be accompanied by the applicant's photograph and shall state the name, age, sex and place of residence of the applicant, the name and location of the school or college from which the applicant was graduated, the length of time devoted to the study of chiropractics and the date of graduation.
  3. All applications shall be signed and sworn to by the applicant.

Acts 1923, ch. 9, § 6; Shan. Supp., § 3654a120 ½; Code 1932, § 7014; Acts 1939, ch. 116, § 4; C. Supp. 1950, § 7014; Acts 1953, ch. 113, § 32; 1976, ch. 781, §§ 7, 8; T.C.A. (orig. ed.), § 63-411; Acts 1982, ch. 887, §§ 1, 2; 1983, ch. 205, § 1; 1984, ch. 937, § 17; 1989, ch. 523, § 2; 2000, ch. 618, § 3; 2014, ch. 949, § 5.

63-4-110. Examination.

The examination of applicants for a license to practice chiropractic will consist of the national board examination as directed by the board. Each applicant must successfully pass all examinations before receiving a license to practice.

Acts 1923, ch. 9, § 7; Shan. Supp., § 3654a121; Code 1932, § 7015; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7015; Acts 1976, ch. 781, § 8; T.C.A. (orig. ed.), § 63-412; Acts 1982, ch. 887, §§ 4, 5; 1983, ch. 205, § 2; 1984, ch. 937, § 18; 1989, ch. 523, §§ 3, 4; 2000, ch. 618, § 4.

Cross-References. Temporary license pending permanent licensure, § 63-4-120.

63-4-111. Reciprocity.

Applicants possessing a valid unrestricted license to practice chiropractic in another state or other regulated jurisdiction for a period of two (2) full years are not required to be examined pursuant to § 63-4-110 and may obtain a license by fulfilling the following:

  1. Providing documentation from the state or jurisdiction of prior practice attesting to the length of time in practice, together with any disciplinary action taken against the licensee while in practice;
  2. Passing the Special Purposes Examination for Chiropractors (SPEC) by the national board or its successor; and
  3. Fulfilling all other requirements of this chapter.

Acts 1923, ch. 9, § 11; Shan. Supp., § 3654a125; Code 1932, § 7019; Acts 1939, ch. 116, § 5; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7019; Acts 1975, ch. 246, § 1; 1976, ch. 781, § 9; T.C.A. (orig. ed.), § 63-413; Acts 1983, ch. 205, § 3; 2000, ch. 618, § 5.

63-4-112. Registration and renewal — Continuing education — Reinstatement — Retirement.

  1. Each licensed practitioner of chiropractic shall register the practitioner's license and renew the practitioner's certificate of registration as provided in §§ 63-1-107 and 63-1-108.
  2. In addition, every licensed chiropractor shall apply to the board for a renewal of the licensed chiropractor's certificate of fitness and pay a renewal fee as set annually by the board. Each application shall be made on a form to be furnished by the board.
    1. The board shall renew such licensee's certificate of fitness upon application made in due form and upon payment of all required fees.
      1. When requested, licensees shall provide the board satisfactory proof of the licensee's attendance at a chiropractic education program or programs conducted by either the American Chiropractic Association, the International Chiropractors Association, the Tennessee Chiropractic Association, or any other educational program approved or conducted by the board which consists of the minimum number of hours established hereunder for the period beginning the preceding January 1. Prior approval of such a course may be obtained by submitting the following information to the board's administrative office at least thirty (30) days prior to the scheduled date of the course:
        1. A course description or outline;
        2. Names of all lecturers;
        3. Brief resume of all lecturers;
        4. Number of hours of educational credit requested;
        5. Date of course;
        6. Copies of materials to be utilized in the course; and
        7. How verification of attendance is to be documented.
      2. Each chiropractic physician must retain independent documentation of continuing education hours attained for a period of four (4) years from the end of the calendar year in which the training is received. Such proof must be produced for inspection and verification, if requested in writing by the board during its verification process.
    2. The minimum number of hours of required continuing education shall be at least twelve (12) hours in any calendar year.
    3. The board may, in its sole discretion, waive the annual education requirement in cases of retirement, certified illness, disability or other undue hardships.
    1. When any such licensee fails to renew the licensee's certificate of fitness and pay the annual renewal fee within sixty (60) days after renewal becomes due as provided in this section and/or fails to meet the annual education requirements of this section, the license of such person shall be automatically revoked at the expiration of sixty (60) days after the renewal was required, without further notice or hearing.
    2. Any person whose license is automatically revoked as provided in this subsection (d) may make application in writing to the board for the reinstatement of such license, and, upon good cause being shown, the board, in its discretion, may reinstate such license upon the payment of all past due fees and the payment of fifty dollars ($50.00) and upon further conditions as the board may require.
  3. Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person files with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter desires to reengage in such practice in this state, such person shall apply for reinstatement with the board on a form provided by the board, provide proof of continuing education as established by the board and shall meet other requirements as may be set by the board.

Acts 1923, ch. 9, § 12; Shan. Supp., § 3654a126; Code 1932, § 7020; impl. am. Acts 1947, ch. 9, §§ 5, 6; C. Supp. 1950, § 7020; Acts 1953, ch. 113, § 34; modified; Acts 1963, ch. 116, § 1; 1975, ch. 335, § 1; 1976, ch. 406, § 3; T.C.A. (orig. ed.), § 63-414; Acts 1986, ch. 675, §§ 1, 2, 4, 18; 1989, ch. 360, §§ 18, 19; 1989, ch. 523, § 5; 1993, ch. 215, §§ 1-3; 1996, ch. 940, § 1; 2000, ch. 618, § 6; 2005, ch. 81, § 1; 2017, ch. 455, § 6.

Amendments. The 2017 amendment deleted “the Tennessee Chiropractic Society” preceding “or any other” in the first sentence of the introductory paragraph of (c)(2)(A).

Effective Dates. Acts 2017, ch. 455, § 8. July 1, 2017.

Cross-References. Retirement, § 63-1-111.

Attorney General Opinions. Constitutionality, OAG 94-010, 1994 Tenn. AG LEXIS 6 (2/2/94).

Constitutionality, OAG 95-006, 1995 Tenn. AG LEXIS 7 (2/8/95).

63-4-113. Applicability of health laws — Birth certificates prohibited.

  1. Chiropractic practitioners shall observe and be subject to all state and municipal regulations relating to the control of contagious and infectious diseases and any and all matters pertaining to public health, reporting to proper health officers the same as other practitioners.
  2. Nothing in this chapter shall permit any chiropractor to make or execute a birth certificate.

Acts 1923, ch. 9, § 17; Shan. Supp., § 3654a131; Code 1932, § 7025; T.C.A. (orig. ed.), § 63-415.

63-4-114. Denial, suspension or revocation of license or certificate.

  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 chiropractic, 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 for violations of any law of the state or of the United States;
    3. Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice chiropractic;
    4. Immoral, unethical, unprofessional or dishonorable conduct;
      1. In-person solicitation, telemarketing, or telephonic solicitation by licensees, employees of licensees, agents of licensees, or independent contractors of licensees to victims of an accident or disaster, unless it is a victim with whom a licensee has a family or prior professional relationship, shall be considered unethical if carried out within thirty (30) days of the accident or disaster;
      2. Telemarketing transcripts shall be maintained for a period of two (2) years following their utilization;
      3. A log of contacts shall be maintained for a period of two (2) years following a telemarketing encounter; and
      4. This subdivision (5) shall not prohibit solicitation by targeted direct mail advertising or other forms of written, radio, or television advertising; provided, that the advertising does not involve coercion, duress, or harassment and is not false, deceptive, or misleading;
    5. Division of fees or agreeing to split or divide fees received for professional services with any person for bringing or referring a patient;
    6. 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 chiropractic by such person;
    7. Rebating or offering to rebate to an insured any payment by the insured's third-party payor to the licensee for services or treatments rendered under the insured's policy;
    8. Submitting to any third-party payor a claim for a service or treatment at an inflated fee or charge or a greater fee or charge than the usual fee the licensee charges for that service or treatment when the service or treatment is rendered without third-party reimbursement;
    9. Submitting to any third-party payor a claim for a service or treatment at a fee or charge in an amount greater than that advertised for such service or treatment at the time of the rendering of the service or treatment that is the subject matter of the claim;
    10. Knowingly or purposefully incorrectly reporting services rendered, reporting incorrect treatment dates or reporting charges for services not rendered for the purpose of obtaining payment from a third-party payor;
    11. 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;
    12. The advertising of chiropractic business in which untrue or misleading statements are made or causing the publication or circulation of fraudulent advertising relative to any disease, human ailment or condition;
    13. 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 as determined by the board;
    14. Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of chiropractic practice; and
    15. Making false, fraudulent, misleading, extravagant or grossly improbable claims or statements as to the efficacy or value of the science or practice of chiropractic.
  2. 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 1923, ch. 9, § 13; Shan. Supp., § 3654a127; Code 1932, § 7021; Acts 1939, ch. 116, § 7; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7021; Acts 1976, ch. 781, § 10; T.C.A. (orig. ed.), § 63-416; Acts 1982, ch. 887, § 6; 1984, ch. 545, § 1; 1988, ch. 747, § 1; 1998, ch. 973, § 2; 2012, ch. 798, § 35; 2012, ch. 848, § 68; 2015, ch. 121, § 1; 2018, ch. 745, § 24.

Compiler's Notes. Acts 1988, ch. 747, § 2 provided that, by the amendment by that act, no action of any kind may be undertaken against any licensed chiropractor in the state because of any alleged contravention of former subdivisions, concerning advertising reduced fees and abrogation of patients' obligations for payment, which may have taken place during their existence.

Amendments. The 2018 amendment added (b).

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

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

Law Reviews.

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

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).

63-4-115. Procedure for suspension, revocation or denial of certificate or license.

  1. In enforcing this section, the board shall, upon probable cause, have the authority to compel an applicant or licensee or certificate holder 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 is involved. The applicant or licensee or certificate holder may have an independent physical or mental examination, which examination report shall be filed with the board for consideration. The committee will submit a report of its findings to the board for use in any hearing that may thereafter ensue.
  2. The board, on its own motion, may investigate any report indicating that a chiropractor is or may be in violation of this chapter. Any chiropractor, any chiropractic society or association or any other person who in good faith shall report to the board any information that a chiropractor is or may be in violation of any provisions of this chapter shall not be subject to suit for civil damages as a result thereof.
  3. All proceedings by the board to deny a certificate of fitness, to revoke or suspend any certificate of fitness or license or to otherwise discipline a licensee shall be subject to and conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  4. An elected officer of the board and a hearing officer, arbitrator or mediator, if any, 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.
  5. 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.
  6. 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 chiropractors, who may be members of the board or may serve either voluntarily or through employment by or under contract with the board.
  7. 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 laws, 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 issues raised in any contested case, criminal prosecution or civil lawsuit that may result from or be incident to cases processed before them.
  8. Notwithstanding any provision of the Uniform Administrative Procedures Act to the contrary, hearing officers are authorized to and may hear board mediation, arbitration or disciplinary contested cases, but may not issue final orders in contested case matters. Notwithstanding any of §§ 4-5-314 and 4-5-315, that may be or are inconsistent, such hearing officers may only issue findings of fact and conclusions of law, which shall be referred directly to the board or a duly constituted panel thereof for final action. The board or duly constituted panel, after hearing testimony or arguments from both parties regarding the appropriate disciplinary action and, if allowed by the board, arguments on any controversy raised by the hearing officer's or designee's order, shall issue a final order to include the imposition of what, if any, disciplinary action is deemed appropriate. Only the board or a duly constituted panel thereof shall have the authority to issue final orders that dispose of a pending contested case, regardless of whether the issues resulting in the dispositive action are procedural, substantive, factual or legal. If a hearing officer is not available when a contested case, or any motion filed therein requiring action, is ready and scheduled to be heard or fails to timely prepare findings and conclusions pursuant to board established guidelines, the board or a duly constituted panel thereof may rule on the motions and/or hear the contested case or utilize the record compiled before the hearing officers and prepare its own findings of fact, conclusions of law and then issue a final order. With regard to findings or conclusions issued by the hearing officer or any mediator or arbitrator, the board or any duly constituted panel thereof that reviews the case may do any of the following:
    1. Adopt the hearing officer's, mediator's or arbitrator's findings of fact and conclusions of law, in whole or in part;
    2. Make its own findings of fact and conclusions of law, based solely on the record and the expertise of the members of the board or panel, in addition to or in substitution of those made by the hearing officer, mediator or arbitrator;
    3. Remand the matter back to the hearing officer, mediator or arbitrator for action consistent with the board or panel findings and conclusions in the matter; or
    4. Reverse the hearing officer's, mediator's or arbitrator's findings and/or dismiss the matter entirely.
  9. 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.
  10. Any elected officer of the board, or any duly appointed or elected chair or 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 1923, ch. 9, § 13; Shan. Supp., § 3654a127; Code 1932, § 7021; Acts 1939, ch. 116, § 7; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; mod. C. Supp. 1950, § 7021; Acts 1953, ch. 113, § 35; 1976, ch. 781, § 11; T.C.A. (orig. ed.), § 63-417; Acts 1982, ch. 887, § 7; 1998, ch. 845, § 1; 1998, ch. 973, § 3.

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

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

Screening panels, § 63-1-138.

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 chiropractic examiners 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).

63-4-116. 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 chiropractic 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 chiropractic as defined by this chapter.
    2. No injunction bond shall be required of the board.
    3. Jurisdiction is conferred upon the circuit and chancery courts of the state to hear and determine such cases as chancery causes and to exercise full and complete jurisdiction in such injunctive proceedings.
  1. The board is also authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is violating § 63-4-114(a)(5). No injunction bond shall be required of the board in such proceedings, and jurisdiction is conferred upon the circuit and chancery courts of this state to hear such cases.

Acts 1923, ch. 9, § 13; Shan. Supp., § 3654a127; Code 1932, § 7021; Acts 1939, ch. 116, § 7; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7021; Acts 1976, ch. 781, § 12; T.C.A. (orig. ed.), § 63-418; Acts 2015, ch. 121, § 2.

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.

63-4-117. Violations.

  1. Any person who violates any provision of this chapter commits a Class B misdemeanor.
  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 chiropractic, who thereafter willfully violates the terms of the injunction by again performing such acts or rendering such services commits a Class E felony.

Acts 1923, ch. 9, § 14; Shan. Supp., § 3654a128; Code 1932, § 7022; impl. am. Acts 1947, ch. 9, § 13; C. Supp. 1950, § 7022; Acts 1976, ch. 781, § 13; T.C.A. (orig. ed.), § 63-419; Acts 1989, ch. 591, §§ 81, 112.

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

Penalties, § 63-1-123.

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

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

63-4-118. Immunity of reviewers from liability.

Any chiropractor who serves on any peer review committee or on any other committee, board, commission or other entity constituted by any statewide chiropractic association, local chiropractic society or governmental or quasi-governmental agency for the purpose of reviewing and evaluating chiropractic acts of other chiropractors or chiropractic auxiliary personnel, shall be immune from liability with respect to any action taken by that chiropractor in good faith and without malice as a member of such committee, board, commission or other entity.

Acts 1975, ch. 228, § 1; T.C.A., § 63-421.

Attorney General Opinions. Liability of chiropractors performing peer review, OAG 98-086, 1998 Tenn. AG LEXIS 86 (4/14/98).

63-4-119. X-ray operators.

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

Acts 1982, ch. 887, § 3; 1983, ch. 205, § 4.

Law Reviews.

Selected Tennessee Legislation of 1983 (N. L. Resener, J. A. Whitson, K. J. Miller), 50 Tenn. L. Rev. 785 (1983).

63-4-120. Externship certificates.

  1. The board may issue an externship certificate to practice chiropractic, to be used only under supervision of a licensed chiropractor, upon payment of a fee as set by the board, to a chiropractor who meets all qualifications and requirements for licensure pursuant to this chapter and who has applied to take the examinations as provided in § 63-4-110.
  2. Externs will be allowed to perform all diagnostic tests and therapeutic interventions as allowed providers licensed by this chapter.
  3. Externship is to last no longer than three hundred sixty-five (365) days from date of certificate issuance. Applicants who provide proof of illness or hardship that hindered their ability to comply with § 63-4-110 may, at the board's discretion, be allowed a second year of externship.
  4. The board may revoke an extern's certificate for violation of any portion of this chapter for failure to maintain proper supervision. “Supervision” is defined as direct oversight by a Tennessee licensed chiropractor. The supervisor shall be on the facility premises while the extern is conducting patient care.
  5. The board reserves the right to adopt any rules and regulations as the board may deem appropriate for externs and the administration of externship program.
  6. One hundred dollars ($100) shall be the administrative fee for applying to and participating in the externship program for each year of externship.

Acts 1983, ch. 205, § 6; 1989, ch. 523, § 6; 2000, ch. 618, § 7.

63-4-121. Chiropractic preceptor program.

  1. The board will allow the chiropractic preceptor program (CPP) to function in the state so long as the preceptor and the intern meet the qualifications as specified by the chiropractic preceptor program advisory committee, or its equivalent; and provided, all guidelines of the committee are followed.
  2. The board reserves the right to adopt any rules and regulations as the board may deem appropriate for the administration of this program.

Acts 1983, ch. 205, § 5.

63-4-122. Advertising.

  1. The board shall adopt rules and regulations to regulate the nature, manner, content and extent of advertising by practitioners who are under the jurisdiction of such board.
  2. Any licensed chiropractor who advertises or announces to the public that the licensed chiropractor is a certified acupuncturist shall be deemed to have engaged in false, misleading or deceptive advertising.

Acts 1984, ch. 546, § 1; 2006, ch. 775, § 3.

Cross-Reference. Advertising, § 63-1-145.

63-4-123. Minimum educational standards and criteria.

    1. The board shall adopt rules that establish minimum educational standards and criteria for chiropractic therapy assistants performing physical agent modalities, physical treatment, and clinical services that are within the scope of practice of a chiropractic physician and, under the supervision of a chiropractic physician, either in the office of the chiropractic physician or in the presence of the chiropractic physician at another location.
    2. These regulations shall include, but not be limited to, provisions for grandfathering, waiver, reciprocity, renewal, continuing education, fees, examination and hardship cases.
  1. No person shall perform therapeutic procedures in a chiropractic physician's office who does not meet these standards and who has not received a certificate of proficiency from the board.

Acts 1999, ch. 306, § 1; 2017, ch. 455, § 7.

Amendments. The 2017 amendment rewrote (a)(1) which read: “(a)(1) The board shall adopt rules and regulations that shall establish minimum educational standards and criteria for persons performing physical agent modalities and physical treatment in a chiropractic physician's office.”

Effective Dates. Acts 2017, ch. 455, § 8. July 1, 2017.

63-4-124. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.

A chiropractor licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of chiropractic examiners may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.

Acts 2004, ch. 579, § 6.

Chapter 5
Dentists

63-5-101. Board of dentistry.

  1. The practice of dentistry and of dental hygiene shall be under the direct supervision of a board to be known as the board of dentistry, referred to in this chapter as the “board.”
  2. The administrative duties pursuant to licensure and the collection of fees for licensure shall be vested in the division of health related boards of the department of health, referred to in this chapter as the “division.”

Acts 1957, ch. 32, § 2; 1969, ch. 29, § 1; 1978, ch. 824, § 1; T.C.A., § 63-530; Acts 1984, ch. 937, § 19.

Compiler's Notes. The board of dentistry, created by this section, terminates June 30, 2021. See §§ 4-29-112, 4-29-242.

Cross-References. Division of health related boards, title 63, ch. 1.

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

Licensing, §§ 68-1-10368-1-107.

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

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

Sales and use tax exemption, § 67-6-335.

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

Textbooks. Tennessee Jurisprudence, 17 Tenn. Juris., Licenses, § 14; 18 Tenn. Juris., Mandamus §  11; 20 Tenn. Juris., Physicians and Surgeons, § 5.

Law Reviews.

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

63-5-102. Composition of board.

The board shall consist of seven (7) practicing dentists, two (2) practicing dental hygienists and one (1) practicing registered dental assistant, whose duty it is to carry out this chapter. Of the seven (7) dentists, two (2) shall be appointed from each grand division of the state, and the appointment of the other dentists shall alternate among the grand divisions on an equal basis, but without regard to consecutive terms of a board member.

Acts 1957, ch. 32, § 3; 1978, ch. 824, § 2; T.C.A., § 63-531; Acts 1984, ch. 528, § 3; 1990, ch. 1031, § 1; 1997, ch. 53, § 1; 2000, ch. 927, § 3; 2001, ch. 330, § 1.

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

63-5-103. Appointment of members — Term of office — Removal.

    1. The dentist members of the board may be appointed by the governor from lists of qualified nominees submitted by interested dentist groups including, but not limited to, the Tennessee Dental Association. No person is eligible for appointment as a dentist member of the board unless such person has been an actual and bona fide resident and a legally licensed practicing dentist of this state for a period of five (5) years or more immediately preceding such appointment.
    2. The dental hygienist members may be appointed by the governor from lists of qualified nominees submitted by interested dental hygienist groups including, but not limited to, the Tennessee Dental Hygienists Association. No person is eligible for appointment as a dental hygienist member of the board unless that person has been an actual and bona fide resident and a legally licensed practicing dental hygienist of this state for a period of five (5) years or more immediately preceding such appointment.
    3. The dental assistant member may be appointed by the governor from lists of qualified nominees submitted by interested dental assistant groups including, but not limited to, the Tennessee Dental Assistants' Association. No person is eligible for appointment as a dental assistant member of the board unless that person has been an actual and bona fide resident and has been a legally registered and practicing dental assistant of this state for a period of five (5) years or more immediately preceding such appointment.
  1. The governor shall consult with interested dental groups, including, but not limited to, the Tennessee Dental Association, the Tennessee Dental Hygienists Association and the Tennessee Dental Assistants' Association to determine qualified persons to fill the positions as provided in subsection (a).
  2. The terms of members of the board are three (3) years, with the terms staggered so that the terms of no more than three (3) members expire each year. No member is eligible to serve on the board for more than three (3) consecutive full terms, but any person thus ineligible shall thereafter be eligible for nomination and appointment to the board, as provided in this section, after three (3) years have elapsed since that person's previous service on the board.
    1. The governor shall make appointments to the board not later than one (1) month after the expiration of the term of office of any member and such or further delay in the appointment shall be deducted from the term of the appointment. All vacancies occurring in the board by such reasons as death or resignation shall be filled by the governor for the unexpired term from lists submitted to the governor as provided in this section. If such vacancy is not filled within thirty (30) days by the governor, the board itself shall fill such vacancy for the unexpired term. No person is eligible to appointment to the board who is regularly employed by or is a member of the governing body of any dental school, college or dental department of any university or any school of dental hygiene or dental assisting or with any dental supply business or dental laboratory.
    2. In making appointments to the board, 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. Members of the board shall continue in office until the expiration of the terms for which they were respectively appointed and until such time as their successors have been duly appointed.
    1. A member of the board may be removed upon one (1) or more of the following grounds:
      1. The refusal or inability for any reason of a board member to perform that member's duties as a member of the board in an efficient, responsible and professional manner;
      2. The misuse of office by a member of the board to obtain personal, pecuniary or material gain or advantage for that member or another through such office; or
      3. The violation of this chapter or of any of the rules and regulations of the board hereafter properly promulgated.
    2. The proceedings for such removal shall be in accordance with title 8, chapter 47.

Acts 1957, ch. 32, § 4; 1978, ch. 824, § 3; 1981, ch. 99, § 1; T.C.A., § 63-532; Acts 1984, ch. 528, § 4; 1985, ch. 71, § 1; 1986, ch. 501, § 1; 1988, ch. 1013, § 42; 1990, ch. 1031, §§ 2, 3; 1997, ch. 53, § 2; 2000, ch. 927, §§ 4, 5; 2001, ch. 330, § 2; 2012, ch. 628, §§ 1, 2.

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

63-5-104. Board meetings and officers — Records — Copy of law to licensees.

    1. The board shall meet at least annually and at such times and places as it may deem necessary for the proper discharge of its duties.
    2. At its annual meeting the board shall elect from its membership a president, vice president and secretary-treasurer.
    3. A majority of the members shall constitute a quorum for the transaction of business.
    4. The proceedings of the board shall be recorded and shall constitute a public record.
  1. The board shall maintain and make available to the division a permanent record that shall list the name, address and license or certificate number of all persons licensed to practice dentistry and of all persons certified as dental specialists, licensed as dental hygienists and registered as dental assistants.
  2. The board shall mail a copy of the law regulating the practice of dentistry to each person who is hereafter licensed to practice dentistry or dental hygiene.

Acts 1957, ch. 32, § 5; 1978, ch. 824, § 4; T.C.A., § 63-533; Acts 1984, ch. 937, § 20; 1990, ch. 1031, §§ 4, 5.

63-5-105. Powers of board.

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

  1. Prescribe rules and regulations for examination of candidates;
  2. Conduct examinations to ascertain the qualifications and fitness of applicants for licenses to practice dentistry and of applicants for certificates to practice a specialty in dentistry or licenses to practice as a dental hygienist or registered as a dental assistant;
  3. Provide standards by which dental schools and colleges, graduate dental programs in hospital settings, schools of dental hygiene and courses of instruction for dental assistants are approved;
  4. Issue licenses to applicants who successfully pass the examination for the practice of dentistry and dental hygiene, to issue certificates to specialists in dentistry who successfully pass the respective examinations for such certificates and to register dental assistants who meet such standards of competency as the board may require by rules and regulations and who pay a nonrefundable application fee as set annually by the board;
  5. Conduct hearings to revoke, suspend or otherwise lawfully discipline the holder of any license or certificate issued under the authority of this chapter or any previous laws authorizing the holder thereof to practice dentistry, a specialty in dentistry, dental hygiene or as a certified and/or registered dental assistant for violations by the licensee or certificate holder of any of the provisions of this chapter or any rule of the board hereafter properly promulgated by the board;
  6. Provide for any evaluations, including onsite, of facilities, equipment and personnel of dentists who use general anesthesia, deep sedation or conscious sedation as the board determines appropriate in the interest of public safety; and
  7. To make such rules and regulations and establish such fees as are necessary to carry out and make effective this chapter.

Acts 1957, ch. 32, § 6; 1978, ch. 824, § 5; 1981, ch. 99, § 2; T.C.A., § 63-534; Acts 1984, ch. 937, § 21; 1988, ch. 635, §§ 1, 2; 1989, ch. 523, § 7; 1990, ch. 1031, §§ 6-8; 1997, ch. 53, § 3; 1999, ch. 341, § 1; 2001, ch. 330, § 3.

63-5-106. Annual report of board.

The board shall make an annual report of its proceedings and activities to the governor, with copies to be made available to any interested parties.

Acts 1957, ch. 32, § 7; 1981, ch. 99, § 3; T.C.A., § 63-535.

63-5-107. License requirement.

  1. It is unlawful for any person to practice dentistry, a specialty in dentistry or dental hygiene in this state, except those who are now licensed or certified as such pursuant to law and those who may hereafter be licensed or certified and registered pursuant to this chapter.
  2. It is unlawful for any person so licensed or certified to practice dentistry or to practice dental hygiene in any calendar year unless or until such person has paid the annual renewal fee for that year as provided in this chapter.
    1. Each person licensed as a dentist or a dental hygienist in accordance with this chapter or registered as a dental assistant pursuant to the rules of the board is required to attend and complete each year, except in the year of initial licensure or registration, the number of hours of board approved continuing education courses prescribed by the board, subject to a minimum of twelve (12) and a maximum of thirty (30) clock hours; provided, that beginning January 3, 2003, in lieu of the annual continuing education requirement, each person licensed as a dentist or dental hygienist or registered as a dental assistant is required to attend and complete during each two-year cycle, except for the two-year cycle of initial licensure, the number of hours of board approved continuing education courses that are prescribed by the board, subject to a minimum of twenty-four (24) and a maximum of sixty (60) clock hours. However, for the purposes of the biennial continuing education requirement for dental hygienists, no more than fifty percent (50%) of such continuing education requirement may be earned from on-line or web-based courses. Sponsors of such courses shall submit a sufficient description of course content to the board in order to obtain approval. The board may approve all, part or none of the course at its discretion. Additional procedures for implementing this requirement may be adopted by the board in its regulations. The board may waive all or part of the continuing education requirements in unusual situations in which an applicant for renewal has demonstrated inability to attend such courses not attributable to fault of the applicant. The board shall have discretion to require completion of continuing education courses of a type and number of hours satisfactory to the board in cases involving license renewal of dentists or dental hygienists who have not actively practiced or have been retired from practice for more than two (2) years. In addition to the foregoing, all applicants shall provide proof of current CPR certification by an organization approved by the board unless such requirement is waived by the board in its discretion; provided, that no dentist who obtains a waiver from the board for CPR requirements shall practice dentistry unless a dentist, dental hygienist or dental assistant who is currently certified in CPR is present.
    2. The board may, but is not required to, monitor or verify certificates of completion submitted by applicants for license renewal. In its discretion, by random sample or in individual cases, the board may require proof of attendance or otherwise investigate compliance with this subsection (c).

Acts 1957, ch. 32, § 8; T.C.A., § 63-536; Acts 1989, ch. 591, § 112; 1990, ch. 1031, § 9; 1991, ch. 143, § 1; 1992, ch. 859, § 1; 2002, ch. 771, § 1; 2007, ch. 340, § 1; 2010, ch. 811, § 1.

Cross-References. Penalty for violation of subsection (a), § 63-5-128.

Law Reviews.

Criminal Law and Procedure — 1960 Tennessee Survey (Robert E. Kendrick), 13 Vand. L. Rev. 1059.

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).

63-5-108. Practice of dentistry and dental hygiene defined.

  1. Dentistry is defined as the evaluation, diagnosis, prevention and/or treatment, by nonsurgical, surgical or related procedures, of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body, provided by a dentist within the scope of such dentist's education, training, and experience, in accordance with the ethics of the profession and applicable law.
  2. Any person is deemed to be practicing dentistry who, either gratuitously or for a salary, fee, money or other remuneration, paid or to be paid, directly to the operator or to any person or agency:
    1. Diagnoses, prescribes for or treats any disease, pain, deformity, deficiency, injury, disorder and condition of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body. Such diagnosis and treatment may include the use of a complete or limited physical evaluation of patients by a board eligible or board certified oral and maxillofacial surgeon or a resident in an approved oral and maxillofacial surgery program practicing in a hospital setting;
    2. Extracts human teeth;
    3. Repairs or fills cavities in human teeth;
    4. Corrects malformations of human teeth or of the jaws;
    5. Performs any oral and maxillofacial surgery;
    6. Subject to subsection (d), takes an impression of the human tooth, teeth or jaws, leading to either:
      1. The fabrication of a model upon which will be constructed a replacement of natural teeth by artificial substitutes; or
      2. The fabrication of a cosmetic metal apparatus to be worn in the human mouth, whether or not the apparatus features silver, gold or platinum caps, jeweled inlays or any other cosmetic features;
    7. Furnishes, supplies, constructs, alters, reproduces or repairs any prosthetic denture, bridge, crown, appliance or any other structure to be used or worn in the human mouth as a substitute for natural teeth, except on the written work order of a licensed and registered dentist;
    8. Places or adjusts such appliance or structure in the human mouth;
    9. Delivers the same to any person other than the licensed and registered dentist upon whose written work order the work was performed;
    10. Offers to the public by any method to furnish, supply, construct, reproduce, reline, repair or otherwise process any prosthetic denture, bridge, appliance or other structure to be worn in the human mouth;
    11. Gives interpretations of dental radiographs;
    12. Administers an anesthetic, except for a topical anesthetic in connection with a dental operation; provided, however, that a duly licensed dentist may delegate the administration of local anesthetic to dental hygienists who possess a permit to do so issued by the board. The board shall establish the qualifications, criteria and curricula required for issuance of permits to administer local anesthetic, by infiltration or by block, to duly licensed dental hygienists;
    13. Uses the words, “Dentist,” “Dental Surgeon,” “Oral Surgeon,” “Oral and Maxillofacial Surgeon,” or letters “D.D.S.,” “D.M.D.,” or any other words, letters, title, or descriptive matter that in any way represents the person as being able to diagnose, treat, prescribe or operate for any disease, pain, deformity, deficiency, injury, disorder, and condition of the oral cavity, maxillofacial area and the adjacent and associated structures and their impact on the human body;
    14. States, or permits to be stated by any means or method whatsoever, that the person can or will attempt to perform dental operations or services or to render diagnosis in connection therewith;
    15. Is the operator of a place where dental operations or dental services are performed; or
    16. Authorizes the practice of “teledentistry” which, as used in this section, means the delivery of dental health care and patient consultation through the use of telehealth systems and technologies, including live, two-way interactions between a patient and a dentist licensed in this state using audiovisual telecommunications technology, or the secure transmission of electronic health records and medical data to a dentist licensed in this state to facilitate evaluation and treatment of the patient outside of a real-time or in-person interaction. Dentists who are licensed in this state and who deliver services using teledentistry shall establish protocols for the practice that should include proper methods of keeping the patient fully informed; proper safeguards ensuring that all state and federal laws and regulations relative to the privacy of health information are followed; proper documentation of all services or treatment rendered via teledentistry; proper procedures to ensure the referral of those patients requiring treatment beyond what can be provided via teledentistry to a dentist licensed in this state; and any such requirements as prescribed by the board of dentistry. Any and all services provided via teledentistry shall be consistent with the in-person provision of those services. Any and all services provided via teledentistry shall comply with this chapter and shall be provided in accordance with the rules of the board of dentistry.
    1. A dental hygienist is an individual who has graduated from a dental hygiene program accredited by the American Dental Association's Commission on Dental Accreditation (CODA) and is licensed under this chapter to practice dental hygiene.
    2. The practice of dental hygiene means the performance of preventive, educational, and therapeutic services including the removal of all hard and soft deposits and the stain from the human teeth to the depth of the gingival sulcus, polishing natural and restored surfaces of teeth, performing clinical examination of teeth and surrounding tissues for diagnosis by the dentist, and performing other procedures that may be delegated by the dentist, under the supervision of a licensed dentist.
    3. No person shall practice dental hygiene in a manner that is separate or independent from a supervising dentist, or establish or maintain an office or a practice that is primarily devoted to the provision of dental hygiene services.
    4. A dental hygienist shall perform, under direct supervision only, root planing, subgingival curettage, administering nitrous oxide, and local anesthesia.
    5. Under general supervision a dental hygienist may provide to patients, for not more than fifteen (15) consecutive business days, all other dental hygiene services not otherwise limited to direct supervision by this chapter or rules adopted by the board, if all of the following requirements are met:
      1. The dental hygienist has at least one (1) year, full-time, or an equivalent amount of experience practicing dental hygiene;
      2. The dental hygienist complies with written protocols for emergencies that the supervising dentist establishes;
      3. The supervising dentist examined the patient not more than eleven (11) months prior to the date the dental hygienist provides the dental hygiene services;
      4. The dental hygienist provides dental hygiene services to the patient in accordance with a written treatment plan developed by the supervising dentist for the patient; and
      5. The patient is notified in advance of the appointment that the supervising dentist will be absent from the location and that the dental hygienist cannot diagnose the patient's dental health care status.
  3. Any duly licensed and registered dentist may assign to duly licensed and registered dental hygienists, registered dental assistants and/or practical dental assistants, as defined by the board in rules and regulations, any tasks or procedures to be performed in the dentist's office for which a licensed and registered dentist exercises direct supervision and full responsibility, except those procedures requiring the professional judgment or skill of a dentist; provided, that duties involving the removal of hard and soft deposits by scaling or curretage from the surfaces of human teeth are assigned only to duly licensed and registered dental hygienists. The board has the authority to permit registered dental assistants to apply sealants to and to polish human teeth, and the board has the discretion to establish criteria and curricula as necessary to ensure that such registered dental assistants are qualified to apply sealants and perform polishing. For eligibility to perform polishing, passage of a clinical and didactic examination  is required. The board is authorized to permit licensed and registered dental hygienists and registered dental assistants to insert, pack, carve and finish amalgam and intracoronal nonmetallic restorations and take final impressions for fixed and removable prosthetic appliances, under the direct supervision and full responsibility of a licensed dentist, and the board shall establish such criteria and curricula as it determines in its discretion are necessary or appropriate to ensure that such hygienists and assistants are qualified to perform such procedures. Tasks and procedures assignable to licensed and registered dental hygienists shall include those enumerated in the board's regulations as of January 1, 1990, and such other additional tasks and procedures as the board may deem appropriate in the future. Procedures requiring professional judgment or skill not assignable to such dental hygienists and dental assistants include the following:
    1. Diagnosis and treatment planning; oral surgery, the cutting of hard and/or soft tissues, excluding any cutting of such tissues involved in subgingival scaling, root planing and gingival curettage, and any intra-oral procedures that would affect the function and/or efficiency of an appliance that, when worn by the patient, would come in direct contact with hard or soft tissue and that could result in tissue irritation or injury;
    2. The placing of permanent fillings or restorations in or on teeth except as provided in this subsection (d); and
    3. Administration of a general or local anesthetic, except for a topical anesthetic in connection with a dental operation; provided, however, that dental hygienists who possess a permit issued pursuant to subdivision (b)(12) may administer a local anesthetic but only under the direct supervision of a licensed and registered dentist who is physically present at the same office location and time and in accordance with rules and regulations of the board.
  4. Notwithstanding any provision of law to the contrary, a dental hygienist may administer nitrous oxide analgesia if directed by a dentist to do so, in accordance with rules and regulations of the board of dentistry, under the direct supervision of a licensed and registered dentist. Patients who have been administered nitrous oxide shall be monitored appropriately.
    1. Except as provided in subdivision (f)(2), a licensed dentist shall not allow, under general supervision, more than three (3) dental hygienists to work at any one (1) time.
    2. A dentist may supervise, under direct supervision, no more than ten (10) dental hygienists while the dentist and each hygienist is providing dental services on a volunteer basis through a nonprofit provider of free mobile clinics in this state.
  5. Any duly licensed and registered dentist who uses general anesthesia, deep sedation or conscious sedation in that dentist's practice, at a level to be determined by the board, must secure a permit from the board by meeting the standards as set in rules and regulations and by paying fees set by the board. Such permit is subject to renewal at intervals upon payment of a fee as set by the board in rules and regulations. Any dental facility in which general anesthesia, deep sedation or conscious sedation is administered by such dentist is subject to standards as may be specified in rules and regulations of the board, including, but not limited to, a facility permit.
    1. Notwithstanding any law to the contrary, the practice of dental hygiene also includes prescriptive authority limited to fluoride agents, topical oral anesthetic agents, and nonsystemic oral antimicrobials that:
      1. Are not controlled substances under state and federal drug laws; and
      2. Do not require a license from the federal drug enforcement agency.
    2. Prescriptive authority under this section must be:
      1. Exercised under the general supervision of a licensed dentist;
      2. Pursuant to rules promulgated by the board; and
      3. In compliance with all applicable laws concerning prescription packaging, labeling, and record keeping requirements.
    3. A prescription written by a dental hygienist under this part must be reviewed by a dentist within thirty (30) days.
    4. The board shall determine by rule the educational and training requirements necessary for a dental hygienist to exercise prescriptive authority pursuant to this section.
    5. The board shall determine by rule the percentage of fluoride or any other active ingredient in any medication that may be prescribed by a dental hygienist under this subsection (h).

Acts 1957, ch. 32, § 9; 1963, ch. 107, § 1; 1969, ch. 29, § 2; 1978, ch. 824, § 6; 1981, ch. 99, § 4; T.C.A., § 63-537; Acts 1988, ch. 635, §§ 3-7; 1989, ch. 523, § 8; 1990, ch. 1031, §§ 10, 11; 1998, ch. 847, §§ 1-3; 1999, ch. 405, §§ 1, 2; 2000, ch. 839, § 1; 2001, ch. 330, § 4; 2002, ch. 771, §§ 2-4; 2003, ch. 161, § 1; 2003, ch. 237, §§ 1-4; 2004, ch. 615, §§ 1-3; 2007, ch. 120, § 1; 2010, ch. 1043, § 8; 2011, ch. 132, § 1; 2012, ch. 945, § 1; 2016, ch. 918, § 1; 2019, ch. 319, § 1; 2020, ch. 724, § 1.

Amendments. The 2019 amendment, effective July 1, 2020, added (h).

The 2020 amendment, in (f)(1), inserted “Except as provided in subdivision (f)(2),” and substituted “shall not” for “may not”; and added (f)(2).

Effective Dates. Acts 2019, ch. 319, § 2. July 1, 2020; provided, that for purposes of promulgating rules, the act took effect May 8, 2019.

Acts 2020, ch. 724, § 2. July 1, 2020.

Cross-References. Employment of and practice by hygienists and assistants, § 63-5-115.

Textbooks. Tennessee Jurisprudence, 20 Tenn. Juris., Physicians and Surgeons, § 5.

Law Reviews.

Criminal Law and Procedure — 1960 Tennessee Survey (Robert E. Kendrick), 13 Vand. L. Rev. 1059.

Attorney General Opinions. Use of botox, other neurotoxins, and dermal fillers by a general dentist.  OAG 14-51, 2014 Tenn. AG LEXIS 54 (4/24/14).

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).

63-5-109. Exemptions.

The following persons, acts, practices and operations are exempt from the other provisions of this chapter:

  1. The practice of their professions by physicians or surgeons licensed as such under the laws of this state, unless they practice dentistry as a specialty;
  2. The practice of dentistry and dental hygiene in the discharge of their official duties by graduate dentists and by dental hygienists in the United States public health service, army, navy, air force, coast guard or veterans administration;
  3. The practice of dentistry by licensed dentists or the practice of dental hygiene by licensed dental hygienists of other states or countries at meetings of the Tennessee Dental Association or Pan Tennessee Dental Association, or component parts thereof, alumni meetings of dental colleges or any other like dental organizations while appearing as clinicians;
  4. Licensed dentists or dental hygienists of other states who are called into Tennessee by licensed dentists of this state for consultative or operative purposes if the board or its designee gives discretionary advance approval in each such instance;
  5. The practice of dentistry or of dental hygiene by graduates of schools or colleges recognized by the board who are duly licensed in other states in the discharge of their official duties in state-supported institutions or official health agencies or other special projects approved by the board between the time of their employment as such and the next examination and licensing by the board;
  6. The practice of dentistry or of dental hygiene by students under the supervision of instructors in any dental school, college or dental department of any school, college, university or school of dental hygiene recognized by the board, but such activities shall not be carried on for profit;
  7. The giving by a registered nurse anesthetist of any anesthetic for a dental operation under the direct supervision of a licensed dentist;
  8. The construction, reproduction, restoration, alteration or repair of bridges, crowns, dentures or any other prosthetic or orthodontic appliances or materials to be used or worn as substitutes for natural teeth or for correction or regulation of natural teeth, upon order, prescription or direction of a licensed dentist, when the impressions, casts or models thereof have been made or taken by a licensed and registered dentist, a licensed and registered dental hygienist under the direct supervision of a licensed and registered dentist or a registered dental assistant under the direct supervision of a licensed and registered dentist; provided, that such prosthetic dentures or orthodontic appliances or bridges or the services rendered in construction, repair, restoration or alteration thereof are not advertised, other than in a professional or trade journal, or by direct mail to licensed dentists or other laboratories and are not sold or delivered directly or indirectly to the public by any unlicensed person or dental laboratory, either as principal or as agent;
  9. Dental interns and externs or graduates of dental and dental hygiene schools or colleges recognized by the board employed by licensed hospitals or other agencies recognized and approved by the board;
  10. Personnel involved in research or developmental projects, approved by the board, that are under the auspices and direction of a recognized educational institution or the department of health;
  11. Graduates of dental schools or colleges serving as clinical instructors in board-recognized teaching institutions, while performing only those duties required by and under the supervision of such teaching institutions, upon completing prescribed registration forms and payment of a fee as set by the board; however, such exemption shall be confined to the interim immediately prior to the next scheduled applicable examination of the board and shall not be extended if the applicant does not successfully pass the examination;
  12. Dentists and dental hygienists duly licensed in other states who desire to work with special projects recognized and approved by the board may do so under the sponsorship of a local dentist and the auspices of the local dental society for a period of six (6) months;
  13. Dentists or dental hygienists duly licensed in other states practicing within authorized Tennessee department of health programs or programs affiliated with the Tennessee department of health for a period not to exceed twenty-four (24) months;
  14. The application of fluoride varnish to the teeth of at-risk, underserved persons in or under the auspices of a state, county or municipal public health clinic by public health nurses or nurse practitioners;
  15. The application of dental sealants to the teeth of individuals in a setting under the direction of a state or local health department by licensed hygienists, without requiring an evaluation by a dentist prior to such application, under a protocol established by the state or a metropolitan health department; or
  16. The application of topical fluoride to the teeth of individuals in a setting under the direction of a state or local health department by licensed hygienists, without requiring an evaluation by a dentist prior to such application, under a protocol established by the state or a metropolitan health department.

Acts 1957, ch. 32, § 10; 1969, ch. 29, § 3; 1973, ch. 166, §§ 2, 3; 1978, ch. 824, § 7; 1981, ch. 99, § 5; T.C.A., § 63-538; Acts 1984, ch. 937, § 22; 1985, ch. 71, § 2; 1988, ch. 635, §§ 8, 9; 1989, ch. 523, § 9; 1990, ch. 1031, §§ 12, 13; 2002, ch. 771, §§ 5, 6; 2004, ch. 563, § 1; 2013, ch. 110, §§ 1-3.

Textbooks. Tennessee Jurisprudence, 20 Tenn. Juris., Physicians and Surgeons, § 5.

63-5-110. Application for license — Reciprocity.

    1. A person desiring to obtain a license to practice dentistry in this state shall make application to the board. The application must be accompanied by a certificate showing that the applicant is a graduate of an accredited dental school or college or from the dental department of a university approved by the board.
    2. The applicant shall be at least eighteen (18) years of age, a citizen of the United States or Canada or legally entitled to live within the United States and of good moral character and reputation.
    3. The application must be accompanied by the applicant's photograph and by a nonrefundable application fee as set by the board in rules and regulations.
  1. The board is authorized to cause a license to be issued to an applicant of good moral character and professional competence who is licensed to practice dentistry in another state, which shall include the District of Columbia or a territory of the United States, if the board determines to its satisfaction that the applicant meets all of the following requirements:
    1. Currently holds a valid license to practice dentistry in another state and provides a copy of such license, and also provides the name of another state in which the applicant is or has been licensed;
    2. Absence of any pending disciplinary charges or action in another state or any current investigation by a disciplinary authority or another state and provides pertinent information about any disciplinary action imposed against the applicant in any other state, which the board is to evaluate and determine whether such is disqualifying for licensure in this state;
    3. Has not failed previously an examination for licensure to practice dentistry in Tennessee;
    4. Graduation from a dental school or college duly accredited by the American Dental Association Commission on Dental Accreditation;
    5. Demonstrates intent to actively practice or teach in Tennessee;
    6. Has, pursuant to the authority of a state dental licensing board or boards:
      1. Practiced dentistry in another state or states for at least five (5) years;
      2. Taught in an American Dental Association accredited institution for at least five (5) years;
      3. Any combination of subdivision (b)(6)(A) or subdivision (b)(6)(B) for at least five (5) years;
      4. Practiced dentistry for at least two (2) years in another state or states and, in addition, presents satisfactory evidence of passing an examination administered by another state substantially equivalent to the examination required for initial licensure in Tennessee, the appropriateness of such examinations to be evaluated and determined by the board;
      5. Taught for at least two (2) years in an American Dental Association accredited institution and, in addition, presents satisfactory evidence of passing an examination administered by a regional testing agency or a clinical board examination administered by another state substantially equivalent to the examination required for initial licensure in Tennessee, the appropriateness of such examination to be evaluated and determined by the board; or
      6. Any combination of subdivision (b)(6)(D) or subdivision (b)(6)(E) for at least two (2) years; and
    7. Payment of a nonrefundable application fee as set by the board.
  2. The board is authorized, in its discretion, to issue a limited license for educational purposes to any dentist who is duly licensed to practice in any other state who meets the requirements of the board and who submits satisfactory evidence of good moral character and professional competence, including a certificate to that effect from the licensing or registration board from all states in which the applicant has held a license, upon payment of a nonrefundable fee as set by the board.
  3. The board shall direct the division to issue a license to an applicant, without the necessity of further examination except as required by § 63-5-113, if the board determines that the applicant meets all of the following qualifications:
    1. Is a graduate with either a D.D.S. or D.M.D. degree of an accredited dental school or college or of a dental department of a university approved by the board;
    2. Is licensed to practice dentistry in another state, the District of Columbia, the Commonwealth of Puerto Rico or a dependency of the United States;
    3. Has successfully completed a graduate training program in a recognized specialty branch of dentistry; and
    4. Is currently duly licensed to practice medicine in this state.
  4. The board is authorized, in its discretion, to issue a limited license for the practice of dentistry in American Dental Association accredited institutions or dental education programs or in federally-designated health professional shortage areas, if the applicant meets the following requirements:
    1. Is a graduate of a school of dentistry with a degree substantially equivalent to either a D.D.S. or D.M.D. degree;
    2. Has successfully completed a graduate training program in a recognized specialty branch of dentistry from an advanced specialty program accredited by the American Dental Association;
    3. Has successfully completed the national board examinations;
    4. Payment of nonrefundable fee, as set by the board;
    5. Provides satisfactory evidence of good moral character and professional competency;
    6. Provides proof of naturalization or ability to live and work in the United States; and
    7. Meets other requirements as set by the board.

Acts 1957, ch. 32, § 11; 1963, ch. 107, § 2; 1971, ch. 161, § 2; 1973, ch. 166, § 4; 1976, ch. 497, § 1; 1978, ch. 824, § 8; 1981, ch. 99, § 6; T.C.A., § 63-539; Acts 1984, ch. 608, § 1; 1984, ch. 937, § 23; 1988, ch. 635, § 10; 1989, ch. 523, § 10; 1991, ch. 143, § 2; 2001, ch. 330, § 5; 2002, ch. 771, § 7.

Cross-References. Licensing, §§  63-1-10363-1-107.

Textbooks. Tennessee Jurisprudence, 20 Tenn. Juris., Physicians and Surgeons, § 5.

Law Reviews.

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

63-5-111. Examinations — Issuance or denial of licenses.

    1. The board may conduct examinations at such times and places as it may designate and charge each examinee a fee for each examination taken as set annually by the board.
    2. The examination may be written or oral, or both, shall include subjects as may be designated by the board and may also include practical tests, working operations and demonstrations, within the discretion of the board.
    3. The board shall recognize a certificate granted by the American Dental Association's Commission on National Board Dental Examinations and may accept the results of its own board examination or the results of an examination conducted by one (1) or more of the regional testing agencies.
    1. If the applicant shall successfully pass the examination and shall be found worthy, the board shall direct the division to issue a license to that applicant.
    2. The board may, within its discretion, refuse to grant a certificate to any person found guilty of making false statements, cheating or of any fraud or deception, either in applying for or in taking the examination.
    3. The board may, within its discretion, refuse to issue a license to any person who fails to apply for the same within ninety (90) days following notification of successful completion of all requirements for the licensure.

Acts 1957, ch. 32, § 12; 1965, ch. 216, § 4; 1969, ch. 29, § 4; 1976, ch. 497, § 2; 1978, ch. 824, § 9; 1981, ch. 99, § 7; T.C.A., § 63-540; Acts 1984, ch. 608, § 2; 1984, ch. 937, §§ 24, 25; 1989, ch. 523, § 11; 2002, ch. 771, § 8.

63-5-112. Specialists.

  1. No licensed dentist shall claim to the public to be a specialist, or be specially qualified in any particular branch of dentistry or to be giving special attention to any branch of dentistry, or claim to limit the dentist's practice to any branch of dentistry, until that dentist has complied with the additional requirements established by the board and has been issued a certificate by the board authorizing that dentist so to do. The board is authorized to certify “specialists” in the following branches of dentistry:
    1. Dental public health;
    2. Endodontics;
    3. Oral and maxillofacial pathology;
    4. Oral and maxillofacial surgery;
    5. Orthodontics and dentofacial orthopedics;
    6. Pediatric dentistry;
    7. Periodontics;
    8. Prosthodontics;
    9. Oral and maxillofacial radiology; and
    10. Any other branch of dentistry hereafter recognized as a specialty by the American Dental Association and approved by the board.
  2. Oral and maxillofacial surgeons are held to the same standard of care as physicians licensed under chapters 6 or 9 of this title.
  3. In considering or acting upon matters related to specialists or special areas of dentistry, the board shall utilize as consultants one (1) or more knowledgeable persons certified in the applicable specialty or knowledgeable in the special area.

Acts 1957, ch. 32, § 13; 1969, ch. 29, § 5; 1981, ch. 99, § 8; T.C.A., § 63-541; Acts 1988, ch. 635, § 11; 1996, ch. 766, § 1; 2001, ch. 330, § 6; 2003, ch. 237, § 5.

Cross-References. Advertising pursuant to board certification and speciality, § 63-1-145.

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).

63-5-113. Examination and certification of specialists.

  1. Any dentist duly licensed in this state who has completed a minimum of two (2) years of graduate education in a dental school accredited by the Commission on Dental Accreditation or the equivalent thereof in a specialty branch of dentistry or who has otherwise met the requirements of the rules promulgated by the board may apply for a certificate as a specialist.
  2. The board may recognize specialty certification of those dentists licensed through the licensure criteria provisions of § 63-5-110, if the requirements for certification in the original state are substantially equivalent to those requirements in this state.
  3. No one shall offer or conduct any school, course, or program that grants credentialed status or that graduates individuals for credentialed status, or its equivalent, in any particular branch of dentistry or any specific area of the practice of dentistry that is not listed as a recognized specialty in § 63-5-112. Dental, dental hygiene, and dental assisting colleges, schools, or programs in this state that are accredited by the Commission on Dental Accreditation are exempt from this subsection (c).

Acts 1957, ch. 32, § 14; 1969, ch. 29, § 6; 1978, ch. 824, § 10; 1981, ch. 99, § 9; T.C.A., § 63-542; Acts 1988, ch. 635, §§ 12, 13; 1989, ch. 523, § 12; 1997, ch. 497, § 1; 2004, ch. 720, § 1; 2015, ch. 194, § 1.

63-5-114. Dental hygienists — Examination — Licensure — Reciprocity.

  1. The board is authorized to issue a license to practice dental hygiene to applicants who are citizens of the United States or Canada or who are legally entitled to live within the United States, who have graduated and received a diploma from a dental hygiene program accredited by the American Dental Association's Commission on Dental Accreditation, that provides a minimum of two (2) academic years of dental hygiene curriculum and that may be completed in a period of time less than two (2) years, in or through an institution of higher education accredited by an agency recognized by the United States department of education to offer college-level programs and who have successfully passed such examinations as may be established by the board. The board may recognize a certificate granted by the joint commission of national dental examinations or accept the results of the southern regional testing agency, or either organization, in lieu of or subject to such examinations as may be required by the board.
    1. Each applicant for a license as a dental hygienist shall pay a nonrefundable application fee to the board, as set annually by the board.
    2. Any applicant submitting to an examination conducted by the board shall, in addition to the application fee, pay a nonrefundable examination fee as set annually by the board.
    3. The license shall be of the type and kind agreed upon by the board.
  2. The secretary of the board shall keep a separate register showing the names and addresses of all dental hygienists so licensed by the board.
  3. The board is authorized in its discretion to issue a license by criteria approval to any dental hygienist who:
    1. Is licensed and has, pursuant to that license, actively engaged in practice for three (3) years or more in another state or states;
    2. Is a graduate of and has received a diploma from a dental hygiene program accredited by the American Dental Association's Commission on Dental Accreditation that provides a minimum of two (2) academic years of dental hygiene curriculum and that may be completed in a period of time less than two (2) years, in or through an institution of higher education accredited by an agency recognized by the United States department of education to offer college-level programs; and
    3. Submits satisfactory evidence of good moral character and professional competence, including a certificate to that effect from the licensing or registration board from all states in which the applicant has held a license, upon payment of a nonrefundable fee as set by the board.
  4. The board is authorized in its discretion to issue a limited license for educational purposes to any dental hygienist who is duly licensed or registered to practice in any other state, who meets the requirements of the board and who submits satisfactory evidence of good moral character and professional competence, including a certificate to that effect from the licensing or registration board from all states in which the applicant has held a license, upon payment of a nonrefundable fee as set by the board.
  5. The board may in its discretion revoke a license to any person who fails to register the license with the board within ninety (90) days following notification of licensure.

Acts 1957, ch. 32, § 15; 1976, ch. 497, § 4; 1978, ch. 824, § 11; 1981, ch. 99, § 10; T.C.A., § 63-543; Acts 1984, ch. 608, § 3; 1988, ch. 635, §§ 14-16; 1989, ch. 523, §§ 13-15; 1990, ch. 1031, §§ 14-18; 1999, ch. 291, §§ 1, 2.

Cross-References. Licensure, §§  63-1-10363-1-107.

63-5-115. Employment of and practice by hygienists and assistants.

  1. A duly licensed and registered dentist may employ licensed and registered dental hygienists, registered dental assistants and practical dental assistants. Such licensed and registered dental hygienists may practice as authorized in this section or § 63-5-108 only in the office of and under the direct and/or general supervision of a licensed and registered dentist, in authorized public health programs or at other locations otherwise authorized by this chapter. Such registered and/or practical dental assistants may practice as authorized in this section or § 63-5-108 only in the office of and under the direct supervision of a licensed and registered dentist except in authorized public health programs. No provisions in this chapter shall be construed as authorizing any licensed and registered dental hygienists, registered dental assistants or practical dental assistants to practice as such except as provided in this section.
  2. Definitions.
    1. Direct Supervision.  As used in this chapter regarding supervision of licensed and registered dental hygienists or registered dental assistants, “direct supervision” means the continuous presence of a supervising dentist within the physical confines of the dental office when licensed and registered dental hygienists or registered dental assistants perform lawfully assigned duties and functions;
    2. General Supervision.  As used in this chapter, “general supervision” is defined as those instances when the dentist is not present in the dental office or treatment facility while procedures are being performed by the dental hygienist, but the dentist has personally diagnosed the condition to be treated, has personally authorized the procedures being performed and will evaluate the performance of the dental hygienist.
  3. Licensed and registered dental hygienists and registered dental assistants are specifically permitted to participate unsupervised in educational functions involving organized groups or health care institutions regarding preventive oral health care. Dental hygienists are permitted to participate in health screenings and similar activities; provided, that no remuneration is given by the organized group to any hygienist or the hygienist's employer for participating in these activities.
    1. Settings in which licensed and registered hygienists may engage in the provision of preventive dental care under the general supervision of a dentist through written protocol include nursing homes, skilled care facilities, nonprofit clinics and public health programs. Dental hygienists licensed and registered pursuant to this chapter are specifically permitted to render such preventive services as authorized in § 63-5-108 or by regulation of the board, as prescribed by the supervising dentist under a written protocol. Dental hygienists rendering such services shall be under the general supervision of a licensed dentist as specified in a written protocol between the supervising dentist and the hygienist which must be submitted in advance to the board. No dentist may enter into a written protocol with more than three (3) dental hygienists at any one time nor may any hygienist be engaged in a written protocol with more than three (3) dentists at any one time. The supervising dentist must process all patient billings. Each written protocol will be valid for a period of two (2) years at which time it must be renewed through resubmission to the board. Should a dentist cease to be the employer/supervisor of a dental hygienist where a written protocol is in force and on file with the board, the dentist must notify the board within ten (10) working days by certified mail, return receipt requested or electronic mail that the written protocol is no longer in force.
    2. Licensed and registered dental hygienists working under written protocol, in addition to those requirements enumerated under the general supervision as authorized by § 63-5-108(c)(5), must have actively practiced as a licensed dental hygienist for at least five (5) years and have practiced two thousand (2,000) hours in the preceding five (5) years or taught dental hygiene courses for two (2) of the proceeding three (3) years in a dental hygiene program accredited by the American Dental Association's Commission on Dental Accreditation and completed six (6) hours of public health continuing education within the past two (2) years; provided, that, after satisfying the requirement of this subsection (d), in subsequent years the hygienist may work on a part-time basis.
    3. Each written protocol, required for off-site practice under general supervision, shall be submitted to the board by certified mail, return receipt requested and shall include at a minimum:
      1. The name, address, telephone number and license number of the employer (supervising) dentist;
      2. The name, address, telephone number and license number of the dental hygienist;
      3. The name, address, telephone number and other pertinent identification from all locations where the dental hygiene services are to be performed; and
      4. A statement signed by the dentist that the dentist and the dental hygienist that meets all minimum standards for general supervision as well as those required for practice under a written protocol as stipulated in this section and § 63-5-108.
    4. The board will receive each written protocol submitted and keep those on file which meet the minimum requirements enumerated in subdivision (d)(3). Those received by the board and determined not to be complete shall be returned to the submitting dentist within thirty (30) days of receipt with a request for the additional information required. The dentist may then resubmit an amended written protocol to the board.
  4. Teledentistry shall not alter or amend the supervision requirements or procedures authorized for licensed and registered dental hygienists or registered dental assistants. Any licensed and registered dental hygienist who, under the supervision of a dentist, assists the dentist in providing dental health services or care using teledentistry is only authorized to perform those services that the dental hygienist is authorized to perform during an in-person patient encounter under general supervision. Services provided by registered dental hygienists through teledentistry should be provided under written protocol in accordance with subsection (d).

Acts 1957, ch. 32, § 16; 1978, ch. 824, § 12; T.C.A., § 63-544; Acts 1988, ch. 635, § 17; 1990, ch. 1031, § 19; 1998, ch. 847, §§ 4, 5; 1999, ch. 405, § 3; 2012, ch. 945, §§ 2, 3; 2016, ch. 918, § 2.

63-5-116. Penalties for unauthorized practice by hygienist or assistant.

  1. The board may revoke or suspend the license of, assess a civil penalty for each separate violation against or otherwise lawfully discipline any dentist who permits any licensed and registered dental hygienist, registered dental assistant and/or practical dental assistant operating under that dentist's supervision to perform any acts or services other than those authorized by this chapter.
  2. The board may also revoke or suspend the license or registration of, assess a civil penalty for each separate violation against or otherwise lawfully discipline any dental hygienist or dental assistant violating any of the provisions of this chapter.

Acts 1957, ch. 32, § 17; 1978, ch. 824, § 13; 1981, ch. 99, § 11; T.C.A., § 63-545; Acts 1990, ch. 1031, §§ 20, 21; 1999, ch. 405, § 4; 2001, ch. 330, § 7.

Cross-References. Discipline generally, § 63-5-124.

Penalties, §§ 63-1-123, 63-1-134.

63-5-117. License renewal.

  1. Each licensed dentist shall pay an annual renewal fee to the board, payable in advance. The secretary of the board shall notify each licensed dentist that such renewal fee is due.
  2. Each licensed dental hygienist shall pay an annual renewal fee to the board as set by the board, payable in advance, for the ensuing year on or before December 31 of each year, which fees shall become part of the fees of the board and handled in the same manner as other fees of the board. The secretary shall notify all licensed dental hygienists prior to December 31 of each year that the fee is due.
  3. Each registered dental assistant shall pay a biennial renewal fee to the board as set by the board, payable in advance, for the ensuing two (2) years on or before December 31 of each even year, which fees shall become a part of the fees of the board to be handled in the same manner as other fees of the board. The secretary shall notify all registered dental assistants prior to December 31 of each even year that such fee is due.
  4. When any licensed dentist, licensed dental hygienist or registered dental assistant fails to register and pay the registration fee within sixty (60) days after registration becomes due as provided in this section, the license or certificate of such person shall be automatically revoked at the expiration of sixty (60) days after the registration was required, without further notice or hearing. Any person whose license or certificate is automatically revoked as provided in this subsection (d) may make application in writing to the Tennessee board of dental examiners for the reinstatement of such license or certificate, and, upon good cause being shown, the board in its discretion may reinstate such license or certificate upon payment of all past-due renewal fees and upon the further payment of a sum as set by the board.
    1. Notwithstanding any provision of 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 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 (e)(1).

Acts 1957, ch. 32, § 18; 1965, ch. 216, § 1; 1969, ch. 29, § 7; 1976, ch. 406, § 5; 1976, ch. 497, § 3; T.C.A., § 63-546; Acts 1985, ch. 71, §§ 3-6; 1989, ch. 360, §§ 20-22; 1989, ch. 523, §§ 16-19; 1990, ch. 1031, §§ 22, 23.

Cross-References. Registration, § 63-1-108.

63-5-118. Certificate to licensee removing from state.

Anyone who is licensed or certified and is an ethical practitioner of dentistry or dental hygiene in the state and who is of good moral character, who shall desire to change residence to another state, territory, the District of Columbia or to a foreign country, upon application to the board, shall receive a special certificate or endorsement signed by the secretary and bearing the seal of the board, which shall attest such facts, the date of licensure or certification and such other facts as may be deemed necessary. The nonrefundable fee for each certificate or endorsement shall be set by the board.

Acts 1957, ch. 32, § 19; 1973, ch. 166, § 5; 1978, ch. 824, § 14; T.C.A., § 63-547; Acts 1989, ch. 523, § 20.

Cross-References. Certificate of fitness for license in other state, § 63-1-118.

63-5-119. Disbursement of fees, fines and penalties — Operating expenses — Compensation — Conference attendance.

  1. All fees coming into the hands of the board, including examination fees, renewal fees, fines and penalties, shall be paid by the board to the state treasurer and become part of the general fund. The commissioner of finance and administration shall make allotments out of the general fund of at least eighty-five percent (85%) of the funds paid into the general fund by the board for the proper expenditures of the board, and no expenditure shall be made by the board until allotment for the expenditure has been made by the commissioner. Such allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
  2. The members of the board shall receive as compensation the sum of one hundred dollars ($100) for each day they are actually engaged in the duties of the board in Tennessee, and all necessary expenses incurred in attending the meetings of the board. All reimbursements 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.
  3. All fines, fees and penalties provided for in this chapter, whether imposed or required by the board or assessed or imposed by a court, judge or jury, shall belong to and be paid to the board.
  4. The secretary of the board shall, in addition to the per diem provided by this section, receive a salary not to exceed five hundred dollars ($500) per month as set annually by the board.
    1. The board may select one (1) or more of its members to attend, at the expense of the board, annual meetings of such agencies and associations as the Southern Regional Testing Agency, American Association of Dental Examiners and the Southern Conference of Dental Deans and Examiners, where attendance is necessary and important to the proper functioning of the board.
    2. The members of the board may receive as compensation for attendance at such annual meetings the sum of fifty dollars ($50.00) for each day they are actually engaged in the duties of the board at such annual meetings.

Acts 1957, ch. 32, § 20; impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; Acts 1969, ch. 29, § 8; 1976, ch. 806, § 1(112); 1978, ch. 824, § 15; T.C.A., § 63-548; Acts 1994, ch. 666, § 1.

Cross-References. Disbursement of fine and penalties, operating expenses, § 63-1-113.

Funds, deposits and disbursements, § 63-1-137.

63-5-120. Exhibit of license.

The holder of the license to practice dentistry or dental hygiene shall, at all times, upon request, exhibit such license along with the annual renewal receipt to any of the members of the board, or its authorized agent, or to any officer of the law.

Acts 1957, ch. 32, § 21; 1969, ch. 29, § 9; T.C.A., § 63-549; Acts 1990, ch. 1031, § 24.

63-5-121. Dental practice to be owned by dentist — Exception for death or disability.

  1. Except where dental services are regularly made available to employees by their employer or where dental services are being provided by an official agency of the state government or any subdivision, any nonprofit organization or hospital, it is unlawful:
    1. For any licensed dentist to practice dentistry as an employee of any person or other entity not engaged primarily in the practice of dentistry; or
    2. For an owner of an active dental practice to be other than a dentist duly licensed to practice in this state.
  2. In the event that a dentist is deceased or becomes substantially disabled, the estate or agent of such dentist may employ another dentist or dentists for a period of not more than two (2) years to provide services to patients until the practice can be sold or otherwise disposed of or closed.
    1. Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with a dentist; provided, that the contractual relationship between the dentist and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the dentist from exercising independent professional judgment in diagnosing and treating patients.
    2. For the purposes of this subsection (c), the term “charitable clinic” means an entity that meets the following standards:
      1. Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. Has clinical facilities located in this state;
      3. Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. Provides one or more of the following services for free or at a discounted rate:
        1. Medical care;
        2. Dental care;
        3. Mental health care; or
        4. Prescription medications;
      5. Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. Is not required to be licensed under § 68-11-202(a)(1).

Acts 1957, ch. 32, § 22; 1981, ch. 99, § 12; T.C.A., § 63-550; Acts 2002, ch. 771, §§ 9, 10; 2016, ch. 766, § 1.

63-5-122. Drug prescriptions.

  1. Licensed dentists of this state may dispense, prescribe or otherwise distribute drugs rational to the practice of dentistry, and any prescriptions shall be written in accordance with state and federal drug laws.
  2. Licensed pharmacists of this state may fill prescriptions of licensed dentists of this state for any drug necessary or proper to the practice of dentistry.
  3. Any handwritten prescription order for a drug prepared by a dentist 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 dentist, 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 dentist 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.
  4. Any typed or computer-generated prescription order for a drug issued by a dentist 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 dentist, 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 dentist 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.
  5. Nothing in this section shall be construed to prevent a dentist from issuing a verbal prescription order.
    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 (f)(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.
  6. [Deleted by 2018 amendment.]

Acts 1957, ch. 32, § 23; 1978, ch. 824, § 16; T.C.A., § 63-551; Acts 2004, ch. 678, § 4; 2005, ch. 12, § 2; 2008, ch. 1035, §§ 3, 9; 2010, ch. 795, §§ 2, 14; 2013, ch. 74, § 3; 2018, ch. 883, § 4.

Compiler's Notes. Acts 2004, ch. 678, § 1 provided that the title of the act, which amended subsection (c) and subsections (d) and (e), 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 non-prescription 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.

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

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

63-5-123. [Repealed.]

Compiler's Notes. Former § 63-5-123 (Acts 1957, ch. 32, § 25; T.C.A., § 63-553; Acts 2002, ch. 771, § 11), concerning jury duty exemption for dentists, was repealed by Acts 2008, ch. 1159, § 7, effective January 1, 2009.

63-5-124. Grounds for denial, suspension or revocation of licenses — Examinations — Investigations of reports — Civil penalties — Costs — Oaths and subpoenas.

  1. The board has the power and it is its duty to deny, suspend, revoke or otherwise restrict or condition the license of, assess a civil penalty for each separate violation against or otherwise lawfully discipline the holder of any license to practice dentistry or any certificate to practice a dental specialty, any license to practice dental hygiene or practice as a registered dental assistant, whenever the licensee or certificate holder is guilty of violating any of the provisions of this chapter or of the following acts or offenses:
    1. Unprofessional, dishonorable or unethical conduct;
    2. A 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;
    3. Making false or misleading statements or representations, being guilty of fraud or deceit in obtaining admission to practice or in being guilty of fraud or deceit in the practice of dentistry or dental hygiene or as a registered dental assistant;
    4. Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of professional practice;
    5. Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants, such as, but not limited to, nitrous oxide sedation, in such manner as to adversely affect the person's ability to practice dentistry, dental hygiene or as a registered dental assistant;
    6. Conviction of a felony, conviction of any offense under state or federal drug laws, or conviction of any offense involving moral turpitude. However, an action taken under this subdivision (a)(6) shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title;
    7. 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;
    8. 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;
    9. Engaging in the practice of dentistry, dental hygiene or as a registered dental assistant when mentally or physically unable to safely do so;
    10. Solicitation by agents or persons of professional patronage or profiting by the acts of those representing themselves to be agents of the licensee or the certificate holder;
    11. Division of fees or agreeing to split or divide fees received for professional services with any person for bringing or referring a patient;
    12. Conducting the practice of dentistry so as to permit directly or indirectly an unlicensed person to perform services or work that under this chapter can be done legally only by persons licensed to practice dentistry or dental hygiene or as a registered dental assistant;
    13. 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 dentistry by such person;
    14. Claiming to the public to be a specialist in some particular branch of dentistry without being certified by the board as such;
    15. Payment or acceptance of commissions in any form or manner on fees for professional services, references, consultations, pathological reports, radiographs, prescriptions or on other services or articles supplied to patients;
    16. Having work done by or obtaining work from a dental laboratory without issuing a written work order as provided in § 63-5-108;
    17. Giving of testimonials, directly or indirectly, concerning the supposed virtue of secret therapeutic agents or proprietary preparations, such as remedies, vaccines, mouth washes, dentifrices or other articles or materials that are offered to the public, claiming radical cure or prevention of diseases by their use;
    18. Any other unprofessional or unethical conduct that may be specified by the board by the means of rules and regulations duly published and promulgated by the board or the violation of any provision of this chapter;
      1. A dentist shall not, on behalf of that dentist, that dentist's partner or associate or any other dentist affiliated with that dentist or that dentist's facility, use or participate in the use of any form of public communication containing a false, fraudulent, misleading or deceptive statement or claim;
      2. Moreover, the fact of promulgation of any forms of public communication covered or prohibited in this section or the rules and regulations promulgated hereunder shall be prima facie evidence that the dentist named either used or permitted the use of the public communication;
      3. A licensed dentist is authorized to use personal professional cards, appointment cards, announcements and related materials and appropriate signs and listings indicating the dentist's office and specialty in accordance with rules and regulations promulgated by the board;
    19. Dispensing, prescribing or otherwise distributing any controlled substance, controlled substance analogue or other drug to any person in violation of any law of the state or of the United States; or
    20. Disciplinary action against a person licensed to practice dentistry or dental hygiene or registered to practice as a dental assistant by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed or registered in this state. A certified copy of the initial or final order, or other equivalent document memorializing the disciplinary action from the disciplining state or territory, shall constitute prima facie evidence of a violation of this section and shall be sufficient grounds upon which to deny, restrict or condition licensure/registration or renewal and/or discipline a person licensed in this state.
    1. In enforcing this section, the board shall, upon probable cause, have the authority to compel an applicant or license or certificate holder 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 is involved. The applicant or license or certificate holder may have an independent physical or mental examination, which examination report shall be filed with the board for consideration. The committee will submit a report of its findings to the board for use in any hearing that may thereafter ensue.
    2. The board may, upon finding of probable cause, require a dentist, dental hygienist or dental assistant to complete drug and/or alcohol treatment through a program designated by, or contracting with, the board. The board in its discretion is authorized to share information, interviews, reports, statements, memoranda or other data at the program director's request. Information shared between the board and the program director shall be deemed not to violate laws requiring confidentiality of investigations or peer review records protected under § 63-5-131.
  2. The board, on its own motion, may investigate any report indicating that a dentist, dental hygienist or dental assistant is or may be in violation of this chapter. Any dentist, dental hygienist, dental assistant, dental or dental related society or association, or any other person who in good faith reports to the board any information that a dentist, dental hygienist or dental assistant is or may be in violation of any provisions of this chapter, is not subject to suit for civil damages as a result thereof.
  3. In assessing a civil penalty pursuant to this chapter, the board should consider the following:
    1. The harm or potential harm of the violation to the public health and welfare;
    2. The extent to which the public was exposed to such harm or potential harm;
    3. The rate, duration and severity of the violations;
    4. The value of the penalty as a deterrent to future violations;
    5. Attempts by the violator to mitigate the harm to the public; and
    6. Such other specific criteria as the board may wish to establish by duly promulgated regulation.
  4. 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, including investigatory costs, against the licensee or person.
    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.
      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 is 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.
    3. 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.
    4. 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 1957, ch. 32, § 26; 1963, ch. 107, § 3; 1969, ch. 29, § 10; 1978, ch. 824, § 18; 1981, ch. 99, § 13; T.C.A., § 63-554; Acts 1984, ch. 608, § 4; 1985, ch. 120, § 8; 1986, ch. 501, §§ 2, 3; 1988, ch. 635, § 18; 1990, ch. 1031, §§ 25, 26; 2000, ch. 927, § 6; 2001, ch. 330, §§ 8, 9; 2002, ch. 771, § 12; 2012, ch. 798, § 36; 2012, ch. 848, §§ 69, 70; 2018, ch. 745, § 25.

Compiler's Notes. Acts 2000, ch. 927, § 7 provided that any increased expenditures resulting from the amendment to this section by the act, which added subsections (e) and (f), shall be paid from funds allotted to the board of dentistry by the commissioner of finance and administration pursuant to § 63-5-119(a).

Amendments. The 2018 amendment added the second sentence in (a)(6).

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

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

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

Discipline relating to unauthorized practice, §§ 63-5-116, 63-5-126.

Grounds for license denial, suspension or revocation, § 63-6-214.

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

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

Law Reviews.

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

Attorney General Opinions. The board of dentistry 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).

63-5-125. Administrative procedures.

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

Acts 1957, ch. 32, § 27; 1981, ch. 99, § 14; T.C.A., § 63-555.

Law Reviews.

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

63-5-126. Enjoining unlawful practice.

  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 dentistry or dental hygiene 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 dentistry or dental hygiene as defined in § 63-5-108. 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 1957, ch. 32, § 28; T.C.A., § 63-556; Acts 1990, ch. 1031, § 27.

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

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).

63-5-127. District attorneys general to assist board.

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. It is 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 1957, ch. 32, § 29; T.C.A., § 63-557.

Law Reviews.

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

63-5-128. Criminal penalties.

  1. Any person who violates any provision of § 63-5-107(a) commits a Class B misdemeanor.
  2. After being convicted of any violation of § 63-5-107(a), any person who again violates § 63-5-107(a) commits a Class E felony.
  3. 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 dentistry as defined in § 63-5-108, who thereafter willfully violates the terms of the injunction by again performing such acts or rendering such services, commits a Class E felony.

Acts 1957, ch. 32, § 30; T.C.A., § 63-558; Acts 1989, ch. 591, §§ 82, 83, 112; 1991, ch. 143, § 3.

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

Penalties, §§  63-1-123, 63-1-134.

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

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

Textbooks. Tennessee Jurisprudence, 6A Tenn. Juris., Constitutional Law, § 58; 20 Tenn. Juris., Physicians and Surgeons, § 5.

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).

63-5-129. Retirement.

Any person licensed to practice dentistry or dental hygiene in this state who has retired or may hereafter retire from such practice in this state is not required to register as required by this chapter; provided, that such person files with the board an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice and other such facts as tend to verify such retirement as the board deems necessary. If such person thereafter reengages in the practice of dentistry or dental hygiene in this state, such person shall apply for registration with the board as provided by this chapter.

Acts 1965, ch. 216, § 2; 1978, ch. 824, § 19; T.C.A., § 63-559; Acts 1990, ch. 1031, § 28.

Cross-References. Retirement, §  63-1-111.

63-5-130. Armed forces or public health service.

Any person licensed to practice dentistry or dental hygiene in this state who is an officer in the commissioned dental corps of the army, navy, air force or the public health service of the United States shall not be required to register as required in this chapter. Such person shall file with the board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person entered the army, navy, air force or the public health service of the United States and such other facts as tend to verify such service as the board shall deem necessary. When such person resigns or is honorably discharged from one (1) of the aforementioned services and engages in the practice of dentistry or dental hygiene in this state or any other state, such person shall, within thirty (30) days, apply for registration with the board as provided for in this chapter.

Acts 1965, ch. 216, § 3; T.C.A., § 63-560.

63-5-131. Immunity of peer review committee from liability — Confidentiality.

  1. As used in this section, “peer review committee” or “committee” means any committee, board, commission or other entity constituted by any statewide dental association or local dental society for the purpose of receiving and evaluating dental acts of other dentists or dental auxiliary personnel or their personal conduct as it relates to the performance of their professional duties.
  2. Any dentist who serves on any peer review committee or on any other committee is immune from liability with respect to any action taken by the dentist in good faith and without malice as a member of such committee, board, commission or other entity.
  3. Dentists, dental hygienists and registered dental assistants, members of boards of directors or trustees of any publicly supported or privately supported hospital or other such provider of health care, or any other individual appointed to any committee, as such term is described in subsection (a), are immune from liability to any patient, individual or organization for furnishing information, data, reports or records to any such committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by such committees undertaken or performed within the scope or functions of the duties of such committees, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
  4. All information, interviews, reports, statements, memoranda or other data furnished to any such peer review committee or other entity and any findings, conclusions or recommendations resulting from the proceedings of such committee or other entity are privileged. The records and proceedings of any such committee or other entity are confidential and shall be used by such committee or other entity and the members thereof only in the exercise of the proper functions of the committee or other entity and shall not become public record nor be available for court subpoena or discovery proceedings. Nothing contained in this subsection (d) applies to records, documents or information otherwise available from original sources, such records, documents or information not to be construed as immune from discovery or use in any civil proceeding solely due to presentation to the committee.

Acts 1974, ch. 656, § 1; T.C.A., § 63-561; Acts 1985, ch. 71, § 7; 1990, ch. 1031, § 29; 1992, ch. 859, § 2.

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

63-5-132. Inactive licenses to perform pro bono services.

The board of dentistry shall establish by rule an inactive license category that allows dentists to perform services without compensation only for those persons receiving services from organizations that have received a determination of exemption under § 501(c)(3) of the Internal Revenue Code. Such inactive license category shall not authorize any other practice of dentistry.

Acts 1997, ch. 345, § 2.

Compiler's Notes. Section 501(c)(3) of the Internal Revenue Code, referred to in this section, is codified as 26 U.S.C. § 501(c)(3).

63-5-133. Dental referral service.

  1. A dental referral service shall not participate in the advertising of, or operate, a dental referral service unless it meets all of the following requirements:
    1. Its patient referrals result from patient-initiated responses to the dental referral service's advertising;
    2. It discloses to any prospective patient in its advertising that participating dentists have paid a fee for participation in the service;
    3. It does not impose a fee on participating dentists dependent on the number of referrals or amount of professional fees paid by the patient to the dentist; and
    4. It duly registers with the board, providing all information reasonably required by the board.
  2. Participating dentists shall not enter into an agreement to accept for dental care or treatment a person referred or recommended by a dental referral service unless the dental referral service meets all the requirements of subsection (a). Participating dentists shall charge no more than their usual and customary fees to any patient so referred or recommended.
    1. “Dental referral service” is a person, firm, partnership, association, corporation, agent or employee of any of the foregoing that engages in any business or service for profit that in whole or in part includes the referral or recommendation of persons to a dentist for any form of dental care or treatment;
    2. “Participating dentist” is a dentist duly licensed under this chapter who has paid a fee to a dental referral service in order to be included in its referral service.
  3. A dental referral service that advertises shall include in each advertisement legible or audible language, or both, a disclaimer containing all the following statements or information:
    1. The advertisement is paid for by participating dentists who have paid a fee to participate; and
    2. No representation is made about the quality of the dental services to be performed or expertise of the participating dentists, and that participating dentists are not more or less qualified than dentists who are not participating in the service.
  4. Dental referral service advertisements shall not do any of the following:
    1. Advertise or solicit patients in a manner that contains a false, fraudulent, misleading or deceptive statement in any material respect;
    2. Publish or circulate, directly or indirectly, any false, fraudulent, misleading or deceptive statement as to the skill or methods of practice of any participating dentist;
    3. Contain a statement or make a recommendation that the dental referral service provides referrals to the most qualified dentists or dental practice; or
    4. Advertise a review process or a screening that misleads the public into thinking a participating dentist has obtained special recognition or joined a selective group of licensed dentists by being a participating dentist in the dental referral service.

Acts 1998, ch. 1025, § 1.

Cross-References. Advertisement pertaining to board certification and specialty, §  63-1-145.

63-5-134. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.

A dentist or a dental hygienist licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of dentistry may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.

Acts 2004, ch. 579, § 4.

Chapter 6
Medicine and Surgery

Part 1
Board of Medical Examiners

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

    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.
  1. 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 §§ 63-1-13163-1-133 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).

NOTES TO DECISIONS

1. Constitutionality.

The regulation of the practice of medicine is constitutional. O'Neil v. State, 115 Tenn. 427, 90 S.W. 627, 1905 Tenn. LEXIS 78, 3 L.R.A. (n.s.) 762 (1905).

This act has been repeatedly upheld and enforced by the Supreme Court. State ex rel. Campbelle v. Hobbs, 174 Tenn. 215, 124 S.W.2d 699, 1938 Tenn. LEXIS 82 (1939).

2. Board Members.

3. —Immunity.

Public policy requires absolute immunity for officials performing quasi-prosecutorial or quasi-judicial functions, at least where protections such as those provided by the federal Administrative Procedure Act are in place. The Tennessee Administrative Procedures Act, compiled in title 4, ch. 5 provides procedural safeguards for contested cases comparable to those provided by the corresponding federal law, 5 U.S.C. § 554 et seq.Watts v. Burkhart, 978 F.2d 269, 1992 U.S. App. LEXIS 27830 (6th Cir. Tenn. 1992).

4. Licensure.

Denial of medical licensure in Tennessee to an applicant was not inappropriate because the decision by the Tennessee Board of Medical Examiners that the applicant's long absence from direct patient care necessitated a formal assessment before the applicant could engage in the practice of emergency medicine in Tennessee was not unclear, arbitrary and capricious, or unsupported by substantial and material evidence. Perez v. Tenn. Bd. of Med. Examiners, — S.W.3d —, 2019 Tenn. App. LEXIS 336 (Tenn. Ct. App. July 3, 2019).

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

      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.
    1. Members of the board shall, upon expiration of their terms of office, be eligible for reappointment to successive terms.
    2. 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.
    3. 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.
  1. All vacancies occurring on the board by reason of death or resignation shall be filled by the board itself for the unexpired term.
  2. 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.
  3. 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.
    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

63-6-201. License requirements.

  1. No person shall practice medicine in any of its departments within this state unless and until such person has obtained a license from the board created by § 63-6-101. The provisions in this chapter with reference to obtaining a license from the board do not apply to any person who on July 1, 1947, was duly and regularly licensed by law to practice medicine in any of its branches in this state.
    1. Notwithstanding the foregoing provisions visiting medical faculty licensed in a country other than the United States and employed full time by a college or university operating an accredited medical school in Tennessee are exempt from the requirement of a license; provided, that the visiting faculty member is a graduate of a medical school, a recognized medical authority approved by the board and the practice of the visiting faculty member is limited to and is incidental to the visiting faculty member's employment at an accredited medical school in Tennessee. Such person is entitled to engage in private practice; provided, that the person enrolls and satisfactorily participates in a three-year residency program approved by the board. No physician authorized under this subsection (b) to engage in private practice shall continue to engage in private practice of any form after a period of three (3) years unless such person meets all the requirements of licensure set forth in § 63-6-207.
    2. It is the responsibility of the dean of the medical school to apply to the board for an exemption for each such visiting faculty member. Such application for exemption shall be filed annually, and an individual applicant may not receive an exemption for a period in excess of two (2) years. It is also the responsibility of the above-named dean to notify the board upon termination of a visiting faculty member's responsibilities.
    3. The board may impose a fee to accompany each application for exemption.

Acts 1901, ch. 78, § 1; 1905, ch. 111, § 1; Shan., § 3609a13; Code 1932, § 6918; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; mod. C. Supp. 1950, § 6918; Acts 1977, ch. 285, § 1; T.C.A. (orig. ed.), § 63-605; Acts 1982, ch. 905, § 3; 1984, ch. 937, §§ 27, 28; 1989, ch. 523, §§ 39, 40; 1990, ch. 1055, § 2; 1994, ch. 732, § 1; 1995, ch. 329, § 5; 2003, ch. 262, § 1.

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

Courses in detection and treatment of child sexual abuse, § 49-7-117.

Exemption from barber licensing law, § 62-3-108.

Exemption from cosmetologists' licensing law, § 62-4-109.

Exemption from jury service, § 22-1-103.

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

Licensing by division of health related boards, §§ 63-3-10363-3-111.

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

Physician assistants, title 63, ch. 19.

Respiratory practitioners, title 63, ch. 27.

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

Law Reviews.

Selected Tennessee Legislation of 1986, 54 Tenn. L. Rev. 457 (1987).

NOTES TO DECISIONS

1. Chiropractors.

Chiropractor did not invade field of practice of medicine where he administered no drugs to patient and gave no treatment to any portion of patient's anatomy other than his 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).

63-6-202. Unlawful activities of itinerant physicians or vendors — Penalties.

  1. It is unlawful for any itinerant physician or vendor of any drug, nostrum, ointment or application of any kind intended for treatment of disease or injury to sell or apply the same or for such itinerant physician or vendor, by writing, printing or other methods, to profess to cure or treat diseases or deformity by any drug, nostrum, manipulation or other expedient in this state.
    1. A violation of this section is a Class A misdemeanor.
    2. Each violation of this section constitutes a separate offense.

Acts 1907, ch. 543, § 4; Shan., § 3609a31; Code 1932, § 6935; Acts 1945, ch. 181, § 8; C. Supp. 1950, § 6935; T.C.A. (orig. ed.), § 63-606; Acts 1989, ch. 591, §§ 1, 6.

Code Commission Notes.

The misdemeanor in this section has been designated as a Class A misdemeanor by authority of § 40-35-110, which provides that an offense designated a misdemeanor without specifications as to category is a Class A misdemeanor. See also § 39-11-114.

Compiler's Notes. The misdemeanor provisions in this section may be affected by the Criminal Sentencing Reform Act of 1989. See §§ 39-11-114, 40-35-110, 40-35-111.

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

Textbooks. Tennessee Jurisprudence, 6 Tenn. Juris., Constitutional Law, § 82; 20 Tenn. Juris., Physicians and Surgeons, § 4.

NOTES TO DECISIONS

1. Constitutionality.

This section is not unconstitutional as arbitrary legislation, or as unlawfully discriminative as between resident and nonresident physicians. Kirk v. State, 126 Tenn. 7, 150 S.W. 83, 1911 Tenn. LEXIS 2 (1911).

The inhibition of advertising remedies is valid as tending to prevent frauds. Kirk v. State, 126 Tenn. 7, 150 S.W. 83, 1911 Tenn. LEXIS 2 (1911).

2. “Sell or Apply.”

Sale of drugs as property is not prohibited, but sale and application of same. The disjunctive “or” between words sell and apply means “and.” Kirk v. State, 126 Tenn. 7, 150 S.W. 83, 1911 Tenn. LEXIS 2 (1911).

63-6-203. Penalties.

    1. Any person who practices medicine or surgery in this state without having first complied with the provisions of this chapter commits a Class B misdemeanor for each instance of such practice.
    2. Each time any person practices medicine or surgery without first obtaining a valid certificate or renewing a certificate constitutes a separate offense.
    3. Any person filing or attempting to file as the person's own a diploma or license of another or a forged affidavit of identification commits a Class E felony.
  1. All fines for offenses under this chapter shall be paid over to the board to constitute a part of the funds of the board to be paid into the state treasury.

Acts 1901, ch. 78, § 18; Shan., § 3609a32; mod. Code 1932, § 6936; Acts 1945, ch. 181, § 9; mod. C. Supp. 1950, § 6936; T.C.A. (orig. ed.), § 63-607; Acts 1989, ch. 591, §§ 84, 112; 1993, ch. 404, § 6.

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

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

Textbooks. Tennessee Jurisprudence, 20 Tenn. Juris., Physicians and Surgeons, § 4.

63-6-204. “Practice of medicine” defined — Construction.

    1. Any person shall be regarded as practicing medicine within the meaning of this chapter who treats, or professes to diagnose, treat, operates on or prescribes for any physical ailment or any physical injury to or deformity of another.
    2. Nothing in this section shall be construed to apply to the administration of domestic or family remedies in cases of emergency or to the laws regulating the practice of dentistry.
    3. This chapter shall not apply to surgeons of the United States army, navy, air force, or marine hospital service regardless of the hospital or practice site; provided, that the surgeon's practice is part of the surgeon's authorized military service or training. This chapter shall also not apply to any registered physician or surgeon of other states when called in consultation by a registered physician of this state, or to midwives, veterinary surgeons, osteopathic physicians, or chiropractors not giving or using medicine in their practice, or to opticians, optometrists, chiropodists, or Christian Scientists.
  1. Nothing in this chapter shall be so construed as to prohibit service rendered by a physician assistant, registered nurse, a licensed practical nurse, or a pharmacist pursuant to a collaborative pharmacy practice agreement, if such service is rendered under the supervision, control and responsibility of a licensed physician or to prohibit the provision of anesthesiology services in licensed health care facilities by a dentist licensed in this state who completed a residency program in anesthesiology at an accredited medical school in years 1963 through 1977.
  2. Nothing in this section shall be construed to prohibit a person, corporation, organization or other entity from employing a physician to treat only the entity's full-time, part-time and contract employees, the entity's retirees and dependents of the entity's employees or retirees; provided, however, that the employment relationship between the physician and the person, corporation, organization or other entity is evidenced by a written contract, job description or documentation, containing language which does not restrict the physician from exercising independent medical judgment in diagnosing and treating patients. Under this section, such person, corporation, organization or other entity shall not be deemed to be engaged in the practice of medicine.
  3. Nothing in this section shall be construed to prohibit a community mental health center as defined in § 33-1-101 from employing a physician; provided, that the employment relationship between the physician and the community mental health center is evidenced by a written contract, job description or documentation, containing language which does not restrict the physician from exercising independent medical judgment in diagnosing and treating patients; provided, for the purposes of this subsection (d), “physician” does not include an anesthesiologist, an emergency department physician, a pathologist or a radiologist.
    1. Nothing in this section prohibits a federally-qualified health center or rural health clinic from employing a physician if the employment relationship between the physician and the federally-qualified health center or rural health clinic is evidenced by a written contract, job description, or documentation containing language that does not restrict the physician from exercising independent medical judgment in diagnosing and treating patients.
    2. As used in this subsection (e):
      1. “Federally-qualified health center” has the same meaning as defined under §§ 1861(aa) and 1905 of the federal Social Security Act (42 U.S.C. §§ 1395x and 1396d, respectively);
      2. “Physician” does not include an anesthesiologist, an emergency department physician, a pathologist, or a radiologist; and
      3. “Rural health clinic” has the same meaning as defined under §§ 1861(aa) and 1905 of the federal Social Security Act (42 U.S.C. §§ 1395x and 1396d, respectively).
    1. Notwithstanding this section, nothing shall prohibit a hospital licensed under title 68, chapter 11, or title 33, chapter 2, or an affiliate of a hospital, from employing licensed physicians other than radiologists, anesthesiologists, pathologists, or emergency physicians, to provide medical services, subject to the following conditions:
      1. Employing entities shall not restrict or interfere with medically appropriate diagnostic or treatment decisions;
      2. Employing entities shall not restrict or interfere with physician referral decisions unless:
        1. The physician so employed has agreed in writing to the specific restrictions at the time that the contract is executed;
        2. The restriction does not, in the reasonable medical judgment of the physician, adversely affect the health or welfare of the patient; and
        3. The employing entity discloses any such restrictions to the patient; and
      3. In the event that there is any dispute relating to subdivision (f)(1)(A) or (B), the employing entity shall have the burden of proof.
    2. Employing entities shall not restrict the employed physician's right to practice medicine upon the termination or conclusion of the employment relationship, except as follows:
      1. For physicians from whom the employing entity has made a bona fide purchase of the physician's practice, the employing entity may impose reasonable geographic restrictions upon the employed physician's practice; provided, that:
        1. The maximum allowable area of the restriction is the greater of:
          1. The county in which the primary practice site is located; or
          2. A ten (10) mile radius from the primary practice site;
        2. The duration of the restriction is two (2) years or less, unless a longer period, not to exceed five (5) years, is determined by mutual agreement of the parties in writing to be necessary to comply with federal statutes, rules, regulations, or IRS revenue rulings or private letter rulings;
        3. Any employment agreement or medical practice sale agreement restricting the right of a physician to practice shall:
          1. Allow the physician to buy back the physician's medical practice for the original purchase price of the practice, or, in the alternative, if the parties agree in writing, at a price not to exceed the fair market value of the practice at the time of the buy back, at which time any such restriction on practice shall be void; and
          2. Not require that the physician give more than thirty-day's notice to exercise the repurchase option; provided, that this provision shall not otherwise affect the contract termination notice requirements; and
        4. If the buy back provision is dependent upon a determination of the fair market value of the practice, the contract shall specify the method of determining fair market value by independent appraisal, in the event that the parties cannot agree as to the fair market value. The contract shall also include the following language:

        “In the event that the employing entity and the physician cannot agree upon the fair market value of the practice within ten (10) business days of the physician's notice of intent to repurchase the practice, the physician may remove any contractual restrictions upon the physician's practice by tendering to the employing entity the amount that was paid to the physician for the practice. The employing entity or the physician may then seek a determination of the fair market value of the practice by the independent appraisal method specified by contract.”

      2. For physicians employed independently of a bona fide practice purchase, employing entities shall not restrict the employed physician's right to practice medicine upon the termination or conclusion of the employment relationship, except as allowed by § 63-1-148 or any successor section.
    3. Notwithstanding the foregoing, in the event that the employment contract with a physician employed independently of a bona fide practice purchase is terminated by the employing entity for reasons other than breach by the employee, any such restrictions shall be void.
    4. In any event, nothing in this section shall prohibit any of the following from employing physicians:
      1. A licensed physician; or
      2. A group of licensed physicians, including, but not limited to, either of the following:
        1. A physicians' professional corporation registered under title 48, chapter 101; or
        2. A domestic nonprofit public benefit corporation:
          1. That is recognized as exempt under § 501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)), or any successor section;
          2. A purpose of which is to engage in medical education and medical research in conjunction with a college or university operating an accredited medical school in Tennessee;
          3. Whose physician-employees are restricted to the medical faculty of such a college or university; and
          4. Which operates as a “faculty practice plan” for purposes of Title XVIII of the federal Social Security Act (42 U.S.C., Chapter 7, subchapter XVIII), and regulations promulgated in connection therewith;

        Provided, that with respect to any such domestic nonprofit public benefit corporation, physician employees of any such faculty practice plan who practice in the specialties of radiology, pathology, anesthesiology and/or emergency medicine shall be restricted to practice as faculty practice plan employees in those health care institutions, including but not limited to hospitals or surgery centers, in which they were practicing as employees of the nonprofit public benefit corporation on May 30, 1997.

    5. A hospital affiliate that employs physicians shall not engage in any business other than the employment of physicians, the management of physicians and health care facilities, or the ownership of property and facilities used in the provision of health care services. An affiliate of a hospital that employs physicians pursuant to this part shall be subject to the authority of the applicable licensing board under either title 68, chapter 11, or title 33, chapter 2 in connection with employment of physicians. Any violation of this statute by an affiliate shall subject any hospital at which the physician has staff privileges, and that controls or is under common control with the affiliate to the penalties and sanctions applied to hospitals that employ physicians.
      1. No radiologist, anesthesiologist, pathologist, or emergency physician may be employed by a hospital or an affiliate of a hospital, and no hospital or an affiliate of a hospital, may employ any physician to provide medical services provided by radiologists, anesthesiologists, pathologists, or emergency physicians; provided, that a physician may be employed to provide emergency medical services if such physician is employed to provide other medical services.
      2. Notwithstanding subdivisions (f)(6)(A) and (f)(1), a “research hospital,” as defined in this section, may employ radiologists, anesthesiologists, or pathologists under the same terms and conditions as other physicians.
    6. As used in this section, unless the context otherwise requires:
      1. “Affiliate” of a hospital means an entity that directly or indirectly is controlled by, or is under common control with, a hospital licensed under title 68, chapter 11 or title 33, chapter 2. “Affiliate” does not mean, however, a health maintenance organization licensed under title 56, chapter 32;
      2. “Anesthesiologist” is a physician who has completed a residency in anesthesiology and whose practice is primarily limited to anesthesiology, including, without limitation, nerve block, pain management, cardiac and respiratory resuscitation, respiratory therapy, management of fluids, electrolyte and metabolic disturbances, or a dentist licensed in the state who completed a residency program in anesthesiology at an accredited medical school in years 1963 through 1977;
      3. “Emergency physician” is a physician who has either completed a residency in emergency medicine, or practiced emergency medicine full time for a three year period, and whose practice is limited to emergency medicine. “Emergency physician” does not include, however, a physician who has been previously employed to provide nonemergent medical services who, over a period of twelve (12) months or more, becomes a full time emergency physician and who remains employed by mutual agreement;
      4. “Employing entity” means a hospital licensed under title 68, chapter 11, or title 33, chapter 2, or an affiliate of such an entity, that employs one (1) or more physicians. “Employing entity” does not mean, however, a health maintenance organization licensed under title 56, chapter 32;
      5. “Pathologist” is a physician who has completed a residency in pathology and whose practice is primarily limited to pathology, including, without limitation, anatomic and clinical pathology;
      6. “Physician” means a person licensed pursuant to chapter 6 or 9 of this title;
      7. “Psychiatrist” means a physician who has completed a residency in psychiatry and whose practice is primarily limited to psychiatry.
      8. “Radiologist” is a physician who has completed a residency in radiology and whose practice is primarily limited to radiology, including, without limitation, diagnostic radiology, radiation therapy, and radiation oncology; and
      9. “Research hospital” means a hospital at which fifty percent (50%) or more of the inpatients treated during the previous calendar year were treated pursuant to research protocols.
    1. Notwithstanding this section, nothing shall prohibit a renal dialysis clinic licensed under title 68, chapter 11 or an affiliate of a renal dialysis clinic from employing licensed physicians other than radiologists, anesthesiologists, pathologists or emergency physicians to provide medical services, subject to the following conditions:
      1. Employing entities shall not restrict or interfere with medically appropriate diagnostic or treatment decisions;
      2. Employing entities shall not restrict or interfere with physician referral decisions unless:
        1. The physician so employed has agreed in writing to the specific restrictions at the time that the contract is executed;
        2. The restriction does not, in the reasonable medical judgment of the physician, adversely affect the health or welfare of the patient; and
        3. The employing entity discloses the restrictions to the patient; and
      3. In the event that there is any dispute relating to subdivision (g)(1)(A) or (g)(1)(B), the employing entity shall have the burden of proof.
    2. Employing entities shall not restrict the employed physician's right to practice medicine upon the termination or conclusion of the employment relationship, except as allowed by § 63-1-148 or any successor section.
    3. Notwithstanding § 63-1-148 or any successor section, in the event that the employment contract with a physician employed independently of a bona fide practice purchase is terminated by the employing entity for reasons other than breach by the employee, the restrictions shall be void.
    4. In any event, nothing in this section shall prohibit any of the following from employing physicians:
      1. A licensed physician; or
      2. A group of licensed physicians, including, but not limited to, either of the following:
        1. A physicians' professional corporation registered under title 48, chapter 101; or
        2. (a)  A domestic nonprofit public benefit corporation:
          1. (ii)  (a)  A domestic nonprofit public benefit corporation:
            1. That is recognized as exempt under § 501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)) or any successor section;
            2. A purpose of which is to engage in medical education and medical research in conjunction with a college or university operating an accredited medical school in Tennessee;
            3. Whose physician-employees are restricted to the medical faculty of such a college or university; and
            4. That operates as a faculty practice plan for purposes of Title XVIII of the federal Social Security Act (42 U.S.C. chapter 7, subchapter XVIII) and regulations promulgated in connection therewith.
          2. Provided, that, with respect to the domestic nonprofit public benefit corporation, physician employees of the faculty practice plan who practice in the specialties of radiology, pathology, anesthesiology or emergency medicine shall be restricted to practice as faculty practice plan employees in those health care institutions, including, but not limited to, hospitals or surgery centers, in which they were practicing as employees of the nonprofit public benefit corporation on May 30, 1997.
      3. “Affiliate” of a renal dialysis clinic means an entity that directly or indirectly is controlled by or is under common control with a renal dialysis clinic licensed under title 68, chapter 11. “Affiliate” does not mean, however, a health maintenance organization licensed under title 56, chapter 32;
      4. “Anesthesiologist” is a physician who has completed a residency in anesthesiology and whose practice is primarily limited to anesthesiology, including, without limitation, nerve block, pain management, cardiac and respiratory resuscitation, respiratory therapy, management of fluids, electrolyte and metabolic disturbances or a dentist licensed in this state who completed a residency program in anesthesiology at an accredited medical school in years 1963 through 1977;
      5. “Emergency physician” is a physician who has either completed a residency in emergency medicine or practiced emergency medicine full-time for a three year period and whose practice is limited to emergency medicine. “Emergency physician” does not include, however, a physician who has been previously employed to provide nonemergent medical services who, over a period of twelve (12) months or more, becomes a full-time emergency physician and who remains employed by mutual agreement;
      6. “Employing entity” means a renal dialysis clinic licensed under title 68, chapter 11 or an affiliate of such an entity that employs one (1) or more physicians. “Employing entity” does not mean, however, a health maintenance organization licensed under title 56, chapter 32;
      7. “Pathologist” is a physician who has completed a residency in pathology and whose practice is primarily limited to pathology, including, without limitation, anatomic and clinical pathology;
      8. “Physician” means a person licensed pursuant to chapter 6 or 9 of this title; and
      9. “Radiologist” is a physician who has completed a residency in radiology and whose practice is primarily limited to radiology, including, without limitation, diagnostic radiology, radiation therapy and radiation oncology.
    1. The general assembly finds that there are special facts above and beyond ordinary competition that would give an unfair advantage to a physician when competing with the physician's former employer, if the former employer is a faculty practice plan. The existence of such special facts warrants protection of the faculty practice plan through restrictive covenants and prohibitions against an employed physician's right to practice medicine upon the termination or conclusion of the employment relationship. The general assembly further finds that the faculty practice plan's right to be free of unfair competition from a former employed physician outweighs any financial hardship to the former employed physician resulting from the operation of any such restrictive covenants or prohibition. The general assembly further finds that restrictive covenants and prohibitions against an employed physician's right to practice medicine upon the termination or conclusion of the employment relationship with a faculty practice plan are reasonable and not inimical to the public interest, subject to the temporal and geographic limitations set forth in subdivision (h)(2).
    2. A faculty practice plan may impose restrictions or prohibitions upon an employed physician's right to practice medicine upon the termination or conclusion of the employment relationship provided that:
      1. The maximum area of the restrictions or prohibitions is the greater of:
  4. The county in which the primary practice site is located; or
    1. Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with a physician; provided, that the contractual relationship between the physician and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the physician from exercising independent professional medical judgment in diagnosing and treating patients.
    2. For the purposes of this subsection (j), the term “charitable clinic” means an entity that meets the following standards:
      1. Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. Has clinical facilities located in this state;
      3. Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. Provides one (1) or more of the following services for free or at a discounted rate:
        1. Medical care;
        2. Dental care;
        3. Mental health care; or
        4. Prescription medications;
      5. Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. Is not required to be licensed under § 68-11-202(a)(1).
    3. For the purposes of this section, the term “employing” shall not allow the employing of those physicians exempted in subdivision (e)(3).
  5. This section does not prohibit a licensed nonresidential office-based opiate treatment facility, as defined in § 33-2-402, from employing or contracting with a physician if the facility has a physician in the ownership structure of its controlling business entity and the employment relationship between the physician to be employed or contracted with and the nonresidential office-based opiate treatment facility is evidenced by a written contract or employment agreement containing language that does not restrict the physician from exercising independent professional medical judgment in diagnosing and treating patients.

An affiliate of a renal dialysis clinic that employs physicians shall not engage in any business other than the employment of physicians, the management of physicians and health care facilities or the ownership of property and facilities used in the provision of health care services or a tissue bank or organ procurement agency. An affiliate of a renal dialysis clinic that employs physicians pursuant to this part shall be subject to the authority of the applicable licensing board under title 68, chapter 11, in connection with employment of physicians. Any violation of this subdivision (g)(5) by an affiliate shall subject any renal dialysis clinic at which the physician has staff privileges and that controls or is under common control with the affiliate to the penalties and sanctions applied to renal dialysis clinics that employ physicians.

No radiologist, anesthesiologist, pathologist or emergency physician may be employed by a renal dialysis clinic or an affiliate of a renal dialysis clinic, and no renal dialysis clinic or an affiliate of a renal dialysis clinic may employ any physician to provide medical services provided by radiologists, anesthesiologists, pathologists or emergency physicians; provided, that a physician may be employed to provide emergency medical services if the physician is employed to provide other medical services.

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

A ten (10) mile radius from the primary practice site; and

The maximum duration of the restrictions or prohibitions is two (2) years.

As used in this subsection (h), “faculty practice plan” means a domestic nonprofit public benefit corporation as defined in subdivision (f)(4)(B)(ii).

As used in this subsection (h), “primary practice site” includes any health care institution, including, but not limited to, a hospital, clinic, surgery center, or physicians' office, that the faculty practice plan or its affiliated college or university owned, leased, or operated within two (2) years before the termination or conclusion of the employment relationship between the physician and the faculty practice plan and at which the employed physician practiced medicine within such period of two (2) years.

This subsection (h) shall not apply:

To any physician employee of a faculty practice plan who practices in the specialties of ophthalmology, pathology, anesthesiology and/or emergency medicine; or

With respect to any physician employee of a faculty practice plan who practices as a primary care physician or in the specialties of obstetrics or general pediatrics in a health resources shortage area as determined in the health access plan most recently published by the department of health.

The requirements of this subsection (h) shall not be construed to preclude the enforceability of any restrictive covenant or prohibition exceeding the requirements or conditions of this subsection (h) that is reasonable and not inimical to the public interest under the common law principles governing restrictive covenants.

Notwithstanding the restrictions contained in this section, a nursing home or affiliate of a nursing home may employ a physician pursuant to § 68-11-205.

Acts 1901, ch. 78, § 19; Shan., § 3609a33; mod. Code 1932, § 6937; Acts 1945, ch. 181, § 10; impl. am. Acts 1947, ch. 2, §§ 1, 2; C. Supp. 1950, § 6937; modified; Acts 1973, ch. 166, § 7; T.C.A. (orig. ed.), § 63-608; Acts 1983, ch. 168, § 1; 1994, ch. 901, § 3; 1995, ch. 200, § 1; 1995, ch. 466, § 1; 1996, ch. 986, §§ 2, 3; 1996, ch. 1043, § 2; 1997, ch. 349, § 1; 1998, ch. 1081, § 1; 2002, ch. 801, §§ 1, 2; 2003, ch. 115, §§ 1, 2; 2005, ch. 20, § 1; 2008, ch. 891, § 2; 2009, ch. 70, § 1; 2011, ch. 271, §§ 1, 2; 2012, ch. 649, § 2; 2014, ch. 695, §§ 1, 2; 2014, ch. 832, § 5; 2016, ch. 766, § 2; 2017, ch. 259, § 1; 2019, ch. 259, § 1; 2020, ch. 574, § 1.

Amendments. The 2017 amendment rewrote (a)(3) which read: “This chapter shall not apply to surgeons of the United States army, navy, air force or marine hospital service, or to any registered physician or surgeon of other states when called in consultation by a registered physician of this state, or to midwives, veterinary surgeons, osteopathic physicians or chiropractors not giving or using medicine in their practice or to opticians, optometrists, chiropodists or Christian Scientists.”

The 2019 amendment added (k).

The 2020 amendment, in (e)(1), substituted “prohibits” for “shall be construed to prohibit”, “federally-qualified” for “federally qualified” twice, inserted “or rural health clinic” twice and substituted “if” for “; provided, that”; and rewrote (e)(2), which read, “For the purposes of this subsection (e), the term “federally qualified health center” means such entities as defined under §§ 1861(aa) and 1905 of the federal Social Security Act (42 U.S.C. §§ 1395x and 1396d, respectively).” also redesignating former (e)(3) as present (e)(2)(b), deleting “For the purposes of this subsection (e)” from the beginning.

Effective Dates. Acts 2017, ch. 259, § 2. July 1, 2017.

Acts 2019, ch. 259, § 2. April 30, 2019.

Acts 2020, ch. 574, § 2. March 19, 2020.

Cross-References. Dentists, title 63, ch. 5.

Duties relating to known or suspected child sexual abuse, §§ 37-1-403, 37-1-605, 37-1-609.

Guidelines for treatment and examinations in workers' compensation cases, § 50-6-204.

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

Midwifery, title 63, ch. 29.

Nursing, title 63, ch. 7.

Opticians, title 63, ch. 14.

Optomestrists, title 63, ch. 8.

Osteopaths, title 63, ch. 9.

Physician assistants, title 63, ch. 19.

Podiatrists, title 63, ch. 3.

Veterinarians, title 63, ch. 12.

Textbooks. Tennessee Jurisprudence, 20 Tenn. Juris., Physicians and Surgeons, §§  4, 6.

Law Reviews.

Contracts — Murfreesboro Medical Clinic, P.A. v. Udom: Physician Noncompete Agreements Go Under the Knife: The Tennessee Supreme Court Rejects Physician Noncompete Agreements (Oscar Carr), 36 U. Mem. L. Rev. 1115 (2006).

Recent Developments in the Law Relating to the Physician's Assistant (A. M. Sadler, Jr. and B. L. Sadler), 24 Vand. L. Rev. 1193.

Attorney General Opinions. Employment of physician for corporate employees, OAG 94-009, 1994 Tenn. AG LEXIS 5 (1/28/94).

A physician or registered nurse may be a member of a professional limited liability company (PLLC) “for the practice of electrolysis” only if he or she holds a license to practice electrology; however, a medical doctor may be member of a PLLC for the practice of medicine and engage, in that capacity, in the practice of activities that would otherwise constitute the practice of electrology and may also employ a registered nurse who is not licensed as an electrologist to perform electrology services under the doctor's supervision and control, OAG 01-002, 2001 Tenn. AG LEXIS 4 (1/4/01).

Provision of medical services by a certified nurse practitioner, registered nurse, advanced practice nurse, licensed practical nurse or physician assistant, OAG 07-116, 2007 Tenn. AG LEXIS 116 (8/8/07).

NOTES TO DECISIONS

1. Acts Beyond Scope of License.

Any licensed chiropractor who, in the practice of his profession, engages in activities beyond the scope of those authorized in § 63-4-101 may be found to have invaded the field of medicine as defined in this section 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).

2. Cumulated Facts Proving Guilt.

Where, under an indictment, the state had proved several instances of the defendant's advising patients, prescribing for them, or administering medicine to them, the state will not be compelled to elect upon which one of several acts the conviction would be sought, because each several instance was not necessarily an offense. Payne v. State, 112 Tenn. 587, 79 S.W. 1025, 1903 Tenn. LEXIS 127 (1903).

A person who makes microscopic examinations of the blood taken from his patients in his diagnosis of their diseases, treats them by placing them under the rays of electric arc light, and also writes prescriptions and prescribes remedies, though no charge is made for prescriptions, is engaged in the practice of medicine. O'Neil v. State, 115 Tenn. 427, 90 S.W. 627, 1905 Tenn. LEXIS 78, 3 L.R.A. (n.s.) 762 (1905).

3. Definition of “Practicing.”

The term “practicing” indicates the pursuit of a profession; and the fact that defendant was pursuing such profession may be proved, in some cases, by proof of a single act, where that act is definite, or by proof of a series of acts of a similar nature. Payne v. State, 112 Tenn. 587, 79 S.W. 1025, 1903 Tenn. LEXIS 127 (1903); O'Neil v. State, 115 Tenn. 427, 90 S.W. 627, 1905 Tenn. LEXIS 78, 3 L.R.A. (n.s.) 762 (1905).

The field of doctors of medicine covers all human illnesses and diseases and their diagnosis, treatment and prevention. 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).

Since doctors of osteopathy and medical doctors did not generally attend the same medical colleges, did not generally receive internship training at the same hospitals and were not examined and licensed by a common medical examining board in Tennessee, the trustees of a public hospital had a legal right to accept only medical doctors as members of the medical staff to the exclusion of doctors of osteopathy and other practitioners who were not medical doctors. State ex rel. Carpenter v. Cox, 61 Tenn. App. 101, 453 S.W.2d 69, 1969 Tenn. App. LEXIS 354 (Tenn. Ct. App. 1969).

4. Corporate Practice of Medicine.

Physician was equitably estopped from alleging contract involved corporate practice of medicine after waiting ten years to raise the issue. Medical Educ. Assistance Corp. v. State, 19 S.W.3d 803, 1999 Tenn. App. LEXIS 824 (Tenn. Ct. App. 1999).

5. Covenants Not to Compete.

Covenants not to compete contained in an employment contract, although not favored in the law, are valid and enforceable if reasonable. Medical Educ. Assistance Corp. v. State, 19 S.W.3d 803, 1999 Tenn. App. LEXIS 824 (Tenn. Ct. App. 1999).

Applying the public policy considerations and special circumstances of Tennessee medical schools, under the facts of the case, the non-competition covenant was enforceable against physician. Medical Educ. Assistance Corp. v. State, 19 S.W.3d 803, 1999 Tenn. App. LEXIS 824 (Tenn. Ct. App. 1999).

Medical practice could not enforce a non-compete clause against the doctor because the restrictions in T.C.A. § 63-6-204 were inapplicable and policy considerations such as the right to freedome of choice in physicians, the right to an on-going relationship with a physician, and the benefits of having an increased number of physicians in any given community outweighed the business interests of the medical practice. Murfreesboro Med. Clinic, P.A. v. Udom, 166 S.W.3d 674, 2005 Tenn. LEXIS 608 (Tenn. 2005), superseded by statute as stated in, Cent. Ind. Podiatry, P.C. v. Krueger, 882 N.E.2d 723, 2008 Ind. LEXIS 203 (Ind. 2008), superseded by statute as stated in, Thomas v. Pediatrix Med. Group of Tenn., P.C., — S.W.3d —, 2010 Tenn. App. LEXIS 569 (Tenn. Ct. App. Sept. 14, 2010).

6. Nurse Practitioners.

Finding against a hospital in a spouse's medical-malpractice action was improper because hospital was not permitted to control the means and methods by which physicians rendered medical care and treatment to hospital patients, and also the nurse practitioner and emergency room physician with whom she consulted were not employees of the hospital; moreover, T.C.A. § 63-6-204(f)(1) and T.C.A. § 68-11-205(b)(6) precluded hospitals from employing emergency physicians and, like other nurse practitioners in Tennessee, the nurse practitioner at issue was authorized to render health care services without being under the omnipresent supervision or direction of a physician. Barkes v. River Park Hosp., Inc., — S.W.3d —, 2008 Tenn. App. LEXIS 780 (Tenn. Ct. App. Dec. 29, 2008), rev'd, 328 S.W.3d 829, 2010 Tenn. LEXIS 947 (Tenn. 2010).

63-6-205. Practice of naturopathy.

  1. It is unlawful for any person to practice naturopathy in this state.
  2. “Naturopathy” means nature cure or health by natural methods and is defined as the prevention, diagnosis and treatment of human injuries, ailments and disease by the use of such physical forces as air, light, water, vibration, heat, electricity, hydrotherapy, psychotherapy, dietetics or massage and the administration of botanical and biological drugs.
  3. In no event shall naturopathy mean the sale of herbs or natural health information exchanges provided as a service so long as:
    1. The sale or provision of information exchanges is not conducted for the purpose of the prevention, diagnosis or treatment of any physical ailment or physical injury to or deformity of another; and
    2. In any instance involving natural health information exchanges, the seller obtains a signed acknowledgement from the buyer that the seller is neither a licensed practitioner of the healing arts in this state, nor meets the recognized qualification criteria that would allow the provision of any form of diagnosis, treatment recommendation or medical care in this state. For the purposes of meeting the requirements of this section, the seller shall keep the signed acknowledgement from the buyer on file for a period of three (3) years.
  4. A violation of this section is a Class B misdemeanor.
  5. This section does not apply to persons who comply with the regulatory laws of the state with respect to the practice of the various healing arts.

Acts 1947, ch. 2, §§ 1, 2; mod. C. Supp. 1950, § 6940.1 (Williams, § 7025.4); T.C.A. (orig. ed.), § 63-609; Acts 1989, ch. 591, § 112; 2009, ch. 416, § 1; 2012, ch. 745, § 1.

Code Commission Notes.

Acts 2009, ch. 416, § 1, which added subsection (c), provided in subdivision (c)(2) that subsection (c) shall be repealed at midnight, June 30, 2012. Acts 2012, ch. 745, § 1, effective July 1, 2012, provided that subsection (c) is amended by deleting subdivision (c)(2) in its entirety. Pursuant to apparent legislative intent, subdivision (c)(1) has been retained, and subdivision (c)(2) has been deleted.

Compiler's Notes. Acts 2009, ch. 416, § 1 provided that subsection (c) shall be repealed at midnight, June 30, 2012.

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

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

Law Reviews.

Constitutional Law — Prohibition of Practice of Naturopathy as a Separate Branch of the Healing Arts, 1 Vand. L. Rev. 451.

NOTES TO DECISIONS

1. Constitutionality.

This act prohibiting practice of naturopathy is a valid exercise of the police power. Davis v. Beeler, 185 Tenn. 638, 207 S.W.2d 343, 1947 Tenn. LEXIS 369 (1947), appeal dismissed, 333 U.S. 859, 68 S. Ct. 745, 92 L. Ed. 1138, 1948 U.S. LEXIS 2375 (1948), dismissed, Young v. Murphy, 68 S. Ct. 745, 333 U.S. 863, 92 L. Ed. 1142, 1948 U.S. LEXIS 2398 (1948).

This act prohibiting practice of naturopathy is not a bill of attainder since loss of right to practice is not the result of punishment for some offense committed, but the result of failure to measure up to legislative requirements. Davis v. Beeler, 185 Tenn. 638, 207 S.W.2d 343, 1947 Tenn. LEXIS 369 (1947), appeal dismissed, 333 U.S. 859, 68 S. Ct. 745, 92 L. Ed. 1138, 1948 U.S. LEXIS 2375 (1948), dismissed, Young v. Murphy, 68 S. Ct. 745, 333 U.S. 863, 92 L. Ed. 1142, 1948 U.S. LEXIS 2398 (1948).

2. Legislative Intent.

The evident intent of the legislature was to withdraw recognition of naturopathy as a separate branch of the healing arts but allow the use of its methods. Davis v. Beeler, 185 Tenn. 638, 207 S.W.2d 343, 1947 Tenn. LEXIS 369 (1947), appeal dismissed, 333 U.S. 859, 68 S. Ct. 745, 92 L. Ed. 1138, 1948 U.S. LEXIS 2375 (1948), dismissed, Young v. Murphy, 68 S. Ct. 745, 333 U.S. 863, 92 L. Ed. 1142, 1948 U.S. LEXIS 2398 (1948).

This section merely required that persons desiring to practice naturopathy obtain a general practitioner's license or one to practice osteopathy. Davis v. Beeler, 185 Tenn. 638, 207 S.W.2d 343, 1947 Tenn. LEXIS 369 (1947), appeal dismissed, 333 U.S. 859, 68 S. Ct. 745, 92 L. Ed. 1138, 1948 U.S. LEXIS 2375 (1948), dismissed, Young v. Murphy, 68 S. Ct. 745, 333 U.S. 863, 92 L. Ed. 1142, 1948 U.S. LEXIS 2398 (1948).

63-6-206. Penalty for unlawful issuance of licenses.

  1. It is a Class B misdemeanor, and disqualifies for office, for the board to issue a license to any person except as prescribed in this chapter. Should the board be so disqualified, the governor shall appoint a new board in full as provided in this chapter.
  2. In no event shall the negligent issuance of a license result in criminal prosecution under this chapter.

Acts 1901, ch. 78, § 22; Shan., § 3609a36; mod. Code 1932, § 6940; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 6940; T.C.A. (orig. ed.), § 63-610; Acts 1984, ch. 937, § 29; 1989, ch. 591, § 112; 1993, ch. 404, § 7.

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

63-6-207. Application for certificate — Special training licenses — St. Jude Children's Research Hospital global collaboration license.

  1. A person desiring to practice medicine or surgery in this state shall make application in writing to the board or via online application, which shall be accompanied by:
    1. If a United States or Canadian medical school graduate:
      1. A certificate from a medical school whose curriculum is approved by the American Medical Association or its extant accreditation program for medical education, or its successor;
      2. A nonrefundable application fee as set by the board and by an examination fee prescribed in this section;
      3. Evidence of the satisfactory completion of:
        1. A one-year United States training program approved by the American Medical Association or its extant accreditation program for medical education, or its successor; or
        2. A primary specialty training program that is accredited by the Royal College of Physicians and Surgeons of Canada and that is of a duration of not less than four (4) years;
      4. Sufficient evidence of good moral character; and
      5. Evidence of being legally entitled to live or work in the United States if the person is not a citizen of the United States or Canada;
    2. If an international medical school graduate:
      1. A certificate from a medical school whose curriculum is judged to be acceptable by the board;
      2. A copy of a permanent Educational Commission for Foreign Medical Graduates (ECFMG) certificate;
      3. A nonrefundable application fee as set by the board and by an examination fee prescribed in this section;
      4. Sufficient evidence of good moral character;
      5. Evidence of being a citizen of the United States or Canada, or legally entitled to live or work in the United States; and
      6. Evidence of satisfactory completion of a three-year residency program approved by the American Medical Association or its extant accreditation program for medical education, or its successor. Such person may apply to the board for licensure and/or testing in accordance with this chapter within twelve (12) months of completion of the residency program if satisfactory performance in such residency is demonstrated to the satisfaction of the board.
  2. All applicants shall present themselves before the board or the board's administrative designee for examination. The board may question in such subjects as the board may deem appropriate. As its qualifying examination, the board accepts the Federation Licensing Examination (FLEX), and/or the National Board of Medical Examiners examination and/or the United States Medical Licensing Examination or its successor examination. Applicants shall successfully complete the United States Medical Licensing Examination within ten (10) years from the date of whichever step of the examination was successfully completed first. An applicant is considered to have successfully completed a step of the examination on the date that the step was taken and not the date on which the passing score was made public by the examination agency; provided, however, that the board is authorized to promulgate rules and regulations creating exceptions that will extend the ten-year time frame provided in this subsection (b). In addition, the board reserves the right to write its own state board examination or contract with other national testing organizations. The board reserves the right to designate its administrative staff to administer the licensing examinations and to collect such application and examination fees as the board, in its discretion, may deem necessary.
  3. The members of the board also have the right to examine all applicants in such oral examinations as they may deem necessary.
  4. The board is authorized in its discretion to issue special training licenses to medical interns, residents and fellows who have met all other qualifications for licensure contained in this chapter and the rules and regulations promulgated pursuant thereto, with the exception of having completed the necessary residency or training programs required by subdivision (a)(1)(C) and/or (a)(2)(F) and the licensure examination. The board also is authorized to promulgate rules and regulations to implement this new licensure category. The initial set of these rules may be processed as emergency rules pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. These special training licenses will be governed by the following:
      1. Such licenses shall be issued only to medical interns, residents and fellows while participating in a training program of one of the accredited medical schools or of one of such medical school's affiliated teaching hospitals in Tennessee, performing duties assigned to meet the requirements of such program, and while under the supervision and control of a physician fully licensed to practice medicine in Tennessee;
      2. No person holding a special training license is permitted to practice medicine outside of such person's duties and responsibilities in the training program without being fully licensed to practice medicine in Tennessee. Termination of participation in the training program for which the special license was issued for any reason terminates that license;
      3. It is the responsibility of the program director or the dean responsible for the training program to submit the necessary information and applications on behalf of each applicant. It also is the responsibility of the program director or the dean to notify the board of the termination of the applicant's participation in the training program, whether by completion of the program or for any other reason;
      4. The board may impose fees to accompany each individual application for a special training license; and
      5. Recipients of the special training license shall not be subject to the occupational tax levied by § 67-4-1702(3)(B);
        1. Notwithstanding subdivision (d)(1), medical students, interns, residents, and clinical fellows who do not hold a special training license pursuant to this subsection (d) are exempt from the requirement of a license to practice medicine or surgery in this state when such medical students, interns, residents, and clinical fellows are participating in a training program of one (1) of the accredited medical schools or of one (1) of its affiliated teaching hospitals in this state, performing duties assigned to meet the requirements of the training program, and while under the supervision and control of a physician fully licensed to practice medicine or surgery in this state. No such student, intern, resident, or clinical fellow is permitted to practice medicine or surgery outside of the person's duties and responsibilities in the training program without being fully licensed to practice medicine or surgery in this state;
        2. It is the responsibility of the program director or the dean responsible for the training program to apply to the board for an exemption for each such medical student, intern, resident, or clinical fellow. Moreover, it is the responsibility of such program director or dean to notify the board of the termination of the applicant's participation in the training program, whether by completion of the program or for any other reason;
      1. The board may impose a fee to accompany each application for exemption;
      2. Eligibility for the exemption provided for in this subdivision (d)(2) shall apply to all eligible persons in training on April 8, 1994, or thereafter.
  5. The board or the board's designee is specifically authorized to conduct applicant interviews periodically as it deems necessary on a case by case basis.
      1. The general assembly finds that St. Jude Children's Research Hospital is unique as a research center hospital in this state and this nation for protocol-based therapy and treatment of children and adolescents with newly diagnosed untreated or suspected cancer, HIV infections, or certain hematologic, immunologic, or genetic diseases. St. Jude Children's Research Hospital's experts are involved in research and treatment in the fields of hematology, oncology, bone marrow transplantation, immunology, genetic diseases and infectious diseases. The hospital's research involves both basic and clinical science and it is a National Cancer Institute Comprehensive Cancer Center. The general assembly finds that supporting research and treatment by qualified physicians and researchers at St. Jude Children's Research Hospital by means of a special St. Jude Children's Research Hospital global collaboration license would substantially benefit the state, the practice of medicine and the health of persons benefitting from treatment or research conducted at the hospital.
      2. The board is authorized in its discretion to issue a special St. Jude Children's Research Hospital global collaboration license to physicians who have met all other qualifications for licensure contained in this chapter and the rules and regulation promulgated pursuant to this chapter, with the exception of having completed the necessary residency or training programs required by subdivision (a)(1)(C) or (a)(2)(F). The board is also authorized to promulgate rules and regulations to implement this new special licensure category.
    1. These special St. Jude Children's Research Hospital global collaboration licenses will be governed by the following:
      1. Such license shall be issued only to physicians while employed by St. Jude Children's Research Hospital;
      2. No person holding a special St. Jude Children's Research Hospital global collaboration license is permitted to practice medicine outside of such person's duties and responsibilities as an employee of St. Jude Children's Hospital without being fully licensed to practice medicine in Tennessee. Termination of employment with St. Jude Children's Research Hospital for any reason terminates the special license;
      3. It is the responsibility of St. Jude Children's Research Hospital to submit the necessary information and applications on behalf of each applicant. It is also the responsibility of St. Jude Children's Research Hospital to notify the board of the termination of the applicant's employment; and
      4. The board may impose fees to accompany each individual application for this special license.
  6. The board may issue a temporary license of limited duration to an international medical school graduate with demonstrated competency. A temporary license may be issued by the board in its discretion as special circumstances may require. The board may promulgate rules prescribing any other conditions or requirements with respect to the issuance of a temporary license pursuant to this subsection (g).
  7. The board is authorized in its discretion to issue limited licenses to physicians who have been out of clinical practice for an extended period of time or who have been, or are at the time of their application, engaged exclusively in administrative medicine. The board may promulgate rules prescribing any other conditions or requirements with respect to the issuance of a limited license pursuant to this subsection (h).

Acts 1901, ch. 78, § 6; Shan., § 3609a18; Code 1932, § 6923; Acts 1945, ch. 181, § 3; C. Supp. 1950, § 6923; Acts 1975, ch. 355, § 14; impl. am. Acts 1976, ch. 575, § 1; T.C.A. (orig. ed.), § 63-611; Acts 1982, ch. 905, § 4; 1985, ch. 468, §§ 1, 2; 1988, ch. 912, § 1; 1989, ch. 302, § 1; 1989, ch. 523, §§ 41, 42; 1990, ch. 1002, § 1; 1990, ch. 1055, §§ 1, 3; 1993, ch. 404, § 8; 1994, ch. 732, § 2; 1995, ch. 97, §§ 1-3; 1995, ch. 329, § 1; 1998, ch. 877, § 1; 2003, ch. 11, § 1; 2004, ch. 562, § 1; 2006, ch. 774, §§ 1, 2; 2009, ch. 566, § 12; 2010, ch. 724, § 1; 2010, ch. 976, § 1; 2014, ch. 949, § 6; 2016, ch. 632, § 1; 2016, ch. 1035, §§ 1-7.

Compiler's Notes. 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.

Acts 2016, ch. 1035, § 8 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.

Law Reviews.

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

NOTES TO DECISIONS

1. Licensure Exemption.

Doctor, who was permitted to practice medicine in Tennessee under a statutory licensure exemption but was not licensed to practice medicine in Tennessee or a contiguous state during the year before the date of the alleged injury or wrongful conduct, did not meet the statutory requirements to testify as an expert witness in a health care liability action because, although the doctor was exempt from the licensure requirement during his fellowship at a university, the licensure exemption did not eliminate the license requirement. Young v. Frist Cardiology, PLLC, 599 S.W.3d 568, 2020 Tenn. LEXIS 148 (Tenn. Apr. 20, 2020).

63-6-208. Exemption for physician for visiting sports team.

  1. A physician who is duly qualified to practice medicine under the laws of another state is exempt from the licensure requirements of § 63-6-201, subject to this section, if either of the following applies:
    1. The physician has a written or oral agreement with a sports team to provide care to team members and coaching staff traveling with the team for a specific sporting event to take place in this state; or
    2. The physician has been invited by a national sport governing body to provide services to athletes and coaching staff at a national sport training center in this state or to provide services to athletes and coaching staff at an event or competition in this state that is sanctioned by the national sport governing body.
  2. The exemption provided by this section only applies while:
    1. The physician's practice is limited to that required by the team or the national sport governing body; and
    2. The services provided by the physician are within the physician's scope of practice.
  3. The exemption provided by subsection (a) permits a physician to provide care or consultation to a person specified in subsection (a). Nothing in this section permits a physician exempt by this section to:
    1. Provide care or consultation to any person residing in this state other than a person specified in subsection (a); or
    2. Practice at a licensed healthcare facility in this state.
  4. An exemption pursuant to subdivision (a)(1) is valid while the physician is traveling with the sports team, subject to the following:
    1. The exemption shall not be longer than ten (10) days in duration for each respective sporting event without prior authorization from the board of medical examiners;
    2. The board of medical examiners may grant an extension of not more than twenty (20) additional days per sporting event; and
    3. No physician shall be exempt for more than thirty (30) total days in a calendar year.
  5. An exemption pursuant to subdivision (a)(2) is valid during the time certified by the national sport governing body; however, no physician shall be exempt for more than thirty (30) total days in a calendar year.
  6. No physician exempt pursuant to this section shall dispense or administer controlled substances unless:
    1. The patient to whom the controlled substance is administered or dispensed is over eighteen (18) years of age and is a person described in subdivision (a)(1) or (a)(2); and
    2. The physician reports all controlled substances dispensed or administered to any applicable state controlled substance database in the physician's state of licensure.
  7. For purposes of this section, “sports team” means a professional, semi-professional, or amateur team including, but not limited to, a college, high school, grade school, or non-school affiliated team, such as those associated with the Amateur Athletic Union (AAU).
  8. The board of medical examiners may enter into agreements with medical licensing boards of other states to implement this section. Agreements may include procedures for reporting potential medical license violations.
  9. The board of medical examiners may 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. 329, § 2.

Compiler's Notes. Former § 63-6-208 (Acts 1901, ch. 78, § 7; Shan., § 3609a20; Code 1932, § 6925; Acts 1945, ch. 181, § 5; C. Supp. 1950, § 6925; T.C.A. (orig. ed.), § 63-612; Acts 1982, ch. 905, § 5; 1984, ch. 937, § 30; 1989, ch. 523, § 43), concerning examinations of applicants for medical licenses, was repealed by Acts 1993, ch. 404, § 9, effective May 19, 1993.

Acts 2017, ch. 329, § 1 provided that the act, which enacted this section, shall be known and may be cited as the  “Visiting Sports Team Act.”

Effective Dates. Acts 2017, ch. 329, § 4. January 1, 2018; provided, that for the purpose of promulgating rules, the act took effect May 9, 2017.

63-6-209. Issue of licenses.

  1. Licenses shall be issued promptly by the division as directed by the board after the board determines that an applicant has met all licensure criteria or qualifications and successfully passed the examination. The board shall also issue to such applicant a certificate of registration signed by the administrator of the health related boards, which certificate shall recite that the person is duly registered for the years specified.
  2. The board also has the authority to issue locum tenens and/or conditional licenses as it deems appropriate after reviewing the qualifications of applicants. In addition to the authority granted the board in § 63-6-214, the board has the authority to issue restricted licenses and special licenses based upon licensure to another state for the limited purpose of authorizing the practice of telemedicine to current applicants or current licensees, or both, as it deems necessary, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  3. Any certificate of registration issued by the board shall contain the name of the person to whom it is issued, the address of the person, the date and number of the license and such other information as the board deems necessary. The address contained on this certificate of registration shall be the address of the licensee where all correspondence and renewal forms from the board shall be sent during the two (2) years for which the certificate of registration has been issued and shall be the address deemed sufficient for purposes of service of process.
  4. Any licensee whose address changes from the address contained on the registration certificate shall, within thirty (30) days thereafter, notify the board of the address change.

Acts 1901, ch. 78, § 11; Shan., § 3609a24; Code 1932, § 6928; Acts 1945, ch. 181, § 6; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 6928; Acts 1953, ch. 113, § 15; 1961, ch. 114, § 1; 1972, ch. 587, § 1; T.C.A. (orig. ed.), § 63-613; Acts 1984, ch. 937, § 31; 1985, ch. 48, § 1; T.C.A., § 63-6-210(a); Acts 1993, ch. 404, § 10; 1996, ch. 1043, § 3.

Cross-References. Issuance of licenses, §  63-1-104.

NOTES TO DECISIONS

1. Service.

Tennessee Department of Health properly obtained service by mail under the Rules of Procedure for Contested Cases of the Rules of the Secretary of State because service by certified mail was sufficient despite the Department's failure to obtain a return receipt signed by the doctor. Wyttenbach v. Bd. of Tenn. Med. Examiners, — S.W.3d —, 2016 Tenn. App. LEXIS 192 (Tenn. Ct. App. Mar. 15, 2016), appeal denied, Wyttenbach v. Bd. of TN Med. Examiners, — S.W.3d —, 2016 Tenn. LEXIS 674 (Tenn. Sept. 23, 2016).

2. Due Process.

Tennessee Department of Health satisfied due process because the steps it took were reasonably calculated to apprise the doctor of the charges against him and of the hearing at which his medical license was revoked; the Department advised the doctor of the alleged conduct that warranted action against his license and provided him with an opportunity to show compliance and mailed the notice of the alleged conduct to the doctor at the address shown on his last license renewal application. Wyttenbach v. Bd. of Tenn. Med. Examiners, — S.W.3d —, 2016 Tenn. App. LEXIS 192 (Tenn. Ct. App. Mar. 15, 2016), appeal denied, Wyttenbach v. Bd. of TN Med. Examiners, — S.W.3d —, 2016 Tenn. LEXIS 674 (Tenn. Sept. 23, 2016).

63-6-210. Renewal of licenses — Retirement — Inactive status — Comparison and sharing of information with the Tennessee Medical Association

  1. Each person licensed to practice medicine in this state shall, pursuant to the renewal system established in subsection (b), biennially apply to the board for a renewal of licensure and shall pay a renewal fee as set by the board. Each application shall be made on a form to be furnished by the board and sent to the licensee well in advance of the scheduled renewal date. The board shall, in its discretion, absent receipt of derogatory information, renew licensure upon application made in due form and upon payment of all required fees and shall issue a new biennial registration certificate.
    1. There is hereby authorized the establishment of 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 this renewal system are valid for twenty-four (24) months and shall expire on the last day of the last month of the license period. However, during any 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, 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 any renewal system for a period of other than twenty-four (24) months shall be proportionate to the biennial 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. A licensee may renew a license within sixty (60) days following the license expiration date upon payment of the renewal fee in addition to a late penalty established by the board for each month or fraction of a month that payment for renewal is late; provided that the late penalty shall not exceed twice the renewal fee. When any licensee fails to renew a license and pay the biennial renewal fee within sixty (60) days after renewal becomes due, as provided in this section, the license shall be automatically revoked at the expiration of sixty (60) days after the renewal was required without further notice or hearing.
  2. Any licensee whose license is automatically revoked as provided in subsection (b), may apply in writing to the board for reinstatement of such license, which may be granted by the board upon the payment of all past due fees and reinstatement fees established by the board, and upon further conditions as the board may require.
  3. Any person licensed to practice by this chapter who has retired or may hereafter retire from practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit of retirement form furnished by the board. The affidavit shall state the date on which the person retired from practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If the person thereafter wishes to reenter practice in this state, the person shall apply for licensure reactivation with the board, pay a reactivation fee as set by the board and shall meet such other reasonable requirements as may be deemed necessary by the board.
  4. The board shall have the authority to create a renewable inactive licensure status as it deems appropriate upon payment of an appropriate fee assessment and compliance with the requirements established by the board for those licensees who actively practice medicine in a state other than Tennessee.
  5. In order to ensure that the board has the most recent and accurate data on licensees and applicants for licensure within this state, the board shall cooperate with the Tennessee Medical Association by comparing and sharing computer data bases and other physician identification file information, including, without limitation, license numbers, medical education numbers, social security numbers, home and business address information and any other data of a similar, nonconfidential nature, for a reasonable charge.

Acts 1901, ch. 78, § 8; Shan., § 3609a21; mod. Code 1932, § 6926; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 6926; Acts 1976, ch. 473, § 1; T.C.A. (orig. ed.), § 63-614; Acts 1984, ch. 937, § 32; 1986, ch. 675, § 5; 1989, ch. 360, §§ 23, 24; 1989, ch. 523, §§ 44, 45; 1993, ch. 404, § 11; 1996, ch. 1043, § 4; 2010, ch. 1043, § 9.

Compiler's Notes. Former § 63-6-210(a) was transferred to § 63-6-209 in 1986.

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

License renewals, §  63-1-107.

Retirement, §  63-1-111.

NOTES TO DECISIONS

1. Revocation.

Tennessee Board of Medical Examiners had authority to revoke a doctor's retired medical license because the doctor still possessed a medical license and remained a licensee when the notice of charges was filed; the statute granting the Board authority to suspend or revoke licenses does not limit that authority based on the current status of a license. Wyttenbach v. Bd. of Tenn. Med. Examiners, — S.W.3d —, 2016 Tenn. App. LEXIS 192 (Tenn. Ct. App. Mar. 15, 2016), appeal denied, Wyttenbach v. Bd. of TN Med. Examiners, — S.W.3d —, 2016 Tenn. LEXIS 674 (Tenn. Sept. 23, 2016).

Reinstatement statute does not distinguish between a physician whose license has been automatically revoked and who has engaged in objectionable behavior prior to the automatic revocation and a physician who has merely lost track of time and neglected to apply for a license renewal within sixty days of the license's expiration date; in both cases, the physician's license has been automatically revoked, and in both cases, the physician is able to apply for reinstatement. Oni v. Tenn. Dep't of Health, — S.W.3d —, 2016 Tenn. App. LEXIS 607 (Tenn. Ct. App. Aug. 23, 2016), appeal denied, — S.W.3d —, 2016 Tenn. LEXIS 971 (Tenn. Dec. 14, 2016).

Physicians whose license have been automatically revoked and who have engaged in objectionable behavior prior to the automatic revocation and physicians who have merely lost track of time and neglected to apply for a license renewal within sixty days of the license's expiration date are “licensees” even after their licenses are automatically revoked; if the Board permanently revokes a physician's license for cause, however, that physician will not have the opportunity to apply for reinstatement Oni v. Tenn. Dep't of Health, — S.W.3d —, 2016 Tenn. App. LEXIS 607 (Tenn. Ct. App. Aug. 23, 2016), appeal denied, — S.W.3d —, 2016 Tenn. LEXIS 971 (Tenn. Dec. 14, 2016).

63-6-211. Licensure of out-of-state and international applicants.

  1. The board is authorized to accept the certificates of licensure from other states as long as the applicant's certificates and qualifications meet or exceed the requirements set forth in § 63-6-207 and the rules promulgated pursuant thereto.
  2. The board is likewise authorized to accept certificates of license from other states or countries and grant licenses to practice medicine in Tennessee to individuals who, at the sole discretion of the board based upon its examination and evaluation of such individuals' credentials, qualifications and reputation within the medical community, qualify as distinguished faculty members at a rank of full professor and upon application and payment of a nonrefundable licensure fee as determined by the board. This type of license shall authorize the practice of medicine in conjunction with a faculty appointment and shall automatically expire at any time the licensee fails to maintain a full-time appointment. The board shall retain the sole discretionary authority to grant or deny annual renewal of such licenses. To be considered for licensure pursuant to this subsection (b), an individual must meet each of the following minimum criteria:
    1. Possess a degree of doctor of medicine or its equivalent;
    2. Have a full-time appointment at professorial rank at an accredited college of medicine in Tennessee;
    3. Have current membership in good standing in medical specialty societies that have restricted and selective membership;
    4. Have been invited to be a lecturer or visiting professor at medical educational institutions either abroad or within the United States;
    5. Have delivered scholarly medical papers before national or international meetings; and
    6. Possess letters of support from the dean of the appointing college of medicine and its appropriate department chairs, as well as from academic colleagues from outside of Tennessee attesting to the individual's distinguished status.
  3. For purposes of enforcing federal immigration laws which relate to the licensure of foreign physicians in this state, the board of medical examiners shall enter into a written agreement, in accordance with federal and other applicable law, between the board and the United States department of homeland security concerning the enforcement of federal immigration laws, which may include participation in the federal systematic alien verification of entitlements program, referred to as the “SAVE program,” and its verification information system, operated by the United States department of homeland security or a successor program designated by the United States department of homeland security or any additional certifying agent within the department or approved by the department.

Acts 1907, ch. 543, § 3; Shan., § 3609a19; Code 1932, § 6924; Acts 1945, ch. 181, § 4; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 6924; Acts 1953, ch. 113, § 14; 1961, ch. 114, § 2; 1972, ch. 587, § 2; T.C.A. (orig. ed.), § 63-615; Acts 1989, ch. 523, §§ 46, 47; 1991, ch. 429, § 1; 1993, ch. 404, § 12; 1994, ch. 732, § 4; 2010, ch. 1122, § 1.

63-6-212. Records.

The board shall keep a record of their proceedings in a book provided for that purpose, which book shall be open for inspection and shall record the name of each applicant, the time of granting a license and the names of the members of the board present. Where a license is denied by the board to any applicant under authority of this chapter, the fact and ground of such denial shall be entered on the minutes of the board and shall be communicated in writing to such applicant.

Acts 1901, ch. 78, § 10; Shan., § 3609a23; Code 1932, § 6927; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 6927; T.C.A. (orig. ed.), § 63-616; Acts 1984, ch. 937, § 33.

63-6-213. Investigation and prosecution of violations — Injunctions — Contested cases.

  1. The members of the board shall investigate any supposed violation of this chapter and report to the proper district attorney general all the cases that in the judgment of such member or members warrant prosecution.
  2. It is the duty of the district attorneys general to prosecute violators of this chapter.
    1. The board may, through the department of health's general counsel, petition any circuit or chancery court having jurisdiction over any person within this state who is practicing medicine without a license or in violation of a restriction or condition placed upon a license, regardless of whether such practice resulted from a license being restricted, conditioned, denied, or because a license has been suspended or revoked by action of the board, or any other reason, to enjoin such person from conducting or continuing to conduct the unlawful practice of medicine 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 are authorized to exercise full and complete jurisdiction in these injunctive proceedings. 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 criminal penalties.
  3. The board shall retain rulemaking authority to adjust the administration of its contested case docket in order to provide for the efficient and orderly disposition of contested cases. This authority may include rulemaking for the setting of reasonable limitations on deadlines for case settlements, and whether several contested cases are set on each meeting's docket of business.

Acts 1901, ch. 78, § 21; Shan., § 3609a35; mod. Code 1932, § 6939; Acts 1945, ch. 181, § 11; C. Supp. 1950, § 6939; T.C.A. (orig. ed.), § 63-617; Acts 1996, ch. 1043, § 5.

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

Law Reviews.

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

63-6-214. Grounds for license denial, suspension or revocation — Reporting misconduct.

  1. The board has the power to:
    1. Deny an application for a license to any applicant who applies for the same through reciprocity or otherwise;
    2. Permanently or temporarily withhold issuance of a license;
    3. Suspend, or limit or restrict a previously issued license for such time and in such manner as the board may determine;
    4. Reprimand or take such action in relation to disciplining an applicant or licensee, including, but not limited to, informal settlements, private censures and warnings, as the board in its discretion may deem proper; or
    5. Permanently revoke a license.
  2. The grounds upon which the board shall exercise such power include, but are not limited to:
    1. Unprofessional, dishonorable or unethical conduct;
    2. Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate any provision of this chapter or, any lawful order of the board issued pursuant thereto or any criminal statute of this state;
    3. Making false statements or representations, being guilty of fraud or deceit in obtaining admission to practice or being guilty of fraud or deceit in the practice of medicine;
    4. Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of medical practice;
    5. Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice medicine;
    6. Violation of the laws governing abortion;
    7. Willfully betraying a professional secret;
    8. The advertising of medical business in which untrue or misleading statements are made or causing the publication or circulation of fraudulent advertising relative to any disease, human ailment or conditions;
    9. Willful violation of the rules and regulations promulgated by the board of medical examiners to regulate advertising by practitioners who are under the jurisdiction of such board;
    10. Conviction of a felony, conviction of any offense under state or federal laws relative to drugs or the practice of medicine, conviction of any offense involving moral turpitude or conviction of any offense for which the person is required to register as a sexual offender or violent sexual offender pursuant to title 40, chapter 39, part 2;
    11. 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;
    12. 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, or in amounts and/or for durations not medically necessary, advisable or justified for a diagnosed condition;
    13. Dispensing, prescribing or otherwise distributing to any person a controlled substance or other drug if such person is addicted to the habit of using controlled substances without making a bona fide effort to cure the habit of such patient;
    14. Dispensing, prescribing or otherwise distributing any controlled substance, controlled substance analogue or other drug to any person in violation of any law of the state or of the United States;
    15. Offering, undertaking or agreeing to cure or treat a disease, injury, ailment or infirmity by a secret means, method, device or instrumentality;
    16. Giving or receiving, or aiding or abetting the giving or receiving, of rebates, either directly or indirectly;
    17. Engaging in the practice of medicine under a false or assumed name, or the impersonation of another practitioner, or a like, similar or different name;
    18. Engaging in the practice of medicine when mentally or physically unable to safely do so;
    19. Using radiation in the treatment of any noncancerous disease, disorder or condition of the skin without first adequately warning the patient of the extent of any known risk of cancer associated with such treatment or repetition of such treatment. Receipt of such advance warning shall be acknowledged by signature of the patient or, in the case of a minor, the patient's parent or guardian and shall be retained by the physician for the period prescribed by the board;
    20. Disciplinary action against a person licensed to practice medicine by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order or other equivalent document memorializing the disciplinary action from the disciplining state or territory shall constitute prima facie evidence of violation of this section and be sufficient grounds upon which to deny, restrict or condition licensure or renewal and/or discipline a person licensed in this state;
      1. Transferring of patient medical information to a person in another state who is not licensed to practice medicine or osteopathy in the state of Tennessee using any electronic, telephonic or fiber optic means or by any other method if such information is employed to diagnose and/or treat persons physically located within the state of Tennessee;
      2. Notwithstanding the provision of subdivision (b)(21)(A), the transfer of such information shall not be prohibited if such information is:
        1. To be used for a second opinion requested by a Tennessee licensed medical doctor or osteopathic physician;
        2. To be used by an out-of-state physician for treatment of a person who is seeking treatment out of Tennessee;
        3. Used to determine if such patient is covered by insurance;
        4. Used by a physician in another state to provide occasional academic consultations to a medical school located in Tennessee;
        5. Used by insurance or related companies for risk evaluation, utilization review, claims processing and/or evaluation of claimants' rehabilitation, including establishing and administering rehabilitation plans. The establishing and administering of such rehabilitation plans shall not include the diagnosis and/or treatment of persons physically located within Tennessee as prohibited by subdivision (b)(21)(A); or
        6. Used in clinical trials for drugs approved by the food and drug administration;
      3. This subdivision (b)(21) does not apply to research hospitals, as defined in § 63-6-204(f)(7)(I);
      4. This subdivision (b)(21) only applies to X-rays and medical imaging; and
    21. No person licensed in this state to practice medicine shall agree or contract with any clinical, bioanalytical or hospital laboratory, wherever located, to pay such laboratory for anatomic pathology services or cytology services and thereafter include such costs in the bill or statement submitted to the patient or any entity or person for payment, unless the practitioner is in compliance with the requirements of § 56-7-1015(g) and discloses on the bill or statement or in writing by a separate disclosure statement in a minimum print size of ten (10) font the name and address of the laboratory and the net amount or amounts paid or to be paid to the laboratory for the anatomic pathology services or cytology services. This subdivision (b)(22) shall not apply to the state or any local government.
  3. In enforcing 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 is involved. The applicant or licensee may have an independent medical practitioner present during such examination, and the applicant may have an independent physical or mental examination, which examination report shall be filed with the board for consideration. The committee will submit a report of its findings to the board, which will then hold a hearing as provided in § 63-6-216.
  4. The board, on its own motion, may investigate any report indicating that a doctor of medicine is or may be in violation of subsection (b). Any doctor of medicine, any medical society or any other person who in good faith reports to the board any information that a doctor of medicine is or may be in violation of subsection (b) shall not be subject to suit for civil damages as a result thereof.
  5. Within thirty (30) days after the conviction of a person known to be a physician, licensed or otherwise lawfully practicing within this state or applying to be so licensed or to practice, of a felony under the laws of this state, the clerk of the court of record in which the conviction was entered shall prepare and forward to the board a certified true and correct abstract of record of the court governing the case. The abstract shall include the name and address of the physician or applicant, the nature of the offense committed, the sentence and the judgment of the court. The board shall prepare the form of the abstract and shall distribute copies thereof to all clerks of courts of record within this state with appropriate instruction for preparation and filing.
  6. The board shall report within sixty (60) days its action regarding restriction, suspension or revocation of a physician's license, limitation on practice privileges or other disciplinary action of the board against any physician to appropriate federal and state agencies. The board may report any of the above-mentioned disciplinary actions to the Federation of State Medical Boards of the United States and the Tennessee Medical Association.
  7. For purposes of actions taken pursuant to subdivisions (b)(4), (12) and (13) or any other subsection in which the standard of care is an issue, any Tennessee licensed physician serving as a board member, hearing officer, designee, arbitrator or mediator is entitled to rely upon that person's own expertise in making determinations concerning the standard of care and is not subject to voir dire concerning such expertise. Expert testimony is not necessary to establish the standard of care. The standard of care for such actions is a statewide standard of minimal competency and practice that does not depend upon expert testimony for its establishment. However, to sustain actions based upon a violation of this standard of care, the board must, in the absence of admissions or other testimony by any respondent or such respondent's agent to the effect that the standard was violated, articulate what the standard of care is in its deliberations. Title 29, chapter 26, and specifically § 29-26-115, concerning the locality rule, do not apply to actions taken pursuant to this chapter.
    1. All materials, documents and other matters relating to, compiled or created pursuant to an investigation conducted by the board's investigators against any health care practitioner under the board's jurisdiction, shall be exempt from the public records act until the filing of a notice of charges. After the filing of a notice of charges, only the information and those materials and documents upon which the charges are based are available for disclosure under the public records act; provided, that the identifying information of the following, as well as all investigator created documents and reports, shall remain confidential at all times unless and until introduced in the proceedings:
      1. A complainant;
      2. Any witness who requests anonymity;
      3. A patient; and
      4. Medical records.
    2. 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, part 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 of 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 physicians, 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, to the extent required by subdivision (h)(2), 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.
  8. Notwithstanding any provision of the Uniform Administrative Procedures Act, to the contrary, hearing officers are authorized to and may hear board mediation, arbitration or disciplinary contested cases, but may not issue final orders in contested case matters. Notwithstanding any of the provisions of §§ 4-5-314 and 4-5-315 which may be or are inconsistent, such hearing officers may only issue findings of fact and conclusions of law, which shall be referred directly to the board or a duly constituted panel thereof for final action. The board or duly constituted panel, after hearing testimony and arguments from both parties regarding the appropriate disciplinary action and, if allowed by the board, arguments on any controversy raised by the hearing officer's or designee's order, shall issue a final order to include the imposition of what, if any, disciplinary action is deemed appropriate. Only the board or a duly constituted panel thereof shall have the authority to issue final orders that dispose of a pending contested case regardless of whether the issues resulting in the dispositive action are procedural, substantive, factual or legal. If a hearing officer is not available when a contested case, or any motion filed therein requiring action, is ready and scheduled to be heard or fails to timely prepare findings and conclusions pursuant to board established guidelines, the board or a duly constituted panel thereof may rule on the motions and/or hear the contested case or utilize the record compiled before the hearing officers and prepare its own findings of fact, conclusions of law and then issue a final order. With regard to findings and conclusions issued by the hearing officer, or any mediator or arbitrator, the board or any duly constituted panel thereof that reviews the case may do any of the following:
    1. Adopt the hearing officer's, mediator's or arbitrator's findings of fact and conclusions of law, in whole or in part;
    2. Make its own findings of fact and conclusions of law, based solely on the record and the expertise of the members of the board or panel, in addition to or in substitution of those made by the hearing officer, mediator or arbitrator;
    3. Remand the matter back to the hearing officer, mediator or arbitrator for action consistent with the board or panel findings and conclusions in the matter; or
    4. Reverse the hearing officer's, mediator's or arbitrator's findings and/or dismiss the matter entirely.
  9. 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.
  10. 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.
  11. Notwithstanding any provision of this chapter or chapter 9 of this title, or any rule or regulation promulgated thereto to the contrary, it shall not be a violation for a physician or osteopathic physician to prescribe, order, sell or otherwise distribute the Schedule IV drugs fenfluramine, its salts and isomers, and salts of isomers and phentermine, for their currently accepted medical use in the United States.
  12. Notwithstanding any provision of this chapter or chapter 9 of this title, or any rule or regulation promulgated thereto to the contrary, whenever a physician is treating obesity in a child who is under eighteen (18) years of age with Schedule IV drugs fenfluramine, its salts and isomers, and salts of isomers and phentermine, the physician shall:
    1. Obtain the consent of the child's parent or guardian; and
    2. Determine that the child's body mass index (BMI) is at least twenty-seven (27), or is at least twenty-five (25) with co-morbidities, including, but not limited to:
      1. Diabetes;
      2. Hypertension;
      3. Dyslipidemia;
      4. Cardiovascular diseases; and
      5. Sleep apnea.
  13. It is not a violation of this chapter or chapter 9 of this title for a physician or osteopathic physician to prescribe, order, or otherwise distribute, for the purpose of treating binge eating disorder, a drug which is approved by the federal food and drug administration for that indication.

Acts 1901, ch. 78, § 15; Shan., § 3609a29; Acts 1917, ch. 13, § 1; Code 1932, § 6932; Acts 1939, ch. 66, § 1; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 6932; Acts 1975, ch. 355, § 15; 1976, ch. 630, §§ 1, 2; 1979, ch. 129, §§ 1, 2, 3; 1980, ch. 605, § 3; T.C.A. (orig. ed.), § 63-618; Acts 1993, ch. 206, § 1; 1994, ch. 732, § 3; 1995, ch. 329, §§ 3, 4; 1996, ch. 1043, § 6; 1997, ch. 236, §§ 2, 3; 1998, ch. 1039, § 1; 1999, ch. 340, §§ 1, 3, 4; 2004, ch. 715, § 1; 2010, ch. 904, § 1; 2010, ch. 952, § 2; 2012, ch. 798, § 37; 2012, ch. 848, § 71; 2016, ch. 952, § 1.

Compiler's Notes. Acts 2010, ch. 904, § 3 provided that the act, which amended § 63-6-214(b)(10) and enacted § 63-6-240, shall apply to any person licensed to practice medicine in this state, whether such license was issued prior to or after July 1, 2010, and to any person applying to practice medicine in this state, whether the application was filed prior to or July 1, 2010.

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

Failure to report treatment of juvenile drug overdoses as professional misconduct, § 68-24-301.

Screening panels, §  63-1-138.

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 medical examiners 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).

NOTES TO DECISIONS

1. Constitutionality.

A physician bringing certiorari to review the findings of the board revoking his license, and after trial on merits, cannot, thereafter on petition for mandatory injunction to reinstate, attack the constitutionality of the statute on the ground that no provision is made for notice and hearing. State Bd. of Medical Examiners v. Friedman, 150 Tenn. 152, 263 S.W. 75, 1923 Tenn. LEXIS 72 (1924).

If the revocation of a physician's license is not merely irregular, but void as based on unconstitutional statute or as failing to follow statutory provisions, injunction or mandamus will lie according to which is appropriate. State Bd. of Medical Examiners v. Friedman, 150 Tenn. 152, 263 S.W. 75, 1923 Tenn. LEXIS 72 (1924).

The provision of (b)(12) is sufficiently clear to a person of ordinary intelligence to put him or her on notice as to what conduct is proscribed and is not unconstitutionally vague. Williams v. State Dep't of Health & Env't, 880 S.W.2d 955, 1994 Tenn. App. LEXIS 115 (Tenn. Ct. App. 1994).

2. Prescriptions.

Where abuse of a drug was a common practice and this fact was known to the medical profession in general, a physician who prescribed this drug, specifically made unlawful, except by prescription, on a sight unseen basis, was grossly negligent and lacked good faith. State v. Sanderson, 550 S.W.2d 236, 1977 Tenn. LEXIS 534 (Tenn. 1977).

Suspension of physician's license was proper where the board's conclusion that physician violated T.C.A. § 63-6-214(b)(12) was based on substantial and material evidence and the board did not have to rely on its own expertise in arriving at that conclusion. Williams v. State Dep't of Health & Env't, 880 S.W.2d 955, 1994 Tenn. App. LEXIS 115 (Tenn. Ct. App. 1994).

3. Right to Practice.

The right to practice medicine is a constitutional property right, of which one cannot be illegally deprived. State Bd. of Medical Examiners v. Friedman, 150 Tenn. 152, 263 S.W. 75, 1923 Tenn. LEXIS 72 (1924).

A license to practice medicine once issued does not constitute a valid contract with the state, and does not confer upon the holder a vested right. State Bd. of Medical Examiners v. Friedman, 150 Tenn. 152, 263 S.W. 75, 1923 Tenn. LEXIS 72 (1924).

4. Assessment of Penalty.

Substantial and material evidence supported the Tennessee Board of Medical Examiners' decision that a physician violated T.C.A. § 63-6-214(b)(1) and (3) by failing to reveal a reckless driving conviction on his medical license renewal application where the decision was based on the physician's credibility, and ignoring any allegedly irrelevant evidence, the applications and the criminal judgment sufficiently supported the decision. Stubblefield v. Tenn. Dep't of Health, — S.W.3d —, 2014 Tenn. App. LEXIS 632 (Tenn. Ct. App. Oct. 6, 2014).

Tennessee Board of Medical Examiners' decision to place the physician's medical license on probation for five years was not arbitrary or capricious where the discipline was imposed after a contested hearing, and the consent degrees involving other physicians were negotiated between the parties. Stubblefield v. Tenn. Dep't of Health, — S.W.3d —, 2014 Tenn. App. LEXIS 632 (Tenn. Ct. App. Oct. 6, 2014).

Nothing in the statute granting the Tennessee Board of Medical Examiners the authority to sanction a licensee limits that authority to those whose licenses have not been automatically revoked due to a failure to renew. Oni v. Tenn. Dep't of Health, — S.W.3d —, 2016 Tenn. App. LEXIS 607 (Tenn. Ct. App. Aug. 23, 2016), appeal denied, — S.W.3d —, 2016 Tenn. LEXIS 971 (Tenn. Dec. 14, 2016).

Tennessee Board of Medical Examiners did not err in basing its revocation of a doctor's license on his failure to pay the administrative costs that were assessed against him because the doctor's payment of the administrative costs in full prior to the date of the remand hearing did not affect the Board's right to base its determination of the appropriate sanction, in part, on the fees that were outstanding when the notice of charges was filed. Oni v. Tenn. Dep't of Health, — S.W.3d —, 2016 Tenn. App. LEXIS 607 (Tenn. Ct. App. Aug. 23, 2016), appeal denied, — S.W.3d —, 2016 Tenn. LEXIS 971 (Tenn. Dec. 14, 2016).

5. Standard of Care.

Tennessee Board of Medical Examiners erred in failing to articulate the applicable standard of care when it found that a physician violated the standard of care by failing to comply with the requirements of Tennessee Medical Practice Act, T.C.A. § 63-6-214(b), because pursuant to § 63-6-214(g) the Board was required to articulate the applicable standard of care in its deliberations; because the case did not involve an error or deficiency in the administrative hearing or the facts but rather, an error of law and a deficiency in the record, the Board's error was properly resolved by remand to the Board to conduct deliberations based on the existing record and to articulate during the deliberations the applicable standard of care as required by the statute. Rich v. Tenn. Bd. of Med. Examiners, 350 S.W.3d 919, 2011 Tenn. LEXIS 957 (Tenn. Oct. 10, 2011).

Whether the Tennessee Board of Medical Examiners adopts the standard of care advanced by an expert witness or independently determines the standard of care based on its own expertise, the Board must articulate the standard upon which its decision is based to allow the reviewing court to know the standard and assess the validity of the Board's decision; similarly, when the Board fails to designate the applicable standard of care, a doctor seeking subsequent review of the Board's decision is placed at an unfair disadvantage, and unless it is clear what standard the doctor is held to have violated, he or she cannot properly assess the Board's conclusions in that regard and prepare an effective argument on appeal. Rich v. Tenn. Bd. of Med. Examiners, 350 S.W.3d 919, 2011 Tenn. LEXIS 957 (Tenn. Oct. 10, 2011).

Requirement that the Tennessee Board of Medical Examiners articulate the applicable standard of care in its deliberations serves a twofold purpose: it gives guidance to other physicians practicing medicine in the state as to the standard to which they are expected to conform and informs the reviewing court of the basis for the Board's decision; articulation of the adopted standard of care is critical in cases where the Tennessee Department of Health and the respondent physician have not agreed as to the applicable standard of care, and have submitted conflicting expert testimony in that regard, and even where only one party has presented expert testimony to establish the applicable standard, the Board may reject such testimony and determine a different standard based on its own expertise. Rich v. Tenn. Bd. of Med. Examiners, 350 S.W.3d 919, 2011 Tenn. LEXIS 957 (Tenn. Oct. 10, 2011).

6. Retired License.

Tennessee Board of Medical Examiners had authority to revoke a doctor's retired medical license because the doctor still possessed a medical license and remained a licensee when the notice of charges was filed; the statute granting the Board authority to suspend or revoke licenses does not limit that authority based on the current status of a license. Wyttenbach v. Bd. of Tenn. Med. Examiners, — S.W.3d —, 2016 Tenn. App. LEXIS 192 (Tenn. Ct. App. Mar. 15, 2016), appeal denied, Wyttenbach v. Bd. of TN Med. Examiners, — S.W.3d —, 2016 Tenn. LEXIS 674 (Tenn. Sept. 23, 2016).

7. Subject Matter Jurisdiction.

Trial court erred in ruling the Board of Medical Examiners lacked subject matter jurisdiction to sanction a doctor because the Board had subject matter jurisdiction over the doctor when the case was remanded, even though during the intervening time period his license was automatically revoked for his failure to seek renewal; the doctor's status as a licensee was not altered by the fact that his license had been revoked, and the Board exercised its discretion to revoke his license for cause. Oni v. Tenn. Dep't of Health, — S.W.3d —, 2016 Tenn. App. LEXIS 607 (Tenn. Ct. App. Aug. 23, 2016), appeal denied, — S.W.3d —, 2016 Tenn. LEXIS 971 (Tenn. Dec. 14, 2016).

8. Revocation.

Doctor failed to show that the decision of the Tennessee Board of Medical Examiners to revoke his license was unwarranted in law or unjustified in fact because the Board's factual findings were supported by the record, and the Board was authorized by statute to revoke a medical license; the Board found the doctor was intentionally dishonest in his dealings with a medical board and that he failed to pay the majority of administrative costs. Oni v. Tenn. Dep't of Health, — S.W.3d —, 2016 Tenn. App. LEXIS 607 (Tenn. Ct. App. Aug. 23, 2016), appeal denied, — S.W.3d —, 2016 Tenn. LEXIS 971 (Tenn. Dec. 14, 2016).

9. Licensure.

Denial of medical licensure in Tennessee to an applicant was not inappropriate because the decision by the Tennessee Board of Medical Examiners that the applicant's long absence from direct patient care necessitated a formal assessment before the applicant could engage in the practice of emergency medicine in Tennessee was not unclear, arbitrary and capricious, or unsupported by substantial and material evidence. Perez v. Tenn. Bd. of Med. Examiners, — S.W.3d —, 2019 Tenn. App. LEXIS 336 (Tenn. Ct. App. July 3, 2019).

63-6-215. Advertising.

  1. The board shall adopt rules and regulations to regulate the nature, manner, content and extent of advertising by practitioners who are under the jurisdiction of such board.
  2. If advertising is permitted, all methods must be allowed: newspaper, radio and television.

Acts 1901, ch. 78, § 16; 1917, ch. 13, § 2; Shan., § 3609a30; Acts 1919, ch. 117, § 1; Code 1932, § 6933; Acts 1945, ch. 181, § 7; C. Supp. 1950, § 6933; Acts 1975, ch. 355, § 16; 1980, ch. 605, §§ 4, 5; T.C.A. (orig. ed.), § 63-619.

Cross-References. Advertisement pertaining to board certification and specialty, §  63-1-145.

Textbooks. Tennessee Jurisprudence, 14 Tenn. Juris., Hospitals, § 3.

63-6-216. Disciplinary proceedings governed by Administrative Procedures Act.

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 1939, ch. 66, § 1; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 6932; T.C.A. (orig. ed.), § 63-620; Acts 1982, ch. 905, § 6.

Attorney General Opinions. Statute of limitations regarding physician discipline.  OAG 11-43, 2011 Tenn. AG LEXIS 45 (5/11/11).

NOTES TO DECISIONS

1. Licensee Rights.

The procedural safeguards of the Administrative Procedures Act, title 4, ch. 5, are applicable to medical license revocation proceedings, and T.C.A. § 4-5-320(c) scrupulously protects the fundamental right of notice and an opportunity to be heard. Watts v. Burkhart, 978 F.2d 269, 1992 U.S. App. LEXIS 27830 (6th Cir. Tenn. 1992).

All disciplinary proceedings against medical licensees are to be conducted in accordance with the Uniform Administrative Procedures Act (UAPA), T.C.A. § 63-6-216. Accordingly, the appellate court reviewed the administrative decision under the same standard as the trial court, the standard of review that was set forth in T.C.A. § 4-5-322(h). Hardy v. State, — S.W.3d —, 2010 Tenn. App. LEXIS 23 (Tenn. Ct. App. Jan. 19, 2010), appeal denied, — S.W.3d —, 2010 Tenn. LEXIS 772 (Tenn. Aug. 25, 2010), cert. denied, Hardy v. Tenn. Dep't of Health, 179 L. Ed. 2d 500, 131 S. Ct. 1603, 79 U.S.L.W. 3512, 2011 U.S. LEXIS 1953 (U.S. 2011).

2. Board Member's Immunity.

Public policy requires absolute immunity for officials performing quasi-prosecutorial or quasi-judicial functions, at least where protections such as those provided by the federal Administrative Procedure Act are in place. The Tennessee Administrative Procedures Act, compiled in title 4, ch. 5, provides procedural safeguards for contested cases comparable to those provided by the corresponding federal law, 5 U.S.C. § 554 et seq.Watts v. Burkhart, 978 F.2d 269, 1992 U.S. App. LEXIS 27830 (6th Cir. Tenn. 1992).

63-6-217. Practice after license revocation — Penalty.

After the board has revoked the license of any person for any of the grounds specified in §§ 63-6-214 and 63-6-215, such person shall not thereafter practice medicine or surgery in the state, and for each and every instance of such practice the person commits a Class B misdemeanor.

Acts 1919, ch. 117, § 2; Shan. Supp., § 3609a30b1; Code 1932, § 6934; T.C.A. (orig. ed.), § 63-621; Acts 1989, ch. 591, § 112.

Cross-References. Penalties, §  63-1-123.

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

Textbooks. Tennessee Jurisprudence, 20 Tenn. Juris., Physicians and Surgeons, § 4.

63-6-218. “Good Samaritan Law.”

  1. This section shall be known and cited as the “Good Samaritan Law.”
  2. Any person, including those licensed to practice medicine and surgery and including any person licensed or certified to render service ancillary thereto, or any member of a volunteer first aid, rescue or emergency squad that provides emergency public first aid and rescue services, shall not be liable to victims or persons receiving emergency care for any civil damages as a result of any act or omission by such person in rendering the emergency care or as a result of any act or failure to act to provide or arrange for further medical treatment or care for the injured person, except such damages as may result from the gross negligence of the person rendering such emergency care, who in good faith:
    1. Renders emergency care at the scene of an accident, medical emergency and/or disaster, while en route from such scene to a medical facility and while assisting medical personnel at the receiving medical facility, including use of an automated external defibrillator, to the victim or victims thereof without making any direct charge for the emergency care; or
    2. Participates or assists in rendering emergency care, including use of an automated external defibrillator, to persons attending or participating in performances, exhibitions, banquets, sporting events, religious or other gatherings open to the general public, with or without an admission charge, whether or not such emergency care is made available as a service, planned in advance by the promoter of the event and/or any other person or association.
  3. A receiving medical facility shall not be liable for any civil damages as a result of any act or omission on the part of any member of a volunteer first aid, rescue or emergency squad that provides emergency public first aid and rescue services while such person is assisting medical personnel at the receiving medical facility.
  4. The members of such volunteer fire squad, while providing fire protection within such area outside of a plant, shall be liable to suit under the provisions of the Governmental Tort Liability Act, compiled in title 29, chapter 20, part 2, if:
    1. A volunteer fire squad is organized by a private company for the protection of the plant and grounds of such company;
    2. Such squad is willing to respond and does respond to calls to provide fire protection for residents living within a six (6) mile radius of the county surrounding such plant; and
    3. The plant is located in a county that does not otherwise provide fire protection to such residents.

Acts 1963, ch. 46, §§ 1, 2; 1976, ch. 551, § 1; T.C.A., § 63-622; Acts 1985, ch. 338, §§ 1-4; 1994, ch. 556, § 1; 1998, ch. 963, § 5; 1999, ch. 488, §§ 1, 2.

Cross-References. Automated external defibrillators, title 68, ch. 140, part 4.

Compressed gases Good Samaritan Law, title 68, ch. 135, part 2.

Emergency Medical Services Act of 1983, title 68, ch. 140, part 5.

Emergency treatment of minors, § 63-6-222.

Good Samaritan Protection Act of 1999, §  29-34-201.

Good Samaritan Volunteer Firefighters’ Assistance Act, §  29-34-206.

Hazardous materials Good Samaritan Law, title 68, ch. 131, part 2.

Immunity from liability for use of automated external defibrillators, §§ 68-140-40468-140-409.

Law Reviews.

1985 Tennessee Survey: Selected Developments in Tennessee Law, 53 Tenn. L. Rev. 415 (1986).

Attorney General Opinions. Personal immunity of emergency medical technicians and paramedics from tort suits, OAG 03-093, 2003 Tenn. AG LEXIS 112 (7/28/03).

The “Good Samaritan Law” applies to an untrained person who uses an automated external defibrillator under the circumstances set forth in the statute. OAG 18-47, 2018 Tenn. AG LEXIS 46 (11/21/2018).

NOTES TO DECISIONS

1. Applicability.

Good Samaritan Law, T.C.A. § 63-6-218, did not insulate a county from liability in an estate's negligence action because the trial court specifically found the injury to the decedent's leg happened in the ambulance in transit to the hospital; the decedent's leg was amputated after suffering the injury. Wilson v. Monroe County, 411 S.W.3d 431, 2013 Tenn. App. LEXIS 53 (Tenn. Ct. App. Jan. 30, 2013), appeal denied, — S.W.3d —, 2013 Tenn. LEXIS 511 (Tenn. June 12, 2013).

2. Pre-existing Duty to Render Aid.

The Good Samaritan Law does not protect a defendant who had a pre-existing duty to render aid to the injured person. Lindsey v. Miami Dev. Corp., 689 S.W.2d 856, 1985 Tenn. LEXIS 511 (Tenn. 1985) (social guest-host relationship).

63-6-219. Surgical assistants.

  1. No person shall use or assume the title “registered surgical assistant” unless such person is registered with the board as a registered surgical assistant.
  2. The board shall register as a registered surgical assistant any applicant who presents satisfactory evidence that the applicant:
    1. Holds and maintains a current credential as a surgical assistant or surgical first assistant issued by the National Board of Surgical Technology and Surgical Assisting, the National Surgical Assistant Association, or the National Commission for Certification of Surgical Assistants or their successors;
    2. Has successfully completed a surgical assistant training program during the applicant's service as a member of any branch of the armed forces of the United States; or
    3. Has practiced as a surgical assistant at any time in the six (6) months prior to July 1, 2017, provided the applicant registers with the board by December 31, 2019.
  3. The board shall have the authority to deny, restrict, condition, revoke, or otherwise discipline the registration of a surgical assistant for violation of this section, violation of any rules promulgated pursuant to this section, or any basis provided in § 63-6-214.

Acts 2017, ch. 410, § 1.

Compiler's Notes. Former § 63-6-219 concerned the Tennessee Peer Review Law of 1967. For similar provisions, see §§ 68-11-272 and 63-1-150.

For the Preamble to the act concerning surgical assistants, please refer to Acts 2017, ch. 410.

Effective Dates. Acts 2017, ch. 410, §  2. July 1, 2017.

63-6-220. Treatment of juvenile drug abusers without parental consent.

  1. Physicians may treat juvenile drug abusers without prior parental consent.
  2. A physician may use the physician's own discretion in determining whether to notify the juvenile's parents of such treatment.

Acts 1972, ch. 597, § 13; T.C.A., § 63-624.

Cross-References. Emergency treatment of minors, § 63-6-222.

Law Reviews.

To Be or Not To Be in Tennessee: Deciding Surrogate Issues, 34 U. Mem. L. Rev. 333 (2004).

63-6-221. Office-based surgeries.

  1. For the purposes of this section, unless the context otherwise requires:
    1. “Board” means the board of medical examiners;
    2. “Level II office-based surgery” means Level II surgery, as defined by the board of medical examiners in its rules and regulations, that is performed outside of a hospital, an ambulatory surgical treatment center or other medical facility licensed by the department of health;
    3. “Office-based surgery” or “Level III office-based surgery” means Level III surgery requiring a level of sedation beyond the level of sedation defined by the board of medical examiners as Level II surgery that is performed outside a hospital, an ambulatory surgical treatment center or other medical facility licensed by the department of health;
    4. “Physician” means any person licensed under this chapter; and
    5. “Surgical suite” means both the operating and recovery room or rooms located in a physician's office where Level III office-based surgery is to be performed.
  2. The board shall have the duty and responsibility to regulate the practice of office-based surgery, including the promulgation of rules necessary to promote patient health and safety in such practices, including, but not limited to, a mechanism by which all office-based surgical suites are surveyed and certified by the board.
  3. The board shall specifically identify in rules the parameters to be used in determining Level III surgical procedures and multiple procedures that may be performed in an office-based setting pursuant to the level of anesthesia involved in the procedures. In addition, the board shall promulgate age and risk classification criteria of patients eligible for Level III office-based surgical procedures.
  4. By December 30, 2007, the board shall adopt rules establishing a specific list of approved Level III surgical procedures that can be performed in a physician's office in this state. The ambulatory surgical center covered procedures list promulgated by the centers of medicare and medicaid shall be used as a guide. No physician shall perform any Level III surgical procedures that are not included on the list promulgated by the board. The board may modify the list as the board deems necessary. The board shall also promulgate rules addressing the minimum requirements deemed necessary by the board for the safe performance of office-based surgery.
  5. Using the rules established for ambulatory surgical treatment centers as guidelines, the board shall promulgate rules relative to infection control, life safety, patient rights, hazardous waste and equipment and supplies necessary to assure the safety of patients undergoing office-based surgery. Any provision in the ambulatory surgical treatment center rules addressing infection control, life safety, patient rights, hazardous waste and equipment and supplies that is not adopted by the board shall require a statement entered into the official minutes from the board justifying the board's decision.
  6. No more than three (3) patients undergoing Level III office-based surgery in a physician’s office may be incapable of self-preservation at the same time. The board shall promulgate rules requiring physician offices that perform office-based surgery to adopt bylaws that put in place a management system and documentation that will ensure that no more than three (3) patients that are in surgery or recovery are incapable of self-preservation at the same time. The bylaws and documentation of the management system shall be included in the application for surgical suite certification.
  7. Except for emergencies, a surgical suite certified for office-based surgery may be utilized only by physician employees of the practice in which the surgical suite is located. Surgical suites may not be shared with other practices or other physicians.
  8. The board shall enter into a memorandum of understanding, contract or other written arrangement with the department of health such that the department:
    1. Provides a site survey of the surgical suites sought to be certified to perform office-based surgery. A physician office at which office-based surgeries are being performed as of October 1, 2007, shall submit both a request for a site survey on an application form developed by the board and remit payment of the office-based surgery fee to the department by October 1, 2007. If the office makes a timely filing in accordance with this subdivision (h)(1), the physician's office may continue to be a site for office-based surgeries pending completion of a survey confirming compliance with board rules and subsequent issuance of a certification of the surgical suite or suites. A physician office at which office-based surgeries are not being performed as of October 1, 2007, shall not perform any such procedures until an application form and payment of the office-based surgery fee is submitted to the board and a site survey is completed by the department and a certification of the surgical suite is issued by the board;
    2. Is authorized to require plans of correction and to verify that the plans of correction have been implemented;
    3. Is authorized to initiate subsequent, unannounced site surveys during regular business hours as long as the physician office continues to be used to perform office-based surgeries, but no more frequently than once every twelve (12) months; and
    4. Is authorized to respond to any complaints made by patients or the public against a physician who performs office-based surgery or a physician's office at which office-based surgery is being performed at the request of the office of investigations.
  9. The results of all site surveys shall be transmitted by the department to the board. The results shall include any requirement for plans of correction, the department's determination of the acceptability of the submitted plans of correction and the department's verification that the plans of correction have been implemented. The board shall make a final determination on certifying the surgical suite for performance of office-based surgeries. The results of site surveys and board determinations shall be shared on a routine basis with the board for licensing health care facilities.
  10. The results of all complaint investigations by department staff shall be transmitted to the board for resolution; however, that information shall at all times be maintained as confidential and not available to the public except to the extent § 63-1-117(g) applies.
  11. Any physician office that desires to be certified to perform office-based surgery shall pay to the department an annual office-based surgery fee as set by the board.
  12. A physician office at which office-based surgery is being performed shall ensure that claims data is reported to the commissioner of health on a form approved by the department of health. The data shall be submitted through a third party approved by the department of health for the purpose of editing the data according to rules and regulations established by the commissioner. The physician office shall be responsible for the costs associated with processing of the data by the approved vendors. The claims data shall be reported at least quarterly to the commissioner. No information shall be made available to the public by the commissioner that reasonably could be expected to reveal the identity of any patient. The claims data reported to the commissioner under this section are confidential and not available to the public until the commissioner processes and verifies the data. The commissioner shall prescribe conditions under which the processed and verified data are available to the public.
    1. Except as provided in subdivision (h)(1), a physician office surgical suite is required to be certified by the board in order to perform office-based surgery. A physician office that proposes to perform office-based surgery shall submit to the board, on an application form provided by the board, at least the following:
      1. Level III procedures expected to be performed by each physician;
      2. The specialty board certification or board eligibility of the physician or physicians performing Level III procedures, if any;
      3. Verification of health care liability coverage for all physicians performing Level III procedures;
      4. Verification of hospital staff privileges for all physicians performing Level III procedures;
      5. The name of a responsible physician in whose name the surgical suite certification shall be issued for that office and a list of the physicians with the practice who are going to be performing Level III office-based surgeries; and
      6. The documentation required by subsection (f) regarding incapacitated patient limits.
    2. The form required by subdivision (m)(1) shall serve as an application form, but the information on the form shall be updated as appropriate when any information on it has changed.
  13. The board shall notify all physicians of the office-based surgery certification requirements. Failure of a physician performing office-based surgery or a physician office at which office-based surgery is being performed to abide by this section, any rules promulgated pursuant to this section or of § 68-11-211 may be grounds for disciplinary action or termination of either the rights of the physician to perform office-based surgery or the surgical suite's certification by the physician's licensing board, or both disciplinary action and termination. For purposes of § 4-5-320(c), the public health, safety and welfare imperatively require emergency action at any time that a previously authorized surgical suite fails to maintain the standards set by the board.
  14. Applicants for initial licensure or reinstatement of a previously issued license shall indicate to the board on the appropriate licensure application if they intend to perform Level II office-based surgery procedures as defined by the rules of the board of medical examiners and that are integral to a planned treatment regimen and not performed on an urgent or emergent basis.
  15. Licensed physicians who perform Level II office-based surgery at the time of licensure renewal shall indicate to the board on the licensure renewal application if the licensee currently performs Level II office-based surgery procedures as defined in the rules of the board of medical examiners and that are integral to a planned treatment regimen and not performed on an urgent or emergent basis.
  16. In order for health care providers and the board to work together to collect meaningful health care data, so as to minimize the frequency and severity of certain unexpected events and improve the delivery of health care services, each physician who performs any Level II office-based surgery or Level III office-based surgery that results in any of the following unanticipated events shall notify the board in writing within fifteen (15) calendar days following the physician's discovery of the event:
    1. The death of a patient during any Level II office-based surgery or Level III office-based surgery or within seventy-two (72) hours thereafter;
    2. The transport of a patient to a hospital emergency department except those related to a natural course of the patient's illness or underlying condition;
    3. The unplanned admission of a patient to a hospital within seventy-two (72) hours of discharge, only if the admission is related to the Level II office-based surgery or Level III office-based surgery, except those related to a natural course of the patient's illness or underlying condition;
    4. The discovery of a foreign object erroneously remaining in a patient from a Level II office-based surgery or Level III office-based surgery at that office; or
    5. The performance of the wrong surgical procedure, surgery on the wrong site or surgery on the wrong patient.
  17. Records of reportable events should be in writing and should include at a minimum the following:
    1. The physician's name and license number;
    2. The date and time of the occurrence or discovery of the incident;
    3. The office and address where the incident took place;
    4. The name and address of the patient;
    5. The type of Level II office-based surgery or Level III office-based surgery that was performed;
    6. The type and dosage of sedation or anesthesia utilized during the procedure;
    7. The circumstances surrounding the incident; and
    8. The type or types of events required to be reported as provided in subsection (q).
  18. The filing of a report as required by subsection (q) does not, in and of itself, constitute an acknowledgement or admission of health care liability, error or omission. Upon receipt of the report, the board may, in its discretion, obtain patient and other records pursuant to authority granted to it in § 63-1-117. The reporting form and any supporting documentation reviewed or obtained by the board pursuant to this section and any amendments to the reports shall be confidential and not subject to discovery, subpoena or legal compulsion for release to any person or entity; nor shall they be admissible in any civil or administrative proceeding, other than a disciplinary proceeding by the board; nor shall they be subject to any open records request made pursuant to title 10, chapter 7, part 5 or any other law. This section shall not affect any of the provisions of or limit the protections provided by § 63-1-150.
  19. Failure to comply with the requirements of subsections (o)-(s) constitutes grounds for disciplinary action by the board in its discretion pursuant to § 63-6-214.

Acts 2007, ch. 373, § 1; 2008, ch. 927, §§ 1, 2; 2010, ch. 637, §§ 1-6; 2012, ch. 798, §§ 38, 39; 2017, ch. 4, § 4.

Compiler's Notes. Former § 63-6-221 (Acts 1975, ch. 182, §§ 1-5; 1976, ch. 403, § 1; T.C.A., §§ 63-625 — 63-629) concerning licensure of Tennessee citizens who attend the Universidad Autonoma de Guadalajara was repealed by Acts 1982, ch. 905, § 8.

Acts 2007, ch. 373, § 6 provided that the board of medical examiners and the board of osteopathic examination are authorized to promulgate public necessity rules (now emergency rules) necessary to carry out the provisions of the act in accordance with the provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Amendments. The 2017 amendment substituted “provided by § 63-1-150” for “§§ 63-6-219 [repealed] and 63-9-114” at the end of (s).

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

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

63-6-222. Emergency treatment of minors.

  1. Any licensed physician may perform emergency medical or surgical treatment on a minor, despite the absence of parental consent or court order, where such physician has a good faith belief that delay in rendering emergency care would, to a reasonable degree of medical certainty, result in a serious threat to the life of the minor or a serious worsening of such minor's medical condition and that such emergency treatment is necessary to save the minor's life or prevent further deterioration of the minor's condition.
  2. Such treatment shall be commenced only after a reasonable effort is made to notify the minor's parents or guardian, if known or readily ascertainable.
  3. Any physician rendering emergency care to a minor pursuant to this section shall not be liable for civil damages, except such damages as may result from the negligence of the physician in rendering such care.

Acts 1981, ch. 242, § 1; T.C.A., § 63-630.

Cross-References. Courses in detection and treatment of child sexual abuse, § 49-7-117.

“Good Samaritan Law,” § 63-6-218.

Prenatal care for minors, § 63-6-223.

Treatment of juvenile drug users, § 63-6-220.

63-6-223. Prenatal and peripartum care for minors.

  1. Any person licensed to practice medicine, including those persons rendering service pursuant to § 63-6-204, may, for the purpose of providing prenatal care, examine, diagnose and treat a minor without the knowledge or consent of the parents or legal guardian of the minor and shall incur no civil or criminal liability in connection therewith except for negligence.
  2. Any person licensed to practice medicine, including those persons rendering service pursuant to § 63-6-204, may, for the purpose of providing peripartum care, which may include providing peripartum analgesia, examine, diagnose, and treat a minor who is at least fourteen (14) years of age without the knowledge or consent of the parents or legal guardian of the minor and shall incur no civil or criminal liability in connection therewith except for negligence.

Acts 1986, ch. 581, § 1; T.C.A., § 63-6-224; Acts 2017, ch. 138, § 1.

Compiler's Notes. Former § 63-6-223 was transferred to § 63-6-224.

Amendments. The 2017 amendment added (b).

Effective Dates. Acts 2017, ch. 138, § 2. July 1, 2017.

Cross-References. Emergency treatment of minors, § 63-6-222.

63-6-224. Regulation of persons operating X-ray equipment. [Transferred.]

Acts 1982, ch. 905, § 7; T.C.A., § 63-6-223; Acts 2000, ch. 956, § 1; transferred § 63-6-902 by Acts 2016, ch. 1029, §  1, effective January 1, 2017.

Former § 63-6-224 was transferred to § 63-6-902 by authority of the Code Commission. For this section as effective on January 1, 2017, please see § 63-6-902.

63-6-225. Unlawful division of fees by physicians.

  1. It is an offense for any licensed physician or surgeon to divide or to agree to divide any fee or compensation of any sort received or charged in the practice of medicine or surgery with any person without the knowledge and consent of the person paying the fee or compensation or against whom the fee may be charged.
  2. This section does not prohibit a physician from compensating any independent contractor that provides goods or services to the physician on the basis of a percentage of the physician's fees generated in the practice of medicine. The percentage paid must be reasonably related to the value of the goods or services provided. Payments by physicians in return for referrals are prohibited.
  3. A violation of this section is a Class B misdemeanor.

Acts 1989, ch. 591, § 3; 1995, ch. 466, § 2.

Compiler's Notes. This section is the successor to former § 39-6-1202.

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

Attorney General Opinions. Applicability of section, OAG 95-030 (4/5/95).

Constitutionality, OAG 95-030 (4/5/95).

NOTES TO DECISIONS

1. Application.

Medical group employer was entitled to recover damages from a surgeon employee for breach of an employment agreement because, although the agreement allowed an unlicensed general corporation owned in part by a non-physician to be compensated through a percentage of the net profits the employee generated in violation of statutes and public policy, the trial court did not err in finding that the employee, by the employee's actions, ratified the voidable agreement and violated the duty of good faith and fair dealing under the agreement. Plastic Surgery Assocs. of Kingsport v. Pastrick, — S.W.3d —, 2015 Tenn. App. LEXIS 345 (Tenn. Ct. App. May 19, 2015), appeal denied, Plastic Surgery Assocs. of Kingsport Inc. v. Pastrick, — S.W.3d —, 2015 Tenn. LEXIS 752 (Tenn. Sept. 16, 2015).

63-6-226. Additional penalty — Suit for recovery.

  1. Any person who violates § 63-6-225 shall also forfeit and pay treble the value of the fee or compensation to the person applying the same or against whom the fee may be charged, or from whom it may have been demanded, and if the party entitled to sue does not sue within two (2) years after the fee or compensation has been paid or demanded, then the state shall have the right to sue for and recover such treble amount, which shall, upon recovery, be paid one-half (½) into the state treasury and one-half (½) to the officer prosecuting the suit.
  2. It is the duty of the attorney general and reporter, or of the district attorney general of any county in which service of process may be had upon the person liable, to institute in the name of the state all suits necessary for the recovery of the sum of money.

Acts 1989, ch. 591, § 3.

Compiler's Notes. This section is the successor to former § 39-6-1203.

Law Reviews.

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

63-6-227. Cancellation of license upon conviction.

The license of any physician or surgeon who is convicted of a violation of § 63-6-225 may, upon the first conviction, and shall, upon any subsequent conviction, be adjudged to be cancelled and annulled by the court before which the conviction may be and, without further trial or hearing, the physician or surgeon shall not thereafter again be admitted to practice medicine or surgery within this state.

Acts 1989, ch. 591, § 3.

Compiler's Notes. This section is the successor to former § 39-6-1204.

Law Reviews.

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

63-6-228. Community health management information systems.

  1. This section shall be known and may be cited as the “Tennessee Community Health Management Information System Law of 1993.”
  2. As used in this section, unless the context otherwise requires:
    1. “Collected data” means health care data consisting of all information, interviews or other reports, statements, memoranda or other information furnished from all sources and in whatever form to the quality assessment committee, together with the records, reports, proceedings and other information used by the quality assessment committee to reach its conclusions in the form of releasable data as defined in this section;
    2. “Community health management information system (CHMIS)” means any broad based organization, including, but not limited to, providers of health care goods and services, payors for health care goods and services, including insurors and employers, and users of health care goods and services, whose goal is to monitor and improve the level of community wellness and the quality of health care rendered by providers of health care delivery services and the financial reimbursement systems in a county having a population in excess of eight hundred thousand (800,000), according to the 1990 federal census or any subsequent federal census;
    3. “Quality assessment committee” means a committee of a CHMIS consisting primarily of physicians and other providers of health care, with insurors and employers, whose purpose is to collect, analyze and refine health care data as part of the CHMIS; and
    4. “Releasable data” means summaries and conclusions of collected data of the quality assessment committee determined by such quality assessment committee to be scientifically valid and formally delivered to the quality executive committee to achieve the purposes of the CHMIS.
  3. It is the stated policy of Tennessee to encourage each CHMIS to candidly, conscientiously and objectively monitor and improve the level of community wellness and quality of health care delivery services and financial reimbursement systems. Tennessee further recognizes that confidentiality is essential both to effective functioning of the CHMIS and to continued improvement in the access to, the efficiency of and the quality of health care services. As incentive for the providers, payors and users of health care services to participate in a quality assessment committee, such quality assessment committee must be protected from liability for its good faith efforts. To this end, a quality assessment committee of a CHMIS should be granted certain immunities relating to its actions undertaken as part of its responsibility to collect, analyze and refine health care data. In instances of a quality assessment committee examining the appropriateness of physicians' fees, this immunity must also extend to restraint of trade claims under title 47, chapter 25.
    1. All health care professional associations and societies and other organizations, including insurors and employers, institutions, foundations, entities and associated communities as identified in subsection (c), physicians, registered nurses, hospitals, hospital administrators and employees, members of boards of directors or trustees of any publicly supported or privately supported hospital or other such provider of health care, any person acting as a staff member of a quality assessment committee of a CHMIS, any person under a contract or other formal agreement with a quality assessment committee of a CHMIS, any person who participates with or assists a quality assessment committee of a CHMIS with respect to its functions or any other individual appointed to any quality assessment committee as such term is described in subsection (b) shall be immune from liability to any patient, individual or organization for furnishing information, data, reports or records to any such quality assessment committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by a quality assessment committee undertaken or performed within the scope or function of the duties of such quality assessment committees, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
    2. Notwithstanding subdivision (d)(1), any person providing information to a quality assessment committee of a CHMIS regarding the analysis and refinement of health care data shall be immune from liability to any person, unless such information is false and the person providing it had actual knowledge of such falsity.
  4. All collected data of the CHMIS are declared to be privileged and shall not be public records nor be available for court subpoena or for discovery proceedings. The CHMIS, through a quality executive committee or similar committee, shall establish particular categories of health care data and refinement periods for each category of health care data, whether such data is collected data or releasable data. Releasable data shall be subject to the privileges and limitations of collected data for refinement periods as determined by the quality executive committee. When the refinement period has expired for a particular category of releasable data, then such immunities and privileges set forth in this subsection (e) shall no longer apply to the releasable data for such category. The disclosure of confidential, privileged quality assessment committee information to original sources during the refinement period, or as a report by the quality assessment committee to the quality executive committee, the CHMIS board of directors or another executive committee within the CHMIS, prior to the expiration of the refinement period does not constitute either a waiver of confidentiality or privilege. Nothing contained in this subsection (e) applies to records made in the regular course of business by a hospital or other provider of health care and information, documents or records otherwise available from original sources are not to be construed as immune from discovery or use in any civil proceedings merely because they were presented during the refinement period of the quality assessment committee.

Acts 1993, ch. 333, § 1.

Compiler's Notes. For table of U.S. decennial populations of Tennessee counties, see Volume 13 and its supplement.

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

63-6-229. Consent to medical treatment by a minor.

Notwithstanding any other provision of law to the contrary, in the absence or unavailability of a spouse, any minor is authorized and empowered to consent for such minor's child, either orally or otherwise, to any surgical or medical treatment or procedures not prohibited by law that may be suggested, recommended, prescribed or directed by a duly licensed physician.

Acts 1995, ch. 317, § 1.

Cross-References. Validity of a durable power of attorney for health care given to a nonparent, see § 34-6-216.

63-6-230. Inactive licenses to perform pro bono services.

The board of medical examiners shall establish by rule an inactive license category that allows physicians to perform services without compensation only for those persons receiving services from organizations that have received a determination of exemption under § 501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)). Such inactive license category shall not authorize any other practice of medicine.

Acts 1997, ch. 345, § 3.

63-6-231. Transfer of patient medical information outside the state.

  1. The transfer of patient medical information to a person in another state who is not licensed to practice medicine or osteopathy in the state of Tennessee, using any electronic, telephonic or fiber optic means or by any other method, constitutes the practice of medicine or osteopathy if such information is employed to diagnose and/or treat, any person physically located within the state of Tennessee.
  2. Notwithstanding subsection (a) to the contrary, the transfer of such information shall not constitute the practice of medicine if:
    1. Such information is to be used by a medical doctor or doctor of osteopathy licensed in Tennessee;
    2. Such information is to be used for a second opinion requested by a Tennessee licensed medical doctor or doctor of osteopathy; provided, no charges are assessed for such second opinion;
    3. Such information is to be used by an out-of-state physician for treatment of a person who is seeking medical treatment out of Tennessee;
    4. Such information is used to determine if such patient is covered by insurance;
    5. Such information is to be used by physicians in another state to provide occasional academic consultations to a medical school located in Tennessee; or
    6. Such information is used by insurance or related companies for risk evaluation, utilization review, claims processing and/or evaluation of claimant's rehabilitation, including establishing and administering rehabilitation plans. The establishing and administering of such rehabilitation plans shall not include the diagnosis and/or treatment of any person physically located within the state of Tennessee as prohibited by subsection (a).
  3. This section shall not apply to research hospitals, as defined in § 63-6-204(f)(7).

Acts 1998, ch. 1017, §§ 1, 2.

63-6-232. Disciplinary complaints against chelation therapist.

All disciplinary complaints filed against a chelation therapist shall be judged by the standard of medical care in the community where such complaint originated.

Acts 2001, ch. 296, § 1.

63-6-233. Continuing medical education.

  1. Any person licensed to practice medicine in this state shall complete continuing medical education as required by the board of medical examiners. The board of medical examiners may establish waivers from such continuing medical education requirements and exemptions for certain licensees through rules and regulations.
  2. The board of medical examiners shall establish the continuing medical educational requirements, waivers and exemptions through rules and regulations promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2001, ch. 320, § 1.

63-6-234. Physicians serving as United States public health service commissioned officers.

A physician serving as a United States public health service commissioned officer who is trained as a national health service corps ready responder shall be authorized to practice medicine at federally qualified health centers while pursuing licensure as provided in this part under the following conditions:

  1. The physician has first filed an application for licensure as provided in this part;
  2. The physician, prior to commencing practice, submits a written statement to the board that all of the physician's medical licenses, including the authority to practice in United States public health service, are unencumbered by disciplinary actions, unresolved disciplinary complaints or unresolved health care liability lawsuits; and
  3. The physician timely complies with all board rules governing the application process and immediately ceases practicing medicine until a license is subsequently granted should the initial licensure application be closed either for failure to provide timely required information or is denied by the board.

Acts 2003, ch. 43, § 1; 2012, ch. 798, § 40.

Cross-References. Licensees in armed forces or public health service, §  63-1-110.

63-6-235. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.

  1. A physician licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of medical examiners may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.
  2. Notwithstanding any other provision of this chapter to the contrary, a retired or inactive physician may apply for and receive a special volunteer license for practice only in volunteer service at benevolent or humanitarian service project locations outside of the state. The board of medical examiners is authorized to promulgate rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this section.

Acts 2004, ch. 579, § 2; 2005, ch. 250, § 1.

Cross-References. Retirement, §§  63-1-111, 63-6-210.

63-6-236. Drug prescriptions.

  1. Any handwritten prescription order for a drug prepared by a physician or surgeon 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 physician or surgeon, 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 physician or surgeon 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 physician or surgeon 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.
  2. Any typed or computer-generated prescription order for a drug issued by a physician or surgeon who is authorized by law to prescribe a drug must be legible so that it is comprehensible by the pharmacist who fills the typed or computer-generated prescription order. The prescription order must contain the name of the prescribing physician or surgeon, 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 physician or surgeon 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 physician or surgeon 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. Nothing in this section shall be construed to prevent a physician or surgeon from issuing a verbal prescription order.
    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, § 5; 2005, ch. 12, § 3; 2008, ch. 1035, §§ 4, 9; 2010, ch. 795, § 12; 2013, ch. 74, § 4.

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 non-prescription 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.

63-6-237. Radiologist assistants.

  1. In addition to the practice permitted by § 63-6-902, a radiologist may utilize the services of a radiologist assistant to practice radiology assistance under the supervision of such radiologist to the extent not prohibited by § 63-6-902.
  2. The board of medical examiners shall define the scope of practice of a radiologist assistant and the educational qualifications necessary to practice as a radiologist assistant by rules promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Such rules shall be consistent with guidelines adopted by the American College of Radiology, the American Society of Radiologic Technologists and the American Registry of Radiologic Technologists (ARRT).
  3. A radiologist assistant must be a radiologic technologist certified by the board of medical examiners under § 63-6-902 and certified and registered with ARRT and credentialed to provide radiology services under the supervision of a radiologist.
  4. A radiologist assistant may not interpret images, make diagnoses or prescribe medications or therapies.
  5. On or after July 1, 2004, a radiology practitioner assistant shall only be known as a radiologist assistant.
  6. On or after July 1, 2008, any person seeking to become a radiologist assistant in Tennessee must have completed an advanced academic program encompassing a nationally recognized radiologist assistant curriculum, as well as completed a radiologist directed clinical preceptorship, all culminating in a baccalaureate degree.
  7. Any person who, on or before December 31, 2008, was practicing as a radiology practitioner assistant in Tennessee and who submits satisfactory proof of that practice to the board, along with an application and the certification fee on or before December 31, 2009, shall be entitled to be certified by the board as a radiologist assistant without having to meet the educational, certification, registration, credentialing or examination requirements of subsections (b) and (c) and rules promulgated pursuant to subsections (b) and (c).

Acts 2004, ch. 704, § 1; 2007, ch. 393, § 1; 2008, ch. 1003, §§ 1-3.

Compiler's Notes. References to “63-6-224” throughout this section were changed to “63-6-902” in light of the transfer of section 63-6-224 to 63-6-902 by the Code Commission in 2016, effective January 1, 2017.

63-6-238. Notice to patients of departure.

Psychiatrists are not required to notify patients that were treated by them at community mental health centers, as defined in § 33-1-101, of their departure from such community mental health centers. Patient records shall remain with the community mental health centers. The transfer of patients' records shall be in compliance with standards set by state and federal law.

Acts 2005, ch. 53, § 2.

Code Commission Notes.

Acts 2010, ch. 904, § 2 purported to add a new section concerning remedial action against persons licensed to practice medicine who are required to register as a sexual offender or violent sexual offender in order to assure safety as § 63-6-238. Since Acts 2005, ch. 53, § 3 added § 63-6-238, ch. 904, § 2 was added as § 63-6-240.

63-6-239. [Repealed.]

Acts 2010, ch. 795, § 3; repealed by Acts 2018, ch. 883, § 5, effective January 1, 2019.

Compiler's Notes. Section 63-6-239 concerning prescriptions for Schedule II controlled substances is repealed by Acts 2018, ch. 883, § 5, 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 § 63-6-239 concerned prescriptions for Schedule II controlled substances.

63-6-240. Remedial action against persons licensed to practice medicine who are required to register as a sexual offender or violent sexual offender in order to assure safety.

    1. The general assembly finds that a person who is licensed to practice medicine in this state and who is required to register with the Tennessee bureau of investigation (TBI) as a sexual offender or violent sexual offender is injurious to the public safety, health and welfare as well as the public's perception of and confidence in the medical profession.
    2. The general assembly further finds that the strongest remedial action possible should be taken against a person's license to practice medicine when such person has been convicted of a sexual offense, or violent sexual offense as both are defined in title 40, chapter 39, part 2, and continues to engage in the practice of medicine in this state after such conviction.
    3. Enactment of this section by the general assembly is declared to be a remedial action necessary to assure the safety of the citizens of this state and their faith and confidence in the medical profession. This section is not to be construed to be punitive against any person to whom this section may apply.
  1. As used in this section:
    1. “Registering agency” means a sheriff's office, municipal police department, metropolitan police department, campus law enforcement agency, the Tennessee department of correction, a private contractor with the Tennessee department of correction or the board with whom sexual offenders and violent sexual offenders are required to register under title 40, chapter 39, part 2;
    2. “Registry” means the registry created by the Tennessee Sexual Offender and Violent Sexual Offender Registration, Verification and Tracking Act of 2004, codified in title 40, chapter 39, part 2;
    3. “Sexual offense” means those offenses defined as “sexual offenses” in § 40-39-202; and
    4. “Violent sexual offense” means those offenses defined as “violent sexual offenses” in § 40-39-202.
    1. If the registering agency of a person who registers as a sexual offender or violent sexual offender, as defined by title 40, chapter 39, part 2, has reason to believe that such person is licensed to practice medicine in this state pursuant to this chapter, the registering agency shall prepare and forward to the board of medical examiners a certified copy of the offender's TBI registration form within thirty (30) days of the sexual offender's or violent sexual offender's registration.
      1. Upon receipt of the form, or upon receipt of credible evidence from any other source indicating that a person licensed to practice medicine in this state has been convicted of a sexual offense or a violent sexual offense, the board shall investigate to determine whether such person is a sexual offender or violent sexual offender, as defined by § 40-39-202, and a person licensed to practice medicine pursuant to this chapter.
      2. If the board determines that the person named on the TBI registration form, or by another source, is a person licensed to practice medicine in this state pursuant to this chapter and the offense for which the person is required to register is a violent sexual offense, such conviction constitutes a material change in the person's licensure qualifications, and the board shall conduct a hearing at which the person may present evidence that the information received by the board is incorrect. If, after the hearing, the board finds the person was convicted of a violent sexual offense and is required to register with the TBI as a violent sexual offender, the board shall revoke the person's license to practice medicine in accordance with § 63-6-216. The person may appeal the ruling of the board as provided in the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, but such appeal shall be limited to the issue of whether or not such person has been convicted of a violent sexual offense and is therefore required to register as a violent sexual offender. The license revocation shall remain in effect during the pendency of any appeal.
      3. If the person licensed to practice medicine is required to register as a sexual offender, the board shall conduct a hearing to determine the extent to which the person poses a continuing risk to patients; the degree to which the person has been rehabilitated; what treatment, if any, the person has undergone; the areas of medicine in which the person is qualified to engage without endangering the safety of patients; and any other factor the board deems relevant in determining the outcome most likely to protect the public while considering the interests of the person. At the conclusion of the hearing, the board may:
        1. Revoke the license of the person; or
        2. If the board does not revoke the license, it may place such conditions on the person's license as it deems appropriate and advisable to protect the interests and safety of the public; provided, the board shall place the following restrictions on the person's license:
          1. Prohibit the physician from engaging in direct patient care or contact; and
          2. Such other conditions and limitations on the person's license as the board deems advisable.
        1. If a person's license to practice medicine was revoked, suspended or conditioned pursuant to subdivision (c)(2)(C) because such person was convicted of a sexual offense and such person applies for and is granted termination of sexual offender registry requirements pursuant to § 40-39-207, such person may petition the board for reinstatement of the person's license to practice medicine.
        2. If a petition is filed for reinstatement pursuant to this subsection (c), the board shall hear the petition within thirty (30) calendar days of its receipt. At the hearing the board shall use the same analysis set out in subdivision (c)(2)(C) to determine whether the person should be permitted to practice medicine in this state under any circumstances.
        3. If the written findings of the board are that the person is no longer a threat to public safety and could return to the practice of medicine in some capacity, it may:
          1. Reinstate the person's license without conditions;
          2. Reinstate the person's license with any or all the conditions available under subdivision (c)(2)(C); or
          3. Remove some or all of the restrictions or conditions that were placed on a license made conditional pursuant to subdivision (c)(2)(C).
        4. If the written findings of the board are that the person could not safely return to the practice of medicine, it shall deny the person's petition and set a date certain after which the person may repetition the board.
      4. If the board receives credible evidence from any source indicating that the person is in violation of the restrictions placed upon such person's license to practice medicine pursuant to this section, the board shall conduct a hearing as provided in subdivision (c)(2)(C). If at the conclusion of the hearing, the board finds that the person is in violation of the restrictions placed upon the person's license in a material respect or in a repetitive manner, the board shall revoke the license. If the board finds that the violation is minor or isolated, it may place other conditions on the person's license, such as increased reporting to the board by both the person and the person's employer or contractor, if any.
      5. This subdivision (c)(2) shall apply regardless of whether commission of the sexual offense or violent sexual offense resulting in the person being required to register as a sexual or violent sexual offender occurred prior to or subsequent to the date the person was licensed to practice medicine in this state.
  2. By September 1, 2010, the board shall compare or have compared a list of all persons who are licensed to practice medicine in this state against the list of persons who are registered as sexual offenders or violent sexual offenders pursuant to title 40, chapter 39, part 2. If it appears from this comparison that the same name appears on both lists, the board shall request a certified copy of that person's TBI registration form. Upon receipt of the form from the TBI, the board shall conduct an investigation to determine if the person licensed to practice medicine in this state is the same person who is a registered sexual offender or violent sexual offender. Such investigation shall take no more than thirty (30) days. If the board determines that the person whose name appears on both lists is the same person, it shall immediately take action as provided in subdivision (c)(2). If the person whose name appears on both lists is not the same person, the board shall take no action.
    1. On July 1, 2010, the board shall determine, before granting a license to practice medicine in this state, or renewing an existing license, if the person who is applying for such a license is registered or is required to be registered as a sexual offender or violent sexual offender pursuant to title 40, chapter 39, part 2.
    2. If any applicant for a license to practice medicine in this state is a registered violent sexual offender or is required to register as a violent sexual offender, the board shall deny the application. If any person who is licensed to practice medicine in this state and is seeking to renew such license is a registered violent sexual offender or is required to register as a violent sexual offender, the board shall revoke the physician's license.
    3. If any applicant to the board is registered as a sexual offender or is required to register as a sexual offender, the board shall consider whether the applicant poses a risk to patients; the degree to which the person has been rehabilitated; what treatment, if any, the person has undergone; the areas of medicine in which the applicant is qualified to engage without endangering the safety of patients; and any other factor the board deems relevant in determining what conditions are most likely to protect the public while considering the interests of the applicant. The board may deny the application or may place such conditions upon the applicant as are necessary to protect the public. If the board grants the license, at a minimum the board shall prohibit the applicant from engaging in direct patient care or contact for so long as the applicant is required to register as a sexual offender.

Acts 2010, ch. 904 , § 2.

Code Commission Notes.

Acts 2010, ch. 904, § 2 purported to add a new section concerning remedial action against persons licensed to practice medicine who are required to register as a sexual offender or violent sexual offender in order to assure safety as § 63-6-238. Since Acts 2005, ch. 53, § 3 added § 63-6-238, ch. 904, § 2 was added as § 63-6-240.

Compiler's Notes. Acts 2010, ch. 904, § 3 provided that the act, which amended § 63-6-214(b)(10) and enacted § 63-6-240, shall apply to any person licensed to practice medicine in this state, whether such license was issued prior to or after July 1, 2010, and to any person applying to practice medicine in this state, whether the application was filed prior to or July 1, 2010.

63-6-241. Physical presence of physician required for abortion.

Notwithstanding § 63-6-209(b) or any other provision of this chapter, no physician licensed under this chapter or chapter 9 of this title shall perform or attempt to perform any abortion, including a medically induced abortion, or shall prescribe any drug or device intended to cause a medical abortion, except in the physical presence of the pregnant woman. No drug or device intended to cause a medical abortion shall be administered or dispensed to a pregnant woman except in the physical presence of her physician

Acts 2011, ch. 434, § 1; 2012, ch. 672, § 1.

Code Commission Notes.

Acts 2012, ch. 961, § 4 purported to enact a new § 63-6-241. Section 63-6-241 was previously enacted by Acts 2011, ch. 434, § 1, as amended by Acts 2012, ch. 672, § 1; § 63-6-242 was previously enacted by Acts 2012, ch. 818, § 1; and § 63-6-243 was previously enacted by Acts 2012, ch. 836, § 1; therefore, Acts 2012, ch. 961, § 4 was enacted as § 63-6-244 by authority of the code commission.

63-6-242. Employee or contractor's unauthorized use of medical doctor's DEA registration number to write prescriptions.

  1. Any medical doctor licensed pursuant to this chapter who has reason to believe that an employee or contractor of the doctor or the doctor's firm, partnership or corporation has used the doctor's federal drug enforcement administration (DEA) registration number without authorization to write prescriptions may make a report to a law enforcement agency.
  2. Any medical doctor, firm, partnership, or corporation making a report pursuant to subsection (a) shall be immune from any civil liability for making such report when made in good faith.

Acts 2012, ch. 818, § 1.

Code Commission Notes.

Acts 2012, ch. 836, § 1 purported to enact § 63-6-242. Section 63-6-242 was previously enacted by Acts 2012, ch. 818, § 1; therefore, Acts 2012, ch. 836, § 1 was enacted as § 63-6-243 by authority of the code commission.

Cross-References. Reporting persons obtaining or attempting to obtain controlled substances, § 53-11-309.

63-6-243. Hormone replacement therapy.

    1. “Hormone replacement therapy clinic” or “hormone therapy clinic” means a medical office in which the clinicians are primarily engaged in hormone replacement or supplementation therapy or a medical office which holds itself out to the public as being primarily or substantially engaged in hormone replacement therapy. For the purposes of this definition, “primarily engaged” means that a majority of the clinic's patients receive hormone replacement therapy and may be further defined by the board by rule. “Hormone replacement therapy clinic” does not mean a medical office in which the clinicians are primarily engaged in obstetrics and gynecology (OB/GYN), urology or primary care.
    2. “Hormone replacement therapy” or “hormone therapy” means the branch of the practice of medicine whereby the patient is treated with medications that include, but are not limited to, creams or natural formulas taken through the skin, under the tongue, in subcutaneous pellets, or orally that contain hormones that have the same bioidentical or similar chemical formula as those produced naturally in the human body or that the provider thinks or claims to be similar or identical, but shall not include the treatment of patients with birth control pills.
  1. In hormone replacement therapy clinics:
    1. All hormone replacement therapy shall be performed by a physician licensed under this chapter or chapter 9 of this title, or delegated by such physician to a certified nurse practitioner licensed pursuant to chapter 7 of this title or a physician assistant licensed pursuant to chapter 19 of this title; and
    2. If hormone replacement therapy is delegated, the supervising physician shall ensure that written protocols are developed for licensees to whom hormone replacement therapy is delegated, that such protocols are updated as necessary and that the patient is informed of both the name and contact information of the supervising physician and an indication of whether the physician is available onsite or remotely.
  2. A physician supervising hormone replacement therapy in a hormone replacement therapy clinic shall ensure that for each patient all of the following requirements are met:
    1. Prior to the initial hormone replacement therapy or course of treatments, an appropriate physical examination shall be conducted;
    2. An appropriate medical history shall be taken and documented on the patient;
    3. A written order for hormone replacement therapy shall be entered by the treating provider in the patient's medical record documenting the diagnosis and medical reason for the patient's need for hormone replacement therapy. If the treating provider is not a physician, the supervising physician shall make a personal review of the historical, physical and therapeutic data gathered by the treating provider and shall so certify the review in the patient's chart within seven (7) days of the patient being served;
    4. The patient gives written consent for hormone replacement therapy, which includes notification of possible complications and reasonable expectations and any applicable FDA warnings associated with any part of the therapy; and
    5. The supervising physician shall be immediately notified upon discovery of a complication.

Acts 2012, ch. 836, § 1.

Code Commission Notes.

Acts 2012, ch. 836, § 1 purported to enact § 63-6-242. Section 63-6-242 was previously enacted by Acts 2012, ch. 818, § 1; therefore, Acts 2012, ch. 836, § 1 was enacted as § 63-6-243 by authority of the code commission.

63-6-244. Interventional pain management.

  1. A physician licensed pursuant to this chapter may only practice interventional pain management if the licensee is either:
    1. Board certified through the American Board of Medical Specialties (ABMS) or the American Board of Physician Specialties (ABPS)/American Association of Physician Specialists (AAPS) in one of the following medical specialties:
      1. Anesthesiology;
      2. Neurological surgery;
      3. Orthopedic surgery;
      4. Physical medicine and rehabilitation;
      5. Radiology; or
      6. Any other board certified physician who has completed an ABMS subspecialty board in pain medicine or completed an ACGME-accredited pain fellowship;
    2. A recent graduate in a medical specialty listed in subdivision (a)(1) not yet eligible to apply for ABMS or ABPS/AAPS board certification; provided, that there is a practice relationship with a physician who meets the requirements of subdivision (a)(1) or an osteopathic physician who meets the requirements of § 63-9-121(a)(1);
    3. A licensee who is not board certified in one of the specialties listed in subdivision (a)(1) but is board certified in a different ABMS or ABPS/AAPS specialty and has completed a post-graduate training program in interventional pain management approved by the board;
    4. A licensee who serves as a clinical instructor in pain medicine at an accredited Tennessee medical training program; or
    5. A licensee who has an active pain management practice in a clinic accredited in outpatient interdisciplinary pain rehabilitation by the commission on accreditation of rehabilitation facilities or any successor organization.
  2. For purposes of this section, “interventional pain management” is the practice of performing 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.
  3. The board is authorized to define through rulemaking the scope and length of the practice relationship established in subdivision (a)(2).
  4. A physician who provides direct supervision of an advanced practice registered nurse or a physician's assistant pursuant to § 63-7-126 or § 63-19-107 must meet the requirements set forth in subdivision (a)(1) or (a)(3).
  5. A physician who violates this section is subject to disciplinary action by the board pursuant to § 63-6-214, including, but not limited to, civil penalties of up to one thousand dollars ($1,000) for every day this section is violated.

Acts 2012, ch. 961, § 4; 2016, ch. 980, § 9.

Code Commission Notes.

Acts 2012, ch. 961, § 4 purported to enact a new § 63-6-241. Section 63-6-241 was previously enacted by Acts 2011, ch. 434, § 1, as amended by Acts 2012, ch. 672, § 1; § 63-6-242 was previously enacted by Acts 2012, ch. 818, § 1; and § 63-6-243 was previously enacted by Acts 2012, ch. 836, § 1; therefore, Acts 2012, ch. 961, § 4 was enacted as § 63-6-244 by authority of the code commission.

Attorney General Opinions. Administering spinal injections in unlicensed settings not permitted unless licensed physician is board certified or meets one of the other statutory requirements.  OAG 14-49, 2014 Tenn. AG LEXIS 51 (4/23/14)

63-6-245. Notice to patients of determination that patient has dense or extremely dense breasts.

  1. As used in this section, “physician” means an individual authorized by this chapter to practice medicine and surgery or osteopathic medicine and surgery pursuant to chapter 9 of this title.
  2. If a physician has determined, after a mammogram is performed, that a patient has dense breasts or extremely dense breasts, based on the breast imaging reporting and data system established by the American College of Radiology, the facility where the mammogram was performed shall provide the following notice to the patient:

    Your mammogram shows that you have dense breast tissue. Dense breast tissue is common. However, dense breast tissue can hide breast cancer, so that it may not be seen on routine mammography. It may also be associated with an increased risk of developing breast cancer. You should discuss these results with your doctor to determine if additional tests might be helpful. A report of your mammogram results, which contains information about your breast density, has been sent to your doctor's office.

  3. This section shall become operative on January 1, 2014. Nothing in this section shall be construed to create or impose liability for failing to comply with the requirements of this section. Nothing in this section shall be deemed to create a duty of care or other legal obligation beyond the duty to provide notice as set forth in this section. Nothing in this section shall be deemed to require a notice that is inconsistent with the federal Mammography Quality Standards Act (42 U.S.C. § 263b) or any regulations promulgated pursuant to that act.

Acts 2013, ch. 387, § 1; 2018, ch. 750, § 1.

Compiler's Notes. Acts 2013, ch. 387, § 2 provided that the act, which enacted this section, may be known and cited as the “Breast Cancer Prevention Act.”

Amendments. The 2018 amendment, effective July 1, 2018, rewrote the notice in (b) which read: “Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the results of your mammogram and may also be associated with an increased risk of breast cancer. This information about the results of your mammogram is given to you to raise your awareness and to inform your conversations with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your physician.”

Effective Dates. Acts 2018, ch. 750, § 2. July 1, 2018.

63-6-246. Maintenance of licensure or certification not required.

  1. As used in this section:
    1. “Continuing medical education” means continued postgraduate medical education required by the board of medical examiners intended to provide medical professionals with knowledge of new developments or reinforcement of previously learned information in their field;
    2. “Maintenance of certification” means any process requiring periodic recertification examinations or other activities to maintain specialty medical board certification;
    3. “Maintenance of licensure” means the proprietary framework for physician license renewal established through the Federation of State Medical Boards or its successor organization, which includes additional periodic testing or requirements other than continuing medical education; and
    4. “Specialty medical board certification” means certification by a board that specializes in one (1) particular area of medicine and typically requires additional examinations other than the board of medical examiners' requirements to practice medicine.
  2. The board shall not deny a physician licensure based on a physician's non-participation in any form of maintenance of licensure, including requiring any form of maintenance of licensure tied to maintenance of certification. The board's regular requirements, including continuing medical education, demonstrate professional competency.
  3. The board shall not require any form of specialty medical board re-certification or any maintenance of certification to practice medicine in this state.

Acts 2017, ch. 438, § 1.

Effective Dates. Acts 2017, ch. 438, § 4. May 25, 2017.

63-6-247. [Repealed.]

Acts 2018, ch. 1037, § 1; repealed by Acts 2019, ch. 229, § 2, effective April 30, 2019.

Compiler's Notes. Former § 63-6-247 concerned acceptance of barter by physician as payment for rendering healthcare services.

Part 3
Phil Timp–Amanda Wilcox Right to Try Act

63-6-301. Short title.

This part shall be known and may be cited as the “Phil Timp-Amanda Wilcox Right to Try Act.”

Acts 2015, ch. 376, § 1.

Compiler's Notes. Former part 3, §§ 63-6-30163-6-310, concerning athletic trainers, was transferred to chapter 24 of this title in 1985.

63-6-302. Part definitions.

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

  1. “Advanced illness” means a progressive disease or medical or surgical condition that entails significant functional impairment, that is not considered by a treating physician to be reversible even with administration of current federal drug administration approved and available treatments, and that, without life-sustaining procedures, will soon result in death;
  2. “Adverse event” means any untoward medical occurrence associated with the use of an investigational drug, biological product, or device in humans, regardless if drug-related;
  3. “Eligible patient” means an individual who meets all of the following conditions:
    1. Has an advanced illness, attested to by the patient's treating physician and confirmed by a second physician;
    2. Has considered all other treatment options currently approved by the United States food and drug administration, and is unable to enter, or be accepted within one (1) week after applying to, a clinical trial within fifty (50) miles of the individual's home;
    3. Has received a recommendation from the patient's physician for an investigational drug, biological product, or device;
    4. Has given written, informed consent for the use of the investigational drug, biological product, or device; and
    5. Has documentation from the patient's physician that the patient meets the requirements of this subdivision (3);
  4. “Investigational drug, biological product, or device” means a drug, biological product, or device that has successfully completed phase 1 of a clinical trial as documented by the National Institutes of Health but has not yet been approved for general use by the federal food and drug administration (FDA) and remains under investigation in a clinical trial that is approved by the FDA; and
  5. “Written, informed consent” means a written document that is signed by the patient, the patient's parent, if the patient is a minor, the patient's legal guardian, or the patient's attorney-in-fact designated by the patient under title 34, chapter 6, part 2, and attested to by the patient's physician and a witness, and that, at a minimum, includes all of the following:
    1. An explanation of the currently approved products and treatments for the disease or condition from which the patient suffers;
    2. An attestation that the patient concurs with the patient's physician in believing that all currently approved and conventionally recognized treatments are unlikely to prolong the patient's life;
    3. Clear identification of the specific proposed investigational drug, biological product, or device that the patient is seeking to use;
    4. A description of the potentially best and worst outcomes of using the investigational drug, biological product, or device and a realistic description of the most likely outcome. The description shall include the possibility that new, unanticipated, different, or worse symptoms might result and that death could be hastened by the proposed treatment. The description shall be based on the physician's knowledge of the proposed treatment in conjunction with an awareness of the patient's condition;
    5. A release of liability relative to the treating physician, licensed healthcare providers, hospital, and manufacturer of the investigational drug, biological product, procedure, or device;
    6. A statement that the patient's health plan or third-party administrator and provider are not obligated to pay for any care or treatments consequent to the use of the investigational drug, biological product, or device, unless they are specifically required to do so by law or contract;
    7. A statement that the patient's eligibility for hospice care may be withdrawn if the patient begins curative treatment with the investigational drug, biological product, or device and that care may be reinstated if this treatment ends and the patient meets hospice eligibility requirements; and
    8. A statement that the patient understands that the patient is liable for all expenses consequent to the use of the investigational drug, biological product, or device and that this liability extends to the patient's estate, unless a contract between the patient and the manufacturer of the drug, biological product, or device states otherwise.

Acts 2015, ch. 376, § 1.

63-6-303. Manufacturer permitted to provide investigational drug, biological product, or device to eligible patient — Conditions.

  1. A manufacturer of an investigational drug, biological product, or device may make available, and an eligible patient may request, the manufacturer's investigational drug, biological product, or device under this part; provided, that this part does not require that a manufacturer make available an investigational drug, biological product, or device to an eligible patient.
  2. A manufacturer may do all of the following:
    1. Provide an investigational drug, biological product, or device to an eligible patient without receiving compensation; and
    2. Require an eligible patient to pay the costs of, or the costs associated with, the manufacture of the investigational drug, biological product, or device.

Acts 2015, ch. 376, § 1.

63-6-304. Payment of costs — Provision of items or services without approval not required.

  1. This part does not expand the coverage required of an insurer under title 56, chapter 7.
  2. A health plan, third-party administrator, or governmental agency may, but is not required to, provide coverage for the cost of an investigational drug, biological product, or device, or the cost of services related to the use of an investigational drug, biological product, or device under this part.
  3. This part does not require any governmental agency to pay costs associated with the use, care, or treatment of a patient with an investigational drug, biological product, or device.
  4. This part does not require any hospital or facility licensed under title 68, chapter 11, or any physician or healthcare provider to provide any items or services unless a request by an eligible patient is approved by the hospital, facility, physician, or healthcare provider.

Acts 2015, ch. 376, § 1.

63-6-305. Patient's heirs not liable for outstanding debt.

If a patient dies while being treated by an investigational drug, biological product, or device, the patient's heirs are not liable for any outstanding debt related to the treatment or lack of insurance due to the treatment.

Acts 2015, ch. 376, § 1.

63-6-306. Action against healthcare provider's license or medicare certification prohibited.

A licensing board or disciplinary subcommittee shall not revoke, fail to renew, suspend, or take any action against a healthcare provider's license issued under this title, based solely on the healthcare provider's recommendations to an eligible patient regarding access to or treatment with an investigational drug, biological product, or device. An entity responsible for medicare certification shall not take action against a healthcare provider's medicare certification based solely on the healthcare provider's recommendation that a patient have access to an investigational drug, biological product, or device.

Acts 2015, ch. 376, § 1.

63-6-307. Official, employee, or agent of state prohibited from blocking eligible patient's access.

An official, employee, or agent of this state shall not block or attempt to block an eligible patient's access to an investigational drug, biological product, or device. The rendering of counseling, advice, or a recommendation consistent with medical standards of care from a licensed healthcare provider is not a violation of this section.

Acts 2015, ch. 376, § 1.

63-6-308. No private cause of action for harm done to eligible patient resulting from investigational drug, biological product, or device — Part does not affect requirements under § 56-7-2365.

  1. This part does not create a private cause of action against a manufacturer of an investigational drug, biological product, or device or against any other person or entity involved in the care of an eligible patient using the investigational drug, biological product, or device for any harm done to the eligible patient resulting from the investigational drug, biological product, or device, if the manufacturer or other person or entity is complying in good faith with the terms of this part and has exercised reasonable care.
  2. This part does not affect any mandatory healthcare coverage for participation in clinical trials under § 56-7-2365.

Acts 2015, ch. 376, § 1.

63-6-309. Reporting of adverse events.

If a patient suffers an adverse event associated with the use of an investigational drug, biological product, or device, the patient's physician shall report the adverse event to the manufacturer of the investigational drug, biological product, or device

Acts 2015, ch. 376, § 1.

Part 4
Interstate Medical Licensure Compact

63-6-401. Short title.

This part shall be known and may be cited as the “Interstate Medical Licensure Compact.”

Acts 2017, ch. 365, § 1.

Code Commission Notes.

Acts 2017, ch. 365, § 1 enacted a new part 13, §§ 63-6-1301 —63-6-1302, but the part has been redesignated as part 4, §§ 63-6-40163-6-402 by authority of the Code Commission.

Effective Dates. Acts 2017, ch. 365, § 2. January 1, 2019.

63-6-402. Interstate Medical Licensure Compact.

The Interstate Medical Licensure Compact is enacted into law and entered into by this state with all states legally joining therein in the form substantially as follows:

INTERSTATE MEDICAL LICENSURE COMPACT

SECTION 1.  PURPOSE

In order to strengthen access to health care, and in recognition of the advances in the delivery of health care, the member states of the Interstate Medical Licensure Compact have allied in common purpose to develop a comprehensive process that complements the existing licensing and regulatory authority of state medical boards, provides a streamlined process that allows physicians to become licensed in multiple states, thereby enhancing the portability of a medical license and ensuring the safety of patients. The Compact creates another pathway for licensure and does not otherwise change a state's existing Medical Practice Act. The Compact also adopts the prevailing standard for licensure and affirms that the practice of medicine occurs where the patient is located at the time of the physician-patient encounter, and therefore, requires the physician to be under the jurisdiction of the state medical board where the patient is located. State medical boards that participate in the Compact retain the jurisdiction to impose an adverse action against a license to practice medicine in that state issued to a physician through the procedures in the Compact.

SECTION 2.  DEFINITIONS

In this compact:

  1. “Bylaws” means those bylaws established by the Interstate Commission pursuant to Section 11 for its governance, or for directing and controlling its actions and conduct.
  2. “Commissioner” means the voting representative appointed by each member board pursuant to Section 11.
  3. “Conviction” means a finding by a court that an individual is guilty of a criminal offense through adjudication, or entry of a plea of guilt or no contest to the charge by the offender. Evidence of an entry of a conviction of a criminal offense by the court shall be considered final for purposes of disciplinary action by a member board.
  4. “Expedited License” means a full and unrestricted medical license granted by a member state to an eligible physician through the process set forth in the Compact.
  5. “Interstate Commission” means the interstate commission created pursuant to Section 11.
  6. “License” means authorization by a state for a physician to engage in the practice of medicine, which would be unlawful without the authorization.
  7. “Medical Practice Act” means laws and regulations governing the practice of allopathic and osteopathic medicine within a member state.
  8. “Member Board” means a state agency in a member state that acts in the sovereign interests of the state by protecting the public through licensure, regulation, and education of physicians as directed by the state government.
  9. “Member State” means a state that has enacted the Compact.
  10. “Practice of Medicine” means the clinical prevention, diagnosis, or treatment of human disease, injury, or condition requiring a physician to obtain and maintain a license in compliance with the Medical Practice Act of a member state.
  11. “Physician” means any person who:
    1. Is a graduate of a medical school accredited by the Liaison Committee on Medical Education, the Commission on Osteopathic College Accreditation, or a medical school listed in the International Medical Education Directory or its equivalent;
    2. Passed each component of the United States Medical Licensing Examination (USMLE) or the Comprehensive Osteopathic Medical Licensing Examination (COMLEX-USA) within three attempts, or any of its predecessor examinations accepted by a state medical board as an equivalent examination for licensure purposes;
    3. Successfully completed graduate medical education approved by the Accreditation Council for Graduate Medical Education or the American Osteopathic Association;
    4. Holds specialty certification or a time-unlimited specialty certificate recognized by the American Board of Medical Specialties or the American Osteopathic Association's Bureau of Osteopathic Specialists;
    5. Possesses a full and unrestricted license to engage in the practice of medicine issued by a member board;
    6. Has never been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;
    7. Has never held a license authorizing the practice of medicine subjected to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-payment of fees related to a license;
    8. Has never had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration; and
    9. Is not under active investigation by a licensing agency or law enforcement authority in any state, federal, or foreign jurisdiction.
  12. “Offense” means a felony, gross misdemeanor, or crime of moral turpitude.
  13. “Rule” means a written statement by the Interstate Commission promulgated pursuant to Section 12 of the Compact that is of general applicability, implements, interprets, or prescribes a policy or provision of the Compact, or an organizational, procedural, or practice requirement of the Interstate Commission, and has the force and effect of statutory law in a member state, and includes the amendment, repeal, or suspension of an existing rule.
  14. “State” means any state, commonwealth, district, or territory of the United States.
  15. “State of Principal License” means a member state where a physician holds a license to practice medicine and which has been designated as such by the physician for purposes of registration and participation in the Compact.

    SECTION 3.  ELIGIBILITY

    SECTION 4.  DESIGNATION OF STATE OF PRINCIPAL LICENSE

    1. the state of primary residence for the physician, or
    2. the state where at least 25% of the practice of medicine occurs, or
    3. the location of the physician's employer, or
    4. if no state qualifies under subsection (1), subsection (2), or subsection (3), the state designated as state of residence for purpose of federal income tax.

      SECTION 5.  APPLICATION AND ISSUANCE OF EXPEDITED LICENSURE

      SECTION 6.  FEES FOR EXPEDITED LICENSURE

      SECTION 7.  RENEWAL AND CONTINUED PARTICIPATION

      SECTION 8.  COORDINATED INFORMATION SYSTEM

      SECTION 9.  JOINT INVESTIGATIONS

      SECTION 10.  DISCIPLINARY ACTIONS

      SECTION 11.  INTERSTATE MEDICAL LICENSURE COMPACT COMMISSION

    5. Discuss information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;
    6. Discuss investigative records compiled for law enforcement purposes; or
    7. Specifically relate to the participation in a civil action or other legal proceeding.

      SECTION 12.  POWERS AND DUTIES OF THE INTERSTATE COMMISSION

      The Interstate Commission shall have the duty and power to:

  16. Adopt a seal and bylaws governing the management and operation of the Interstate Commission;
  17. Report annually to the legislatures and governors of the member states concerning the activities of the Interstate Commission during the preceding year. Such reports shall also include reports of financial audits and any recommendations that may have been adopted by the Interstate Commission;
  18. Coordinate education, training, and public awareness regarding the Compact, its implementation, and its operation;
  19. Maintain records in accordance with the bylaws;
  20. Seek and obtain trademarks, copyrights, and patents; and
  21. Perform such functions as may be necessary or appropriate to achieve the purposes of the Compact.

    SECTION 13.  FINANCE POWERS

    SECTION 14.  ORGANIZATION AND OPERATION OF THE INTERSTATE COMMISSION

    1. The liability of the executive director and employees of the Interstate Commission or representatives of the Interstate Commission, acting within the scope of such person's employment or duties for acts, errors, or omissions occurring within such person's state, may not exceed the limits of liability set forth under the constitution and laws of that state for state officials, employees, and agents. The Interstate Commission is considered to be an instrumentality of the states for the purposes of any such action. Nothing in this subsection shall be construed to protect such person from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person.
    2. The Interstate Commission shall defend the executive director, its employees, and subject to the approval of the attorney general or other appropriate legal counsel of the member state represented by an Interstate Commission representative, shall defend such Interstate Commission representative in any civil action seeking to impose liability arising out of an actual or alleged act, error or omission that occurred within the scope of Interstate Commission employment, duties or responsibilities, or that the defendant had a reasonable basis for believing occurred within the scope of Interstate Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such person.
    3. To the extent not covered by the state involved, member state, or the Interstate Commission, the representatives or employees of the Interstate Commission shall be held harmless in the amount of a settlement or judgment, including attorney's fees and costs, obtained against such persons arising out of an actual or alleged act, error, or omission that occurred within the scope of Interstate Commission employment, duties, or responsibilities, or that such persons had a reasonable basis for believing occurred within the scope of Interstate Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from intentional or willful and wanton misconduct on the part of such persons.

      SECTION 15.  RULEMAKING FUNCTIONS OF THE INTERSTATE COMMISSION

      SECTION 16.  OVERSIGHT OF INTERSTATE COMPACT

      SECTION 17.  ENFORCEMENT OF INTERSTATE COMPACT

      SECTION 18.  DEFAULT PROCEDURES

      SECTION 19.  DISPUTE RESOLUTION

      SECTION 20.  MEMBER STATES, EFFECTIVE DATE AND AMENDMENT

      SECTION 21.  WITHDRAWAL

      SECTION 22.  DISSOLUTION

      SECTION 23.  SEVERABILITY AND CONSTRUCTION

      SECTION 24.  BINDING EFFECT OF COMPACT AND OTHER LAWS

A physician must meet the eligibility requirements as defined in Section 2(k) to receive an expedited license under the terms and provisions of the Compact.

A physician who does not meet the requirements of Section 2(k) may obtain a license to practice medicine in a member state if the individual complies with all laws and requirements, other than the Compact, relating to the issuance of a license to practice medicine in that state.

A physician shall designate a member state as the state of principal license for purposes of registration for expedited licensure through the Compact if the physician possesses a full and unrestricted license to practice medicine in that state, and the state is:

A physician may redesignate a member state as state of principal license at any time, as long as the state meets the requirements in subsection (a).

The Interstate Commission is authorized to develop rules to facilitate redesignation of another member state as the state of principal license.

A physician seeking licensure through the Compact shall file an application for an expedited license with the member board of the state selected by the physician as the state of principal license.

Upon receipt of an application for an expedited license, the member board within the state selected as the state of principal license shall evaluate whether the physician is eligible for expedited licensure and issue a letter of qualification, verifying or denying the physician's eligibility, to the Interstate Commission.

Static qualifications, which include verification of medical education, graduate medical education, results of any medical or licensing examination, and other qualifications as determined by the Interstate Commission through rule, shall not be subject to additional primary source verification where already primary source verified by the state of principal license.

The member board within the state selected as the state of principal license shall, in the course of verifying eligibility, perform a criminal background check of an applicant, including the use of the results of fingerprint or other biometric data checks compliant with the requirements of the Federal Bureau of Investigation, with the exception of federal employees who have suitability determination in accordance with 5 C.F.R. 731.202.

Appeal on the determination of eligibility shall be made to the member state where the application was filed and shall be subject to the law of that state.

Upon verification in subsection (b), physicians eligible for an expedited license shall complete the registration process established by the Interstate Commission to receive a license in a member state selected pursuant to subsection (a), including the payment of any applicable fees.

After receiving verification of eligibility under subsection (b) and any fees under subsection (c), a member board shall issue an expedited license to the physician. This license shall authorize the physician to practice medicine in the issuing state consistent with the Medical Practice Act and all applicable laws and regulations of the issuing member board and member state.

An expedited license shall be valid for a period consistent with the licensure period in the member state and in the same manner as required for other physicians holding a full and unrestricted license within the member state.

An expedited license obtained through the Compact shall be terminated if a physician fails to maintain a license in the state of principal licensure for a non-disciplinary reason, without redesignation of a new state of principal licensure.

The Interstate Commission is authorized to develop rules regarding the application process, including payment of any applicable fees, and the issuance of an expedited license.

A member state issuing an expedited license authorizing the practice of medicine in that state may impose a fee for a license issued or renewed through the Compact.

The Interstate Commission is authorized to develop rules regarding fees for expedited licenses.

A physician seeking to renew an expedited license granted in a member state shall complete a renewal process with the Interstate Commission if the physician:

Maintains a full and unrestricted license in a state of principal license;

Has not been convicted, received adjudication, deferred adjudication, community supervision, or deferred disposition for any offense by a court of appropriate jurisdiction;

Has not had a license authorizing the practice of medicine subject to discipline by a licensing agency in any state, federal, or foreign jurisdiction, excluding any action related to non-payment of fees related to a license; and

Has not had a controlled substance license or permit suspended or revoked by a state or the United States Drug Enforcement Administration.

Physicians shall comply with all continuing professional development or continuing medical education requirements for renewal of a license issued by a member state.

The Interstate Commission shall collect any renewal fees charged for the renewal of a license and distribute the fees to the applicable member board.

Upon receipt of any renewal fees collected in subsection (c), a member board shall renew the physician's license.

Physician information collected by the Interstate Commission during the renewal process will be distributed to all member boards.

The Interstate Commission is authorized to develop rules to address renewal of licenses obtained through the Compact.

The Interstate Commission shall establish a database of all physicians licensed, or who have applied for licensure, under Section 5.

Notwithstanding any other provision of law, member boards shall report to the Interstate Commission any public action or complaints against a licensed physician who has applied or received an expedited license through the Compact.

Member boards shall report disciplinary or investigatory information determined as necessary and proper by rule of the Interstate Commission.

Member boards may report any non-public complaint, disciplinary, or investigatory information not required by subsection (c) to the Interstate Commission.

Member boards shall share complaint or disciplinary information about a physician upon request of another member board.

All information provided to the Interstate Commission or distributed by member boards shall be confidential, filed under seal, and used only for investigatory or disciplinary matters.

The Interstate Commission is authorized to develop rules for mandated or discretionary sharing of information by member boards.

Licensure and disciplinary records of physicians are deemed investigative.

In addition to the authority granted to a member board by its respective Medical Practice Act or other applicable state law, a member board may participate with other member boards in joint investigations of physicians licensed by the member boards.

A subpoena issued by a member state shall be enforceable in other member states.

Member boards may share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.

Any member state may investigate actual or alleged violations of the statutes authorizing the practice of medicine in any other member state in which a physician holds a license to practice medicine.

Any disciplinary action taken by any member board against a physician licensed through the Compact shall be deemed unprofessional conduct which may be subject to discipline by other member boards, in addition to any violation of the Medical Practice Act or regulations in that state.

If a license granted to a physician by the member board in the state of principal license is revoked, surrendered or relinquished in lieu of discipline, or suspended, then all licenses issued to the physician by member boards shall automatically be placed, without further action necessary by any member board, on the same status. If the member board in the state of principal license subsequently reinstates the physician's license, a license issued to the physician by any other member board shall remain encumbered until that respective member board takes action to reinstate the license in a manner consistent with the Medical Practice Act of that state.

If disciplinary action is taken against a physician by a member board not in the state of principal license, any other member board may deem the action conclusive as to matter of law and fact decided, and:

impose the same or lesser sanction(s) against the physician so long as such sanctions are consistent with the Medical Practice Act of that state; or

pursue separate disciplinary action against the physician under its respective Medical Practice Act, regardless of the action taken in other member states.

If a license granted to a physician by a member board is revoked, surrendered or relinquished in lieu of discipline, or suspended, then any license(s) issued to the physician by any other member board(s) shall be suspended, automatically and immediately without further action necessary by the other member board(s), for ninety (90) days upon entry of the order by the disciplining board, to permit the member board(s) to investigate the basis for the action under the Medical Practice Act of that state. A member board may terminate the automatic suspension of the license it issued prior to the completion of the ninety (90) day suspension period in a manner consistent with the Medical Practice Act of that state.

The member states hereby create the “Interstate Medical Licensure Compact Commission”.

The purpose of the Interstate Commission is the administration of the Interstate Medical Licensure Compact, which is a discretionary state function.

The Interstate Commission shall be a body corporate and joint agency of the member states and shall have all the responsibilities, powers, and duties set forth in the Compact, and such additional powers as may be conferred upon it by a subsequent concurrent action of the respective legislatures of the member states in accordance with the terms of the Compact.

The Interstate Commission shall consist of two voting representatives appointed by each member state who shall serve as Commissioners. In states where allopathic and osteopathic physicians are regulated by separate member boards, or if the licensing and disciplinary authority is split between multiple member boards within a member state, the member state shall appoint one representative from each member board. A Commissioner shall be a(n):

Allopathic or osteopathic physician appointed to a member board;

Executive director, executive secretary, or similar executive of a member board; or

Member of the public appointed to a member board.

The Interstate Commission shall meet at least once each calendar year. A portion of this meeting shall be a business meeting to address such matters as may properly come before the Commission, including the election of officers. The chairperson may call additional meetings and shall call for a meeting upon the request of a majority of the member states.

The bylaws may provide for meetings of the Interstate Commission to be conducted by telecommunication or electronic communication.

Each Commissioner participating at a meeting of the Interstate Commission is entitled to one vote. A majority of Commissioners shall constitute a quorum for the transaction of business, unless a larger quorum is required by the bylaws of the Interstate Commission. A Commissioner shall not delegate a vote to another Commissioner. In the absence of its Commissioner, a member state may delegate voting authority for a specified meeting to another person from that state who shall meet the requirements of subsection (d).

The Interstate Commission shall provide public notice of all meetings and all meetings shall be open to the public. The Interstate Commission may close a meeting, in full or in portion, where it determines by a two-thirds vote of the Commissioners present that an open meeting would be likely to:

Relate solely to the internal personnel practices and procedures of the Interstate Commission;

Discuss matters specifically exempted from disclosure by federal statute;

Discuss trade secrets, commercial, or financial information that is privileged or confidential;

Involve accusing a person of a crime, or formally censuring a person;

The Interstate Commission shall keep minutes which shall fully describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, including record of any roll call votes.

The Interstate Commission shall make its information and official records, to the extent not otherwise designated in the Compact or by its rules, available to the public for inspection.

The Interstate Commission shall establish an executive committee, which shall include officers, members, and others as determined by the bylaws. The executive committee shall have the power to act on behalf of the Interstate Commission, with the exception of rulemaking, during periods when the Interstate Commission is not in session. When acting on behalf of the Interstate Commission, the executive committee shall oversee the administration of the Compact including enforcement and compliance with the provisions of the Compact, its bylaws and rules, and other such duties as necessary.

The Interstate Commission may establish other committees for governance and administration of the Compact.

Oversee and maintain the administration of the Compact;

Promulgate rules which shall be binding to the extent and in the manner provided for in the Compact;

Issue, upon the request of a member state or member board, advisory opinions concerning the meaning or interpretation of the Compact, its bylaws, rules, and actions;

Enforce compliance with Compact provisions, the rules promulgated by the Interstate Commission, and the bylaws, using all necessary and proper means, including but not limited to the use of judicial process;

Establish and appoint committees including, but not limited to, an executive committee as required by Section 11, which shall have the power to act on behalf of the Interstate Commission in carrying out its powers and duties;

Pay, or provide for the payment of the expenses related to the establishment, organization, and ongoing activities of the Interstate Commission;

Establish and maintain one or more offices;

Borrow, accept, hire, or contract for services of personnel;

Purchase and maintain insurance and bonds;

Employ an executive director who shall have such powers to employ, select or appoint employees, agents, or consultants, and to determine their qualifications, define their duties, and fix their compensation;

Establish personnel policies and programs relating to conflicts of interest, rates of compensation, and qualifications of personnel;

Accept donations and grants of money, equipment, supplies, materials and services, and to receive, utilize, and dispose of them in a manner consistent with the conflict of interest policies established by the Interstate Commission;

Lease, purchase, accept contributions or donations of, or otherwise to own, hold, improve or use, any property, real, personal, or mixed;

Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;

Establish a budget and make expenditures;

The Interstate Commission may levy on and collect an annual assessment from each member state to cover the cost of the operations and activities of the Interstate Commission and its staff. The total assessment must be sufficient to cover the annual budget approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated upon a formula to be determined by the Interstate Commission, which shall promulgate a rule binding upon all member states.

The Interstate Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same.

The Interstate Commission shall not pledge the credit of any of the member states, except by, and with the authority of, the member state.

The Interstate Commission shall be subject to a yearly financial audit conducted by a certified or licensed public accountant and the report of the audit shall be included in the annual report of the Interstate Commission.

The Interstate Commission shall, by a majority of Commissioners present and voting, adopt bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes of the Compact within twelve (12) months of the first Interstate Commission meeting.

The Interstate Commission shall elect or appoint annually from among its Commissioners a chairperson, a vice-chairperson, and a treasurer, each of whom shall have such authority and duties as may be specified in the bylaws. The chairperson, or in the chairperson's absence or disability, the vice-chairperson, shall preside at all meetings of the Interstate Commission.

Officers selected in subsection (b) shall serve without remuneration from the Interstate Commission.

The officers and employees of the Interstate Commission shall be immune from suit and liability, either personally or in their official capacity, for a claim for damage to or loss of property or personal injury or other civil liability caused or arising out of, or relating to, an actual or alleged act, error, or omission that occurred, or that such person had a reasonable basis for believing occurred, within the scope of Interstate Commission employment, duties, or responsibilities; provided that such person shall not be protected from suit or liability for damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of such person.

The Interstate Commission shall promulgate reasonable rules in order to effectively and efficiently achieve the purposes of the Compact. Notwithstanding the foregoing, in the event the Interstate Commission exercises its rulemaking authority in a manner that is beyond the scope of the purposes of the Compact, or the powers granted hereunder, then such an action by the Interstate Commission shall be invalid and have no force or effect.

Rules deemed appropriate for the operations of the Interstate Commission shall be made pursuant to a rulemaking process that substantially conforms to the “Model State Administrative Procedure Act” of 2010, and subsequent amendments thereto.

Not later than thirty (30) days after a rule is promulgated, any person may file a petition for judicial review of the rule in the United States District Court for the District of Columbia or the federal district where the Interstate Commission has its principal offices, provided that the filing of such a petition shall not stay or otherwise prevent the rule from becoming effective unless the court finds that the petitioner has a substantial likelihood of success. The court shall give deference to the actions of the Interstate Commission consistent with applicable law and shall not find the rule to be unlawful if the rule represents a reasonable exercise of the authority granted to the Interstate Commission.

The executive, legislative, and judicial branches of state government in each member state shall enforce the Compact and shall take all actions necessary and appropriate to effectuate the Compact's purposes and intent. The provisions of the Compact and the rules promulgated hereunder shall have standing as statutory law but shall not override existing state authority to regulate the practice of medicine.

All courts shall take judicial notice of the Compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of the Compact which may affect the powers, responsibilities or actions of the Interstate Commission.

The Interstate Commission shall be entitled to receive all service of process in any such proceeding, and shall have standing to intervene in the proceeding for all purposes. Failure to provide service of process to the Interstate Commission shall render a judgment or order void as to the Interstate Commission, the Compact, or promulgated rules.

The Interstate Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of the Compact.

The Interstate Commission may, by majority vote of the Commissioners, initiate legal action in the United States District Court for the District of Columbia, or, at the discretion of the Interstate Commission, in the federal district where the Interstate Commission has its principal offices, to enforce compliance with the provisions of the Compact, and its promulgated rules and bylaws, against a member state in default. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation including reasonable attorney's fees.

The remedies herein shall not be the exclusive remedies of the Interstate Commission. The Interstate Commission may avail itself of any other remedies available under state law or the regulation of a profession.

The grounds for default include, but are not limited to, failure of a member state to perform such obligations or responsibilities imposed upon it by the Compact, or the rules and bylaws of the Interstate Commission promulgated under the Compact.

If the Interstate Commission determines that a member state has defaulted in the performance of its obligations or responsibilities under the Compact, or the bylaws or promulgated rules, the Interstate Commission shall:

Provide written notice to the defaulting state and other member states, of the nature of the default, the means of curing the default, and any action taken by the Interstate Commission. The Interstate Commission shall specify the conditions by which the defaulting state must cure its default; and

Provide remedial training and specific technical assistance regarding the default.

If the defaulting state fails to cure the default, the defaulting state shall be terminated from the Compact upon an affirmative vote of a majority of the Commissioners and all rights, privileges, and benefits conferred by the Compact shall terminate on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of the default.

Termination of membership in the Compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to terminate shall be given by the Interstate Commission to the governor, the majority and minority leaders of the defaulting state's legislature, and each of the member states.

The Interstate Commission shall establish rules and procedures to address licenses and physicians that are materially impacted by the termination of a member state, or the withdrawal of a member state.

The member state which has been terminated is responsible for all dues, obligations, and liabilities incurred through the effective date of termination including obligations, the performance of which extends beyond the effective date of termination.

The Interstate Commission shall not bear any costs relating to any state that has been found to be in default or which has been terminated from the Compact, unless otherwise mutually agreed upon in writing between the Interstate Commission and the defaulting state.

The defaulting state may appeal the action of the Interstate Commission by petitioning the United States District Court for the District of Columbia or the federal district where the Interstate Commission has its principal offices. The prevailing party shall be awarded all costs of such litigation including reasonable attorney's fees.

The Interstate Commission shall attempt, upon the request of a member state, to resolve disputes which are subject to the Compact and which may arise among member states or member boards.

The Interstate Commission shall promulgate rules providing for both mediation and binding dispute resolution as appropriate.

Any state is eligible to become a member state of the Compact.

The Compact shall become effective and binding upon legislative enactment of the Compact into law by no less than seven (7) states. Thereafter, it shall become effective and binding on a state upon enactment of the Compact into law by that state.

The governors of non-member states, or their designees, shall be invited to participate in the activities of the Interstate Commission on a non-voting basis prior to adoption of the Compact by all states.

The Interstate Commission may propose amendments to the Compact for enactment by the member states. No amendment shall become effective and binding upon the Interstate Commission and the member states unless and until it is enacted into law by unanimous consent of the member states.

Once effective, the Compact shall continue in force and remain binding upon each and every member state; provided that a member state may withdraw from the Compact by specifically repealing the statute which enacted the Compact into law.

Withdrawal from the Compact shall be by the enactment of a statute repealing the same, but shall not take effect until one (1) year after the effective date of such statute and until written notice of the withdrawal has been given by the withdrawing state to the governor of each other member state.

The withdrawing state shall immediately notify the chairperson of the Interstate Commission in writing upon the introduction of legislation repealing the Compact in the withdrawing state.

The Interstate Commission shall notify the other member states of the withdrawing state's intent to withdraw within sixty (60) days of its receipt of notice provided under subsection (c).

The withdrawing state is responsible for all dues, obligations and liabilities incurred through the effective date of withdrawal, including obligations, the performance of which extend beyond the effective date of withdrawal.

Reinstatement following withdrawal of a member state shall occur upon the withdrawing state reenacting the Compact or upon such later date as determined by the Interstate Commission.

The Interstate Commission is authorized to develop rules to address the impact of the withdrawal of a member state on licenses granted in other member states to physicians who designated the withdrawing member state as the state of principal license.

The Compact shall dissolve effective upon the date of the withdrawal or default of the member state which reduces the membership in the Compact to one (1) member state.

Upon the dissolution of the Compact, the Compact becomes null and void and shall be of no further force or effect, and the business and affairs of the Interstate Commission shall be concluded and surplus funds shall be distributed in accordance with the bylaws.

The provisions of the Compact shall be severable, and if any phrase, clause, sentence, or provision is deemed unenforceable, the remaining provisions of the Compact shall be enforceable.

The provisions of the Compact shall be liberally construed to effectuate its purposes.

Nothing in the Compact shall be construed to prohibit the applicability of other interstate compacts to which the states are members.

Nothing herein prevents the enforcement of any other law of a member state that is not inconsistent with the Compact.

All laws in a member state in conflict with the Compact are superseded to the extent of the conflict.

All lawful actions of the Interstate Commission, including all rules and bylaws promulgated by the Commission, are binding upon the member states.

All agreements between the Interstate Commission and the member states are binding in accordance with their terms.

In the event any provision of the Compact exceeds the constitutional limits imposed on the legislature of any member state, such provision shall be ineffective to the extent of the conflict with the constitutional provision in question in that member state.

Acts 2017, ch. 365, § 1.

Code Commission Notes.

Acts 2017, ch. 365, § 1 enacted a new part 13, §§ 63-6-1301 —63-6-1302, but the part has been redesignated as part 4, §§ 63-6-40163-6-402 by authority of the Code Commission.

Effective Dates. Acts 2017, ch. 365, § 2. January 1, 2019.

Part 5
Physicians' Conflict of Interest Disclosure Act of 1991

63-6-501. Short title.

This part shall be known as the “Physicians' Conflict of Interest Disclosure Act of 1991.”

Acts 1991, ch. 349, § 1.

Law Reviews.

The Brief Life of the Gag Clause: Why Anti-Gag Clause Legislation Isn't Enough, 67 Tenn. L. Rev. 1 (1999).

63-6-502. Conflict of interest — How addressed.

  1. Physicians are free to enter lawful contractual relationships, including the acquisition of ownership interests in health facilities, equipment or pharmaceuticals, but these can create potential conflicts of interest.
  2. The potential conflict of interest shall be addressed by the following:
    1. The physician has a duty to disclose to the patient or referring colleagues such physician's ownership interest in the facility or therapy at the time of referral and prior to utilization;
    2. The physician shall not exploit the patient in any way, as by inappropriate or unnecessary utilization;
    3. The physician's activities shall be in strict conformity with the law;
    4. The patient shall have free choice either to use the physician's proprietary facility or therapy or to seek the needed medical services elsewhere; and
    5. When a physician's commercial interest conflicts so greatly with the patient's interest as to be incompatible, the physician shall make alternative arrangements for the care of the patient.
  3. The board shall have the authority to promulgate rules and regulations to effectuate this section.

Acts 1991, ch. 349, § 1.

63-6-503. Federal law.

Nothing in this part is intended to nor shall it permit any action that is inconsistent with the federal Patient and Program Protection Act of 1987, or other provisions of federal law that prohibits such arrangements as a condition to receipt of federal funds.

Acts 1991, ch. 349, § 2.

Compiler's Notes. The act referred to in this section is apparently the Medicare and Medicaid Patient and Program Protection Act of 1987, P.L. 100-93, which amended numerous sections throughout 42 U.S.C.

Part 6
Health Care Referrals

63-6-601. Part definitions.

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

  1. “Entity” or “health care entity” means and includes a health care facility and an agency, company or health care professional, other than the referring physician, providing health care services;
  2. “Health care facility” means and includes any real property or equipment of a health care institution as that term is defined in § 68-11-1602;
  3. “Health care service” means and includes a diagnostic, treatment, therapy or rehabilitation service.

Acts 1993, ch. 408, § 2.

Law Reviews.

The Brief Life of the Gag Clause: Why Anti-Gag Clause Legislation Isn't Enough, 67 Tenn. L. Rev. 1 (1999).

Attorney General Opinions. A pharmacy falls within the definition of a “health care entity” as that term is defined in T.C.A. § 63-6-601. OAG 14-100, 2014 Tenn. AG LEXIS 103 (10/31/14).

63-6-602. Physician owned health care entities — Referrals prohibited — Exceptions.

  1. Physician investment in health care can provide important benefits for patient care; however, when physicians refer patients to entities in which they have an ownership interest, a potential conflict of interest exists. A physician having an investment interest in a health care entity shall not refer patients to the entity unless:
    1. The physician performs health care services at the entity; or
    2. The investment interest satisfies the requirements set forth in § 63-6-603.
  2. Subsection (a) shall not apply to physicians when a health care facility leases premises or equipment from an entity owning the premises or equipment, even if physicians have an ownership interest in the entity that leases the premises or equipment to the health care facility and refer patients to the health care facility, if:
    1. There is a written lease agreement between the health care facility leasing the premises or equipment and the entity owning the premises or equipment;
    2. The lease specifies the premises or equipment covered by the lease;
    3. The term of the lease is for not less than one (1) year;
    4. The aggregate rental charge is set in advance, is consistent with fair market value in arms-length transactions and is not determined in a manner that takes into account the volume or value of any referrals by physicians having an ownership interest in the entity leasing the premises or space to the health care facility; and
    5. A physician having an ownership interest in the entity leasing the premises or space to the health care facility discloses that interest to any patient referred by the physician to the health care facility.
    1. Subsection (a) shall not apply in the limited circumstances where the referring physician is referring physical therapy services and, in writing, the physician:
      1. Discloses the physician's investment interest or financial relationship to patients when making a referral of the patient for physical therapy services;
      2. Notifies patients that they may receive physical therapy services at the provider of their choice;
      3. Informs patients that they have the option to use one (1) of the alternative providers; and
      4. Assures patients that they will not be treated differently by the physician if they do not choose to use the physician-owned entity.
    2. Notwithstanding any law to the contrary, nothing in subdivision (c)(1) shall be construed to affect the ability of the commissioner of labor and workforce development to regulate, through the workers’ compensation comprehensive medical fee schedule and regulated system established by rules promulgated pursuant to § 50-6-204, all health care providers providing services to workers’ compensation patients.

Acts 1993, ch. 408, §§ 3, 11; 2006, ch. 875, §§ 1, 2.

Cross-References. Physicians' conflict of interest disclosure, title 63, ch. 6, part 5.

Attorney General Opinions. A pharmacy falls within the definition of a “health care entity” as that term is defined in T.C.A. § 63-6-601. OAG 14-100, 2014 Tenn. AG LEXIS 103 (10/31/14).

63-6-603. Where physicians may invest in and refer to an outside entity — Requirements.

There may be situations in which a needed entity would not be built or instituted if referring physicians were prohibited from investing in the entity and a need might exist when there is no entity of reasonable quality in the community or when use of existing entities is onerous for patients. Therefore, physicians may invest in and refer to an outside entity, whether or not they provide direct care or services at or for the entity, if there is a demonstrated need in the community for the entity and alternative financing is not available. In such cases, the following requirements apply:

  1. Individuals who are not in a position to refer patients to the entity shall be given a bona fide opportunity to invest in the entity and be able to invest on the same terms that are offered to referring physicians. The terms on which investment interests are offered to physicians shall not be related to the past or expected volume of referrals or other business from the physicians;
  2. There is no requirement that any physician investor make referrals to the entity or otherwise generate business as a condition for remaining an investor;
  3. The entity shall not market or furnish its items or services to referring physician investors differently than to other investors;
  4. The entity shall not loan funds or guarantee a loan for physicians in a position to refer to the entity;
  5. The return on the physician's investment shall be tied to the physician's equity in the entity rather than to the volume of referrals;
  6. Investment contracts shall not include noncompetition clauses that prevent physicians from investing in other entities;
  7. Physicians shall disclose their investment interest to their patients when making a referral. Patients shall be given a list of effective alternative entities if any such entities become reasonably available, informed that they have the option to use one of the alternative entities and assured that they will not be treated differently by the physician if they do not choose the physician-owned entity. These disclosure requirements also apply to physician investors who directly provide care or services for their patients in entities outside their office practice;
  8. The physician's ownership interest shall be disclosed, when requested, to third party payers;
  9. An internal utilization review program is established to ensure that investing physicians do not exploit their patients in any way, such as by inappropriate or unnecessary utilization; and
  10. When a physician's financial interest conflicts so greatly with the patient's interest as to be incompatible, the physician shall make alternative arrangements for the care of the patient.

Acts 1993, ch. 408, § 4.

Cross-References. Physicians' conflict of interest disclosure, title 63, ch. 6, part 5.

63-6-604. Prohibited cross referral arrangements.

Cross referral arrangements or schemes between physicians or between physicians and entities, in which the physician or physicians know or should know that the arrangement has as its principal purpose generating referrals to an entity that if made directly by one of the participating physicians would be in violation of this part, are prohibited.

Acts 1993, ch. 408, § 5.

63-6-605. Preexisting investments — Compliance.

If physicians have invested in entities prior to July 1, 1993, the physicians shall reevaluate their activity in accordance with this part and comply with its provisions. If compliance with the need and alternative investor criteria is not practical, it is essential that the identification of reasonably available alternative entities be provided.

Acts 1993, ch. 408, § 6.

63-6-606. Disposal of ownership interests — Cessation of referrals.

  1. On and after July 1, 1995, all physicians are required either to:
    1. Dispose of their ownership interests in entities outside their office practice at which they do not directly provide care or services when they have an investment interest in the entity unless the entity meets the requirements of § 63-6-602; or
    2. Cease referring patients to such entities.
  2. Physicians are encouraged to seek out potential buyers of a minority race before disposing of facilities or equipment regulated by this part. Upon request, the office of minority business enterprise in the department of economic and community development shall provide information relative to potential minority purchasers.

Acts 1993, ch. 408, §§ 7, 10.

63-6-607. Violations — Sanctions.

Any physician who makes or causes to be made a referral prohibited by this part is in violation of the medical practice law, as compiled in this chapter. Willful violations of this part are considered unprofessional conduct, which conduct is subject to licensure sanction by the board of medical examiners, including suspension, revocation or other restriction deemed appropriate by the board. In addition, the board is authorized to impose civil penalties of an amount up to five thousand dollars ($5,000) for each prohibited referral.

Acts 1993, ch. 408, § 8.

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

63-6-608. Investment interests in publicly traded entities.

The definition of “investment interest” does not include a publicly traded entity in which such physician has an investment interest if all of the following requirements are met:

  1. The entity's stock is listed for trading on the New York Stock Exchange or the American Stock Exchange or is a national market system security traded under an automated interdealer quotation system operated by the National Association of Securities Dealers;
  2. The entity had, at the end of the corporation's most recent fiscal year, total assets of at least fifty million dollars ($50,000,000), determined in accordance with generally accepted accounting principles, related to the furnishing of health services;
  3. The entity markets and furnishes its services to physician-investors and other physicians on the same and equal terms;
  4. All stock of the entity, including the stock of any predecessor privately held company, is one (1) class without preferential treatment as to status or remuneration;
  5. The entity does not issue loans or guarantee any loans for physicians who are in a position to refer patients to such entity if the physician uses any portion of the loan to obtain the investment interest;
  6. The income on the physician's investment is not tied to referral volumes and is directly proportional to the physician's equity interest in the entity;
  7. The physician's investment interest does not exceed one-half of one percent (0.5%) of the entity's total equity; and
  8. The physician purchases the investment interest either:
    1. On terms generally available to the public; or
    2. In exchange for an investment interest acquired by the physician before July 1, 1993; provided, the terms of the exchange are consistent with fair market value in an arms-length transaction and are not related to the volume or value of any referrals from the physician to the corporation and the investment interest is not held after December 31, 1997.

Acts 1993, ch. 408, § 9.

Part 7
Volunteer Health Care Services Act

63-6-701. Short title.

This part shall be known and may be cited as the “Volunteer Health Care Services Act.”

Acts 1995, ch. 299, § 1.

Cross-References. Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-702. Legislative findings.

  1. The general assembly finds that:
    1. Access to high quality health care services is a concern of all persons;
    2. Access to such services is severely limited for some residents of this state, particularly those who reside in remote, rural areas or in the inner city;
    3. Physicians and other health care professionals have traditionally worked to assure broad access to health care services; and
    4. Many health care providers from Tennessee and elsewhere are willing to volunteer their services to address the health care needs of Tennesseans who may otherwise not be able to obtain such services.
  2. The general assembly further finds that it is the public policy of this state to encourage and facilitate voluntary provision of health care services.

Acts 1995, ch. 299, § 2.

Cross-References. Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-703. Part definitions.

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

  1. “Free clinic” means a not for profit, out-patient, nonhospital facility in which a health care provider engages in the voluntary provision of health care services to patients without charge to the recipient of the services or to a third party;
  2. “Health care provider” means any physician, surgeon, dentist, nurse, optometrist or other practitioner of a health care discipline, the professional practice of which requires licensure or certification under this title or under a comparable provision of law of another state, territory, district or possession of the United States;
  3. “Licensed health care provider” means any health care provider holding a current license or certificate issued under:
    1. This title; or
    2. A comparable provision of the law of another state, territory, district or possession of the United States;
  4. “Regularly practice” means to practice for more than sixty (60) days within any ninety-day period;
  5. “Sponsoring organization” means any organization that organizes or arranges for the voluntary provision of health care services and that registers with the department of health as a sponsoring organization in accordance with § 63-6-706 and charges recipients based on one (1) of the following criteria:
    1. On a sliding scale according to income;
    2. A fee at the time of service of no more than fifty dollars ($50.00); or
    3. No fee to the recipient; and
  6. “Voluntary provision of health care services” means the providing of professional health care services by the health care provider either without charge to the recipient of the services or to a third party, or recipients are charged on a sliding scale according to income. Nothing shall preclude a health care provider from collecting the charges described in subdivision (5)(B) on behalf of the sponsoring organization as long as the health care provider retains none of the payment and forwards all collections to the sponsoring organization.

Acts 1995, ch. 299, § 3; 2009, ch. 581, § 1; 2013, ch. 235, § 1; 2014, ch. 575, § 1; 2014, ch. 615, § 1.

Cross-References. Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-704. Licensure requirements.

  1. Notwithstanding any provision of law to the contrary, no additional license or certificate otherwise required under this title is necessary for the voluntary provision of health care services by any person who:
    1. Is a duly licensed health care provider as defined under § 63-6-703; or
    2. Lawfully practices under an exception to the licensure or certification requirements of any state, territory, district or possession of the United States; provided, that the person does not and will not regularly practice in Tennessee.
  2. Subsection (a) does not apply to any person whose license or certificate is suspended or revoked pursuant to disciplinary proceedings in any jurisdiction. Furthermore, subsection (a) does not apply to a licensed health care provider who renders services outside the scope of practice authorized by the provider's licensure, certification or exception to such licensure or certification.

Acts 1995, ch. 299, § 4.

Cross-References. Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-705. Applicability.

With regard to a person who voluntarily provides health care services and who is covered by § 63-6-704(a), the prohibitions expressed in § 63-6-202, relative to itinerant physicians, shall not apply and all requirements regarding display of a license or certificate shall be satisfied by the presentation for inspection, upon request, of a photocopy of the applicable license, certificate or statement of exemption.

Acts 1995, ch. 299, § 5.

Cross-References. Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-706. Registration requirements — Revocation.

    1. Before providing volunteer medical services in this state, a sponsoring organization shall register with the department of health by submitting a registration fee of fifty dollars ($50.00) and filing a registration form. The fifty-dollar registration fee shall not apply to any sponsoring organization as defined in § 63-6-703 when providing volunteer health care services in cases of natural or man-made disasters. Such registration form shall contain:
      1. The name of the sponsoring organization;
      2. The name of principal individual or individuals who are the officers or organizational officials responsible for the operation of the sponsoring organization;
      3. The address, including street, city, zip code and county, of the sponsoring organization's principal office address and the same address information for each principal or official listed in subdivision (a)(1)(B);
      4. Telephone numbers for the principal office of the sponsoring agency and each principal or official listed in subdivision (a)(1)(B); and
      5. Such additional information as the department shall require.
    2. Upon any change in the information required under subdivision (a)(1), the sponsoring organization shall notify the department in writing of such change within thirty (30) days of its occurrence.
  1. The sponsoring organization shall file a quarterly voluntary services report with the department during the current quarter that lists all licensed health care providers who provided voluntary health care services during the preceding quarter. The sponsoring organization shall maintain on file for five (5) years following the date of service additional information, including the date, place and type of services provided.
  2. Each sponsoring organization shall maintain a list of health care providers associated with its provision of voluntary health services. For each such health care provider, the organization shall maintain a copy of a current license, certificate or statement of exemption from licensure or certification or, in the event that the health care provider is currently licensed in the state of Tennessee, a copy of the health care provider's license verification obtained from a state-sponsored website.
  3. The sponsoring organization shall maintain such records for a period of at least five (5) years following the provision of health care services and shall furnish such records upon request to any regulatory board established under this title.
  4. Compliance with subsections (a) and (b) shall be prima facie evidence that the sponsoring organization has exercised due care in its selection of health care providers.
  5. The department may revoke the registration of any sponsoring organization that fails to comply with the requirements of subsections (a)-(e). Any such revocation shall be conducted in accordance with the Uniform Administrative Procedures Act, complied in title 4, chapter 5.

Acts 1995, ch. 299, §§ 6, 7; 2000, ch. 723, § 1; 2007, ch. 69, § 1.

Cross-References. Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-707. Liability insurance coverage.

No contract of professional liability insurance covering a health care provider in this state, issued or renewed on or after May 26, 1995, shall exclude coverage to any provider who engages in the voluntary provision of health care services; provided, that the sponsoring organization and the health care provider comply with the requirements of this part.

Acts 1995, ch. 299, § 8.

Cross-References. Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-708. Immunity for voluntary provision of health care services.

    1. No person who is licensed, certified or authorized by the board of any of the professions of the healing arts, as enumerated in this title, shall be liable for any civil damages for any act or omission resulting from the rendering of such services, unless the act or omission was the result of such person's gross negligence or willful misconduct if the person:
      1. Is engaging in the voluntary provision of health care services within the limits of the person's license, certification or authorization; and
      2. The services are delivered to any patient of:
        1. A sponsoring organization; or
        2. A free clinic.
    2. The volunteer licensee who is providing free care shall not receive compensation of any type, directly or indirectly, or any benefits of any type whatsoever, or any consideration of any nature, from anyone for the free care. Nor shall such services be part of the provider's training or assignment.
    3. The volunteer licensee must be acting within the scope of such license, certification or authority.
    4. A health care licensee providing free health care shall not engage in activities at a clinic or at the health care licensee's office, if the activities are performed on behalf of the sponsoring organization, unless those activities are authorized by the appropriate authorities to be performed at the clinic or office and the clinic or office is in compliance with all applicable rules and regulations.
  1. For purposes of this section, any commissioned or contract medical officer or dentist serving on active duty in the United States armed forces and assigned to duty as a practicing, commissioned or contract medical officer or dentist at any military hospital or medical facility owned and operated by the United States government shall be deemed to be licensed pursuant to this part.

Acts 2005, ch. 208, § 1; 2007, ch. 69, § 2; 2009, ch. 581, § 2; 2014, ch. 575, § 2.

Cross-References. Good Samaritan law, § 63-6-218.

Good Samaritan Protection Act of 1999, § 29-34-201 et seq.

Grounds for license denial, suspension or revocation, § 63-6-214.

Immunity, § 63-1-117.

Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-709. Liability of volunteer crisis response team member — Applicability.

    1. “Crisis intervention” means a session at which crisis response services are rendered by a critical incident stress management team member during or after a crisis or disaster.
    2. “Crisis response services” means consultation, risk assessment, referral and crisis intervention services provided by a critical incident stress management team to individuals affected by crisis or disaster.
    3. “Critical incident stress management team member,” referred to also as “team member,” means an individual specially trained to provide crisis response services as a member of an organized community or local crisis response team that holds membership in a registered critical incident stress management team.
    4. “Registered team” means a team formally registered with a recognized training agency. For the purposes of this section, a recognized training agency shall include the International Critical Incident Stress Foundation, the National Organization for Victim Assistance, the National Red Cross, the Tennessee Public Safety Network and other such organizations.
    5. “Training session” means a session providing crisis response training by a qualified, trained trainer utilizing the standards established by the accrediting agencies set out in subdivision (a)(4).
    6. “Volunteer” means a person who serves and receives no remuneration for services except reimbursement for actual expenses.
    1. Any volunteer crisis response team member who participates in a crisis intervention shall not be liable in tort for any personal injuries or infliction of emotional distress of any participant to the crisis intervention that is caused by the act or an omission of a crisis response team member during the course of a crisis intervention.
    2. Subdivision (b)(1) shall not apply unless the intervention or training is conducted within generally accepted protocols of a registered team as defined by a nationally recognized accrediting agency.
  1. The tort immunity in subsection (b) does not apply if:
    1. The team member acted with actual malice or willful intent to injure the subject;
    2. The team member acted outside the scope of assigned duties;
    3. The team member acted without team coordination and dispatch;
    4. The action involved the commission of a crime;
    5. The action involved sexual harassment, sexual or physical abuse;
    6. The actions involved any form of moral turpitude or moral misconduct within the normally accepted community standards; or
    7. If damages resulted from gross negligence of the team member.

Acts 2008, ch. 921, § 1.

Cross-References. Good Samaritan law, § 63-6-218.

Good Samaritan Protection Act of 1999, § 29-34-201 et seq.

Grounds for license denial, suspension or revocation, § 63-6-214.

Immunity, § 63-1-117.

Inactive licenses to perform pro bono services, § 63-6-230.

Special volunteer license for practice in free health clinic, § 63-6-235.

63-6-710. Free clinics for veterans — Use of armory as site.

  1. This section may be known and cited as the “Kenneth Harry–Hill Tennessee Veterans Health Care Act of 2015.” This section may also be known as the “Mission Tennessee for Veterans Program.”
  2. In addition to any other health care authorized by this part, a licensed healthcare provider who is a member of the national guard in this state, under title 58, chapter 1, part 2, may provide healthcare services to veterans and other persons who lack health insurance at a free clinic operated on the site of an armory, as defined in § 58-1-507. The free clinic is authorized to provide limited primary health care, but not emergency care or urgent care services. Healthcare providers rendering services under this subsection (b) shall be deemed to be engaging in the voluntary provision of healthcare services under this part.
    1. The military department is authorized to permit the use of an armory as a site of a free clinic on a temporary basis.
    2. The military department is also authorized to permit members of the national guard who are licensed healthcare providers in this state to volunteer at free clinics operated at an armory under this section.
    3. The military department is authorized to accept donations of medical supplies and services to assist the operation of a free clinic at an armory under this section.
  3. A free clinic operating under this section is authorized to participate in appropriate networks and public information activities in order to facilitate access to free healthcare services by veterans.
  4. 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.
  5. For the purposes of this section, “veteran” means a Tennessee resident who has entered and served in the United States armed forces and who was discharged or released therefrom under conditions other than dishonorable.

Acts 2015, ch. 277, § 1.

63-6-711. Immunity for those dispensing previously owned eyeglasses — Applicability.

  1. Subject to the requirements of subsection (b), none of the following shall be civilly liable for any damages arising out of dispensing previously owned eyeglasses to a person:
    1. A sponsoring organization;
    2. A free clinic and any optometrist, ophthalmologist, or dispensing optician providing services at the free clinic; or
    3. Any organization that provides previously owned eyeglasses to a sponsoring organization or a free clinic free of charge and that is exempt from federal taxation under § 501(c)(3) or § 501(c)(4) of the Internal Revenue Code of 1986 (26 U.S.C. § 501(c)(3) and (4)).
  2. In order for the immunity conferred by subsection (a) to apply:
    1. The person to whom the previously owned eyeglasses are dispensed must be fourteen (14) years of age or older;
    2. The previously owned eyeglasses must be dispensed without charge; and
    3. Before the previously owned eyeglasses are dispensed, a licensed optometrist or ophthalmologist shall have:
      1. Personally examined the recipient of the eyeglasses and issued a prescription for the eyeglasses; or
      2. Personally consulted with the licensed optometrist or ophthalmologist who issued a prescription for the eyeglasses.
  3. The previously owned eyeglasses may be dispensed by an optometrist or ophthalmologist or a dispensing optician working with the optometrist or ophthalmologist.
  4. The immunity conferred by this section shall not apply if the organization or person granted immunity engages in grossly negligent or willful and wanton misconduct in dispensing the previously owned eyeglasses.

Acts 2016, ch. 665, § 1.

63-6-712. Satisfaction of continuing education requirements.

  1. Notwithstanding this title to the contrary, a healthcare provider may satisfy one (1) hour of continuing education requirements for maintaining a license issued pursuant to this title through the performance of one (1) hour of voluntary provision of healthcare services as provided in this part. The maximum amount of hours of a continuing education requirement that a healthcare provider may satisfy through the voluntary provision of healthcare services pursuant to this subsection (a) is the lesser of eight (8) hours annually or twenty percent (20%) of the total annual required for the applicable license.
  2. Upon providing evidence of completion of the voluntary provision of healthcare services, the healthcare provider shall identify in any documentation required to be submitted to the applicable licensing board, the name and contact information of the sponsoring organization.
  3. The division of health related boards may promulgate rules to administer this section in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, including a fee to be charged to the healthcare provider for satisfying continuing education requirements pursuant to this section.

Acts 2017, ch. 350, § 1.

Effective Dates. Acts 2017, ch. 350, § 2. May 11, 2017.

Part 8
Genetic Counselors' Licensing Act

63-6-801. Short title.

This part shall be known and may be cited as the “Genetic Counselors' Licensing Act.”

Acts 2007, ch. 366, § 1.

63-6-802. Part definitions.

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

  1. “ABGC” means the American Board of Genetic Counseling;
  2. “ABMG” means the American Board of Medical Genetics;
  3. “Board” means the board of medical examiners, created by § 63-6-101;
  4. “CEU” means a continuing education unit as defined by the ABGC;
  5. “Department” means the department of health;
  6. “Division” means the division of health related boards within the department;
  7. “Genetic counselor” means a person licensed under this part to engage in the practice of genetic counseling;
  8. “Practice of genetic counseling” means the process of helping people understand and adapt to the medical, psychological and familial implications of genetic contributions to disease performed pursuant to a referral. This process integrates the following:
    1. Interpretation of family and medical histories to assess the chance of disease occurrence or recurrence;
    2. Education about inheritance, testing, management, prevention, resources and research; and
    3. Counseling to promote informed choices and adaptation to the risk or condition;
  9. “Referral” means a written or telecommunicated authorization for genetic counseling services from a physician licensed to practice medicine in all its branches or an advanced practice registered nurse or physician assistant who has an agreement and signed protocols with a supervising physician that authorizes referrals to a genetic counselor; and
  10. “Supervision” means the ongoing, direct clinical review for the purposes of training or teaching by an approved supervisor who monitors the performance or a person's supervised interaction with a client and provides regular documented face-to-face consultation, guidance and instructions with respect to the clinical skills and competencies of the person supervised. Supervision may include, without being limited to, the review of case presentations, audio tapes, video tapes and direct observation.

Acts 2007, ch. 366, § 1; 2016, ch. 980, § 10.

63-6-803. Scope of genetic counseling.

  1. Genetic counseling is a communication process, conducted by one (1) or more appropriately trained individuals, that includes:
    1. Estimating the likelihood of occurrence or recurrence of any potentially inherited or genetically influenced condition. This assessment may involve:
      1. Obtaining and analyzing a complete health history of the person and family;
      2. Reviewing pertinent medical records;
      3. Evaluating the risks from exposure to possible mutagens or teratogens; and
      4. Recommending genetic testing or other evaluations to assist in the diagnosis of a condition or determine the carrier status of one (1) or more family members;
    2. Helping the individual, family, health care provider or public to:
      1. Appreciate the medical, psychological and social implications of a disorder, including its features, variability, usual course and management options;
      2. Learn how genetic factors contribute to the disorder and affect the chance for recurrence of the condition in other family members;
      3. Understand available options for coping with, preventing, or reducing the chance of occurrence or recurrence of a condition;
      4. Select the most appropriate, accurate and cost-effective methods of diagnosis; and
      5. Understand genetic tests, including, but not limited to, diagnostic genetic tests, screening tests or predispositional genetic tests, coordinate testing for inherited disorders and interpret complex genetic test results;
    3. Facilitating an individual's or family's:
      1. Exploration of the perception of risk and burden associated with a genetic disorder;
      2. Decision making regarding testing or medical interventions consistent with their beliefs, goals, needs, resources, culture and ethical/moral views; and
      3. Adjustment and adaptation to the condition or their genetic risk by addressing needs for psychological, social and medical support.

Acts 2007, ch. 366, § 1.

63-6-804. Licensure requirement — Exceptions.

  1. No person shall engage in the practice of genetic counseling, act or represent that person to be a genetic counselor, or to use such titles as “genetic counselor,” “licensed genetic counselor,” “gene counselor,” “genetic associate” or any words, letters, abbreviations or insignia indicating or implying that the person is a genetic counselor, unless that person holds a license or temporary license and otherwise complies with this part and the rules and regulations adopted by the board.
  2. The following persons may engage in the practice of genetic counseling subject to the stated circumstances and limitations without being licensed under this part:
    1. Other qualified and licensed health care professionals who are practicing within their scope of practice. Individuals may not use the title genetic counselor or any other title tending to indicate they are genetic counselors unless licensed as such in this state;
    2. Students enrolled in an approved academic program in genetic counseling, if practice constitutes a part of a supervised course of study and the student is designated by a title clearly indicating the student's status as a student or trainee;
    3. An individual trained as a genetic counselor who is reapplying for the ABGC certification examination and gathering logbook cases under supervision in an approved genetic counseling training site;
    4. Individuals employed by a state genetics center that provides education regarding single gene conditions, including, but not limited to, sickle cell, cystic fibrosis and hemoglobinopathies. The individual may not use the title genetic counselor or any other title tending to indicate the individual is a genetic counselor unless licensed as such in this state; and
    5. Visiting ABGC or ABMG certified genetic counselors from outside the state performing activities and services for a period of thirty (30) days each year. Visiting genetic counselors must be licensed, if licensure is available in their home state.

Acts 2007, ch. 366, § 1.

63-6-805. Compliance with ethical codes.

  1. All licensees shall comply with the current code of ethics adopted by the National Society of Genetic Counselors, except to the extent that it conflicts with state laws or the rules of the board. If the code of ethics conflicts with state law or rules, state law or rules govern the matter. A violation of the code of ethics or state law or rules may subject a licensee to disciplinary action.
  2. Each applicant or licensee is responsible for being familiar with and following the code of ethics.
  3. A copy of the code of ethics may be obtained by writing the National Society of Genetic Counselors, 401 N. Michigan Avenue, Chicago, IL 60611 or by visiting the website www.nsgc.org.

Acts 2007, ch. 366, § 1.

63-6-806. Rules and regulations — Qualifications for licensure — Fees — Renewal.

  1. The board shall promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules and regulations that are reasonably necessary to regulate advertising and for the performance of the various duties imposed upon the board for the proper administration of this part.
  2. No person shall represent to be or function as a genetic counselor under this part unless that person holds a valid genetic counselor license or temporary license issued by the board. The board shall establish the qualifications that are prerequisite to issuance of licenses and temporary licenses; provided, that:
    1. To qualify for a license to practice genetic counseling, a person shall have:
      1. Earned a masters degree from a genetic counseling training program that is accredited by the ABGC or an equivalent as determined by the ABGC or the ABMG; and
      2. Met the examination requirement for certification and have current certification as a genetic counselor by the ABGC or the ABMG;
    2. For one (1) year after the effective date of the rules adopted under this part, a license may be issued, at the discretion of the board, to an applicant not meeting the requirements of subdivision (b)(1)(B) if the applicant has practiced as a genetic counselor since 1980 and the committee has completed an investigation of the applicant's work history. The investigation may include, but is not limited to, completion by the applicant of a questionnaire regarding the applicant's work history and scope of practice; and
      1. A temporary license to practice genetic counseling may be issued to an applicant who meets all of the requirements for licensure except the examination requirement of subdivision (b)(1)(B);
      2. Temporary license applicants shall have active candidate status conferred by ABGC and take the next available certification examination;
      3. A temporary license shall not be issued if the applicant has failed the ABGC certification examination more than twice;
      4. Temporary licensees shall practice under the general supervision of a licensed genetic counselor or a licensed physician with current ABMG certification in clinical genetics;
      5. A temporary license shall expire upon the earliest of one (1) of the following:
        1. Issuance of full licensure;
        2. Ninety (90) days after notification of failing the certification exam without obtaining current active candidate status; or
        3. The date printed on the temporary license.
  3. The board shall set fees, after consultation with the department, relative to the application, licensing and renewal in amounts sufficient to pay all of the expenses of the board that are directly attributable to the performance of the board's duties pursuant to this part, including, but not limited to, the following fees:
    1. Application, licensure and temporary licensure fee;
    2. Renewal fee;
    3. Late renewal fee;
    4. Continuing education course approval fee; and
    5. Duplicate licensure fee.
  4. The board shall review and approve or reject the qualifications of applicants for licensure and to issue all approved full, restricted, conditioned or temporary licenses.
  5. The board shall biennially review and approve or reject the qualifications of each applicant for biennial licensure renewal. The board shall require the receipt of evidence satisfactory to the board of the applicant's successful completion, within a two-year period prior to the application for license renewal, of five (5) CEUs, category 1 or 2, or fifty (50) contact hours approved for recertification purposes by the ABGC. A licensee shall be responsible for maintaining competent records of having completed qualified professional education for a period of four (4) years after the close of the two-year period to which the records pertain. It is the responsibility of the licensee to maintain such information with respect to having completed a qualified professional education that demonstrates the education meets the requirements under this section. The board may, in its discretion, waive or modify the continuing education requirement in cases of retirement, illness, disability or other undue hardship.
  6. The board shall collect or receive all fees, fines and moneys owed pursuant to this part and shall pay the fees, fines and moneys into the general fund of the state. For purposes of implementing subsection (c), all fees, fines or moneys collected pursuant to the regulation of genetic counselors shall so be designated.

Acts 2007, ch. 366, § 1.

63-6-807. Denial, suspension, or revocation of license — Other disciplinary actions.

  1. The board shall have the power to:
    1. Deny, restrict or condition a license;
    2. Permanently or temporarily withhold issuance of a license;
    3. Suspend, limit or restrict a previously issued license, for the time and in the manner that the board determines;
    4. Reprimand, suspend, revoke or take any other disciplinary action in relation to an applicant or license holder that the board, in its discretion, deems proper; or
    5. Permanently revoke a license.
  2. The grounds upon which the board shall exercise the powers in subsection (a) shall include, but are not limited to, circumstances in which the person:
    1. Is guilty of fraud or deceit in the procurement or holding of the license;
    2. Has been convicted of a felony in a court of competent jurisdiction, either within or outside of this state, unless the conviction has been reversed and the holder of the license was discharged or acquitted or if the holder has been pardoned with full restoration of civil rights, in which case the license shall be restored;
    3. Is or has been physically or mentally incapable of practicing at a level of competency that protects the public health, safety and welfare;
    4. Has knowingly aided and abetted a person who is not a license holder or is not otherwise authorized pursuant to this part to perform the duties of a license holder under this part;
    5. Has undertaken or engaged in any practice beyond the scope of practice stated in § 63-6-803;
    6. Has impersonated a license holder or former license holder or is under an assumed name performing the duties authorized to be performed only by a licensed person;
    7. Has been found guilty of a violation of the code of ethics as provided in § 63-6-805;
    8. Is or has been found guilty of incompetence or negligence in performance as a license holder;
    9. Has been found guilty of unethical conduct;
    10. Violates or attempts to violate, directly or indirectly, or assists or aids in the violation of, or conspires to violate, any provision of this part or any lawful order of the board issued pursuant to this part, or any of the rules or regulations promulgated pursuant to this part or any criminal statute of the state;
    11. Is habitually intoxicated or engages in personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in a manner that adversely affects the person's ability to practice; or
    12. Has received disciplinary action from another state for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order or other equivalent document memorializing the disciplinary action from the disciplining state shall constitute prima facie evidence of violation of this section and shall be sufficient grounds upon which to deny, restrict or condition licensure or renewal or to discipline a person licensed in this state.

Acts 2007, ch. 366, § 1; 2012, ch. 848, § 72.

63-6-808. Retirement of license and relicensure.

Any person who has been issued a license to practice under this part and who wishes to retire the license shall file with the board an affidavit, on a form to be furnished by the board, stating the date on which the person retired from practice and any other information deemed necessary by the board. If that person decides to reengage in practice in this state, the person shall apply for licensure as provided by this part and shall not be liable for licensure renewal fees that accrued during the period of retirement.

Acts 2007, ch. 366, § 1.

Part 9
Radiologic Imaging and Radiation Therapy

63-6-901. Radiologic imaging and radiation therapy board of examiners.

  1. The Tennessee radiologic imaging and radiation therapy board of examiners, or for the purposes of this part, the “board,” is hereby created.
    1. The board shall consist of nine (9) members who shall serve staggered terms. Initial board members shall be appointed on or before October 1, 2016, as follows:
      1. The governor shall appoint:
        1. One (1) licensed radiographer who shall serve a three-year term;
        2. One (1) licensed nuclear medicine technologist who shall serve a two-year term;
        3. One (1) licensed radiation therapist who shall serve a one-year term;
        4. One (1) full-time educator of a program that prepares providers licensed under § 63-6-902 who shall serve a two-year term; and
        5. One (1) licensed magnetic resonance technologist or licensed computed tomography technologist who shall serve a two-year term;
      2. The speaker of the house of representatives shall appoint:
        1. One (1) radiologist who shall serve a two-year term; and
        2. One (1) public member who shall serve a two-year term; and
      3. The speaker of the senate shall appoint:
        1. One (1) medical physicist, diagnostic or therapeutic, who shall serve a three-year term; and
        2. One (1) licensed physician practicing in a hospital setting who shall serve a three-year term.
    2. Upon the expiration of the terms of the initial board members, members shall be appointed by the appointing authority making the initial appointment for terms of three (3) years. Members shall serve until their successors are appointed. Successors shall be appointed by the appointing authority making the original appointment and shall be registered in the same specialty as the member of the board who the member replaces. No member may serve more than two (2) consecutive terms.
  2. Except for the public member of the board, every member of the board shall hold a valid license issued by the board in the category of license for that member's respective modality, shall be a resident of this state, and shall remain in active practice and in good standing with the board as a licensee during the member's term. The public member shall be a resident of this state and shall not be:
    1. A currently or actively licensed practitioner; or
    2. A person who administers radiation therapy procedures under this part.
  3. A vacancy shall be filled in the same manner as the original appointment and shall be filled within forty-five (45) days after the vacancy occurs. Appointees to fill vacancies shall serve the remainder of the unexpired term and until their successors have been duly appointed and qualified.
  4. The board may remove any of its members for neglect of duty, incompetence, or unprofessional conduct. A member subject to disciplinary proceedings as a licensee shall be disqualified from participating in the official business of the board until the charges have been resolved.
  5. Each member of the board shall receive per diem and reimbursement for travel and expenses as provided in the comprehensive travel rules promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  6. The officers of the board shall be a chair, who shall be licensed under § 63-6-902; a vice chair; and other officers deemed necessary by the board to carry out this part. All officers shall be elected annually by the board for one-year terms and shall serve until their successors are elected and qualified.
  7. The board shall hold at least two (2) meetings each year to conduct business and to review the standards and rules for improving the administration of radiologic imaging and radiation therapy procedures. The board shall establish the procedures for calling, holding, and conducting regular and special meetings. A majority of board members constitutes a quorum.
  8. The board shall have the power and duty to:
    1. Administer this part;
    2. Issue interpretations of this part;
    3. Adopt rules as may be necessary to implement this part;
    4. Employ and fix the compensation of personnel that the board determines is necessary to carry out this part, and incur other expenses necessary to effectuate this part;
    5. Examine and determine the qualifications and fitness of applicants for licensure, renewal of licensure, and reciprocal licensure;
    6. Issue, renew, deny, suspend, or revoke licenses and carry out any disciplinary actions authorized by this part;
    7. Set fees for licensure, license renewal, and other services deemed necessary to carry out this part;
    8. Conduct investigations for the purpose of determining whether violations of this part, or grounds for disciplining licensees, exist;
    9. Conduct administrative hearings in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5; and
    10. Maintain a record of all proceedings and make available to licensees and other concerned parties an annual report of all board action.

Acts 2016, ch. 1029, § 2.

Compiler's Notes. Acts 2016, ch. 1029, § 1, which enacted this section, requires that the board be appointed by October 1, 2016; however, the act does not take effect until January 1, 2017.

The Tennessee radiologic imaging and radiation therapy board of examiners, created by this section, terminated June 30, 2020, and is in its wind-up period, pursuant to the provisions of § 4-29-112. Wind-up is scheduled to be complete June 30, 2021. See § 4-29-112.

63-6-902. Regulation of operators of X-ray equipment — Licenses and accreditations — Standards — Definitions.

    1. With regard to operators of radiologic imaging and radiation therapy equipment in hospitals, outpatient diagnostic centers, recuperation centers, physicians' offices, or any other setting for human subjects, the board has the authority to promulgate rules to:
      1. Establish and issue limited X-ray machine operator licenses to qualified individuals for the performance of chest, extremities, skull, sinus, and lumbar spine radiography and bone densitometry with the exclusion of the performance of fluoroscopy, computed tomography, magnetic resonance imaging, mammography, nuclear medicine, radiation therapy, mobile imaging procedures, or imaging procedures using oral and intravenous contrast media;
      2. Establish and issue full radiologic imaging or radiation therapy licenses to individuals who hold current and unrestricted national certification from the American Registry of Radiologic Technologists, the Nuclear Medicine Technology Certification Board, or any equivalent nationally recognized radiologic imaging or radiation therapy certification organization recognized by the board;
      3. Establish the minimum educational courses, curricula, hours, and standards that are prerequisite to issuance of limited X-ray machine operator licenses;
      4. Accept the standards of nationally recognized educational organizations relative to the educational courses, curricula, hours, and standards that are prerequisite to the issuance of radiography, radiation therapy, magnetic resonance, and nuclear medicine full-scope licenses;
      5. Select the examination or examinations to be utilized for the board's limited certification examination or examinations and the prerequisites, if any, for admission to the examination or examinations. The board is authorized to enter into a contract or agreement with the chosen examination service or services or select an intermediary between the board and the examination service or services to process applicants for the examination or examinations;
      6. Establish any other criteria for issuance of licenses that are reasonably related to the safe and competent performance of radiologic imaging and radiation therapy procedures;
      7. Establish a mechanism for board accreditation of educational courses that are training individuals for limited X-ray machine operator licensure and that meet the requirements established pursuant to subdivision (a)(1)(C). The mechanism shall establish the causes and standards that are grounds for withdrawal of the course accreditation and the mechanism for that withdrawal;
      8. Establish the fees to be paid for application, licensure, renewal, and late renewal of licenses;
      9. Establish the fees to be paid for application, renewal, and late renewal of board accreditation of the providers of training programs for limited X-ray machine operators;
      10. Establish the required number of hours, types of courses, and methods of proving compliance for continuing education for limited X-ray machine operator licensees; and
      11. Accept the standards of nationally recognized credentialing agencies relative to the number of hours, types of courses, and methods of proving compliance for continuing education for radiography license holders. A licensee will not be required to duplicate the continuing education hours submitted to the American Registry of Radiologic Technologists, the Nuclear Medicine Technology Certification Board, or any other certification organization recognized by the board for renewal. Submission of continued certification in good standing with any of the approved agencies with the renewal application shall be acceptable.
    2. The board may, upon application and payment of proper fees, grant a license to a person who resides in this state and has been licensed, certified, or registered to perform radiologic imaging or administer radiation therapy procedures in another jurisdiction if that jurisdiction's standards of competency are substantially equivalent to those provided by this section in accordance with rules promulgated by the board.
  1. The licenses and accreditations issued pursuant to this section must be renewed and may be retired and reactivated pursuant to procedures established by the board. A person holding a license issued pursuant to this section may be disciplined for the same causes and under the same procedures as contained in § 63-6-214 for the board of medical examiners and in § 63-9-111 for the board of osteopathic examination.
  2. The standards established by the board pursuant to subsection (a) shall be at least as stringent as any current or future mandatory federal standards.
    1. No person shall perform radiologic imaging or radiation therapy procedures in hospitals, outpatient diagnostic centers, recuperation centers, physicians' offices, or any other setting on or in humans without being licensed as a physician or licensed by the board pursuant to this section. Persons enrolled in a board-recognized or independently accredited radiologic technology or radiation therapy educational program are exempt from the licensure requirements of this section only as to radiologic imaging or radiation therapy procedures performed within or under the auspices of that program. After completion of the course or program and while awaiting first opportunity to sit for the certification examination, but for no more than six (6) months, and for a period of time within which to receive the examination scores, but no more than seventy-five (75) days thereafter, such persons are exempt from the licensure requirements of this section.
    2. This section shall not apply to operators of ionizing radiation equipment who are practicing within the scope of practice of a certification or license granted by this state under this title.
  3. A person holding a license under this section may use radioactive substances or equipment emitting ionizing radiation or magnetic resonance for radiologic imaging and radiation therapy procedures on or in humans for diagnostic or therapeutic purposes only by prescription of an individual authorized by this state to prescribe radiologic imaging or radiation therapy procedures and under the supervision of a licensed practitioner.
  4. The operation of a business in which radiologic imaging or radiation therapy procedures contemplated by this section are performed that is not owned by a physician, group of physicians, medical professional corporation, limited liability medical professional company, or an entity or facility licensed by the division of healthcare facilities is prohibited.
  5. As used in this section:
    1. “Board” means the Tennessee radiologic imaging and radiation therapy board of examiners established pursuant to §  63-6-901;
    2. “Hospital” has the same meaning as defined in § 68-11-201;
    3. “Limited X-ray machine operator” means a person who is licensed under this section to perform, under the supervision of a licensed practitioner, static diagnostic radiography procedures or bone density procedures using equipment which emits external ionizing radiation resulting in diagnostic radiographic images of selected specific parts of the human anatomy or bone density measurements;
    4. “Mobile imaging”:
      1. Means any arrangement in which radiologic imaging services are transported to various sites; and
      2. Does not include movement within a hospital or movement to a site where the equipment will be located permanently;
    5. “Outpatient diagnostic center” has the same meaning as defined in § 68-11-201;
    6. “Physician's office” means anywhere the practice of medicine as defined in § 63-6-204, or the practice of osteopathic medicine as defined in § 63-9-106, which includes the performance of radiologic imaging or radiation therapy procedures contemplated by this section, is conducted, except where that practice is conducted in or under the auspices of a facility or entity licensed by the division of healthcare facilities;
    7. “Radiation therapy” means the use or application of ionizing radiation for the purpose of treating disease or illness on or in humans;
    8. “Radiography” means the creation or acquisition of static or dynamic images of the structures of the human body using ionizing radiation from an external source by a full-scope imaging professional;
    9. “Radiologic imaging”:
      1. Means the performance of any procedure or administration of any article intended for use in the diagnosis or visualization of disease or other medical conditions in human beings. These procedures include, but are not limited to, radiography, nuclear medicine, computed tomography, fluoroscopy, magnetic resonance, and other procedures using ionizing radiation or magnetic resonance; and
      2. Does not include the use of ultrasound; and
    10. “Recuperation center” has the same meaning as defined in § 68-11-201.

T.C.A. § 63-6-224; Acts 2016, ch. 1029, § 1; Acts 1982, ch. 905, § 7; T.C.A., § 63-6-223; Acts 2000, ch. 956, § 1.

Code Commission Notes.

This section was transferred from former § 63-6-224 by the code commission in 2016, effective January 1, 2017.

Cross-References. Regulations for operation of X-ray equipment, § 63-9-112.

Part 10
Acupuncture

63-6-1001. Part definitions.

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

  1. “ACAOM” means the Accreditation Commission for Acupuncture and Oriental Medicine;
  2. “Acupuncture” means a form of health care developed from traditional and modern oriental medical concepts that employs oriental medical diagnosis and treatment and adjunctive therapies and diagnostic techniques for the promotion, maintenance and restoration of health and the prevention of disease;
  3. “ADS” means an acupuncture detoxification specialist trained in, and who performs only, the five-point auricular detoxification treatment;
  4. “Board” means the Tennessee board of medical examiners;
  5. “NADA” means the National Acupuncture Detoxification Association;
  6. “NCCAOM” means the National Certification Commission for Acupuncture and Oriental Medicine; and
  7. “Practice of acupuncture” means the insertion of acupuncture needles and the application of moxibustion to specific areas of the human body based on oriental medical diagnosis as a primary mode of therapy. Adjunctive therapies within the scope of acupuncture may include acupressure, cupping, thermal and electrical treatment and the recommendation of dietary guidelines and supplements and therapeutic exercise based on traditional oriental medical concepts.

Acts 2000, ch. 685, § 3.

Compiler's Notes. Acts 2000, ch. 685, § 1 provided that the purpose of the act is to promote the health, safety and welfare of the people of Tennessee by establishing an orderly system of acupuncture certification and to provide a valid, effective means of establishing certification requirements without undue financial burden to the people of Tennessee through the use of a national certifying commission that has been established to certify the competency of acupuncturists.

Acts 2000, ch. 685, § 14 provided that it is the intent of the general assembly that certification of acupuncturists under this board shall cease and terminate on June 30, 2002. After June 30, 2002, the board shall issue licenses to those acupuncturists who are certified upon such date who meet the qualifications set out in this act. Certification is intended to be a temporary measure and shall expire as licensure of acupuncturists is implemented.

Attorney General Opinions. Chiropractors may not practice a treatment modality that involves the insertion of needles with the intent bring about the same result as the needle insertion techniques applied in the practice of acupuncture, without first obtaining a certification to practice acupuncture, OAG 05-020, 2005 Tenn. AG LEXIS 20 (3/08/05).

63-6-1002. Application.

  1. This part shall not apply to:
    1. Physicians licensed under this chapter or chapter 9 of this title, nor shall this part be construed so as to prevent the practice of acupuncture by such physicians or to prevent such physicians from using the title “acupuncturist”;
    2. Registered nurses who are nationally certified as holistic nurses and who have successfully completed an accredited education program in acupuncture; or
    3. Chiropractic physicians licensed under chapter 4 of this title, nor shall any part of this title be construed so as to prevent the practice of acupuncture by chiropractic physicians who have completed two hundred fifty (250) hours of an accredited acupuncture course and have passed the National Board of Chiropractic Examiners acupuncture exam.
  2. It is otherwise unlawful to practice acupuncture for compensation or gratuitously unless certified under this part. This restriction does not apply to the following:
    1. Students practicing acupuncture under the supervision of a certified acupuncturist as part of a course of study approved by the committee; or
    2. Individuals who do not otherwise possess the credentials required for the practice of acupuncture by this part or regulations promulgated hereunder by the board are granted limited certification as an ADS for the purpose of the treatment of alcoholism, substance abuse or chemical dependency if they meet the following conditions:
      1. Provide documentation of successful completion of a board-approved training program in auricular detoxification acupuncture that meets or exceeds standards of training set by NADA;
      2. Practice auricular detoxification treatment in a hospital, clinic or treatment facility that provides comprehensive alcohol and substance abuse or chemical dependency services, including counseling, under the supervision of a certified acupuncturist or medical director;
      3. Satisfy all appropriate ethical standards specified in § 63-6-1007; and
      4. Limit their practice to the five-point auricular detoxification treatment.
  3. A violation of this section is a Class C misdemeanor. A person who violates this section shall also be subject to the sanctions specified in § 63-6-1007.

Acts 2000, ch. 685, § 4; 2006, ch. 775, § 2.

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

63-6-1003. Tennessee advisory committee for acupuncture.

  1. To assist the board in the performance of its duties, there is hereby established the Tennessee advisory committee for acupuncture.
  2. The committee shall consist of five (5) members appointed by the governor. Three (3) of the members shall be certified acupuncturists, one (1) shall be an ADS practicing in Tennessee and one (1) shall be a consumer member who is neither employed in nor has any other direct or indirect affiliation with the health care profession or industry. The three (3) acupuncturists initially appointed need not be certified at the time of their appointments, but must meet all the qualifications for certification.
    1. Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the committee:
      1. Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the committee shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the committee, prior to serving as a member of the committee. This subdivision (c)(1)(A) shall apply to all persons appointed or otherwise named to the committee after July 1, 2010;
      2. No person who is a member of the committee shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the committee during such person's period of service as a member of the committee. This subdivision (c)(1)(B) shall apply to all persons appointed or otherwise named to the committee after July 1, 2010, and to all persons serving on the committee on such date who are not registered as lobbyists; and
      3. No person who serves as a member of the committee shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the committee for one (1) year following the date such person's service on the committee ends. This subdivision (c)(1)(C) shall apply to persons serving on the committee as of July 1, 2010, and to persons appointed to the committee subsequent to such date.
    2. A person who violates this subsection (c) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (c). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  3. In addition to all other requirements for membership on the committee, all persons appointed or otherwise named to serve as members of the committee after July 1, 2010, shall be residents of this state.
  4. Of the initial appointments to the committee, two (2) members shall be appointed for terms of three (3) years, two (2) members shall be appointed for terms of two (2) years and one (1) member shall be appointed for a term of one (1) year. All regular appointments thereafter shall be for terms of four (4) years. No person may serve more than two (2) consecutive full terms as a member of the committee. Each member shall serve on the committee until a successor is appointed. Vacancies shall be filled by appointment of the governor for the unexpired term.
  5. At the committee's first meeting each year after any new members have been appointed, the members shall choose one (1) member to chair the committee for the year and another to serve as co-chair. No person shall chair the committee for more than five (5) consecutive years.
    1. The committee shall meet at least once each year within forty-five (45) days after the appointment of the new members. The committee shall meet at other times as needed to perform its duties.
      1. Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year shall be removed as a member of the committee.
      2. The committee's chair shall promptly notify, or cause to be notified, the appointing authority of any member who fails to satisfy the attendance requirement as prescribed in subdivision (g)(2)(A).
  6. Each member shall receive all necessary expenses incident to conducting the business of the committee and, in addition thereto, shall be entitled to a per diem of fifty dollars ($50.00) for each day's service in conducting the business of the committee. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  7. The committee shall receive from the division of health related boards of the department of health all administrative, investigatory and clerical services as provided for in § 63-1-101. Committee expenses shall be paid from funds generated by certification fees generated by acupuncturists and acupuncture detoxification specialists.

Acts 2000, ch. 685, § 5; 2010, ch. 995, §§ 3, 4; 2016, ch. 616, § 3.

Compiler's Notes. The Tennessee advisory committee for acupuncture, created by this section, terminates June 30, 2022. See §§ 4-29-112, 4-29-243.

Acts 2010, ch. 995, § 5 provided that the provision in the act prohibiting a consumer with any other direct or indirect affiliation with the health care profession or industry from serving on the committee shall apply to all consumer member appointments made to the committee after July 1, 2010.

63-6-1004. Promulgation of rules and regulations.

  1. The board, in consultation with the committee, shall:
    1. Establish the qualifications and fitness of applicants of certifications, renewal of certifications and reciprocal certifications;
    2. Establish grounds for revocation, suspension or denial of certification;
    3. Establish grounds for placing on probation a holder of a certificate;
    4. Establish the categories of fees and the amount of fees that may be imposed in connection with certification;
    5. Issue declaratory orders pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5;
    6. If deemed necessary by the committee, establish standards of continuing education; and
    7. Adopt and use a seal to authenticate official documents of the committee.
  2. Any actions taken under this section shall only be effective after adoption of a majority vote of the members of the committee. The board, by a majority vote of its members at the next board meeting at which administrative matters are considered, may rescind any action taken by the committee.

Acts 2000, ch. 685, § 6.

63-6-1005. Certification to practice.

  1. To receive certification to practice acupuncture from the board, a person must document:
    1. Either:
      1. Current active status as a diplomate in acupuncture of the NCCAOM; or
      2. Current state licensure in good standing by another state with substantially equivalent or higher standards;
    2. Successful completion of a three-year post secondary training program or acupuncture college program that is ACAOM accredited or in candidacy status or that meets ACAOM's standards; and
    3. Successful completion of a NCCAOM-approved clean needle technique course.
  2. The committee shall waive the requirements of subsection (a) for an applicant residing in Tennessee upon July 1, 2001, who presents satisfactory evidence to the committee of successful completion of an approved apprenticeship or tutorial program that meets NCCAOM standards shall be granted certification by the board.
  3. The committee shall waive the requirements of subsection (a) and an applicant presenting satisfactory evidence to the committee that such applicant held a license in good standing from another state immediately prior to practicing in Tennessee and who has continually practiced in Tennessee since that time shall be granted certification by the board.
  4. ADSs who meet the requirements listed in § 63-6-1002 shall be issued a limited acupuncture certificate.

Acts 2000, ch. 685, § 7.

63-6-1006. Renewal of certificate.

A certificate to practice acupuncture must be renewed every two (2) years. To renew a certificate, a person must submit proof of current active NCCAOM certification in acupuncture or document compliance with § 63-6-1005. To renew an ADS certificate, a person must submit proof of current active practice in auricular detoxification treatment, as determined by the committee.

Acts 2000, ch. 685, § 8.

63-6-1007. Disciplinary action.

The board, in consultation with the committee, may deny, suspend or revoke certification, require remedial education or issue a letter of reprimand, if an applicant or certified acupuncturist:

  1. Engages in false or fraudulent conduct that demonstrates an unfitness to practice acupuncture, including:
    1. Misrepresentation in connection with an applicant for certification or an investigation by the committee;
    2. Attempting to collect fees for services that were not performed;
    3. False advertising, including guaranteeing that a cure will result from an acupuncture treatment; or
    4. Dividing or agreeing to divide a fee with anyone for referring the patient for acupuncture;
  2. Fails to exercise proper control over one's practice by:
    1. Delegating professional responsibilities to a person the acupuncturist knows or should know is not qualified to perform; or
    2. Failing to exercise proper control over uncertified personnel working with the practice;
  3. Fails to maintain records in a proper manner by:
    1. Failing to keep written records describing the course of treatment for each patient;
    2. Refusing to provide a patient, upon request, records that have been prepared for or paid for by the patient; or
    3. Revealing personally identifiable information about a patient, without consent, unless otherwise authorized by law;
  4. Fails to exercise proper care of a patient, including the exercising or attempting to exercise undue influence in the acupuncturist-patient relationship by making sexual advances or requests for sexual activity or making submission to such conduct a condition of treatment;
  5. Displays substance abuse or mental impairment to such a degree as to interfere with the ability to provide safe and effective treatment;
  6. Is convicted of or pleads guilty or no contest to any crime that demonstrates an unfitness to practice acupuncture;
  7. Negligently fails to practice acupuncture with the level of skill recognized within the profession as acceptable under such circumstances;
  8. Willfully violates any provision of this part or rule of the commission; or
  9. Has had a certificate or license denied, suspended or revoked in another jurisdiction for any reason that would be grounds for such action in Tennessee.

Acts 2000, ch. 685, § 9.

63-6-1008. Use of needles.

  1. All certified individuals under this part shall use only presterilized, disposable needles in their administration of acupuncture treatments. The use of staples in the practice of acupuncture is prohibited.
  2. Health practices shall include:
    1. Hands shall be washed with soap and water or other disinfectant before handling needles and between treatment of different patients;
    2. Skin in the area of penetration shall be thoroughly swabbed with alcohol or other germicidal solution before inserting needles; and
    3. Individuals shall pass a nationally recognized clean needle technique course before being allowed to practice acupuncture and related techniques.

Acts 2000, ch. 685, § 10.

63-6-1009. Fees.

  1. The board, in consultation with the committee, shall set fees relative to the application, certification and renewal thereof in amounts sufficient to pay all of the expenses of certification and of the committee directly attributable to the performance of its duties under this part.
  2. All deposits and disbursements shall be handled in accordance with § 63-1-137.

Acts 2000, ch. 685, § 11.

63-6-1010. Use of titles.

  1. The titles “licensed acupuncturist” or “ADS” may be used by persons certified under this part. No person who is not properly licensed to practice medicine or osteopathy shall use certification under this part to identify such person as a doctor or physician.
  2. Each person certified to practice acupuncture shall post the certificate in a conspicuous location at such person's place of practice.

Acts 2000, ch. 685, § 12.

Part 11
Intractable Pain Treatment Act [Repealed]

63-6-1101. [Repealed]

Acts 2001, ch. 327, §§ 2-12; 2001, ch. 436, § 3; 2012, ch. 848, § 73; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.Acts 2001, ch. 327, § 2; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1102. [Repealed]

Acts 2001, ch. 327, § 3; 2012, ch. 848, § 73; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1103. [Repealed]

Acts 2001, ch. 327, § 4; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1104. [Repealed]

Acts 2001, ch. 327, § 5; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1105. [Repealed]

Acts 2001, ch. 327, § 6; ; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1106. [Repealed]

Acts 2001, ch. 327, § 7; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1107. [Repealed]

Acts 2001, ch. 327, § 8; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1108. [Repealed]

Acts 2001, ch. 327, § 9; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1109. [Repealed]

Acts 2001, ch. 327, § 10; 2001, ch. 436, § 3; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1110. [Repealed]

Acts 2001, ch. 327, § 11; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

63-6-1111. [Repealed]

Acts 2001, ch. 327, § 12; repealed by Acts 2015, ch. 26, § 1, effective July 1, 2015.

Compiler's Notes. Former title 63, ch. 6, part 11, §§ 63-6-110163-6-1111, concerned the Intractable Pain Treatment Act.

Acts 2015, ch. 26, § 2 provided that  within one hundred eighty (180) days of July 1, 2015, the board of medical examiners shall promulgate a rule in accordance with the Uniform Administrative Procedures Act, compiled in Tennessee Code Annotated, Title 4, Chapter 5, to repeal any rule or regulation promulgated by the board under the authority conferred by Tennessee Code Annotated, Section 63-6-1111.

Part 12
Cytopathology Services

63-6-1201. Part definitions.

For purposes of this part, unless the context otherwise requires:

  1. “Cytopathology services” means the examination of cells from fluids, aspirates, washings, brushings or smears, including the Pap test examination performed by a physician or under the supervision of a physician; and
  2. “Onsite medical clinic” means a medical clinic located on the premises of the patient's employer for which cytopathology services are provided and for which a patient has no financial obligation to pay for the cytopathology services.

Acts 2006, ch. 1003, § 6; 2007, ch. 117, § 1.

Compiler's Notes. Acts 2007, ch. 117, § 3 provided that the commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of the act, which amended the introductory paragraph and added subdivision (2). The rules and regulations shall be promulgated in accordance with the provisions of title 4, chapter 5.

63-6-1202. Claims, bills or demands for payment for services.

A clinical laboratory or physician, located in this state, or in another state, providing cytopathology services for patients in this state, shall present or cause to be presented a claim, bill or demand for payment for these services only to the following:

  1. The patient directly;
  2. The responsible insurer or other third party payor;
  3. The hospital, public health clinic, nonprofit health clinic ordering the services, or onsite medical clinic;
  4. The referring laboratory, other than a laboratory of a physician's office or group practice that does not perform the technical or professional component of the cytopathology service for which the claim, bill, or demand is presented; or
  5. Governmental agencies or their specified public or private agent, agency, or organization on behalf of the recipient of the services.

Acts 2006, ch. 1003, § 2; 2007, ch. 117, § 2.

Compiler's Notes. Acts 2007, ch. 117, § 3 provided that the commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of the act, which amended subdivision (3). The rules and regulations shall be promulgated in accordance with the provisions of title 4, chapter 5.

63-6-1203. Restrictions on solicitation for payment by licensed practitioner.

Except as provided by § 63-6-1206, no licensed practitioner in the state shall, directly or indirectly, charge, bill or otherwise solicit payment for cytopathology services, unless the professional component of the services was rendered personally by the licensed practitioner or under the licensed practitioner's direct supervision in accordance with § 353 of the Public Health Service Act (42 U.S.C. § 263a).

Acts 2006, ch. 1003, § 3.

63-6-1204. Reimbursement of licensed practitioner.

No patient, insurer, third party payor, hospital, public health clinic or nonprofit health clinic shall be required to reimburse any licensed practitioner for charges or claims submitted in violation of this part.

Acts 2006, ch. 1003, § 4.

63-6-1205. Assignment of benefits.

Nothing in this part shall be construed to mandate the assignment of benefits for cytopathology services as defined in § 63-6-1201.

Acts 2006, ch. 1003, § 5.

63-6-1206. Referring laboratory.

This part does not prohibit billing of a referring laboratory for cytopathology services in instances where a sample or samples must be sent to another specialist; provided, that, for purposes of this section, “referring laboratory” does not include a laboratory of a physician's office or group practice that does not perform the technical or professional component of the cytopathology service involved.

Acts 2006, ch. 1003, § 7.

63-6-1207. Violations.

The appropriate state licensing board having jurisdiction over any practitioner who may request or provide cytopathology services may revoke, suspend or deny renewal of the license of any practitioner who violates this part.

Acts 2006, ch. 1003, § 8.

Chapter 7
Nursing

Part 1
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).

NOTES TO DECISIONS

1. Compensation.

One may practice the nursing profession with or without receiving compensation, and the statute regarding expert witnesses does not contain a compensation requirement, and to read one into the statute would be contrary to the legislature's intent; the trial court erred in holding that a nurse was not qualified as a medical expert because she did not receive monetary compensation for her services as her mother-in-law's private duty nurse, as monetary compensation is not required to establish that an expert has practiced in his or her field. Adkins v. Assocs. of the Memorial/Mission Outpatient Surgery Ctr., LLC, — S.W.3d —, 2015 Tenn. App. LEXIS 19 (Tenn. Ct. App. Jan. 13, 2015)

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;
    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
  12. 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. “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.
  1. 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.
    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.

NOTES TO DECISIONS

1. Opinion Testimony.

Emergency room nurse's testimony about the life-threatening nature of the victim's injuries was within her field of expertise. State v. Bonds, 502 S.W.3d 118, 2016 Tenn. Crim. App. LEXIS 266 (Tenn. Crim. App. Apr. 7, 2016).

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. 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.
  1. The applicant for a temporary permit shall pay a fee as set by the board.
  2. 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.
  3. The applicant for a duplicate original license or a duplicate renewal certificate shall pay a fee as set by the board.
  4. The applicant for a school transcript shall pay a fee as set by the board.
  5. The applicant for a change in name shall pay a fee as set by the board.
  6. 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. 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.
  1. 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.
  2. The applicant for a permit shall pay a fee as set by the board.
  3. 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.
  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.

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.
    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).
  3. 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.
  4. 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.
  5. 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.

NOTES TO DECISIONS

1. Suspension Improper.

In light of the absence of any evidence or factual findings regarding a nurse's current psychological condition, the Tennessee board of nursing acted arbitrarily and capriciously by immediately suspending her license as part of a disciplinary proceeding for her abandonment of patients; while the board had the statutory authority to require nurses to submit evidence of nursing competence, including satisfactory physical and mental health, before the renewal of their registration, it did not have the statutory authority in the absence of evidence that supported a finding that a nurse's psychological condition rendered the nurse unfit to practice nursing to summarily suspend the nurse's license pending a psychological examination. Miller v. Tenn. Bd. of Nursing, 256 S.W.3d 225, 2007 Tenn. App. LEXIS 613 (Tenn. Ct. App. Sept. 26, 2007), rehearing denied, 256 S.W.3d 225, 2007 Tenn. App. LEXIS 826 (Tenn. Ct. App. Oct. 22, 2007), appeal denied, — S.W.3d —, 2008 Tenn. LEXIS 214 (Tenn. Apr. 7, 2008).

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

    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.
  1. 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.
    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.
  2. 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.
  3. 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).

NOTES TO DECISIONS

1. Midwifery.

Because the legislature has specifically excluded the practice of midwifery from the definition of medicine in § 63-6-204 and because this chapter does not deal with midwifery nor is it included within the definition of professional nursing in § 63-7-103, the board of nursing did not have jurisdiction over a licensed nurse while she was rendering services as a lay midwife. Leggett v. Tennessee Bd. of Nursing, 612 S.W.2d 476, 1980 Tenn. App. LEXIS 412 (Tenn. Ct. App. 1980).

The nursing board could not properly discipline a registered nurse for her activities as a lay midwife unless the actions were such as to affect the quality of nursing services rendered by the nurse when she was acting as a nurse. Leggett v. Tennessee Bd. of Nursing, 612 S.W.2d 476, 1980 Tenn. App. LEXIS 412 (Tenn. Ct. App. 1980).

2. Patient Abandonment.

Tennessee board of nursing properly ordered a nurse to pay a civil penalty for engaging in unprofessional conduct by abandoning patients in violation of T.C.A. § 63-7-115(a)(1)(F) and Tenn. Comp. R. & Regs. 1000-2-.13(1)(c), as the patients required continued administration of medications and monitoring, and the nurse gave no notice to her supervisor that she was leaving the hospital before the end of her shift. Miller v. Tenn. Bd. of Nursing, 256 S.W.3d 225, 2007 Tenn. App. LEXIS 613 (Tenn. Ct. App. Sept. 26, 2007), rehearing denied, 256 S.W.3d 225, 2007 Tenn. App. LEXIS 826 (Tenn. Ct. App. Oct. 22, 2007), appeal denied, — S.W.3d —, 2008 Tenn. LEXIS 214 (Tenn. Apr. 7, 2008).

In a nurse's disciplinary action where the nurse abandoned patients by leaving the hospital before the end of her shift without notifying her supervisor, while the nurse testified that the records regarding the vandalism and resisting arrest charges had been expunged, she failed to present evidence supporting her claim; in the absence of the corroborating evidence that the records regarding her two convictions had been lawfully expunged, the nurse's testimony that she had pled guilty to vandalism and resisting arrest provided the substantial and material evidence needed to support the Tennessee board of nursing's conclusion that the nurse was “guilty of a crime” for the purpose of T.C.A. § 63-7-115(a)(1)(B). Miller v. Tenn. Bd. of Nursing, 256 S.W.3d 225, 2007 Tenn. App. LEXIS 613 (Tenn. Ct. App. Sept. 26, 2007), rehearing denied, 256 S.W.3d 225, 2007 Tenn. App. LEXIS 826 (Tenn. Ct. App. Oct. 22, 2007), appeal denied, — S.W.3d —, 2008 Tenn. LEXIS 214 (Tenn. Apr. 7, 2008).

3. License

Tennessee Board of Nursing did not err by denying the applicant a contested case because this section did not mandate that a contested case occur, and even if the applicant's liberty interests were implicated, he received all of the process to which he was entitled because his meetings with the Board qualified as a name-clearing hearing. Butler v. Tenn. Bd. of Nursing, — S.W.3d —, 2016 Tenn. App. LEXIS 792 (Tenn. Ct. App. Oct. 25, 2016).

4. Convictions.

Pursuant to Oklahoma law, the Tennessee Board of Nursing was not entitled to rely on the applicant's expunged “conviction” in determining that the applicant was guilty of a crime pursuant to this section because the Oklahoma district court specifically ruled in its order that any court record pertaining to the applicant's misdemeanor conviction was sealed and that it be deemed never to have occurred. Butler v. Tenn. Bd. of Nursing, — S.W.3d —, 2016 Tenn. App. LEXIS 792 (Tenn. Ct. App. Oct. 25, 2016).

5. Revocation.

Revocation of a nurse's certificate to practice as an advanced practice nurse, license to practice as a registered nurse, and multistate privilege to practice in any other party state, was appropriate because the Tennessee Board of Nursing found that the nurse self-injected testosterone without authorization, never filed a notice and formulary, consumed alcohol and exhibited impaired behavior while treating patients, engaged in a sexual relationship with a patient, improperly prescribed medication, and provided incompetent care to patients. Hollahan v. Tenn. Dep't of Health, — S.W.3d —, 2017 Tenn. App. LEXIS 815 (Tenn. Ct. App. Dec. 19, 2017).

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.
    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.
  4. 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.
  5. 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.
  6. Review of the action of the board in suspending or revoking any license shall be pursuant to title 27, chapter 9.
  7. 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.
  8. 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.
    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.
      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.
      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.
        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.
      5. [Deleted by 2018 amendment.]
    2. 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.
    3. 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.
    4. 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.
    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.
  2. 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.
    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:
  8. Intentionally or negligently causing physical or emotional injury to a patient;
    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).
      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.
    1. 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.
    2. 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.
    3. 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.
    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.
  9. A licensed nurse for the purpose of this section shall include a registered nurse, a licensed practical nurse, or either one.
    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;
      1. Is certified in perioperative nursing; or
        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
    2. 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

63-7-201. Creation.

There is created a board to be known as the board of nursing, composed of eleven (11) members, referred to in this chapter as “board,” appointed by the governor in the manner and for the terms of office as provided in § 63-7-202.

Acts 1967, ch. 78, § 2; T.C.A., § 63-730; Acts 1984, ch. 755, § 3; 2005, ch. 387, § 16.

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 nursing, created by this section, terminates June 30, 2021. See §§ 4-29-112, 4-29-242.

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

Persons regulated by board: exemption from certification requirements for professional counselors and marital and family therapists, § 63-22-113.

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

63-7-202. Composition — Candidates — Qualifications — Vacancies.

  1. The governor shall appoint eleven (11) members to the board, as follows:
    1. Nine (9) members, one (1) from each congressional district, who are either an advanced practice registered nurse or a registered nurse at the time of their appointment. At least two (2) members shall be registered nurses. At least three (3) members shall be advanced practice registered nurses. For the purposes of this section, an advanced practice registered nurse shall not include registered nurses;
    2. One (1) member who is a licensed practical nurse at the time of such nurse's appointment; and
    3. One (1) consumer member.
  2. In making appointments to the board, the governor shall consider appointing members who work in a variety of healthcare positions, including the following practice settings:
    1. A Level I trauma center licensed pursuant to title 68, chapter 11, part 2;
    2. An acute care hospital;
    3. A critical access hospital or a rural hospital;
    4. A mental health facility licensed under title 33; and
    5. A long-term care facility.
  3. No more than three (3) members shall be engaged in an academic position at the time of their appointment to the board.
  4. In making appointments to the board, the governor should consider the importance of geographical diversity to this board.
    1. Members of the board may be appointed by the governor from lists of qualified persons submitted by interested nursing groups, including, but not limited to, their respective organizations. Each list may contain a minimum of three (3) times as many names as the number of appointments to be made. Lists of persons shall be submitted at least forty-five (45) days prior to the expiration of the term of office of any members of the board. The appointment provisions of this subdivision (e)(1) shall not apply to the public member serving on the board.
    2. In making appointments to the board in accordance with subdivision (e)(1), the governor shall consult with interested nursing groups, including, but not limited to, their respective organizations to determine qualified persons to fill the positions.
  5. Each licensee member appointed to serve on the board shall:
    1. Be a resident of this state for at least one (1) year immediately preceding appointment;
    2. Be currently licensed and in good standing with an unencumbered license;
    3. Be currently engaged in the practice of nursing; and
    4. Have no less than five (5) years of experience as an advanced practice registered nurse, registered nurse, or licensed practical nurse.
  6. The consumer member appointed to the board shall:
    1. Be a resident of this state for at least one (1) year immediately preceding their appointment;
    2. Not have a direct or indirect financial interest in healthcare services;
    3. Not have been a healthcare provider or be enrolled in any health-related educational program; and
    4. Not be a member or employee of any board of control of any public or private healthcare organization.
  7. A vacancy on the board shall be filled for the unexpired term by appointment by the governor in such a manner to ensure the requirements of this section are met.
  8. In making appointments to the board, 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.
  9. Except as provided in subsection (k), members currently holding appointments on the board shall serve their full terms. As vacancies occur, new appointments shall be filled by the governor in accordance with this section.
  10. No member shall serve more than eight (8) continuous years on the board. A member shall be eligible to be reappointed after not serving on the board for four (4) years. The term of any member of the board with eight (8) or more years of service on the board on April 25, 2012, shall terminate January 1, 2013.

Acts 1967, ch. 78, § 3; 1981, ch. 462, § 1; T.C.A., § 63-731; Acts 1984, ch. 755, § 4; 1988, ch. 1013, § 45; 2005, ch. 387, §§ 13, 14; 2012, ch. 814, § 3; 2016, ch. 980, §§ 16, 17.

Attorney General Opinions. Delegation of Governor’s appointing authority to private entities for purpose of submitting lists for appointments to state licensing boards or agencies.  OAG 10-67, 2010 Tenn. AG LEXIS 73 (5/17/10).

63-7-203. Terms of members.

Members of the board shall serve for a term of four (4) years or until their successor shall be appointed. No member may serve more than two (2) consecutive terms. At least four (4) years shall lapse before a member may be reappointed to the board or may serve in any capacity associated with the board.

Acts 1967, ch. 78, § 4; T.C.A., § 63-732; Acts 2012, ch. 814, § 4.

63-7-204. Organization.

Promptly after the appointment of the board, it shall meet and organize by electing one (1) member to serve as chair and one (1) member to serve as vice chair.

Acts 1967, ch. 78, § 5; T.C.A., § 63-733.

Cross-References. Director of health-related licensing division as ex officio member, § 63-1-133.

63-7-205. Meetings — Quorum.

  1. Six (6) members of the board shall constitute a quorum for a meeting.
  2. No action of the board shall be valid unless authorized by the affirmative vote of a majority of members present.
  3. The board shall hold at least one (1) regular meeting each year and such other meetings as the board may determine.

Acts 1967, ch. 78, § 6; T.C.A., § 63-734; Acts 1984, ch. 755, § 5; 2005, ch. 387, § 15.

63-7-206. Disposition of fees and moneys received — Operating expenses — Compensation.

  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 for the expenditure 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.
  3. 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 and other administrative or disciplinary functions of the board and necessary expenses for traveling and subsistence while attending such meetings or performing such functions. 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.

Acts 1967, ch. 78, § 7; 1976, ch. 501, § 1; 1976, ch. 806, § 1(114); T.C.A., § 63-735; modified; Acts 2005, ch. 80, § 1.

63-7-207. Powers and duties.

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

      1. Employ, with the approval of the governor, an executive director, who shall not be a member of the board. The executive director shall be entitled to have and receive a salary to be fixed by the board and approved by the commissioner of human resources and the commissioner of finance and administration;
      2. Employ such other personnel as may be necessary for the effective and efficient discharge of the duties of the board;
    1. Such executive director and other employees shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter;
  1. Maintain an office in Nashville;
  2. Adopt a seal that shall bear the words “Tennessee Board of Nursing” and the imprint thereof shall be placed upon all official papers of the board;
  3. Adopt and from time to time revise such rules and regulations as may be necessary to govern its proceedings and to carry into effect the purpose of this chapter;
  4. Make an annual report to the governor the first week in July, together with a statement of the receipts and disbursements of the board and maintain such records as may be required by the applicable laws and regulations of the state;
  5. Cause the prosecution of persons violating this chapter;
  6. Prescribe the minimum curricular and minimum standards for schools of nursing and for courses of training preparing persons for licensure under this chapter and provide for surveys of such schools or an affiliation of schools and courses;
  7. Approve such schools and courses as meet the requirements of this chapter and the rules and regulations of the board;
  8. Conduct examinations to ascertain the qualifications and fitness of applicants and issue licenses to applicants who successfully pass the examination for the practice of professional nursing or practical nursing;
  9. Conduct hearings upon charges of suspension or revocation of a license or approval of a school of nursing or course of training and deny, suspend or revoke for proper cause licenses or approval of schools or course of training as provided in this chapter. Any action of or ruling or order made or entered by the board shall be subject to review by the courts of this state in the same manner and subject to the same powers and conditions as now provided by law in regard to the rulings, orders and findings of other quasi-judicial bodies in Tennessee, where not otherwise specifically provided;
  10. Promote nursing education and nursing service through the state through surveys, institutes, conferences or such other means as may result in improved nursing education and nursing services in the state;
  11. Determine the state, national and other meetings to be attended by the employees or individual members of the board in the interest of the advancement of nursing in this state;
  12. Annually publish a directory listing all persons licensed to practice as a professional or practical nurse in Tennessee. The board shall have the authority to adopt and promulgate rules and regulations governing the distribution of such directories. Such regulations may establish a reasonable price, not to exceed ten dollars ($10.00) per directory, to be charged for the directories. The directories shall be available free of charge to nonprofit health agencies operating in the state of Tennessee, federal and state governmental agencies, local health departments and individual licensees;
  13. Establish and examine the qualifications, competencies, training, education and experience required of a registered nurse applying for a certificate of fitness as a nurse practitioner, as defined by the board, sufficient to prepare such person to write and sign prescriptions and/or issue drugs in accordance with the limitations and provisions of § 63-1-132;
  14. 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;
  15. By January 1, 2002, the board of nursing shall implement a plan to assure continuing competence of licensees, using educationally sound methods to promote learning and assess outcomes pertinent to contemporary standards of nursing practice;
  16. Compile and disseminate demographic data collected on all licensees; and
  17. 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 nursing workforce to provide a basis for improving the delivery of quality health care.

Acts 1967, ch. 78, § 8; 1976, ch. 501, § 2; 1976, ch. 806, § 1(114); 1980, ch. 851, § 3; T.C.A., § 63-736; Acts 1985, ch. 120, § 10; 1998, ch. 1047, §§ 2, 3; 1999, ch. 439, § 3; 2001, ch. 314, § 1.

Cross-References. Certified nurse practitioners' prescription and drug authorization powers, § 63-7-123.

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

NOTES TO DECISIONS

1. Midwifery.

Because the legislature has specifically excluded the practice of midwifery from the definition of medicine in § 63-6-204 and because this chapter does not deal with midwifery nor is it included within the definition of professional nursing in § 63-7-103, the board of nursing did not have jurisdiction over a licensed nurse while she was rendering services as a lay midwife. Leggett v. Tennessee Bd. of Nursing, 612 S.W.2d 476, 1980 Tenn. App. LEXIS 412 (Tenn. Ct. App. 1980).

63-7-208. Qualifications of executive director.

The executive director shall serve as consultant on nursing education and nursing service and shall have the following minimum qualifications:

  1. Master's degree in nursing from a recognized college or university;
  2. License to practice nursing in this state; and
  3. At least five (5) years' experience in any combination of administration, teaching or supervision in schools of nursing or public health nursing agencies.

Acts 1967, ch. 78, § 9; T.C.A., § 63-737; Acts 1982, ch. 712, § 1.

Cross-References. Executive directorship authorized, § 63-7-207.

63-7-209. Duties of executive director.

The duties of the executive director of the board shall be such as are prescribed by the board and shall include the following:

  1. Within thirty (30) days after the election of the officers of the board, the executive director shall certify to the governor the names of the officers so elected. A vacancy in any office or in the board membership shall likewise be certified by the executive director to the governor;
  2. Keep a record of the minutes of the meetings of the board, a record of all persons applying for licenses under this chapter and of the actions of the board thereon and a register of all nurses who have complied with the requirements of the chapter. Such records shall at all reasonable times be open to public inspection;
  3. Make a bond in such sum as required by the board, conditioned on the faithful performance of the duties of the office. The premium of the bond shall be paid by the board;
  4. Issue licenses to nurses complying with the requirements of this chapter and issue renewal certificates as provided in this chapter; and
  5. From time to time, as may be determined by the board, render such reports and accountings as the board may order.

Acts 1967, ch. 78, § 10; T.C.A., § 63-738.

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

63-7-210. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.

A nurse licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of nursing may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.

Acts 2004, ch. 579, § 5.

Part 3
Interstate Nurse Licensure Compact [Repealed]

63-7-301. [Repealed.]

Acts 2002, ch. 538, § 1; repealed by Acts 2016, ch 591, § 2, effective January 19, 2018.

Compiler's Notes. Former part 3, §§ 63-7-301–63-7-304 concerned Interstate Nurse Licensure Compact.

Acts 2016, ch. 591, § 3 provided that the state board of nursing is directed to inform the executive secretary of the Tennessee Code Commission by letter of the effective dates for the new compact enacted by this act and the withdrawal from the old compact codified in Tennessee Code Annotated, Title 63, Chapter 7, Part 3. The state board of nursing informed the executive secretary of the Tennessee Code Commission that the effective date for the new compact and withdrawal from the old compact is January 19, 2018. See Chapter 7, Part 4 of this title for the new compact.

63-7-302. [Repealed.]

Acts 2002, ch. 538, § 2; repealed by Acts 2016, ch. 591, § 2, effective January 19, 2018.

Compiler's Notes. Former part 3, §§ 63-7-301–63-7-304 concerned Interstate Nurse Licensure Compact.

Acts 2016, ch. 591, § 3 provided that the state board of nursing is directed to inform the executive secretary of the Tennessee Code Commission by letter of the effective dates for the new compact enacted by this act and the withdrawal from the old compact codified in Tennessee Code Annotated, Title 63, Chapter 7, Part 3. The state board of nursing informed the executive secretary of the Tennessee Code Commission that the effective date for the new compact  and withdrawal from the old compact is January 19, 2018. See Chapter 7, Part 4 of this title for the new compact.

63-7-303. [Repealed.]

Acts 2002, ch. 538, § 3; repealed by Acts 2016, ch 591, § 2, effective January 19, 2018.

Compiler's Notes. Former part 3, §§ 63-7-301–63-7-304 concerned Interstate Nurse Licensure Compact.

Acts 2016, ch. 591, § 3 provided that the state board of nursing is directed to inform the executive secretary of the Tennessee Code Commission by letter of the effective dates for the new compact enacted by this act and the withdrawal from the old compact codified in Tennessee Code Annotated, Title 63, Chapter 7, Part 3. The state board of nursing informed the executive secretary of the Tennessee Code Commission that the effective date for the new compact  and withdrawal from the old compact is January 19, 2018. See Chapter 7, Part 4 of this title for the new compact.

63-7-304. [Repealed.]

Acts 2002, ch. 538, § 4; repealed by Acts 2016, ch 591, § 2, effective January 19, 2018.

Compiler's Notes. Former part 3, §§ 63-7-301–63-7-304 concerned Interstate Nurse Licensure Compact.

Acts 2016, ch. 591, § 3 provided that the state board of nursing is directed to inform the executive secretary of the Tennessee Code Commission by letter of the effective dates for the new compact enacted by this act and the withdrawal from the old compact codified in Tennessee Code Annotated, Title 63, Chapter 7, Part 3. The state board of nursing informed the executive secretary of the Tennessee Code Commission that the effective date for the new compact  and withdrawal from the old compact is January 19, 2018. See Chapter 7, Part 4 of this title for the new compact.

Part 4
Interstate Nurse Licensure Compact

63-7-401. Short title.

This part may be known and cited as the “Nurse Licensure Compact.”

Acts 2016, ch. 591, § 1.

Compiler's Notes. Acts 2016, ch. 591, § 3 provided that the state board of nursing is directed to inform the executive secretary of the Tennessee Code Commission by letter of the effective dates for the new compact enacted by this act and the withdrawal from the old compact codified in Tennessee Code Annotated, Title 63, Chapter 7, Part 3. The state board of nursing informed the executive secretary of the Tennessee Code Commission that the effective date for the new compact  and withdrawal from the old compact is January 19, 2018.

The lnterstate Nurse Licensure Compact, created by this section terminates June 30, 2028. See §§ 4-29-112, 4-29-249.

Effective Dates. Acts 2016, ch. 591, § 3. January 19, 2018.

63-7-402. Enactment — Text of compact.

The Nurse Licensure Compact is enacted into law and entered into by this state with all states legally joining the compact and in the form substantially as follows:

THE NURSE LICENSURE COMPACT

Article I.  Findings and Declaration of Purpose

a.  The party states find that:

1.  The health and safety of the public are affected by the degree of compliance with and the effectiveness of enforcement activities related to state nurse licensure laws;

2.  Violations of nurse licensure and other laws regulating the practice of nursing may result in injury or harm to the public;

3.  The expanded mobility of nurses and the use of advanced communication technologies as part of our nation's health care delivery system require greater coordination and cooperation among states in the areas of nurse licensure and regulation;

4.  New practice modalities and technology make compliance with individual state nurse licensure laws difficult and complex;

5.  The current system of duplicative licensure for nurses practicing in multiple states is cumbersome and redundant for both nurses and states; and

6.  Uniformity of nurse licensure requirements throughout the states promotes public safety and public health benefits.

b.  The general purposes of this compact are to:

1.  Facilitate the states' responsibility to protect the public's health and safety;

2.  Ensure and encourage the cooperation of party states in the areas of nurse licensure and regulation;

3.  Facilitate the exchange of information between party states in the areas of nurse regulation, investigation and adverse actions;

4.  Promote compliance with the laws governing the practice of nursing in each jurisdiction;

5.  Invest all party states with the authority to hold a nurse accountable for meeting all state practice laws in the state in which the patient is located at the time care is rendered through the mutual recognition of party state licenses;

6.  Decrease redundancies in the consideration and issuance of nurse licenses; and

7.  Provide opportunities for interstate practice by nurses who meet uniform licensure requirements.

Article II.  Definitions

As used in this compact:

a.  “Adverse action” means any administrative, civil, equitable or criminal action permitted by a state's laws which is imposed by a licensing board or other authority against a nurse, including actions against an individual's license or multistate licensure privilege such as revocation, suspension, probation, monitoring of the licensee, limitation on the licensee's practice, or any other encumbrance on licensure affecting a nurse's authorization to practice, including issuance of a cease and desist action.

b.  “Alternative program” means a non-disciplinary monitoring program approved by a licensing board.

c.  “Coordinated licensure information system” means an integrated process for collecting, storing and sharing information on nurse licensure and enforcement activities related to nurse licensure laws that is administered by a nonprofit organization composed of and controlled by licensing boards.

d.  “Current significant investigative information” means:

1.  Investigative information that a licensing board, after a preliminary inquiry that includes notification and an opportunity for the nurse to respond, if required by state law, has reason to believe is not groundless and, if proved true, would indicate more than a minor infraction; or

2.  Investigative information that indicates that the nurse represents an immediate threat to public health and safety regardless of whether the nurse has been notified and had an opportunity to respond.

e.  “Encumbrance” means a revocation or suspension of, or any limitation on, the full and unrestricted practice of nursing imposed by a licensing board.

f.  “Home state” means the party state which is the nurse's primary state of residence.

g.  “Licensing board” means a party state's regulatory body responsible for issuing nurse licenses.

h.  “Multistate license” means a license to practice as a registered or a licensed practical/vocational nurse (LPN/VN) issued by a home state licensing board that authorizes the licensed nurse to practice in all party states under a multistate licensure privilege.

i.  “Multistate licensure privilege” means a legal authorization associated with a multistate license permitting the practice of nursing as either a registered nurse (RN) or LPN/VN in a remote state.

j.  “Nurse” means RN or LPN/VN, as those terms are defined by each party state's practice laws.

k.  “Party state” means any state that has adopted this compact.

l.  “Remote state” means a party state, other than the home state.

m.  “Single-state license” means a nurse license issued by a party state that authorizes practice only within the issuing state and does not include a multistate licensure privilege to practice in any other party state.

n.  “State” means a state, territory or possession of the United States and the District of Columbia.

o.  “State practice laws” means a party state's laws, rules and regulations that govern the practice of nursing, define the scope of nursing practice, and create the methods and grounds for imposing discipline. “State practice laws” do not include requirements necessary to obtain and retain a license, except for qualifications or requirements of the home state.

Article III. General Provisions and Jurisdiction

a.  A multistate license to practice registered or licensed practical/vocational nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing a nurse to practice as a registered nurse (RN) or as a licensed practical/vocational nurse (LPN/VN), under a multistate licensure privilege, in each party state.

b.  A state must implement procedures for considering the criminal history records of applicants for initial multistate license or licensure by endorsement. Such procedures shall include the submission of fingerprints or other biometric-based information by applicants for the purpose of obtaining an applicant's criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state's criminal records.

c.  Each party state shall require the following for an applicant to obtain or retain a multistate license in the home state:

1.  Meets the home state's qualifications for licensure or renewal of licensure, as well as, all other applicable state laws;

2.

i.  Has graduated or is eligible to graduate from a licensing board-approved RN or LPN/VN prelicensure education program; or

ii.  Has graduated from a foreign RN or LPN/VN prelicensure education program that (a) has been approved by the authorized accrediting body in the applicable country and (b) has been verified by an independent credentials review agency to be comparable to a licensing board-approved prelicensure education program;

3.  Has, if a graduate of a foreign prelicensure education program not taught in English or if English is not the individual's native language, successfully passed an English proficiency examination that includes the components of reading, speaking, writing and listening;

4.  Has successfully passed an NCLEX-RN(R) or NCLEX-PN(R) Examination or recognized predecessor, as applicable;

5.  Is eligible for or holds an active, unencumbered license;

6.  Has submitted, in connection with an application for initial licensure or licensure by endorsement, fingerprints or other biometric data for the purpose of obtaining criminal history record information from the Federal Bureau of Investigation and the agency responsible for retaining that state's criminal records;

7.  Has not been convicted or found guilty, or has entered into an agreed disposition, of a felony offense under applicable state or federal criminal law;

8.  Has not been convicted or found guilty, or has entered into an agreed disposition, of a misdemeanor offense related to the practice of nursing as determined on a case-by-case basis;

9.  Is not currently enrolled in an alternative program;

10.  Is subject to self-disclosure requirements regarding current participation in an alternative program; and

11.  Has a valid United States Social Security number.

d.  All party states shall be authorized, in accordance with existing state due process law, to take adverse action against a nurse's multistate licensure privilege such as revocation, suspension, probation or any other action that affects a nurse's authorization to practice under a multistate licensure privilege, including cease and desist actions. If a party state takes such action, it shall promptly notify the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the home state of any such actions by remote states.

e.  A nurse practicing in a party state must comply with the state practice laws of the state in which the client is located at the time service is provided. The practice of nursing is not limited to patient care, but shall include all nursing practice as defined by the state practice laws of the party state in which the client is located. The practice of nursing in a party state under a multistate licensure privilege will subject a nurse to the jurisdiction of the licensing board, the courts and the laws of the party state in which the client is located at the time service is provided.

f.  Individuals not residing in a party state shall continue to be able to apply for a party state's single-state license as provided under the laws of each party state. However, the single-state license granted to these individuals will not be recognized as granting the privilege to practice nursing in any other party state. Nothing in this compact shall affect the requirements established by a party state for the issuance of a single-state license.

g.  Any nurse holding a home state multistate license, on the effective date of this compact, may retain and renew the multistate license issued by the nurse's then-current home state, provided that:

1.  A nurse, who changes primary state of residence after this compact's effective date, must meet all applicable Article III.c. requirements to obtain a multistate license from a new home state.

2.  A nurse who fails to satisfy the multistate licensure requirements in Article III.c. due to a disqualifying event occurring after this compact's effective date shall be ineligible to retain or renew a multistate license, and the nurse's multistate license shall be revoked or deactivated in accordance with applicable rules adopted by the Interstate Commission of Nurse Licensure Compact Administrators (“Commission”).

Article IV. Applications for Licensure in a Party State

a.  Upon application for a multistate license, the licensing board in the issuing party state shall ascertain, through the coordinated licensure information system, whether the applicant has ever held, or is the holder of, a license issued by any other state, whether there are any encumbrances on any license or multistate licensure privilege held by the applicant, whether any adverse action has been taken against any license or multistate licensure privilege held by the applicant and whether the applicant is currently participating in an alternative program.

b.  A nurse may hold a multistate license, issued by the home state, in only one party state at a time.

c.  If a nurse changes primary state of residence by moving between two party states, the nurse must apply for licensure in the new home state, and the multistate license issued by the prior home state will be deactivated in accordance with applicable rules adopted by the Commission.

1.  The nurse may apply for licensure in advance of a change in primary state of residence.

2.  A multistate license shall not be issued by the new home state until the nurse provides satisfactory evidence of a change in primary state of residence to the new home state and satisfies all applicable requirements to obtain a multistate license from the new home state.

d.  If a nurse changes primary state of residence by moving from a party state to a non-party state, the multistate license issued by the prior home state will convert to a single-state license, valid only in the former home state.

Article V.  Additional Authorities Invested in Party State Licensing Boards

a.  In addition to the other powers conferred by state law, a licensing board shall have the authority to:

1.  Take adverse action against a nurse's multistate licensure privilege to practice within that party state.

i.  Only the home state shall have the power to take adverse action against a nurse's license issued by the home state.

ii.  For purposes of taking adverse action, the home state licensing board shall give the same priority and effect to reported conduct received from a remote state as it would if such conduct had occurred within the home state. In so doing, the home state shall apply its own state laws to determine appropriate action.

2.  Issue cease and desist orders or impose an encumbrance on a nurse's authority to practice within that party state.

3.  Complete any pending investigations of a nurse who changes primary state of residence during the course of such investigations. The licensing board shall also have the authority to take appropriate action(s) and shall promptly report the conclusions of such investigations to the administrator of the coordinated licensure information system. The administrator of the coordinated licensure information system shall promptly notify the new home state of any such actions.

4.  Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, as well as, the production of evidence. Subpoenas issued by a licensing board in a party state for the attendance and testimony of witnesses or the production of evidence from another party state shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage and other fees required by the service statutes of the state in which the witnesses or evidence are located.

5.  Obtain and submit, for each nurse licensure applicant, fingerprint or other biometric-based information to the Federal Bureau of Investigation for criminal background checks, receive the results of the Federal Bureau of Investigation record search on criminal background checks and use the results in making licensure decisions.

6.  If otherwise permitted by state law, recover from the affected nurse the costs of investigations and disposition of cases resulting from any adverse action taken against that nurse.

7.  Take adverse action based on the factual findings of the remote state provided that the licensing board follows its own procedures for taking such adverse action.

b.  If adverse action is taken by the home state against a nurse's multistate license, the nurse's multistate licensure privilege to practice in all other party states shall be deactivated until all encumbrances have been removed from the multistate license. All home state disciplinary orders that impose adverse action against a nurse's multistate license shall include a statement that the nurse's multistate licensure privilege is deactivated in all party states during the pendency of the order.

c.  Nothing in this compact shall override a party state's decision that participation in an alternative program may be used in lieu of adverse action. The home state licensing board shall deactivate the multistate licensure privilege under the multistate license of any nurse for the duration of the nurse's participation in an alternative program.

Article VI.  Coordinated Licensure Information System and Exchange of Information

a.  All party states shall participate in a coordinated licensure information system of all licensed registered nurses (RNs) and licensed practical/vocational nurses (LPNs/VNs). This system will include information on the licensure and disciplinary history of each nurse, as submitted by party states, to assist in the coordination of nurse licensure and enforcement efforts.

b.  The Commission, in consultation with the administrator of the coordinated licensure information system, shall formulate necessary and proper procedures for the identification, collection and exchange of information under this compact.

c.  All licensing boards shall promptly report to the coordinated licensure information system any adverse action, any current significant investigative information, denials of applications (with the reasons for such denials) and nurse participation in alternative programs known to the licensing board regardless of whether such participation is deemed nonpublic or confidential under state law.

d.  Current significant investigative information and participation in nonpublic or confidential alternative programs shall be transmitted through the coordinated licensure information system only to party state licensing boards.

e.  Notwithstanding any other provision of law, all party state licensing boards contributing information to the coordinated licensure information system may designate information that may not be shared with non-party states or disclosed to other entities or individuals without the express permission of the contributing state.

f.  Any personally identifiable information obtained from the coordinated licensure information system by a party state licensing board shall not be shared with non-party states or disclosed to other entities or individuals except to the extent permitted by the laws of the party state contributing the information.

g.  Any information contributed to the coordinated licensure information system that is subsequently required to be expunged by the laws of the party state contributing that information shall also be expunged from the coordinated licensure information system.

h.  The Compact administrator of each party state shall furnish a uniform data set to the Compact administrator of each other party state, which shall include, at a minimum:

1.  Identifying information;

2.  Licensure data;

3.  Information related to alternative program participation; and

4.  Other information that may facilitate the administration of this compact, as determined by Commission rules.

i.  The Compact administrator of a party state shall provide all investigative documents and information requested by another party state.

Article VII. Establishment of the Interstate Commission of Nurse Licensure Compact Administrators

a.  The party states hereby create and establish a joint public entity known as the Interstate Commission of Nurse Licensure Compact Administrators.

1.  The Commission is an instrumentality of the party states.

2.  Venue is proper, and judicial proceedings by or against the Commission shall be brought solely and exclusively, in a court of competent jurisdiction where the principal office of the Commission is located. The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.

3.  Nothing in this compact shall be construed to be a waiver of sovereign immunity.

b.  Membership, Voting and Meetings

1.  Each party state shall have and be limited to one administrator. The head of the state licensing board or designee shall be the administrator of this compact for each party state. Any administrator may be removed or suspended from office as provided by the law of the state from which the administrator is appointed. Any vacancy occurring in the Commission shall be filled in accordance with the laws of the party state in which the vacancy exists.

2.  Each administrator shall be entitled to one (1) vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the Commission. An administrator shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for an administrator's participation in meetings by telephone or other means of communication.

3.  The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws or rules of the commission.

4.  All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in Article VIII.

5.  The Commission may convene in a closed, nonpublic meeting if the Commission must discuss:

i.  Noncompliance of a party state with its obligations under this compact;

ii.  The employment, compensation, discipline or other personnel matters, practices or procedures related to specific employees or other matters related to the Commission's internal personnel practices and procedures;

iii.  Current, threatened or reasonably anticipated litigation;

iv.  Negotiation of contracts for the purchase or sale of goods, services or real estate;

v.  Accusing any person of a crime or formally censuring any person;

vi.  Disclosure of trade secrets or commercial or financial information that is privileged or confidential;

vii.  Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;

viii.  Disclosure of investigatory records compiled for law enforcement purposes;

ix.  Disclosure of information related to any reports prepared by or on behalf of the Commission for the purpose of investigation of compliance with this compact; or

x.  Matters specifically exempted from disclosure by federal or state statute.

6.  If a meeting, or portion of a meeting, is closed pursuant to this provision, the Commission's legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision. The Commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefor, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction.

c.  The Commission shall, by a majority vote of the administrators, prescribe bylaws or rules to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of this compact, including but not limited to:

1.  Establishing the fiscal year of the Commission;

2.  Providing reasonable standards and procedures:

i.  For the establishment and meetings of other committees; and

ii.  Governing any general or specific delegation of any authority or function of the Commission;

3.  Providing reasonable procedures for calling and conducting meetings of the Commission, ensuring reasonable advance notice of all meetings and providing an opportunity for attendance of such meetings by interested parties, with enumerated exceptions designed to protect the public's interest, the privacy of individuals, and proprietary information, including trade secrets. The Commission may meet in closed session only after a majority of the administrators vote to close a meeting in whole or in part. As soon as practicable, the Commission must make public a copy of the vote to close the meeting revealing the vote of each administrator, with no proxy votes allowed;

4.  Establishing the titles, duties and authority and reasonable procedures for the election of the officers of the Commission;

5.  Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the Commission. Notwithstanding any civil service or other similar laws of any party state, the bylaws shall exclusively govern the personnel policies and programs of the Commission; and

6.  Providing a mechanism for winding up the operations of the Commission and the equitable disposition of any surplus funds that may exist after the termination of this compact after the payment or reserving of all of its debts and obligations;

d.  The Commission shall publish its bylaws and rules, and any amendments thereto, in a convenient form on the website of the Commission.

e.  The Commission shall maintain its financial records in accordance with the bylaws.

f.  The Commission shall meet and take such actions as are consistent with the provisions of this compact and the bylaws.

g.  The Commission shall have the following powers:

1.  To promulgate uniform rules to facilitate and coordinate implementation and administration of this compact. The rules shall have the force and effect of law and shall be binding in all party states;

2.  To bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any licensing board to sue or be sued under applicable law shall not be affected;

3.  To purchase and maintain insurance and bonds;

4.  To borrow, accept or contract for services of personnel, including, but not limited to, employees of a party state or nonprofit organizations;

5.  To cooperate with other organizations that administer state compacts related to the regulation of nursing, including but not limited to sharing administrative or staff expenses, office space or other resources;

6.  To hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of this compact, and to establish the Commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel and other related personnel matters;

7.  To accept any and all appropriate donations, grants and gifts of money, equipment, supplies, materials and services, and to receive, utilize and dispose of the same; provided that at all times the Commission shall avoid any appearance of impropriety or conflict of interest;

8.  To lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve or use, any property, whether real, personal or mixed; provided that at all times the Commission shall avoid any appearance of impropriety;

9.  To sell, convey, mortgage, pledge, lease, exchange, abandon or otherwise dispose of any property, whether real, personal or mixed;

10.  To establish a budget and make expenditures;

11.  To borrow money;

12.  To appoint committees, including advisory committees comprised of administrators, state nursing regulators, state legislators or their representatives, and consumer representatives, and other such interested persons;

13.  To provide and receive information from, and to cooperate with, law enforcement agencies;

14.  To adopt and use an official seal; and

15.  To perform such other functions as may be necessary or appropriate to achieve the purposes of this compact consistent with the state regulation of nurse licensure and practice.

h.  Financing of the Commission

1.  The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization and ongoing activities.

2.  The Commission may also levy on and collect an annual assessment from each party state to cover the cost of its operations, activities and staff in its annual budget as approved each year. The aggregate annual assessment amount, if any, shall be allocated based upon a formula to be determined by the Commission, which shall promulgate a rule that is binding upon all party states.

3.  The Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same; nor shall the Commission pledge the credit of any of the party states, except by, and with the authority of, such party state.

4.  The Commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the Commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the Commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the Commission.

i.  Qualified Immunity, Defense and Indemnification

1.  The administrators, officers, executive director, employees and representatives of the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred, within the scope of Commission employment, duties or responsibilities; provided that nothing in this paragraph shall be construed to protect any such person from suit or liability for any damage, loss, injury or liability caused by the intentional, willful or wanton misconduct of that person.

2.  The Commission shall defend any administrator, officer, executive director, employee or representative of the Commission in any civil action seeking to impose liability arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities; provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel; and provided further that the actual or alleged act, error or omission did not result from that person's intentional, willful or wanton misconduct.

3.  The Commission shall indemnify and hold harmless any administrator, officer, executive director, employee or representative of the Commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities, provided that the actual or alleged act, error or omission did not result from the intentional, willful or wanton misconduct of that person.

Article VIII.  Rulemaking

a.  The Commission shall exercise its rulemaking powers pursuant to the criteria set forth in this Article and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment and shall have the same force and effect as provisions of this compact.

b.  Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.

c.  Prior to promulgation and adoption of a final rule or rules by the Commission, and at least sixty (60) days in advance of the meeting at which the rule will be considered and voted upon, the Commission shall file a notice of proposed rulemaking:

1.  On the website of the Commission; and

2.  On the website of each licensing board or the publication in which each state would otherwise publish proposed rules.

d.  The notice of proposed rulemaking shall include:

1.  The proposed time, date and location of the meeting in which the rule will be considered and voted upon;

2.  The text of the proposed rule or amendment, and the reason for the proposed rule;

3.  A request for comments on the proposed rule from any interested person; and

4.  The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.

e.  Prior to adoption of a proposed rule, the Commission shall allow persons to submit written data, facts, opinions and arguments, which shall be made available to the public.

f.  The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment.

g.  The Commission shall publish the place, time and date of the scheduled public hearing.

1.  Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing. All hearings will be recorded, and a copy will be made available upon request.

2.  Nothing in this section shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the Commission at hearings required by this section.

h.  If no one appears at the public hearing, the Commission may proceed with promulgation of the proposed rule.

i.  Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the Commission shall consider all written and oral comments received.

j.  The Commission shall, by majority vote of all administrators, take final action on the proposed rule and shall determine the effective date of the rule, if any, based on the rulemaking record and the full text of the rule.

k.  Upon determination that an emergency exists, the Commission may consider and adopt an emergency rule without prior notice, opportunity for comment or hearing, provided that the usual rulemaking procedures provided in this compact and in this section shall be retroactively applied to the rule as soon as reasonably possible, in no event later than ninety (90) days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to:

1.  Meet an imminent threat to public health, safety or welfare;

2.  Prevent a loss of Commission or party state funds; or

3.  Meet a deadline for the promulgation of an administrative rule that is required by federal law or rule.

l.  The Commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency or grammatical errors. Public notice of any revisions shall be posted on the website of the Commission. The revision shall be subject to challenge by any person for a period of thirty (30) days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing, and delivered to the Commission, prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the Commission.

Article IX.  Oversight, Dispute Resolution and Enforcement

a.  Oversight

1.  Each party state shall enforce this compact and take all actions necessary and appropriate to effectuate this compact's purposes and intent.

2.  The Commission shall be entitled to receive service of process in any proceeding that may affect the powers, responsibilities or actions of the Commission, and shall have standing to intervene in such a proceeding for all purposes. Failure to provide service of process in such proceeding to the Commission shall render a judgment or order void as to the Commission, this compact or promulgated rules.

b.  Default, Technical Assistance and Termination

1.  If the Commission determines that a party state has defaulted in the performance of its obligations or responsibilities under this compact or the promulgated rules, the Commission shall:

i.  Provide written notice to the defaulting state and other party states of the nature of the default, the proposed means of curing the default or any other action to be taken by the Commission; and

ii.  Provide remedial training and specific technical assistance regarding the default.

2.  If a state in default fails to cure the default, the defaulting state's membership in this compact may be terminated upon an affirmative vote of a majority of the administrators, and all rights, privileges and benefits conferred by this compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default.

3.  Termination of membership in this compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the Commission to the governor of the defaulting state and to the executive officer of the defaulting state's licensing board and each of the party states.

4.  A state whose membership in this compact has been terminated is responsible for all assessments, obligations and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination.

5.  The Commission shall not bear any costs related to a state that is found to be in default or whose membership in this compact has been terminated unless agreed upon in writing between the Commission and the defaulting state.

6.  The defaulting state may appeal the action of the Commission by petitioning the U.S. District Court for the District of Columbia or the federal district in which the Commission has its principal offices. The prevailing party shall be awarded all costs of such litigation, including reasonable attorneys' fees.

c.  Dispute Resolution

1.  Upon request by a party state, the Commission shall attempt to resolve disputes related to the compact that arise among party states and between party and non-party states.

2.  The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes, as appropriate.

3.  In the event the Commission cannot resolve disputes among party states arising under this compact:

i.  The party states may submit the issues in dispute to an arbitration panel, which will be comprised of individuals appointed by the compact administrator in each of the affected party states and an individual mutually agreed upon by the compact administrators of all the party states involved in the dispute.

ii.  The decision of a majority of the arbitrators shall be final and binding.

d.  Enforcement

1.  The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this compact.

2.  By majority vote, the Commission may initiate legal action in the U.S. District Court for the District of Columbia or the federal district in which the Commission has its principal offices against a party state that is in default to enforce compliance with the provisions of this compact and its promulgated rules and bylaws. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing party shall be awarded all costs of such litigation, including reasonable attorneys' fees.

3.  The remedies herein shall not be the exclusive remedies of the Commission. The Commission may pursue any other remedies available under federal or state law.

Article X. Effective Date, Withdrawal and Amendment

a.  This compact shall become effective and binding on the earlier of the date of legislative enactment of this compact into law by no less than twenty-six (26) states or December 31, 2018. All party states to this compact, that also were parties to the prior Nurse Licensure Compact, superseded by this compact, (“Prior compact”), shall be deemed to have withdrawn from said Prior compact within six (6) months after the effective date of this compact.

b.  Each party state to this compact shall continue to recognize a nurse's multistate licensure privilege to practice in that party state issued under the Prior compact until such party state has withdrawn from the Prior compact.

c.  Any party state may withdraw from this compact by enacting a statute repealing the same. A party state's withdrawal shall not take effect until six (6) months after enactment of the repealing statute.

d.  A party state's withdrawal or termination shall not affect the continuing requirement of the withdrawing or terminated state's licensing board to report adverse actions and significant investigations occurring prior to the effective date of such withdrawal or termination.

e.  Nothing contained in this compact shall be construed to invalidate or prevent any nurse licensure agreement or other cooperative arrangement between a party state and a non-party state that is made in accordance with the other provisions of this compact.

f.  This compact may be amended by the party states. No amendment to this compact shall become effective and binding upon the party states unless and until it is enacted into the laws of all party states.

g.  Representatives of non-party states to this compact shall be invited to participate in the activities of the Commission, on a nonvoting basis, prior to the adoption of this compact by all states.

Article XI. Construction and Severability

This compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this compact shall be severable, and if any phrase, clause, sentence or provision of this compact is declared to be contrary to the constitution of any party state or of the United States, or if the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this compact and the applicability thereof to any government, agency, person or circumstance shall not be affected thereby. If this compact shall be held to be contrary to the constitution of any party state, this compact shall remain in full force and effect as to the remaining party states and in full force and effect as to the party state affected as to all severable matters.

Acts 2016, ch. 591, § 1.

Compiler's Notes. Acts 2016, ch. 591, § 3 provides that the state board of nursing is directed to inform the executive secretary of the Tennessee Code Commission by letter of the effective dates for the new compact enacted by this act and the withdrawal from the old compact codified in Tennessee Code Annotated, Title 63, Chapter 7, Part 3. The state board of nursing informed the executive secretary of the Tennessee Code Commission that the effective date for the new compact  and withdrawal from the old compact is January 19, 2018.

Effective Dates. Acts 2016, ch. 591, § 3. January 19, 2018.

63-7-403. “Head of the state licensing board” defined.

For the purposes of this part, the term “head of the state licensing board” means the executive director of the state board of nursing.

Acts 2016, ch. 591, § 1.

Compiler's Notes. Acts 2016, ch. 591, § 3 provides that the state board of nursing is directed to inform the executive secretary of the Tennessee Code Commission by letter of the effective dates for the new compact enacted by this act and the withdrawal from the old compact codified in Tennessee Code Annotated, Title 63, Chapter 7, Part 3. The state board of nursing informed the executive secretary of the Tennessee Code Commission that the effective date for the new compact  and withdrawal from the old compact is January 19, 2018.

Effective Dates. Acts 2016, ch. 591, § 3. January 19, 2018.

Chapter 8
Optometry Law

63-8-101. Short title.

This chapter may be cited as the “Optometry Law.”

Acts 1925, ch. 99, § 1; Shan. Supp., § 3654a9b1; mod. Code 1932, § 7026; C. Supp. 1950, § 7026; T.C.A. (orig. ed.), § 63-801.

Cross-References. Aid to the blind, title 71, ch. 4, part 1.

Assignment of insurance benefits to health care provider, § 56-7-118.

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

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.

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).

63-8-102. Chapter definitions.

As used in this chapter unless the context otherwise requires:

  1. “Board” means the board of optometry created by this chapter or similar boards created by the optometry law of other states;
  2. “Certificate of fitness” means the certificate issued by the board certifying to the division that the person therein named has met the requirements of this chapter and passed the standard examination given by the board;
  3. “Certificate of registration” means the certificate issued by the division of health related boards under chapter 1 of this title;
  4. “Division” means the division of health related boards in the department of health;
  5. “Itinerant certificate” means a certificate issued to an itinerant optometrist;
  6. “Itinerant optometrist” means an optometrist who maintains an office at a location other than such optometrist's principal office;
  7. “Muscular anomalies” means any deviation from the normal standard;
  8. “Objective method” means examination for observing symptoms and/or signs with various instruments and techniques that the optometrist finds by means of one (1) or more of the optometrist's five (5) senses; an examination of the eye or eyes conducted by an optometrist, independent of the patient's statements;
  9. “Ophthalmic materials” means any lens that has a spherical, cylindrical or prismatic power or value used before or upon the eye, any contact lens that has no prescription power and any frame or other appliance used for the purpose of holding or positioning any ophthalmic lenses before the eyes;
  10. “Optometrist” means a person who is engaged in the practice of optometry as defined;
  11. “Orthoptic training” means any ocular exercise for the correction or relief of abnormal muscles or functions of the eyes;
  12. “Practice of optometry as a profession” means:
    1. The employment of objective or subjective methods, either or both, for the purpose of ascertaining defects of vision or muscular anomalies or other abnormal conditions of the eyes;
    2. The prescribing of ophthalmic lenses or prisms to remedy or relieve defects of vision or muscular anomalies and the prescribing of contact lenses, including those with prescription power and those without prescription power which are worn for cosmetic purposes;
    3. The orthoptic training, the adjusting or fitting or adapting of lenses or prisms or eyeglasses or spectacles to remedy or relieve defects of vision or muscular anomalies; or
    4. The supplying, replacement or duplication of an ophthalmic lens or frame; and
      1. One who is engaged in the practice of optometry as a profession as defined in this subdivision (12) and who has sufficient education and professional competence, as determined by the board, is authorized to examine, diagnose, manage and treat conditions and diseases of the eye and eyelid including:
  1. The administration and prescribing of pharmaceutical agents rational to the diagnosis and treatment of conditions or diseases of the eye or eyelid;
  2. The performance of primary eye care procedures rational to the treatment of conditions or diseases of the eye or eyelid as determined by the board;
  3. The performance or ordering of procedures and laboratory tests rational to the diagnosis of conditions or diseases of the eye or eyelid;
  4. Additionally, the authority to administer benadryl, epinephrine or equivalent medication to counteract anaphylaxis or anaphylactic reaction; and
    1. The use of a local anesthetic in conjunction with the primary care treatment of an eyelid lesion; provided, however, that no optometrist shall use a local anesthetic for this purpose unless that optometrist has met the certification requirements set forth in § 63-8-112(4) and in the rules of the board of optometry for the administration of pharmaceutical agents in the performance of primary eye care procedures. Nothing in this subdivision (12)(E)(i)(e ) shall be construed as allowing an optometrist to perform any reconstructive surgical procedure on the eyelid. Nothing in this subdivision (12)(E)(i)(e ) shall be construed as allowing an optometrist to perform any procedure not approved by the board of optometry prior to April 8, 2014;
    2. An optometrist may utilize local anesthesia by injection in performing the following procedures pursuant to this subdivision (12)(E)(i)(e ):
      1. Needle drainage of an eyelid abscess, hematoma, bulla, and seroma;
      2. Excision of a single epidermal lesion without characteristics of malignancy, no larger than five millimeters (5 mm) in size and no deeper than the dermal layer of the skin;
      3. Incision and curettage of a nonrecurrent chalazion;
      4. Simple repair of an eyelid laceration no larger than two and one-half centimeters (2.5 cm) and no deeper than the orbicularis muscle and not involving the eyelid margin or lacrimal drainage structures; or
      5. Removal of foreign bodies in the eyelid not involving lid margin, lacrimal drainage structures, and extending no deeper than the orbicularis muscle;
    3. An optometrist who uses a local anesthetic in the manner allowed by this subdivision (12)(E)(i)(e ) shall provide to the board of optometry proof that the optometrist has current CPR certification by an organization approved by the board; provided, that the optometrist may meet this requirement by providing proof to the board that another person who has current CPR certification will be present in the office of the optometrist at all times that a local anesthetic is used by the optometrist in conjunction with the treatment of an eyelid lesion. Compliance with this provision shall also require that the optometrist maintain in the optometrist's office an AED at all times that a local anesthetic is administered by the optometrist;

All optometrists practicing in this state are prohibited from using nondiagnostic ophthalmic lasers. All optometrists practicing in this state are also prohibited from performing cataract surgery or any surgical procedure requiring other than a topical anesthetic. All optometrists practicing in this state are also prohibited from performing radial keratotomy;

Any optometrist practicing under the authority of this section shall be held to the same standards of care as that of other physicians providing similar services. No optometrist shall practice under this section unless and until the optometrist has submitted to the board evidence of satisfactory completion of all education requirements of § 63-8-112 and has been certified by the board as educationally qualified;

One who is engaged in the practice of optometry as a profession, as hereinabove defined, and who has sufficient education and professional competence, as determined by the board, and who has transcript credit of at least six (6) quarter hours in a course or courses in general and ocular pharmacology, with particular emphasis on diagnostic pharmaceutical agents applied topically to the eye, from a college or university accredited by a regional or professional accreditation organization that is recognized or approved by the board, is authorized to utilize in connection therewith diagnostic pharmaceutical agents (miotics, mydriatics, cycloplegics and anesthetics) applied topically only;

“Principal office” means the office location so designated by the optometrist involved; provided, that such office is the location at which the optometrist engages in the majority of the optometrist's practice;

“Standard examination” means the examination prescribed by § 63-8-115; and

“State” means any of the fifty (50) states of the union, the District of Columbia and territories of the United States.

Acts 1925, ch. 99, § 2; Shan. Supp., § 3654a10; Code 1932, § 7027; Acts 1935, ch. 129, § 1; 1939, ch. 90, §§ 1, 2; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7027; Acts 1953, ch. 113, § 37; 1975, ch. 116, § 1; modified; Acts 1977, ch. 490, § 2; 1979, ch. 406, §§ 1-8; T.C.A. (orig. ed.), § 63-802; Acts 1984, ch. 937, § 34; 1987, ch. 217, § 1; 1993, ch. 295, § 1; 2003, ch. 167, § 1; 2005, ch. 4, §§ 1, 2; 2014, ch. 638, § 1.

Compiler's Notes. Acts 2014, ch. 638, § 2 provided that the board of optometry is authorized to promulgate rules to effectuate the purposes of this act, which added subdivision (E)(i)(e ) in the definition of “practice of optometry as a profession.” All rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Cross-References. Drug or medicine provisions related to optometrists, §§ 53-10-104, 53-10-105.

Prohibition against optometrists dispensing legend drugs without a prescription, § 53-10-101.

NOTES TO DECISIONS

1. Constitutionality.

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).

2. Area of Competency.

Testimony by optometrist in workers' compensation suit that upon examination of employee's eye he found cloudiness of retina, that such condition could cause reduction in vision and such cloudiness could result from acid burn such as employee had suffered in course of employment, was properly admissible. Bowser-Briggs, Inc. v. Bennett, 224 Tenn. 565, 458 S.W.2d 792, 1970 Tenn. LEXIS 356 (1970).

3. Classed as a Profession.

The practice of optometry is a profession under this chapter. State ex rel. Loser v. National Optical Stores Co., 189 Tenn. 433, 225 S.W.2d 263, 1949 Tenn. LEXIS 439 (1949).

4. Itinerants.

The former restriction of itinerants to not more than three counties was reasonable when applied to all of the class. Saunders v. Swann, 155 Tenn. 310, 292 S.W. 458, 1926 Tenn. LEXIS 49 (1927).

5. “Person” Defined.

The word “person” relative to eligibility to practice profession of optometry means a natural person, not a corporation. State ex rel. Loser v. National Optical Stores Co., 189 Tenn. 433, 225 S.W.2d 263, 1949 Tenn. LEXIS 439 (1949).

63-8-103. Board of optometry — Created — Members — Terms.

    1. A board is created that shall be known and designated as the board of optometry. This board shall consist of five (5) members, all of whom shall be licensed to practice the full scope of optometry and be residents of Tennessee and actively practicing optometrists in Tennessee for a period of five (5) or more years immediately preceding their appointment.
    2. No person shall be eligible for appointment who is in any way connected with or has any financial interest in the optical dispensary or optical department of any institution of learning or in the wholesale optical or optometric supply business.
  1. The present board members shall serve out their respective terms. Thereafter, on a staggered basis, members shall be appointed for five-year terms. No member shall serve for more than ten (10) consecutive years.

Acts 1925, ch. 99, § 4; Shan. Supp., § 3654a12; Code 1932, § 7029; C. Supp. 1950, § 7029; Acts 1979, ch. 406, § 9; T.C.A. (orig. ed.), § 63-803; Acts 1989, ch. 428, § 1; 2003, ch. 167, § 3.

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 §§ 63-1-13163-1-133, 68-1-101.

The board of optometry, 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.

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

63-8-104. Oath of board members.

All members of the board shall, before entering upon the duties of their office, take and subscribe to the oath, filed with the secretary-treasurer of the board.

Acts 1925, ch. 99, § 4; Shan. Supp., § 3654a12; Code 1932, § 7029; C. Supp. 1950, § 7029; modified; T.C.A. (orig. ed.), § 63-804.

63-8-105. Appointments to the board.

  1. The members of the board shall be appointed by the governor. Members may be appointed from lists of qualified nominees submitted by interested optometric groups, including, but not limited to, the Tennessee Association of Optometric Physicians. The governor shall consult with such interested groups to determine qualified persons to fill the positions.
  2. A member shall continue to serve until that member's successor is appointed. A vacancy created by the death, resignation or removal of a member shall be temporarily filled by the board after thirty (30) days. The person filling such vacancy shall serve until the governor makes the appointment as provided in this section. An appointment shall be for the remainder of the unexpired term.

Acts 1925, ch. 99, § 4; Shan. Supp., § 3654a12; Code 1932, § 7029; C. Supp. 1950, § 7029; Acts 1955, ch. 331, § 1; 1979, ch. 406, § 10; T.C.A. (orig. ed.), § 63-805; Acts 1988, ch. 1013, § 46; 1989, ch. 428, § 2; 2011, ch. 164, § 1; 2012, ch. 696, § 1.

63-8-106. Removal of members of board.

  1. The governor or the board shall have the right to remove from office any or all of the members of the board for inefficiency, neglect of duty or the violation of this chapter.
  2. If the certificate of registration or license of any member of the board is suspended or revoked for cause after the hearing provided for in this chapter, the member's membership on the board shall automatically cease.

Acts 1925, ch. 99, § 4; Shan. Supp., § 3654a12; Code 1932, § 7029; C. Supp. 1950, § 7029; Acts 1979, ch. 406, § 11; T.C.A. (orig. ed.), § 63-806.

63-8-107. Officers of board — Meetings — Examinations.

  1. The board shall choose one (1) of its members as chair, one (1) as vice chair and one (1) as secretary-treasurer, annually.
  2. The board may meet, in its discretion, at such times and places as it may deem proper for the examination of applicants who wish to practice optometry in this state and for the transaction of business.
  3. The board shall offer the standard examination for the issuance of the certificate of fitness at least twice a year.

Acts 1925, ch. 99, § 4; Shan. Supp., § 3654a13; Code 1932, § 7030; C. Supp. 1950, § 7030; Acts 1953, ch. 113, § 39; 1979, ch. 406, § 12; T.C.A. (orig. ed.), § 63-807; Acts 1989, ch. 428, § 3.

63-8-108. Quorum — Records of board.

  1. A majority of the members of the board shall at all times constitute a quorum for the transaction of business, and the proceedings of the board shall be recorded in a minute book that shall be open at all reasonable times to public inspection.
  2. The board shall keep a record book in which shall be registered the name, address and a certificate of fitness, a license, certificate of registration or permit of all persons legally entitled to practice optometry in this state, together with the names and addresses of those optometrists whose certificates or licenses have been suspended or revoked.

Acts 1925, ch. 99, § 4; Shan. Supp., § 3654a12; Code 1932, § 7029; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7029; T.C.A. (orig. ed.), § 63-808.

63-8-109. Reports of board.

The secretary-treasurer of the board shall make such reports of the operation of the board as requested by the governor, appropriate committees of the general assembly or as otherwise required by law.

Acts 1925, ch. 99, § 4; impl. am. Acts 1925, ch. 115, § 32; Shan. Supp., § 3654a13; Code 1932, § 7030; mod. C. Supp. 1950, § 7030; modified; Acts 1979, ch. 406, § 13; T.C.A. (orig. ed.), § 63-809.

63-8-110. Compensation of board members.

The members of the board shall be paid their expenses, including mileage, hotel expenses, meals and the sum of one hundred dollars ($100) per diem when actually engaged in the discharge of their official duties. Each member shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 1925, ch. 99, § 4; impl. am. Acts 1925, ch. 115, § 24; Shan. Supp., § 3654a13; Code 1932, § 7030; Acts 1935, ch. 129, § 3; 1939, ch. 90, § 4; C. Supp. 1950, § 7030; Acts 1953, ch. 113, § 39, modified; Acts 1974, ch. 614, § 1; 1976, ch. 426, § 1; 1976, ch. 806, § 1(115); T.C.A. (orig. ed.), § 63-810; Acts 1989, ch. 428, § 4; 2003, ch. 167, § 4.

63-8-111. Administrative support.

The board shall receive administrative support from the division.

Acts 1925, ch. 99, § 4; Shan. Supp., § 3654a13; Code 1932, § 7030; C. Supp. 1950, § 7030; Acts 1953, ch. 113, § 39; modified; impl. am. Acts. 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; T.C.A. (orig. ed.), § 63-811; Acts 1984, ch. 937, § 34; 1989, ch. 428, § 5.

63-8-112. Powers of board — Examinations.

The board is given authority to:

  1. Make rules, regulations, policies and procedures not inconsistent with the laws of this state for the proper performance of its duties to carry out the purposes and to enforce this chapter;
  2. Provide a standard of efficiency as to the moral, educational and experience qualifications and fitness of all persons who desire to practice optometry in Tennessee in conformity with this chapter;
  3. Conduct both written examinations and written or oral clinical examinations of such character as to thoroughly test the qualifications of applicants and refuse to grant a certification to any person who, in its discretion, is found deficient. The board may prepare its own examinations, contract for the preparation of examinations or questions and may select appropriate standardized examinations, such as that of the National Board of Examiners in Optometry and the International Association of Board of Examiners in Optometry. The board is authorized to pay any expenses involved with conducting the examinations, including expenses involved with contracting with persons who participate in the examination process. The board shall not issue a certificate to any person beyond the scope of that person's education and training as determined by the board;
      1. Certify optometrists to administer and prescribe pharmaceutical agents for treatment and perform primary eye care procedures as provided in § 63-8-102(12)(E). No optometrist shall be certified to prescribe or use pharmaceutical agents for treatment purposes in the practice of optometry unless and until that optometrist meets all of the following:
  1. The optometrist has been certified to utilize diagnostic pharmaceutical agents;
  2. The optometrist has completed at least one hundred fifty (150) classroom hours and at least forty (40) hours of clinical experience relative to diagnosis and treatment of ocular disease, including the use of pharmaceutical agents; and
  3. The optometrist has taken and successfully passed the examination administered by or approved by the board;

Nothing in this section shall be construed as prohibiting the board of optometry from requiring additional education, training or experience of an optometrist before allowing an optometrist to examine, diagnose, manage and treat conditions and diseases of the eye and eyelid authorized by this chapter;

The board shall require each optometrist certified to use pharmaceutical agents for treatment purposes in the practice of optometry to complete a minimum of ten (10) hours of continuing education annually on diagnosis and treatment and use of pharmaceutical agents in the practice of optometry;

The board shall provide the board of pharmacy semiannually with a list of optometrists so certified pursuant to this section and shall provide each certified optometrist with an application certificate that shall be prominently displayed in the optometrist's professional office;

Investigate possible violations of and enforce this chapter;

Determine the members to attend the meetings of the persons responsible for examining and licensing optometrists in other jurisdictions and other meetings or conventions that will assist the board in performing its duties. Members shall be paid their expenses in attending such meetings in accordance with state travel regulations;

Seek injunctions to prevent violations of this chapter. Such actions shall be brought in the chancery court of Davidson County or the chancery court of the county in which the defendant resides or does business. Such actions may be brought by ten (10) or more licensed optometrists or a state association of optometrists as well as by the board;

Issue, in its discretion, a certification of identification, upon the payment of a fee as set by the board to a legal, ethical and competent practitioner of optometry in this state who may desire to become licensed in another state;

Issue, in its discretion, a duplicate certificate in the event the original is lost or destroyed. The person entitled thereto must make written application to the board for a duplicate, under affidavit setting forth that such certificate was lost or destroyed and the circumstances under which the loss or destruction occurred. The fee for issuing the duplicate shall be set by the board and must accompany the application. Should the original subsequently be found, it must be forwarded immediately to the secretary-treasurer and not be used by the person to whom issued originally or by any other person; and

Set information requirements for ocular prescriptions.

Acts 1925, ch. 99, § 5; Shan. Supp., § 3654a16; Code 1932, § 7031; Acts 1935, ch. 129, § 4; 1939, ch. 90, §§ 1, 5; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; mod. C. Supp. 1950, § 7031; impl. am. Acts 1953, ch. 113, § 39; Acts 1953, ch. 113, § 40; 1976, ch. 426, § 4; 1979, ch. 406, §§ 14-17; T.C.A. (orig. ed.), § 63-814; Acts 1984, ch. 937, § 35; 1987, ch. 217, § 2; 1989, ch. 428, § 6; 1989, ch. 523, §§ 51-53; 1993, ch. 295, §§ 2, 3.

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

Prohibition against optometrists dispensing legend drugs without a prescription, § 53-10-101.

63-8-113. Unlawful practices — Advertising.

  1. It is unlawful for any person not duly licensed in accordance with this chapter to:
    1. Engage in the practice of optometry;
    2. Claim to be a practitioner of optometry;
    3. Attempt by any means whatsoever to determine the kind or power of ophthalmic materials needed by any person to remedy or relieve defects of vision or muscular anomalies;
    4. Hold out as a registered or licensed optometrist;
    5. Hold out as being able to examine the human eye for the purpose of fitting or prescribing ophthalmic materials;
    6. Test the vision of any person by any means for the purpose of fitting that person with or prescribing ophthalmic materials;
    7. Display a sign or symbol that leads the public to believe that such person is an optometrist;
    8. Make measurements involving the eyes or the optical requirement thereof for the purpose of prescribing ophthalmic materials;
    9. Unless otherwise authorized by law, fill an order or prescription for ophthalmic materials; or
    10. Unless otherwise authorized by law, sell or dispense ophthalmic materials.
  2. It is unlawful for any person, including optometrists licensed under this chapter, to:
    1. Impersonate a licensed optometrist;
    2. Practice optometry under a false or assumed name;
    3. Peddle, sell or render optometric services from door to door;
    4. Canvass or solicit ophthalmic materials or optometric services in person or by agents, except as authorized by the board. Advertising in accordance with this chapter and the rules and regulations of the board is not solicitation;
    5. Practice optometry after the person's certificate of fitness or registration has been revoked or during suspension of same or, after failing to pay the annual renewal fee or after failing to submit satisfactory evidence of having met minimum continuing education requirements as set by the board;
    6. Offer optometric services or ophthalmic materials as a prize, premium or gift, separately or in combination with other merchandise or services, except as authorized by the board; or
    7. Discount optometric services contingent upon the purchase of ophthalmic materials or to otherwise tie in the performing of optometric services with the purchase of ophthalmic materials.
  3. It is unlawful for any licensed optometrist to:
    1. Advertise optometric services or ophthalmic materials, except as provided in subsection (d);
    2. Practice optometry as an employee of any person or business or organization not engaged primarily in health care delivery;
    3. Practice optometry under a name other than the optometrist's own unless board approved;
    4. Appoint agents or other persons to take orders for optometric services or ophthalmic materials;
    5. Split or share fees with any person or organization in return for solicitation of customers by that person or organization;
    6. Practice or offer to practice optometry in or in conjunction with any retail store or other commercial establishment where merchandise is displayed or offered for sale. Any licensed, registered optometrist practicing in premises of such type prior to April 17, 1967, shall be permitted to continue the independent practice in that optometrist's present location or in such new location to which the retail store or other commercial establishment might move; but when any such optometrist vacates any such premises, no other optometrist shall be permitted to practice in such vacated premises; or
    7. Engage in practice in any temporary or mobile office except as authorized by the board or any office that does not have the appropriate instrumentation for diagnosis and treatment for the practice of optometry as established by the board.
    1. An optometrist may advertise ophthalmic materials, including prices. All advertising by persons licensed to practice optometry in this state, regardless of the media employed for such advertising, shall be subject to the requirements and limitations of this section, as follows:
      1. No person shall advertise optometric services or ophthalmic materials by statements that are fraudulent, deceptive or likely to mislead the public, such as bait and switch tactics;
      2. No person shall advertise or infer through advertising that the person has superior professional skills or competence, except board certification may be listed;
      3. No person shall advertise to guarantee optometric services or use words of similar import;
      4. All advertising shall contain the optometrist's name and the designation “O.D.” or “Doctor of Optometry” or a professional corporation name, so long as such corporate name does not permit or imply action, advertising, services or practices forbidden by this chapter or rules and regulations of the board and such corporate name has been approved in advance by the board as being in compliance with the foregoing; and
      5. Optometrists shall not advertise routine optometric services such as eye examinations except in accordance with regulations promulgated by the board.
    2. The board is given authority to place reasonable time, place and manner restrictions on the advertising of optometric services if it finds that to be in the public interest. Further, the board may require that any advertising disclose any information necessary to protect the public, including whether specialists are certified.

Acts 1925, ch. 99, § 3; Shan. Supp., § 3654a11; Code 1932, § 7028; Acts 1935, ch. 129, § 2; 1939, ch. 90, §§ 1, 3; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; mod. C. Supp. 1950, § 7028; Acts 1953, ch. 113, § 38; 1967, ch. 84, § 1; 1977, ch. 490, § 1; 1979, ch. 406, §§ 18, 31; T.C.A. (orig. ed.), § 63-815; Acts 1989, ch. 428, § 7.

Cross-References. Advertisement pertaining to board certification and specialty, §  63-1-145.

Exemption from licensing requirements for practice of medicine, § 63-6-204.

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

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

Attorney General Opinions. Constitutionality, OAG 91-56, 1991 Tenn. AG LEXIS 56 (6/4/91).

NOTES TO DECISIONS

1. Constitutionality.

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).

Exhibits were evidence that the Tennessee legislature was concerned about dangers of optometrists practicing in, or in conjunction with, any commercial entity, regardless of in-state or out-of-state ownership, which is a legitimate concern. Also, plaintiffs failed to establish how the activities summarized in the exhibits impacted the legislative process so as to produce a discriminatory statute. Lenscrafters, Inc. v. Robinson, 248 F. Supp. 2d 705, 2003 U.S. Dist. LEXIS 3538 (M.D. Tenn. 2003).

Law prohibiting plaintiff retail optical stores from leasing space and equipment inside their stores to licensed optometrists was not adopted for discriminatory purposes and any burdens imposed did not clearly exceed the statute's putative benefits; thus, the statute was not an unconstitutional infringement on interstate commerce. LensCrafters, Inc. v. Wadley, 248 F. Supp. 2d 705, 2003 U.S. Dist. LEXIS 3613 (M.D. Tenn. 2003).

Plaintiff retail optical outlets offered no authority in support of their argument that a statute prohibiting retail optical stores from leasing space and equipment inside their stores to licensed optometrists could be invalidated under the equal protection clause; moreover, defendants cited legislative history indicating that the T.C.A. § 63-8-113(c)(6) was intended to apply to in-state retail stores leasing space to onsite optometrists as well as out-of-state retail stores leasing space to onsite optometrists and thus, the provision did not violate the equal protection clause. LensCrafters, Inc. v. Wadley, 248 F. Supp. 2d 705, 2003 U.S. Dist. LEXIS 3613 (M.D. Tenn. 2003).

Law prohibiting plaintiff retail optical stores from leasing space and equipment inside their stores to licensed optometrists was rationally related to the state's goal of insulating health care professionals from commercial influences; thus, the statute stood up under strict scrutiny on the stores' due process claim. LensCrafters, Inc. v. Wadley, 248 F. Supp. 2d 705, 2003 U.S. Dist. LEXIS 3613 (M.D. Tenn. 2003).

Dismissal of plaintiffs' Commerce Clause challenge to T.C.A. § 63-8-113(c)(6) was affirmed because no rational factfinder could have concluded that the challenged provision was purposefully discriminatory; the challenged provision did not discriminate among optical companies wishing to sell eyewear, as both in-state and out-of-state optical companies were prohibited from leasing space to optometrists. Lenscrafters, Inc. v. Robinson, 403 F.3d 798, 2005 FED App. 174P, 2005 U.S. App. LEXIS 6149 (6th Cir. Tenn. 2005), cert. denied, 546 U.S. 1172, 126 S. Ct. 1335, 164 L. Ed. 2d 51, 2006 U.S. LEXIS 1174 (2006).

Summary dismissal of plaintiffs' due process clause and equal protection clause challenges to T.C.A. § 63-8-113(c)(6) was affirmed because the state had offered a legitimate government objective (protecting healthcare professionals from commercial influences) and statute was rationally related to accomplishing that objective. Lenscrafters, Inc. v. Robinson, 403 F.3d 798, 2005 FED App. 174P, 2005 U.S. App. LEXIS 6149 (6th Cir. Tenn. 2005), cert. denied, 546 U.S. 1172, 126 S. Ct. 1335, 164 L. Ed. 2d 51, 2006 U.S. LEXIS 1174 (2006).

2. Penalty.

A violation of T.C.A. § 63-8-113 is a misdemeanor. 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).

3. Retail Store.

An entity engaged primarily in the business of selling eyeglasses and frames is a retail store or other commercial establishment as defined in T.C.A. § 63-8-113. LensCrafters, Inc. v. Sundquist, 33 S.W.3d 772, 2000 Tenn. LEXIS 688 (Tenn. 2000).

63-8-114. Exemptions.

Nothing in this chapter shall be construed:

  1. As applying to medical doctors and doctors of osteopathic medicine lawfully entitled to practice their profession in this state;
  2. As applying to an optometric faculty member licensed in another state and employed full time by an accredited school or college of optometry in this state; provided, that the practice of the faculty member is limited and is incidental to the faculty member's employment at the accredited school or college of optometry in the state of Tennessee. An optometry faculty member is limited to the scope of such member's license unless the member has passed an examination or a standardized examination that has been utilized by the therapeutic certification panel. An optometric faculty member may not practice beyond the scope of a fully certified Tennessee optometrist. This shall not be construed as a grant of permission for the optometric faculty member to engage in the private practice of optometry in any form. It is the responsibility of the dean of the school or college of optometry to apply to the board for an exemption for each such faculty member;
  3. To prevent persons, firms and corporations from selling ophthalmic lenses or ophthalmic products at wholesale in a permanently established place of business on prescription to those who are legally qualified to prescribe them, nor to prevent an optical mechanic from doing the merely mechanical work upon such lenses or frames or fitting thereof nor to prevent the wholesale house from selling ready-to-wear eyeglasses or spectacles as merchandise, at wholesale, to merchants for the purpose of resale as merchandise, when neither the wholesaler nor purchaser to whom the wholesaler sells practices optometry;
  4. To prevent a retail merchant from selling ready-to-wear spectacles or eyeglasses if such merchant does not assist the customer in fitting or selecting such products or otherwise engage in the practice of optometry; however, contact lenses, with or without prescription power, may not be ordered, sold or dispensed by a retail merchant;
  5. To prevent licensed dispensing opticians from preparing, adapting and dispensing ophthalmic materials within the scope of their lawful practice; or
    1. To prohibit a charitable clinic from employing or contracting with an optometrist; provided, that the contractual relationship between the optometrist and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the optometrist from exercising independent professional judgment in the practice of optometry;
    2. For the purposes of this subdivision (6), the term “charitable clinic” means an entity that meets the following standards:
      1. Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. Has clinical facilities located in this state;
      3. Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. Provides one (1) or more of the following services for free or at a discounted rate:
  1. Medical care;
  2. Dental care;
  3. Mental health care; or
  4. Prescription medications;

Utilizes volunteer healthcare professionals and nonclinical volunteers; and

Is not required to be licensed under § 68-11-202(a)(1).

Acts 1925, ch. 99, § 3; Shan. Supp., § 3654a11; Code 1932, § 7028; Acts 1935, ch. 129, § 2; 1939, ch. 90, §§ 1, 3; mod. C. Supp. 1950, § 7041.1 (Williams, § 7028); Acts 1967, ch. 84, § 2; 1979, ch. 406, §§ 19, 20; T.C.A. (orig. ed.), § 63-816; Acts 1989, ch. 428, § 8; 1994, ch. 901, § 4; 2005, ch. 4, § 3; 2016, ch. 766, § 3.

Compiler's Notes. Acts 1989, ch. 428, § 13 provided that the provisions of that act shall be liberally construed to effect its purpose, and insofar as the provisions of that act may be inconsistent with the provisions of any other law, the provisions of ch. 428 shall be controlling.

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

NOTES TO DECISIONS

1. Constitutionality.

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

63-8-115. Qualifications of applicants.

  1. Every person who desires to practice optometry in this state shall submit an application to the board. Each applicant must show sufficient information for the board to determine that the applicant meets all of the following requirements:
    1. Is over twenty-one (21) years of age;
    2. Is of good moral character;
    3. Is a graduate of a school or college of optometry accredited by a regional or professional accreditation organization that is recognized or approved by the board and is in good standing, as determined by the board; and
    4. Has passed examinations and met the requirements established by the board for the scope of practice desired.
  2. An applicant who is licensed to practice optometry in a state other than Tennessee, in addition to the foregoing requirements, must show that the applicant is an optometrist in good standing in such state. If the applicant has been disciplined, the applicant must fully set forth the circumstances surrounding the discipline, so that the board may determine therefrom the applicant's character and fitness.
  3. All applications to take examinations shall be accompanied by nonrefundable fees to defray the cost of preparing and conducting the examination and the application process as determined by the board.

Acts 1925, ch. 99, § 7; Shan. Supp., § 3654a19; Code 1932, § 7032; Acts 1935, ch. 129, § 5; 1939, ch. 90, § 6; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; mod. C. Supp. 1950, § 7032; Acts 1953, ch. 113, § 41; 1971, ch. 161, § 2; 1976, ch. 426, § 5; 1979, ch. 406, § 21; T.C.A. (orig. ed.), § 63-817; Acts 1989, ch. 428, § 9; 1989, ch. 523, § 54; 2003, ch. 167, § 2.

Law Reviews.

Constitutional Protection of Aliens, 40 Tenn. L. Rev. 235.

63-8-116. Display of certificate.

Each person to whom a certificate of registration is issued shall keep the certificate conspicuously displayed in that person's office, as required by § 63-1-109 and shall when requested exhibit the same to any member or representative of the board.

Acts 1925, ch. 99, § 10; Shan. Supp., § 3654a27b1; Code 1932, § 7036; Acts 1939, ch. 90, § 1; 1947, ch. 9, § 9; mod. C. Supp. 1950, § 7036; T.C.A. (orig. ed.), § 63-818.

63-8-117. [Repealed.]

Compiler's Notes. Former § 63-8-117 (Acts 1935, ch. 129, § 5; 1939, ch. 90, § 6; C. Supp. 1950, § 7032; T.C.A. (orig. ed.), § 63-819), concerning jury duty exemption for optometrists, was repealed by Acts 2008, ch. 1159, § 8, effective January 1, 2009.

63-8-118. Discrimination between ocular practitioners prohibited.

No state board, commission or department created or existing by act of the general assembly, including public schools or other state agencies in the performance of their duties, shall in any way show any discrimination between ocular practitioners. All boards or commissions shall honor ocular reports or other professional services by legally qualified and licensed optometrists in this state.

Acts 1939, ch. 90, § 2; C. Supp. 1950, § 7027; T.C.A. (orig. ed.), § 63-820.

63-8-119. Annual registration — Continuing education.

  1. Every registered optometrist who desires to continue to practice in this state shall pay an annual renewal fee to defray the cost of regulating optometry and shall furnish satisfactory evidence of having met minimum continuing education requirements, as set by the board. The board may, in its sole discretion, waive the annual educational requirement and/or fee in cases of certified illness, disability, other undue hardship or retirement.
  2. The board shall annually arrange for or approve a program or programs of continuing optometric education held in this state sufficient to meet the minimum annual educational requirements for each level of practice. The board shall list on its website the organizations whose continuing education courses are deemed approved to meet the requirements of the board. The courses offered by these organizations shall be considered approved by the board and shall be available to optometrists as a means of satisfying their annual continuing education obligation, in addition to the continuing education courses which have been approved by the Council on Optometric Practitioner Education.
  3. The board is authorized to use such portion of the annual renewal fees as is deemed necessary or proper to provide for continuing optometric educational programs.
  4. The board is authorized to adopt such rules and regulations as it may deem necessary or appropriate for establishing an approved program or programs of continuing optometric education, including, but not limited to, those prescribing the substantive content of all courses or other forms of optometric education that will satisfy the annual educational requirement.
  5. The board shall issue annual renewal certificates to optometrists who pay their annual renewal fees and furnish satisfactory evidence of having met minimum continuing education requirements.
  6. The board is authorized to promulgate rules and regulations providing for the automatic revocation of the certificates of optometrists failing to meet the terms of this section.
    1. After hearing, the board may provide conditions for the reinstatement of the certificates. These conditions may include, but are not limited to, the payment of delinquent fees, the payment of a civil penalty, the attendance or completion of courses of study, the passage of examinations, the passage of physical or mental examinations and the treatment of any physical or mental ailments.
    2. After hearing, the board may refuse to reinstate the certificates revoked under this section upon any of the grounds set forth in § 63-8-120.
  7. The board may formulate a policy that would allow retirees to practice where their services are needed on a temporary basis.
    1. Notwithstanding any provision of 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 (i).

Acts 1947, ch. 9, § 5; mod. C. Supp. 1950, § 7033; Acts 1953, ch. 113, § 42; 1963, ch. 293, § 1; 1974, ch. 543, § 1; 1976, ch. 406, § 6; T.C.A. (orig. ed.), § 63-821; Acts 1984, ch. 937, § 36; 1986, ch. 675, § 6; 1989, ch. 360, §§ 30-32; 1989, ch. 428, § 10; 1989, ch. 523, §§ 55, 56; 2010, ch. 719, § 1.

Cross-References. Licensing and registration, §§ 63-1-103-112.

Law Reviews.

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

63-8-120. Discipline of certificate holders.

  1. The board may refuse to issue an annual renewal certificate, may suspend or revoke any certificate issued by it, censure, reprimand, place on probation and assess a civil penalty up to one thousand dollars ($1,000) for each separate violation whenever the certificate holder is found guilty of any of the following acts or offenses:
    1. Fraud in procuring a license;
    2. Immoral, unprofessional or dishonorable conduct;
    3. Habitual intoxication or addiction or misuse of drugs;
    4. Conviction of a felony;
    5. Use of untruthful or improbable statements or flamboyant or extravagant claims concerning such licensee's professional excellence or abilities;
    6. Practicing under any other name than the certificate holder's own unless board approved;
    7. Failure to renew annual certificate;
    8. Solicitation of optometric services or ophthalmic materials in person or by agent by any means other than advertising authorized by this chapter;
    9. Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the practice of optometry;
    10. Practice beyond the scope of the certificate;
    11. Furnishing spectacle prescriptions that do not at least meet the informational requirements established by the board or refusing to furnish a copy of a spectacle prescription at no additional cost to the patient at the end of the examination;
    12. Advertising of optometric services or ophthalmic materials in any manner other than permitted by this chapter or rule and regulation of the board;
    13. Engaging in the practice of optometry as an employee of any person, firm or corporation not engaged primarily in health care delivery;
    14. Division of fees or agreeing to split or divide the fees received for professional services with any person for bringing or referring a patient;
    15. Peddle or sell ophthalmic materials as to render or attempt to render optometric services from house to house or door to door. This shall not prohibit, however, an optometrist from attending, prescribing and furnishing ophthalmic materials to a patient who, by reason of illness or physical or mental infirmity, is confined to the patient's place of abode or in a hospital or other institution;
    16. Signing or making in one's professional capacity any certificate known to be false at the time it is signed or made;
    17. Committing any act that is made unlawful by § 63-8-113; or
    18. Committing any act contrary to this chapter or the rules and regulations of the board.
  2. The board may set guidelines for the implementation of the discipline of certificate holders.
  3. The board may require a mental or physical examination of a certificate holder that the board believes may be a threat to that certificate holder or the public or incapable of practicing optometry in accordance with this chapter and the standards established by the board.
  4. The board may provide conditions upon optometrists continuing to practice or upon the reinstatement of certificates. These conditions may include, but are not limited to, the payment of civil penalties, the attendance or completion of courses of study, the passage of examinations, the passage of physical or mental examinations and the treatment of any physical or mental ailments.
    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. 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.
    3. 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.
      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.
  5. 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 1925, ch. 99, § 12; Shan. Supp., § 3654a31; Code 1932, § 7038; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7038; Acts 1953, ch. 113, § 43; 1967, ch. 84, § 3; 1979, ch. 406, §§ 22-29; T.C.A. (orig. ed.), § 63-822; Acts 1989, ch. 428, § 11; 1999, ch. 440, § 3; 2012, ch. 798, § 41; 2018, ch. 745, § 26.

Amendments. The 2018 amendment added (f).

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

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

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

Law Reviews.

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

Attorney General Opinions. The board of optometry 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).

NOTES TO DECISIONS

1. Constitutionality.

Complainants were not entitled to assail this section as violating due process without a showing that the manner of its enforcement amounted to a denial of due process. Seawell v. Beeler, 199 Tenn. 438, 287 S.W.2d 54, 1956 Tenn. LEXIS 342 (1956).

63-8-121. Administrative procedures.

The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, shall apply to all proceedings of the board and regulations promulgated pursuant to this chapter.

Acts 1925, ch. 99, § 12; Shan. Supp., § 3654a32; Code 1932, § 7039; mod. C. Supp. 1950, § 7039; Acts 1953, ch. 113, § 44; 1979, ch. 406, § 30; T.C.A. (orig. ed.), § 63-823.

Law Reviews.

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

63-8-122. Penalties.

A violation of this chapter is a Class B misdemeanor.

Acts 1925, ch. 99, § 3; Shan. Supp., § 3654a11; Code 1932, § 7028; impl. am. Acts 1947, ch. 9, § 13; C. Supp. 1950, § 7041.1; T.C.A. (orig. ed.), § 63-824; Acts 1984, ch. 937, § 37; 1989, ch. 428, § 12; 1989, ch. 591, § 112.

Cross-References. Penalties, § 63-1-123.

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

63-8-123. Regulation of laboratory practices of optometrists.

The commissioner of health has the authority to regulate the laboratory practices of optometrists to ensure that such practices are in full compliance with the Clinical Laboratory Improvement Act (CLIA) (42 U.S.C. § 263a).

Acts 1993, ch. 295, § 9.

63-8-124. Public policy.

It is the public policy of the state that:

  1. Optometrists rendering visual care to citizens shall practice in an ethical, professional manner;
  2. Optometrists' practices shall be free from any influences that would interfere with their exercise of professional judgment;
  3. The visual welfare of the optometrist's patient shall be the prime consideration at all times; and
  4. Optometrists shall not be associated with any person or persons in any manner that might degrade or reduce the quality of visual care received by the citizens of this state.

Acts 2003, ch. 246, § 1.

63-8-125. Lease between an optometrist and manufacturer, wholesaler or retailer of ophthalmic materials — Control of professional judgment or practice by lessor prohibited.

  1. A manufacturer, wholesaler or retailer of ophthalmic materials who leases space to an optometrist shall not, directly or indirectly, control or attempt to control the professional judgment or practice of an optometrist.
  2. As used in this section, the phrase “control or attempt to control the professional judgment or practice of an optometrist” includes, but is not limited to:
    1. Setting or attempting to set the professional fees or hours of an optometrist or the number of patients to be seen by an optometrist;
    2. Restricting or attempting to restrict an optometrist's discretion to schedule appointments at times convenient to the optometrist's patients;
    3. Terminating or threatening to terminate a lease with an optometrist as a means of controlling or attempting to control the professional judgment or practice of the optometrist;
    4. Sharing with an optometrist telephone lines or other telecommunication services; provided, however, that nothing in this section shall preclude an optometrist from entering into a business arrangement involving the delegation of clerical tasks and functions to persons who are not employees of the optometrist but are under the optometrist's general supervision, so long as the business arrangement is in compliance with state and federal law;
    5. Employing or contracting for the services of an optometrist if part of the optometrist's duties involve the practice of optometry, except that an optometrist may legally contract to provide optometric services to the employees of the manufacturer, wholesaler or retailer;
    6. Paying an optometrist for a service not provided;
    7. Restricting an optometrist's access to leased office space when the optometrist needs such access to provide emergency care to a patient;
    8. Restricting or attempting to restrict the scope of practice of the optometrist in a way that prevents the optometrist from providing the full range of diagnostic and treatment services authorized by Tennessee law; provided, however, that a manufacturer, wholesaler or retailer of ophthalmic materials who leases space to an optometrist may restrict that optometrist from offering spectacles, lenses or frames to the optometrist's patients or to the public in the leased space in direct competition with the lessor;
    9. Limiting or attempting to limit the optometric services and ophthalmic materials that the optometrist may prescribe to the optometrist's patients or the information that may be disseminated to the patients or the public by the optometrist; and
    10. Limiting or attempting to limit the optometrist's exercise of independent professional judgment or responsibility in any way.
  3. A lease between an optometrist and a manufacturer, wholesaler or retailer of ophthalmic materials must comply with all the following provisions:
    1. The lease must not contain any provision through which the manufacturer, wholesaler or retailer of ophthalmic materials controls or attempts to control the professional judgment or practice of the optometrist; and
    2. The leased space must be large enough to include a secure location for storage of confidential patient records. Representatives of the lessor are only permitted on the lessee's premises on reasonable notice and at times not disruptive to the practice of the optometrist. Lessor shall have no access to confidential patient information except in compliance with state and federal law.
  4. The board may promulgate rules and regulations pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to implement this section.
  5. The board may file an action in an appropriate court to enjoin any violation of this section by any manufacturer, wholesaler or retailer of ophthalmic materials. If successful in establishing a violation or violations of this section, the board may recover court costs and reasonable attorney's fees.
  6. An optometrist may file an action in an appropriate court to enjoin a manufacturer, wholesaler or retailer of ophthalmic materials from controlling or attempting to control the professional judgment or practice of that optometrist. If successful in establishing a violation or violations of this section, the optometrist may also recover any actual damages sustained by the optometrist, as well as court costs and reasonable attorney's fees.
  7. The attorney general and reporter may file suit in an appropriate court to enjoin any violation of this section by a manufacturer, wholesaler or retailer of ophthalmic materials. If successful in establishing a violation or violations of this section, the attorney general and reporter may also recover a civil penalty not to exceed one thousand dollars ($1,000) per day for each violation of this section, plus court costs and reasonable attorney's fees.

Acts 2003, ch. 246, § 2.

Compiler's Notes. Acts 2003, ch. 246, § 3 provided that the act, which enacted this section, shall apply to leases entered into or renewed after July 1, 2003.

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

Enjoining violations, § 63-1-121.

63-8-126. Drug prescriptions.

  1. Any handwritten prescription order for a drug prepared by an optometrist 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 optometrist, 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 optometrist 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 an optometrist 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 optometrist, 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 optometrist 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 an optometrist from issuing a verbal prescription order.
    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, § 6; 2005, ch. 12, § 5; 2008, ch. 1035, §§ 6, 9; 2010, ch. 795, § 15; 2013, ch. 74, § 6.

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 non-prescription 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.

63-8-127. Prohibition against requirement of minimum purchase of ophthalmic materials as a condition of participation in vision or health care plan.

  1. No person shall require an optometrist to purchase a minimum quantity or minimum dollar amount of a specified brand of ophthalmic materials in order to participate as a provider in a vision or other health care plan.
  2. An optometrist may file an action in the chancery court of the county in which the optometrist's office is located to enjoin a violation of this section. If successful in establishing a violation, the optometrist may recover court costs and reasonable attorney's fees.

Acts 2005, ch. 123, § 1.

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

63-8-128. Inactive licenses to perform pro bono services.

The board of optometry shall establish by rule an inactive license category that allows optometrists to perform services without compensation only for those persons receiving services from organizations that have received a determination of exemption under §  501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)). Such inactive license category shall not authorize any other practice of optometry.

Acts 1997, ch. 345, § 4; T.C.A., §  63–8–133.

Code Commission Notes.

Former §  63-8-133 was transferred to §  63-8-128 by the code commission in 2010.

Cross-References. Licensees in armed forces or public health service, § 63-1-110.

63-8-129. [Repealed.]

Acts 2010, ch. 795, § 4; T.C.A. § 63-8-134; repealed by Acts 2018, ch. 883, § 7, effective January 1, 2019.

Compiler's Notes. Former § 63-8-129 was transferred to this section by the authority of the Code Commission in 2017.

Section 63-8-129 concerning prescriptions for Schedule II controlled substances is repealed by Acts 2018, ch. 883, § 7, 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 § 63-6-239 concerned prescriptions for Schedule II controlled substances.

Chapter 9
Osteopathic Physicians

63-9-101. Board — Composition and terms of members — Administrative support.

  1. There shall be a board of osteopathic examination, referred to as “board” in this chapter, consisting of six (6) persons, appointed by the governor. One (1) of these persons shall be a citizen member who does not engage in any profession, business or activity subject to regulation by the board, and five (5) members shall be osteopathic physicians. These persons shall be residents of this state; and the five (5) osteopathic physician members shall be graduates of a legally chartered osteopathic college in good standing and having the power to confer degrees in osteopathic medicine and shall have been, at the time of their appointment, actively engaged in the practice of their profession for a period of at least five (5) years. In making appointments to the board, 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.
  2. Their terms of office shall be so designated by the governor that the term of one (1) member shall expire each year. Thereafter, in each year the governor shall appoint one (1) person to fill the vacancy on the board, the term of the appointee to be five (5) years. A vacancy occurring from any other cause shall be filled by the governor for the unexpired term in the same manner.
  3. The board shall have a common seal and shall formulate rules to govern its actions.
  4. The board shall receive administrative support from the division of health related boards, referred to as the “division” in this chapter.

Acts 1905, ch. 255, § 1; Shan., § 3654a4; mod. Code 1932, § 7003; Acts 1939, ch. 150, § 1; C. Supp. 1950, § 7003; Acts 1976, ch. 727, § 1; T.C.A. (orig. ed.), § 63-901; Acts 1984, ch. 937, § 38; 1988, ch. 1013, § 47; 1994, ch. 901, § 4; 1996, ch. 1042, § 2.

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 §§ 63-1-13163-1-133, 68-1-101.

The Board of osteopathic examination, created by this section, terminates June 30, 2025. See §§ 4-29-112, 4-29-246.

Cross-References. Assignment of insurance benefits to health care provider, § 56-7-118.

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

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

Occupation tax on osteopathic physicians, title 67, ch. 4, part 17.

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

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.

63-9-102. Meetings and records of board.

  1. The board shall meet at the call of the president and at such other times and places as a majority of the board may appoint.
  2. Four (4) members of the board shall constitute a quorum, but no certificates of fitness to practice osteopathic medicine shall be granted on an affirmative vote of less than three (3).
  3. The board shall keep a record of its proceedings and a register of all applicants for certificates of fitness, giving the name and location of the institution granting the applicant the degree of doctor of or diploma in osteopathic medicine, the date of the applicant's diploma and also stating whether the applicant was rejected or a certificate granted. The books and register shall be prima facie evidence of all matters recorded therein.

Acts 1905, ch. 255, § 1; Shan., § 3654a4; mod. Code 1932, § 7003; Acts 1939, ch. 150, § 1; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7003; Acts 1976, ch. 727, § 2; T.C.A. (orig. ed.), § 63-902; Acts 1994, ch. 901, § 4; 1996, ch. 1042, § 3.

63-9-103. Disposition of funds — Operating expenses — Compensation of members.

  1. The board shall pay all money received as fees 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. No expenditures 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 the state.
  2. Each member of the board shall receive one hundred dollars ($100) per diem and expenses when actually engaged in the discharge of official duties. 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.

Acts 1905, ch. 255, § 3; Shan., § 3654a6; impl. am. Acts 1925, ch. 115, § 32; Code 1932, § 7005; Acts 1939, ch. 150, § 1; C. Supp. 1950, § 7005; Acts 1953, ch. 113, § 29; 1976, ch. 727, § 3; 1976, ch. 806, § 1(100); T.C.A. (orig. ed.), § 63-903; Acts 2017, ch. 175, § 1.

Amendments. The 2017 amendment substituted “one hundred dollars ($100)” for “fifty dollars ($50)” in the first sentence of (b).

Effective Dates. Acts 2017, ch. 175, § 2. April 24, 2017.

63-9-104. Application for certificate to practice — Special training and conditional licenses.

  1. Before engaging in the practice of osteopathic medicine, a person shall submit an application to the secretary of the board for a certificate of fitness to practice osteopathic medicine on a form prescribed by the board in writing or via online application, which includes:
    1. The person's name, age, which shall not be less than eighteen (18) years, and residence;
    2. The name of the school of osteopathic medicine from which the person was graduated, which shall have been in good repute as such at the time of the issuing of the person's diploma, as determined by the board;
    3. The date of the person's diploma, evidence that such diploma was granted on personal attendance and completion of the course of study approved by the board;
    4. Such other information as the board may require; and
    5. Sufficient evidence that the applicant is of good moral character.
    1. Each applicant shall pay a nonrefundable application fee as set by the board.
    2. On notice of acceptance, each applicant for examination shall pay an examination fee as set by the board.
    3. Each applicant accepted by reciprocity will pay a reciprocity fee as set by the board.
    1. Notwithstanding subsection (a), osteopathic medical students, interns, residents, and clinical fellows, while participating in a training program approved by the American Osteopathic Association or the American Medical Association, performing duties assigned to meet the requirements of such a training program and while under the supervision and control of a physician, either a doctor of osteopathic medicine or a doctor of medicine licensed to practice in this state, are exempt from the requirement of a license. No such student, intern, resident, or clinical fellow shall be permitted to practice osteopathic medicine outside of the person's duties and responsibilities in the approved training program without being licensed to practice osteopathic medicine.
    2. It is the responsibility of the program director or the dean responsible for the training program to apply to the board of osteopathic examination for an exemption for each such medical student, intern, resident, or clinical fellow. It is the responsibility of such program director or dean to notify the board of the termination of an applicant's participation in the training program, whether by completion of the program or for any other reason.
    3. The board of osteopathic examination may impose a fee to accompany each application for exemption.
  2. The board is authorized, in its discretion, to issue special training licenses to osteopathic medical interns, residents and fellows who have met all other qualifications for licensure contained in this chapter and the rules and regulations promulgated pursuant thereto, with the exception of having completed the necessary residency or training programs required by subdivision (a)(4) and properly promulgated rules, and the licensure examination. The board also is authorized to promulgate rules and regulations to implement this new licensure category. The initial set of these rules may be processed as emergency rules pursuant to § 4-5-208. These special training licenses will be governed by the following:
    1. Such licenses shall be issued only to osteopathic medical interns, residents and fellows while participating in a training program of one of the accredited medical schools or of one of such medical school's affiliated teaching hospitals in Tennessee, performing duties assigned to meet the requirements of such program and while under the supervision and control of a physician, either a doctor of osteopathic medicine or a doctor of medicine fully licensed to practice medicine in Tennessee;
    2. No person holding a special training license is permitted to practice osteopathic medicine outside of such person's duties and responsibilities in the training program without being fully licensed to practice medicine in Tennessee. Termination of participation in the training program for which the special license was issued for any reason terminates that license;
    3. It is the responsibility of the program director or the dean responsible for the training program to submit the necessary information and applications on behalf of each applicant. It also is the responsibility of the program director or the dean to notify the board of the termination of the applicant's participation in the training program, whether by completion of the program or for any other reason;
    4. The board may impose fees to accompany each individual application for a special training license; and
    5. Recipients of the special license shall not be subject to the occupational tax levied by § 67-4-1702(3)(A);
  3. The board also has the authority to issue locum tenens and/or conditional licenses as it deems appropriate after reviewing the qualifications of applicants. In addition to the authority granted the board in § 63-9-111, the board has the authority to issue restricted licenses to current applicants or current licensees, or both, as it deems necessary, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
    1. Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with an osteopathic physician; provided, that the contractual relationship between the osteopathic physician and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the osteopathic physician from exercising independent professional medical judgment in diagnosing and treating patients.
    2. For the purposes of this subsection (f), the term “charitable clinic” means an entity that meets the following standards:
      1. Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. Has clinical facilities located in this state;
      3. Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. Provides one (1) or more of the following services for free or at a discounted rate:
        1. Medical care;
        2. Dental care;
        3. Mental health care; or
        4. Prescription medications;
      5. Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. Is not required to be licensed under § 68-11-202(a)(1).
    3. For the purposes of this section, the term “employing” shall not allow the employing of osteopathic physicians with the same specialties as those physicians exempted in § 63-6-204(e)(3).

Acts 1905, ch. 255, § 2; Shan., § 3654a5; mod. Code 1932, § 7004; Acts 1939, ch. 150, § 1; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7004; Acts 1953, ch. 113, § 25; 1971, ch. 161, § 2; 1973, ch. 44, § 1; 1976, ch. 727, § 4; T.C.A. (orig. ed.), § 63-904; Acts 1982, ch. 948, § 1; 1988, ch. 808, § 1; 1989, ch. 523, §§ 57-60; 1992, ch. 744, § 1; 1994, ch. 901, § 4; 1996, ch. 712, §§ 1, 2; 2009, ch. 566, § 12; 2014, ch. 949, § 8; 2016, ch. 632, §§ 2, 3; 2016, ch. 766, § 4.

Compiler's Notes. 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.

Cross-References. Application for licenses, §§ 63-1-103, 63-9-122.

Law Reviews.

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

63-9-105. Examination of applicants — Reciprocity.

  1. The board shall subject all applicants to an examination in the subjects of diagnosis, surgery, gynecology, obstetrics and such other subjects as the board may require. The board may, in its discretion, conduct its own written examination or administer a national examination.
  2. The board may, in its discretion, dispense with an examination in the case of an osteopathic physician duly licensed to practice osteopathic medicine in any other state or territory of the United States or in the District of Columbia, if the applicant has met the same or equivalent educational standards required by the state of Tennessee, and shall present a certificate of examination and registration by the legally constituted board of such other state or district or a certificate issued by the national board of examiners for osteopathic physicians and surgeons.

Acts 1905, ch. 255, § 2; Shan., § 3654a5; mod. Code 1932, § 7004; Acts 1939, ch. 150, § 1; C. Supp. 1950, § 7004; Acts 1976, ch. 727, § 6; T.C.A. (orig. ed.), § 63-906; Acts 1982, ch. 948, § 2; 1994, ch. 901, § 4.

63-9-106. Right of licensees to practice — Cross-referrals.

  1. Upon the issuance of a certificate of fitness by the board and the issuance of a license and a certificate of registration by the division as provided in chapter 1 of this title, the person receiving the same shall be entitled to practice in any county of this state osteopathic medicine, which is defined as a separate, complete and independent school of medicine and surgery utilizing full methods of diagnosis and treatment of physical and mental health and disease, including the prescription and administration of drugs, medicines and biologicals, operative surgery, obstetrics and radiological and other electromagnetic emissions, which places special emphasis on the interrelationship of the musculoskeletal system to other body systems as taught and practiced by recognized associated colleges of osteopathic medicine.
    1. The provisions of chapter 6, part 6 of this title relative to cross-referral arrangements and physician ownership and investment interests in and referrals to a health care entity shall apply to any person practicing osteopathic medicine in this state.
    2. Any osteopathic physician who makes or causes to be made a referral prohibited pursuant to subdivision (b)(1) is in violation of this chapter as of the dates specified in chapter 6, part 6 of this title. Willful violations of subdivision (b)(1) are considered unprofessional conduct, subject to licensure sanctions by the board of osteopathic examination, including suspension, revocation or other restriction deemed appropriate by the board. In addition, the board is authorized to impose civil penalties of an amount up to five thousand dollars ($5,000) for each prohibited referral.
  2. When medical training and specialty board certification are considerations in the credentialing of osteopathic physicians, no state board, commission or department, created or existing, or hospital, health care facility, medical staff, professional service corporation or professional limited liability corporation, health maintenance organization, preferred provider organization, independent practice association, managed care organization, health plan or any other insurance provider shall discriminate, on the basis of education, against eligible osteopathic physicians who have:
    1. Graduated from medical school and postdoctoral programs approved by either the American Osteopathic Association or the Accreditation Council for Graduate Medical Education; or
    2. Been awarded board eligibility or board certification by specialty boards recognized by either the American Osteopathic Association or the American Board of Medical Specialties.

Acts 1905, ch. 255, § 5; Shan., § 3654a8; Code 1932, § 7007; Acts 1939, ch. 150, § 1; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7007; T.C.A. (orig. ed.), § 63-907; Acts 1994, ch. 901, §§ 1, 4; 1997, ch. 285, § 1.

Cross-References. Exemption from licensing requirements for practice of medicine, § 63-6-204.

Licensing by board for healing arts, § 63-1-104.

NOTES TO DECISIONS

1. Hospital Staff Membership.

Since doctors of osteopathy and medical doctors do not generally attend the same medical colleges, do not generally receive internship training at the same hospitals and are not examined and licensed by a common medical examining board in Tennessee, the trustees of a public hospital have a legal right to accept only medical doctors as members of the medical staff to the exclusion of doctors of osteopathy and other practitioners who are not medical doctors. State ex rel. Carpenter v. Cox, 61 Tenn. App. 101, 453 S.W.2d 69, 1969 Tenn. App. LEXIS 354 (Tenn. Ct. App. 1969).

63-9-107. Renewal of certificates and licenses — Continuing education — Retirement.

  1. Every registered osteopathic physician shall annually pay a renewal fee as set by the board; provided, that satisfactory evidence is presented to the board that such licensee in the year preceding the application for renewal successfully completed the required number of hours in courses, programs, internships or residencies as established and approved by the board through rules and regulations promulgated in accordance with the Uniform Administrative Procedures Act, as compiled in title 4, chapter 5.
  2. Each person having a certificate of registration or license shall be notified prior to the due date of the renewal fee.
    1. When any licensed osteopathic physician shall fail to register and pay the annual registration fee within sixty (60) days after registration becomes due as provided in this section, the license of such person shall be automatically revoked at the expiration of the sixty (60) days after the registration was required, without further notice or hearing.
    2. Any person whose license is automatically revoked as provided in this chapter may make application in writing to the board for the reinstatement of such license and, upon good cause being shown, the board, in its discretion, may reinstate such license upon payment of all past-due renewal fees and upon further payment of a sum to be set by the board.
  3. Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
    1. Notwithstanding any provision of 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 (e).

Acts 1939, ch. 150, § 1; impl. am. Acts 1947, ch. 9, §§ 2-4, 9; C. Supp. 1950, § 7008.2; Acts 1953, ch. 113, § 30; modified; Acts 1963, ch. 211, § 2; 1976, ch. 406, § 2; 1976, ch. 727, §§ 7, 8; T.C.A. (orig. ed.), § 63-908; Acts 1982, ch. 948, § 3; 1984, ch. 937, §§ 39-41; 1986, ch. 675, § 7; 1989, ch. 360, §§ 33, 34; 1989, ch. 523, §§ 61, 62; 2001, ch. 245, § 1.

Cross-References. License renewals, § 63-1-107.

Retirement, §  63-1-111.

63-9-108. Application of health laws.

  1. Osteopathic physicians shall observe and be subject to all state and municipal regulations relating to:
    1. The control of contagious diseases;
    2. The reporting and certifying of births and deaths; and
    3. All matters pertaining to public health.
  2. Such reports shall be accepted by the officer or department to whom the same are made, equally with reports of physicians of any other school of medicine.

Acts 1905, ch. 255, § 4; Shan., § 3654a7; Code 1932, § 7006; Acts 1939, ch. 150, § 1; C. Supp. 1950, § 7006; T.C.A. (orig. ed.), § 63-909.

63-9-109. Penalties.

  1. Any person who practices or pretends or attempts to practice or use the science or system of osteopathic medicine in treating diseases of the human body or any person who buys, sells or fraudulently obtains any diploma, certificate, license or record of registration to practice osteopathic medicine illegally obtained or signed or issued unlawfully or under fraudulent representation or who uses in any of the forms or letters, “osteopathy,” “osteopath,” “osteopathist,” “diplomate in osteopathy,” “D.O.,” “osteopathic physician,” “doctor of osteopathy,” or any other title or letters, either alone or with other qualifying words or phrases, under such circumstances as to induce the belief that the person who uses such term is engaged in the practice of osteopathic medicine without having complied with this chapter commits a Class B misdemeanor.
  2. Nothing in this section shall be construed to prohibit any lawfully qualified osteopathic physician or surgeon in any other state meeting a registered osteopathic practitioner in the state of Tennessee for consultation.

Acts 1905, ch. 255, § 6; Shan., § 3654a9; Code 1932, § 7008; Acts 1939, ch. 150, § 1; impl. am. Acts 1947, ch. 9, § 13; C. Supp. 1950, § 7008; T.C.A. (orig. ed.), § 63-910; Acts 1984, ch. 937, § 42; 1989, ch. 591, § 112; 1994, ch. 901, § 6.

Cross-References. Penalties, § 63-1-123.

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

63-9-110. Investigation and prosecution of violations.

  1. The board shall investigate every supposed violation of this chapter coming within the scope of the authority of such board and report to the proper district attorney general all cases that, in the judgment of the board, warrant prosecution.
  2. Every police officer, sheriff and peace officer is charged with the duty of investigating every supposed violation of this chapter that comes to such officer's notice or of which such officer has received complaint and of apprehending and arresting all violators.
  3. It is the duty of the attorney general and reporter and of the several district attorneys general to prosecute violations of this chapter.

Acts 1939, ch. 150, § 1; C. Supp. 1950, § 7008; T.C.A. (orig. ed.), § 63-911.

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

63-9-111. Denial, suspension and revocation of licenses or certificates — Enjoining violations — Enforcement — Investigations.

  1. The board has the power to:
    1. Deny an application for a license to any applicant who applies for the same through reciprocity or otherwise;
    2. Permanently or temporarily withhold issuance of a license;
    3. Suspend or limit or restrict a previously issued license for such time and in such manner as the board may determine;
    4. Reprimand or take such action in relation to disciplining an applicant or licensee as the board in its discretion may deem proper; or
    5. Permanently revoke a license.
  2. The grounds upon which the board shall exercise the powers set forth in subsection (a) include, but are not limited to:
    1. Unprofessional, dishonorable or unethical conduct;
    2. Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provisions of this chapter or any lawful order of the board issued pursuant thereto or any criminal statute of the state;
    3. Making false statements or representations, being guilty of fraud or deceit in obtaining admission to practice or in being guilty of fraud or deceit in the practice of medicine;
    4. Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of medical practice;
    5. Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice medicine;
    6. Violation of the laws governing abortion;
    7. The willful violation without legal justification of a privileged communication;
    8. Obtaining a fee as personal compensation or causing financial gain or benefit for an employer, person, partnership, corporation or any other legal entity by a fraudulent representation or by the use of a fraudulent diagnosis, therapy or treatment;
    9. Conviction of a felony, conviction of any offense under state or federal drug laws or conviction of any offense involving moral turpitude;
    10. The use of any false or fraudulent statement in any document connected with practice under this chapter;
    11. 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;
    12. Dispensing, prescribing or otherwise distributing to any person a controlled substance or other drug if such person is addicted to the habit of using controlled substances without making a bona fide effort to cure the habit of such patient;
    13. 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 the United States;
    14. Engaging in the practice of medicine under a false or assumed name, or the impersonation of another practitioner, or a like, similar or different name;
    15. Knowingly performing any act that in any way assists an unlicensed person to unlawfully practice as provided under this chapter;
    16. Violating or attempting to violate, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any provisions of this chapter;
    17. The failure of the licensee to designate the licensee's professional degree in accordance with § 63-1-109;
    18. Should any person holding a license to practice hereunder be adjudged mentally incompetent or insane by any final order or adjudication of any court of competent jurisdiction, the license of such person shall forthwith be automatically suspended upon the entry of the order, and such suspension shall be effective and continue until the licensee is found or adjudged by such court to be mentally competent or until such person is duly discharged as restored to mental competence in any other manner provided by law;
    19. The advertising of medical business in which untrue or misleading statements are made or causing the publication or circulation of fraudulent advertising relative to any disease, human ailment or condition;
    20. Engaging in the practice of medicine when mentally or physically unable to safely do so;
    21. Disciplinary action against the licensee to practice medicine by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a licensee licensed in this state. A certified copy of the initial or final order or other equivalent document memorializing the disciplinary action from the disciplining state or territory shall constitute prima facie evidence of a violation of this section and shall be sufficient grounds upon which to deny, restrict or condition licensure or renewal and/or discipline a licensee licensed in this state;
    22. No person licensed in this state to practice osteopathy shall agree or contract with any clinical, bioanalytical or hospital laboratory, wherever located, to pay such laboratory for anatomic pathology services or cytology services and thereafter include such costs in the bill or statement submitted to the patient or any entity or person for payment, unless the practitioner is in compliance with the requirements of § 56-7-1015(g) and discloses on the bill or statement, or in writing by a separate disclosure statement in a minimum print size of ten (10) font, the name and address of the laboratory and the net amount or amounts paid or to be paid to the laboratory for the anatomic pathology services or cytology services. This subdivision (b)(22) shall not apply to the state or any local government; and
      1. Transferring of patient medical information to a person in another state who is not licensed to practice medicine or osteopathy in Tennessee using any electronic, telephonic or fiber optic means or by any other method if such information is employed to diagnose and/or treat persons physically located within Tennessee is prohibited;
      2. Notwithstanding subdivision (b)(23)(A), the transfer of such information shall not be prohibited if such information is:
        1. To be used for a second opinion requested by a Tennessee licensed medical doctor or osteopathic physician;
        2. To be used by an out-of-state physician for treatment of a person who is seeking treatment out of Tennessee;
        3. Used to determine if such patient is covered by insurance;
        4. Used by a physician in another state to provide occasional academic consultations to a medical school located in Tennessee;
        5. Used by insurance or related companies for risk evaluation, utilization review, claims processing and/or evaluation of claimants’ rehabilitation, including establishing and administering rehabilitation plans. The establishing and administering of such rehabilitation plans shall not include the diagnosis and/or treatment of persons physically located within Tennessee; or
        6. Used in clinical trials for drugs approved by the food and drug administration;
      3. This subdivision (b)(23) does not apply to research hospitals, as defined in § 63-6-204(f)(7)(I);
      4. This subdivision (b)(23) only applies to X-rays and medical imaging.
    1. In enforcing 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 is involved.
    2. Failure of an applicant or a licensee to submit to such examination when ordered shall constitute an admission of the allegations against the applicant or licensee, unless such failure was due to circumstances beyond the applicant's or licensee's control.
    3. The applicant or licensee may have an independent medical practitioner present during such examination.
    4. The committee will submit a report of its findings to the board, which will then hold a hearing as provided in this section.
  3. 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.
    1. In addition to the powers and duties expressly granted by this chapter in the matter of suspension or revocation of a license or certificate, the board is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is practicing or attempting to practice osteopathy without possessing a valid license so to practice and to enjoin any unauthorized person, firm or corporation from performing any act or rendering any service in violation of this chapter.
    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.
  4. The board shall at all times have the power to call upon the district attorneys general in the various judicial districts to assist the board, and 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. The attorney general and reporter and the attorney general and reporter's assistants shall serve as legal advisers to the board.
  5. The board, on its own motion, may investigate any report that an osteopathic physician is or may be in violation of subsection (b). Any osteopathic physician, any medical society or any other person who in good faith shall report to the board any information that an osteopathic physician is or may be in violation of subsection (b) shall not be subject to suit for civil damage as a result thereof.
  6. 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.

Acts 1939, ch. 150, § 1; mod. C. Supp. 1950, § 7008.1; Acts 1963, ch. 211, § 3; 1976, ch. 727, § 9; T.C.A. (orig. ed.), § 63-912; Acts 1982, ch. 948, § 4; 1985, ch. 120, § 11; 1996, ch. 1042, §§ 4, 5; 1997, ch. 175, § 1; 1999, ch. 340, §§ 2-4; 2004, ch. 715, § 2; 2010, ch. 952, § 3; 2012, ch. 798, § 42; 2012, ch. 848, § 74.

Code Commission Notes.

Former subsection (i) was redesignated as subdivision (b)(23) by the code commission in 2010.

Cross-References. Advertisement pertaining to board certification and specialty, §  63-1-145.

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

Enjoining violations, §   63-1-121.

Grounds for license denial, suspension or revocation, § 63-6-214.

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

Law Reviews.

Toward a Unified Approach to Privileges and Relevancy (Thomas F. Guernsey), 17 Mem. St. U.L. Rev. 1 (1986).

63-9-112. Operation of X-ray equipment in physicians' offices — Adoption of rules and regulations establishing minimum educational standards.

  1. The board shall have, in regard to operators of X-ray equipment and/or machines in physician offices, the authority, by rules and regulations, to:
    1. Establish and issue limited X-ray certifications to qualified individuals in the areas of densitometry, chest, extremities, skull and/or sinus and lumbar spine;
    2. Establish and issue full X-ray certifications to individuals who hold current and unrestricted national certification from the American Registry of Radiologic Technologists;
    3. Establish the minimum educational courses, curriculum, hours and standards that are prerequisite to issuance of the limited certificates;
    4. Select the examination or examinations to be utilized as the board's limited certification examination or examinations and the prerequisites, if any, for admission to the examination or examinations. The board is authorized to enter into a contract or agreement with the chosen examination service or services or select an intermediary between the board and the examination service or services to process applicants for the examination or examinations;
    5. Establish any other criteria for issuance of limited certificates that are reasonably related to the safe and competent performance of X-ray procedures;
    6. Establish a mechanism for the board accreditation of educational courses that are operating for purposes of qualifying individuals for limited certification and that meet the requirements established pursuant to the rules promulgated under the authority of subdivision (a)(3) and that establish the causes and standards that are grounds for withdrawal of the course accreditation and the mechanism for that withdrawal;
    7. Establish the fees to be paid for application and certification, renewal and late renewal of certificates and the fees required to be paid for application, renewal and late renewal of educational course accreditation; and
    8. Establish the required number of hours, types of courses and methods of proving compliance for biennial continuing education for all certificate holders.
  2. The certificates and accreditations issued pursuant to this section must be renewed and may be retired and reactivated pursuant to board established procedures. A person holding a certificate issued pursuant to this section may be disciplined for the same causes and under the same procedures as contained in § 63-6-214 for the medical board and § 63-9-111 for the board of osteopathic examination.
  3. The standards established by the board pursuant to subsection (a) shall be at least as stringent as any mandatory federal standards.
  4. No person shall perform X-ray procedures in a physician's office without being licensed as a physician or certified by the board pursuant to this section. Persons who have enrolled in a board recognized radiologic training program are exempt from the certification requirements of this section only as to X-ray procedures performed within or under the auspices of the program in which they are enrolled. After completion of the course but while awaiting the first opportunity to sit for the certification examination, but for no more than six (6) months, and for a period of time within which to receive the examination scores, but no more than seventy-five (75) days thereafter, such persons are exempt from the certification requirements of this section.
  5. No X-ray procedures may be performed by any person holding a certificate issued pursuant to this section without:
    1. An order from a physician licensed pursuant to chapter 6 of this title or an osteopathic physician licensed pursuant to this chapter; and
    2. A physician licensed pursuant to chapter 6 of this title or an osteopathic physician licensed pursuant to this chapter exercising full supervision, responsibility and control over the services being provided. The board is authorized to establish, by rules and regulations, the levels of supervision required of physicians utilizing persons certified pursuant to this section.
  6. A physician's office for purposes of this section means anywhere the practice of medicine as defined in § 63-6-204 or the practice of osteopathy as defined in § 63-9-106, which includes the performance of X-ray procedures contemplated by this section, is being conducted, except where that practice is conducted in or under the auspices of a facility or entity licensed by the department of health's division of health care facilities. The operation of a business in which X-ray procedures contemplated by this section are performed that is not owned by a physician, group of physicians, medical professional corporation, limited liability medical professional company or an entity or facility licensed by the division of health care facilities is prohibited.

Acts 1990, ch. 726, § 1; 2000, ch. 956, § 1.

Cross-References. Regulations for operation of X-ray equipment, § 63-6-224.

63-9-113. Supervised osteopathic medical service by physician assistant, registered nurse, licensed practical nurse, or pharmacist not prohibited.

Nothing in this chapter shall be so construed as to prohibit osteopathic medical service rendered by a physician assistant, registered nurse, a licensed practical nurse, or a pharmacist pursuant to a collaborative pharmacy practice agreement, if such osteopathic medical service is rendered under the supervision, control and responsibility of a licensed osteopathic physician.

Acts 1992, ch. 604, § 5; 2014, ch. 832, § 6.

63-9-114. [Repealed.]

Acts 1996, ch. 1042, § 1; repealed by Acts 2017, ch. 4, § 2, effective March 15, 2017.

Compiler's Notes. Former § 63-9-114 concerned medical review committee confidentiality.

63-9-115. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.

A physician licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of osteopathic examination may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.

Acts 2004, ch. 579, § 3.

63-9-116. Drug prescriptions.

  1. Any handwritten prescription order for a drug prepared by an osteopathic physician 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 osteopathic physician, 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 osteopathic physician 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 an osteopathic physician 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.
  2. Any typed or computer-generated prescription order for a drug issued by an osteopathic physician 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 osteopathic physician, 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 osteopathic physician 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 an osteopathic physician 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. Nothing in this section shall be construed to prevent an osteopathic physician from issuing a verbal prescription order.
    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, § 7; 2005, ch. 12, § 6; 2008, ch. 1035, §§ 7, 9; 2010, ch. 795, § 16; 2013, ch. 74, § 7.

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 non-prescription 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.

63-9-117. Office-based surgery.

  1. For the purposes of this section, unless the context otherwise requires:
    1. “Board” means the board of osteopathic examination;
    2. “Level II office-based surgery” means Level II surgery as defined by the board of osteopathic medical examination in its rules and regulations that is performed outside of a hospital, ambulatory surgical treatment center or other medical facility licensed by the department of health;
    3. “Office-based surgery” means Level III surgery requiring a level of sedation beyond the level of sedation defined by the board of medical examiners as Level II surgery that is performed outside a hospital, an ambulatory surgical treatment center or other medical facility licensed by the department of health;
    4. “Physician” means any person licensed under this chapter; and
    5. “Surgical suite” means both the operating and recovery room or rooms located in a physician's office where Level III office-based surgery is to be performed.
  2. The board shall have the duty and responsibility to regulate the practice of office-based surgery, including the promulgation of rules necessary to promote patient health and safety in such practices, including, but not limited to, a mechanism by which all office-based surgical suites are surveyed and certified by the board.
  3. The board shall specifically identify in rules the parameters to be used in determining Level III surgical procedures and multiple procedures that may be performed in an office-based setting pursuant to the level of anesthesia involved in the procedures. In addition, the board shall promulgate age and risk classification criteria of patients eligible for Level III office-based surgical procedures.
  4. By December 30, 2007, the board shall adopt rules establishing a specific list of approved Level III surgical procedures that can be performed in a physician's office in this state. The ambulatory surgical center covered procedures list promulgated by the centers of medicare and medicaid shall be used as a guide. No physician shall perform any Level III surgical procedures that are not included on the list promulgated by the board. The board may modify the list as the board deems necessary. The board shall also promulgate rules addressing the minimum requirements deemed necessary by the board for the safe performance of office-based surgery.
  5. Using the rules established for ambulatory surgical treatment centers as guidelines, the board shall promulgate rules relative to infection control, life safety, patient rights, hazardous waste and equipment and supplies necessary to assure the safety of patients undergoing office-based surgery. Any provision in the ambulatory surgical treatment center rules addressing infection control, life safety, patient rights, hazardous waste and equipment and supplies that is not adopted by the board shall require a statement entered into the official minutes from the board justifying the board's decision.
  6. No more than three (3) patients undergoing Level III office-based surgery in a physician's office may be incapable of self-preservation at the same time. The board shall promulgate rules requiring physician offices that perform office-based surgery to adopt bylaws that put in place a management system and documentation that will insure that no more than three (3) patients that are in surgery or recovery are incapable of self-preservation at the same time. The bylaws and documentation of the management system shall be included in the application for surgical suite certification.
  7. Except for emergencies, a surgical suite certified for office-based surgery may be utilized only by physician employees of the practice in which the surgical suite is located. Surgical suites may not be shared with other practices or other physicians.
  8. The board shall enter into a memorandum of understanding, contract or other written arrangement with the department of health such that the department:
    1. Provides a site survey of the surgical suites sought to be certified to perform office-based surgery. A physician office at which office-based surgeries are being performed as of October 1, 2007, shall submit both a request for a site survey on an application form developed by the board and remit payment of the office-based surgery fee to the department by October 1, 2007. If the office makes a timely filing in accordance with this subdivision (h)(1), the physician's office may continue to be a site for office-based surgeries pending completion of a survey confirming compliance with board rules and subsequent issuance of a certification of the surgical suite or suites. A physician office at which office-based surgeries are not being performed as of October 1, 2007, shall not perform any such procedures until an application form and payment of the office-based surgery fee is submitted to the board and a site survey is completed by the department and a certification of the surgical suite is issued by the board;
    2. Is authorized to require plans of correction and to verify that the plans of correction have been implemented;
    3. Is authorized to initiate subsequent, unannounced site surveys during regular business hours as long as the physician office continues to be used to perform office-based surgeries, but no more frequently than once every twelve (12) months; and
    4. Is authorized to respond to any complaints made by patients or the public against a physician who performs office-based surgery or a physician's office at which office-based surgery is being performed at the request of the office of investigations.
  9. The results of all site surveys shall be transmitted by the department to the board. The results shall include any requirement for plans of correction, the department's determination of the acceptability of the submitted plans of correction, and the department's verification that the plans of correction have been implemented. The board shall make a final determination on certifying the surgical suite for performance of office-based surgeries. The results of site surveys and board determinations shall be shared on a routine basis with the board for licensing health care facilities.
  10. The results of all complaint investigations by department staff shall be transmitted to the board for resolution; however, the information shall at all times be maintained as confidential and not available to the public except to the extent § 63-1-117(b) applies.
  11. Any physician office that desires to be certified to perform office-based surgery shall pay to the department an annual office-based surgery fee as set by the board.
  12. A physician office at which office-based surgery is being performed shall ensure that claims data is reported to the commissioner of health on a form approved by the department of health. The data shall be submitted through a third party approved by the department of health for the purpose of editing the data according to rules and regulations established by the commissioner. The physician office shall be responsible for the costs associated with processing of the data by the approved vendors. The claims data shall be reported at least quarterly to the commissioner. No information shall be made available to the public by the commissioner that reasonably could be expected to reveal the identity of any patient. The claims data reported to the commissioner under this section are confidential and not available to the public until the commissioner processes and verifies the data. The commissioner shall prescribe conditions under which the processed and verified data are available to the public.
    1. Except as provided in subdivision (h)(1), a physician office surgical suite is required to be certified by the board in order to perform office-based surgery. A physician office that proposes to perform the surgery shall submit to the board, on an application form provided by the board, at least the following:
      1. Level III procedures expected to be performed by each physician;
      2. The specialty board certification or board eligibility of the physician or physicians performing Level III procedures, if any;
      3. Verification of health care liability coverage for all physicians performing Level III procedures;
      4. Verification of hospital staff privileges for all physicians performing Level III procedures;
      5. The name of a responsible physician in whose name the surgical suite certification shall be issued for that office and a list of the physicians with the practice who are going to be performing Level III office-based surgeries; and
      6. The documentation required by subsection (f) regarding incapacitated patient limits.
    2. The form required by subdivision (m)(1) shall serve as an application form, but the information on the form shall be updated as appropriate when any information on it has changed.
  13. The board shall notify all physicians of the office-based surgery certification requirements. Failure of a physician performing office-based surgery, or a physician office at which office-based surgery is being performed, to abide by this section, any rules promulgated pursuant to this section or of § 68-11-211 may be grounds for disciplinary action or termination of either the rights of the physician to perform office-based surgery or the surgical suite's certification by the physician's licensing board, or both disciplinary action and termination. For purposes of § 4-5-320(c), the public health, safety and welfare  imperatively require emergency action at any time that a previously authorized surgical suite fails to maintain the standards set by the board.
  14. Applicants for initial licensure or reinstatement of a previously issued license shall indicate to the board on the appropriate licensure application if they intend to perform Level II office-based surgery procedures as defined by the rules of the board of osteopathic examination and that are integral to a planned treatment regimen and not performed on an urgent or emergent basis.
  15. Licensed osteopathic physicians who perform Level II office-based surgery at the time of licensure renewal shall indicate to the board on the licensure renewal application if the licensee currently performs Level II office-based surgery procedures as defined in the rules of the board of osteopathic examination and that are integral to a planned treatment regimen and not performed on an urgent or emergent basis.
  16. In order for health care providers and the board to work together to collect meaningful health care data, so as to minimize the frequency and severity of certain unexpected events and improve the delivery of health care services, each osteopathic physician who performs any Level II office-based surgery that results in any of the following unanticipated events shall notify the board in writing within fifteen (15) calendar days following the physician's discovery of the event:
    1. The death of a patient during any Level II office-based surgery or within seventy-two (72) hours thereafter;
    2. The transport of a patient to a hospital emergency department except those related to a natural course of the patient's illness or underlying condition;
    3. The unplanned admission of a patient to a hospital within seventy-two (72) hours of discharge, only if the admission is related to the Level II office-based surgery except those related to a natural course of the patient's illness or underlying condition;
    4. The discovery of a foreign object erroneously remaining in a patient from a Level II office-based surgery at that office; or
    5. The performance of the wrong surgical procedure, surgery on the wrong site or surgery on the wrong patient.
  17. Records of reportable events should be in writing and should include at a minimum the following:
    1. The physician's name and license number;
    2. The date and time of the occurrence or discovery of the incident;
    3. The office and address where the incident took place;
    4. The name and address of the patient;
    5. The type of Level II office-based surgery that was performed;
    6. The type and dosage of sedation or anesthesia utilized during the procedure;
    7. The circumstances surrounding the incident; and
    8. The type or types of events required to be reported as provided in subsection (q).
  18. The filing of a report as required by subsection (q) does not, in and of itself, constitute an acknowledgement or admission of health care liability, error or omission. Upon receipt of the report, the board may, in its discretion, obtain patient and other records pursuant to authority granted to it in § 63-1-117. The reporting form and any supporting documentation reviewed or obtained by the board pursuant to this section and any amendments to the reports shall be confidential and not subject to discovery, subpoena or legal compulsion for release to any person or entity; nor shall they be admissible in any civil or administrative proceeding, other than a disciplinary proceeding by the board; nor shall they be subject to any open records request made pursuant to title 10, chapter 7, part 5 or any other law. This section shall not affect any of the provisions of or limit the protections provided by § 63-1-150.
  19. Failure to comply with the requirements of subsections (o)-(s) constitutes grounds for disciplinary action by the board in its discretion pursuant to § 63-9-111.

Acts 2007, ch. 373, § 5; 2008, ch. 927, §§ 3, 4; 2012, ch. 798, §§ 43, 44; 2017, ch. 4, § 5.

Compiler's Notes. Acts 2007, ch. 373, § 6 provided that the board of medical examiners and the board of osteopathic examination are authorized to promulgate public necessity rules (now emergency rules) necessary to carry out the provisions of the act in accordance with the provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Amendments. The 2017 amendment substituted “provided by § 63-1-150” for “provided by §§ 63-6-219 [repealed] and 63-9-114” at the end of (s).

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

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

63-9-118. [Repealed.]

Acts 2010, ch. 795, § 5; repealed by Acts 2018, ch. 883, § 8, effective January 1, 2019.

Compiler's Notes. Section 63-9-118 concerning prescriptions for Schedule II controlled substances is repealed by Acts 2018, ch. 883, § 8, 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 § 63-6-239 concerned prescriptions for Schedule II controlled substances.

63-9-119. Employee or contractor's unauthorized use of osteopathic physician's DEA registration number to write prescriptions.

  1. Any osteopathic physician licensed pursuant to this chapter who has reason to believe that an employee or contractor of the physician or the physician's firm, partnership or corporation has used the physician's federal drug enforcement administration (DEA) registration number without authorization to write prescriptions may make a report to a law enforcement agency.
  2. Any osteopathic physician, firm, partnership, or corporation making a report pursuant to subsection (a) shall be immune from any civil liability for making such report when made in good faith.

Acts 2012, ch. 818, § 2.

Code Commission Notes.

Acts 2012, ch. 836, § 2 purported to enact § 63-9-119. Section 63-9-119 was previously enacted by Acts 2012, ch. 818, § 2; therefore, Acts 2012, ch. 836, § 2 was enacted as § 63-9-120 by authority of the code commission.

Acts 2012, ch. 961, § 5 purported to enact a new § 63-9-119. Section 63-9-119 was previously enacted by Acts 2012, ch. 818, § 2, and § 63-9-120 was previously enacted by Acts 2012, ch. 836, § 2; therefore, Acts 2012, ch. 961, § 5 was enacted as § 63-9-121 by authority of the code commission.

63-9-120. Hormone replacement therapy.

    1. “Hormone replacement therapy clinic” or “hormone therapy clinic” means a medical office in which the clinicians are primarily engaged in hormone replacement or supplementation therapy or a medical office which holds itself out to the public as being primarily or substantially engaged in hormone replacement therapy. For the purposes of this definition, “primarily engaged” means that a majority of the clinic's patients receive hormone replacement therapy and may be further defined by the board by rule. “Hormone replacement therapy clinic” does not mean a medical office in which the clinicians are primarily engaged in obstetrics and gynecology (OB/GYN), urology or primary care.
    2. “Hormone replacement therapy” or “hormone therapy” means the branch of the practice of medicine whereby the patient is treated with medications that include, but are not limited to, creams or natural formulas taken through the skin, under the tongue, in subcutaneous pellets, or orally that contain hormones that have the same bioidentical or similar chemical formula as those produced naturally in the human body or that the provider thinks or claims to be similar or identical, but shall not include the treatment of patients with birth control pills.
  1. In hormone replacement therapy clinics:
    1. All hormone replacement therapy shall be performed by a physician licensed under chapter 6 of this title or this chapter, or delegated by such physician to a certified nurse practitioner licensed pursuant to chapter 7 of this title or a physician assistant licensed pursuant to chapter 19 of this title; and
    2. If hormone replacement therapy is delegated, the supervising physician shall ensure that written protocols are developed for licensees to whom hormone replacement therapy is delegated, that such protocols are updated as necessary and that the patient is informed of both the name and contact information of the supervising physician and an indication of whether the physician is available onsite or remotely.
  2. A physician supervising hormone replacement therapy in a hormone replacement therapy clinic shall ensure that for each patient, all of the following requirements are met:
    1. Prior to the initial hormone replacement therapy or course of treatments, an appropriate physical examination shall be conducted;
    2. An appropriate medical history shall be taken and documented on the patient;
    3. A written order for hormone replacement therapy shall be entered by the treating provider in the patient's medical record documenting the diagnosis and medical reason for the patient's need for hormone replacement therapy. If the treating provider is not a physician, the supervising physician shall make a personal review of the historical, physical and therapeutic data gathered by the treating provider and shall so certify the review in the patient's chart within seven (7) days of the patient being served;
    4. The patient gives written consent for hormone replacement therapy, which includes notification of possible complications and reasonable expectations and any applicable FDA warnings associated with any part of the therapy; and
    5. The supervising physician shall be immediately notified upon discovery of a complication.

Acts 2012, ch. 836, § 2.

Code Commission Notes.

Acts 2012, ch. 836, § 2 purported to enact § 63-9-119. Section 63-9-119 was previously enacted by Acts 2012, ch. 818, § 2; therefore, Acts 2012, ch. 836, § 2 was enacted as § 63-9-120 by authority of the code commission.

63-9-121. Interventional pain management.

  1. A physician licensed in this chapter may only practice interventional pain management if the licensee is either:
    1. Board certified through the American Osteopathic Association (AOA) or the American Board of Physician Specialties (ABPS)/American Association of Physician Specialists (AAPS) in one of the following medical specialties:
      1. Anesthesiology;
      2. Neuromusculoskeletal medicine;
      3. Orthopedic surgery;
      4. Physical medicine and rehabilitation;
      5. Radiology; or
      6. Any other board certified physician who has completed an ABMS subspecialty board in pain medicine or completed an ACGME-accredited pain fellowship;
    2. A recent graduate of a medical specialty listed in subdivision (a)(1) not yet eligible to apply for AOA or ABPS/AAPS specialty certification; provided, that there is a practice relationship with an osteopathic physician who meets the requirements of subdivision (a)(1) or a physician who meets the requirements of § 63-6-244(a)(1);
    3. A licensee who is not board certified in one of the specialties listed in subdivision (a)(1) but is board certified in a different AOA or ABPS/AAPS specialty and has completed a post-graduate training program in interventional pain management approved by the board;
    4. A licensee who serves as a clinical instructor in pain medicine at an accredited Tennessee medical training program; or
    5. A licensee who has an active pain management practice in a clinic accredited in outpatient interdisciplinary pain rehabilitation by the commission on accreditation of rehabilitation facilities or any successor organization.
  2. For purposes of this section, interventional pain management is the practice of performing 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.
  3. The board is authorized to define through rulemaking the scope and length of the practice relationship established in subdivision (a)(2).
  4. An osteopathic physician who provides direct supervision of an advanced practice registered nurse or a physician's assistant pursuant to § 63-7-126 or § 63-19-107 must meet the requirements set forth in subdivision (a)(1) or (a)(3).
  5. An osteopathic physician who violates this section is subject to disciplinary action by the board pursuant to § 63-9-111, including, but not limited to, civil penalties of up to one thousand dollars ($1,000) for every day this section is violated.

Acts 2012, ch. 961, § 5; 2016, ch. 980, § 18.

Code Commission Notes.

Acts 2012, ch. 961, § 5 purported to enact a new § 63-9-119. Section 63-9-119 was previously enacted by Acts 2012, ch. 818, § 2, and § 63-9-120 was previously enacted by Acts 2012, ch. 836, § 2; therefore, Acts 2012, ch. 961, § 5 was enacted as § 63-9-121 by authority of the code commission.

63-9-122. Exemption for physician for visiting sports team.

  1. A physician who is duly qualified to practice medicine under the laws of another state is exempt from the licensure requirements of § 63-9-104, subject to this section, if either of the following applies:
    1. The physician has a written or oral agreement with a sports team to provide care to team members and coaching staff traveling with the team for a specific sporting event to take place in this state; or
    2. The physician has been invited by a national sport governing body to provide services to athletes and coaching staff at a national sport training center in this state or to provide services to athletes and coaching staff at an event or competition in this state that is sanctioned by the national sport governing body.
  2. The exemption provided by this section only applies while:
    1. The physician's practice is limited to that required by the team or the national sport governing body; and
    2. The services provided by the physician are within the physician's scope of practice.
  3. The exemption provided by subsection (a) permits a physician to provide care or consultation to a person specified in subsection (a). Nothing in this section permits a physician exempt by this section to:
    1. Provide care or consultation to any person residing in this state other than a person specified in subsection (a); or
    2. Practice at a licensed healthcare facility in this state.
  4. An exemption pursuant to subdivision (a)(1) is valid while the physician is traveling with the sports team, subject to the following:
    1. The exemption shall not be longer than ten (10) days in duration for each respective sporting event without prior authorization from the board of osteopathic examination;
    2. The board of osteopathic examination may grant an extension of not more than twenty (20) additional days per sporting event; and
    3. No physician shall be exempt for more than thirty (30) total days in a calendar year.
  5. An exemption pursuant to subdivision (a)(2) is valid during the time certified by the national sport governing body; however, no physician shall be exempt for more than thirty (30) total days in a calendar year.
  6. No physician exempt pursuant to this section shall dispense or administer controlled substances unless:
    1. The patient to whom the controlled substance is administered or dispensed is over eighteen (18) years of age and is a person described in subdivision (a)(1) or (a)(2); and
    2. The physician reports all controlled substances dispensed or administered to any applicable state controlled substance database in the physician's state of licensure.
  7. For purposes of this section, “sports team” means a professional, semi-professional, or amateur team including, but not limited to, a college, high school, grade school, or non-school affiliated team, such as those associated with the Amateur Athletic Union (AAU).
  8. The board of osteopathic examination may enter into agreements with medical licensing boards of other states to implement this section. Agreements may include procedures for reporting potential medical license violations.
  9. The board of osteopathic examination may 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. 329, § 3.

Compiler's Notes. Acts 2017, ch. 329, § 1 provided that the act, which enacted this section, shall be known and may be cited as the  “Visiting Sports Team Act.”

Effective Dates. Acts 2017, ch. 329, § 4. January 1, 2018; provided, that for the purpose of promulgating rules, the act took effect May 9, 2017.

63-9-123. Maintenance of licensure or certification not required.

  1. As used in this section:
    1. “Continuing medical education” means continued postgraduate medical education required by the board of osteopathic medical examination intended to provide medical professionals with knowledge of new developments or reinforcement of previously learned information in their field;
    2. “Maintenance of certification” means any process requiring periodic recertification examinations or other activities to maintain specialty medical board certification;
    3. “Maintenance of licensure” means the proprietary framework for physician license renewal established through the Federation of State Medical Boards or its successor organization, which includes additional periodic testing or requirements other than continuing medical education; and
    4. “Specialty medical board certification” means certification by a board that specializes in one (1) particular area of medicine and typically requires additional examinations other than the board of osteopathic examination's requirements to practice medicine.
  2. The board shall not deny a physician licensure based on a physician's non-participation in any form of maintenance of licensure, including requiring any form of maintenance of licensure tied to maintenance of certification. The board's regular requirements, including continuing medical education, demonstrate professional competency.
  3. The board shall not require any form of specialty medical board recertification or any maintenance of certification to practice medicine in this state.

Acts 2017, ch. 438, § 2.

Effective Dates. Acts 2017, ch. 438, § 4. May 25, 2017.

Chapter 10
Pharmacy

Part 1
Third-Party Prescription Program Act

63-10-101. Short title.

This part shall be known and may be cited as the “Third-Party Prescription Program Act.”

Acts 1981, ch. 104, § 2; T.C.A., § 63-1051.

Compiler's Notes. Former parts 1 and 2 of this chapter, §§ 63-10-10163-10-217 (Acts 1931, ch. 84, §§ 1-8, 11, 12, 14; 1939, ch. 36, § 2; C. Supp. 1950, §§ 7002.1 — 7002.7, 7002.10 — 7002.13, 7002.16, 7002.17, 7002.19; Acts 1951, ch. 15, § 1; 1951, ch. 108, §§ 1-8; 1957, ch. 246, § 1; 1959, ch. 63, § 1; 1959, ch. 65, § 1; 1959, ch. 68, § 1; 1959, ch. 171, § 1; 1961, ch. 100, §§ 1-3, 5-8; 1961, ch. 101, §§ 1, 3-5; 1963, ch. 181, § 1; 1965, ch. 271, §§ 1, 2; 1967, ch. 16, § 1; 1967, ch. 17, § 1; 1968, ch. 18, § 1; 1970, ch. 412, §§ 1-3; 1970, ch. 413, §§ 1, 2; 1970, ch. 414, § 1; 1970, ch. 415, § 1; 1970, ch. 431, § 1; 1971, ch. 79, §§ 1-5; 1971, ch. 161, § 2; 1972, ch. 465, § 1; 1972, ch. 508, §§ 1-6; 1972, ch. 597, § 9; 1972, ch. 702, § 1; 1973, ch. 110, §§ §§ 1-13; 1974, ch. 466, §§ 1-5; 1976, ch. 591, §§ 1-9; 1976, ch. 806, § 1(116); 1977, ch. 66, § 8; 1977, ch. 180, §§ 1, 2; 1978, ch. 906, § 40; 1979, ch. 84, § 3; 1979, ch. 257, §§ 1-9; 1980, ch. 451, §§ 10, 11; 1980, ch. 851, §§ 9, 10; 1981, ch. 38, §§ 1, 2; 1981, ch. 358, §§ 2, 4; T.C.A. (orig. ed.), §§ 63-1001 — 63-1008, 63-1010, 63-1011, 63-1013 — 63-1016, 63-1018 — 63-1026; Acts 1982, ch. 673, §§ 2-4; 1983, ch. 101, §§ 1-3; 1983, ch. 201, § 1; 1984, ch. 676, § 12; 1984, ch. 726, § 1; 1984, ch. 757, § 1; 1985, ch. 354, §§ 16-21, 31, 32; 1986, ch. 485, §§ 3-9; 1987, ch. 217, §§ 5-10; 1987, ch. 244, §§ 2, 4, 6; 1988, ch. 1013, § 48; 1989, ch. 360, §§ 35, 36; 1989, ch. 523, §§ 174-179, 182-185; 1989, ch. 591, § 113; 1990, ch. 1026, §§ 16-19, 46, 47; 1994, ch. 722, §§ 5-10; 1994, ch. 741, § 1; 1995, ch. 474, § 3; 1996, ch. 754; §§ 4, 5, concerning the board of pharmacy, were repealed by Acts 1996, ch. 651, § 2, effective January 1, 1997. For new provisions effective January 1, 1997, see part 2 of this chapter.

Law Reviews.

Thoughts on a Faded Peacock: The Effect of ERISA's Preemption Provision on State Third Party Prescription Drug Program Statutes (Richard M. Rindler and Evan Miller), 39 Vand. L. Rev. 23 (1986).

63-10-102. Part definitions.

As used in this part, “program” and “third-party prescription program” mean any system of providing for the reimbursement of pharmaceutical services under a contractual arrangement or agreement between a provider of such services and another party who is not the consumer of those services. Such programs may include, but not be limited to, employee benefit plans whereby a consumer receives prescription drugs or other pharmaceutical services and those services are paid for by an agent of the employer or others.

Acts 1981, ch. 104, § 3; T.C.A., § 63-1052; T.C.A. § 63-10-302.

63-10-103. Contract between pharmacy and program administrator.

Any agreement or contract entered into in this state between the program administrator of a third-party prescription program and a pharmacy shall include a statement of:

  1. The method and amount of reimbursement to the pharmacy for services rendered to persons enrolled in such program;
  2. The frequency of payment by such program administrator to the pharmacy for such services rendered; and
  3. A method for the adjudication of complaints or the settlement of disputes between the parties.

Acts 1981, ch. 104, § 4; T.C.A., § 63-1053; T.C.A. § 63-10-303.

63-10-104. Cancellation of program benefits.

  1. The administrator of a program shall notify all pharmacies enrolled in such program of any cancellation of the coverage of benefits of any group enrolled in such program at least thirty (30) days prior to the effective date of such cancellation. In those cases where the administrator of a program is not notified at least thirty (30) days prior to the effective date of such cancellation, the administrator shall notify all pharmacies enrolled in such program of the cancellation as soon as practicable after having received such notice.
  2. All persons enrolled in a program shall be notified of its cancellation, and the administrator of such program shall make every reasonable effort to gain possession of any plan identification cards such persons may have been issued pursuant to such program.
  3. Any person who utilizes a program identification card to obtain services from a pharmacy after having received notice of the cancellation of the person's benefits shall be liable to the program administrator of such program for all moneys paid by such program administrator for any services received pursuant to the illegal use of such identification card.

Acts 1981, ch. 104, § 5; T.C.A., § 63-1054; T.C.A. § 63-10-304.

63-10-105. Denying or withholding payment.

  1. No program administrator shall deny payment for services to any pharmacy that may have resulted from the fraudulent or illegal use of an identification card by any person, unless the pharmacy has been notified that the card has been cancelled or discontinued and that the program administrator has been unsuccessful in attempting to regain possession of the card.
  2. No program administrator shall withhold any payments to any pharmacy beyond the time period specified in the payment schedule provisions of the agreement, except that individual claims for payment may be returned to the pharmacy for cause, such as incomplete or illegible information, and may then be resubmitted by the pharmacy to the program administrator after the appropriate corrections have been made.
  3. No program administrator shall deny or withhold payment to any pharmacy for duplicate prescription refills or prescription refills that are dispensed early in relation to the prior day's supply dispensed, where such refills are for the purpose of replacing lost or destroyed medication or providing the patient with the quantity necessary for extended travel away from the community in which the patient resides or for any other bona fide reason that causes the patient to be without medication, when the discontinuation of the medicine would, in the pharmacist's professional judgment, place the patient at risk of harm.

Acts 1981, ch. 104, § 6; T.C.A., § 63-1055; Acts 1997, ch. 172, § 1; T.C.A. § 63-10-305.

63-10-106. Reimbursement rates.

No agreement between a program administrator and a pharmacy shall establish reimbursement rates or procedures that result in reimbursement rates for services rendered to persons covered by the plan that are less than the usual and customary rate charged by that vendor and paid by ordinary consumers for the same or similar services. This section does not apply to any agreements involving a pharmacy that is a member of an organized pharmacy network, such as a preferred provider organization (PPO) or a professional service administration organization (PSAO).

Acts 1981, ch. 104, § 7; T.C.A., § 63-1056; Acts 1993, ch. 388, § 1; T.C.A. 63-10-306.

63-10-107. Applicability.

This part does not apply to any services rendered pursuant to the Medical Assistance Act of 1968, compiled in title 71, chapter 5, part 1.

Acts 1981, ch. 104, § 9; T.C.A. § 63-1058; T.C.A. § 63-10-308; T.C.A. § 63–10–108.

Compiler's Notes. Former § 63-10-307 (now § 63-10-107) (Acts 1981, ch. 104, § 8; T.C.A., § 63-1057), concerning the institution, amendment or alteration of third-party prescription programs, was repealed by Acts 1993, ch. 388, § 2, effective May 17, 1993.

Former § 63-10-108 was transferred to this section by the authority of the Code Commission in 2017.

63-10-108. Price level determinations.

  1. The commissioner of health, in cooperation with the board of pharmacy, shall determine the price level of prescriptions furnished under this part and those furnished otherwise. A determination shall also be made of the price level in other states having a program similar to that provided in this part and those that do not.
  2. The commissioner shall prepare a comparison of the price level determinations required by this section no later than January 31 of each year and shall furnish copies of such comparison to committees of the general assembly.

Acts 1981, ch. 104, § 10; T.C.A. § 63-1059; T.C.A. § 63-10-309; T.C.A. § 63-10-109.

Compiler's Notes. Former § 63-10-109 was transferred to this section by the authority of the Code Commission in 2017.

Former § 63-10-108 was transferred to § 63-10-107 by the authority of the Code Commission in 2017.

Part 2
Pharmacy Practice

63-10-201. Short title.

Parts 2-5 of this chapter shall be known and may be cited as the “Tennessee Pharmacy Practice Act of 1996.”

Acts 1996, ch. 651, § 19; T.C.A. § 63-10-401; Acts 2007, ch. 407, § 2.

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

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

Physician assistants, §§ 63-19-106, 63-19-107.

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

Prevention of abuse of drugs by pharmacist, § 53-10-112.

Law Reviews.

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

The Pharmacist's Duty to Warn When Dispensing Prescription Drugs: Recent Tennessee Developments, 22 Mem. St. U.L. Rev. 517 (1992).

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

NOTES TO DECISIONS

1. Standard of Care.

The pharmacist is a professional who has a duty to his customer to exercise the standard of care required by the pharmacy profession in the same or similar communities as the community in which he practices his profession. Dooley v. Everett, 805 S.W.2d 380, 1990 Tenn. App. LEXIS 856 (Tenn. Ct. App. 1990).

63-10-202. Practice of pharmacy.

The practice of pharmacy within the state is declared to be a professional practice affecting public health, safety and welfare and is subject to regulation and control in the public interest. It is further declared to be a matter of public interest and concern that the practice of pharmacy, as defined in § 63-10-204, merit and receive the confidence of the public and that only qualified persons be permitted to engage in the practice of pharmacy.

Acts 1996, ch. 651, § 2; T.C.A. § 63-10-402.

Cross-References.

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-203. Statement of purpose.

  1. The purpose of parts 2-5 of this chapter is to define and regulate the practice of pharmacy to protect the health, safety and welfare of the people of Tennessee.
  2. The persons engaged in the practice of pharmacy shall be pharmacists, duly recognized by the state as necessary health care providers, and shall be entrusted through parts 4-6 of this chapter with a provision of care intended to enhance patients' wellness, prevent illness and optimize outcomes.

Acts 1996, ch. 651, § 3; T.C.A. § 63-10-403; Acts 2007, ch. 407, § 2.

Cross-References.

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-204. Definitions.

As used in parts 2-5 of this chapter, unless the context otherwise requires:

  1. “Administer” means the direct application of a drug to a patient or research subject by injection, inhalation, ingestion, topical application or by any other means;
  2. “Board” means the Tennessee board of pharmacy;
  3. “Certification” means a voluntary process by which a practitioner's training, experience and knowledge are identified as meeting or surpassing a standard, defined or approved by the board beyond that required for licensure or registration;
  4. “Collaborative pharmacy practice” is the practice of pharmacy whereby one (1) or more licensed pharmacists licensed in this state, jointly and voluntarily work with one (1) or more prescribers licensed in this state, under a collaborative pharmacy practice agreement to provide patient care services, to achieve optimal medication use and desired patient outcomes;
  5. “Collaborative pharmacy practice agreement” is a written and signed agreement entered into voluntarily between one (1) or more licensed pharmacists in this state, and one (1) or more prescribers licensed in this state, each of whom is in active practice in this state providing patient care services in this state, that provides for collaborative pharmacy practice, as defined by law;
  6. “Compounding” means the preparation, mixing, assembling, packaging or labeling of a drug or device:
    1. As the result of a prescription order or initiative based on the prescriber-patient-pharmacist relationship in the course of professional practice;
    2. In anticipation of prescription orders based on routine, regularly observed prescribing patterns;
    3. For the purpose of, or as an incident to, research, teaching or chemical analysis and not for sale or dispensing;
    4. For use in a licensed prescribing practitioner's office for administration to the prescribing practitioner's patient or patients when the product is not commercially available upon receipt of an order from the prescriber;
    5. For use in a health care facility for administration to a patient or patients receiving treatment or services provided by that facility when the product is not commercially available upon receipt of an order from an authorized licensed medical practitioner of the facility;
    6. For use by emergency medical services for administration to a patient or patients receiving services from them under authorized medical control when the product is not commercially available upon receipt of an order from a licensed prescriber authorized to provide medical control; or
    7. For use by a licensed veterinarian for administration to their nonhuman patient or patients or for dispensing to nonhuman patients in the course of the practice of veterinary medicine upon receipt of an order from a veterinarian when the product is not commercially available.
  7. “Continuing education” means planned, organized learning experiences and activities beyond the basic educational or preparatory program. These learning experiences and activities are designed to promote the continuous development of skills, attitudes and knowledge necessary to maintain proficiency, provide quality service or products, be responsive to needs and keep abreast of significant change;
  8. “Continuous quality improvement program” means a system of standards and procedures to identify and evaluate quality-related events and to improve patient care;
  9. “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;
  10. “Deliver” or “delivery” means the actual, constructive or attempted transfer from one person to another whether or not there is an agency relationship;
  11. “Device” means an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent or other similar or related article, including any component part or accessory, that is required under federal or state law to be ordered or prescribed by a person duly authorized;
  12. “Dietary supplement” means a product, other than tobacco, intended to supplement the diet that bears or contains one (1) or more of the following ingredients: a vitamin, mineral, herb or other botanical, amino acid, dietary substance for use by humans to supplement the diet by increasing the total dietary intake, or a concentrate, metabolite, constituent, extract or combination of any of these ingredients and any other products designated as dietary supplements by federal or state law;
  13. “Director” means the director of the health related boards;
  14. “Dispense” means preparing, packaging, compounding or labeling for delivery and actual delivery of a prescription drug, nonprescription drug or device in the course of professional practice to a patient or the patient's agent, to include a licensed health care practitioner or a health care facility providing services or treatment to the patient or patients, by or pursuant to the lawful order of a prescriber;
  15. “Distribute” or “distribution” means the sale, purchase, trade, delivery, handling, storage, or receipt of a product or the arrangement of the sale, purchase, trade, delivery, handling, storage, or receipt of a product through third parties; provided, that “distribute” or “distribution” does not include dispensing or administering a product pursuant to a prescription, medical order, or an over-the-counter order. For the purposes of this part, transfers and sales of drugs or devices from one (1) licensed pharmacy to another shall not constitute distribution of drugs or devices;
  16. “Distributor” means a person engaged in the distribution of drugs or devices; provided, that “distributor” does not include licensed wholesale distributors or licensed third-party logistics providers;
  17. “Division” means the division of health related boards;
  18. “Doctor of pharmacy” means a person duly licensed by the board to engage in the practice of pharmacy. “Doctor of pharmacy” and “pharmacist” shall be used interchangeably within parts 4-6 of this chapter and, any other provision of Tennessee Code Annotated and in any rule or regulation promulgated by the state and its agencies;
  19. “Drug” means any of the following:
    1. Articles recognized as drugs or drug products in any official compendium or supplement thereto;
    2. Articles, other than food, intended to affect the structure or function of the body of humans or other animals;
    3. Articles, including radioactive substances, intended for use in the diagnosis, cure, mitigation, treatment or prevention of disease in humans or other animals; or
    4. Articles intended for use as a component of any articles specified in this subdivision (19);
  20. “Executive director” means the executive director of the Tennessee board of pharmacy;
  21. “Label” means any written, printed or graphic matter on the immediate container of a drug or device;
  22. “Labeling” means the process of affixing all labels and other written, printed or graphic matter:
    1. Upon any article or any of its containers or wrappers; or
    2. Accompanying such article;
  23. “Licensure” means the process by which an agency of government grants permission to an individual to engage in a given occupation upon finding that the applicant has attained the minimal degree of competency necessary to ensure that the public health, safety and welfare will be reasonably protected;
  24. “Manufacturer” means any person, except a pharmacist compounding in the normal course of professional practice, engaged in the commercial production, preparation, propagation, conversion or processing of a drug, either directly or indirectly, by extraction from substances of natural origin or independently by means of chemical synthesis, or both, and includes any packaging or repackaging of a drug or the labeling or relabeling of its container and the promotion and marketing of such drugs or devices;
  25. “Medical order” means a lawful order of a prescriber for a specific patient that may or may not include a prescription order, such orders subject to rules and regulations as may be promulgated from time to time by the respective boards that license the persons who are authorized to prescribe drugs;
  26. “Medication therapy management program” means the distinct pharmacist-provided service or group of services that optimize therapeutic outcomes for individual patients. Medication therapy management services are independent of but can occur in conjunction with the provision of a medication product;
  27. “Nonprescription device” means a device that may be sold or dispensed without a prescription order and that is labeled and packaged in compliance with applicable state or federal law;
  28. “Nonprescription drug” means a drug that may be sold or dispensed without a prescription and that is labeled and packaged in compliance with applicable state or federal law;
  29. “Outsourcing facility” means a facility engaged in the compounding of sterile drugs that has elected to register as an outsourcing facility with the U.S. food and drug administration and that complies with all relevant federal laws and regulations;
  30. “Patient education” means the communication of information to the patient or caregiver by the pharmacist;
  31. “Patient profile” means a written or electronic record of individual patient information, created in a pharmacy practice, for use by a pharmacist in the provision of pharmacy patient care services, including drug use review and patient counseling requirements. The profile may include, but is not limited to, demographic information, medical history, medication and devices utilized, testing results and pharmacist comments;
  32. “Peer review committee” or “pharmacist review committee” means any committee, board, commission or other entity of any national, state or local professional association or society, including an impaired pharmacist peer review committee, a drug utilization review committee or a committee of any pharmacy benefits management organization, health care provider network, licensed health care institution or any health care organization, system or foundation, the function of which, or one of the functions of which, is to review, evaluate and improve the quality of pharmacy-related services provided by pharmacists or pharmacy auxiliary personnel, to provide intervention, support or rehabilitative referrals or services or to determine that pharmacy-related services rendered by pharmacists or pharmacy auxiliary personnel were professionally indicated or were performed in compliance with applicable quality standards, or that the cost of pharmacy-related services rendered by pharmacists or pharmacy auxiliary personnel was reasonable;
  33. “Person” means any individual, partnership, association, corporation and the state, its departments, agencies and employees, and the political subdivisions of Tennessee and their departments, agencies and employees, except the department of health and local health departments;
  34. “Pharmacist” means an individual health care provider licensed by the state, pursuant to parts 4-6 of this chapter, to practice the profession of pharmacy;
  35. “Pharmacist-in-charge” means the supervisory pharmacist who has the authority and responsibility for compliance with laws and rules pertaining to the practice of pharmacy at the practice site of the pharmacist-in-charge;
  36. “Pharmacy” means a location licensed by this state where drugs are compounded or dispensed under the supervision of a pharmacist, as defined in the rules of the board and where prescription orders are received or processed;
  37. “Pharmacy intern” means an individual enrolled in or a graduate of a recognized school or college of pharmacy under rules established by the board who is serving a period of time of practical experience under the supervision of a pharmacist, as defined in the rules of the board;
  38. “Pharmacy technician” means an individual who is specifically trained and designated to assist pharmacists in the practice of pharmacy;
    1. “Practice of pharmacy” means a patient-oriented health service profession in which pharmacists interact and consult with patients and other health care professionals to enhance patients' wellness, prevent illness, and optimize outcomes. The practice involves:
      1. Interpretation, evaluation and implementation of medical orders and prescription orders;
      2. Responsibility for compounding and dispensing prescription orders, including radioactive substances;
      3. Participation in drug, dietary supplement and device selection, storage, distribution and administration;
      4. Drug evaluation, utilization or regimen review;
      5. Maintenance of patient profiles and other pharmacy records;
      6. Provision of patient education and counseling;
      7. Provision of patient care services and activities pursuant to a collaborative pharmacy practice agreement;
      8. Drug or drug-related research; and
      9. Those professional acts, professional decisions or professional services necessary to maintain all areas of a patient's pharmacist-provided care;
    2. Nothing in this chapter authorizes a pharmacist to order laboratory tests or prescribe any prescription drugs except pursuant to a medical order by the attending prescriber for each patient or pursuant to a collaborative pharmacy practice agreement jointly agreed upon by a pharmacist or pharmacists and a prescriber or prescribers; provided, that pharmacists are authorized to conduct and assist patients with tests approved for home use. Pharmacists may convey orders for laboratory tests when authorized by the attending prescriber and may prescribe prescription drugs when required to carry out a medical order or perform activities pursuant to a collaborative pharmacy practice agreement when authorized by the attending prescriber;
  39. “Prescriber” means an individual authorized by law to prescribe drugs;
  40. “Prescription drug” means a drug that under federal or state law is required to be dispensed only pursuant to a prescription order or is restricted to use by prescribers and that under federal law must be labeled with either the symbol “Rx only” or the statement “Caution: Federal law restricts this drug to use by, or on the order of, a licensed veterinarian”;
      1. “Prescription order” means and includes any order, communicated through written, verbal, or electronic means by a physician, certified physician assistant, pharmacist in accordance with a collaborative pharmacy practice agreement pursuant to this section, dentist, veterinarian, optometrist authorized pursuant to § 63-8-102(12), or other allied medical practitioner, for any drug, device, or treatment;
      2. “Prescription order” means and includes any order, communicated through written, verbal, or electronic means by a nurse authorized pursuant to § 63-6-204, who is prescribing in collaboration with and under the control and responsibility of a licensed physician, and who meets the requirements pursuant to § 63-7-207(14);
    1. Nothing in this chapter shall prohibit the verbal communication to a pharmacist of a direct order for a prescription from a physician, registered nurse, licensed practical nurse or physician assistant pursuant to § 63-6-204, or dentist, veterinarian, optometrist authorized pursuant to § 63-8-102(12), or other allied medical practitioner by a pharmacist pursuant to § 63-9-113 nor shall this chapter prohibit verbal communication of a direct order for a prescription from one (1) pharmacist to another when ordered pursuant to a collaborative pharmacy practice agreement;
    2. Nothing in this chapter shall require an advanced practice registered nurse specializing as a certified registered nurse anesthetist (CRNA) to obtain authorization to prescribe pursuant to § 63-7-123 in order to select, order, or administer appropriate drugs 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. Such an order by a CRNA for drugs shall only be valid for dispensing for administration at the facility where the anesthesia services are being provided;
  41. “Provider” or “necessary health care provider” includes a pharmacist who provides health care services within the scope of pharmacy practice;
  42. “Quality assurance program” means a system for identifying problems in patient care that are resolved via administrative, clinical or educational actions to ensure that final products and outcomes meet applicable specifications;
  43. “Quality-related event” means the inappropriate dispensing or administration of a prescribed medication, including, but not limited to:
    1. A variation from the prescriber's medical or prescription order, including, but not limited to:
      1. Dispensing an incorrect drug;
      2. Dispensing an incorrect drug strength;
      3. Dispensing an incorrect dosage form;
      4. Dispensing the drug to the wrong patient; and
      5. Providing inadequate or incorrect packaging, labeling or directions for use; and
    2. Failure to identify, prevent, resolve and manage potential and actual drug and drug-related problems, including, but not limited to:
      1. Over-utilization and under-utilization;
      2. Therapeutic duplication;
      3. Drug-age contraindications;
      4. Drug-allergy contraindications;
      5. Drug-disease contraindications;
      6. Drug-gender contraindications;
      7. Drug-drug interactions;
      8. Incorrect drug dosage;
      9. Incorrect duration of drug therapy; and
      10. Clinical abuse or misuse;
  44. “Third-party logistics provider” means a person who provides or coordinates warehousing or other logistics services of a drug or device on behalf of a manufacturer, wholesale distributor, or dispenser of the drug or device, but does not take ownership of the drug or device, nor has responsibility to direct the sale or disposition of the drug or device;
  45. “Unprofessional conduct” means the conduct of a pharmacist, pharmacy intern or pharmacy technician that is detrimental to patients or to the profession of pharmacy;
  46. “Wholesale distribution” means the distribution of a drug or device to persons other than the patient or consumer, or the receipt of a drug or device by persons other than the patient or consumer; provided, that “wholesale distribution” does not include the distribution or receipt of products, transactions, or services that are exempted from this definition by rule. For the purposes of this part, transfers and sales of drugs or devices from one licensed pharmacy to another shall not constitute wholesale distribution of drugs or devices; and
  47. “Wholesaler” or “wholesale distributor” means a person primarily engaged in the wholesale distribution of drugs or devices; provided, that “wholesaler” or “wholesale distributor” does not include licensed third-party logistics providers. For the purposes of this part, transfers and sales of drugs or devices from one licensed pharmacy to another shall not constitute wholesale distribution of drugs or devices.

Acts 1996, ch. 651, § 4; T.C.A. § 63-10-404; Acts 2006, ch. 768, § 1; 2007, ch. 407, §§ 2, 3; 2013, ch. 266, §§ 1, 2; 2014, ch. 832, §§ 1-3; 2015, ch. 293, §§ 3, 4; 2015, ch. 513, §  1; 2016, ch. 980, § 19; 2017, ch. 334, § 6; 2018, ch. 617, § 1.

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

Amendments. The 2017 amendment, in the definition of “prescription order”, deleted “nurse authorized pursuant to § 63-6-204, who is prescribing under the supervision, control and responsibility of a licensed physician, and who meets the requirements pursuant to § 63-7-207(14),” following “certified physician assistant,” in present (A)(i), and added (A)(ii).

The 2018 amendment substituted “the distinct pharmacist-provided service” for “the distinct service” in the definition of “medication therapy management program”.

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

Acts 2018, ch. 617, § 2. July 1, 2018.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

NOTES TO DECISIONS

1. “Practice of Pharmacy.”

A license to practice pharmacy does not empower pharmacists to inject drugs into a patient. Reeves-Sain Med., Inc. v. Bluecross Blueshield of Tenn., 40 S.W.3d 503, 2000 Tenn. App. LEXIS 663 (Tenn. Ct. App. 2000).

Because the statute defining the practice of pharmacy does not contain a prohibition on making a medical diagnosis, it does not render a pharmacist ipso facto incompetent to express any opinion on causation for purposes of satisfying the statute regarding expert testimony in a health care liability action when the pharmacist's expert opinion is otherwise admissible and relevant. Kidd v. Dickerson, — S.W.3d —, 2020 Tenn. App. LEXIS 443 (Tenn. Ct. App. Oct. 5, 2020).

2. Home Infusion Therapy.

Because a pharmacy license covers the pharmaceutical component of home infusion therapy, but by its terms does not cover the non-pharmaceutical component, T.C.A. § 56-7-2359(a)(1) does not prevent the health care insurer from imposing additional requirements on the non-pharmaceutical component of home infusion therapy. Reeves-Sain Med., Inc. v. Bluecross Blueshield of Tenn., 40 S.W.3d 503, 2000 Tenn. App. LEXIS 663 (Tenn. Ct. App. 2000).

63-10-205. Consultation on drugs by board to department of health.

  1. The board shall, at the request of the commissioner of health, provide consultation to the department of health regarding drugs to be issued by the department or by a local health clinic.
  2. The department of health shall develop policies and protocols for inventory controls, accountability, repackaging, security, storage and issuance of drugs by state and local health departments. The commissioner shall appoint a state or regional pharmacist to oversee these activities.
  3. The commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of this section.

Acts 1996, ch. 651, § 5; T.C.A. § 63-10-405; Acts 2014, ch. 585, § 1.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-206. Sale of nonprescription drugs and devices.

  1. Any nonprescription drug or device can be sold in its original single package by any retail business unless such nonprescription drug or device is required by federal or state law to be dispensed or sold only by or under the supervision of a pharmacist.
  2. Notwithstanding subsection (a) to the contrary, any insulin preparation shall be dispensed only by or under the supervision of a pharmacist. All insulin preparations must be properly stored in an area not accessible to the general public.
  3. In order to comply with federal and state law requiring pharmacies to maintain patient profiles with a comprehensive list of medications and devices, pharmacists are authorized to execute prescription orders for nonprescription drugs and devices.
  4. Nothing in this section shall be construed as exempting nonprescription drugs and devices dispensed on a prescription order executed by a pharmacist from application of the sales and use tax provisions of title 67, chapter 6.

Acts 1996, ch. 651, § 6; T.C.A. § 63-10-406.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-207. Dispensing of medication prior to authorization.

  1. Notwithstanding any provision of law to the contrary, a pharmacist may, in good faith, dispense to a patient without proper authorization the number of dosages of a prescription drug necessary to allow such patient to secure such authorization from such patient's prescriber, not to exceed a seventy-two-hour supply, if:
    1. The patient offers satisfactory evidence to the pharmacist that the prescriber has placed the patient on a maintenance medication and that such patient is without valid refills or for some valid reason cannot obtain proper authorization; and
    2. In the judgment of the pharmacist, the health, safety and welfare of the patient would otherwise be endangered.
  2. This section shall not be construed to authorize dispensing of controlled substance medication without proper authorization.
  3. If proper authorization cannot be obtained during the seventy-two-hour period, then the pharmacist may dispense the number of dosages necessary for one (1) additional consecutive seventy-two-hour period in accordance with the requirements of this section.
    1. For the purpose of this subsection (d) only, “patient” means a patient from this state, or another state or territory, who was displaced by a disaster, as defined in § 58-2-101, when the patient is present in this state.
    2. A pharmacist in this state may, in good faith, dispense to a patient without proper authorization or a valid prescription the number of dosages of a prescription drug necessary to allow the patient to secure proper authorization or a valid prescription from the patient's prescriber.
    3. The amount of a prescription drug dispensed under this subsection (d) shall not exceed a twenty-day supply.
    4. Prescription information may be obtained from a prescription label, verbal medical order, verbal prescription order, or any other means determined to be legitimate in the professional judgment of the pharmacist.

Acts 1996, ch. 651, § 7; T.C.A. § 63-10-407; Acts 2007, ch. 407, § 4; 2018, ch. 615, § 1.

Amendments. The 2018 amendment added (d).

Effective Dates. Acts 2018, ch. 615, § 2. July 1, 2018.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-208. Penalty for violation.

Any violation of parts 2-5 of this chapter, unless otherwise specified by law, shall be classified as a Class C misdemeanor.

Acts 1996, ch. 651, § 12; T.C.A. § 63-10-408; Acts 2007, ch. 407, § 2.

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

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-209. Distribution of drugs or drug samples by manufacturer's representative — Distribution of free samples.

  1. Nothing in this chapter shall prohibit the distribution of drugs or sample drugs by a manufacturer's representatives acting in the normal and customary performance of their duties.
  2. Manufacturers or their agents may distribute free samples of prescription drugs or controlled substances to practitioners authorized by law to prescribe or dispense such drugs or to pharmacies of health care entities at the written request of a practitioner in accordance with federal law.

Acts 1996, ch. 651, § 21; T.C.A. § 63-10-409; Acts 2007, ch. 407, § 5.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-210. Registration fees for out-of-state pharmacies mailing into Tennessee.

A pharmacy that dispenses and mails a prescription into Tennessee from another state shall first pay the licensure fee required of a Tennessee pharmacy in accordance with the fees established by the board under the authority of § 63-10-308. The license fees for out-of-state pharmacies and pharmacists shall not exceed those charged to Tennessee pharmacies and pharmacists.

Acts 1996, ch. 970, § 1; T.C.A. § 63-10-410; Acts 2007, ch. 407, § 6.

Law Reviews.

Seeing Through the Murky Vial: Does the FDA Have the Authority to Stop Compounding Pharmacies from Pirate Manufacturing?, 66 Vand. L. Rev. 1609 (2013).

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

Attorney General Opinions. Inspection fees for out-of-state pharmacies licensed in Tennessee.  OAG 14-05, 2014 Tenn. AG LEXIS 6  (1/9/14).

63-10-211. Consortia for bulk purchases authorized.

It is not a violation of any state law relative to restraint of trade, antitrust or any provision of the licensing laws for pharmacists, pharmacies, wholesalers, distributors or manufacturers under § 63-10-306 for pharmacists, independently or through any pharmacist or pharmacy, to form a consortium for the purpose of making bulk purchases of drugs or other medical equipment and supplies for the purpose of resale in their pharmacies.

Acts 1997, ch. 278, § 1; T.C.A. § 63-10-411.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-212. Confidentiality of information entrusted to pharmacist.

  1. Notwithstanding any requirement of state law to the contrary, a pharmacist is immune from liability to any person for disclosing patient information to a person authorized by this title to prescribe drugs or devices or to communicate a prescription order where necessary to:
    1. Fulfill the pharmacist's responsibility to carry out prospective drug use review under state law and 42 CFR Part 456 for the purpose of identifying and resolving actual or potential drug-related problems, including, for example, therapeutic duplication, drug-drug interactions, incorrect drug dosage, drug-disease contraindication, duration of drug treatment, or over-utilization or under-utilization and any other drug therapy problems outlined in 42 CFR § 456.705;
    2. Assist prescribers in obtaining a comprehensive drug history on a patient;
    3. Prevent abuse or misuse of any drug or device and the diversion of controlled substances; or
    4. Provide a medication therapy management program or a quality assurance program.
  2. Disclosure of information pursuant to this section shall not constitute a waiver of any confidentiality or privilege that may be provided by law.
  3. This section shall apply only to confidentiality or privilege and shall not apply to actions arising in negligence.

Acts 1999, ch. 371, § 1; T.C.A. § 63-10-412; Acts 2007, ch. 407, § 7.

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

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-213. Legibility of prescriptions.

  1. No pharmacist may dispense medication pursuant to a handwritten, typed or computer-generated prescription order for a drug issued by a prescriber in this state, unless the prescription order is comprehensible to the pharmacist. Nothing in this section shall be construed to prohibit a pharmacist from dispensing medication pursuant to a verbal prescription order.
  2. If a prescriber issues a prescription order, then it is the duty of the prescriber to issue a legible order. A pharmacist shall make a reasonable attempt to contact the prescriber to seek clarification of a prescription order that is not comprehensible to the pharmacist, in which case the pharmacist must not dispense medication until the pharmacist obtains clarification. A pharmacist shall not be liable to any person for any reasonable delay caused when a pharmacist has reasonably sought clarification of a prescription order.
  3. Nothing in this section shall be construed to prevent a pharmacist from dispensing medication prior to authorization in accordance with § 63-10-207.

Acts 2004, ch. 678, § 8; 2005, ch. 12, § 7.

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 non-prescription 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.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-214. Centralized prescription processing — Licensing — Rules.

  1. Each pharmacy participating in centralized prescription processing shall be licensed by the board of pharmacy.
  2. The board shall promulgate rules relative to centralized prescription processing, including, but not limited to, the usage of common electronic files or a common database.

Acts 2008, ch. 966, § 1.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

Attorney General Opinions. “High volume” or “central fill” pharmacies are allowed to do business in Tennessee, OAG 09-016 (2/25/09).

63-10-215. Transfer of prescriptions to another prescription form.

  1. Pharmacists, pharmacy interns and pharmacy technicians are authorized to comply with federal and state prescription requirements, including the requirement of a separate prescription for a Schedule II controlled substance found in §§ 63-1-160, 63-7-123(b)(3)(B), and 63-19-107(2)(E)(ii), by transferring from a prescription containing a Schedule Il controlled substance any drug that is a nonscheduled prescription drug or any prescribed supply to another prescription form.
  2. The transfer authorized in subsection (a) may be accomplished by scanning, photocopying or transcribing, by hand or other means, and shall include all information regarding each drug or supply being transferred.
  3. The prescription generated in a pharmacy by the transfer process shall not be required to be on tamper-resistant prescription paper.
  4. The prescription generated in a pharmacy utilizing the transfer process shall be recognized as a valid, legal prescription order and shall serve as the original prescription for recordkeeping and other purposes.

Acts 2011, ch. 201, § 1; 2018, ch. 883, § 11.

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 2018 amendment, effective January 1, 2019, substituted “§§ 63-1-160, 63-7-123(b)(3)(B), and 63-19-107(2)(E)(ii),” for “§§ 63-3-128, 63-5-122(g), 63-6-239, 63-8-129, 63-9-118, 63-7-123(b)(3)(B) and (F), and 63-19-107(2)(E)(ii) and (2)(G),” in (a).

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

63-10-216. Compounding pharmacies.

  1. Prior to initial licensure in this state as a compounding pharmacy, a pharmacy located outside of this state must have an inspection by the regulatory or licensing agency of the state in which the pharmacy practice site is physically located. Out-of-state pharmacy practice sites must provide a copy of the most recent inspection by the regulatory or licensing agency of the state in which the pharmacy practice site is physically located, which must have been within the previous twelve (12) months. Prior to renewal of its license in this state, an out-of-state pharmacy practice site must provide the most recent inspection by the regulatory or licensing agency of the state in which the pharmacy practice site is physically located or equivalent regulatory entity, and which must have been within the previous twelve (12) months. The board of pharmacy shall have the right to require additional information before issuing or renewing a pharmacy license to insure compliance with applicable laws of this state and any rules and policies of the board.
  2. Any compounding pharmacy having an active Tennessee license shall notify the board within fourteen (14) business days of receipt of any order or decision by a regulatory agency, other than the Tennessee board of pharmacy, imposing any disciplinary action, including any warning, on the pharmacy.
  3. Any pharmacies engaged in sterile compounding must comply with relevant United States Pharmacopeia (USP) guidelines as adopted by the board by rule or policy.
  4. Any pharmacies engaging in sterile compounding, except hospital pharmacies compounding for inpatients of a hospital, shall report on a quarterly basis to the board the quantity of sterile compounded products dispensed in a defined time period in accordance with policies adopted by the board; provided, however, that the executive director of the board may request this information from a hospital pharmacy for cause and the hospital pharmacy shall be required to respond in a timely manner as defined by the executive director of the board.

Acts 2013, ch. 266, § 3.

Law Reviews.

Seeing Through the Murky Vial: Does the FDA Have the Authority to Stop Compounding Pharmacies from Pirate Manufacturing?, 66 Vand. L. Rev. 1609 (2013).

Attorney General Opinions. Inspection fees for out-of-state pharmacies licensed in Tennessee.  OAG 14-05, 2014 Tenn. AG LEXIS 6  (1/9/14).

63-10-217. Collaborative pharmacy practice agreements.

  1. A collaborative pharmacy practice agreement under this chapter shall be between one (1) or more pharmacists licensed in this state and an individual prescriber licensed in this state, or one (1) or more prescribers licensed in this state in an organized medical group, including but not limited to, staff of a licensed health care facility, clinic, group medical practice, accountable care organization, or patient-centered medical home. When a collaborative practice pharmacy agreement is being established between a pharmacist or pharmacists and an organized medical group or one (1) or more members employed or contracted by an organized medical group, the chief medical officer, medical director, or a designated physician in that group shall be required to approve the collaborative pharmacy practice agreement in order to permit provision of patient care services, as defined in the collaborative pharmacy practice agreement.
  2. The collaborative pharmacy practice agreement shall define the nature and scope of patient care services to be provided by the pharmacist. The prescriber or prescribers entering into the agreement retain the ultimate authority regarding the scope of services provided by pharmacists in accordance with a collaborative pharmacy practice agreement. The patient care services authorized to be provided by one (1) or more pharmacists in accordance with a collaborative pharmacy practice agreement shall be within the scope of practice of the authorizing prescriber or prescribers. Any patient care services provided by a pharmacist or pharmacists pursuant to a collaborative pharmacy practice agreement shall be documented in a patient record accessible by the pharmacist and the prescriber or communicated to the prescriber or prescribers within three (3) business days in accordance with the collaborative pharmacy practice agreement.
  3. An individual prescriber licensed in this state or one (1) or more prescribers licensed in this state in an organized medical group, as described in the definition of collaborative pharmacy practice agreement in § 63-10-204, may employ pharmacists for the purpose of providing patient care services pursuant to a collaborative pharmacy practice agreement, as defined in § 63-10-204, for the benefit of a patient or patients of that prescriber or prescribers in that organized medical group. No retail pharmacy may employ a prescriber for the purpose of maintaining, establishing or entering into a collaborative practice agreement with a patient. Nothing shall prohibit a pharmacy or pharmacist or group of pharmacists from employing or entering into a professional contract with a physician or licensed medical practitioner for the purpose of conducting quality assurance reviews of its pharmacists that are engaged in the practice of collaborative drug therapy.
    1. If the collaborative practice agreement includes one (1) or more prescribers who are advanced practice registered nurses (APRNs), the collaborating physician who has primary responsibility for collaborating with the APRN, must also approve and sign the collaborative pharmacy practice agreement. The collaborating physician may only approve a collaborative pharmacy practice agreement of an APRN if the services authorized in the agreement are included in the routine services delivered by the collaborating physician in the physician's medical practice. An authorizing prescriber entering into collaborative pharmacy practice agreements shall be available for consultation with the pharmacist or pharmacists as needed.
    2. If the collaborative practice agreement includes one (1) or more prescribers who are physician assistants (PAs), the supervising physician who has primary responsibility for supervising the PA, must also approve and sign the collaborative pharmacy practice agreement. The supervising physician may only approve a collaborative pharmacy practice agreement of a PA if the services authorized in the agreement are included in the routine services delivered by the supervising physician in the physician's medical practice. An authorizing prescriber entering into collaborative pharmacy practice agreements shall be available for consultation with the pharmacist or pharmacists as needed.
  4. Pharmacists and authorizing prescribers entering into collaborative pharmacy practice agreements shall maintain a copy of the written collaborative pharmacy practice agreement on file at their places of practice.
  5. Collaborative pharmacy practice agreements shall be reviewed and renewed biennially, at a minimum.
  6. The board of pharmacy, in collaboration with the board of medical examiners and board of osteopathic examination, shall promulgate rules establishing appropriate minimum standards applicable for provisions to be contained in any collaborative practice agreement, including, but not limited to, provisions regarding drugs or drug categories such as controlled substances covered under the collaborative pharmacy practice agreement. All such rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2014, ch. 832, § 4; 2016, ch. 980, § 20; 2017, ch. 334, § 7.

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

Amendments. The 2017 amendment rewrote (d) which read: “If the collaborative practice agreement includes one (1) or more prescribers who are either advanced practice registered nurses (APRN) or physician assistants (PA), the supervising physician who has primary responsibility for supervising the APRN or PA, must also approve and sign the collaborative pharmacy practice agreement. The supervising physician may only approve a collaborative pharmacy practice agreement of an APRN or PA if the services authorized in the agreement are included in the routine services delivered by the supervising physician in the physician's medical practice. An authorizing prescriber entering into collaborative pharmacy practice agreements shall be available for consultation with the pharmacist or pharmacists as needed.”

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

63-10-218. Professional judgment in dispensing of varying quantities of medication not to exceed ninety-day supply — Exclusion of controlled substances.

  1. Unless the prescriber has specified on the prescription that dispensing a prescription for a maintenance medication in an initial amount followed by periodic refills is medically necessary, a pharmacist may exercise professional judgment to dispense varying quantities of medication per fill up to the total number of dosage units as authorized by the prescriber on the original prescription including any refills, so long as the units dispensed do not exceed a ninety-day supply.
  2. This section does not apply to controlled substances or to any medications for which a report to the controlled substance database is required pursuant to § 53-10-305.

Acts 2016, ch. 656, § 1.

63-10-219. Provision of hormonal contraceptives.

  1. As used in this section, “hormonal contraceptive” means a self-administered drug, or a transdermal patch applied to the skin of a patient, by the patient or by a practitioner, that releases a drug composed of a combination of hormones that are approved by the United States food and drug administration to prevent pregnancy.
  2. Pursuant to this section, a pharmacist, in good faith, is authorized to provide hormonal contraceptives according to a valid collaborative pharmacy practice agreement containing a nonpatient-specific prescriptive order and standardized procedures developed and executed by one (1) or more authorized prescribers.
  3. Pursuant to this section, a pharmacist may provide hormonal contraceptives to individuals who are:
    1. Eighteen (18) years of age or older; or
    2. Under eighteen (18) years of age, if the individual is an emancipated minor as defined in § 39-11-106.
  4. The board of pharmacy, in collaboration with the board of medical examiners and the board of osteopathic examination, shall adopt rules to establish standard procedures for the provision of hormonal contraceptives by pharmacists. The standardized procedures adopted pursuant to this section shall require a pharmacist to:
    1. Complete a training program approved by the department of health related to the provision of hormonal contraceptives;
    2. Provide the patient with a self-screening risk assessment tool developed or approved by the department of health;
    3. Provide the patient with documentation about the hormonal contraceptive that was provided to the patient and advise the patient to consult with a primary care practitioner or women's healthcare practitioner;
    4. Provide the patient with a standardized factsheet that includes, but is not limited to, the indications and contraindications for use of the drug, the appropriate method for using the drug, the importance of medical follow-up, and other appropriate information;
    5. Provide the patient with the contact information of a primary care practitioner or women's healthcare practitioner within a reasonable period of time after provision of the hormonal contraceptive; and
    6. Either dispense the hormonal contraceptive, or refer the patient to a pharmacy that may dispense the hormonal contraceptive, as soon as practicable after the pharmacist determines that the patient should receive the medication.
  5. The rules promulgated under this section shall prohibit a pharmacist from requiring a patient to schedule an appointment with the pharmacist for the provision or dispensing of a hormonal contraceptive.
    1. A pharmacist, pharmacist's employer, or pharmacist's agent may charge an annual administrative fee for services provided pursuant to this section in addition to any costs associated with the dispensing of the drug and paid by the pharmacy benefit.
    2. Upon an oral, telephonic, electronic, or written request from a patient or customer, a pharmacist or pharmacist's employee shall disclose the total cost that a consumer would pay for pharmacist-provided hormonal contraceptives. As used in this subdivision (f)(2), “total cost” includes providing the consumer with specific information regarding the price of the hormonal contraceptive and the price of the administrative fee charged. This limitation is not intended to interfere with other contractually agreed-upon terms between a pharmacist, a pharmacist's employer, or a pharmacist's agent, and a health insurance plan or insurer. Patients who are insured or covered and receive a pharmacy benefit that covers the cost of hormonal contraceptives shall not be required to pay an administrative fee. These patients shall be required to pay co-payments pursuant to the terms and conditions of their coverage.
  6. All state and federal laws governing insurance coverage of contraceptive drugs, devices, products, and services shall apply to hormonal contraceptives provided by a pharmacist under this section.
  7. The board of pharmacy, board of medical examiners, and board of osteopathic examination are authorized to ensure compliance with this section, and each board is specifically charged with the enforcement of this section with respect to its respective licensees.
  8. Any pharmacist or prescriber acting in good faith and with reasonable care involved in the provision of hormonal contraceptives pursuant to this section shall be immune from disciplinary or adverse administrative actions under this title for acts or omissions during the provision of a hormonal contraceptive.
  9. Any pharmacist or prescriber involved in the provision of hormonal contraceptives pursuant to this section shall be immune from civil liability in the absence of gross negligence or willful misconduct for actions authorized by this section.
  10. This section shall not apply to a valid patient-specific prescription for a hormonal contraceptive issued by an authorized prescriber and dispensed by a pharmacist pursuant to that valid prescription.

Acts 2016, ch. 942, § 1.

Compiler’s Notes. For preamble to act relative to the establishment of a method through which pharmacists may provide contraceptive therapies to patients, see Acts 2016, ch. 942.

63-10-220. Facilities engaging in distribution of dialysate and devices for home use.

  1. This chapter does not apply to a facility to the extent the facility engages in the distribution of dialysate or devices necessary to perform home peritoneal kidney dialysis to patients with end stage renal disease if:
    1. The dialysate are comprised of dextrose or icodextrin, and the dialysate and devices are approved or cleared by the federal food and drug administration, as required by federal law;
    2. The dialysate and devices are lawfully held by a manufacturer or manufacturer's agent that is properly registered with the board as a manufacturer or third-party logistics provider;
    3. The dialysate and devices are held and delivered in their original, sealed packaging from the facility;
    4. The dialysate and devices are delivered only by the manufacturer or the manufacturer's agent and only upon receipt and review of a physician's prescription by a pharmacist licensed in this state before dispensing; and
    5. The manufacturer or manufacturer's agent delivers the dialysate and devices directly to:
      1. Patients with end stage renal disease or such patient's designee for the patient's self-administration of the dialysis therapy; or
      2. Healthcare providers or institutions for administration or delivery of the dialysis therapy to a patient with end stage renal disease.
  2. Records of all sales and distribution of dialysate and devices made pursuant to this section must be retained and made readily available for inspection and copying by the board of pharmacy for two (2) years from the date of distribution.
  3. The board of pharmacy retains oversight of all drugs for peritoneal dialysis except dialysate.

Acts 2017, ch. 89, § 1.

Effective Dates. Acts 2017, ch. 89, § 2. July 1, 2017.

63-10-221. Medication therapy management — Standards.

Medication therapy management provided under this chapter as part of the practice of pharmacy shall meet the standards for medication therapy management established by rule by the board of pharmacy.

Acts 2017, ch. 363, § 2.

Effective Dates. Acts 2017, ch. 363, § 4. July 1, 2017.

63-10-222. Medication therapy management pilot program — Reporting of costs and patient outcomes.

The bureau of TennCare is directed to report to the senate health and welfare committee and the committee of the house of representatives having oversight over TennCare regarding program costs and patient outcomes related to incorporating the pharmacist-provided medication therapy management pilot program on or before April 15 of each year the pilot program is supported.

Acts 2017, ch. 363, § 3; 2019, ch. 345, § 129.

Amendments. The 2019 amendment substituted “committee of the house of representatives having oversight over TennCare” for “health committee of the house of representatives”.

Effective Dates. Acts 2017, ch. 363, § 4. July 1, 2017.

Acts 2019, ch. 345, § 148. May 10, 2019.

Cross-References. Reporting requirement satisfied by notice to general assembly members of publication of report, § 3-1-114.

Medication therapy management pilot program, § 71-5-155.

63-10-223. Agreement limiting ability of pharmacist to discuss issue related to dispensing of controlled substance with patient void and unenforceable.

  1. The general assembly finds that patient access to information about controlled substances is crucial to combating the deadly opioid epidemic in this state and that any obstacle to patients' receiving information about controlled substances is a serious threat to public health.
  2. Any agreement purporting to limit the ability of a pharmacist to discuss any issue related to the dispensing of a controlled substance with a patient is contrary to the public policy of this state and is void and unenforceable. This includes, but is not limited to, information about the risks, effects, and characteristics of the controlled substance; what to expect when taking the controlled substance and how the controlled substance should be used; reasonable alternatives to the prescribed controlled substance; and any applicable cost sharing for a controlled substance or any amount an individual would pay for a controlled substance if that individual were paying cash.

Acts 2018, ch. 1039, § 7.

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

Part 3
Board of Pharmacy

63-10-301. Creation — Composition — Duties and powers — List of opioid drugs incorporating tamper or abuse resistant properties.

  1. There shall exist and be maintained within this state a board of pharmacy. The board shall consist of seven (7) members, one (1) of whom shall be a consumer, who shall enforce parts 2-5 of this chapter and all laws that pertain to the practice of pharmacy and shall cooperate with other state and federal governmental agencies regarding any violations of any pharmacy drug or drug-related laws. The board has all of the duties, powers, responsibilities and authority specifically granted or necessary to the enforcement of parts 2-5 of this chapter, as well as other duties, powers, responsibilities and authority that may be granted by law.
  2. 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 and other administrative functions of the board, as well as the necessary expenses for traveling and subsistence while attending the meetings and performing the other administrative functions. 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.
  3. The board of pharmacy shall publish a list of opioid drugs incorporating tamper or abuse resistance properties. Inclusion of a drug on such list shall not require that a drug bear a labeling claim with respect to reduction of tampering, abuse or abuse potential at the time of listing. The inclusion of a drug on the list shall not prohibit a pharmacist from substituting an opioid drug, brand or generic, that is otherwise eligible for interchange or substitution under title 53, chapter 10, part 2. The inclusion of a drug on the list shall require that the drug has been submitted to the United States food and drug administration with a study related to tamper or abuse resistance properties. Following the publication of the initial list by the board of pharmacy, if the United States food and drug administration approves an opioid drug that bears in its label a claim to the drug's tamper or abuse resistance properties, such drug shall be added to the board of pharmacy list. This list shall be made available to prescribers, pharmacists, the commissioner of health, the commissioner of mental health and substances abuse services and the commissioner of safety.

Acts 1996, ch. 651, § 8; T.C.A. § 63-10-501; Acts 2007, ch. 407, §§ 2, 8; 2012, ch. 575, § 2; 2012, ch. 932, § 1.

Compiler's Notes. The regulatory board created by this section is attached to the division of regulatory boards in the department of commerce and insurance for purposes of administration. See §§ 4-3-1304, 56-1-30156-1-306.

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

Acts 2016, ch. 773, § 3, provided that representatives of the board of pharmacy shall appear before the government operations joint evaluation committee on education, health and general welfare no later than November 18, 2016, to update the joint evaluation committee on the board's progress in addressing the findings set forth in the October 2015 performance audit report issued by the division of state audit.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-302. Appointment — Qualifications — Term of appointment — Removal.

  1. The governor shall appoint the members of the board and shall make appointments so that the pharmacist members of the board shall be graduates of a recognized school or college of pharmacy. In making appointments to the board, 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 one (1) person serving on the board is a member of a racial minority.
  2. No pharmacist shall be eligible for appointment to the board unless such person has been a pharmacist under this or some other law of this state for a period of at least five (5) years and, during the terms of such person's incumbency, shall be actively engaged in the practice of pharmacy.
  3. No consumer shall be eligible for appointment to the board to represent the public at large unless such person has been a resident of Tennessee for at least five (5) years, currently resides in Tennessee and is a nonhealth care professional by education. The consumer member shall not own or have any financial or other interest in any health care facility or business.
  4. The terms of appointment shall be for six (6) years, or until their successors have qualified, and no member of the board is eligible for reappointment.
  5. Interested pharmacist groups, including, but not limited to, the Tennessee Pharmacists Association, may annually recommend five (5) duly qualified persons for each vacancy from whom the governor may be requested to make appointments. The governor shall consult with such groups to determine qualified persons to fill the positions. The appointment provisions of this subsection (e) shall not apply to the consumer member serving on the board. Appointees shall, within ten (10) days after appointment, make oath or affirmation to be filed with the secretary of state that they will faithfully and impartially perform their duties.
  6. Members guilty of misconduct may be removed by the governor upon the recommendation of the remaining members. Vacancies occurring other than by expiration of terms may be filled as to unexpired terms by the governor from the most recent list of nominees of the interested pharmacist groups as provided in subsection (e).

Acts 1996, ch. 651, § 9; T.C.A. § 63-10-502; Acts 2012, ch. 720, § 3.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-303. Officers — Quorum — Panels — Executive director.

  1. The board shall have a president and a vice president, who shall be elected annually from its pharmacist members.
  2. A majority of the members of the board shall constitute a quorum. The board president may, when it is deemed necessary, split the board into panels of three (3) or more each to conduct contested case hearings or disciplinary matters. When the board is split into panels for purposes of contested case hearings and disciplinary matters, three (3) or more members shall constitute a quorum.
  3. The division shall employ on behalf of and in consideration of the recommendation of the board an executive director who shall be a pharmacist who has been licensed in Tennessee for a period of at least five (5) years. The executive director's duties shall be those specified by the board and by the director and may include, but not be limited to, recording and compiling the minutes of the board, supervising the employees assigned by the division to support the board, performing such studies and research as the board or division directs, representing the board at such functions as authorized by the board and the division and acting as consultant to the division in its enforcement duties on behalf of the board.

Acts 1996, ch. 651, § 10; T.C.A. § 63-10-503; Acts 2007, ch. 407, § 9.

Cross-References.

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

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

63-10-304. Enforcement of pharmaceutical laws — Rules and regulations.

  1. It is the duty of the board to enforce all the laws of the state now or hereafter enacted that pertain to the practice of pharmacy, the manufacture, distribution or sale of drugs, and the medication use process, including, but not limited to compounding, selection, preparation/production, dispensing/distribution, patient administration, education and monitoring of drugs, devices, chemicals or poisons. The division shall employ for the board the necessary administrative and clerical staff and investigators who are pharmacists to carry out the board's duty to enforce the pharmaceutical laws. The pharmacist investigators shall be authorized to conduct inspections of pharmacies and any other site where drugs, medicines, chemicals, pharmaceuticals or poisons are manufactured, stored, sold, dispensed, distributed or administered and shall conduct investigations of any licensee of the board. The pharmacist investigators may also assist in inspections and investigations undertaken by other health related boards attached to the division, and investigators assigned to these other health related boards may assist pharmacist investigators as appropriate.
    1. The board shall adopt, amend and repeal rules for the proper administration and enforcement of parts 2-5 of this chapter, consistent with such provisions. The rules shall be adopted, amended or repealed in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
    2. The board shall adopt rules establishing minimum standards and conditions for operation of a pharmacy.
    3. If the board determines it necessary in order to protect the health and welfare of the citizens of this state, it may adopt rules concerning the practice of pharmacy in this state also applicable to the practice of pharmacy located in another state.
  2. The board also has the power and authority to adopt, amend and repeal rules of professional conduct appropriate to the establishment and maintenance of a high standard of integrity and dignity in the profession of pharmacy.
  3. The board shall meet at least annually and at such other times as it deems necessary to perform its duties under this chapter.
  4. The board shall keep a record of all its proceedings. The board shall issue and maintain a register of all persons to whom licenses have been issued and all renewals and a register of pharmacists having been designated as a pharmacist-in-charge. The board may maintain a register of pharmacy technicians as necessary to maintain public welfare.
    1. The board is authorized to conduct hearings and issue orders concerning alleged violations of parts 2-5 of this chapter or rules promulgated pursuant to parts 2-5 of this chapter and shall retain jurisdiction over all of its orders to allow, when good cause is established, modification of those orders and the reinstatement or reactivation of any license or certificate that the board revoked or suspended pursuant to those orders.
    2. The board is authorized to petition any circuit or chancery court having jurisdiction of any person who is practicing pharmacy in Tennessee without a valid license or who has violated any of the provisions of parts 2-5 of this chapter or the rules of the board to enjoin that person from continuing to practice within this state.
    3. The director is granted authority to issue subpoenas for witnesses and records and to administer oaths to witnesses.
    1. The board may join professional organizations and associations organized to promote the improvement of the standards of the practice of pharmacy for the protection of the health and welfare of the public.
    2. The board may authorize, subject to the approval of the commissioner, administrative and investigative personnel and board members to attend local, state, regional and national meetings and to perform other necessary functions. These personnel shall be reimbursed for all travel and other necessary expenses, which shall be claimed and paid in accordance with the prevailing travel regulations of state government.
  5. The board has the other duties, powers and authority necessary to enforce parts 2-5 of this chapter.
  6. The board shall adopt rules establishing minimum standards and conditions for receiving, preparing, maintaining, transferring and dispensing of prescription orders.
    1. The board of pharmacy shall regularly notify each holder of a pharmacy or a pharmacist license of changes that are to be implemented or enforced by the board that affect the licensee. These changes shall include newly promulgated or amended statutes, rules, policies or guidelines.
    2. The board of pharmacy shall establish and maintain a link or links on the board of pharmacy website to the statutes, rules, policies and guidelines that are implemented or enforced by the board and affect the licensee.
    3. The board of pharmacy shall mandate that the licensee maintain at the site of the licensee's practice a copy of the board of pharmacy statutes, rules, policies and guidelines.

Acts 1996, ch. 651, § 11; T.C.A. 63-10-504; Acts 2007, ch. 407, §§ 2, 10-14; 2008, ch. 1072, § 1; 2009, ch. 29, § 1.

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

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-305. Power of board to suspend, revoke, or refuse to issue licenses — Civil penalties.

The board is authorized to deny, restrict or condition any application for licensure or certification and is authorized to revoke or suspend any license or certification previously issued or otherwise discipline and assess civil penalties against a applicant, licensee or holder of a certificate upon a finding that the applicant, licensee or holder of a certificate has:

  1. Been convicted of a crime;
  2. Been convicted of violating any of the laws of this state or of the United States relating to drugs or to the practice of pharmacy;
  3. Been addicted to the use of alcohol, narcotics or other drugs;
  4. Engaged in conduct prohibited or made unlawful by any of the provisions of parts 2-5 of this chapter or any other laws of the state or of the United States relating to drugs or to the practice of pharmacy;
  5. Exhibited an incapacity of a nature that prevents a pharmacist from engaging in the practice of pharmacy with reasonable skill, confidence and safety to the public;
  6. Been guilty of dishonorable, immoral, unethical or unprofessional conduct;
  7. Had the license to practice pharmacy suspended or revoked by another state for disciplinary reasons; or
  8. Failed to comply with a lawful order or duly promulgated rule of the board.

Acts 1996, ch. 651, § 13; T.C.A. § 63-10-505; Acts 2007, ch. 407, §§ 2, 15, 16.

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

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

NOTES TO DECISIONS

Decisions Under Prior Law

1. Person Under Sixteen.

It was negligence per se for a pharmacist to sell to a 15-year-old girl a quantity of bichloride of mercury and a bottle of tincture of iodine, which the purchaser took with suicidal intent, from which she suffered permanent physical injury. Eckerd's, Inc. v. McGhee, 19 Tenn. App. 277, 86 S.W.2d 570, 1935 Tenn. App. LEXIS 38 (Tenn. Ct. App. 1935).

2. Suicidal Intent.

In an action to recover damages for physical injuries sustained by a 15-year-old girl by swallowing bichloride of mercury tablets and the contents of a bottle of tincture of iodine, sold to her by defendant, the inferences to be drawn therefrom held to warrant a ruling that plaintiff purchased the poison with suicidal intent, with knowledge of the consequences of taking the poison. Eckerd's, Inc. v. McGhee, 19 Tenn. App. 277, 86 S.W.2d 570, 1935 Tenn. App. LEXIS 38 (Tenn. Ct. App. 1935).

3. Civil Nature of Hearings.

Testimony given by a witness under a grant of immunity could be used against him in a subsequent hearing under former § 63-10-209, since proceedings under that section were civil rather than criminal in nature. Burley v. United States Drug Enforcement Administration, 443 F. Supp. 619, 1977 U.S. Dist. LEXIS 12486 (M.D. Tenn. 1977).

63-10-306. License requirements.

  1. Except as otherwise provided in parts 2-5 of this chapter, it is unlawful for any individual to engage in the practice of pharmacy unless currently licensed or otherwise authorized under parts 2-5 of this chapter to practice under any facet of the provisions of parts 2-5 of this chapter.
  2. The board is authorized to establish the experience and education qualifications necessary for admission to the board's licensure or certification examination or examinations.
  3. The board may utilize any national certification or licensure examination or contract any qualified examination agency to prepare and administer its licensure examination or examinations, and the board shall establish by rule the minimum score necessary to pass any licensure or certification examination or examinations required by the board.
  4. An applicant for licensure as a pharmacist shall be at least twenty-one (21) years of age, be a graduate of a school or college of pharmacy recognized by the board, and submit an application for licensure on a form or forms approved by the board in writing or via online application and pursuant to board rules and regulations.
  5. When satisfied that the qualifications of pharmacists licensed in other states are equivalent to or greater than requirements for licensure in this state, the board may grant licenses to reciprocal applicants from other states. The board may refuse to issue licenses to reciprocal applicants from other states on such grounds as the board may establish in its regulations.
  6. The board has the authority to license and register pharmacists, pharmacies, wholesalers, distributors, pharmacy technicians, manufacturers, third-party logistics providers, and such other persons as the board may be required to license under federal or state law upon requirements established by the board's rules. This subsection (f) shall not be construed to include manufacturers' representatives, unless otherwise required by federal or state law.
  7. The board shall have the authority to establish the criteria, timing and procedure for renewal of licenses and certifications.
  8. The board is authorized to establish any and all necessary requirements for continuing education for those the board licenses or to whom the board issues certificates. This authority includes, but is not limited to, the establishment of the number of hours required, approval of providers and course content, enforcement and qualification for waiver of the requirements or extension of time in which to obtain the continuing education.
  9. The board shall define by rule the scope of practice of a pharmacy technician and the qualifications necessary to practice as a pharmacy technician. The board may designate by rule which national or other qualified pharmacy technician certification agencies will be recognized in this state for purposes of holding the status of a certified pharmacy technician.
  10. Any person licensed by the board of pharmacy under this section and holding a valid wholesaler license is considered to be licensed as a drug distributor until such a time when the board can promulgate rules to implement the third-party logistic provider (3PL) licensing process.

Acts 1996, ch. 651, § 14; T.C.A. § 63-10-506; Acts 2007, ch. 407, §§ 2, 17, 18; 2014, ch. 949, § 9; 2015, ch. 293, § 5; 2017, ch. 268, § 1.

Amendments. The 2017 amendment added (j).

Effective Dates. Acts 2017, ch. 268, § 2. May 4, 2017.

Cross-References. Licensing, §§  63-1-10363-1-112.

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-307. Inspection of sites — Physicians regulated by board of medical examiners.

  1. The board or its designated agents have the power and authority to regulate the practice of pharmacy and to inspect any site or professional pharmacy practice, other than storage sites utilized by manufacturer's representatives, where drugs, medicines, chemicals, pharmaceuticals or poisons are manufactured, stored, sold, dispensed, distributed or administered.
  2. Authority over drug dispensing in the office of a physician licensed to practice under chapter 6 of this title shall be vested in the board of medical examiners.

Acts 1996, ch. 651, § 15; T.C.A. § 63-10-507; Acts 2007, ch. 407, § 19.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-308. Administrative fees.

  1. The board is authorized to establish fees necessary to carry out parts 2-5 of this chapter pursuant to duly promulgated rules.
  2. All monies received by the board shall be deposited and dispensed pursuant to § 63-1-137.

Acts 1996, ch. 651, § 16; T.C.A. § 63-10-508; Acts 2007, ch. 407, § 20.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-309. Administrative procedure.

The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, shall govern all matters and procedures respecting the hearing and judicial review of any contested case as defined therein, arising under parts 2-5 of this chapter.

Acts 1996, ch. 651, § 17; T.C.A. § 63-10-509; Acts 2007, ch. 407, § 2.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-310. Transfer of board of pharmacy to department of health.

For the purposes of transferring the board of pharmacy from the department of commerce and insurance to the department of health, the existing members of the board of pharmacy shall continue to serve as members of the Tennessee board of pharmacy until their terms expire. All rules and regulations of the state board of pharmacy shall remain in force and effect until modified, superseded or repealed by the board of pharmacy. All orders, decisions, licenses and certifications previously issued by the board of pharmacy or the department of commerce and insurance relating to or on behalf of the board of pharmacy shall remain in full force and effect and shall hereafter be administered and enforced by the department of health. To this end, the division of health related boards shall have the authority, consistent with the statutes and regulations pertaining to the programs and functions transferred in this section, to modify orders, decisions, licenses and certifications previously issued and to adopt and issue new orders as may be necessary for the administration of the programs or functions transferred in this section.

Acts 1996, ch. 651, § 18; T.C.A. § 63-10-510; Acts 2007, ch. 407, § 21.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-311. Promulgation of rules regarding oversight of facilities that manufacture, warehouse, and distribute medical devices.

The board shall promulgate rules regarding the board's oversight of facilities that manufacture, warehouse, and distribute medical devices. The rulemaking process shall begin no later than September 1, 2018. The rulemaking process shall be in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and shall include the formation of an advisory committee, in accordance with § 4-5-205, composed of medical device industry representatives and a representative of the department of economic and community development. The rules promulgated pursuant to this section shall be reviewed every three (3) years for the purpose of reviewing the advancements of new medical device technologies.

Acts 2018, ch. 1029, § 1.

Effective Dates. Acts 2018, ch. 1029, § 2. July 1, 2018.

Part 4
Peer Review

63-10-401. Statement of policy.

It is the policy of the state to encourage committees made up of Tennessee's licensed pharmacists to candidly, conscientiously and objectively evaluate their peers' professional conduct, competence and ability to practice pharmacy and their personal conduct as it relates to the performance of their professional duties. It is further the policy of the state to encourage pharmacists to implement continuous quality improvement programs and quality assurance programs to identify and evaluate quality-related events, reduce medication-related errors, generate data useful to studying the causes of medication errors and improve patient care. The state further recognizes that confidentiality is essential to effective functioning of peer review committees, continuous quality improvement programs and quality assurance programs and to continued improvement in patient safety and patient care.

Acts 1996, ch. 651, § 22; T.C.A. § 63-10-601; Acts 2006, ch. 768, § 2.

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

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-402. Immunity for furnishing information to peer review committees.

All national, state or local public or private organizations, institutions, foundations, systems, provider networks or professional associations or societies, pharmacists, auxiliary pharmacy personnel, pharmacy committee staff personnel, any person under a contract or other formal agreement with a peer review committee and any person who participates with or assists a peer review committee, members of boards of directors or trustees of any public or private hospital, managed care organization or other health care provider or any individual appointed to any peer review committee is immune from liability to any patient, individual or organization for furnishing information, data, reports or records to any such committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by such committees, if made or taken in good faith without malice and on the basis of facts reasonably known or reasonably believed to exist.

Acts 1996, ch. 651, § 22; T.C.A. § 63-10-602.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-403. Immunity for reports regarding competence or professional conduct of pharmacist or personnel.

Notwithstanding § 63-10-402, any person providing information, whether as a witness or otherwise, to a peer review committee regarding the competence or professional conduct of a pharmacist or pharmacy auxiliary personnel is immune from liability to any person, unless such information is false and the person providing it had actual knowledge of its falsity.

Acts 1996, ch. 651, § 22; T.C.A. § 63-10-603.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-404. Presumption of good faith.

A member of a peer review committee or any other person reporting information to a peer review committee 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.

Acts 1996, ch. 651, § 22; T.C.A. § 63-10-604.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-405. Information provided to committees privileged.

  1. All information, interviews, reports, statements, memoranda or other data furnished to any peer review committee, association board, organization board or other entity and any findings, conclusions or recommendations resulting from the proceedings of such committee, board or entity are privileged. The records and proceedings of any peer review committee, board or entity are confidential and shall be used by such committee, board or entity, and the members thereof, only in the exercise of the proper functions of the committee, board or entity and shall not be public records nor be available for court subpoena or for discovery proceedings. One (1) proper function of a peer review committee includes advocacy for pharmacists and pharmacy auxiliary personnel before other peer review committees, health care organizations, insurance companies, national, state or local accreditation organizations, federal and state agencies and the board of pharmacy of this state or any other state. The disclosure of confidential, privileged peer review committee information during advocacy, or as a report to the board of pharmacy, or to the affected pharmacist or pharmacy auxiliary personnel under review does not constitute either a waiver of confidentiality or privilege. Nothing contained in this subsection (a) applies to records, documents or information otherwise available from original sources and such records, documents or information are not to be construed as immune from discovery or use in any civil proceedings solely due to presentation to the committee.
  2. All information, interviews, reports, statements, memoranda or other documents and materials created in the course of operation of a pharmacy continuous quality improvement program or quality assurance program shall be privileged and confidential and shall not be subject to discovery or subpoena or other means of legal process or introduction into evidence in any civil action, arbitration, administrative proceeding or state board of pharmacy proceeding. The pharmacy shall hold the privilege to all information, interviews, reports, statements, memoranda or other documents and materials created in the course of the pharmacy's continuous quality improvement program or quality assurance program. The privilege may be waived by the pharmacy. Nothing in this subsection (b) shall affect the discoverability of any records not solely generated for or maintained as a component of a pharmacy's ongoing continuous quality improvement program and quality assurance program.
  3. Nothing in subsection (b) shall be construed to prohibit a pharmacy from compiling, disclosing, reporting or otherwise using information or data that may be generated from the privileged and confidential documents and materials described in subsection (b), where the compiling, disclosing, reporting or otherwise using of the information or data is for the purpose of conducting research, providing education, reporting to federal or state patient safety or quality improvement databases, developing best practice guidelines or for similar other purposes, if personal information is redacted prior to disclosure.

Acts 1996, ch. 651, § 22; T.C.A. § 63-10-605; Acts 2006, ch. 768, § 3.

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

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-406. Part not applicable to review of physician's conduct.

In no event, however, shall the protections provided in this part apply to any type of review by a peer review committee or pharmacist review committee, as defined in this chapter, related to any acts, conduct or professional services rendered by physicians under chapter 6 or 9 of this title. A peer review committee or pharmacist review committee may convey information to licensed physicians or physician licensing boards.

Acts 1996, ch. 651, § 22; T.C.A. § 63-10-606.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

Part 5
Prescription Drug Donation Repository Program

63-10-501. Part definitions.

As used in this part:

  1. “Anti-rejection drug” means a prescription drug that suppresses the immune system to prevent or reverse rejection of a transplanted organ;
  2. “Board” means the board of pharmacy;
  3. “Cancer drug” means a prescription drug that is used to treat any of the following:
    1. Cancer or the side effects of cancer; or
    2. The side effects of any prescription drug that is used to treat cancer or the side effects of cancer;
  4. “Controlled substance” means the same as defined in § 39-17-402;
  5. “Department” means the department of health;
  6. “Donor” means a person, a pharmacy, or medical facility as well as any drug manufacturer or wholesaler licensed by the board of pharmacy, who donates prescription drugs to a repository program approved pursuant to this part;
  7. “Eligible individual” means an indigent person or an uninsured person who meets all other criteria established by board rule;
  8. “Indigent” means a person with an income that is below two hundred percent (200%) of the federal poverty level as defined by the most recently revised poverty income guidelines published by the United States department of health and human services;
  9. “Medical facility” means any of the following:
    1. A physician's office;
    2. A hospital;
    3. A health clinic;
    4. A nonprofit health clinic, which includes a federally qualified health center as defined in 42 U.S.C. § 1396d(l)(2)(B); a rural health clinic, as defined in 42 U.S.C. § 1396d(l)(1); and a nonprofit health clinic that provides medical care to patients who are indigent, uninsured, or underinsured;
    5. A free clinic as defined in § 63-6-703;
    6. A charitable organization as defined in § 48-101-501; or
    7. A nursing home as defined in § 68-11-201;
  10. “Pharmacy” means a pharmacy as defined in § 63-10-204;
  11. “Prescription drug” means the same as defined in § 63-10-204, except the drug is only tablet or capsule form, and includes cancer drugs and anti-rejection drugs, but does not include controlled substances and drugs covered by the risk evaluation and mitigation strategy program of the federal food and drug administration; and
  12. “Supplies” means the supplies necessary to administer the prescription drugs donated.

Acts 2017, ch. 392, § 1.

Compiler's Notes. Former part 5, §§ 63-10-50163-10-508, concerning the Nina Norman Prescription Drug Donation Act of 2006 is repealed by Acts 2017, ch. 392, § 1, effective January 1, 2018.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Cross-References. Tennessee Affordable Drug Act of 2005, § 53-10-201 et seq.

Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-502. Prescription drug donation repository program.

    1. The department of health, in cooperation with the board of pharmacy, may promulgate rules to establish and enforce a prescription drug donation repository program under which a person or organization may donate prescription drugs and supplies for use by an organization that has received a determination of exemption from the United States internal revenue service pursuant to 26 U.S.C. § 501(c)(3), and that meets eligibility criteria specified by rule for administering the program.
    2. Enforcement authority for rules promulgated pursuant to this part shall vest in the board of pharmacy.
    3. Organizations who administer a drug donation repository program shall report the following data to the department every year:
      1. Number of donors during the reporting year;
      2. Number of donations during the reporting year;
      3. List of prescription drugs and supplies donated during the reporting year;
      4. Number of people who received donations of prescription drugs or supplies during the reporting year;
      5. Total number of prescription drugs and supplies dispensed during the reporting year; and
      6. Total cost to eligible individuals who received donations during the reporting year.
    4. Rules promulgated pursuant to this part shall specify the format and method of transmission for data reported pursuant to subdivision (a)(3).
  1. Donations of prescription drugs and supplies under the program may be made directly to the repository program as required by the department or on the premises of a medical facility or pharmacy that elects to participate in the program and meets the requirements established by the department. Donations of prescription drugs and supplies may be made by mail.
  2. A medical facility or pharmacy may charge an individual who receives a prescription drug or supplies a handling fee that does not exceed an amount established by rule.
  3. A medical facility or pharmacy that receives prescription drugs or supplies may distribute the prescription drugs or supplies to another eligible medical facility or pharmacy for use pursuant to the program.
  4. Participation in the program is voluntary.

Acts 2017, ch. 392, § 1.

Compiler's Notes. Former part 5, §§ 63-10-50163-10-508, concerning the Nina Norman Prescription Drug Donation Act of 2006 is repealed by Acts 2017, ch. 392, § 1, effective January 1, 2018.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-503. Acceptance and dispensing of donated prescription drugs and supplies.

  1. A prescription drug or supplies may be accepted and dispensed under the prescription drug donation repository program if all of the following conditions are met:
    1. The prescription drug is in its original sealed and tamper-evident packaging. However, a prescription drug in a single-unit dose or blister pack with the outside packaging opened may be accepted if the single-unit dose packaging remains intact;
    2. The prescription drug or supplies are inspected before the prescription drug or supplies are dispensed by a licensed pharmacist employed by or under contract with the medical facility or pharmacy, and the licensed pharmacist determines that the prescription drug or supplies are not adulterated or misbranded; and
    3. The prescription drug or supplies are prescribed by a healthcare practitioner for use by an eligible individual and are dispensed by a pharmacist.
  2. A prescription drug or supplies donated under this part shall not be resold.
    1. If a donor receives official notice of a recall of a prescription drug donated pursuant to this part, the donor shall make every effort, as required by rule, to notify the repository program to whom the drugs were donated of the recall.
    2. If an organization who is administering a drug repository program receives official notice of a recall of a prescription drug donated pursuant to this part, the organization shall make every effort as required by rule, to notify the pharmacy, medical facility, or patient, if known, to whom such donated drugs were dispensed, of the recall.
    3. Any donor or drug repository program who receives notice of a recall shall dispose of all recalled prescription drugs pursuant to board of pharmacy rules.
  3. A prescription drug dispensed through the prescription drug donation repository program is not eligible for reimbursement under the medical assistance program.
  4. The department shall adopt rules establishing all of the following:
    1. Requirements for medical facilities and pharmacies to accept and dispense donated prescription drugs and supplies, including all of the following:
      1. Eligibility criteria for participation by medical facilities and pharmacies;
      2. Standards and procedures for accepting, safely storing, and dispensing donated prescription drugs and supplies;
      3. Standards and procedures for inspecting donated prescription drugs to determine if the prescription drugs are in their original sealed and tamper-evident packaging, or if the prescription drugs are in single-unit doses or blister packs and the outside packaging is opened, if the single-unit dose packaging remains intact; and
      4. Standards and procedures for inspecting donated prescription drugs and supplies to determine that the prescription drugs and supplies are not adulterated or misbranded;
    2. Additional eligibility criteria for indigent or uninsured persons;
    3. Necessary forms for administration of the prescription drug donation repository program, including forms for use by individuals who donate, accept, distribute, or dispense the prescription drugs or supplies under the program;
    4. A means by which an individual who is eligible to receive donated prescription drugs and supplies may indicate eligibility;
    5. The maximum handling fee that a medical facility or pharmacy may charge for accepting, distributing, or dispensing donated prescription drugs and supplies under the program; and
    6. A list of prescription drugs that the prescription drug donation repository program will accept.

Acts 2017, ch. 392, § 1.

Compiler's Notes. Former part 5, §§ 63-10-50163-10-508, concerning the Nina Norman Prescription Drug Donation Act of 2006 is repealed by Acts 2017, ch. 392, § 1, effective January 1, 2018.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-504. Immunity and exemption.

  1. Except for gross negligence, willful misconduct, or bad faith, a drug manufacturer is not civilly liable or subject to criminal prosecution for injury, death, or loss to a person or property for matters related to the donation, acceptance, or dispensing of a prescription drug manufactured by the drug manufacturer that is donated under this part, including liability for failure to transfer or communicate product or consumer information or the expiration date of the donated prescription drug.
  2. Except as provided in subsection (d), a medical facility or another person who is not a drug manufacturer subject to subsection (a) is not civilly liable or subject to criminal prosecution for injury to or the death of an individual to whom a donated prescription drug is dispensed under this part except due to its own gross negligence, willful misconduct, or bad faith. The medical facility or other person who is not a drug manufacturer subject to subsection (a) is also exempt from disciplinary action related to the facility's or person's acts or omissions related to the donation, acceptance, distribution, or dispensing of a donated prescription drug under this part.
  3. Except for gross negligence, willful misconduct, or bad faith, the department of health or the board of pharmacy shall not be civilly liable or subject to criminal prosecution for injury, death, or loss to a person or property resulting from matters related to the donation, acceptance, distribution, or dispensing of a prescription drug donated pursuant to this part.
  4. The immunity and exemption provided in subsections (b) and (c) do not extend to the following:
    1. The donation, acceptance, distribution, or dispensing of a donated prescription drug under this part by a person if the person's acts or omissions are not performed reasonably and in good faith; or
    2. Acts or omissions outside the scope of the program.

Acts 2017, ch. 392, § 1.

Compiler's Notes. Former part 5, §§ 63-10-50163-10-508, concerning the Nina Norman Prescription Drug Donation Act of 2006 is repealed by Acts 2017, ch. 392, § 1, effective January 1, 2018.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-505. No restriction on use of samples.

This part shall not restrict the use of samples by a physician or other person legally authorized to prescribe drugs pursuant to this title during the course of the physician's or other person's duties at a medical facility or pharmacy.

Acts 2017, ch. 392, § 1.

Compiler's Notes. Former part 5, §§ 63-10-50163-10-508, concerning the Nina Norman Prescription Drug Donation Act of 2006 is repealed by Acts 2017, ch. 392, § 1, effective January 1, 2018.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-506. Resale of prescription drugs not authorized.

This part does not authorize the resale of prescription drugs by any person.

Acts 2017, ch. 392, § 1.

Compiler's Notes. Former part 5, §§ 63-10-50163-10-508, concerning the Nina Norman Prescription Drug Donation Act of 2006 is repealed by Acts 2017, ch. 392, § 1, effective January 1, 2018.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-507. Dispensing after expiration date prohibited.

A medical facility or pharmacy may not dispense a prescription drug after the expiration date of the drug.

Acts 2017, ch. 392, § 1.

Compiler's Notes. Former part 5, §§ 63-10-50163-10-508, concerning the Nina Norman Prescription Drug Donation Act of 2006 is repealed by Acts 2017, ch. 392, § 1, effective January 1, 2018.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-508. Donation by long-term facility.

Notwithstanding this title or title 68, or any rule, a long-term care facility licensed under title 68 may donate prescription drugs to the repository program established by this part.

Acts 2017, ch. 392, § 1.

Compiler's Notes. Former part 5, §§ 63-10-50163-10-508, concerning the Nina Norman Prescription Drug Donation Act of 2006 is repealed by Acts 2017, ch. 392, § 1, effective January 1, 2018.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Cross-References. Tennessee Pharmacy Practice Act of 1996, title 63, ch. 10, parts 2-5.

63-10-509. Promulgation of rules.

The department of health, in consultation with the board, is authorized to promulgate rules to effectuate the purposes of this part. The rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2017, ch. 392, § 1.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

63-10-510. Providing rule to health committee of house of representatives and health and welfare committee of senate for comment.

Notwithstanding this part or the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any rule promulgated to implement the provisions of this part 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.

Acts 2017, ch. 392, § 1.

Effective Dates. Acts 2017, ch. 392, § 3. January 1, 2018; provided, that for purposes of promulgating rules, the act took effect on May 18, 2017.

Part 6
Federally Qualified Health Center Prescription Drug Dispensing Pilot Program

63-10-601. Definitions — Requirements — Legislative intent.

  1. As used in this section, unless the context otherwise requires:
    1. “Federally qualified health center (FQHC)” means such entities as they are defined in §§ 1861(aa) and 1905 of the federal Social Security Act (42 U.S.C. §§ 1395x and 1396d); and
    2. “Telepharmacy in FQHCs” means an FQHC central pharmacy with one (1) or more FQHC remote sites in which all sites are connected via computer link, videolink and audiolink.
  2. Notwithstanding any other provision of this chapter, in an FQHC pilot project, as authorized in this section, a registered pharmacy technician employed by the FQHC is authorized to issue prescription drugs that have been filled by a pharmacist employed by the FQHC and delivered to the FQHC satellite clinic by an agent of the FQHC. The issuance of the prescription drugs may occur without the physical, onsite supervision of an on-duty pharmacist only under the conditions as provided in subsection (c). Registered pharmacy technicians performing services authorized in this section shall be permitted to function under the supervision of the FQHC pharmacist by means of telepharmacy with at least one (1) monthly onsite visit to review inventory controls, accountability, security, storage and issuance.
  3. In an FQHC pilot project, as authorized in this section, a registered pharmacy technician is authorized to issue prescription drugs to a patient of the FQHC and offer counseling by a pharmacist by means of telepharmacy. The FQHC pharmacist may provide patient counseling and supervision of the registered pharmacy technician when on duty at the pharmacy practice site of a FQHC.
  4. It is the intent of the general assembly that this section shall comply with all applicable requirements of the federal 340B drug pricing program, pursuant to § 340B of the Public Health Service Act (42 U.S.C. § 256b), and shall apply exclusively to the uninsured or underinsured income-eligible patients of the FQHCs participating as defined in subsection (e) for whom the prescription is not covered by third-party reimbursement.
  5. On or after July 1, 2008, the department of health and the board of pharmacy shall identify one (1) FQHC for a voluntary pilot program originating in a county located in the eastern grand division of the state in order to implement the telepharmacy provisions at no more than two (2) eligible satellite clinics as described in this section. The eligible FQHC shall have an onsite pharmacy in one (1) location, eligible satellite clinics, be responsible for all costs associated with the telemedicine equipment and connectivity, have at least one (1) year of experience with telemedicine, adequate technical support, appropriate staffing, access to the patient's medical record and participate in the 340B drug pricing program. Only the approved pilot program in the FQHC shall be eligible for the supervision, delivery and issuance of prescription drugs to qualified patients as defined in subsection (d). This pilot program is not authorized to deliver or issue pharmaceutical products defined elsewhere as Schedule I, II, III or IV drugs. The pilot program shall report information regarding patient satisfaction and safety to the board of pharmacy, the health and human resources committee of the house of representatives and the general welfare health and human resources committee of the senate by February 1, 2010. If the board of pharmacy determines that data demonstrates the pilot is successful, then the board may expand the project beyond the one (1) FQHC to as many FQHCs as it deems appropriate.

Acts 2008, ch. 1028, § 1.

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

63-10-602. Rules for administration and enforcement.

The board of pharmacy shall adopt, amend and repeal rules for the proper administration and enforcement of parts 2-5 of this chapter consistent with § 63-10-601. The rules shall be adopted, amended or repealed in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2008, ch. 1028, § 2.

Part 7
Ensuring Patient Access to Pharmacy Drug Disposal Programs Act of 2015

63-10-701. Short title.

This part shall be known and may be cited as the “Ensuring Patient Access to Pharmacy Drug Disposal Programs Act of 2015.”

Acts 2015, ch. 40, § 2.

63-10-702. Part definitions.

As used in this part:

  1. “Authorized pharmacy disposal site” means any pharmacy practice site that qualifies as a collection site under 21 CFR 1317.40; and
  2. “Pharmacy drug disposal program” means any voluntary drug disposal program located at, or implemented by, a Tennessee-licensed pharmacy located in this state, in accordance with all state and federal rules and regulations.

Acts 2015, ch. 40, § 3.

63-10-703. Participation in pharmacy drug disposal programs.

  1. Any Tennessee-licensed pharmacy located within this state is authorized to participate in a pharmacy drug disposal program that meets or exceeds the minimum requirements set forth in federal rules and regulations regarding collection and destruction of prescription drugs, including controlled and noncontrolled substances.
    1. Participation in a pharmacy drug disposal program by a Tennessee-licensed pharmacy located within this state shall be voluntary.
    2. The pharmacist-in-charge, as defined by § 63-10-204, for the pharmacy practice site shall be responsible for deciding whether the pharmacy participates in a pharmacy drug disposal program.
    3. No person shall mandate pharmacist participation in a pharmacy drug disposal program at a pharmacy practice site.

Acts 2015, ch. 40, § 4.

Code Commission Notes.

Subsections (c), (d), and (e) of § 63-10-703, as enacted by Acts 2015, ch. 40, § 4, have been codified as  §§ 63-10-704, 63-10-705, and 63-10-706, respectively, by authority of the code commission.

63-10-704. Immunity of participants.

Any pharmacy practice site voluntarily participating in a pharmacy drug disposal program shall be held harmless and shall not be held liable for any theft, robbery, or other criminal activity related to its participation in the pharmacy drug disposal program or the collection, storage, or destruction of prescription drugs, including controlled and noncontrolled substances collected through a pharmacy drug disposal program, as long as the pharmacy practice site is acting in good faith and operating in compliance with all state and federal rules and regulations regarding drug disposal.

Acts 2015, ch. 40, § 4.

Code Commission Notes.

Subsections (c), (d), and (e) of § 63-10-703, as enacted by Acts 2015, ch. 40, § 4, have been codified as  §§ 63-10-704, 63-10-705, and 63-10-706, respectively, by authority of the code commission.

63-10-705. List of participants to be maintained by board.

The board of pharmacy shall maintain a list of Tennessee-licensed pharmacies located within this state that participate in pharmacy drug disposal programs as authorized by state and federal rules and regulations.

Acts 2015, ch. 40, § 4.

Code Commission Notes.

Subsections (c), (d), and (e) of § 63-10-703, as enacted by Acts 2015, ch. 40, § 4, have been codified as  §§ 63-10-704, 63-10-705, and 63-10-706, respectively, by authority of the code commission.

63-10-706. Promulgation of rules.

The board of pharmacy shall promulgate rules necessary for implementation of this part. All such rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2015, ch. 40, § 4.

Code Commission Notes.

Subsections (c), (d), and (e) of § 63-10-703, as enacted by Acts 2015, ch. 40, § 4, have been codified as  §§ 63-10-704, 63-10-705, and 63-10-706, respectively, by authority of the code commission.

Chapter 11
Psychologists

Part 1
Board of Examiners in Psychology

63-11-101. Board creation — Composition — Immunity from civil action.

  1. There is created a board of examiners in psychology, referred to as the “board” in this chapter, to consist of ten (10) members who shall be appointed by the governor under conditions set forth in this chapter.
    1. Two (2) members shall be chosen from and shall be members of the faculty, with the rank of assistant professor or above, of the accredited colleges and universities in the state and shall be engaged in teaching, research and/or administration of psychology.
    2. Four (4) members shall be licensed psychologists.
    3. Two (2) members shall be either a licensed psychological examiner or a licensed senior psychological examiner.
    4. One (1) member shall be a private citizen who is neither a licensed psychologist nor a licensed psychological examiner or licensed senior psychological examiner and who has no professional or commercial interest in the practice of psychology.
    5. Beginning July 1, 2014, the chair of the applied behavior analyst licensing committee of the board of examiners in psychology shall serve as an ex officio voting member of the board.
  2. The board shall perform such duties and exercise such powers as this chapter prescribes and confers upon it.
  3. No member of the board shall be liable to civil action for any act performed in good faith in the performance of its duties as set forth in this chapter.

Acts 1953, ch. 169, § 4 (Williams, § 7082.4); T.C.A. (orig. ed.), § 63-1101; Acts 1992, ch. 986, §§ 3, 7; 1993, ch. 102, § 1; 2000, ch. 926, §§ 3, 4; 2001, ch. 123, § 1; 2014, ch. 918, §§ 3, 4.

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 §§ 63-1-132, 63-1-133, 68-1-101.

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

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

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.

63-11-102. Appointment and terms of members — Removal.

  1. Original appointments to the board are for terms as follows: One (1) practicing psychologist for a term of one (1) year, one (1) academic psychologist for a term of two (2) years, one (1) practicing psychologist for a term of three (3) years, one (1) academic psychologist for a term of four (4) years and one (1) practicing psychologist for a term of five (5) years. The original appointments to the board for the licensed psychological examiner member and citizen member shall be four (4) and five (5) years, respectively. All subsequent appointments shall be for terms of five (5) years.
  2. Vacancies shall be filled for any unexpired terms, and members shall serve until their successors are appointed and have qualified. Only practicing psychologists shall be appointed to succeed practicing psychologists, and only academic psychologists shall be appointed to succeed academic psychologists. Board members shall be ineligible for reappointments for a period of five (5) years following completion of their terms.
    1. Appointments to the board for the psychologist members may be made from lists of qualified candidates to be furnished to the governor by interested psychology groups, including, but not limited to, the Tennessee Psychological Association. Each list shall contain the names of academic psychologists and practicing psychologists. Appointments to the board for the psychological examiner and senior psychological examiner members may be made from lists of qualified candidates to be submitted to the governor from interested psychological examiner groups, including, but not limited to, the Tennessee Psychological Association Division of Psychological Examiners. Each list shall contain the names of psychological examiners and senior psychological examiners. All vacancies occurring in the board may be filled by the governor for the unexpired term from the lists of qualified candidates within thirty (30) days after the vacancy occurs. The governor shall consult with such interested groups to determine qualified persons to fill positions on the board.
    2. In making appointments to the board, 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. Any board members may be removed by the governor after notice and hearing for incompetence, neglect of duty, malfeasance in office or moral turpitude.

Acts 1953, ch. 169, § 5 (Williams, § 7082.5); T.C.A. (orig. ed.), § 63-1102; Acts 1988, ch. 1013, § 49; 1992, ch. 986, §§ 4, 5, 8, 9; 2001, ch. 123, § 2; 2012, ch. 629, § 1.

63-11-103. Members' oath — Reports and records.

  1. Immediately and before entering upon the duties of the office, the members of the board shall take the constitutional oath of office and shall file the same in the office of the governor who, upon receiving the oath of office, shall issue to each member a certificate of appointment.
  2. The board shall have available for the governor or the governor's representative detailed reports on proceedings, and shall keep adequate records of all licenses and certificates and shall make an annual report in such form as required by the governor.

Acts 1953, ch. 169, § 6 (Williams, § 7082.6); T.C.A. (orig. ed.), § 63-1103; Acts 2001, ch. 123, § 3.

63-11-104. Organization — Meetings — Expenses — Powers.

  1. The board shall elect annually a chair and vice chair.
  2. Each member shall receive all necessary expenses incident to conducting the business of the board and, in addition thereto, shall be entitled to a per diem of one hundred dollars ($100) for each day's service in conducting the business of the board. All reimbursements 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.
  3. The board shall hold at least one (1) regular meeting each year, the required meeting to be held at the state capitol. Called meetings may be held at the discretion of the chair or at the written request of any two (2) members of the board.
  4. The board shall adopt a seal, which must be affixed to all certificates issued by the board.
    1. The board shall, periodically, adopt such rules and regulations as it may deem necessary for the performance of its duties and shall examine and pass upon the qualifications of the applicants for the practice of psychology as provided in this chapter.
      1. Six (6) members of the board at all times constitute a quorum.
      2. Any action taken by the board shall require the approval of six (6) of its members.
  5. The board shall be empowered to hire such assistance as is necessary to carry on its activities, within the limits of funds available to the board, and shall be empowered to accept grants from foundations or institutions to develop tests and carry on its functions.
  6. 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.
  7. The board shall establish continuing educational requirements for psychologists designated as health service providers and psychological examiners, senior psychological examiners and certified psychological assistants.

Acts 1953, ch. 169, § 7 (Williams, § 7082.7); 1976, ch. 517, § 3; 1976, ch. 806, § 1(101); T.C.A. (orig. ed.), § 63-1104; Acts 1984, ch. 937, § 43; 1992, ch. 986, §§ 6, 10; 1994, ch. 780, § 1; 1995, ch. 167, § 1; 2000, ch. 926, § 5; 2001, ch. 334, § 12; 2014, ch. 918, § 5.

Part 2
General Provisions

63-11-201. Levels of practice — Valid license or certificate required.

  1. Four (4) levels of psychological practice are defined for the purposes of this chapter. Such levels are to be known and are referred to as:
    1. Psychological examiner;
    2. Senior psychological examiner;
    3. Psychologist; and
    4. Certified psychological assistant.
  2. Any and all individuals who engage in the practice of psychology as a psychological examiner, senior psychological examiner or psychologist must possess in full force and virtue a valid license under this chapter.
  3. Any person engaged in the practice of psychology as a certified psychological assistant must possess in full force and virtue a valid certificate to practice under this chapter.
    1. Nothing in this section shall be construed to prohibit a charitable clinic from employing or contracting with a psychologist; provided, that the contractual relationship between the psychologist and the charitable clinic is evidenced by a written contract, job description, or documentation, containing language that does not restrict the psychologist from exercising independent professional judgment in diagnosing and treating patients.
    2. For the purposes of this subsection (d), the term “charitable clinic” means an entity that meets the following standards:
      1. Has received a determination of exemption from the internal revenue service under 26 U.S.C. § 501(c)(3) or is a distinct part of an entity that has received such a determination of exemption;
      2. Has clinical facilities located in this state;
      3. Has a primary mission to provide health care or dental care services to low-income, uninsured, or underserved individuals;
      4. Provides one (1) or more of the following services for free or at a discounted rate:
        1. Medical care;
        2. Dental care;
        3. Mental health care; or
        4. Prescription medications;
      5. Utilizes volunteer healthcare professionals and nonclinical volunteers; and
      6. Is not required to be licensed under § 68-11-202(a)(1).

Acts 1953, ch. 169, § 2 (Williams, § 7082.2); T.C.A. (orig. ed.), § 63-1105; Acts 2001, ch. 123, § 4; 2016, ch. 766, § 5.

Cross-References. Courses in detection and treatment of child sexual abuse, § 49-7-117.

Licensing, § 63-1-10363-1-112.

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

NOTES TO DECISIONS

1. Valid License.

On an appeal from a finding that petitioner, an inmate, was competent to withdraw his petition for postconviction relief, there was no error in the consideration of a doctor's report and testimony. His license was not suspended but was in a grace period of payment of his license fee and thus, his license was valid; the assessments employed by the doctor enjoyed longstanding acceptance and use in the psychological community; the doctor was qualified to administer the tests; the inmate's counsel had the opportunity to question the doctor regarding the reliability of the personality assessments; and any consideration as to the reliability of the testing in a non-contact setting went to the weight of the testimony and not its admissibility. Hugueley v. State, — S.W.3d —, 2011 Tenn. Crim. App. LEXIS 426 (Tenn. Crim. App. June 8, 2011), appeal denied, — S.W.3d —, 2011 Tenn. LEXIS 1207 (Tenn. Dec. 13, 2011), rehearing denied, — S.W.3d —, 2012 Tenn. LEXIS 47 (Tenn. Jan. 11, 2012), cert. denied, Hugueley v. Tennessee, 184 L. Ed. 2d 504, 133 S. Ct. 763, 568 U.S. 1051, 2012 U.S. LEXIS 9286  (U.S. 2012).

63-11-202. Practice of psychological examiner — Senior psychological examiners.

  1. A person practices as a psychological examiner within the meaning of this chapter when the person claims to be a psychological examiner and/or renders to individuals or to the public health-related clinical activities or services involving the application of recognized principles, methods and procedures of the science and profession of psychology, such as interviewing or administering and interpreting tests of mental abilities, aptitudes, interests and personality characteristics, for such purposes as psychological evaluation or for educational or vocational selection, guidance or placement. The psychological examiner shall practice the following health-related clinical activities or services only under qualified supervision provided by a psychologist or a senior psychological examiner:
    1. Overall personality appraisal or classification;
    2. Personality counseling;
    3. Psychotherapy;
    4. Behavior analysis; or
    5. Personality readjustment techniques.
  2. Nothing in this section shall be construed as expanding or restricting the scope of practice for a psychological examiner.
  3. Those psychological examiners rendering health-related clinical activities or services who have been duly licensed prior to July 1, 1991, who request to the board in writing or via online application, shall be senior psychological examiners. Those duly licensed psychological examiners rendering health-related clinical activities or services licensed after July 1, 1991, will qualify for senior psychological examiner licensure upon completion of at least five (5) years of applied experience from the date their temporary permit was first issued by the board and upon completion of two hundred (200) hours of post-licensure continuing education units distributed by categories according to the November 1997 rules and regulations governing continuing education units. A person practices as a senior psychological examiner within the meaning of this chapter when the person claims to be a senior psychological examiner and/or renders to individuals or to the public for remuneration any service involving the application of recognized principles, methods and procedures of the science and profession of psychology. A senior psychological examiner, while possessing a different scope of practice than a psychologist, shall be considered a health service provider and thereby able to engage in these designated areas of health-related psychological practice without supervision:
    1. Interviewing or administering and interpreting tests of mental abilities, aptitudes, interests and personality characteristics for such purposes as psychological evaluation or for educational or vocational selection guidance or placement;
    2. Overall personality appraisal or classification, psychological testing, projective testing, evaluations for disability or vocational purposes;
    3. Diagnosis of nervous and mental disorders;
    4. Personality counseling;
    5. Psychotherapy;
    6. Behavior analysis;
    7. Personality readjustment techniques; or
    8. Supervision of a psychological examiner.

Acts 1953, ch. 169, § 2 (Williams, § 7082.2); T.C.A. (orig. ed.), § 63-1106; Acts 1999, ch. 500, §§ 1, 2; 2001, ch. 123, § 5; 2003, ch. 21, §§ 1, 2; 2010, ch. 769, §§ 1, 2; 2014, ch. 949, § 10.

63-11-203. Practice of psychologist.

    1. “Practice of psychologist” means the observation, description, evaluation, interpretation and modification of human behavior by the application of psychological principles, methods and procedures for the purpose of assessing, preventing or eliminating symptomatic, maladaptive or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health and mental health.
      1. “Practice of psychologist” includes, but is not limited to:
        1. Psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes and neuropsychological functioning;
        2. Counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback and behavior analysis and therapy;
        3. Psychological diagnosis and treatment of mental, emotional and nervous disorders or disabilities, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury or disability;
        4. Case management and utilization review of psychological services;
        5. Psychoeducational evaluation, therapy, remediation and consultation;
        6. Forensic evaluation; provided, that a person licensed under this chapter performing forensic evaluation is considered to be acting within their lawful scope of practice and the practice of forensic evaluation is not exclusive to individuals licensed under this chapter;
        7. Parent coordination; provided, that a person licensed under this chapter performing parent coordination is considered to be acting within their lawful scope of practice and the practice of parent coordination is not exclusive to individuals licensed under this chapter; and
        8. Telepsychology, which means the practice of psychology via electronic communications technology by persons licensed under this chapter.
      2. Psychological services may be rendered to individuals, families, groups and the public.
    2. “Practice of psychologist” is construed within the meaning of this definition without regard to whether payment is received for services rendered.
  1. A person represents that person to be a psychologist if that person uses any title or description of services incorporating the words “psychology,” “psychological” or “psychologist,” if such person possesses expert qualification in any area of psychology or if that person offers to the public or renders to individuals or to groups of individuals services defined as the practice of psychology in this chapter.

Acts 1953, ch. 169, § 2 (Williams, § 7082.2); T.C.A. (orig. ed.), § 63-1107; Acts 1992, ch. 991, § 1; 2014, ch. 809, § 1.

NOTES TO DECISIONS

1. Illustrative Care.

Where the only purpose of the doctor's evaluation was to determine whether the defendant was competent to be executed, the performance of the forensic evaluation did not constitute the “practice of psychology” under T.C.A. § 63-11-203(a) and no authorization was required under T.C.A. § 63-11-211(b)(5). Coe v. State, 17 S.W.3d 193, 2000 Tenn. LEXIS 116 (Tenn. 2000), cert. denied, Bell v. Coe, 529 U.S. 1034, 120 S. Ct. 1460, 146 L. Ed. 2d 344, 2000 U.S. LEXIS 2200 (2000), cert. denied, Coe v. Tennessee, 146 L. Ed. 2d 344, 120 S. Ct. 1460, 529 U.S. 1034, 2000 U.S. LEXIS 2199 (2000).

63-11-204. Restrictions on methods of treatment.

  1. Nothing in §§ 63-11-201 — 63-11-203 shall be construed as permitting the use of those forms of psychotherapy that involve the administration or prescription of drugs or electroshock or in any way infringing upon the practice of medicine as defined in the laws of this state.
  2. The psychologist, or psychological examiner or senior psychological examiner or certified psychological assistant who engages in psychotherapy must establish and maintain effective intercommunication with a psychologically-oriented physician, usually a psychiatrist, to make provision for the diagnosis and treatment of medical problems by a physician with an unlimited license to practice the healing arts in this state.
  3. A psychologist or, psychological examiner or senior psychological examiner or certified psychological assistant must not attempt to diagnose, prescribe for, treat or advise a client with reference to problems or complaints falling outside the boundaries of psychological practice.
  4. Sections 63-11-203 and 63-11-208(c) and (d) are subject to the limitations of this section.

Acts 1953, ch. 169, § 2 (Williams, § 7082.2); T.C.A. (orig. ed.), § 63-1108; Acts 1992, ch. 991, § 25; 2001, ch. 123, §§ 6, 7.

63-11-205. Use of identifying terms.

    1. It is specifically prohibited that any individuals or organizations shall present themselves or be presented to the public by any title incorporating the name “psychological,” “psychologist” or “psychology” other than those licensed as psychologists or, psychological examiners or, senior psychological examiners or certified psychological assistants.
    2. Any psychological scientist employed by a recognized research laboratory, college or university may use the academic or research title conferred upon such psychological scientist by the administration of such laboratory, college or university; and
    3. Persons licensed by the state board of education in areas of school psychology, school psychologist or school psychological services worker and employed as such in the department of education or in any public or nonpublic elementary or secondary school are not required to be licensed under this chapter while performing in the course of their employment. Nothing in this chapter shall be construed so as to apply to persons licensed by the state board of education in areas of school psychology, school psychologist or school psychological services worker who are employed as such in the department of education or in any public or nonpublic elementary or secondary school while performing in the course of their employment.
  1. Nothing in this section shall be construed as permitting such persons to offer their services to any other persons or organizations as consultants or to accept remuneration for any psychological services other than that of their institutional salaries unless they have been licensed or certified under this chapter.
  2. Visiting lecturers from recognized laboratories, colleges or universities are exempt from this section and may utilize their academic or research title when presenting lectures to similar institutions or organizations.
  3. Students of psychology, psychological interns and other persons preparing for the profession of psychological examiner or, senior psychological examiner or, certified psychological assistant or psychologist under qualified supervision in recognized training institutions or facilities may be designated by such titles as “psychological intern,” “psychological trainee” or others clearly indicating such training status.
  4. Psychologists with competency in areas other than the provision of health services shall retain the right to use the title of licensed psychologist with competence in areas other than health services and to practice within their area of competency.

Acts 1953, ch. 169, § 3 (Williams, § 7082.3); 1976, ch. 451, § 1; T.C.A. (orig. ed.), § 63-1109; Acts 1992, ch. 991, §§ 11, 23, 24; 2001, ch. 123, §§ 8-10.

63-11-206. Unlicensed practice — Penalties — Supervised practice — Evaluation techniques — Temporary licenses — Provisional licenses.

  1. Any person who engages in the practice of psychology and does not then possess in full force and virtue a valid license to practice as psychological examiner or, psychologist or senior psychological examiner or a certificate to practice as a psychological assistant under this chapter and chapter 1 of this title commits a Class B misdemeanor.
  2. Nothing in this chapter shall be construed to prevent members of other recognized professions that are licensed, certified or regulated under the laws of this state from rendering services consistent with their professional training and code of ethics; provided, that they do not represent themselves to be psychologists or, psychological examiners or, senior psychological examiners or certified psychological assistants. Duly recognized members of the clergy shall not be restricted from functioning in their ministerial capacity; provided, that they do not represent themselves to be psychologists or psychological examiners or senior psychological examiners or certified psychological assistants.
    1. Students of psychology, psychological interns and other persons preparing for the profession of psychological examiner or, psychologist or, senior psychological examiner or certified psychological assistant may perform as a part of their training the functions in §§ 63-11-202 and 63-11-203, but only under qualified supervision.
    2. A person practices as a “certified psychological assistant” within the meaning of this chapter when the person claims to be a certified psychological assistant and/or renders to individuals or to the public for remuneration any service involving the application of recognized principles, methods and procedures of the science and profession of psychology and only under the direct employment and supervision of either the psychologist or senior psychological examiner employing the certified psychological assistant or the employing community mental health center or state governmental agency. Any and all work performed by a certified psychological assistant is supervised by a psychologist or senior psychological examiner as determined by the board.
  3. Use of psychological techniques by governmental institutions and by business and industrial organizations for employment placement, evaluation, promotion or job adjustment of their own officers or employees or by employment agencies for the evaluation of their own clients prior to recommendation for employment is also specifically allowed; however, no industrial or business firm or corporation may sell or offer to the public or to other firms or corporations for remuneration any psychological services as specified in §§ 63-11-202 and 63-11-203, unless such services are performed or supervised by individuals duly and appropriately licensed under this chapter.
      1. A temporary license may be issued by the board for an applicant who has successfully completed the academic course work and training for the license sought and who is scheduled for initial written examination. No temporary permit for a psychological examiner shall be issued for applications received by the board after December 31, 2004.
      2. The temporary license will allow the applicant to perform the functions specified in §§ 63-11-202 and 63-11-203, for which the applicant is seeking licensure under qualified supervision.
      3. In order to receive a temporary license, the applicant must submit a completed application for a temporary license with the applicant's completed application for the desired license, and all appropriate fees, to the board.
        1. A temporary license may be issued by the board for an applicant who has a current license from another state or territory. The temporary license will allow the applicant to perform under qualified supervision the functions specified in §§ 63-11-202 and 63-11-203.
        2. In order to receive a temporary license, the applicant must submit a completed application for a temporary license with the applicant's completed application for the desired license, and all appropriate fees, to the board.
        3. Applications for temporary licenses for applicants currently licensed in another state or territory shall be reviewed and approved or denied by a current member of the board designated by the board to perform this function.
        4. If an applicant is issued a temporary license, the license shall remain valid until the board grants or denies the license application.
        5. However, no person shall be issued more than one (1) temporary license nor shall any temporary license be valid for a period of more than one (1) year.
      1. Such a temporary license may be issued to allow an applicant to perform the functions specified in § 63-11-203 if the applicant has:
        1. Successfully completed an approved American Psychological Association academic course of study;
        2. Previously taken and passed, according to Tennessee standards, the national licensing examination;
        3. A current license in another state or territory in good standing.
      2. Such a temporary license with designation as a health service provider may be issued to an applicant who meets the requirements of subdivision (e)(2)(B) and has:
        1. Successfully completed an American Psychological Association-approved internship; and
        2. Had at least one (1) year of full-time postdoctoral experience delivering health services.
      3. Such a temporary license may be issued to allow an applicant to perform the functions specified in § 63-11-202 if the applicant has:
        1. Previously taken and passed, according to Tennessee standards, the national licensing examination; and
        2. A current license in another state or territory in good standing.
    1. The fee for all temporary licenses shall be set by the board in an amount not to exceed one hundred dollars ($100). Until such time as the board establishes a fee by rule, the fee shall be fifty dollars ($50.00).
  4. Nothing in this chapter shall be construed to expand or limit in any way the practice of psychological examiners as provided in § 63-11-202 or, senior psychological examiners as provided in § 63-11-202 or certified psychological assistants as provided in subdivision (c)(2) and § 63-11-207(b), nor shall this chapter limit the use of the title “psychological examiner” for persons duly licensed as psychological examiners.
  5. Notwithstanding subsection (a), persons providing services in programs of the department of mental health and substance abuse services or the department of intellectual and developmental disabilities either as employees or through contract agencies are not engaged in the practice of psychology and need not be licensed or certified under this chapter unless they provide services as a psychological examiner or as a psychologist, or as a senior psychological examiner or certified psychological assistant.
    1. A provisional license to practice as a psychologist with the designation as a health service provider may be issued by the board of examiners in psychology to an applicant who has successfully completed the academic and internship requirements of § 63-11-208(c)(3) and (d)(1)(A) and who is to be engaged in a one-year post-doctoral experience required by § 63-11-208(d)(2)(A). Such provisional licensure will allow the applicant to perform the functions specified in §§ 63-11-203 and 63-11-208(d)(2)(B) under the qualified supervision of a psychologist acceptable to the board and who is licensed in Tennessee with a designation as a health service provider in good standing.
    2. In order for a provisional license to remain valid, the licensee must take and pass the examination for professional practice in Tennessee (EPPP) at the level set for licensure as a psychologist in Tennessee within one (1) year of the issuance of the provisional license unless the applicant previously passed the EPPP at that level. A second failure of the EPPP after the issuance of a provisional license shall result in its revocation.
    3. In order for the provisional license to remain valid, the licensee must take and pass the oral and/or jurisprudence examination developed by the board within two (2) years of the issuance of the provisional license. The second failure of the oral and/or jurisprudence examination will result in the revocation of the provisional license.
    4. The board may consider petitions of the licensee regarding extraordinary circumstances that would necessitate delay in taking the written or oral examination.

Acts 1953, ch. 169, § 9 (Williams, § 7082.9); 1955, ch. 56, § 1; 1976, ch. 451, § 2; T.C.A. (orig. ed.), § 63-1110; Acts 1987, ch. 316, § 1; 1988, ch. 661, §§ 1, 2; 1989, ch. 591, § 112; 1992, ch. 991, §§ 5-9, 22, 26, 27; 1995, ch. 167, §§ 2-4; 1999, ch. 505, §§ 1, 2; 2000, ch. 646, § 1; 2000, ch. 947, § 6; 2001, ch. 123, §§ 11-16; 2010, ch. 769, §§ 3, 4; 2010, ch. 1100, § 100; 2012, ch. 575, § 1.

Compiler's Notes. 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.

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

63-11-207. Qualifications and application to practice as examiner — Expiration of period to issue licenses — Certification of psychological assistants.

    1. Any person wishing to obtain the right to practice as a psychological examiner in this state, who has not heretofore been licensed to do so, shall, before it is lawful for such person to practice as a psychological examiner in this state, make application to the board through the chair, upon such form and in such manner as shall be adopted and prescribed by the board.
    2. Unless such a person has obtained a license as prescribed in subdivision (a)(1), it is unlawful for such person to practice; and if such person practices as a psychological examiner without first having obtained such a license, such person has violated this chapter.
    3. A candidate for such license shall furnish the board with satisfactory evidence that such candidate:
      1. Is of good moral character;
      2. Is a citizen of the United States;
      3. Has had two (2) academic years of graduate training in psychology, including a master's degree, from an accredited educational institution recognized by the board as maintaining satisfactory standards, or in lieu thereof, such training and experience as the board shall consider equivalent thereto. The board may, at its discretion, consider equivalent training and experience when presented by qualified applicants with a masters' degree in psychology whose credentials differ slightly than those prescribed in this subdivision (a)(3)(C). In such cases the qualified candidate must petition the board for a waiver and specifically request the board utilize its discretionary authority;
      4. Is competent as a psychological examiner, as shown by passing such examinations, written or oral, or both, as the board deems necessary;
      5. Is not considered by the board to be engaged in unethical practice; and
      6. Has not, within the preceding six (6) months, failed an examination given by the board; provided, that the board may, at its discretion, accept satisfactory substitute training and experience in lieu of that prescribed in subdivision (c)(3).
    4. No new psychological examiner licenses shall be issued for applications received by the board after December 31, 2004.
    5. The discontinued issuance of psychological examiners licenses or the designation of senior psychological examiners shall in no way impair or abridge the right of duly licensed psychological examiners to practice within the scope of their license or to renew their licensure status as required by law.
    1. Any person seeking to practice as a certified psychological assistant in this state shall, before it is lawful for such person to practice as a certified psychological assistant, make application to the board through the chair, upon such form and in such manner as shall be adopted and prescribed by the board, including, but not limited to, the proper registration with the board of the supervisor of record for the certified psychological assistant. Unless such person obtains a proper certificate as issued by the board, it is unlawful for a person to practice; and if such person practices as a certified psychological assistant without first having obtained a proper certificate, such person has violated this chapter.
    2. A candidate for certification shall furnish the board with satisfactory evidence that such candidate:
      1. Is of good moral character;
      2. Is a citizen of the United States;
      3. Is not considered by the board to be engaged in unethical practice; and
      4. Has had two (2) academic years of graduate training in psychology, including a master's degree, from an accredited educational institution recognized by the board as maintaining satisfactory standards, or in lieu thereof, such training and experience as the board shall consider equivalent thereto. Such graduate training must include specialized training in psychological assessment, test construction and measurement, the administration and interpretation of psychological testing, interviewing skills and social history methods. The board may, at its discretion, consider equivalent training and experience when presented by qualified applicants with a master's degree in psychology whose credentials differ slightly than those prescribed in this subdivision (b)(2)(D). However, all applicants must in their graduate training show evidence of supervised practicum experience in the administration and interpretation of psychological testing, assessment procedures and social history and feedback interviewing techniques as determined by the board in order to fulfill educational requirements for certification.

Acts 1953, ch. 169, § 8 (Williams, § 7082.8); T.C.A. (orig. ed.), § 63-1111; Acts 1984, ch. 937, § 44; 1995, ch. 167, § 5; 1996, ch. 973, § 3; 1996, ch. 980, § 1; 2001, ch. 123, § 17.

Law Reviews.

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

63-11-208. Qualifications and application to practice as psychologist — Specialty certification.

  1. Any person wishing to obtain the right to practice as a psychologist in this state, who has not heretofore been licensed to do so, shall, before it is lawful for such person to practice psychology in this state, make application to the board through the chair upon such form and in such manner as shall be adopted and prescribed by the board.
  2. Unless such a person has obtained a license as prescribed in subsection (a), it is unlawful for such person to practice; and if such person practices psychology without first having obtained such a license, such person has violated this chapter.
  3. A candidate for such license shall furnish the board with satisfactory evidence that such candidate:
    1. Is of good moral character;
    2. Is a citizen or legal resident of the United States;
    3. Has received a doctorate in psychology from an accredited educational institution recognized by the board as maintaining satisfactory standards. After December 31, 1995, all such doctoral programs must be approved by the American Psychological Association, listed by the American Association of State Psychology Boards, or such equivalent standards as are determined by the board;
    4. Is competent in psychology, as shown by passing such examinations, written or oral, or both, as the board deems necessary;
    5. Is not considered by the board to be engaged in unethical practice;
    6. Has not within the preceding six (6) months failed an examination given by the board; and
    7. The board may, at its discretion, consider equivalent training and experience when presented by qualified applicants with a doctoral degree in psychology whose credentials differ slightly than those prescribed in subdivisions (c)(3) and (d)(1)(A). In such cases, the applicant must petition the board for a waiver and specifically request the board utilize its discretionary authority.
  4. Any licensed psychologist who provides or offers health services to the public must be designated by the board as a health service provider. In addition to the requirements for licensure as a psychologist prescribed in subsection (c), an applicant for designation as a health service provider must demonstrate to the board that such applicant:
      1. Has had at least a one-year internship of no less than one thousand nine hundred (1,900) hours in psychology at a site where health services are normally provided and that is part of an organized integrated training program. After December 30, 1995, all such internships must be approved by the American Psychological Association (APA) or listed by the Association of Psychological Post-Doctoral and Internship Centers (APPIC), or such equivalent standards as are determined by the board;
      2. Until December 31, 1999, internships listed in the Directory of Internships for Doctoral Students in School Psychology, published by the Joint Committee on Internships for the Council of Directors of School Psychology Programs, Division 16 of the American Psychological Association and the National Association of School Psychologists, shall be considered to satisfy the internship approval requirement of this subsection (d); and
      1. Has successfully completed at least one (1) year postdoctoral experience delivering health services, supervised by a licensed psychologist designated by the board as a health service provider. If the year of postdoctoral training was not in the state of Tennessee, equivalent supervision must be documented to the satisfaction of the board;
      2. For purposes of this chapter, “health service,” in any variation, means the delivery of direct, preventive, assessment and therapeutic intervention services to individuals whose growth, adjustment or functioning is actually impaired or may be at risk of impairment.
  5. Notwithstanding subsection (d), the board may designate as a health service provider, with practice restriction to recipients in an intellectual disabilities facility under the department of intellectual and developmental disabilities, a person who meets all of the following criteria:
    1. The person holds a doctorate in psychology from a regionally accredited institution;
    2. The person is currently licensed as a psychologist in at least one (1) state;
    3. The person has academic training in intellectual disability and postdoctoral clinical experience in the field of intellectual disability of at least five (5) years' duration;
    4. The department submits to the board a description of the applicant's proposed functioning at the intellectual disability facility;
    5. The department certifies that the applicant has training and experience adequate to perform the applicant's proposed functioning within the department, that the department is unable to recruit otherwise qualified psychologists to provide psychological services and that this inability threatens the integrity of the department's services and the ability of the department to meet the needs of its clients; and
    6. Any psychologist granted designation as a health service provider by the board under this subsection (e) shall surrender this designation upon termination of such person's employment with the department, which designation shall, thereafter, be null and void.

Acts 1953, ch. 169, § 8 (Williams, § 7082.8); T.C.A. (orig. ed.), § 63-1112; Acts 1984, ch. 937, § 45; 1990, ch. 928, §§ 1, 2; 1991, ch. 18, §§ 1, 2; 1992, ch. 991, § 2; 1996, ch. 973, §§ 1, 2; 2000, ch. 947, § 6; 2010, ch. 1100, § 101; 2011, ch. 158, § 33.

Compiler's Notes. 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.

Law Reviews.

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

63-11-209. Application and examination fees.

  1. Each applicant for a permanent license or certificate shall pay to the board a nonrefundable application fee as set annually by the board.
  2. In addition thereto, each applicant subject to examination under this chapter shall pay an examination fee to the board as set annually by the board.
  3. Each applicant seeking licensure without examination as provided in § 63-11-211 shall, in addition to the application fee provided in this section, pay a fee as set annually by the board.

Acts 1953, ch. 169, § 15 (Williams, § 7082.15); 1955, ch. 56, § 1; 1972, ch. 590, § 1; 1976, ch. 517, § 1; T.C.A. (orig. ed.), § 63-1113; Acts 1986, ch. 675, § 19; 1989, ch. 523, §§ 27-29; 2001, ch. 123, § 18.

63-11-210. Examination of applicants.

  1. Examination of applicants for a license or certificate to practice psychology shall be made by the board at least once a year according to methods and in such subject fields as may be deemed by the board to be the most practical and expeditious to test the applicant's qualifications.
    1. Such examinations shall include the basic psychological sciences.
    2. The board shall require the examinations to be written or oral, or both; provided, that in any written examination such applicant shall be designated by a number instead of the applicant's name so that the applicant's identity shall not be disclosed to the members of the board until the examination papers have been graded.
    3. The board shall grade the written examinations returned by the candidates and shall keep them for at least one (1) year.
    4. A candidate shall be held to have passed the examination upon the affirmative vote of three (3) or more members of the board.
    5. Any unsuccessful candidate may, upon written request to the board, see the candidate's graded paper.

Acts 1953, ch. 169, § 10 (Williams, § 7082.10); T.C.A. (orig. ed.), § 63-1114; Acts 2001, ch. 123, § 19.

63-11-211. Licensure without examination.

  1. The board may, at its discretion, grant a certificate without an assembled examination to any person residing or employed in the state who has not previously failed the appropriate examination given by the board and who, at the time of application, is licensed or certified by a similar board of another state whose standards, in the opinion of the board, are not lower than those required by this chapter, or who has been practicing psychology in another state and has qualifications not lower than those required by this chapter, and is able to satisfy the board that to grant that person a license would be in the public interest, or who has been certified by the American Board of Examiners in Professional Psychology.
  2. Notwithstanding subsection (a), the board shall grant a license without an assembled written or oral examination to any person who at the time of application:
    1. Is licensed or certified in good standing with a similar board of another state;
    2. Has passed the National Examination for the Practice of Professional Psychology at a level greater than or equal to the level required in this state;
    3. Can show reasonable proof that the applicant has available employment in this state by means of letters or other reasonable proof;
    4. Received a psychologist license after January 1, 1995, but before June 1, 1995; and
    5. The board may permit a psychologist licensed in good standing in another state, who meets standards acceptable to the board, to perform the functions of §§ 63-11-203 and 63-11-208(d)(2)(B) and practice as a psychologist in Tennessee without possessing a current license for a period of time, not to exceed twelve (12) days per year, for such purposes as special training or consultation, special evaluation and/or intervention or serving as an expert witness. Nothing in this section shall be construed to permit the regular, repetitive or ongoing provision of psychological services, the supervision of psychological services or the solicitation or advertisement of services to the general public, all of which are governed by the usual and customary processes of licensure for psychologists.

Acts 1953, ch. 169, § 11 (Williams, § 7082.11); modified; T.C.A. (orig. ed.), § 63-1115; Acts 1998, ch. 878, § 1; 1999, ch. 505, § 3; 2000, ch. 646, § 2.

NOTES TO DECISIONS

1. Written Authorization.

The written authorization referred to in T.C.A. § 63-11-211(b)(5) must be obtained only by an out-of-state psychologist who will perform the functions of a psychologist or a health service provider. Coe v. State, 17 S.W.3d 193, 2000 Tenn. LEXIS 116 (Tenn. 2000), cert. denied, Bell v. Coe, 529 U.S. 1034, 120 S. Ct. 1460, 146 L. Ed. 2d 344, 2000 U.S. LEXIS 2200 (2000), cert. denied, Coe v. Tennessee, 146 L. Ed. 2d 344, 120 S. Ct. 1460, 529 U.S. 1034, 2000 U.S. LEXIS 2199 (2000).

2. Authorization Not Required.

Where the only purpose of the doctor's evaluation was to determine whether the defendant was competent to be executed, the performance of the forensic evaluation did not constitute the practice of psychology as defined in T.C.A. § 63-11-203(a) and no authorization was required under T.C.A. § 63-11-211(b)(5). Coe v. State, 17 S.W.3d 193, 2000 Tenn. LEXIS 116 (Tenn. 2000), cert. denied, Bell v. Coe, 529 U.S. 1034, 120 S. Ct. 1460, 146 L. Ed. 2d 344, 2000 U.S. LEXIS 2200 (2000), cert. denied, Coe v. Tennessee, 146 L. Ed. 2d 344, 120 S. Ct. 1460, 529 U.S. 1034, 2000 U.S. LEXIS 2199 (2000).

63-11-212. Issuing license or certificate — Enforcement of chapter.

  1. The board has authority to administer oaths, to summon witnesses and to take testimony in all matters relating to its duties.
    1. The board shall be the sole agency in this state empowered to certify concerning competence in the practice of psychology to the division and the sole board empowered to recommend licensure or certification for the practice of psychology to the division.
    2. No individual shall be issued a license or certificate for the practice of psychology who has not been previously certified at the appropriate level of practice by the board.
    3. The board shall certify as competent to practice psychology all persons who shall present satisfactory evidence of attainments and qualifications under provisions of this chapter, the rules and regulations of the board and chapter 1 of this title.
    4. Such certification shall be signed by the chair of the board under the board's adopted seal.
  2. It is the duty of the board chair under the direction of the board to aid the solicitors in the enforcement of this chapter and the prosecution of all persons charged with the violation of its provisions.

Acts 1953, ch. 169, § 16 (Williams, § 7082.16); T.C.A. (orig. ed.), § 63-1116; Acts 2001, ch. 123, §§ 20, 21.

Cross-References. Licensure, §§  63-1-10363-1-112.

63-11-213. Privileged communications.

For the purpose of this chapter, the confidential relations and communications between licensed psychologist or psychological examiner or senior psychological examiner or certified psychological assistant and client are placed upon the same basis as those provided by law between attorney and client; and nothing in this chapter shall be construed to require any such privileged communication to be disclosed.

Acts 1953, ch. 169, § 17 (Williams, § 7082.17); T.C.A. (orig. ed.), § 63-1117; Acts 2001, ch. 123, § 22.

Cross-References. Communications between attorney and client, § 23-3-105.

Communications between psychiatrist and patient, § 24-1-207.

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

Rule Reference. This section is referred to in the Advisory Commission Comments under Rule 501 of the Tennessee Rules of Evidence.

Textbooks. Tennessee Law of Evidence (2nd ed., Cohen, Paine and Sheppeard), Rule 501; § 501.7.

Law Reviews.

Evidence — Privileged Communications in Divorce Actions: Psychiatrist-Patient and Presence of Third Parties, 40 Tenn. L. Rev. 110.

Hospital Records as Evidence: New Rules and Old Statutes (Donald F. Paine), 26 No. 3 Tenn. B.J. 33 (1990).

Should Tennessee Bury the Dead Man Statute As Arkansas Has? (W. Dent Gitchel), 18 Mem. St. U.L. Rev. 195 (1989).

Toward a Unified Approach to Privileges and Relevancy (Thomas F. Guernsey), 17 Mem. St. U.L. Rev. 1 (1986).

When a Child's Best Interests Are At Issue: Privacy of Mental Health Records In Divorce and Custody Proceedings, 49 Tenn. B.J. 21 (2013).

Attorney General Opinions. Privileged communications to psychologists/therapists and their agents, OAG 92-74, 1992 Tenn. AG Lexis 72 (12/29/92).

Obtaining a parent’s mental-health information in child-custody cases. OAG 14-55, 2014 Tenn. AG Lexis 57 (5/14/14)

NOTES TO DECISIONS

1. Communications in Presence of Spouse.

While the statute on marital privilege, T.C.A. § 24-1-201, exempts disclosure of confidences in a divorce action, the psychologist-patient privilege in T.C.A. § 63-11-213 does not; therefore, only the spouses, not the psychologist who engages them in joint counseling, can testify about matters arising in the joint counseling. Guity v. Kandilakis, 821 S.W.2d 595, 1991 Tenn. App. LEXIS 627 (Tenn. Ct. App. 1991), rehearing denied, — S.W.2d —, 1991 Tenn. App. LEXIS 652 (Tenn. Ct. App. Aug. 30, 1991).

In a divorce action, it was erroneous for the trial judge to instruct a psychologist to testify about marital counseling sessions which included both spouses, over the objection of one spouse, because the presence of the objecting spouse at the joint counseling sessions did not constitute waiver of the psychologist-patient privilege. Guity v. Kandilakis, 821 S.W.2d 595, 1991 Tenn. App. LEXIS 627 (Tenn. Ct. App. 1991), rehearing denied, — S.W.2d —, 1991 Tenn. App. LEXIS 652 (Tenn. Ct. App. Aug. 30, 1991).

2. Suit for Breach of Confidential Relationship.

A psychologist is immune from suit by his patient for breach of the confidential relationship when the psychologist is compelled to testify against his patient by the court. Guity v. Kandilakis, 821 S.W.2d 595, 1991 Tenn. App. LEXIS 627 (Tenn. Ct. App. 1991), rehearing denied, — S.W.2d —, 1991 Tenn. App. LEXIS 652 (Tenn. Ct. App. Aug. 30, 1991).

3. Privileges Compared.

The psychologist-client privileges and the social worker-client privilege under former T.C.A. § 63-23-107 (now § 63-23-109) are placed on the same basis as the attorney-client privilege by the Tennessee Code. Kirchner v. Mitsui & Co. (U.S.A.), Inc., 184 F.R.D. 124, 1998 U.S. Dist. LEXIS 20241 (M.D. Tenn. 1998).

4. Custody Issues.

Trial court erred by failing to consider a husband's claims that his psychological records were protected from disclosure by the psychologist-client privilege under T.C.A. § 63-11-213) as it provided no reasoning as to why the husband's records were not protected from discovery by the privilege or the extent to which the husband possibly waived the privilege. Culbertson v. Culbertson, 393 S.W.3d 678, 2012 Tenn. App. LEXIS 328 (Tenn. Ct. App. May 23, 2012), review or rehearing denied, — S.W.3d —, 2012 Tenn. LEXIS 722 (Tenn. Sept. 26, 2012).

63-11-214. Code of ethics.

The board of examiners shall adopt a code of ethics to govern appropriate practices or behavior as referred to in §§ 63-11-207, 63-11-208 and 63-11-215 and shall file such code with the secretary of state within thirty (30) days prior to the effective date of such code.

Acts 1953, ch. 169, § 18 (Williams, § 7082.18); T.C.A. (orig. ed.), § 63-1118.

Textbooks. Tennessee Criminal Practice and Procedure (Raybin), § 27.76.

63-11-215. Denial, restriction, suspension or revocation of license or certificate — Disciplinary action.

  1. The board has the power to:
    1. Deny an application for a license or certificate to any applicant;
    2. Permanently or temporarily withhold issuance of a license or certificate;
    3. Suspend, limit or restrict a previously issued license or certificate for such time and in such manner as the board may determine;
    4. Reprimand or take such action in relation to disciplining an applicant or licensee or certified person as the board in its discretion may deem proper; or
    5. Permanently revoke a license or certificate.
  2. The grounds upon which the board shall exercise the powers enumerated in subsection (a) include, but are not limited to:
    1. Unprofessional, dishonorable or unethical conduct;
    2. Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision of this chapter or any lawful order of the board issued pursuant thereto, or any criminal statute of the state;
    3. Making false statements or representations, being guilty of fraud or deceit in obtaining admission to practice or being guilty of fraud or deceit in the course of professional practice;
    4. Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of practice;
    5. Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such manner as to adversely affect the person's ability to practice the person's profession;
    6. Willfully betraying a professional secret;
    7. The advertising of psychological practice in which untrue or misleading statements are made or causing the publication or circulation of fraudulent advertising relative to any disease, human ailment or condition;
    8. Willful violation of the rules and regulations that may be promulgated by the board to regulate advertising by practitioners who are under the jurisdiction of such board;
    9. Conviction of a felony, conviction of any offense under state or federal drug laws or conviction of any offense involving moral turpitude;
    10. 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;
    11. Offering, undertaking or agreeing to cure or treat a disease, injury, ailment or infirmity by a secret means, method, device or instrumentality;
    12. Giving, receiving or aiding or abetting in the giving or receiving of rebates, either directly or indirectly;
    13. Engaging in practice under a false or assumed name or the impersonation of another practitioner of a like, similar or different name;
    14. Engaging in practice when mentally or physically unable to safely do so;
    15. Violation of chapter 6 of this title; and
    16. Practice of a level of psychology inappropriate or beyond the scope of the particular license or licenses or certification held by the licensee or certified person.
  3. 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 1953, ch. 169, § 12 (Williams, § 7082.12); Acts 1955, ch. 56, § 1; 1979, ch. 201, § 1; T.C.A. (orig. ed.), § 63-1119; Acts 1985, ch. 120, § 12; 2001, ch. 123, §§ 23-28; 2012, ch. 798, § 45; 2012, ch. 848, § 75; 2018, ch. 745, § 27.

Amendments. The 2018 amendment added (c).

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

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

Law Reviews.

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

63-11-216. Administrative procedure.

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

Acts 1953, ch. 169, § 13 (Williams, § 7082.13); Acts 1979, ch. 201, § 2; T.C.A. (orig. ed.), § 63-1120; Acts 1985, ch. 120, § 13; 2001, ch. 123, § 29.

63-11-217. Review of board actions.

Any action of or ruling or order made or entered by the board declining to issue a certificate, declining to recommend licensure or certification or suspending or revoking a certificate or license shall be subject to review by the courts of this state in the same manner and subject to the same powers and conditions as now provided by law in regard to rulings, orders and findings of other quasi-judicial bodies in this state, where not otherwise specifically provided.

Acts 1953, ch. 169, § 14 (Williams, § 7082.14); Acts 1979, ch. 201, § 3; T.C.A. (orig. ed.), § 63-1121; Acts 2001, ch. 123, § 30.

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

63-11-218. Annual registration fee — Revocation and renewal of licenses and certification — Registration by retirees.

  1. Each licensed psychologist or psychological examiner or senior psychological examiner or certified psychological assistant shall pay an annual registration fee as set annually by the board, payable in advance, for the ensuing year. As a condition of renewal, the board may require that the licensee or certified person establish that the licensee or certified person has satisfied any continuing education requirements established by board rule.
    1. When any licensee or certified person shall fail to pay the annual fee after the renewal fee becomes due and satisfy such continuing education requirements for renewal as may be established by the board, as provided in this section, the license or certificate of such person shall be automatically revoked by the board without further notice or hearing, unless renewal is completed and all fees paid prior to the expiration of sixty (60) days from the date such renewal fees become due.
    2. Any person whose license or certificate is automatically revoked as provided in this section may make application in writing to the board for the reinstatement of such license or certificate; and upon good cause being shown, the board, in its discretion, may reinstate such license or certificate upon payment of all past due annual registration fees, proof that any continuing education renewal requirement established by the board has been satisfied and upon further payment of a sum to be set by the board.
  2. Any person licensed or certified to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
    1. Notwithstanding this chapter to the contrary, the division, with the approval of the commissioner, shall establish a system of license or certification renewals at alternative intervals that will allow for the distribution of the license or certification workload as uniformly as is practicable throughout the calendar year. Licenses or certificates 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 or certification 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 certificates 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 or certificate 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 or certification expiration date under the alternative method authorized in this subsection (d).

Acts 1976, ch. 517, § 2; T.C.A., § 63-1123; Acts 1984, ch. 937, §§ 46-48; 1986, ch. 675, §§ 8, 20; T.C.A., § 63-11-219; Acts 1987, ch. 316, § 2; 1989, ch. 360, §§ 37, 38; 1989, ch. 523, §§ 30, 31; 2001, ch. 123, §§ 31-35.

Cross-References. License and registration fees, § 63-1-112.

Retirement, § 63-1-111.

NOTES TO DECISIONS

1. Valid License.

On an appeal from a finding that petitioner, an inmate, was competent to withdraw his petition for postconviction relief, there was no error in the consideration of a doctor's report and testimony. His license was not suspended but was in a grace period of payment of his license fee and thus, his license was valid; the assessments employed by the doctor enjoyed longstanding acceptance and use in the psychological community; the doctor was qualified to administer the tests; the inmate's counsel had the opportunity to question the doctor regarding the reliability of the personality assessments; and any consideration as to the reliability of the testing in a non-contact setting went to the weight of the testimony and not its admissibility. Hugueley v. State, — S.W.3d —, 2011 Tenn. Crim. App. LEXIS 426 (Tenn. Crim. App. June 8, 2011), appeal denied, — S.W.3d —, 2011 Tenn. LEXIS 1207 (Tenn. Dec. 13, 2011), rehearing denied, — S.W.3d —, 2012 Tenn. LEXIS 47 (Tenn. Jan. 11, 2012), cert. denied, Hugueley v. Tennessee, 184 L. Ed. 2d 504, 133 S. Ct. 763, 568 U.S. 1051, 2012 U.S. LEXIS 9286  (U.S. 2012).

63-11-219. [Reserved.]

  1. As used in this section, “peer review committee” or “committee” means any committee, board, commission or other entity constituted by any statewide psychological association or local psychological association for the purpose of receiving and evaluating professional acts of other practitioners of psychology as defined in this chapter.
  2. Any practitioner of psychology who serves on any peer review committee or on any other committee is immune from liability with respect to any action taken in good faith and without malice as a member of such committee, board, commission or other entity.
  3. Practitioners of psychology, any individuals appointed to a committee as defined in subsection (a) and members of the boards of directors of facilities as defined in §§ 33-5-402 and 68-11-201 are immune from liability to any client, patient, individual or organization for furnishing information, data, reports or records to any such committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by such committee, undertaken or performed within the scope or functions of the duties of such committee, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
    1. All information, interviews, reports, statements, memoranda or other data furnished to a peer review committee, associational board or governing board, and any findings, conclusions or recommendations resulting from the proceedings of such committees, associational boards and governing boards are privileged.
    2. The records and proceedings are confidential and shall be used only in the exercise of the proper functions of the committees, associational boards or governing boards and shall not become public records nor be available for court subpoena or discovery proceedings.
    3. Nothing contained in this subsection (d) applies to records, documents or information otherwise available from original sources and such records, documents or information are not to be construed as immune from discovery or use in any civil proceedings solely due to presentation to the committee.

Acts 1990, ch. 653, § 1; 2000, ch. 947, § 8M.

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

63-11-221. Health service providers in internship program — Waiver of supervised postdoctoral experience.

Any person currently enrolled in an internship program satisfying the requirements of § 63-11-208(d)(1) and who completes the internship and all other degree requirements by December 31, 1992, shall be designated as a health service provider without completing the one-year full-time supervised postdoctoral experience as provided in § 63-11-208(d)(1) if an application for such designation is submitted by July 1, 1993.

Acts 1992, ch. 991, § 3.

63-11-222. Psychologists licensed as of June 30, 1992 — Health service provider designation.

  1. Any psychologist licensed under this chapter as a school, clinical or counseling psychologist as of June 30, 1992, shall be designated by the board as a health service provider; provided, that such person submits an application to the board for such designation by July 1, 1993. Any psychologist licensed under this chapter other than as a school, clinical or counseling psychologist as of June 30, 1992, who documents to the satisfaction of the board that such person has been engaged in providing health services as a psychologist for a minimum of two (2) years shall be designated by the board as a health service provider; provided, that application for such designation is submitted to the board by July 1, 1993.
  2. Notwithstanding any provision of subsection (a) or any other law to the contrary, the board shall designate as a health service provider any person who meets the following criteria:
    1. Holds a Ph.D. in education from an accredited college or university;
    2. Possesses at least three thousand nine hundred (3,900) hours of clinical experience supervised by licensed clinical and counseling psychologists at an accredited school of medicine;
    3. Is a national board certified counselor;
    4. Has been practicing in Tennessee as a professional counselor for a period of six (6) or more years;
    5. Was licensed by the board as a psychologist on July 15, 1992, with a declared specialty area other than school, clinical or counseling psychology; and
    6. Has submitted to the board an application for such designation by December 31, 1994.

Acts 1992, ch. 991, § 4; 1995, ch. 104, § 1.

63-11-223. Titles referring to licensed psychologist and health care provider.

For purposes of federal legislation and regulations referencing qualifications with respect to the provision of psychological services and other titles in this code, unless the context otherwise requires, “licensed clinical psychologist,” “licensed counseling psychologist” or “licensed school psychologist” in any variation refers to a psychologist licensed under this chapter and designated as a health service provider.

Acts 1992, ch. 991, § 10.

63-11-224. Third-party reimbursement.

“Community mental health centers,” as defined in § 33-1-101, institutes or governmental agencies, doctoral clinical psychology students in university-operated training clinics and those qualifying psychologists employing psychologists with temporary or provisional licenses shall be eligible to receive third-party reimbursement from any managed care plan or third-party payor for usual and customary professional services rendered by the employed psychologist with a provisional or temporary license.

Acts 1999, ch. 505, § 4; 2000, ch. 947, § 8F; 2009, ch. 69, § 1.

63-11-225. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.

A psychologist licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of examiners in psychology may issue a special volunteer license, as such license is defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.

Acts 2004, ch. 579, § 7.

63-11-226. Notice to patients of departure.

Psychologists, senior psychological examiners and psychological examiners are not required to notify patients that were treated by them at community mental health centers, as defined in § 33-1-101, of their departure from such community mental health centers. Patient records shall remain with the community mental health centers. The transfer of patients' records shall be in compliance with standards set by state and federal law.

Acts 2005, ch. 53, § 1.

Part 3
Applied Behavior Analyst Licensing Committee

63-11-301. Public policy statement — Committee established.

  1. The practice of behavior analysis in this state is hereby declared to affect the public health, safety, and welfare of citizens of this state.
  2. To assist the board of examiners in psychology in the performance of its duties, there is hereby established the applied behavior analyst licensing committee to protect the public from:
    1. The practice of applied behavior analysis by unqualified persons; and
    2. Unprofessional, unethical and harmful conduct by behavior analysis practitioners.
  3. No person shall represent to be or function as a behavior analyst or assistant behavior analyst in this state unless such person holds a valid license issued by the committee. The committee shall also regulate the practice of applied behavior analysis.

Acts 2014, ch. 918, § 2.

63-11-302. Part definitions.

As used in this part:

  1. “Board” means the board of examiners in psychology, created by § 63-11-101;
  2. “Certifying entity” or “BACB” means the nationally accredited behavior analyst certification board or its successor;
  3. “Co-employed relationship” means the licensed behavior analyst and licensed assistant behavior analyst are employed by the same employer;
  4. “Committee” means the applied behavior analyst licensing committee of the board of examiners in psychology, created by § 63-11-303;
  5. “Employee-employer relationship” means the licensed behavior analyst is the employer of the licensed assistant behavior analyst. This relationship may include contractual employment or consultant services;
  6. “Human services professional” means an individual licensed or certified in this state as a:
    1. Physical therapist or physical therapist assistant;
    2. Occupational therapist or occupational therapist assistant;
    3. Clinical social worker;
    4. Masters social worker;
    5. Social work associate;
    6. Psychologist or health service psychologist;
    7. Speech pathologist;
    8. Audiologist;
    9. Professional counselor or professional counselor candidate;
    10. Marital and family therapist or marital and family therapist candidate;
    11. Licensed psychological examiner; or
    12. Senior licensed psychological examiner;
  7. “Licensed assistant behavior analyst” or “LABA” means an individual who is certified as a board certified assistant behavior analyst (BCABA) and is licensed in this state to practice applied behavior analysis under the extended authority and supervision of a licensed behavior analyst;
  8. “Licensed behavior analyst” or “LBA” means an individual who is certified as a board certified behavior analyst (BCBA) or board certified behavior analyst-doctoral (BCBA-D) and is licensed in this state to practice applied behavior analysis as an independent practitioner;
    1. “Practice of applied behavior analysis” means the design, implementation, and evaluation of environmental modifications by a behavior analyst to produce socially significant improvements in human behavior. It includes the empirical identification of functional relations between behavior and environmental factors, known as functional assessment and analysis;
    2. Applied behavior analysis (ABA) interventions are based on scientific research and the direct observation and measurement of behavior and environment. They utilize contextual factors, motivating operations, antecedent stimuli, positive reinforcement, and other procedures to help people develop new behaviors, increase or decrease existing behaviors, and emit behaviors under specific environmental conditions;
    3. The practice of applied behavior analysis expressly excludes psychological testing, neuropsychology, psychotherapy, cognitive therapy, sex therapy, psychoanalysis, hypnotherapy, and long-term counseling as treatment modalities;
  9. “Real-time supervision” means observation and provision of feedback to a supervisee's delivery of ABA services by an LBA or an LABA who is supervised by an LBA during interactions occurring in person or via technology that permits auditory and visual contact between supervisors and supervisees;
  10. “Supervisee” means a person who delivers ABA services under the extended authority and supervision of an LBA or an LABA who is supervised by an LBA; and
  11. “Supervision” means the direct observation and provision of feedback to a supervisee by an LBA or an LABA who is supervised by an LBA.

Acts 2014, ch. 918, § 2.

63-11-303. Creation — Authority — Membership — Conduct of meetings.

  1. There is hereby created the applied behavior analyst licensing committee of the board of examiners in psychology, which shall consist of five (5) members appointed by the governor.
  2. The committee is authorized to issue licenses to individuals who meet the requirements specified in this part, and to promulgate rules and regulations for the implementation of the part including, but not limited to, the setting of fees and the establishment of disciplinary actions. The committee shall maintain a list of all licensees that shall be provided to any interested party on written request.
    1. The committee as created shall consist of:
      1. Three (3) persons licensed as board certified behavior analysts or board certified behavior analysts-doctoral;
      2. One (1) person certified as a board certified assistant behavior analyst; and
      3. One (1) public member who is a consumer of applied behavior analysis services and holds neither certification.
    2. The members listed in subdivisions (c)(1)(A) and (B) may be appointed by the governor from lists of qualified nominees submitted by interested behavior analyst groups including, but not limited to, the Tennessee Association of Behavior Analysts.
    3. The governor shall consult with interested behavior analyst groups including, but not limited to, the Tennessee Association of Behavior Analysts, to determine qualified persons to fill the positions as provided in this subsection (c).
    4. Initial appointees to the committee shall serve staggered terms as follows:
      1. One (1) of the persons appointed pursuant to subdivision (c)(1)(A) shall serve an initial term of one (1) year;
      2. One (1) of the persons appointed pursuant to subdivision (c)(1)(A) and the person listed in subdivision (c)(1)(C) shall serve initial terms of two (2) years; and
      3. One (1) of the persons appointed pursuant to subdivision (c)(1)(A) and the person listed in subdivision (c)(1)(B) shall serve initial terms of three (3) years.
        1. Upon the expiration of the first full term of the member appointed pursuant to subdivision (c)(4)(A) on June 30, 2018, the governor shall appoint a licensed board certified behavior analyst to serve on the committee for a term of three (3) years.
        2. Upon the expiration of the first full terms of the members appointed pursuant to subdivision (c)(4)(B) on June 30, 2019, the governor shall appoint a licensed board certified behavior analyst and a public member, who holds no credentials as a licensed board certified behavior analyst or as a licensed assistant behavior analyst, to serve on the committee for terms of three (3) years.
        3. Upon the expiration of the first full terms of the members appointed pursuant to subdivision (c)(4)(C) on June 30, 2020, the governor shall appoint a licensed board certified behavior analyst and a licensed assistant behavior analyst to serve on the committee for terms of three (3) years.
      1. No member appointed pursuant to subdivision (c)(5)(A) or any member appointed subsequent to such members shall be eligible to serve more than one (1) consecutive three-year term.
      2. Members' terms shall begin on July 1 and expire on June 30.
  3. 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. All members of the committee shall serve as such without compensation, but they shall be entitled to receive necessary travel and other appropriate expenses while engaged in the committee's work.
  4. The committee shall be provided administrative support by the division of health related boards in the department of health.
    1. The committee shall meet at least once per quarter.
      1. Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year shall be removed as a member of the committee.
      2. The chair of the committee shall promptly notify, or cause to be notified, the appointing authority of any member who fails to satisfy the attendance requirement as prescribed in subdivision (f)(2)(A).
  5. The committee shall elect a chair from among its members appointed pursuant to subdivision (c)(1)(A) at the first meeting held in each fiscal year. A committee meeting may be called upon reasonable notice in the discretion of the chair and shall be called at any time upon reasonable notice by a petition of three (3) committee members to the chair.
  6. Any actions taken in accordance with this part shall only be effective after adoption by majority vote of the members of the committee and after adoption by a majority vote of the members of the board at the next board meeting at which administrative matters are considered following the adoption by the committee.

Acts 2014, ch. 918, § 2; 2016, ch. 609, § 3.

Compiler's Notes. The applied behavior analyst licensing committee of the board of examiners in psychology, created by this section, terminates June 30, 2022. See §§ 4-29-112, 4-29-243.

63-11-304. Application for license — Requirements.

Each person desiring to obtain a license shall submit an application and fee to the committee. The application shall include evidence that the applicant meets all of the following requirements for licensure:

  1. The applicant is at least twenty-one (21) years of age;
  2. The applicant is of good moral character and conducts his or her professional activities in accordance with accepted professional and ethical standards, including the certifying entity's Professional Disciplinary and Ethical Standards and Guidelines for Responsible Conduct for Behavior Analysts;
  3. The applicant has not had a professional credential refused, revoked, suspended, or restricted and does not have a complaint, allegation, or investigation pending in any regulatory jurisdiction in the United States or in another country for reasons that relate to unprofessional conduct, unless the committee finds that the conduct has been corrected or that mitigating circumstances exist that prevent resolution;
  4. LBA applicants shall:
    1. Be certified as a BCBA or board certified behavior analyst-doctoral at the time of application; and
    2. Not be the subject of disciplinary actions by the certifying entity; and
  5. LABA applicants shall:
    1. Be certified as a board certified assistant behavior analyst at the time of application;
    2. Not be the subject of disciplinary actions by the certifying entity; and
    3. Provide proof of ongoing supervision by an LBA who is currently certified as a BCBA or board certified behavior analyst-doctoral in a manner consistent with the certifying entity's requirements for supervision of board certified assistant behavior analysts.

Acts 2014, ch. 918, § 2.

63-11-305. Use of titles — Practice of applied behavior analysis — Penalty for violation.

  1. No person shall use the title “licensed behavior analyst” or “licensed assistant behavior analyst” unless that person holds the applicable license issued by the committee.
  2. No person shall practice applied behavior analysis unless that person is licensed by the committee as an LBA or an LABA or meets criteria for one (1) of the exemptions in § 63-11-306.
  3. Any person who violates this section commits a Class B misdemeanor, punishable by a fine only, the suspension or revocation of a license issued pursuant to this part, or both fine and loss of licensure.

Acts 2014, ch. 918, § 2.

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

63-11-306. Exceptions from application of part.

This part shall not be construed as prohibiting or restricting the practice of any of the following:

  1. Other human services professionals who are licensed, registered, or certified by the state; provided, such individuals are working within the scope of practice of their professions and the scope of their training and competence;
  2. Unlicensed persons who deliver applied behavior analysis (ABA) services under the extended authority and direction of an LBA or an LABA who is supervised by an LBA. Such persons shall not represent themselves as professional behavior analysts;
  3. Family members of recipients of ABA services who implement certain ABA procedures with recipients under the extended authority and direction of LBAs or LABAs who are supervised by LBAs. Such persons shall not represent themselves as professional behavior analysts;
  4. Behavior analysts who practice with nonhumans, including applied animal behaviorists and animal trainers. Such persons may use the title “behavior analyst” but may not represent themselves as LBAs or LABAs unless they hold one (1) of the credentials issued by the committee;
  5. Persons who provide general ABA services to organizations, so long as those services are for the benefit of the organizations and do not involve direct services to individuals;
  6. Matriculated college or university students, interns, or postdoctoral fellows whose activities are part of a defined behavior analysis program of study, practicum, or intensive practicum; provided, that the practice under this exemption is directly supervised by an LBA in this state or an instructor in a BACB approved course sequence. Students, interns, and postdoctoral fellows shall not represent themselves as professional behavior analysts but shall use titles that clearly indicate their trainee status, such as “behavior analysis student,” “behavior analysis intern,” or “behavior analysis trainee”;
  7. Persons who teach behavior analysis or conduct behavior analytic research; provided, that such teaching or research does not involve the delivery of direct behavior analytic services. Such persons may use the title “behavior analyst” but may not represent themselves as LBAs or LABAs unless they hold one (1) of the credentials issued by the committee; and
  8. Unlicensed persons pursuing experiential training in behavior analysis consistent with the BACB's experience requirements; provided, such experience is supervised by an LBA in this state who meets BACB supervisor requirements, and that the supervised experience is conducted in accordance with other BACB standards and requirements.

Acts 2014, ch. 918, § 2.

63-11-307. Term of license — Requirements for initial or renewed licensure — Provisional licensing — Promulgation of rules.

  1. Licenses for LBAs and LABAs shall be valid for two (2) years from the date of issuance.
  2. A person applying for initial or renewed licensure shall provide:
    1. Evidence of current certification at the required certification level;
    2. A photocopy of valid photo identification;
    3. A completed application form; and
    4. A notarized statement indicating that the applicant is in good standing with the certifying entity and the committee, and has complied with all requirements of this part.
  3. The committee may grant provisional licenses for LBA and LABA to any person qualified by the department of intellectual and developmental disabilities (DIDD) to provide behavior analysis services prior to July 12, 2012, if such person:
    1. Provides a notarized statement and evidence that they are in good standing with the standards and the guidelines of DIDD for granting such qualification;
    2. Provides a photocopy of a valid photo identification;
    3. Submits a completed application form;
    4. Pays all applicable fees for licensure and licensure renewal for the required certification level; and
    5. Has received certification by the BACB and applied for and obtained a regular license under the terms of this section by July 1, 2019.
  4. The committee shall promulgate rules to establish reasonable and necessary fees for licensure and licensure renewal for both LBAs and LABAs so that, in the aggregate, such fees produce sufficient revenue to cover the cost of administering this part.

Acts 2014, ch. 918, § 2.

63-11-308. Supervision of licensed assistant behavior analysts.

  1. A LBA shall provide supervision of applied behavior analysis (ABA) services under the LBA's extended authority and direction to all designated persons as provided in this part.
  2. A LABA shall work under the supervision of an LBA.
    1. A LBA shall provide supervision to a maximum of six (6) LABAs concurrently, with the supervision to be conducted as follows:
      1. A minimum of two (2) hours for each forty (40) hours of services provided by a LABA;
      2. A minimum of one-half (½) of all supervision hours shall involve real time interactions;
      3. A minimum of one-half (½) of all supervision hours shall involve one-to-one interactions between supervisors and supervisees. The remainder may be conducted in small group format.
    2. Acceptable supervision activities include:
      1. Direct observation of the LABA delivering ABA services to service recipients;
      2. Direct observation of the LABA training family members and staff to implement ABA assessment or intervention procedures;
      3. Demonstrating ABA assessment or intervention procedures;
      4. Coaching supervisees in implementing ABA assessment or intervention procedures;
      5. Reviewing and discussing treatment goals and procedures;
      6. Reviewing service recipient progress data; and
      7. Reviewing and discussing relevant research articles and other professional literature.
  3. A formal professional relationship shall exist between a supervising LBA and LABA in the form of:
    1. A co-employed relationship; or
    2. An employee-employer relationship.
  4. LABAs shall notify the committee within ten (10) business days of any change in supervision status.

Acts 2014, ch. 918, § 2.

63-11-309. Complaints regarding unprofessional conduct — Sanctions.

  1. All complaints regarding the unprofessional conduct of licensees shall be submitted to the committee in writing.
  2. An administrative staff person shall be appointed to serve under the direction of the committee to assist with investigations conducted in accordance with this section.
  3. Sanctions for unprofessional conduct shall be established by the committee.

Acts 2014, ch. 918, § 2.

63-11-310. Compliance with ethical standards — Reporting of disciplinary sanctions — Grounds for forfeiture or nonrenewal of license — Notifications to committee.

  1. All licensees shall comply with their respective certifying entity's Guidelines for Responsible Conduct and Professional Disciplinary and Ethical Standards.
  2. Any person licensed under this part who receives disciplinary sanctions from the person's certifying entity shall report such sanctions to the committee within five (5) business days after the disciplinary sanctions have been imposed. Such sanctions may include, but not be limited to, the denial of initial or renewal certification, revocation, suspension, or any other limitation of certification or combination of sanctions. Any licensee who loses certification for any reason shall immediately forfeit their license issued by the committee and shall stop providing ABA services in this state.
  3. Other grounds for forfeiture or nonrenewal of a license issued in accordance with this part include:
    1. Obtaining or attempting to obtain a license by making a false or misleading statement, failing to make a required statement, or engaging in fraud or deceit in any communication to the committee;
    2. Gross or repeated negligence, incompetence, misconduct, or malpractice in professional work including, but not limited to:
      1. Any physical or mental condition that currently impairs a licensee's competent professional performance or that poses a substantial risk to the recipient of behavior analysis services;
      2. Professional conduct that constitutes an extreme and unjustified deviation from the customary standard of practice accepted in the applied behavior analytic community that creates a serious risk of harm to, or deception of, service recipients;
      3. Abandonment of a service recipient resulting in the termination of imminently needed care without adequate notice or provision for transition;
      4. Professional record keeping or data collection that constitutes an extreme and unjustified deviation from the customary standard of practice for the field, or deceptively altering a service recipient's records or data;
      5. Engaging in blatant fraud, deception, misrepresentation, false promise or pretense, intimidation in the practice of applied behavior analysis, or in solicitation of service recipients;
      6. The unauthorized material disclosure of confidential service recipient information;
      7. Limitation, sanction, revocation, or suspension by a health care organization, professional organization, or other private or governmental body, relating to behavior analysis practice, public health or safety, or behavior analysis certification or licensure; or
      8. Any conviction of a felony or misdemeanor directly relating to behavior analysis practice or public health or safety.
  4. Applicants and licensees shall notify the committee of the following within thirty (30) days of their occurrence:
    1. A change of name, address, or other vital information;
    2. The filing of any criminal charge or civil action against the applicant or licensee;
    3. The initiation of any disciplinary charges, investigations, or findings or sanctions by a health care organization, federal or state agency, or other professional association against the licensee; and
    4. Any other change in information provided by the applicant or licensee to the committee.
  5. 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 2014, ch. 918, § 2; 2018, ch. 745, § 28.

Amendments. The 2018 amendment added (e).

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

63-11-311. Reciprocal licensing.

  1. The committee may, in its discretion, grant a license to any person residing or employed in this state who has not previously failed to attain a license as a behavior analyst or assistant behavior analyst and who, at the time of application:
    1. Is licensed or certified by a similar entity in another state whose standards, in the opinion of the committee, are not less stringent than those required by this part; and
    2. Is able to satisfy the committee that to grant such person a license would be in the public interest.
  2. Notwithstanding subsection (a), the committee shall grant a license to a person who at the time of application:
    1. Is licensed or certified in good standing with a similar entity of another state;
    2. Is certified as a BCBA, a BCBA-D or a BCABA; and
    3. Can show reasonable proof that the applicant has available employment in this state.

Acts 2014, ch. 918, § 2.

63-11-220. Peer review committees — Liability — Confidentiality of information.

Chapter 12
Tennessee Veterinary Practice Act

Part 1
Tennessee Veterinary Practice Act

63-12-101. Short title.

This chapter shall be known and may be cited as the “Tennessee Veterinary Practice Act.”

Acts 1967, ch. 80, § 1; T.C.A., § 63-1201; 2016, ch. 819, § 2.

Compiler's Notes. Acts 2006, ch. 716, §§  1-3 provided: “Notwithstanding any provision of the law to the contrary, the board of veterinary medical examiners shall refund all monetary fines and civil penalties imposed and collected in fiscal years 2004-2005 and 2005-2006 for the artificial insemination of livestock without a veterinary medical license, upon proper application by a person or persons fined for such practice.

“The provisions of this act shall not be construed to be an appropriation of funds, and no funds shall be obligated or expended pursuant to this act unless such funds are specifically appropriated by the general appropriations act.

“The board of veterinary medical examiners shall promulgate rules and regulations to effectuate the purposes of this act. All such rules and regulations shall be promulgated in accordance with the provisions of Tennessee Code Annotated, title 4, chapter 5.”

Cross-References. Occupation tax on veterinarians, title 67, ch. 4, part 17.

Law Reviews.

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

Attorney General Opinions. The unlicensed sale or distribution of prescription veterinary drugs is a violation of the Pharmacy Practice Act, OAG 03-135, 2003 Tenn. AG LEXIS 151 (10/13/03).

Both criminal and civil penalties may be imposed upon an unlicensed person or entity for selling or distributing prescription veterinary drugs, OAG 03-135, 2003 Tenn. AG LEXIS 151 (10/13/03).

The Board of Veterinary Medical Examiners has jurisdiction over an unlicensed person or entity that is selling or distributing prescription veterinary drugs, provided that such sale or distribution occurs either within the scope of practice of veterinary medicine, or with respect to any person, corporation or similar organization required to be licensed, permitted or authorized by the Board of Veterinary Medical Examiners; in addition, the Board of Pharmacy has jurisdiction over an unlicensed person or entity that is selling or distributing prescription veterinary drugs without a license, OAG 03-135, 2003 Tenn. AG LEXIS 151 (10/13/03).

NOTES TO DECISIONS

1. Relation to Employment Law.

Where employee reported violations of Tennessee's Veterinary Practice Act and the Non-livestock Animal Humane Death Act, as well as the regulations pertaining to those Acts, the employee did not have to show a subjective intent to promote the public good in order to pursue her claims based upon refusal to participate, or that she acted solely with a purpose to further the public good, without any consideration of his or her own personal interest. Coleman v. Humane Soc'y of Memphis, — S.W.3d —, 2014 Tenn. App. LEXIS 77 (Tenn. Ct. App. Feb. 14, 2014).

63-12-102. Purpose of chapter.

It is hereby declared that the practice of veterinary medicine is a privilege that is granted by legislative authority in the interest of the public health, safety and welfare. To protect the public from being misled by incompetent, unscrupulous and unauthorized practitioners and from unprofessional or illegal practices by persons licensed to practice veterinary medicine, this chapter is enacted in the interest of the health, safety and welfare of the animal population and the citizens of Tennessee.

Acts 1967, ch. 80, § 2; T.C.A., § 63-1202; Acts 1983, ch. 57, § 1.

Law Reviews.

Selected Tennessee Legislation of 1983 (N. L. Resener, J. A. Whitson, K. J. Miller), 50 Tenn. L. Rev. 785 (1983).

63-12-103. Chapter definitions.

As used in this chapter:

  1. “Animal” means any animal other than man and includes fowl, birds, reptiles and fish, wild or domestic, living or dead;
  2. “Board” means the board of veterinary medical examiners;
  3. “Certified animal control agency” means a county or municipal animal shelter, dog pound or animal control agency, private humane society, state, county or municipal law enforcement agency, or any combination thereof, that temporarily houses stray, unwanted or injured animals and that is certified pursuant to this chapter;
  4. “Certified animal euthanasia technician” means a person employed by a certified animal control agency who is authorized by the board to humanely euthanize animals by administering such drugs as are designated by the board for such use;
  5. “Complainant” means the board or any other person who initiates a proceeding;
  6. “Consultation” means when a licensed veterinarian receives advice in person, telephonically, electronically, or by any other method of communication, from a veterinarian licensed in this or any other state, or other person whose expertise, in the opinion of the licensed veterinarian, would benefit a patient. Under all circumstances, the responsibility for the welfare of the patient remains with the licensed veterinarian receiving consultation;
  7. “License” means any permit, approval, registration or certificate issued by the board;
  8. “Licensed veterinarian” means a person who is validly and currently licensed to practice veterinary medicine in this state;
  9. “Licensed veterinary technician” means a person who has successfully completed the examination requirements prescribed by the board and has been issued a license;
    1. “Practice of veterinary medicine” means to:
      1. Diagnose, treat, correct, change, alleviate, or prevent animal disease, illness, pain, deformity, defect, injury, or other physical, dental, or mental conditions by any method or mode, including:
  1. The prescription, dispensing, administration or application of any drug, medicine, biologic, apparatus, anesthetic, or other therapeutic or diagnostic substance or medical or surgical, including cosmetic, technique;
  2. The use of complementary, alternative, and integrative therapies;
  3. The use of any manual, mechanical, biological, or chemical procedure for the testing of pregnancy, or for the management or treatment of sterility or infertility;
  4. The rendering of advice or recommendation by any means including telephonic and other electronic communications with regard to subdivisions (10)(A)(i)(a)-(c) ; and
  5. The collection of blood or other samples for the purpose of diagnosing disease or other conditions. This shall not apply to:
    1. Any unlicensed personnel employed by the United States department of agriculture or the Tennessee department of agriculture who are engaged in animal disease control programs, or who perform laboratory examinations. This section does not prohibit extension personnel or vocational agriculture teachers from doing educational work that is considered normal to their profession in their government positions; or
    2. The removal of an embryo from livestock or companion animal for the purpose of transplanting such embryo into another female animal or for the purpose of cryopreserving such embryo;
      1. The practice of veterinary medicine occurs wherever the patient is at the time services are rendered;

        “Preceptor” means a person who is a last year student duly enrolled and in good standing in a recognized college of veterinary medicine. Such person's presence in a practice may be as part of a formal preceptorship program of the person's college or as an informal arrangement between the person and a veterinarian licensed by the board. The preceptor must be under direct supervision of such licensed veterinarian;

        “Veterinarian-client-patient relationship” means:

        “Veterinarian” means a person who has received a doctor of veterinary medicine degree or its equivalent from an approved school or college of veterinary medicine;

        “Unprofessional or unethical conduct,” among other things, means any conduct of a character likely to deceive or defraud the public, objectionable advertising, obtaining any fee or compensation by fraud or misrepresentation, sharing office space with any person illegally practicing veterinary medicine, employing either directly or indirectly any unlicensed person to practice veterinary medicine or render any veterinary service except as provided in this chapter or the violation of any rule adopted by the board, which shall provide a code of professional ethics to be followed and carried out by persons licensed under this chapter;

        “Temporary license” means temporary permission to practice veterinary medicine issued pursuant to this chapter;

        “School of veterinary medicine” means any veterinary school or college, department of a university or college, legally organized, whose course of study in the art and science of veterinary medicine conforms to the standards required for accreditation by the American Veterinary Medical Association and approved by the board;

        “Responsible supervision” or words of similar purport mean the control, direction and regulation by a licensed veterinarian of the duties involving veterinary services that such veterinarian delegates to such veterinarian's personnel;

      2. The veterinarian has assumed responsibility for making clinical judgments regarding the health of the animal and the need for medical treatment, has obtained informed consent, and the client has agreed to follow the veterinarian's instructions;
      3. The veterinarian has sufficient knowledge of the animal to initiate at least a general or preliminary diagnosis of the medical condition of the animal;
      4. The veterinarian has seen the animal within the last twelve (12) months or is personally acquainted with the keeping and care of the animal, either by virtue of an examination of the animal or by medically appropriate visits to the premises where the animal is maintained within the last twelve (12) months;
      5. The veterinarian is readily available or has arranged for emergency coverage for follow-up evaluation in the event of adverse reactions or the failure of the treatment regimen;
      6. The veterinarian must maintain medical records as required by the board of veterinary medical examiners; and
      7. The veterinarian-client-patient relationship cannot be established or maintained solely by telephone or other electronic means;

        “Veterinary facility” means:

      8. Animal medical center — A veterinary or animal medical center means a facility in which consultative, clinical and hospital services are rendered and in which a large staff of basic and applied veterinary scientists perform significant research and conduct advanced professional educational programs;
      9. Clinics — A veterinary or animal clinic means a facility in which the practice conducted is essentially an outpatient type of practice;
      10. Hospital — A veterinary or animal hospital means a facility in which the practice conducted includes the confinement, as well as the treatment, of patients;
      11. Mobile facility — A practice conducted from a vehicle with special medical or surgical facilities or from a vehicle suitable only for making house or farm calls. Regardless of mode of transportation, such practice shall have a permanent base of operations with a published address and telephone facilities for making appointments or responding to emergency situations; and
      12. Office — A veterinary facility where a limited or consultative practice is conducted and that provides no facilities for the housing of patients;

        “Veterinary medicine” includes veterinary surgery, obstetrics, dentistry and all other branches or specialties of veterinary medicine; and

        “Veterinary technician” means a person who is a graduate of a veterinary technology program accredited by the American Veterinary Medical Association.

Represent, directly or indirectly, publicly or privately, an ability and willingness to do an act described in subdivision (10)(A); and

Use any title, words, abbreviation, or letters in a manner or under circumstances that induce the belief that the person using them is qualified to do any act described in subdivision (10)(A)(i). Such use shall be prima facie evidence of the intention to represent oneself as engaged in the practice of veterinary medicine;

Acts 1967, ch. 80, § 3; T.C.A., § 63-1203; Acts 1982, ch. 598, § 1; 1983, ch. 57, § 2; 1997, ch. 106, § 2; 1999, ch. 375, §§ 1, 2; 2010, ch. 804, §§ 1, 2; 2016, ch. 819, § 3.

Amendments. The 2016 amendment, in the definition of “practice of veterinary medicine”, redesignated the former introductory language as present (A), redesignated former (A)-(C) as present (A)(i)-(iii), respectively, redesignated former (A)(i)-(v) as present (A)(a )-(e ), respectively, redesignated former (A)(v)(a ) and (b ) as present (A)(e )(1 ) and (e )(2 ) and added present (B).

63-12-104. Creation of board — Appointment and removal of members.

  1. There is created the board of veterinary medical examiners, referred to as the “board” in this chapter.
  2. The board shall be composed of:
    1. Five (5) licensed doctors of veterinary medicine, who shall be graduates of an approved school of veterinary medicine and of good standing in their profession and who have had not less than five (5) years' actual experience in the practice of veterinary medicine;
    2. One (1) licensed veterinary technician who shall be a graduate of an approved veterinary technology program, is of good standing in the profession, and who has had not less than five (5) years' actual experience as a licensed veterinary technician; and
    3. One (1) member of the general public as provided by § 63-1-124.
  3. The members of the board shall be appointed by the governor for a term of five (5) years. Each member so appointed shall serve until the expiration of the particular five-year term to which the member is appointed and thereafter until the member's successor has been appointed by the governor. The governor shall appoint new members to the board to serve after the date of expiration of each of these terms until August 1 of the fifth calendar year thereafter. In making appointments to the board, 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.
  4. In the event of a vacancy on the board, the governor shall appoint a new member to serve out the unexpired term. No member may be reappointed to the board until one (1) year after the expiration of the member's term of office, except that a person appointed for a term of less than five (5) years may be reappointed.
  5. Members of the board may be appointed by the governor from lists of qualified nominees submitted by interested veterinary groups, including, but not limited to, the Tennessee Veterinary Medical Association. The governor shall consult with such interested groups to determine qualified persons to fill the positions. This subsection (e) shall not apply to the appointment of the public member.
  6. No person who has been appointed a member of the board shall continue on the board if during the term of the member's appointment the member shall:
    1. Transfer the member's legal residence to another state;
    2. Be or become the owner of, or be employed by, any wholesale or jobbing house dealing in supplies, equipment or instruments used or useful in the practice of veterinary medicine; or
    3. Have the member's license to practice veterinary medicine rescinded for cause in accordance with this chapter.
  7. The governor may suspend any member of the board for malfeasance, misfeasance, gross inefficiency or misconduct or upon any of the constitutional grounds upon which officers may be suspended by the governor.
  8. The state veterinarian, as appointed by the commissioner of agriculture, shall serve as a nonvoting, ex officio member of the board of veterinary medical examiners.

Acts 1967, ch. 80, § 4; T.C.A., § 63-1204; Acts 1988, ch. 1013, § 50; 1998, ch. 649, §§ 1, 2; 1999, ch. 375, §§ 3, 4; 2004, ch. 567, § 1; 2012, ch. 695, § 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 §§ 63-1-13163-1-133, 68-1-101.

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

Cross-References. State examining boards, general provisions, title 4, ch. 19.

63-12-105. Meetings of board — Officers — Rules and regulations — Quorum — Seal.

  1. The board shall meet annually at such time and place as may be agreed upon by a majority of the members, at which meeting it shall elect from its membership a president, vice president, and secretary. The board is authorized to create other officers and to adopt such rules and regulations as may be proper for the efficient operation of the board.
  2. Four (4) members of the board shall constitute a quorum for the transaction of all business.
  3. The board shall meet at such other times and places to conduct business upon call of the president.
  4. The board shall adopt a seal that shall be affixed to all licenses issued by the board and to other papers requiring the same.

Acts 1967, ch. 80, § 5; T.C.A., § 63-1205; Acts 1983, ch. 57, § 3; 1998, ch. 649, § 3.

Cross-References. Additional quorum provisions, § 63-12-107.

63-12-106. Powers of board.

The board is authorized to:

  1. Adopt reasonable rules governing the practice of veterinary medicine as are necessary to enable it to carry out and make effective the purpose and intent of this chapter. Such rules shall be adopted pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5;
  2. Adopt rules of professional conduct appropriate to establish and maintain a high standard of integrity, skills and practice in the profession of veterinary medicine. In prescribing such rules of professional conduct, the board may be guided by the principles of veterinary medical ethics adopted by the American Veterinary Medical Association and the Tennessee Veterinary Medical Association;
  3. Have its rules printed and distributed to all licensed doctors of veterinary medicine;
  4. Bring proceedings in courts for the enforcement of this chapter or any rules made pursuant thereto;
  5. Hold at least one (1) regular meeting each year at such time and place as fixed by the board. Other meetings may be held upon the call of the president and secretary. The regular meetings will be for the purpose of conducting examinations of applications for license to practice veterinary medicine, the election of officers and to consider any other business that may properly come before the board;
  6. Pass upon the qualifications of applicants for a license to practice veterinary medicine in this state;
  7. Prescribe the subjects, character, manner, time and place of holding examinations and the filing of applications for examinations and to conduct the examinations;
  8. Issue temporary permits or licenses, which shall be signed by the secretary, to duly qualified applicants;
  9. Provide for, regulate and require all persons licensed in accordance with this chapter to renew their license annually, require as a condition precedent to such annual renewal the payment of the annual renewal fee as provided in § 63-12-121, issue annual renewal licenses to such persons and suspend or revoke the license of such persons who fail, refuse or neglect to renew same or pay such fees;
  10. Conduct investigations and hearings upon complaints calling for discipline of a licensee or applicant for license or certificate or permit holder or applicant for a certificate or a permit;
  11. Take testimony on any matter under its jurisdiction, and any member thereof may administer oaths;
  12. Issue summonses and subpoenas, including subpoenas duces tecum, which shall be signed by either the president or the secretary-treasurer of the board, for any witness in connection with any matter within the jurisdiction of the board;
  13. Adopt such forms as it may deem necessary;
  14. Establish continuing educational requirements; and
  15. Issue such certificates as are authorized under this chapter.

Acts 1967, ch. 80, §§ 6, 35; T.C.A., § 63-1206; Acts 1983, ch. 57, § 4; 1997, ch. 106, §§ 3, 4.

Attorney General Opinions. The adoption by the board of veterinary medical examiners of various proposed rules concerning the definition of “physical plant” would not exceed its statutory authority under the Veterinary Practice Act, T.C.A. § 63-12-101, OAG 02-007, 2002 Tenn. AG LEXIS 5 (1/4/02).

63-12-107. Meetings of board.

  1. The board shall meet at least once each year at such times and places as it may decide upon and remain in session sufficiently long to examine all who may make application at the appointed time for a license.
  2. Four (4) members of the board shall constitute a quorum for the transaction of business and examination of candidates for license. A majority of those present shall be necessary to reject any application, but such rejection shall not bar the applicant from reexamination at the next regular meeting of the board.

Acts 1967, ch. 80, § 7; T.C.A., § 63-1207; Acts 1998, ch. 649, § 4.

Cross-References. Additional quorum provisions, § 63-12-105.

63-12-108. Compensation of members — Expenses of board.

  1. The members of the board shall receive as compensation for their services one hundred dollars ($100) per day for each day or portion thereof, each, while in actual service of the board, which, together with the necessary expenses of each meeting of the board, shall be paid out of any moneys in the treasury of the board upon the certificate of the president and secretary.
  2. 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.

Acts 1967, ch. 80, § 8; 1976, ch. 806, § 1(117); T.C.A., § 63-1208; Acts 2013, ch. 440, § 1.

63-12-109. Funds of board — Disposition of surplus.

It is unlawful for the board or any member thereof, in any manner whatsoever or for any purpose, to charge or obligate the state for the payment of any money, and the board shall look alone to the revenue derived from the operation of this chapter for the compensation designated in § 63-12-108. If the revenue is not sufficient to pay each member in full, together with the necessary expenses of the board, then the amount available shall be prorated among the members. But if there should be a greater revenue derived than shall be required to pay the compensation and expenses, including, but not limited to, the administrative and personnel expenses deemed necessary in the discretion of the board to conduct inspections and issue licenses, permits and certificates as provided by this chapter, directed, any surplus shall be paid to the state treasurer, who shall receipt the board for the amount so received and shall account for the money as for other state revenue.

Acts 1967, ch. 80, § 9; T.C.A., § 63-1209; Acts 1997, ch. 106, § 10.

63-12-110. Records of board — Confidentiality.

  1. The board shall keep records of its proceedings in a book provided for that purpose, especially with relation to the issuance, denial, renewal, suspension and revocation of licenses to practice veterinary medicine.
    1. All licenses issued by the board shall be numbered and recorded by the secretary in a file for that purpose; and where a license is denied by the board to any applicant under this chapter, the fact and grounds for such denial shall be entered on the minutes of the board.
    2. The time of issuance or denial of license shall be noted along with the names of those board members present, and such file or record shall be open to public inspection.
  2. These records shall be maintained in the division.
  3. Information received by the board through inspections and investigations shall be confidential and shall not be disclosed except in a proceeding involving the question of license.

Acts 1967, ch. 80, § 10; T.C.A., § 63-1210; Acts 1983, ch. 57, § 5.

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

63-12-111. Approval of veterinary schools.

  1. The board may approve schools and colleges of veterinary medicine which maintain standards of training and reputability sufficient to admit their graduates to the examinations given by the board.
  2. In determining the standard of training and reputation of schools or colleges of veterinary medicine, the board may approve schools and colleges that are accredited by the American Veterinary Medical Association.
  3. The board may approve graduates of foreign schools of veterinary medicine that have been approved by the American Veterinary Medical Association or by obtaining proof that the college or school maintains standards equal to the standards of approved colleges or schools in the United States to take the examinations given by the board.

Acts 1967, ch. 80, § 11; T.C.A., § 63-1211.

63-12-112. License requirement — Qualifications of applicants.

  1. Any person wishing to practice veterinary medicine in this state shall obtain a license from the board. It is unlawful for such person to practice veterinary medicine as defined in § 63-12-103 unless the person obtains a license; and if the person so practices, the person shall be considered to have violated this chapter.
  2. The board may admit to examination any applicant who submits satisfactory evidence that the applicant:
    1. Is a graduate of a school or college of veterinary medicine approved by the board;
    2. Is in good physical and mental health;
    3. Is of good moral character;
    4. Is a citizen of the United States or Canada or legally entitled to live within the United States;
    5. Subscribes to and will uphold the principles incorporated in the Constitution of the United States; and
    6. Has paid the required fee.
  3. Any person holding a license to practice veterinary medicine in this state that is valid on September 1, 1967, is considered to be licensed to practice veterinary medicine under this chapter and is subject to all the provisions thereof.

Acts 1967, ch. 80, §§ 12, 35; T.C.A., § 63-1212; Acts 1982, ch. 611, § 1; 1983, ch. 57, § 6.

Cross-References. Exemption from licensing requirements for practice of medicine, § 63-6-204.

Licensing, §§ 63-1-10363-1-112.

Law Reviews.

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

63-12-113. Temporary licenses.

The board may issue a temporary license to practice veterinary medicine, to be used only under the direct supervision of a licensed veterinarian, upon payment of a fee as set by the board, to:

  1. A veterinarian who meets all qualifications and requirements pursuant to this chapter and who has applied to take the examination as provided in § 63-12-115. Such license shall remain valid until the results of the examinations are made known to the applicant;
    1. Failure on both examinations will result in immediate termination of the license;
      1. If the applicant fails one (1) of the examinations, the applicant may be issued a second temporary license but must continue under direct supervision of a licensed veterinarian and only until the results of the next regularly scheduled examination are known;
      2. If an applicant fails the same examination on two (2) separate testing dates, the applicant may, in the discretion of the board, and upon agreeing to meet any additional requirements of the board, be issued a third temporary license for up to one (1) year, plus the time until the results of the second regularly scheduled examination after issuance of the temporary license are made known;
      3. No applicant shall be allowed to take the same examination more than three (3) times;
    2. During the validity of the temporary license, the applicant must be under the direct supervision of a licensed veterinarian;
    3. New graduates applying for such temporary license must provide the name and address of practice of the supervising veterinarian and any other requirements specified by the board in rules and regulations;
    1. A veterinarian duly licensed according to the laws of another state and who has made application for permanent licensure in Tennessee;
      1. A temporary license issued under this section shall be valid until the board rules on the applicant's request;
      2. If the board's decision is to issue a license without examination, the temporary license expires on receipt of the permanent license;
      3. If the board's decision is for examination, then the law applies as stated in subdivision (1);
    2. An applicant who holds a license in another state or states must provide the name or names of such states, meet all qualifications and requirements pursuant to this chapter, provide the name and address of practice of the supervising veterinarian, and meet such other requirements as specified by the board in rules and regulations. All information submitted by an applicant will be subject to verification by the board;
  2. A graduate of a nonaccredited or nonapproved college of veterinary medicine who has satisfactorily completed the fourth year of clinical study at an accredited or approved college of veterinary medicine, successfully passed the examination as provided in § 63-12-115 and is enrolled in the Educational Commission for Foreign Veterinary Graduates (ECFVG) program of the American Veterinary Medical Association or other certification program deemed by the board to be equivalent to the ECFVG program may be granted a temporary license. The holder of a temporary license issued under this section must practice under the direct supervision of a veterinarian licensed in Tennessee. The temporary license is valid until the candidate obtains the ECFVG or equivalent certification; provided, that a temporary license issued pursuant to this section shall not be valid for more than a maximum of eighteen (18) months from the date the temporary license is issued.

Acts 1967, ch. 80, § 13; T.C.A., § 63-1213; Acts 1983, ch. 57, § 7; 1989, ch. 523, § 71; 2004, ch. 522, § 1.

Cross-References. Temporary authorization to practice, § 63-1-142.

63-12-114. Application for examination.

    1. Any person desiring to take the state board written and oral examination shall make application in writing to the board on blanks provided for that purpose at least forty-five (45) days before the examination.
    2. The application for the state board written and oral examination shall be accompanied by a nonrefundable application fee as set by the board.
    3. The application for the national board examination shall be accompanied by a nonrefundable application fee as set by the board.
    4. Any person desiring to take the clinical competency test shall make application in writing to the board on blanks provided for that purpose at least forty-five (45) days before the examination.
    5. The application for the clinical competency test shall be accompanied by a nonrefundable application fee as set by the board.
    1. Applicants who are accepted for the state board written and oral examination shall pay a fee to the board at least forty-five (45) days prior to taking the examination, as set by the board.
    2. Applicants who are accepted for the national board examination shall pay a fee to the board at least forty-five (45) days prior to taking the examination as set by the board.
    3. Applicants who are accepted for the clinical competency test shall pay a fee to the board at least forty-five (45) days prior to taking the examination as set by the board.
  1. The board shall give notice of the time and place of all examinations in such manner as the board may consider expedient.

Acts 1967, ch. 80, § 14; 1980, ch. 568, § 1; T.C.A., § 63-1214; Acts 1988, ch. 752, §§ 1, 2; 1989, ch. 523, §§ 72-77.

Cross-References. Application for licenses, § 63-1-103.

63-12-115. Examinations.

  1. The examination of applicants for license to practice veterinary medicine shall be administered by designated board members, and will consist of the national board examination and the state board examination and will be conducted under uniform rules and regulations adopted by the board.
  2. The board shall require the applicant to take a written examination in the English language, in veterinary anatomy, veterinary surgery, veterinary physiology, veterinary pathology, veterinary obstetrics, veterinary materia medica and veterinary practice, chemistry and such other subjects related to veterinary medicine as the board may require.
  3. The examination may include oral and practical examinations.
  4. The minimum passing grade shall be established by the board.

Acts 1967, ch. 80, § 15; T.C.A., § 63-1215; Acts 1983, ch. 57, § 8.

63-12-116. Issuance of licenses.

  1. If the applicant for examination be found worthy and competent by the board, it shall issue to the applicant a certificate of license to practice veterinary medicine in this state.
  2. Each licensee shall be entitled to exercise all the rights and privileges of a doctor of veterinary medicine. Every person practicing veterinary medicine shall be governed by the laws of this state and the rules adopted by the board.

Acts 1967, ch. 80, § 16; T.C.A., § 63-1216.

63-12-117. Issuance of license without examination — Reciprocity.

The board, in its discretion, may issue a license without a written examination to a qualified applicant who furnishes satisfactory proof that the applicant is a graduate of an approved veterinary college and meets all other standards adopted by the board in rules and regulations. At its discretion, the board may orally or practically examine any person qualifying for license under this section or may enter into agreement for reciprocal licensing with other states having substantially similar requirements for licensure.

Acts 1967, ch. 80, § 17; T.C.A., § 63-1217; Acts 1983, ch. 57, § 9.

63-12-118. Veterinary wellness committees.

  1. As used in this section, “veterinary wellness committee” or “committee” means any committee, board, commission, or other entity established by any state-wide veterinary medical association or local veterinary medical association for the purpose of providing immediate and continuing help to veterinary professionals licensed to practice veterinary medicine or veterinary technology, students of veterinary medicine and veterinary technology, certified animal euthanasia technicians, and employees of veterinary practices in this state who suffer from physical or mental conditions that result from disease, disorder, trauma, or age and that impair their ability to perform their duties in veterinary medicine with reasonable skill and safety.
  2. Veterinary wellness committee members, employees, and agents, including volunteers, taking any action authorized by this chapter, engaging in the performance of any duties on behalf of the committee, or participating in any administrative or judicial proceeding resulting from their participation on the committee, shall be immune from civil or criminal liability with respect to any action taken in good faith and without malice.
  3. All information, interviews, reports, statements, memoranda, or other data furnished to or produced by a veterinary wellness committee and any findings, conclusions, reports, or recommendations resulting from the proceedings of the committee are privileged and confidential. Information and actions taken by the committee shall be privileged and held in strictest confidence and shall not be disclosed or required to be disclosed to any person or entity outside of the committee, unless such disclosure is authorized by the member of the veterinary profession to whom it relates. Nothing contained in this subsection (c) applies to records, documents, or information otherwise available from original sources, and such records, documents, or information are not immune from discovery or use in any civil proceedings solely due to having been presented to the committee.

Acts 2016, ch. 819, § 5.

Compiler's Notes. Former § 63-12-118 (Acts 1967, ch. 80, § 18; T.C.A., § 63-1218), concerning recordation and display of licenses, was repealed by Acts 1983, ch. 57, § 10. For present provisions, see § 63-1-109.

63-12-119. Penalty for unlicensed practice.

Any person who practices or attempts to practice veterinary medicine in this state and makes a charge for the practice without having complied with this chapter commits a Class B misdemeanor for each instance of such practice.

Acts 1967, ch. 80, § 19; T.C.A., § 63-1219; Acts 1989, ch. 591, § 112.

Cross-References. Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, recovery, § 63-1-134.

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

63-12-120. Continuing education.

  1. Each license holder under this chapter, except as otherwise provided, shall be required to meet continuing educational requirements each year within the renewal period, which are approved by the board, such as those conducted or sponsored by the Tennessee Veterinary Medical Association, the Southern Veterinary Medical Association, the American Veterinary Medical Association or any of its constituent branches. The minimum number of hours of attendance for continuing education so required shall be prescribed by the board. However, postgraduate study or attendance at an institution or an educational session approved by the board shall be considered equivalent, but the board shall have the right, for good cause shown, to prescribe the type and character of postgraduate study to be done by any doctor of veterinary medicine in order to comply with the requirements of this chapter.
  2. The board, in its discretion, may waive the annual continuing education requirements for good cause shown.
  3. The board shall promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, rules that establish criteria for issuance of the continuing education credits required by this section.

Acts 1967, ch. 80, § 20; T.C.A., § 63-1220; Acts 1983, ch. 57, § 11; 1984, ch. 906, § 3.

63-12-121. Renewal of license — Disposition of fines and fees — Expenses — Retirement.

  1. All persons who are now or may hereafter be licensed to practice veterinary medicine in this state shall renew such license as follows:
    1. Each year, the secretary-treasurer of the board shall mail an application for renewal of license to every person holding a valid current license;
    2. The applicant shall fill in the application and return it to the secretary-treasurer of the board;
    3. The applicant shall furnish the board such evidence as it may require of having complied with provisions pursuant to this chapter relating to the annual educational program;
    4. The annual renewal fee shall be set by the board and shall be paid at the time the application for renewal of license is filed;
    5. If any holder of a license fails to renew the license within sixty (60) days after registration becomes due, as provided in this section, the license or certificate of such person shall be automatically revoked at the expiration of the sixty (60) days after the registration was required, without further notice or hearing unless requested;
    6. However, during any war or national emergency, the holder of a license on active duty with the armed services shall not be required to renew the license until January 1 of the year following the date of the holder's release from such active duty; and
    7. The acceptance of any fee by the board shall not in any way affect the board's powers or duties with respect to the revocation, suspension or refusal to grant any license.
  2. All fines for offenses for the violation of this chapter shall be paid over to the board and shall become a part of the receipts of the board. All money received by the board shall be paid into the state treasury and become a part of the general fund of the state. The budget director shall make such allotments out of the general fund as the budget director may deem proper for the necessary expenses of the board, and no expenditure shall be made by the board unless and until such allotment has been made by the budget director. Such allotments shall be disbursed under the general budgetary laws of this state.
  3. Any person licensed to practice veterinary medicine who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in the practice of veterinary medicine in this state, such person shall apply for registration with the board as provided by this chapter and shall meet continuing education requirements as set by the board.
    1. Notwithstanding any provision of 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 (d).

Acts 1967, ch. 80, § 21; impl. am. Acts 1978, ch. 934, §§ 22, 36; T.C.A., § 63-1221; Acts 1983, ch. 57, § 12; 1988, ch. 752, § 3; 1989, ch. 360, §§ 39-42; 1989, ch. 523, § 212.

Cross-References. Deposits and disbursement of funds, §   63-1-137.

Disposition of fines and penalties, operating expenses, §  63-1-113.

License renewals, §  63-1-107.

Retirement, § 63-1-111.

63-12-122. Reissuance of license after revocation or suspension.

  1. The board, by an affirmative vote of three (3), at any time after suspension or revocation of a license for good and sufficient cause, may reissue a license to the person affected, conferring upon the person all the rights and privileges pertaining to the practice of veterinary medicine.
  2. Any person to whom such license may be reissued shall pay the same fee as upon the issuance of the original license.

Acts 1967, ch. 80, § 22; T.C.A., § 63-1222.

63-12-123. Issuance of duplicate license.

  1. The board may issue a duplicate license to replace one that has been lost or destroyed or where a name change is requested, for a fee as set by the board.
  2. Each duplicate license shall have the word “Duplicate” typed or printed across its face.

Acts 1967, ch. 80, § 23; T.C.A., § 63-1223; Acts 1983, ch. 57, § 13; 1989, ch. 523, § 78.

63-12-124. Denial, suspension or revocation of license — Investigation — Immunity of informants.

  1. The board, pursuant to the procedure prescribed in this section, has the power to deny, suspend or revoke any license or to otherwise discipline an applicant or licensee who is found guilty by the board of one (1) or more of the following:
    1. Willful or repeated violation of any provisions of this chapter or any rules of the board;
    2. Fraud or deceit in procuring or attempting to procure a license to practice veterinary medicine, or presenting to the board dishonest or fraudulent evidence of qualification or fraud or deception in the process of examination for the purpose of securing a license;
    3. The willful failure to display a license;
    4. Fraud, deception, misrepresentation, dishonest or illegal practices in or connected with the practice of veterinary medicine in any of its branches;
    5. Willfully making any misrepresentation in the inspection of food for human consumption;
    6. Fraudulently issuing or using any health certificate, vaccination certificate, inspection certificate, test chart or other blank form used in the practice of veterinary medicine to the dissemination of animal disease, transportation of diseased animals or the sale of inedible products of animal origin for human consumption;
    7. Fraud or dishonesty in applying, treating or reporting on tuberculin, diagnostic or other biological test;
    8. Failure to keep the equipment and premises of the business establishment in a clean and sanitary condition;
    9. Refusing to permit the board or any legal representative of the board to inspect the business premises of the licensee during regular business hours;
    10. Circulating knowingly untrue, fraudulent, misleading or deceptive advertising;
    11. Gross malpractice or a pattern of continued or repeated malpractice, ignorance, negligence or incompetence in the course of veterinary medical practice;
    12. Unprofessional or unethical conduct or engaging in practices in connection with the practice of veterinary medicine that are in violation of the standards of professional conduct as defined in this section or prescribed by the rules of the board;
    13. Conduct reflecting unfavorably upon the profession of veterinary medicine;
    14. The willful making of any false statement as to a material matter in any oath or affidavit that is required by this chapter;
    15. Revocation by another state of a license to practice veterinary medicine in that state, in which case the record of such revocation shall be conclusive evidence;
    16. Conviction on a charge of cruelty to animals;
    17. Conviction of a felony under federal or state law involving use, misuse, possession or sale of any controlled substance or controlled substance analogue;
    18. Conviction of a felony in the courts of this state, or of any other state, territory or country that, if committed in this state, would be a felony;
      1. The record of conviction in a court of competent jurisdiction shall be sufficient evidence for disciplinary action to be taken as may be considered proper by the board. For the purpose of this chapter, a conviction shall be considered to be a conviction that has been upheld by the highest appellate court having jurisdiction or a conviction upon which the time for filing an appeal has passed; and
      2. A record of conviction upon charges that involve the unlawful practice of veterinary medicine; and based upon such record of conviction, without any other testimony, the board may take temporary disciplinary action even though an appeal for review by a higher court may be pending;
    19. Permitting or allowing another to use the licensee's license for the purpose of treating or offering to treat sick, injured or affected animals;
    20. Engaging in the practice of veterinary medicine under a false or assumed name or the impersonation of another practitioner of a like, similar or different name;
    21. Has been guilty of employing or permitting any person who does not hold a license to practice veterinary medicine in this state to perform work that, under this chapter, can lawfully be done only by persons holding such license and permitted by law to practice veterinary medicine in this state. It shall be conclusively presumed that any unlicensed person, if employed by a licensed person, was employed for such purpose if the unlicensed person has attended any school of veterinary medicine or surgery, accredited or otherwise, for a period of over thirty (30) days;
    22. Addiction to the habitual use of intoxicating liquors, narcotics or other stimulants to such an extent as to incapacitate the applicant or licensee from the performance of the applicant's or the licensee's professional obligations and duties;
    23. Professional incompetence;
    24. Having been adjudged mentally incompetent by a court of competent jurisdiction and the disabilities of such person not having been restored or the voluntary commitment or admission to a state hospital or other mental institution. The record of adjudication, judgment, order or voluntary commitment is conclusive evidence of such mental illness; and upon receipt of a certified copy of any such adjudication, judgment, order or record of voluntary commitment by the board, it may suspend the license of the person so adjudicated or committed;
    25. Failure to report, as required by law, or making false report of, any contagious or infectious disease as referred to under the United States department of agriculture (USDA) standards for accreditation of veterinarians in Tennessee and other states;
    26. Has been found guilty of using biologicals or other drugs that have deteriorated or after the expiration date of that particular lot or serial number;
    27. Has been convicted of any crime involving moral turpitude;
    28. Dispensing, prescribing or otherwise distributing any controlled substance or any other drug not in the course of the accepted practice of veterinary medicine; or
    29. Practicing veterinary medicine without establishing and maintaining a valid veterinarian-client-patient relationship.
  2. The board may, on its own motion, cause to be investigated any report indicating that a veterinarian is or may be in violation of this chapter.
  3. Any person who in good faith shall report to the board any information that a veterinarian is or may be in violation of any provisions of this chapter shall not be subject to suit for civil damages as a result thereof.
  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 1967, ch. 80, § 24; T.C.A., § 63-1224; Acts 1983, ch. 57, § 14; 2012, ch. 848, § 76; 2016, ch. 819, § 4; 2018, ch. 745, § 29.

Amendments. The 2018 amendment added (d).

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

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

Criminal background checks, § 63-1-116.

Grounds for license denial, suspension or revocation, § 63-6-214.

Law Reviews.

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

63-12-125. Administrative procedures.

The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, shall apply to all proceedings of the board and regulations promulgated pursuant to this chapter.

Acts 1967, ch. 80, § 25; T.C.A., § 63-1225; Acts 1983, ch. 57, § 15.

63-12-126, 63-12-127. [Repealed.]

Compiler's Notes. Former §§ 63-12-126, 63-12-127 (Acts 1967, ch. 80, §§ 26, 27; T.C.A., §§ 63-1226, 63-1227), concerning procedure in disciplinary actions, were repealed by Acts 1983, ch. 57, § 16. For new provisions, see § 63-12-125.

63-12-128. Disciplinary orders against violators — Judicial review.

  1. The board has the authority to enter an order to discipline any person, corporation or other similar organization, public or private, for-profit or not-for-profit, who or which, after proper hearing, has been found guilty by the board of a violation of one (1) or more provisions of this chapter or any rule of the board. The board, based upon the evidence and its findings of fact, may enter its final order, which may include one (1) or more of the following provisions:
    1. Suspend or limit the right to practice veterinary medicine in this state;
    2. Suspend or limit the right to hold a certificate or premises permit in this state;
    3. Revoke the license to practice veterinary medicine. Following revocation of such license, the licensee may be relicensed at the discretion of the board with or without examination;
    4. Impose judgment and penalties, but suspend enforcement thereof and place the licensee or license applicant, certificate holder or certificate applicant, premises permit holder or premises permit applicant on probation;
    5. Suspend the imposition of judgment and penalties;
    6. Refuse to issue a new license, certificate or premises permit;
    7. Withhold any license, certificate or premises permit, either permanently or for a period of time, when the same, has not been delivered;
    8. Suspend or limit the right to own or operate a veterinary facility in this state; or
    9. Take such other action in relation to discipline as the board in its discretion may deem proper.
  2. Immediately upon entry of the final order by the board, a copy thereof shall be delivered to the respondent and the respondent's counsel, if any, either personally or by registered or certified mail.
  3. Judicial review of orders of the board may be had by writ of certiorari or as otherwise provided by the laws of this state.

Acts 1967, ch. 80, § 28; T.C.A., § 63-1228; Acts 1996, ch. 771, § 1; 1996, ch. 773, §§ 1, 2; 1997, ch. 106, §§ 5-7; 2010, ch. 1043, §§ 10, 11.

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

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

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

63-12-129. Enforcement.

  1. The enforcement of the laws and rules of the board regulating the practicing of veterinary medicine in this state is primarily vested in the board, who may have the following powers and duties:
    1. To employ investigators, counsel and clerical assistance or any other necessary personnel;
    2. To inspect all veterinary facilities to determine sanitary conditions, physical equipment, methods of operation, keeping of records, etc. This inspection shall be by a member of the board or a licensed veterinarian representing the board;
    3. To inspect licenses; and
    4. To conduct investigations of all alleged violations.
  2. The powers granted to the board shall not curtail or in any manner affect or eliminate the duties, efforts and assistance of the department of health in the enforcement of this chapter.
  3. All expenses, compensation or fees incurred in connection with enforcement duties and powers shall be paid from the funds of the board and in all respects treated as other expenses of the board, subject to this chapter.

Acts 1967, ch. 80, § 29; T.C.A., § 63-1229; Acts 1996, ch. 771, § 4; 1996, ch. 773, § 3.

63-12-130. Prosecution of violators.

  1. The state and county prosecuting attorneys shall prosecute all persons charged with the violation of any of this chapter or rules of the board.
  2. The secretary-treasurer of the board, or other person employed or designated by the board, shall assist the prosecuting attorneys by furnishing them evidence of such violations whenever the board comes into possession of same.

Acts 1967, ch. 80, § 30; T.C.A., § 63-1230.

63-12-131. Fraudulent filing of license or diploma.

Any person filing or attempting to file as the person's own the diploma or license of another, a forged or fictitious license or diploma or certificate or forged affidavit or identification commits a Class E felony.

Acts 1967, ch. 80, § 31; T.C.A., § 63-1231; Acts 1989, ch. 591, § 85.

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

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

63-12-132. Enjoining violations.

In addition to the penalties herein provided in this chapter, the board may institute legal proceedings to enjoin the violation of this chapter or rules of the board in any court of competent jurisdiction; and such court may grant a temporary or permanent injunction restraining the violation thereof.

Acts 1967, ch. 80, § 32; T.C.A., § 63-1232.

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

63-12-133. Exemptions.

  1. This chapter shall not be construed as applying to:
    1. Students in schools or colleges of veterinary medicine when in performance of duties or actions assigned by their instructors or when working under the immediate supervision of a licensed veterinarian;
    2. Any lawfully qualified veterinarian residing in another state or country, when meeting in consultation with a licensed veterinarian of this state, who:
      1. Does not open an office or appoint a place to do business within this state;
      2. Does not print or use letterhead or business cards reflecting addresses in this state;
      3. Does not establish answering services or advertise the existence of a practice's address within this state; and
      4. Practices veterinary medicine as a consultant while rendering services directly to the public, under the direction of and in consultation with licensees of this state, for less than twelve (12) days per calendar year.
    3. Any veterinarian in the employ of a state agency or the United States government while actually engaged in the performance of the veterinarian's official duties; however, this exemption shall not apply to such person when the person is not engaged in carrying out the person's official duties or is not working at the installations for which the person's services were engaged;
    4. Prevent any person or the person's regular employee from administering to the ills and injuries of the person's own animals, including, but not limited to, castration of animals and dehorning of cattle, unless title has been transferred or employment provided for the purpose of circumventing this law;
    5. State agencies, accredited schools, institutions, foundations, business corporations or associations, physicians licensed to practice medicine and surgery in all its branches, graduate doctors of veterinary medicine or persons under the direct supervision thereof, who or which conduct experiments and scientific research on animals in the development of pharmaceuticals, biologicals, serums or methods of treatment or techniques for the diagnosis or treatment of human ailments, or when engaged in the study and development of methods and techniques directly or indirectly applicable to the problems of the practice of veterinary medicine;
    6. Veterinary aides, nurses, laboratory technicians or other employees of a licensed veterinarian who administer medication or render auxiliary or supporting assistance under the responsible supervision of such licensed veterinarian;
    7. Any person gratuitously treating animals in cases of emergency; provided, that the person does not claim to be a veterinarian or use any title or degree appertaining to the practice thereof;
    8. Any merchant or manufacturer selling at the merchant's or manufacturer's regular place of business medicines, feed, appliances or other products used in the prevention or treatment of animal diseases. This shall not be construed to authorize the sale of medicines or biologicals that must be obtained by a prescription from a veterinarian, but shall only include the right to sell those medicines that are classified as proprietary and that are commonly known as over-the-counter medicines;
    9. Any person advising with respect to or performing acts that the board by rule has prescribed as accepted livestock management practice;
    10. Any person or such person's employees when removing an embryo from the person's own food animal for the purpose of transplanting or cryopreserving such embryo; and
    11. The use of any manual procedure for the testing of pregnancy in bovine animals when performed by a farmer as defined in § 67-6-207(e)(1), (3), (4) and (5), only if:
      1. Such farmer testing for pregnancy is not compensated by the person who owns such animals, other than by the exchange of services for or the use of equipment by such farmer performing the pregnancy test; and
      2. The results of such testing are for the owner's use only and not to affect commerce.
  2. The operations known as castrating and dehorning are not regarded as practicing veterinary surgery, and nothing in this chapter shall be construed to prohibit anyone from castrating or dehorning any wild or domestic animal.
  3. For the purposes of this chapter, the practice of veterinary medicine shall not include the artificial insemination of livestock, as the term livestock is defined in § 43-1-114. The practice of artificial insemination shall be considered an accepted livestock management practice.
  4. [Deleted by 2018 amendment.]

Acts 1967, ch. 80, § 33; T.C.A., § 63-1233; Acts 2006, ch. 532, § 1; 2010, ch. 804, §§ 3-5; 2014, ch. 568, § 5; 2017, ch. 274, § 1; 2018, ch. 679, § 1.

Amendments. The 2017 amendment added (d).

The 2018 amendment deleted former (d) which read: “(d)  For the purposes of this chapter, the practice of veterinary medicine does not include massage therapy to animals, which means the manipulation of the soft tissues of the animal body with the intention of positively affecting the health and well-being of the animal. This therapy does not include the diagnosis, treatment, correction, alleviation, or prevention of any animal disease, illness, pain, deformity, defect, injury, or other physical or mental condition. This subsection (d) shall expire on July 1, 2018.”

Effective Dates. Acts 2017, ch. 274, § 2. May 4, 2017.

Acts 2018, ch. 679, § 7. July 1, 2018 at 12:01 a.m.

63-12-134. Lien for services.

  1. Every licensed veterinarian has a lien on each animal or pet treated, boarded or cared for by the veterinarian while in the veterinarian's custody and under contract with the owner of such animal or pet for payment of charges for treatment, board or care of such animal or pet. Such veterinarian has the right to retain such animal or pet until such charges are paid.
    1. If the charges due for the services named in this section are not paid within ten (10) days after demand for the charges due on the owner of such animal or pet, in person, or by registered or certified mail with return receipt requested, addressed to the owner at the address given when such animal or pet is delivered, and the receipt has been returned by the United States postal authorities, such animal or pet shall be deemed to be abandoned and the licensed veterinarian is authorized to sell the animal or pet either at public or private sale and if the veterinarian does not succeed in selling such animal or pet within ten (10) days, then the veterinarian is authorized to dispose of such animal or pet in any manner that the veterinarian deems proper or turn the animal or pet over to the nearest humane society or dog pound in the area for disposal as such custodian deems proper.
    2. An animal shall also be considered abandoned by its owner if the owner gives a licensed veterinarian a false address and telephone number and the demand mailed by the licensed veterinarian by registered or certified mail, return receipt requested, is returned undelivered. Under the circumstances provided in this subdivision (b)(2), the licensed veterinarian may consider the animal abandoned when the veterinarian receives notice that the mailed demand is undeliverable; and the licensed veterinarian may dispose of the animal as provided in subdivision (b)(1). As an alternative, the licensed veterinarian may turn the animal or pet over to the nearest humane society or animal control shelter in the area for disposition of the animal as such custodian deems proper without first offering the animal or pet for sale.
  2. The giving of notice to the owners as provided in subsection (b) relieves the licensed veterinarian or any custodian to whom such animal or pet may be given of any further liability for disposal.
  3. Failure of the owner of any such animal or pet to receive the demand by registered or certified mail provided for in this section does not render the licensed veterinarian liable to the owner of such animal or pet for the disposal thereof in any manner provided in this section.
  4. When any animal or pet is sold as authorized in this section to satisfy a lien for any of the services enumerated, any moneys realized from the sale, less such charges and any expenses incurred in making the demand for payment thereof in connection with the sale, shall be paid to the owner of the animal or pet.
  5. No legal proceeding for the enforcement of the lien created by this law is necessary concerning abandoned animals as defined in subsection (b), other than compliance with the requirements provided in this section.

Acts 1967, ch. 80, § 34; T.C.A., § 63-1234; Acts 1983, ch. 57, § 17; 1997, ch. 204, § 1.

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

63-12-135. Licensed veterinary technicians — Unauthorized practice.

  1. The board shall examine and license veterinary technicians and has the same authority in the regulation, examination and qualification of licensed veterinary technicians as it has under this chapter for the practice of veterinary medicine and veterinarians.
  2. Any licensed veterinarian may assign to a licensed veterinary technician regularly employed by the veterinarian any task or procedure to be performed for which the veterinarian exercises responsible supervision and full responsibility except those procedures requiring professional judgment or skill as prescribed by board rule.
  3. The fees provided in this chapter pertaining to applications, licensing and renewal for veterinarians also apply to licensed veterinary technicians.
  4. It is a Class B misdemeanor for any person to use in connection with the person's name any designation intending to imply that the person is a veterinary technician or a licensed veterinary technician unless the person meets the requirements contained in this chapter.
  5. The board may, on its own motion, cause to be investigated any report indicating that a licensed veterinary technician is or may be in violation of this chapter. Any person who in good faith reports to the board any information that a licensed veterinary technician is or may be in violation of any provisions of this chapter is not subject to suit for civil damages as a result thereof.

Acts 1972, ch. 688, § 1; T.C.A., § 63-1235; Acts 1983, ch. 57, § 18; 1989, ch. 591, § 112; 1999, ch. 375, §§ 5, 7, 9-11; 2013, ch. 440, § 2.

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

Penalty for unlicensed practice, § 63-12-119.

63-12-136. [Reserved.]

  1. It is unlawful for any licensed veterinarian to practice veterinary medicine as an employee of any person other than a veterinarian duly licensed in this state or a veterinary facility operated at all times under the direct medical supervision of a veterinarian duly licensed in this state.
  2. No person, corporation or other similar organization, public or private, for-profit or not-for-profit, other than a veterinarian duly licensed in this state, shall own or operate a veterinary facility within this state, except as follows:
    1. Any person, corporation or other similar organization, public or private, for-profit or not-for-profit, shall apply for and receive a premises permit before the commencement of operations at the veterinary facility; and
    2. The owner of the veterinary facility shall not restrict or interfere with medically appropriate veterinary diagnostic or treatment decisions by the licensed veterinarians employed at the veterinary facility.
  3. The following are exempt from this section:
    1. A veterinarian employed by a person, corporation or other similar organization, public or private, for-profit or not-for-profit, to treat such employer's animals;
    2. A veterinarian employed by an official agency of the federal or state government or any subdivision thereof; and
    3. A veterinarian employed by any licensed research facility.

Acts 1983, ch. 57, § 19; 1996, ch. 771, § 3; 1996, ch. 773, § 5.

Attorney General Opinions. A court could find that the board of veterinary medical examiners still had authority to enforce a facilities permit system for non-veterinarians under T.C.A. § 63-12-137(b)(1), even if T.C.A. §§ 63-12-139 and 63-12-140 were repealed, OAG 02-007, 2002 Tenn. AG LEXIS 5 (1/4/02).

63-12-138. Peer review committees — Immunity — Confidentiality of information.

  1. As used in this section, “peer review committee” or “committee” means any committee, board, commission or other entity constituted by any statewide veterinary medical association, or local veterinary medical association or local veterinary association for the purpose of receiving and evaluating veterinary acts of other veterinarians or veterinary auxiliary personnel.
  2. Any veterinarian who serves on any peer review committee or on any other committee shall be immune from liability with respect to any action taken by the veterinarian in good faith and without malice as a member of such committee, board, commission or other entity.
  3. Veterinarians, licensed veterinary technicians and members of boards of directors of any publicly supported or privately supported animal health care facility, or any other individual appointed to any committee, as described in subsection (a), shall be immune from liability to any client, patient, individual or organization for furnishing information, data, reports or records to any such committee or for damages resulting from any decision, opinions, actions and proceedings rendered, entered or acted upon by such committees undertaken or performed within the scope or functions of the duties of such committees, if made or taken in good faith and without malice and on the basis of facts reasonably known or reasonably believed to exist.
  4. All information, interviews, reports, statements, memoranda or other data furnished to any such peer review committee or other entity and any findings, conclusions or recommendations resulting from the proceedings of such committee or other entity are privileged. The records and proceedings of any such committee or other entity are confidential and shall be used by such committee or other entity and the members thereof only in the exercise of the proper functions of the committee or other entity and shall not become public record nor be available for court subpoena or discovery proceedings. Nothing contained in this subsection (d) applies to records, documents or information otherwise available from original sources, such records, documents or information not to be construed as immune from discovery or use in any civil proceedings solely due to presentation to the committee.

Acts 1987, ch. 293, § 1; 1999, ch. 375, § 8.

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

63-12-139. Premises permits.

  1. Any person who owns or operates any veterinary facility, including mobile clinics, or any other premises where a licensed veterinarian practices or where the practice of veterinary medicine occurs shall apply for and secure a premises permit from the board prior to the commencement of any services that would subject the provider of those services to licensure under this chapter. Any premises in operation on January 1, 1997, shall register with the board by filling out an application as required by the board.
  2. Any premises at which veterinary services are provided and not owned or leased by a licensed veterinarian on January 1, 1997, shall be inspected prior to the opening of such premises. Upon receipt of the application and payment of the application and inspection fee established by the board, the board shall cause such premises to be inspected by an authorized agent of the board within thirty (30) days of receipt of the application. Any premises in which a licensed veterinarian operates a practice on January 1, 1997, shall be granted a temporary permit upon submission of the registration required by subsection (a), which temporary permit shall remain in effect until the premises are inspected by the board. Any premises for which a permit has been granted on or after January 1, 1997, shall be inspected by the board within sixty (60) days of any change of ownership or legal responsibility for the premises. If the board is unable to complete any inspection of the premises within the thirty- or sixty-day time periods prescribed in this subsection (b), it shall issue a temporary premises permit, which shall remain in effect until the inspection required by this section is completed.
    1. A premises permit shall be issued if the premises meet minimum standards established by board rules as to sanitary conditions and physical plant. In lieu of the procedures identified in subsection (b), the board may issue a premises permit upon certification by the applicant that the premises have been inspected and accredited by a recognized organization, the standards of which are found by the board to meet or exceed the minimum standards established by board rules.
    2. Except as provided in subdivision (c)(3), all veterinary facilities located in retail establishments shall have an entrance into the permitted premises that is directly on a public street or other area which adjoins the establishment, and such entrance shall be separate from the entrance primarily used by regular retail customers. For purposes of this chapter, “retail establishment” means any retail store in excess of two thousand five hundred (2,500) square feet that primarily sells goods not related to the practice of veterinary medicine; companion animal retail facilities that primarily sell goods in the categories of companion animal nutrition, food, supplies, and behavioral products; or any veterinary facility located in an enclosed shopping mall or enclosed shopping center.
    3. Veterinary facilities located in retail establishments that were issued a premises permit prior to January 1, 2015, and that have a separate entrance used by regular retail customers shall maintain and utilize the separate entrance in order to comply with subdivision (c)(2). Veterinary facilities located in retail establishments that were issued a premises permit prior to January 1, 2015, and that do not have a separate entrance used by regular retail customers on July 1, 2016, are in compliance with subdivision (c)(2).
    4. The costs of any inspection undertaken by the board shall be set by the board and paid in advance by the applicant, in addition to the fee established by the board for the premises permit.
  3. Each application for a premises permit submitted by a person not licensed under this chapter shall state the name and address of the licensed veterinarian who will be responsible for the practice of veterinary medicine on the premises. The supervising veterinarian shall be licensed in Tennessee. The applicant shall also include the name or names and address or addresses of the licensee or licensees who will be onsite when the practice of veterinary medicine occurs. The applicant shall affirm that the practice of veterinary medicine shall not be provided on the premises without the physical presence of a veterinarian licensed in this state. An application for a premises permit submitted pursuant to this subsection (d) may be denied if any veterinarian submitted by the applicant has been previously disciplined by the board. The holder of a premises permit shall notify the board of any change of ownership or legal responsibility for premises for which a permit has been issued, any change as to the supervising veterinarian for the premises and any change as to the licensed veterinarian or veterinarians who will be employed to provide veterinary medical services at the premises at least thirty (30) days prior to the effective date of the change unless the change arises from unforeseen circumstances, in which case notice shall be given within five (5) days of the effective date of the change.
  4. The board shall deny any application for a premises permit if the inspection reveals that the premises do not meet the minimum standards established by the board. The applicant shall pay the inspection fee for each additional reinspection required to determine whether any deficiencies found by the board have been brought into compliance with the minimum standards established by board rules and regulations as to sanitary conditions and physical plant.
  5. Any practitioner who provides veterinary services on a house-call basis and does not maintain a veterinary facility for the receipt of patients shall not be required to secure a premises permit, but must provide for appropriate equipment and facilities as established by the board.
  6. Any practitioner who provides veterinary services solely to agricultural animals and does not maintain a veterinary facility for the receipt of patients shall not be required to obtain a premises permit, but must provide for appropriate equipment and facilities as established by the board.
  7. Mobile large and small animal veterinary clinics operating in more than one (1) location and examining and/or treating animals belonging to multiple clients whose animals are not permanently housed or boarded at that location shall have a premises permit for the mobile facilities that are utilized unless exempted by state or local public health officials. Such mobile clinics shall also specify the locations at which such mobile clinics will operate. Such information shall be considered as part of the application for a premises permit. Any change in the locations at which the mobile clinics will operate shall be reported to the board at least thirty (30) days in advance of the effective date of the change.
  8. The following are exempt from this section:
    1. A veterinary facility owned by a person, corporation or other similar organization, public or private, for-profit or not-for-profit, to treat such employer's animals;
    2. A veterinary facility operated by an official agency of the federal or state government; and
    3. A licensed research facility.
  9. The board shall be authorized to employ such persons who may be required, in its discretion, to inspect premises under the jurisdiction of the board. The board shall establish a fee schedule for inspections required under this chapter. An applicant for a premises permit shall remit to the board an application fee, which shall be equal to the license fee required of licensed veterinarians. A licensed veterinarian or an applicant for licensure as a veterinarian shall not be required to submit an additional fee for a premises permit but shall be required to submit the required inspection fee, if such licensed veterinarian or applicant also submits an application for a premises permit.
  10. The board of veterinary examiners is authorized to issue a limited waiver to the requirement for a premises permit under this section to a veterinarian who meets the following requirements:
    1. The waiver is granted for one (1) day, once in a calendar year;
    2. The waiver is applicable to only one (1) county and only one (1) waiver shall be granted in each county in a calendar year;
    3. The waiver is only for livestock testing; and
    4. The waiver is only for one (1) location, which shall be a farm.

Acts 1996, ch. 771, § 2; 2013, ch. 440, §§ 3, 4; 2016, ch. 819, § 1.

Attorney General Opinions. The term “physical plant” as used in the statute may be defined by the board of veterinary medical examiners by rule and, as the Veterinary Practice Act does not define “physical plant,” the board may apply the common understanding of the term as used in a context which is reasonably related to the ownership or operation of any veterinary facility or any other premises where a licensed veterinarian practices or where the practice of veterinary medicine occurs, OAG 02-007, 2002 Tenn. AG LEXIS 5 (1/4/02).

63-12-140. Operation without permit prohibited — Penalty.

  1. It is an offense to knowingly operate a veterinary facility in this state without a premises permit.
  2. A violation of this section is a Class B misdemeanor and each violation constitutes a separate offense.

Acts 1996, ch. 771, § 2.

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

63-12-141. Euthanasia of animals — Certificate — Fees — Penalty.

  1. The board of veterinary medical examiners, upon submission of a complete application and payment of a fee established by the board, shall issue to any animal control agency that it determines to be qualified a certificate authorizing the agency to apply to the federal drug enforcement agency, including any successor entity, for a restricted controlled substance registration certificate for the purchase, possession and use of sodium pentobarbital or other drugs as authorized by the board for administration by a certified animal euthanasia technician to euthanize injured, sick or abandoned animals. It is a Class B misdemeanor for any person or entity to use or imply that such person or entity has been granted a certificate as a certified animal control agency unless a certificate has been granted under this title.
  2. The board, upon submission of a complete application and payment of a fee established by the board, shall issue to any person who it determines to be qualified a certificate for such person to function as a certified animal euthanasia technician. It is a Class B misdemeanor for any person or entity to use or imply that such person or entity has been granted a certificate as a certified animal euthanasia technician unless a certificate has been granted under this title.
  3. Euthanasia of animals.  Euthanasia of animals in a certified animal control agency may only be performed by a licensed veterinarian, including a licensed veterinary technician employed by and functioning under the direct supervision of a licensed veterinarian or a certified animal euthanasia technician as provided by law. A certified animal control agency that employs a certified animal euthanasia technician may purchase, possess and administer sodium pentobarbital or such other drug that the board may approve for the euthanasia of animals. Sodium pentobarbital and such other drugs approved by the board shall be the only drugs used for the euthanasia of animals in a certified animal control agency.
  4. Renewal of Certification.  Certified animal control agencies and certified animal euthanasia technicians shall be required to renew their certificates at such intervals, upon such conditions and upon the payment of such fees as may be established by the board.

Acts 1997, ch. 106, § 1; 1999, ch. 375, § 6.

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

63-12-142. Immunity for certain emergency treatment.

Any licensed veterinarian or ancillary veterinary personnel employed by and working under the direct supervision of a licensed veterinarian who, in good faith, at such person's own initiative, renders emergency treatment to an ill or injured animal gratuitously and without making charge for such treatment is not liable to the owner of the animal for any civil damages arising from the treatment provided to the animal except in cases of gross negligence. If the licensed veterinarian or ancillary veterinary personnel acting under the direct supervision of a licensed veterinarian performs euthanasia on an animal, it is presumed that it was a humane act necessary to relieve pain and suffering.

Acts 1997, ch. 484, § 1.

63-12-143. Cost of prosecution.

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.

Acts 1999, ch. 436, § 3.

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

63-12-144. Certificate authorizing chemical capture of animals by certified animal chemical capture technicians — Protocol — Offense — Certification course.

    1. The board of veterinary medical examiners, upon submission of a complete application and payment of a fee established by the board, shall issue to any governmental animal control agency that the board determines to be qualified and that has a valid premises permit issued by the board a certificate authorizing chemical capture of animals under this section by certified animal chemical capture technicians.
    2. The agencies shall submit, as part of the application, a written protocol for chemical capture of animals by certified animal chemical capture technicians to the board for approval. The protocol shall include, at a minimum:
      1. The procedure for removing the dart from a captured animal;
      2. First aid care of the dart wound;
      3. The  procedure for providing veterinary care to the animal immediately upon capture;
      4. The appropriate location and handling of the animal during recovery from anesthesia; and
      5. The supervisory structure regarding who makes the final decision to proceed with the chemical capture of an animal.
    3. It is a Class B misdemeanor for any person or entity to engage in the chemical capture of animals or imply that the person or entity has been granted a certificate as a certified animal control agency with a premises permit unless the certificate and permit have been granted under this title.
    1. The board, upon submission of a complete application and payment of a fee established by the board, shall issue to any person who the board determines to be qualified a certificate for the person to function as a certified animal chemical capture technician. Applicants shall be required to have successfully completed a sixteen-hour chemical immobilization certification course. The course must be approved by the board, and the curriculum of the course shall include pharmacology, proper administration, recordkeeping, chemical capture technology, animal behavior, postimmobilization procedures, proper public and personnel safety, and marksmanship training.
    2. It is a Class B misdemeanor for any person to chemically capture animals or imply that the person has been granted a certificate as a certified animal chemical capture technician unless a certificate has been granted under this title.
  1. The chemical capture of dogs and cats, as defined in § 44-17-601, shall only be performed by a licensed veterinarian, a licensed veterinary technician employed by and functioning under the direct supervision of a licensed veterinarian or a certified animal chemical capture technician as provided by law. Telazol and such other drugs that the board may approve shall be the only drugs used for the chemical capture of dogs and cats by a certified animal chemical capture technician.
  2. Tranquilizer guns shall be used for the humane chemical capture of dogs and cats. Any such tranquilizer gun shall have the capability to track the darts it shoots and shall be well maintained and kept in a high state of repair at all times.
  3. Certified animal control agencies and certified animal chemical capture technicians shall be required to renew their certificates at such intervals, upon such conditions and upon the payment of such fees as may be established by the board.
  4. Nothing in this part shall be construed to limit in any way the practice of a licensed veterinarian as provided by law.

Acts 2008, ch. 805, § 2.

Compiler's Notes. Acts 2008, ch 805, § 3 provided that the board of veterinary medical examiners is authorized to promulgate rules and regulations to effectuate the purposes of the act. The rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

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

63-12-145. Preemption of regulation of veterinarian medicine — Local regulation.

  1. The general assembly intends by this chapter, other provisions of the Tennessee Code Annotated and any rules and regulations promulgated pursuant to this chapter and the Tennessee Code Annotated to occupy and preempt the entire field of legislation concerning the regulation of the practice of veterinary medicine, including, but not limited to, the regulation of any act or procedure utilized within the practice of veterinary medicine.
  2. Notwithstanding subsection (a), a municipality, metropolitan government or county may regulate the time and place of the business operations of a person or facility holding a license or certificate under this chapter; provided, that the regulation does not conflict with state laws or regulations governing the practice of veterinary medicine.

Acts 2009, ch. 149, § 1.

Part 2
Animal Massage Therapy

63-12-201. Part definitions.

As used in this part:

  1. “Animal massage therapy” means the manipulation of the soft tissues of the animal body with the intention of positively affecting the health and well-being of the animal. “Animal massage therapy” does not include the diagnosis, treatment, correction, alleviation, or prevention of any animal disease, illness, pain, deformity, defect, injury, or other physical or mental condition, or otherwise constitute the practice of veterinary medicine;
  2. “Certified animal massage therapist” means a person who qualifies for, and voluntarily obtains, certification under this part; and
  3. “Registered animal massage therapist” means a person who qualifies for, and voluntarily obtains, certification under this part.

Acts 2018, ch. 679, § 3.

Effective Dates. Acts 2018, ch. 679, § 7. July 1, 2018 at 12:01 a.m.

63-12-202. Use of term “certified animal massage therapist” or “registered animal massage therapist” — Prohibitions.

  1. No person shall use the title “certified animal massage therapist” or “registered animal massage therapist” unless the person meets the requirements of this part.
  2. This part shall not prohibit any person from rendering or offering to render animal massage therapy services; provided, that a person who is not certified or registered under this part shall not use, or knowingly allow themselves to be identified by, the title “certified animal massage therapist” or “registered animal massage therapist”.
  3. Persons who hold themselves out as certified animal massage therapists or registered animal massage therapists without complying with § 63-12-203 are in violation of the Tennessee Consumer Protection Act, compiled in title 47, chapter 18, part 1.

Acts 2018, ch. 679, § 4.

Effective Dates. Acts 2018, ch. 679, § 7. July 1, 2018 at 12:01 a.m.

63-12-203. Use of term “certified animal massage therapist” or “registered animal massage therapist” — Requirements.

In order to use the term “certified animal massage therapist” or “registered animal massage therapist”, a person must:

  1. Complete at least fifty (50) hours of training in anatomy and physiology, kinesiology, and pathologies in order to gain aptitude in preventing the delay of care to animals;
  2. Complete at least fifty (50) hours of supervised in-class hands-on work, which would include assessment and execution of bodywork skills being studied, benefits of massage, benefits of acupressure, and practice guidelines; and
  3. Take and pass an examination by the National Board of Certification for Animal Acupressure and Massage or a comparable examination that tests the aptitude in the course of training described in subdivisions (1) and (2).
  4. [Deleted by 2019 amendment.]

Acts 2018, ch. 679, § 5; 2019, ch. 69, § 1.

Amendments. The 2019 amendment deleted former (4), which read: “Post a surety bond under § 63-12-204.”

Effective Dates. Acts 2018, ch. 679, § 7. July 1, 2018 at 12:01 a.m.

Acts 2019, ch. 69, § 2. July 1, 2019.

63-12-204. Liability insurance requirement.

A person practicing animal massage therapy shall obtain liability insurance in the amount of twenty-five thousand dollars ($25,000) for the benefit of any person who is damaged because of the negligence of the person in the performance of animal massage therapy services.

Acts 2018, ch. 679, § 6.

Effective Dates. Acts 2018, ch. 679, § 7. July 1, 2018 at 12:01 a.m.

63-12-137. Veterinary practice to be owned by veterinarian — Exemptions.

Chapter 13
Occupational and Physical Therapy Practice Act

Part 1
General Provisions

63-13-101. Short title.

This chapter shall be known and may be cited as the “Occupational and Physical Therapy Practice Act.”

Acts 1984, ch. 921, § 2; T.C.A., § 63-13-201; Acts 1999, ch. 528, § 2.

Compiler's Notes. Former part 1 of this chapter (Acts 1976, ch. 650, §§ 1-14; 1979, ch. 201, § 4; 1979, ch. 285, §§ 1, 2; T.C.A., §§ 63-1301 — 63-1315; Acts 1982, ch. 670, § 1), concerning physical therapists, was repealed by Acts 1984, ch. 921, § 1 and the present provisions concerning occupational and physical therapy were enacted as former part 2.

Former parts 2, 3 and 4 of this chapter were transferred to parts 1, 2 and 3 of this chapter in 1986.

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

Attorney General Opinions. Advertising and treatment by massage therapists, OAG 95-033, 1995 Tenn. AG LEXIS 27 (4/6/95).

Intramuscular Manual Therapy (“IMT”), also known as trigger-point dry needling, not within the scope of practice of physical therapy. OAG 14-62, 2014 Tenn. AG Lexis 64 (6/19/14).

63-13-102. Legislative intent.

This chapter is enacted for the purposes of protecting the public health, safety, and welfare and providing for state administrative control, supervision, licensure and regulation of the practice of physical therapy and occupational therapy. It is the general assembly's intent that only individuals who meet and maintain prescribed standards of competence and conduct may engage in the practice of physical therapy and occupational therapy as authorized by this chapter. This chapter is intended to promote the public interest and to accomplish the purposes stated in this section.

Acts 1984, ch. 921, § 2; T.C.A., §§ 63-13-205, 63-13-105; Acts 1999, ch. 528, § 3.

63-13-103. Chapter definitions.

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

  1. “ACOTE” means the Accreditation Council for Occupational Therapy Education, a nationally recognized accrediting agency for professional programs in the field of occupational therapy;
  2. “AOTA” means the American Occupational Therapy Association;
  3. “Board” means:
    1. As used in part 2 of this chapter, the board of occupational therapy; and
    2. As used in part 3 of this chapter, the board of physical therapy;
  4. “Competence” is the application of knowledge, skills, and behaviors required to function effectively, safely, ethically, and legally within the context of the patient's role and environment;
  5. “Division” means the division of health related boards of the department of health;
  6. “Dry needling” means a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying neural, muscular, and connective tissues for the management of neuromusculoskeletal conditions, pain, and movement impairments;
  7. “NBCOT” means the National Board for Certification in Occupational Therapy;
  8. “Occupational therapist” means a person licensed to engage in occupational therapy practice under this chapter;
  9. “Occupational therapy assistant” means a person licensed to assist in occupational therapy practice under the supervision of an occupational therapist;
    1. “Occupational therapy practice” means the therapeutic use of everyday life activities (occupations) for the purpose of enabling individuals or groups to participate in roles and situations in home, school, workplace, community and other settings. Occupational therapy addresses the physical, cognitive, psychosocial and sensory aspects of performance in a variety of contexts to support engagement in occupations that affect health, well-being and quality of life. “Occupational therapy practice” includes, but is not limited to:
      1. The screening, evaluation, assessment, planning, implementation and discharge planning of an occupational therapy program or services in consultation with the client, family members, caregivers and other appropriate persons;
      2. Selection and administration of standardized and nonstandardized tests and measurements to evaluate factors affecting activities of daily living, instrumental activities of daily living, education, work, play, leisure and social participation, including:
  1. Body functions and body structures;
  2. Habits, routines, roles and behavior patterns;
  3. Cultural, physical, environmental, social and spiritual context and activity demands that affect performance; and
  4. Performance skills, including motor, process and communication/interaction skills;
  5. Prevention of barriers to performance, including disability prevention;
  6. Care coordination, case management, discharge planning and transition services;
  7. Consulting services to groups, programs, organizations or communities;
  8. Assessment, recommendations and training in techniques and equipment to enhance functional mobility, including wheelchair management;
  9. Driver rehabilitation and community mobility; and
  10. Management of feeding and eating skills to enable feeding and eating performance;

Methods or strategies selected to direct the process of interventions, such as:

Modification or adaptation of an activity or the environment to enhance performance;

Establishment, remediation or restoration of a skill or ability that has not yet developed or is impaired;

Maintenance and enhancement of capabilities without which performance in occupations would decline;

Health promotion and wellness to enable or enhance performance and safety of occupations; and

Interventions and procedures to promote or enhance safety and performance in activities of daily living, instrumental activities of daily living, education, work, play, leisure and social participation, including:

Therapeutic use of occupations, exercises and activities;

Training in self-care, self-management, home management and community/work reintegration;

Development, remediation or compensation of physical, cognitive, neuromuscular and sensory functions and behavioral skills;

Therapeutic use of self, including an individual's personality, insights, perceptions and judgments as part of the therapeutic process;

Education and training of individuals, family members, caregivers and others;

Management of occupational therapy services, including the planning, organizing, staffing, coordinating, directing or controlling of individuals and organizations;

Providing instruction in occupational therapy to students in an accredited occupational therapy or occupational therapy assistant educational program by persons who are trained as occupational therapists or occupational therapy assistants; and

Administration, interpretation and application of research to occupational therapy services;

Occupational therapy services are provided for the purpose of promoting health and wellness to those clients who have, or are at risk of developing, illness, injury, disease, disorder, impairment, disability, activity limitation or participation restriction and may include:

Training in the use of prosthetic devices;

Assessment, design, development, fabrication, adaptation, application, fitting and training in the use of assistive technology and adaptive and selective orthotic devices;

Application of physical agent modalities with proper training and certification;

Assessment and application of ergonomic principles; and

Adaptation or modification of environments, at home, work, school or community, and use of a range of therapeutic procedures, such as wound care management, techniques to enhance sensory, perceptual and cognitive processing and manual therapy techniques, to enhance performance skills, occupational performance or the promotion of health and wellness;

Occupational therapy practice may occur in a variety of settings, including, but not limited to:

Institutional inpatient settings, such as acute rehabilitation facilities, psychiatric hospitals, community and specialty hospitals, nursing facilities and prisons;

Outpatient settings, such as clinics, medical offices and therapist offices;

Home and community settings, such as homes, group homes, assisted living facilities, schools, early intervention centers, daycare centers, industrial and business facilities, hospices, sheltered workshops, wellness and fitness centers and community mental health facilities;

Research facilities; and

Educational institutions;

“Occupational therapy practice” includes specialized services provided by occupational therapists or occupational therapy assistants who are certified or trained in areas of specialization that include, but are not limited to, hand therapy, neurodevelopmental treatment, sensory integration, pediatrics, geriatrics and neurorehabilitation, through programs approved by AOTA or other nationally recognized organizations;

“Occupations” means everyday life activities, named, organized and given value and meaning by individuals and their culture. “Occupations” includes everything that people do to occupy their time, including caring for their needs, enjoying life and contributing to the social and economic fabric of their communities;

“Onsite supervision” means the supervising physical therapist or physical therapist assistant must:

Be continuously onsite and present in the department or facility where assistive personnel are performing services;

Be immediately available to assist the person being supervised in the services being performed; and

Maintain continued involvement in appropriate aspects of each treatment session in which a component of treatment is delegated to assistive personnel;

“Physical therapist” or “physiotherapist” means a person who is licensed pursuant to this chapter to practice physical therapy;

“Physical therapist assistant” means a person who meets the requirements of this chapter for licensure as a physical therapist assistant and who performs physical therapy procedures and related tasks that have been selected and delegated only by the supervising physical therapist;

“Physical therapy” means the care and services provided by or under the direction and supervision of a physical therapist who is licensed pursuant to this chapter;

“Physical therapy assistive personnel”:

“Other assistive personnel” means other trained or educated health care personnel not defined in subdivisions (14) and (16)(B), who perform specific designated tasks related to physical therapy under the supervision of a physical therapist. At the discretion of the supervising physical therapist, and if properly credentialed and not prohibited by any other law, “other assistive personnel” or “other support personnel” may be identified by the title specific to their training or education; and

“Physical therapy aide,” inclusive of the terms “aide,” “technician” and “transporter,” means a person trained by and under the direction of a physical therapist who performs designated and supervised routine physical therapy tasks;

“Practice of physical therapy” means:

Examining, evaluating and testing individuals with mechanical, physiological and developmental impairments, functional limitations and disability or other health and movement-related conditions in order to determine a physical therapy treatment diagnosis, prognosis, a plan of therapeutic intervention and to assess the ongoing effect of intervention;

Alleviating impairments and functional limitations by designing, implementing, and modifying therapeutic interventions that include, but are not limited to, therapeutic exercise, functional training, manual therapy, therapeutic massage, assistive and adaptive orthotic, prosthetic, protective and supportive equipment, airway clearance techniques, debridement and wound care, physical agents or modalities, dry needling, mechanical and electrotherapeutic modalities and patient-related instruction;

Reducing the risk of injury, impairments, functional limitation and disability, including the promotion and maintenance of fitness, health and quality of life in all age populations; and

Engaging in administration, consultation, education and research;

“Restricted physical therapist assistant license” means a license on which the committee has placed any restrictions due to action imposed by the committee;

“Restricted physical therapy license” means a license on which the committee places restrictions or conditions, or both, as to scope of practice, place of practice, supervision of practice, duration of licensed status or type of condition of patient to whom the licensee may provide services;

“Supervision” of the physical therapist assistant means the supervising physical therapist will be readily available to the physical therapist assistant being supervised. When the physical therapist assistant is practicing in an offsite setting, the supervising physical therapist will be immediately accessible by telecommunications. Patient conferences will be regularly scheduled and documented and supervisory visits will be made as further outlined in the rules and regulations; and

“Unlicensed person working in occupational therapy” means a person who performs specific supportive tasks related to occupational therapy practice under the direct supervision of an occupational therapist or an occupational therapy assistant and whose activities do not require professional or advanced training in the basic anatomical, biological, psychological and social sciences involved in the provision of occupational therapy services. Such persons are often referred to as aides, technicians, transporters or support staff.

Acts 1984, ch. 921, § 2; T.C.A., § 63-13-202; Acts 1988, ch. 824, §§ 1-4; 1988, ch. 1023, §§ 1, 2; 1991, ch. 245, §§ 1, 2; 1993, ch. 225, § 1; T.C.A., § 63-13-102; Acts 1999, ch. 415, § 1; 1999, ch. 528, § 4; 2006, ch. 765, § 1; 2007, ch. 115, § 1; 2015, ch. 124, §§ 1, 2; 2020, ch. 790, §§ 1, 2.

Compiler's Notes. Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2020 amendment inserted “or “physiotherapist”” in the definition of “Physical therapist”; and added the definition of “Competence”.

Effective Dates. Acts 2020, ch. 790, § 17. July 15, 2020.

63-13-104. Unauthorized practice of medicine — Scope of practice.

  1. Nothing in this chapter shall be construed as allowing physical therapists to practice medicine, osteopathy, podiatry, chiropractic or nursing.
    1. The scope of practice of physical therapy shall be under the written or oral referral of a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy, with exceptions as stated in § 63-13-303.
    2. The scope of practice of physical therapy shall not include the performance of treatment where the physical therapist or physical therapist assistant uses direct thrust to move a joint of the patient's spine beyond its normal range of motion without exceeding the limits of anatomical integrity.

Acts 1999, ch. 528, § 10; 2007, ch. 423, § 1; T.C.A. 63-13-109.

Compiler's Notes. Former § 63-13-109 was transferred to this section by the authority of the Code Commission in 2017.

Part 2
Certification of Occupational Therapists and Assistants

63-13-201. Legislative purpose.

  1. This part is enacted to:
    1. Safeguard the public health, safety and welfare;
    2. Protect the public from being misled by incompetent, unscrupulous and unauthorized persons;
    3. Assure the highest degree of professional conduct on the part of occupational therapists and occupational therapy assistants; and
    4. Assure that the available occupational therapy services are of high quality to persons in need of such services.
  2. It is the purpose of this part to provide for the regulation of persons offering occupational therapy services to the public.

Acts 1984, ch. 921, § 3; T.C.A., § 63-13-301; Acts 1999, ch. 415, § 2.

Compiler's Notes. Acts 1984, ch. 921, § 7, provided that all rules, regulations, procedures and practices in effect under the former Physical Therapy Practice Act formerly compiled in §§ 63-13-10163-13-115 and under the State Occupational Therapy Practice Act, formerly compiled in §§ 63-21-10163-21-111, shall continue in effect until such time as the state board of occupational and physical therapy examiners takes appropriate action to modify the rules, regulations, procedures or practices. Assets, liabilities, contracts, property, records and unexpended balances of appropriations or other funds employed, held by, or available to the board of physical therapy examiners are transferred to the board of occupational and physical therapy examiners. All disciplinary actions arising from conduct prohibited by former title 63, ch. 13, part 1 or former title 63, ch. 21, part 1, prior to July 1, 1984, shall be maintained, or subject to action, by the board of occupational and physical therapy examiners according to the laws in effect at the time the prohibited conduct occurred.

Former part 2, §§ 63-13-20163-13-205, was transferred to part 1 in 1986.

63-13-202. Applicants for licensure — Qualifications — Examinations.

An applicant for licensure as an occupational therapist or as an occupational therapy assistant shall file an application showing, to the satisfaction of the board of occupational therapy, that the applicant:

  1. Is of good moral character;
  2. Has successfully completed the academic requirements of an educational program accredited by ACOTE or its predecessor organization. The accredited program shall be a program for occupational therapists or a program for occupational therapy assistants, depending upon the category of licensure for which the applicant is applying;
  3. Has successfully completed the period of supervised fieldwork experience required by ACOTE; and
  4. Has made an acceptable score on a written or computerized examination designed to test the applicant's knowledge of the basic and clinical services related to occupational therapy, occupational therapy techniques and methods and other subjects that may help to determine an applicant's fitness to practice. The board of occupational therapy shall approve an examination for occupational therapists and an examination for occupational therapy assistants and shall establish standards for acceptable performance on each examination. The board is authorized to use the entry level national examinations prepared and administered by NBCOT as the examinations used to test applicants for licensure as occupational therapists or occupational therapy assistants and is authorized to use the standards of NBCOT in determining an acceptable score on each examination.

Acts 1984, ch. 921, § 3; T.C.A., § 63-13-302; Acts 1999, ch. 415, § 2; 2006, ch. 765, § 4; 2007, ch. 115, § 7.

Compiler's Notes. Former part 2, §§ 63-13-20163-13-205, was transferred to part 1 in 1986.

Cross-References. Licensure, §  63-1-10363-1-112.

63-13-203. Determining qualifications of applicants — Granting licenses and permits.

  1. In determining the qualifications of an applicant for licensure as an occupational therapist or as an occupational therapy assistant, only a majority vote of the board of occupational therapy shall be required.
  2. Licenses and permits issued by the board shall be granted by the board as provided in § 63-13-204.

Acts 1984, ch. 921, § 3; T.C.A., § 63-13-303; Acts 1999, ch. 415, § 2; 2007, ch. 115, § 7.

Compiler's Notes. Former part 2, §§ 63-13-20163-13-205, was transferred to part 1 in 1986.

63-13-204. Licenses — Issuance — Fees — Revocation — Reinstatement — Renewal.

    1. The board of occupational therapy shall issue a license to any person who meets the requirements of this part upon payment of the appropriate fees.
    2. Each licensed occupational therapist or occupational therapy assistant shall pay a biennial renewal fee to the board as prescribed in this part, payable in advance, for the ensuing years. The secretary of the board shall notify each licensee.
    3. When any licensee fails to register and pay the biennial registration fee within thirty (30) days after registration becomes due as provided in this section, the license of such person shall be administratively revoked at the expiration of the thirty (30) days after the registration was required, without further notice or hearing. Any person whose license is automatically revoked as provided in this section may make application in writing to the board for the reinstatement of such license; and, upon good cause being shown, the board in its discretion may reinstate such license upon payment of all past-due renewal fees.
  1. For purposes of implementing § 63-13-108(b) [repealed], the board shall prescribe and publish nonrefundable fees.
    1. Notwithstanding any provision of 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 biennial 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).
  2. The board is authorized to establish requirements for assessing continued competence of licensees.

Acts 1984, ch. 921, § 3; T.C.A., § 63-13-304; Acts 1989, ch. 360, §§ 43, 44; 1989, ch. 523, § 32; 1999, ch. 415, § 2; 2003, ch. 109, § 1; 2007, ch. 115, § 7.

Compiler's Notes. Former § 63-13-204 was transferred to § 63-13-104 in 1986 and was later transferred to 63-13-108 in 1999 before being repealed by Acts 2007, ch. 115, § 2, effective July 1, 2007.

Former § 63-13-108, referred to in this section, was repealed by Acts 2007, ch. 115, § 2, effective July 1, 2007.

63-13-205. Limited permits — Failure of initial examination.

  1. A limited permit may be issued by the board to an applicant who has applied for a license under § 63-13-202, has successfully completed the educational and field experience requirements of §  63-13-202(2) and (3) and is scheduled to take the examination required by § 63-13-202(4).
  2. An applicant who has received a limited permit shall take the examination within ninety (90) days of the date the applicant received the limited permit. If the applicant does not take the examination within that ninety-day period, the limited permit expires at the end of the ninety-day period.
  3. If an applicant fails the examination, the applicant's limited permit expires upon the board's receipt of notice that the applicant failed the examination.
  4. If an applicant passes the examination, the applicant's limited permit remains effective until the board grants or denies a license to the applicant.
  5. An applicant may obtain a limited permit only once.
  6. A limited permit allows an applicant to engage in occupational therapy practice under the supervision of a licensed occupational therapist.
  7. The board shall adopt rules governing the supervision of persons to whom a limited permit has been issued. The rules shall address, at a minimum, initial and periodic inspections, written evaluations, written treatment plans, patient notes and periodic evaluation of performance.

Acts 1984, ch. 921, § 3; T.C.A., § 63-13-305; Acts 1999, ch. 415, § 2; 2006, ch. 765, § 5; 2007, ch. 115, § 7.

Compiler's Notes. Former § 63-13-205 was transferred to § 63-13-105 in 1986 and was later transferred to 63-13-102 in 1999.

63-13-206. Supervision of an occupational therapy assistant by an occupational therapist.

  1. A licensed occupational therapy assistant shall practice under the supervision of an occupational therapist who is licensed in Tennessee.
  2. The supervising occupational therapist is responsible for all services provided by the occupational therapy assistant, including, but not limited to, the formulation and implementation of a plan of occupational therapy services for each client, and has a continuing responsibility to follow the progress of each client and to ensure the effective and appropriate supervision of the occupational therapy assistant according to the needs of the client.
  3. The supervising occupational therapist shall assign to the occupational therapy assistant only those duties and responsibilities that the occupational therapy assistant is qualified to perform.
  4. The board shall adopt rules governing the supervision of occupational therapy assistants by occupational therapists. Those rules may address the following:
    1. The manner in which the supervising occupational therapist oversees the work of the occupational therapy assistant;
    2. The ratio of occupational therapists to occupational therapy assistants required under different conditions and in different practice settings; and
    3. The documentation of supervision contacts between the supervising occupational therapist and the occupational therapy assistant.
  5. The rules adopted by the board shall recognize that the frequency, methods and content of supervision of occupational therapy assistants by occupational therapists may vary by practice setting and are dependent upon the following factors, among others:
    1. Complexity of the client's needs;
    2. Number and diversity of clients;
    3. Skills of the occupational therapy assistant and the supervising occupational therapist;
    4. Type of practice setting; and
    5. Requirements of the practice setting.

Acts 1999, ch. 415, § 2; 2006, ch. 765, § 6.

Compiler's Notes. Former § 63-13-206, concerning construction of part and activities not prohibited, was transferred to § 63-13-208 in 1999.

63-13-207. Delegation of tasks to unlicensed personnel.

  1. A licensed physician, occupational therapist or licensed occupational therapy assistant may delegate to an unlicensed person specific routine tasks associated with nontreatment aspects of occupational therapy practice that are not evaluative, assessive, task selective or recommendational in nature and do not require making decisions or making assessment or treatment entries in official patient records, if the following conditions are met:
    1. The physician, occupational therapist or occupational therapy assistant accepts professional responsibility for the performance of that duty by the person to whom it is delegated. In the case of duties delegated by an occupational therapy assistant, the occupational therapy assistant, the physician and occupational therapist who supervises the occupational therapy assistant shall be responsible;
    2. The unlicensed person does not perform any duties that require licensure under this chapter; and
    3. The physician, occupational therapist or occupational therapy assistant ensures that the unlicensed person has been appropriately trained for the performance of the tasks.
  2. Tasks that may be delegated may include:
    1. Transporting of patients;
    2. Preparing or setting up a work area or equipment;
    3. Routine department maintenance or housekeeping activities;
    4. Taking care of patient's personal needs during treatments; and
    5. Clerical, secretarial or administrative duties.

Acts 1999, ch. 415, § 2; 2006, ch. 765, § 7.

Compiler's Notes. Former § 63-13-207, concerning denial, suspension or revocation of certificate, was transferred to § 63-13-209 in 1999.

63-13-208. Construction of part — Activities not prohibited.

  1. Nothing in this part shall be construed as preventing or restricting the practice, services or activities of:
    1. Any person licensed under any chapter of this title;
    2. Any person employed as an occupational therapist or occupational therapy assistant by an agency of the United States government while providing occupational therapy services in that capacity;
    3. Any person pursuing a course of study leading to a degree or certificate in occupational therapy in an educational program accredited or granted developing program status by ACOTE, if:
      1. The activities and services constitute a part of a supervised course of study; and
      2. The person is designated by a title that clearly indicates the person's status as a student;
    4. Any person fulfilling the supervised fieldwork experience requirements of § 63-13-202(3), if the activities and services constitute a part of the experience necessary to meet the requirements of § 63-13-202(3);
    5. An occupational therapist or occupational therapy assistant who is licensed or certified to practice in another state that has licensure or certification requirements at least as stringent as the requirements of this part while in Tennessee for the purpose of providing educational, consulting or training services for no more than fourteen (14) days in a calendar year; and
    6. Any person who is certified by the National Council for Therapeutic Recreation Certification as a certified therapeutic recreation specialist, while engaged in practicing the profession of recreation therapy.
  2. Nothing in this part shall prevent certified orthotists from designing, fabricating and fitting orthotic devices.
  3. Nothing in this part shall prevent any person employed by a physician from performing activities related to casting and splinting or teaching exercises related to specific treatment by the employing physician.

Acts 1984, ch. 921, § 3; T.C.A., § 63-13-306; Acts 1994, ch. 901, § 2; T.C.A., § 63-13-206; Acts 1999, ch. 415, § 2; 2006, ch. 765, § 8.

Compiler's Notes. Former § 63-13-208, concerning administrative procedure, was transferred to § 63-13-210 in 1999.

63-13-209. Denial, suspension or revocation of license.

  1. The board of occupational therapy has the power and it is its duty to deny, suspend or revoke the license of or to otherwise lawfully discipline a licensee whenever the licensee is guilty of violating any of this part or is guilty of any of the following acts or offenses:
    1. Unprofessional, dishonorable or unethical conduct;
    2. Violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of, or conspiring to violate, any provision of this part or any lawful order of the board issued pursuant thereto or any criminal statute of this state;
    3. Making false or misleading statements or representations, being guilty of fraud or deceit in obtaining admission to practice or being guilty of fraud or deceit in the licensee's practice;
    4. Gross health care liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of professional practice;
    5. Habitual intoxication or personal misuse of any drugs or the use of intoxicating liquors, narcotics, controlled substances, controlled substance analogues or other drugs or stimulants in such a manner as to adversely affect the person's ability to practice;
    6. Conviction of a felony, conviction of any offense under state or federal drug laws or conviction of any offense involving moral turpitude;
    7. 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;
    8. Engaging in practice when mentally or physically unable to safely do so;
    9. Solicitation by agents or persons generally known as “cappers” or “steerers” of professional patronage or profiting by the acts of those representing themselves to be agents of the licensee;
    10. Division of fees or agreeing to split or divide fees received for professional services with any person for bringing or referring a patient;
    11. Conducting practice so as to permit, directly or indirectly, an unlicensed person to perform services or work that, under this part, can be done legally only by persons licensed to practice;
    12. Professional connection or association with any person, firm or corporation in any manner in an effort to avoid and circumvent this part or lending one's name to another for illegal practice;
    13. Payment or acceptance of commissions, in any form or manner, on fees for professional services, references, consultations, pathological reports, prescriptions or on other services or articles supplied to patients;
    14. Giving of testimonials, directly or indirectly, concerning the supposed virtue of secret therapeutic agents or proprietary preparations, such as remedies, or other articles or materials that are offered to the public, claiming radical cure or prevention of diseases by their use;
    15. Violating the code of ethics adopted by the board;
    16. Any other unprofessional or unethical conduct that may be specified by the rules duly published and promulgated by the board or the violation of any provision of this part;
    17. On behalf of the licensee, the licensee's partner, associate or any other person affiliated with the licensee or the licensee's facility, use or participate in the use of any form of public communication containing a false, fraudulent, misleading or deceptive statement or claim; or
    18. Disciplinary action against a person licensed to practice occupational therapy by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order or other equivalent document memorializing the disciplinary action from the disciplining state or territory shall constitute prima facie evidence of violation of this section and be sufficient grounds upon which to deny, restrict or condition licensure or renewal and/or discipline a person licensed in this state.
  2. In enforcing this section, the board of occupational therapy shall, upon probable cause, have the authority to compel an applicant or licensee to submit to a mental or physical examination, or both, by a designated board of at least three (3) practicing physicians, including a psychiatrist, where a question of mental condition is involved. The applicant or licensee may have an independent physical or mental examination, which examination report shall be filed with the board for consideration. The physicians' board shall submit a report of its findings to the board for use in any hearing that may thereafter ensue.
  3. The board, on its own motion, may cause to be investigated any report indicating that a licensee is or may be in violation of this part. Any licensee, any occupational therapist or occupational therapy-related society or association or any other person who in good faith reports to the board any information that a licensee is or may be in violation of any provisions of this part shall not be subject to suit for civil damages as a result thereof.
  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 1984, ch. 921, § 3; T.C.A., §§ 63-13-307, 63-13-207; Acts 1999, ch. 415, § 2; 2006, ch. 765, § 9; 2007, ch. 115, §§ 7, 8; 2012, ch. 798, § 46; 2012, ch. 848, § 77; 2018, ch. 745, § 30.

Compiler's Notes. Former § 63-13-209, concerning unlawful practices and penalty, was transferred to § 63-13-211 in 1999.

Amendments. The 2018 amendment added (d).

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

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

63-13-210. Administrative procedure.

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

Acts 1984, ch. 921, § 3; T.C.A., §§ 63-13-308, 63-13-208; Acts 1999, ch. 415, § 2; 2007, ch. 115, § 7.

Compiler's Notes. Former § 63-13-210, concerning certification requirement, was transferred to § 63-13-212 in 1999.

63-13-211. Unlawful practices — Penalty.

  1. It is unlawful for any person to violate this part. It is unlawful for any person who is not licensed under this part as an occupational therapist or an occupational therapy assistant or whose license has been suspended or revoked to use, in connection with the person's name or place of business, the words “occupational therapist,” “occupational therapist registered,” “licensed occupational therapist,” “occupational therapy assistant,” “certified occupational therapy assistant” or “licensed occupational therapy assistant,” the letters “OT,” “OTA,” “OTR,” “OT/L,” “OTA/L” or “COTA” or any other words, letters, abbreviations or insignia indicating or implying that the person is an occupational therapist or an occupational therapy assistant or who in any way, orally, in writing, in print or by sign, directly or by implication, claims to be an occupational therapist or an occupational therapy assistant.
  2. A violation of this part is a Class B misdemeanor.

Acts 1984, ch. 921, § 3; T.C.A., § 63-13-309; Acts 1989, ch, 591, § 112; T.C.A. § 63-13-209; Acts 1999, ch. 415, § 2; 2006, ch. 765, § 10.

Compiler's Notes. Former § 63-13-211, concerning reciprocity and waiver of requirements, was transferred to § 63-13-213 in 1999.

Cross-References. Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, recovery, § 63-1-134.

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

63-13-212. License requirement.

No person shall practice occupational therapy or act as an occupational therapy assistant, nor claim to be able to practice occupational therapy or act as an occupational therapy assistant, unless the person holds a license and otherwise complies with this part and the rules adopted by the board.

Acts 1984, ch. 921, § 3; T.C.A., §§ 63-13-310, 63-13-210; Acts 1999, ch. 415, § 2.

Compiler's Notes. Former § 63-13-212, concerning foreign-trained applicants, was transferred to § 63-13-214 in 1999.

Cross-References. Licensing, §§ 63-1-10363-1-112.

63-13-213. Reciprocity.

The board of occupational therapy may grant a license to an applicant who presents proof of current licensure or certification as an occupational therapist or occupational therapy assistant in another state, the District of Columbia or a territory of the United States and who possesses educational and experiential qualifications that meet or exceed the requirements for licensure in Tennessee, as determined by the board of occupational therapy.

Acts 1984, ch. 921, § 3; T.C.A., §§ 63-13-311, 63-13-211; Acts 1999, ch. 415, § 2; 2006, ch. 765, § 11; 2007, ch. 115, § 7.

Compiler's Notes. Former § 63-13-213, concerning retirement, was transferred to § 63-13-215 in 1999.

63-13-214. Internationally trained applicants.

Applicants for licensure who have completed educational programs outside the United States shall furnish proof of good moral character and of completion of an educational program and supervised fieldwork substantially similar to those contained in § 63-13-202(2) and (3) and shall satisfy the examination requirements of §  63-13-202(4).

Acts 1984, ch. 921, § 3; T.C.A., §§ 63-13-312, 63-13-212; Acts 1999, ch. 415, § 2; 2006, ch. 765, § 12.

63-13-215. Retirement — Inactive status.

  1. Any person licensed by the board of occupational therapy to practice in this state who has retired or may retire from such practice in this state shall not be required to register as required by this chapter if such person files with the board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which the person retired from such practice and any other facts, as the board shall consider necessary, that tend to verify such retirement. If such person thereafter reengages in practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet such continuing education requirements that are established by the board, except for good and sufficient reasons as determined by the board.
  2. Any person licensed by the board of occupational therapy may place the person's license on inactive status by filing the proper forms with the board and by paying a biennial fee in accordance with rules adopted by the board. If the person thereafter reengages in active practice in this state, the person shall apply for relicensure with the board as provided by this part and shall meet the continuing education requirements that are established by the board, except for good and sufficient reasons as determined by the board.

Acts 1984, ch. 921, § 3; T.C.A., §§ 63-13-313, 63-13-213; Acts 1999, ch. 415, § 2; 2006, ch. 765, § 13; 2007, ch. 115, § 7.

Cross-References. Retirement, §  63-1-111.

63-13-216. Board of occupational therapy.

  1. There is created a board of occupational therapy, which shall perform the same functions and have the same duties and responsibilities that were performed by the committee of occupational therapy prior to July 1, 2007.
  2. The board shall consist of five (5) members appointed by the governor, each of whom shall be a resident of this state. Three (3) members of the board shall be licensed occupational therapists who have had at least five (5) years of experience in the actual practice or teaching of occupational therapy immediately preceding their appointment. One (1) member of the board shall be a licensed occupational therapy assistant who has had at least five (5) years of experience in the actual practice of occupational therapy or teaching of an occupational therapy assistant curriculum immediately preceding the appointment. One (1) member of the board shall be a person who is not engaged in the practice of occupational therapy and who is not professionally or commercially associated with the health care industry.
  3. The occupational therapist and occupational therapy assistant members may be appointed by the governor from lists of nominees submitted by interested occupational therapy groups, including, but not limited to, the Tennessee Occupational Therapy Association. The governor shall consult with the interested occupational therapy groups to determine qualified persons to fill positions on the board.
  4. The occupational therapists and the occupational therapy assistant who are serving on the committee of occupational therapy on July 1, 2007, shall continue to serve as members of the board until the expiration of their terms.
  5. The board shall organize annually and select a chair and a secretary. Meetings shall be held as frequently as may be required.
  6. A quorum of the board shall consist of at least three (3) members.
  7. The division shall provide administrative, investigatory and clerical services to the board.
  8. Each member of the board shall be reimbursed for actual expenses incurred in the performance of official duties on the board and shall be entitled to a per diem of one hundred dollars ($100) for each day of service in conducting the business of the board. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  9. All regular appointments to the board shall be for terms of three (3) years each. Each member shall serve until a successor is appointed. Vacancies shall be filled by appointment of the governor for the remainder of the unexpired term.
  10. The governor may, at the request of the board, remove any member of the board for misconduct, incompetence or neglect of duty.
  11. In making appointments to the board, the governor shall strive to ensure that at least one (1) member is sixty (60) years of age or older, that at least one (1) member is a racial minority and that the gender balance of the board reflects the gender balance of the state's population.
  12. The board shall have the power and duty to:
    1. Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules reasonably necessary for the performance of its duties and the proper administration of this part;
    2. Grant, in the board's name, all licenses approved by the board; and
    3. Collect and receive all fees, fines and moneys owed pursuant to this part and to pay the fees, fines and moneys into the general fund of the state.
  13. After July 1, 2007, the board shall assume and fulfill all powers and duties previously assigned to the committee of occupational therapy, and the rules adopted by the committee of occupational therapy shall become the rules of the board without further action by the board.

Acts 2007, ch. 115, § 9; 2014, ch. 603, § 3; 2017, ch. 211, § 1.

Compiler's Notes. The board of occupational therapy, created by this section, terminates June 30, 2025. See §§ 4-29-112, 4-29-246.

Amendments. The 2017 amendment, in (c), substituted “may be appointed” for “shall be appointed” in the first sentence, and substituted “with the interested occupational therapy groups” for “with such interested groups” in the second sentence.

Effective Dates. Acts 2017, ch. 211, § 4. April 28, 2017.

Part 3
Licensure of Physical Therapists and Assistants

63-13-301. License requirement.

    1. A physical therapist, or physiotherapist, licensed under this chapter is fully authorized to practice physical therapy.
    2. A physical therapist, or physiotherapist, is not licensed under this chapter unless the individual holds a degree from a professional physical therapy program accredited by a national accreditation agency recognized by the United States department of education and by the board of physical therapy.
  1. No person shall practice or in any manner claim to be engaging in the practice of physical therapy or designate as being a physical therapist unless duly licensed as a physical therapist in accordance with this chapter.

Acts 1999, ch. 528, § 12; 2020, ch. 790, § 3.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2020 amendment, in (a)(1), inserted “, or physiotherapist” and deleted “as defined in this chapter” following “physical therapy”; and added (a)(2).

Effective Dates. Acts 2020, ch. 790, § 17. July 15, 2020.

Attorney General Opinions. Provision of physical therapy services by a non-professional corporation, OAG 94-131, 1994 Tenn. AG LEXIS 144 (11/8/94).

63-13-302. Referrals — Ethical standards.

  1. A physical therapist shall refer persons under the physical therapist's care to appropriate health care practitioners, after consultation with the referring practitioner, if the physical therapist has reasonable cause to believe symptoms or conditions are present that require services beyond the scope of practice or when physical therapy treatment is contraindicated.
  2. Physical therapists shall adhere to the recognized standards of ethics of the physical therapy profession and as further established by rule.

Acts 1999, ch. 528, § 13.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

63-13-303. Exceptions to referral requirements.

  1. The practice of physical therapy must be under the written or oral referral of a referring practitioner who is a licensed doctor of medicine, chiropractic, dentistry, podiatry, or osteopathy, except a licensed physical therapist may:
    1. Conduct an initial patient visit without referral;
    2. Provide physical assessments or instructions, including a recommendation of exercise to an asymptomatic person, without the referral of a referring practitioner;
      1. In emergency circumstances, including minor emergencies, provide assistance to a person to the best of a physical therapist's ability without the referral of a referring practitioner. Except as provided in subdivision (a)(4), the physical therapist shall refer the person to the appropriate healthcare practitioner, as indicated, immediately after providing assistance;
      2. For the purposes of subdivision (a)(3)(A):
        1. “Emergency circumstances” means instances where emergency medical care is required; and
        2. “Emergency medical care” means bona fide emergency services provided after the sudden onset of 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 patient's health in serious jeopardy;
          2. Serious impairment to bodily functions; or
          3. Serious dysfunction of any bodily organ or part; and
    3. Treat a patient without a referral when, within the scope of practice of physical therapy, the following are met:
      1. The patient's physician, as defined in § 63-6-204(f)(7) has been notified;
      2. If the physical therapist determines, based on clinical evidence, that no progress has been made with respect to that patient's condition within thirty (30) days, immediately following the date of the patient's initial visit with the physical therapist, then the physical therapist shall not provide any additional physical therapy services and shall refer the patient to a healthcare practitioner who qualifies as a referring practitioner;
      3. Physical therapy services must not continue beyond ninety (90) days without consulting with the patient's appropriate healthcare practitioner;
      4. If the patient was previously diagnosed by a licensed physician with chronic, neuromuscular, or developmental conditions, and the evaluation, treatment, or services are being provided for problems or symptoms associated with one (1) or more of those previously diagnosed conditions, then subdivisions (a)(4)(B) and (a)(4)(C) do not apply; and
      5. A physical therapist shall refer patients under the physical therapist's care to appropriate healthcare practitioners, if, at any time, the physical therapist has reasonable cause to believe symptoms or conditions are present that require services beyond the scope of practice of a physical therapist, reasonable therapeutic progress is not being achieved for the patient, or physical therapy treatment is contraindicated.
  2. No person shall practice physical therapy other than upon the referral of a patient by a person who is licensed in this or another state to practice medicine, chiropractic, dentistry, osteopathic medicine or podiatric medicine, within the scope of those practices, and whose license is in good standing and who holds a CPR certificate or its equivalent, unless one of the following conditions is met:
    1. The person holds a master's or doctorate degree from a professional physical therapy program that is accredited by a national accreditation agency recognized by the United States department of education and by the board of physical therapy and the person has completed at least one (1) year of experience as a licensed physical therapist;
    2. The person has successfully completed a residency or clinical fellowship in physical therapy at a program approved by the board; or
      1. The person has completed at least three (3) years of experience as a licensed physical therapist; and
      2. The person has completed a course approved by the board of physical therapy and offered by an accredited university of at least fifteen (15) hours, designed to enable the physical therapist to identify signs and symptoms of systemic disease, particularly those that can mimic cardiological, neurological, oncological or musculoskeletal disorders and to recognize conditions that require timely referral to a physician, dentist, osteopath, podiatrist or chiropractor.
  3. It is unprofessional conduct, for the purposes of § 63-13-312, for a physical therapist to knowingly initiate services to a patient in violation of subdivision (a)(4).

Acts 1999, ch. 528, § 14; 2007, ch. 115, § 10; 2007, ch. 423, § 2; 2020, ch. 790, §§ 4, 5.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2020 amendment, in (a), substituted “must” for “shall” and inserted “referring practitioner who is a”; substituted “initial patient visit” for “initial evaluation of a patient” in (a)(1); in (a)(3)(A), inserted “physical” following “best of a” and substituted “healthcare” for “health care”; rewrote (a)(4) which read: “(4) Treat a patient without a referral when all of the following apply: (A)  When a patient provides the name of a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy and expressly wants the physical therapist to inform that physician, the physical therapist shall inform the patient's licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy no later than five (5) business days after the evaluation. A consultation shall occur between the physical therapist and the patient's licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy within the first six (6) visits or fifteen (15) business days, whichever comes first, of the findings of the patient's initial visit for physical therapy and any subsequent visits. Should that consultation not take place, no further therapy beyond the six (6) visits or fifteen (15) days, whichever comes first, shall be delivered; (B)  When a patient does not provide the name of a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy or expressly states to the therapist that the patient does not want a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy informed of the initiation of therapy services, the therapist shall have the patient sign a consent form that confirms the patient either does not have a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy or does not want a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy informed of the initiation of therapy treatment. The consent form shall be maintained in the patient's record; (C)  If the patient presents to the physical therapist for a problem for which the patient has been seen by a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy within the past twelve (12) months, the consent of the patient is not necessary to inform that licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy of the presentation for the physical therapy treatment. If the patient has no licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy, then the physical therapist shall make a suggestion from the list of available providers and shall inform the patient of the thirty-day limitation in subdivision (a)(4)(E); (D)  If the physical therapist determines, based on reasonable evidence, that no substantial progress has been made with respect to that patient within fifteen (15) calendar days or six (6) visits, whichever occurs first, immediately following the date of the patient's initial visit with the physical therapist, the physical therapist shall not provide any additional physical therapy services and shall refer the patient to a licensed physician, doctor of chiropractic, dentist, podiatrist or osteopath. If the patient previously was diagnosed with chronic, neuromuscular or developmental conditions by a physician, doctor of chiropractic, dentist, podiatrist or osteopath and the evaluation, treatment or services are being provided for problems or symptoms associated with one (1) or more of those previously diagnosed conditions, then this subdivision (a)(4)(D) shall not apply. If a patient returns to the physical therapist within ninety (90) days of treatment with the same complaint, then the physical therapist shall make an immediate referral to the appropriate health care provider; (E)  When a patient's licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy has not been notified of the physical therapy services, under no circumstances should therapy services continue beyond thirty (30) days immediately following the date of the patient's first visit; (F) (i) It shall be considered unprofessional conduct for the purposes of § 63-13-312 for a physical therapist to knowingly initiate services for the same complaint for which a patient: (a)  Has started therapy services but another therapist did not inform a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy within five (5) business days of the initial evaluation in accordance with subdivision (a)(4)(A); (b)  Has reached the fifteen (15) day and six (6) visit limit imposed by subdivision (a)(4)(D) where no substantial progress has been made from another physical therapist; or (c)  Has reached the thirty-day limit imposed by subdivision (a)(4)(E); (ii)  This subdivision (a)(4)(F) does not apply if a referral from a licensed doctor of medicine, chiropractic, dentistry, podiatry or osteopathy is made; and (G)  If, at any time, the physical therapist has reason to believe that the patient has symptoms or conditions that require treatment or services beyond the scope of practice of a physical therapist, the physical therapist shall refer the patient to a licensed health care practitioner acting within the practitioner's scope of practice.”; and added (c)

Effective Dates. Acts 2020, ch. 790, § 17. July 15, 2020.

63-13-304. Board powers and duties.

  1. The board of physical therapy has the power and authority to:
    1. Evaluate the qualifications of applicants for licensure and provide for the examination of physical therapists and physical therapist assistants;
    2. Adopt passing scores for examination;
    3. Issue licenses to those who qualify under this chapter;
    4. Regulate the practice of physical therapy by interpreting and enforcing this chapter, including disciplinary action;
    5. Adopt and revise rules, as it deems necessary and appropriate, consistent with this chapter, for the discharge of its obligation under this section. Such rules, when lawfully adopted, shall have the effect of law;
    6. Establish requirements for assessing continuing competence of licensees; and
    7. Assess all license and registration fees.
  2. The board of physical therapy shall establish minimum competency requirements that a physical therapist shall demonstrate in order to practice dry needling.

Acts 1999, ch. 528, § 15; 2007, ch. 115, § 10; 2015, ch. 124, § 3.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

63-13-305. Claims and practices of other licensed professionals — Exemptions from licensure.

  1. Nothing in this chapter shall be construed as restricting a person licensed or certified under any other law of this state from engaging in the profession or practice for which the person is licensed or certified; provided, that the person does not claim to be a physical therapist, a physical therapist assistant or a provider of physical therapy.
  2. The following persons shall be exempt from licensure as a physical therapist or physical therapist assistant under this chapter:
    1. A person who is pursuing a course of study leading to a degree as a physical therapist or physical therapist assistant in a professional education program approved by the board and is satisfying supervised clinical education requirements related to physical therapy education;
    2. A physical therapist or physical therapist assistant while practicing in the United States armed services, United States public health service or veterans administration as based on requirements under federal regulations for state licensure of health care providers;
    3. A physical therapist or physical therapist assistant licensed in another United States jurisdiction, or a foreign-educated or internationally trained physical therapist credentialed in another country, performing physical therapy as part of teaching or participating in an educational seminar of no more than sixty (60) days in a calendar year; and
    4. A physical therapist or physical therapist assistant licensed in another United States jurisdiction who is temporarily performing physical therapy for members of established athletic teams, athletic corporations or performing arts companies that are training, competing or performing in Tennessee; provided, however, that a person performing physical therapy in this state pursuant to this subdivision (b)(4) shall agree to use the secretary of state for service of process pursuant to title 20, chapter 2, part 2.
  3. The practice of dry needling by a physical therapist licensed under this chapter shall not constitute the practice of acupuncture under chapter 6, part 10 of this title.
  4. Nothing in this chapter shall be construed as restricting persons licensed under any other law of this state from performing physical agent modalities for which they have received education and training.

Acts 1999, ch. 528, § 16; 2003, ch. 8, § 1; 2007, ch. 115, § 10; 2015, ch. 124, § 4; 2020, ch. 790, § 6.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2020 amendment inserted “or internationally trained” in (b)(3).

Effective Dates. Acts 2020, ch. 790, § 17. July 15, 2020.

63-13-306. Application — Examinations.

  1. An applicant for licensure as a physical therapist or physical therapist assistant shall file an application as required by the board. A nonrefundable application fee and cost of the examination shall accompany the completed written or online application. Fees shall be established by the rules promulgated by the board.
  2. After the application process has been completed, an applicant shall take the examination for physical therapist licensure that covers current physical therapy practice.
  3. After the application process has been completed, an applicant shall take the examination for physical therapist assistant licensure that covers current technical application of physical therapy services.
  4. Examinations shall be available within the state at such time and place as the board shall determine. The board shall determine the passing score.
  5. Applicants who do not pass the examination after the first attempt may retake the examination one (1) additional time without reapplication for licensure up to a total of six (6) attempts. Applications remain active for twelve (12) months. After twelve (12) months, applicants must submit a new application with all applicable fees.

Acts 1999, ch. 528, § 17; 2007, ch. 115, § 10; 2014, ch. 949, § 11; 2020, ch. 790, § 7.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2020 amendment, in (e), in the first sentence, substituted “up to a total of” for “This must occur within” and deleted “months of initial board approval to take the examination. Prior to being approved by the board for subsequent testing beyond two (2)” preceding “attempts” and “individuals shall” following the same, added the second sentence, and in the last sentence, inserted “After twelve (12) months, applicants must” and deleted “and demonstrate evidence satisfactory to the board of having successfully completed additional clinical training and/or course work as determined by the board and defined in the rules.” following “fees.”

Effective Dates. Acts 2020, ch. 790, § 17. July 15, 2020.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-13-307. Qualifications of applicants — Reciprocity.

  1. An applicant for licensure as a physical therapist shall have the following qualifications:
    1. [Deleted by 2020 amendment.]
    2. Be of good moral character;
    3. Have completed the application process;
    4. Be a graduate of a professional physical therapy program accredited by a national accreditation agency recognized by the United States department of education and by the board of physical therapy; and
    5. Have successfully passed an examination approved by the board.
  2. An applicant for license as a physical therapist assistant shall meet the following requirements:
    1. [Deleted by 2020 amendment.]
    2. Be of good moral character;
    3. Have completed the application process;
    4. Be a graduate of a physical therapist assistant education program accredited by an accreditation agency approved by the board; and
    5. Have successfully passed an examination approved by the board.
  3. The board shall issue a license to a physical therapist or physical therapist assistant who has a valid unrestricted license from another United States jurisdiction in which such person, when granted such license, previously met all requirements as specified in subsections (a) and (b) and as further established by rules promulgated by the board.
  4. An applicant for licensure as a physical therapist who has been educated outside the United States, foreign-educated, or internationally trained shall meet the following qualifications:
    1. [Deleted by 2020 amendment.]
    2. Be of good moral character;
    3. Have completed the application process;
    4. Provide satisfactory evidence that the applicant's education is substantially equivalent to the requirements of physical therapists educated in accredited educational programs as determined by the board. If the board determines that a foreign-educated applicant's education is not substantially equivalent, it may require completion of additional course work before proceeding with the application process;
    5. Provide written proof that the school of physical therapy education is recognized by its own ministry of education;
    6. Provide written proof of authorization to practice as a physical therapist without limitations in the country where the professional education occurred;
    7. Provide proof of legal authorization to reside and seek employment in the United States or its territories;
    8. Have the applicant's educational credentials evaluated by a board-approved credential evaluation agency;
    9. Have passed the board approved English proficiency examinations, if the applicant's native language is not English;
    10. Have participated in and completed an interim supervised clinical practice period prior to licensure; and
    11. Have successfully passed the examination approved by the board.
  5. Notwithstanding this section, if the foreign-educated physical therapist applicant is a graduate of a professional physical therapy education program accredited by an agency approved by the board, the requirements in subdivisions (d)(4), (5), (8) and (10) may be waived.
  6. In determining the qualifications of an applicant for licensure as a physical therapist or as a physical therapist assistant, only a majority vote of the board of physical therapy shall be required.

Acts 1999, ch. 528, § 18; 2007, ch. 115, § 10; 2020, ch. 790, §§ 8-11.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2020 amendment, deleted former (a)(1) which read: “Must be at least eighteen (18) years of age;”; in (a)(4), substituted “physical therapy program” for “physical therapy education program”, “a national” for “an” and “agency recognized by the United States department of education and by the board of physical therapy” for “agency approved by the board”; deleted former (b)(1) which read: “Must be at least eighteen (18) years of age;”; inserted “, foreign-educated, or internationally trained” in the introductory paragraph of (d); and deleted former (d)(1) which read: “Must be at least eighteen (18) years of age;”.

Effective Dates. Acts 2020, ch. 790, § 17. July 15, 2020.

Cross-References. Licensure, §§  63-1-10363-1-112.

63-13-308. License renewal — Eligibility to apply for physical therapy licensure compact privileges — Changes in name or address — Retirement — Inactive Status — Exemption from continuing education requirements.

  1. A physical therapist or physical therapist assistant licensed under this part shall renew the person's license as specified in the rules. An individual who fails to renew the license by the date of expiration shall not practice physical therapy or function as a physical therapist assistant in this state.
  2. A physical therapist or physical therapist assistant licensed in a jurisdiction that is a member state of the Physical Therapy Licensure Compact is eligible to become a licensee for compact privileges in this state, subject to the requirements in § 63-13-402.
  3. Each licensee shall report to the division a name change and changes in business and home address within thirty (30) days of the change.
  4. A person licensed by the board to the practice of physical therapy in this state who has retired, or may retire, from the practice in this state is not required to register as required by this part if the person files with the board an affidavit on a form to be furnished by the board, which affidavit states the date on which the person retired from the practice and any other facts the board considers necessary that tend to verify the retirement. If the person thereafter reengages in the practice in this state, the person must apply for licensure with the board as provided by this part and meet the continuing education requirements that are established by the board, except for good and sufficient reasons as determined by the board.
  5. A person licensed by the board may place their license on inactive status by filing the proper forms with the board and by paying a biennial fee in accordance with rules. If the person thereafter reengages in active practice of physical therapy in this state, then the person must apply for relicensure with the board as provided by this part and meet the continuing education requirements as are established by the board, except for good and sufficient reasons as determined by the board.

Acts 1999, ch. 528, § 19; 2005, ch. 51, § 1; 2007, ch. 115, § 10; 2020, ch. 790, § 12.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2020 amendment inserted “ — Eligibility to apply for physical therapy licensure compact privileges" in the section heading; substituted “the person's” for “such person's” in the first sentence of (a); added present (b), redesignating former (b) through (d) as present (c) through (e); substituted “A person” for “Any person” in the first sentences of both present (d) and (e); in present (d), in the first sentence, substituted “the practice of physical therapy” for the first occurrence of “practice”, substituted the second and third occurrences of “the practice” for “such practice”, substituted “the person files” for “such person files”, deleted “as” preceding “the board considers” substituted “tend” for “tend” and “the retirement.” for “such retirement.” and rewrote the second sentence which read: “If such person thereafter reengages in practice in this state, such person shall apply for licensure with the board as provided by this part and shall meet such continuing education requirements that are established by the board, except for good and sufficient reasons as determined by the board.”; rewrote the second sentence in present (e) which read: “If such person thereafter reengages in active practice in this state, such person shall apply for relicensure with the board as provided by this part and shall meet such continuing education requirements as are established by the board, except for good and sufficient reasons as determined by the board.”; and deleted former (e) which read: “A licensee who has been continuously licensed in this state since 1960 and who is at least seventy-one (71) years of age shall be exempt from any continuing education requirements imposed by the board under this chapter.”

Effective Dates. Acts 2020, ch. 790, § 17. July 15, 2020.

Cross-References. Licensure, §§ 63-1-10363-1-112.

Retirement, §  63-1-111.

63-13-309. Reinstatement of license — Failure to renew license.

  1. Reinstatement of a lapsed license following a renewal deadline requires payment of a renewal fee, a late renewal penalty fee and a reinstatement fee, in accordance with rules promulgated by the board.
  2. Reinstatement of a license that has lapsed for more than three (3) consecutive years requires reapplying for a license and payment of fees in accordance with board rules. The individual shall successfully demonstrate to the board competency in the practice of physical therapy or, shall serve an internship under a restricted license or take remedial courses as determined by the board, or any combination of the preceding, at the board's discretion. The board may also require the applicant to take an examination.
  3. When any license holder fails to renew and pay the biennial renewal fee within sixty (60) days after renewal becomes due, as provided in this section, the license of such person shall be administratively revoked at the expiration of the sixty (60) days after the renewal was required, without further notice or hearing. Any person whose license is administratively revoked, as provided in this subsection (c), may make application in writing to the board for the reinstatement of such license; and, upon good cause being shown, the board, in its discretion, may reinstate such license upon payment of all required fees.

Acts 1999, ch. 528, § 20; 2007, ch. 115, § 10.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

Cross-References. Licensure, §§   63-1-10363-1-112.

63-13-310. Unlawful use of titles or designations indicating licensure.

  1. A physical therapist shall use the letters “PT” or “DPT”, as appropriate for the individual's education, in connection with their name or place of business to denote licensure under this part.
  2. It is unlawful for any person or for any business entity, its employees, agents or representatives to use in connection with such person's name or the name or activity of the business the words “physical therapy,” “physical therapist,” “physiotherapy,” “physiotherapist,” “registered physical therapist,” “licensed physical therapist,” “doctor of physical therapy,” or the letters “PT,” “LPT,” “DPT,” or “RPT” or any other words, abbreviations or insignia indicating or implying directly or indirectly that physical therapy is provided or supplied, including the billing of services labeled as physical therapy, unless such services are provided by or under the direction of a physical therapist licensed in accordance with this part.
  3. Nothing in this chapter shall be construed as restricting a person licensed or certified under any other law of this state from engaging in the profession or practice for which the person is licensed or certified; provided, that the person does not claim to be a physical therapist, a physical therapist assistant or a provider of physical therapy.
  4. A physical therapist assistant shall use the letters “PTA” in connection with the person's name to denote licensure.
  5. No person shall use the title “physical therapist assistant” or use the letters “PTA” in connection with the person's name or any other words, abbreviations or insignia indicating or implying, directly or indirectly, that the person is a physical therapist assistant unless the person is licensed as a physical therapist assistant in accordance with this part.

Acts 1999, ch. 528, § 21; 2015, ch. 124, § 5; 2020, ch. 790, § 13.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Former part 3 of this chapter, concerning licensure of physical therapists and assistants, was repealed and reenacted by Acts 1999, ch. 528, § 10, effective June 21, 1999. The former provisions, excluding those previously transferred, were §§ 63-3-30163-3-310 (Acts 1984, ch. 921, § 4; T.C.A., §§ 63-13-40163-13-410; Acts 1988, ch. 824, §§ 5-16; 1989, ch. 360, § 45; 1989, ch. 523, §§ 33-38; 1989, ch. 591, §§ 86, 112; 1991, ch. 245, §§ 5-13; 1992, ch. 998, §§ 1, 2; 1993, ch. 225, §§ 2, 3; 1994, ch. 901, § 4; 1995, ch. 226, §§ 4-7; 1998, ch. 974, § 1).

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2020 amendment inserted “or "DPT", as appropriate for the individual's education,” in (a).

Effective Dates. Acts 2020, ch. 790, § 17. July 15, 2020.

Attorney General Opinions. Authority of physical therapy board as to chiropractor advertising “physical therapy” services where the services offered are not performed by or under direction of licensed physical therapist.  OAG 12-27, 2012 Tenn. AG LEXIS 27 (2/29/12).

63-13-311. Supervision of students and assistive personnel.

  1. Physical therapists are responsible for the patient care given by physical therapist assistants, assistive personnel and students on clinical affiliations under their supervision. The physical therapist may delegate to the physical therapist assistant, assistive personnel and clinical students selected acts, tasks or procedures that fall within the scope of their education or training.
  2. Physical therapist assistants shall at all times be under the supervision of a licensed physical therapist as defined in § 63-13-103 and as further set forth in the rules promulgated by the board.
  3. Physical therapy aides, other assistive personnel and clinical students shall at all times perform patient care activities under the onsite supervision of a licensed physical therapist or physical therapist assistant as defined in § 63-13-103.
  4. Physical therapist students and physical therapist assistant students shall at all times be under the supervision of a physical therapist as further set forth in the rules promulgated by the board.

Acts 1999, ch. 528, § 22.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

NOTES TO DECISIONS

1. Workers' Compensation Liability.

When physical therapists were required to supervise the therapists'  assistance, such requirement did not make the physical therapists the employees of an insured with whom the therapists contracted, for purposes of making the insured liable to insurers for workers'  compensation premiums for the therapists, because this was a requirement imposed by law that did not show whether the insured could exercise the requisite control over the therapists. Cont'l Cas. Co. v. Theraco, Inc., 437 S.W.3d 841, 2014 Tenn. App. LEXIS 16 (Tenn. Ct. App. Jan. 14, 2014), appeal denied, — S.W.3d —, 2014 Tenn. LEXIS 451 (Tenn. May 28, 2014).

63-13-312. Denial, suspension or revocation of licenses.

  1. The board has the power, and it shall be its duty, to deny, suspend or revoke the license of, or to otherwise lawfully discipline, a licensee who is guilty of violating any of this part or is guilty of the following acts or offenses:
    1. Practicing physical therapy in violation of this chapter or any rule or written order adopted by the board;
    2. Practicing or offering to practice beyond the scope of physical therapy practice as defined in this chapter;
    3. Making false or misleading statements or representations, being guilty of fraud or deceit in obtaining admission to practice or being guilty of fraud or deceit in the licensee's practice;
    4. Engaging in the performance of substandard care by a physical therapist due to ignorance, incompetence or a deliberate or negligent act or failure to act, regardless of whether actual injury to the patient is established;
    5. Engaging in the performance of substandard care by a physical therapist assistant, which includes exceeding the authority to perform the task selected and delegated by the supervising physical therapist, regardless of whether actual injury to the patient is established;
    6. Inadequately supervising or delegating duties that exceed the scope of practice for assistive personnel in accordance with this chapter and rules adopted by the board;
    7. Conviction of a felony or any offense involving moral turpitude in the courts of this state or any other state, territory or country. “Conviction,” as used in this subdivision (a)(7), includes a finding or verdict of guilt or a plea of nolo contendere;
    8. Practicing as a physical therapist or working as a physical therapist assistant when physical or mental abilities are impaired by the use of controlled substances, controlled substance analogues, other habit-forming drugs, chemicals or alcohol;
    9. Disciplinary action against a person licensed to practice as a physical therapist or physical therapist assistant by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed in this state. A certified copy of the initial or final order or other equivalent document shall constitute prima facie evidence of a violation of this section and be sufficient grounds upon which to deny, restrict or condition licensure or renewal and/or discipline a person licensed in this state;
    10. Engaging in sexual misconduct. “Sexual misconduct,” for the purpose of this section, includes:
      1. Engaging in or soliciting sexual relationships, whether consensual or nonconsensual, while a physical therapist or physical therapist assistant/patient relationship exists;
      2. Making sexual advances, requesting sexual favors and engaging in other verbal conduct or physical conduct or physical contact of a sexual nature with patients; and
      3. Intentionally viewing a completely or partially disrobed patient in the course of treatment, if the viewing is not related to patient diagnosis or treatment under current practice standards;
    11. Directly or indirectly requesting, receiving or participating in the dividing, transferring, assigning, rebating or refunding of an unearned fee or profiting by means of a credit or other valuable consideration, such as an unearned commission, discount or gratuity in connection with the furnishing of physical therapy services. Nothing in this subdivision (a)(11) prohibits the members of any regularly and properly organized business entity recognized by law and comprised of physical therapists from dividing fees received for professional services among themselves as they determine necessary to defray their joint operating expenses. Physical therapists employed by or contracting with a physician, physician group, as defined in accordance with the federal Physician Self-Referral Law (42 U.S.C. § 1395nn), or entity primarily owned by physicians and receiving wages or other compensation and/or benefits pursuant to the employment or contract shall not be deemed to be in violation of any provision under this chapter solely by virtue of the employment or contract and shall not be subject to licensure denial, suspension, revocation or any other disciplinary action or other penalty described under this chapter solely by virtue of the employment or contract. This subdivision (a)(11) shall not be interpreted in such a way as to create a prohibition on the corporate practice of any health care professional where no such prohibition previously existed;
    12. Failing to adhere to standards of ethics of the physical therapy profession;
    13. Charging unreasonable or fraudulent fees for services performed or not performed;
    14. Making misleading, deceptive, untrue or fraudulent representations in violation of this chapter, or otherwise, in practice of the profession;
    15. Being under a current judgment of mental incompetency rendered by a court of competent jurisdiction;
    16. Aiding or abetting a person not licensed in this state who directly or indirectly performs activities requiring a license;
    17. Failing to report to the board any act or omission of a licensee, applicant or any other person which violates this chapter;
    18. Interfering with, or refusing to cooperate in, an investigation or disciplinary proceeding, including willful misrepresentation of facts or by the use of threats or harassment against any patient or witness to prevent the patient or witness from providing evidence in a disciplinary proceeding or any legal action;
    19. Failing to maintain patient confidentiality without prior written consent or unless otherwise required by law;
    20. Failing to maintain adequate patient records that contain a minimum of an evaluation of objective finding, a physical therapy treatment diagnosis, the plan of care including desired outcomes, the treatment record, a discharge plan including results of intervention and sufficient information to identify the patient;
    21. Promoting unnecessary devices, treatment intervention or service for the financial gain of the practitioner or of a third party;
    22. Providing treatment intervention unwarranted by the condition of the patient, nor shall the licensee continue treatment beyond the point of reasonable benefit;
    23. A violation or attempted violation, directly or indirectly, or assisting in or abetting the violation of or conspiring to violate any provisions of this chapter or any lawful order of the board issued pursuant thereto or any criminal statute of this state;
    24. Division of fees or agreeing to split fees or divide fees received for professional services with any person for bringing or referring a patient outside the scope of § 63-13-315;
    25. Payment or acceptance of commissions, in any form or manner, on fees for professional services, references, consultations, pathological reports, prescriptions or on other services or articles supplied to patients;
    26. Acting in a manner inconsistent with generally accepted standards of physical therapy practice; or
    27. Practicing physical therapy with a mental or physical condition that impairs the ability of the licensee to practice with skill and safety.
  2. 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 1999, ch. 528, § 23; 2006, ch. 875, § 3; 2007, ch. 115, § 10; 2012, ch. 848, § 78; 2018, ch. 745, § 31; 2020, ch. 790, § 14.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2018 amendment added (b).

The 2020 amendment added (a)(26) and (a)(27).

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

Acts 2020, ch. 790, § 17. July 15, 2020.

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

Grounds for license denial, suspension or revocation, §  63-6-214.

63-13-313. Disciplinary actions of the board.

The board may, upon proof of the violation of any provision of this chapter, take the following disciplinary actions singly or in combination:

  1. Deny an application for a license to any applicant who applies for the same through reciprocity or otherwise;
  2. Permanently or temporarily withhold issuance of a license;
  3. Suspend, limit or restrict a previously issued license for such time and in such manner as the board may determine;
  4. Issue a letter of reprimand;
  5. Reprimand or take such action in relation to disciplining an applicant or licensee, including, but not limited to, informal settlements and letters of warning as the board, in its discretion, may deem proper;
  6. Revoke a license;
  7. Refuse to issue or renew a license; or
  8. Impose civil penalties for violation of this chapter pursuant to § 63-1-134. In addition, the board may, in its discretion, assess and collect the reasonable costs incurred in a disciplinary hearing when action is taken against a person's license.

Acts 1999, ch. 528, § 25; 2007, ch. 115, § 10.

Compiler's Notes. Former part 3, §§ 63-13-30163-13-313, was transferred to part 2 of this chapter in 1986.

Attorney General Opinions. Authority of physical therapy board as to chiropractor advertising “physical therapy” services where the services offered are not performed by or under direction of licensed physical therapist.  OAG 12-27, 2012 Tenn. AG LEXIS 27 (2/29/12).

63-13-314. Administrative procedure for disciplinary actions — Jurisdiction of board.

  1. All proceedings for disciplinary action against a licensee shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  2. The board retains jurisdiction to modify or refuse to modify, upon request of any party, any of its orders issued pursuant to this section.

Acts 1999, ch. 528, § 26; 2007, ch. 115, § 10.

63-13-315. Penalties.

  1. A person commits a Class B misdemeanor if the person engages in an activity requiring a license issued according to this chapter and who fails to obtain the required license, who violates any other provision of this chapter or who uses any word, title, or representation implying that the person is licensed to engage in the practice of physical therapy. A person claims to be a physical therapist when using a title, letters or any description of services that incorporates one (1) or more of the terms, designations or abbreviations specifically restricted under §§ 63-13-103 and 63-13-310.
  2. The board may authorize an investigation of any person to the extent necessary to determine if the person is engaged in the unlawful practice of physical therapy.
  3. The board may, through the office of the attorney general and reporter, apply for injunctive relief in any court of competent jurisdiction to enjoin any person from committing an act in violation of this chapter. Injunctive proceedings are in addition to, and not in lieu of, all penalties and other remedies prescribed in this chapter.
  4. A person who aids or requires another person to directly or indirectly violate this chapter or rules, who permits the person's license or a license issued by this board to be used by any person other than the licensee or who acts with the intent to violate or evade this chapter or rules is subject to a civil penalty of not more than one thousand dollars ($1,000) for each violation.

Acts 1999, ch. 528, § 27.

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

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

Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, recovery, §  63-1-134.

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

Attorney General Opinions. Authority of physical therapy board as to chiropractor advertising “physical therapy” services where the services offered are not performed by or under direction of licensed physical therapist.  OAG 12-27, 2012 Tenn. AG LEXIS 27 (2/29/12).

63-13-316. Peer assistance program — Fees.

  1. In lieu of a disciplinary proceeding as set forth in this chapter, the board may permit a licensee pursuant to this part to actively participate in a board approved peer assistance program under the following conditions:
    1. The board has evidence that the licensee is impaired;
    2. The licensee has not been convicted of a felony relating to a controlled substance or controlled substance analogue in a court of law of the United States or any other territory or country;
    3. The licensee enters into a written agreement with the board for a restricted license and complies with all the terms of the agreement, including making satisfactory progress in the program and adhering to any limitations on the licensee's practice imposed by the board to protect the public. Failure to enter into such an agreement shall activate an immediate investigation and disciplinary proceeding by the board; and
    4. As part of the agreement established between the licensee and the board, the licensee shall sign a waiver allowing the peer assistance program to release information to the board if the licensee does not comply with the requirements of this section or is unable to practice with reasonable skill or safety.
  2. The board shall establish fees for all licensees to effect the purposes of this section.

Acts 1999, ch. 528, § 28; 2007, ch. 115, § 10; 2012, ch. 848, § 79.

63-13-317. Disclosures to patient — Confidentiality of information — Complaints — Display of license.

  1. Physical therapists shall inform the patient of any financial arrangements connected to the referral process.
  2. Physical therapists shall disclose in writing any financial interest in products they endorse and recommend to their patients.
  3. The licensee has the responsibility to ensure that the patient has knowledge of freedom of choice in services and products.
  4. Information relating to the physical therapist-patient relationship is confidential and may not be communicated to a third party not involved in that patient's care without the prior written consent of the patient. The physical therapist-patient confidentiality does not extend to cases in which the physical therapist has a duty to report information as required by law.
  5. Any person may submit a complaint regarding any licensee or any other person potentially in violation of this chapter. Confidentiality shall be maintained subject to law.
  6. The department shall keep all information relating to the receiving and investigation of complaints filed against licensees confidential until the information becomes public record as required by law.
  7. Each licensee shall display a copy of the licensee's license or current renewal verification in a location accessible to public view at the licensee's place of employment.

Acts 1999, ch. 528, § 29.

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

Display of license or registration certificate, §  63-1-109.

63-13-318. Board of physical therapy.

  1. There is created a board of physical therapy, which shall perform the same functions and have the same duties and responsibilities that were performed by the committee of physical therapy prior to July 1, 2007.
  2. The board shall consist of five (5) members appointed by the governor, each of whom shall be a resident of this state. Three (3) members of the board shall be licensed physical therapists who have had at least five (5) years of experience in the actual practice or teaching of physical therapy immediately preceding their appointment. One (1) member of the board shall be a licensed physical therapist assistant who has had at least five (5) years of experience in the actual performance of physical therapy procedures and related tasks or teaching of a physical therapist assistant curriculum immediately preceding the appointment. One (1) member of the board shall be a person who is not engaged in the practice of physical therapy and who is not professionally or commercially associated with the health care industry.
  3. The physical therapist and physical therapist assistant members may be appointed by the governor from lists of nominees submitted by interested physical therapy groups, including, but not limited to, the Tennessee Physical Therapy Association. The governor shall consult with the interested physical therapy groups to determine qualified persons to fill positions on the board.
  4. The physical therapists and the physical therapist assistant who are serving on the committee of physical therapy on July 1, 2007, shall continue to serve as members of the board until the expiration of their terms.
  5. The board shall organize annually and select a chair and a secretary. Meetings shall be held as frequently as may be required.
  6. A quorum of the board shall consist of at least three (3) members.
  7. The division shall provide administrative, investigatory and clerical services to the board.
  8. Each member of the board shall be reimbursed for actual expenses incurred in the performance of official duties on the board and shall be entitled to a per diem of one hundred dollars ($100) for each day of service in conducting the business of the board. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  9. All regular appointments to the board shall be for terms of three (3) years each. Each member shall serve until a successor is appointed. Vacancies shall be filled by appointment of the governor for the remainder of the unexpired term.
  10. The governor may, at the request of the board, remove any member of the board for misconduct, incompetence or neglect of duty.
  11. In making appointments to the board, the governor shall strive to ensure that at least one (1) member is fifty-five (55) years of age or older, that at least one (1) member is a racial minority, and that the gender balance of the board reflects the gender balance of the state's population.
  12. After July 1, 2007, the board shall assume and fulfill all powers and duties previously assigned to the committee of physical therapy, and the rules adopted by the committee of physical therapy shall become the rules of the board without further action by the board.

Acts 2007, ch. 115, § 11. 2014, ch. 600, § 3; 2017, ch. 211, § 2; 2020, ch. 790, § 15.

Compiler's Notes. The board of physical therapy, created by this section, terminates June 30, 2025. See §§ 4-29-112, 4-29-246

Acts 2016, ch. 810, § 2 provided that the chair of the board of physical therapy selected pursuant to § 63-13-318(e) shall notify the government operations committee of the senate and the government operations committee of the house of representatives within thirty (30) days of the date the Physical Therapy Licensure Compact comes into effect as provided in Section 11 of the compact (Section 11 of the compact is codified at § 63-13-402.)

Acts 2020, ch. 790, § 17 provided that the act, which amended this section, applies to actions occurring on or after July 15, 2020.

Amendments. The 2017 amendment, in (c), substituted “may be appointed” for “shall be appointed” in the first sentence, and substituted “with the interested physical therapy groups” for “with such interested groups” in the second sentence.

The 2020 amendment substituted “fifty-five (55) years of age” for “sixty (60) years of age” in (k).

Effective Dates. Acts 2017, ch. 211, § 4. April 28, 2017.

Acts 2020, ch. 790, § 17. July 15, 2020.

Part 4
Physical Therapy Licensure Compact [Contingent implementation date. See Compiler's Notes.]

63-13-401. Short title.

This part shall be known and may be cited as the “Physical Therapy Licensure Compact.”

Acts 2016, ch. 810, § 1.

Compiler's Notes. Acts 2016, ch. 810, which enacted this part, provides that the compact will come into effect on the date on which the compact statute is enacted into law in the tenth member state.  The act provides that the chair of the board of physical therapy shall notify the government operations committees of the senate and house of representatives within 30 days of the date the compact comes into effect as provided in the compact.

The physical therapy licensure compact, created by this section, terminates June 30, 2028. See §§ 4-29-112, 4-29-249.

63-13-402. Text of Compact.

The Physical Therapy Licensure Compact is enacted into law and entered into by this state with all states legally joining therein in the form substantially as follows:

Physical Therapy Licensure Compact

Section 1. Purpose

The purpose of this Compact is to facilitate interstate practice of physical therapy with the goal of improving public access to physical therapy services. The practice of physical therapy occurs in the state where the patient/client is located at the time of the patient/client encounter. The Compact preserves the regulatory authority of states to protect public health and safety through the current system of state licensure. This Compact is designed to achieve the following objectives:

1.  Increase public access to physical therapy services by providing for the mutual recognition of other member state licenses;

2.  Enhance the states' ability to protect the public's health and safety;

3.  Encourage the cooperation of member states in regulating multi-state physical therapy practice;

4.  Support spouses of relocating military members;

5.  Enhance the exchange of licensure, investigative, and disciplinary information between member states; and

6.  Allow a remote state to hold a provider of services with a compact privilege in that state accountable to that state's practice standards.

Section 2. Definitions

As used in this Compact, and except as otherwise provided, the following definitions shall apply.

1.  “Active Duty Military” means full-time duty status in the active uniformed service of the United States, including members of the National Guard and Reserve on active duty orders pursuant to 10 U.S.C. Section 1209 and 1211.

2.  “Adverse Action” means disciplinary action taken by a physical therapy licensing board based upon misconduct, unacceptable performance, or a combination of both.

3.  “Alternative Program” means a non-disciplinary monitoring or practice remediation process approved by a physical therapy licensing board. This includes, but is not limited to, substance abuse issues.

4.  “Compact privilege” means the authorization granted by a remote state to allow a licensee from another member state to practice as a physical therapist or work as a physical therapist assistant in the remote state under its laws and rules. The practice of physical therapy occurs in the member state where the patient/client is located at the time of the patient/client encounter.

5.  “Continuing competence” means a requirement, as a condition of license renewal, to provide evidence of participation in, and/or completion of, educational and professional activities relevant to practice or area of work.

6.  “Data system” means a repository of information about licensees, including examination, licensure, investigative, compact privilege, and adverse action.

7.  “Encumbered license” means a license that a physical therapy licensing board has limited in any way.

8.  “Executive Board” means a group of directors elected or appointed to act on behalf of, and within the powers granted to them by, the Commission.

9.  “Home state” means the member state that is the licensee's primary state of residence.

10.  “Investigative information” means information, records, and documents received or generated by a physical therapy licensing board pursuant to an investigation.

11.  “Jurisprudence Requirement” means the assessment of an individual's knowledge of the laws and rules governing the practice of physical therapy in a state.

12.  “Licensee” means an individual who currently holds an authorization from the state to practice as a physical therapist or to work as a physical therapist assistant.

13.  “Member state” means a state that has enacted the Compact.

14.  “Party state” means any member state in which a licensee holds a current license or compact privilege or is applying for a license or compact privilege.

15.  “Physical therapist” means an individual who is licensed by a state to practice physical therapy.

16.  “Physical therapist assistant” means an individual who is licensed/certified by a state and who assists the physical therapist in selected components of physical therapy.

17.  “Physical therapy,” “physical therapy practice,” and “the practice of physical therapy” mean the care and services provided by or under the direction and supervision of a licensed physical therapist.

18.  “Physical Therapy Compact Commission” or “Commission” means the national administrative body whose membership consists of all states that have enacted the Compact.

19.  “Physical therapy licensing board” or “licensing board” means the agency of a state that is responsible for the licensing and regulation of physical therapists and physical therapist assistants.

20.  “Remote State” means a member state other than the home state, where a licensee is exercising or seeking to exercise the compact privilege.

21.  “Rule” means a regulation, principle, or directive promulgated by the Commission that has the force of law.

22.  “State” means any state, commonwealth, district, or territory of the United States of America that regulates the practice of physical therapy.

Section 3. State Participation in the Compact

A.  To participate in the Compact, a state must:

1.  Participate fully in the Commission's data system, including using the Commission's unique identifier as defined in rules;

2.  Have a mechanism in place for receiving and investigating complaints about licensees;

3.  Notify the Commission, in compliance with the terms of the Compact and rules, of any adverse action or the availability of investigative information regarding a licensee;

4.  Fully implement a criminal background check requirement, within a time frame established by rule, by receiving the results of the Federal Bureau of Investigation record search on criminal background checks and use the results in making licensure decisions in accordance with Section 3.B.;

5.  Comply with the rules of the Commission;

6.  Utilize a recognized national examination as a requirement for licensure pursuant to the rules of the Commission; and

7.  Have continuing competence requirements as a condition for license renewal.

B.  Upon adoption of this statute, the member state shall have the authority to obtain biometric-based information from each physical therapy licensure applicant and submit this information to the Federal Bureau of Investigation for a criminal background check in accordance with 28 U.S.C. § 534 and 42 U.S.C. § 14616.

C.  A member state shall grant the compact privilege to a licensee holding a valid unencumbered license in another member state in accordance with the terms of the Compact and rules.

D.  Member states may charge a fee for granting a compact privilege.

Section 4. Compact Privilege

A.  To exercise the compact privilege under the terms and provisions of the Compact, the licensee shall:

1.  Hold a license in the home state;

2.  Have no encumbrance on any state license;

3.  Be eligible for a compact privilege in any member state in accordance with Section 4D, G and H;

4.  Have not had any adverse action against any license or compact privilege within the previous 2 years;

5.  Notify the Commission that the licensee is seeking the compact privilege within a remote state(s);

6.  Pay any applicable fees, including any state fee, for the compact privilege;

7.  Meet any jurisprudence requirements established by the remote state(s) in which the licensee is seeking a compact privilege; and

8.  Report to the Commission adverse action taken by any non-member state within 30 days from the date the adverse action is taken.

B.  The compact privilege is valid until the expiration date of the home license. The licensee must comply with the requirements of Section 4.A. to maintain the compact privilege in the remote state.

C.  A licensee providing physical therapy in a remote state under the compact privilege shall function within the laws and regulations of the remote state.

D.  A licensee providing physical therapy in a remote state is subject to that state's regulatory authority. A remote state may, in accordance with due process and that state's laws, remove a licensee's compact privilege in the remote state for a specific period of time, impose fines, and/or take any other necessary actions to protect the health and safety of its citizens. The licensee is not eligible for a compact privilege in any state until the specific time for removal has passed and all fines are paid.

E.  If a home state license is encumbered, the licensee shall lose the compact privilege in any remote state until the following occur:

1.  The home state license is no longer encumbered; and

2.  Two years have elapsed from the date of the adverse action.

F.  Once an encumbered license in the home state is restored to good standing, the licensee must meet the requirements of Section 4A to obtain a compact privilege in any remote state.

G.  If a licensee's compact privilege in any remote state is removed, the individual shall lose the compact privilege in any remote state until the following occur:

1.  The specific period of time for which the compact privilege was removed has ended;

2.  All fines have been paid; and

3.  Two years have elapsed from the date of the adverse action.

H.  Once the requirements of Section 4G have been met, the license must meet the requirements in Section 4A to obtain a compact privilege in a remote state.

Section 5. Active Duty Military Personnel or Their Spouses

A licensee who is active duty military or is the spouse of an individual who is active duty military may designate one of the following as the home state:

A.  Home of record;

B.  Permanent Change of Station (PCS); or

C.  State of current residence if it is different than the PCS state or home of record.

Section 6. Adverse Actions

A.  A home state shall have exclusive power to impose adverse action against a license issued by the home state.

B.  A home state may take adverse action based on the investigative information of a remote state, so long as the home state follows its own procedures for imposing adverse action.

C.  Nothing in this Compact shall override a member state's decision that participation in an alternative program may be used in lieu of adverse action and that such participation shall remain non-public if required by the member state's laws. Member states must require licensees who enter any alternative programs in lieu of discipline to agree not to practice in any other member state during the term of the alternative program without prior authorization from such other member state.

D.  Any member state may investigate actual or alleged violations of the statutes and rules authorizing the practice of physical therapy in any other member state in which a physical therapist or physical therapist assistant holds a license or compact privilege.

E.  A remote state shall have the authority to:

1.  Take adverse actions as set forth in Section 4.D. against a licensee's compact privilege in the state;

2.  Issue subpoenas for both hearings and investigations that require the attendance and testimony of witnesses, and the production of evidence. Subpoenas issued by a physical therapy licensing board in a party state for the attendance and testimony of witnesses, and/or the production of evidence from another party state, shall be enforced in the latter state by any court of competent jurisdiction, according to the practice and procedure of that court applicable to subpoenas issued in proceedings pending before it. The issuing authority shall pay any witness fees, travel expenses, mileage, and other fees required by the service statutes of the state where the witnesses and/or evidence are located; and

3.  If otherwise permitted by state law, recover from the licensee the costs of investigations and disposition of cases resulting from any adverse action taken against that licensee.

F.  Joint Investigations

1.  In addition to the authority granted to a member state by its respective physical therapy practice act or other applicable state law, a member state may participate with other member states in joint investigations of licensees.

2.  Member states shall share any investigative, litigation, or compliance materials in furtherance of any joint or individual investigation initiated under the Compact.

Section 7. Establishment of the Physical Therapy Compact Commission.

A.  The Compact member states hereby create and establish a joint public agency known as the Physical Therapy Compact Commission:

1.  The Commission is an instrumentality of the Compact states.

2.  Venue is proper and judicial proceedings by or against the Commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the Commission is located. The Commission may waive venue and jurisdictional defenses to the extent it adopts or consents to participate in alternative dispute resolution proceedings.

3.  Nothing in this Compact shall be construed to be a waiver of sovereign immunity.

B.  Membership, Voting, and Meetings. Each member state shall have and be limited to one (1) delegate selected by that member state's licensing board. The delegate shall be a current member of the licensing board, who is a physical therapist, physical therapist assistant, public member, or the board administrator. Any delegate may be removed or suspended from office as provided by the law of the state from which the delegate is appointed. The member state board shall fill any vacancy occurring in the Commission. Each delegate shall be entitled to one (1) vote with regard to the promulgation of rules and creation of bylaws and shall otherwise have an opportunity to participate in the business and affairs of the Commission. A delegate shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for delegates' participation in meetings by telephone or other means of communication. The Commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.

C.  The Commission shall have the following powers and duties:

1.  Establish the fiscal year of the Commission;

2.  Establish bylaws;

3.  Maintain its financial records in accordance with the bylaws;

4.  Meet and take such actions as are consistent with the provisions of this Compact and the bylaws;

5.  Promulgate uniform rules to facilitate and coordinate implementation and administration of this Compact. The rules shall have the force and effect of law and shall be binding in all member states;

6.  Bring and prosecute legal proceedings or actions in the name of the Commission, provided that the standing of any state physical therapy licensing board to sue or be sued under applicable law shall not be affected;

7.  Purchase and maintain insurance and bonds;

8.  Borrow, accept, or contract for services of personnel, including, but not limited to, employees of a member state;

9.  Hire employees, elect or appoint officers, fix compensation, define duties, grant such individuals appropriate authority to carry out the purposes of the Compact, and to establish the Commission's personnel policies and programs relating to conflicts of interest, qualifications of personnel, and other related personnel matters;

10.  Accept any and all appropriate donations and grants of money, equipment, supplies, materials and services, and to receive, utilize and dispose of the same; provided that at all times the Commission shall avoid any appearance of impropriety and/or conflict of interest;

11.  Lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve or use, any property, real, personal or mixed; provided that at all times the Commission shall avoid any appearance of impropriety;

12.  Sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property real, personal, or mixed;

13.  Establish a budget and make expenditures;

14.  Borrow money;

15.  Appoint committees, including standing committees comprised of members, state regulators, state legislators or their representatives, and consumer representatives, and such other interested persons as may be designated in this Compact and the bylaws;

16.  Provide and receive information from, and cooperate with, law enforcement agencies;

17.  Establish and elect an Executive Board; and

18.  Perform such other functions as may be necessary or appropriate to achieve the purposes of this Compact consistent with the state regulation of physical therapy licensure and practice.

D.  The Executive Board. The Executive Board shall have the power to act on behalf of the Commission according to the terms of this Compact.

1.  The Executive Board shall be comprised of nine members:

a.  Seven voting members who are elected by the Commission from the current membership of the Commission;

b.  One ex-officio, nonvoting member from the recognized national physical therapy professional association; and

c.  One ex-officio, nonvoting member from the recognized membership organization of the physical therapy licensing boards.

2.  The ex-officio members will be selected by their respective organizations.

3.  The Commission may remove any member of the Executive Board as provided in bylaws.

4.  The Executive Board shall meet at least annually.

5.  The Executive Board shall have the following duties and responsibilities:

a.  Recommend to the entire Commission changes to the rules or bylaws, changes to this Compact legislation, fees paid by Compact member states such as annual dues, and any commission Compact fee charged to licensees for the compact privilege;

b.  Ensure Compact administration services are appropriately provided, contractual or otherwise;

c.  Prepare and recommend the budget;

d.  Maintain financial records on behalf of the Commission;

e.  Monitor Compact compliance of member states and provide compliance reports to the Commission;

f.  Establish additional committees as necessary; and

g.  Other duties as provided in rules or bylaws.

E.  Meetings of the Commission

1.  All meetings shall be open to the public, and public notice of meetings shall be given in the same manner as required under the rulemaking provisions in Section 9.

2.  The Commission or the Executive Board or other committees of the Commission may convene in a closed, non-public meeting if the Commission or Executive Board or other committees of the Commission must discuss:

a.  Non-compliance of a member state with its obligations under the Compact;

b.  The employment, compensation, discipline or other matters, practices or procedures related to specific employees or other matters related to the Commission's internal personnel practices and procedures;

c.  Current, threatened, or reasonably anticipated litigation;

d.  Negotiation of contracts for the purchase, lease, or sale of goods, services, or real estate;

e.  Accusing any person of a crime or formally censuring any person;

f.  Disclosure of trade secrets or commercial or financial information that is privileged or confidential;

g.  Disclosure of information of a personal nature where disclosure would constitute a clearly unwarranted invasion of personal privacy;

h.  Disclosure of investigative records compiled for law enforcement purposes;

i.  Disclosure of information related to any investigative reports prepared by or on behalf of or for use of the Commission or other committee charged with responsibility of investigation or determination of compliance issues pursuant to the Compact; or

j.  Matters specifically exempted from disclosure by federal or member state statute.

3.  If a meeting, or portion of a meeting, is closed pursuant to this provision, the Commission's legal counsel or designee shall certify that the meeting may be closed and shall reference each relevant exempting provision.

4.  The Commission shall keep minutes that fully and clearly describe all matters discussed in a meeting and shall provide a full and accurate summary of actions taken, and the reasons therefore, including a description of the views expressed. All documents considered in connection with an action shall be identified in such minutes. All minutes and documents of a closed meeting shall remain under seal, subject to release by a majority vote of the Commission or order of a court of competent jurisdiction.

F.  Financing of the Commission

1.  The Commission shall pay, or provide for the payment of, the reasonable expenses of its establishment, organization, and ongoing activities.

2.  The Commission may accept any and all appropriate revenue sources, donations, and grants of money, equipment, supplies, materials, and services.

3.  The Commission may levy on and collect an annual assessment from each member state or impose fees on other parties to cover the cost of the operations and activities of the Commission and its staff, which must be in a total amount sufficient to cover its annual budget as approved each year for which revenue is not provided by other sources. The aggregate annual assessment amount shall be allocated based upon a formula to be determined by the Commission, which shall promulgate a rule binding upon all member states.

4.  The Commission shall not incur obligations of any kind prior to securing the funds adequate to meet the same; nor shall the Commission pledge the credit of any of the member states, except by and with the authority of the member state.

5.  The Commission shall keep accurate accounts of all receipts and disbursements. The receipts and disbursements of the Commission shall be subject to the audit and accounting procedures established under its bylaws. However, all receipts and disbursements of funds handled by the Commission shall be audited yearly by a certified or licensed public accountant, and the report of the audit shall be included in and become part of the annual report of the Commission.

G.  Qualified Immunity, Defense, and Indemnification

1.  The members, officers, executive director, employees and representatives of the Commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error or omission that occurred, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties or responsibilities; provided that nothing in this paragraph shall be construed to protect any such person from suit and/or liability for any damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of that person.

2.  The Commission shall defend any member, officer, executive director, employee or representative of the Commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities; provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel; and provided further, that the actual or alleged act, error, or omission did not result from that person's intentional or willful or wanton misconduct.

3.  The Commission shall indemnify and hold harmless any member, officer, executive director, employee, or representative of the Commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error or omission that occurred within the scope of Commission employment, duties, or responsibilities, or that such person had a reasonable basis for believing occurred within the scope of Commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful or wanton misconduct of that person.

Section 8. Data System

A.  The Commission shall provide for the development, maintenance, and utilization of a coordinated database and reporting system containing licensure, adverse action, and investigative information on all licensed individuals in member states.

B.  Notwithstanding any other provision of state law to the contrary, a member state shall submit a uniform data set to the data system on all individuals to whom this Compact is applicable as required by the rules of the Commission, including:

1.  Identifying information;

2.  Licensure data;

3.  Adverse actions against a license or compact privilege;

4.  Non-confidential information related to alternative program participation;

5.  Any denial of application for licensure, and the reason(s) for such denial; and

6.  Other information that may facilitate the administration of this Compact, as determined by the rules of the Commission.

C.  Investigative information pertaining to a licensee in any member state will only be available to other party states.

D.  The Commission shall promptly notify all member states of any adverse action taken against a licensee or an individual applying for a license. Adverse action information pertaining to a licensee in any member state will be available to any other member state.

E.  Member states contributing information to the data system may designate information that may not be shared with the public without the express permission of the contributing state.

F.  Any information submitted to the data system that is subsequently required to be expunged by the laws of the member state contributing the information shall be removed from the data system.

Section 9. Rulemaking

A.  The Commission shall exercise its rulemaking powers pursuant to the criteria set forth in this Section and the rules adopted thereunder. Rules and amendments shall become binding as of the date specified in each rule or amendment.

B.  If a majority of the legislatures of the member states rejects a rule, by enactment of a statute or resolution in the same manner used to adopt the Compact within 4 years of the date of adoption of the rule, then such rule shall have no further force and effect in any member state.

C.  Rules or amendments to the rules shall be adopted at a regular or special meeting of the Commission.

D.  Prior to promulgation and adoption of a final rule or rules by the Commission, and at least thirty (30) days in advance of the meeting at which the rule will be considered and voted upon, the Commission shall file a Notice of Proposed Rulemaking:

1.  On the website of the Commission or other publicly accessible platform; and

2.  On the website of each member state physical therapy licensing board or other publicly accessible platform or the publication in which each state would otherwise publish proposed rules.

E.  The Notice of Proposed Rulemaking shall include:

1.  The proposed time, date, and location of the meeting in which the rule will be considered and voted upon;

2.  The text of the proposed rule or amendment and the reason for the proposed rule;

3.  A request for comments on the proposed rule from any interested person; and

4.  The manner in which interested persons may submit notice to the Commission of their intention to attend the public hearing and any written comments.

F.  Prior to adoption of a proposed rule, the Commission shall allow persons to submit written data, facts, opinions, and arguments, which shall be made available to the public.

G.  The Commission shall grant an opportunity for a public hearing before it adopts a rule or amendment if a hearing is requested by:

1.  At least twenty-five (25) persons;

2.  A state or federal governmental subdivision or agency; or

3.  An association having at least twenty-five (25) members.

H.  If a hearing is held on the proposed rule or amendment, the Commission shall publish the place, time, and date of the scheduled public hearing. If the hearing is held via electronic means, the Commission shall publish the mechanism for access to the electronic hearing.

1.  All persons wishing to be heard at the hearing shall notify the executive director of the Commission or other designated member in writing of their desire to appear and testify at the hearing not less than five (5) business days before the scheduled date of the hearing.

2.  Hearings shall be conducted in a manner providing each person who wishes to comment a fair and reasonable opportunity to comment orally or in writing.

3.  All hearings will be recorded. A copy of the recording will be made available on request.

4.  Nothing in this section shall be construed as requiring a separate hearing on each rule. Rules may be grouped for the convenience of the Commission at hearings required by this section.

I.  Following the scheduled hearing date, or by the close of business on the scheduled hearing date if the hearing was not held, the Commission shall consider all written and oral comments received.

J.  If no written notice of intent to attend the public hearing by interested parties is received, the Commission may proceed with promulgation of the proposed rule without a public hearing.

K.  The Commission shall, by majority vote of all members, take final action on the proposed rule and shall determine the effective date of the rule, if any, based on the rulemaking record and the full text of the rule.

L.  Upon determination that an emergency exists, the Commission may consider and adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided that the usual rulemaking procedures provided in the Compact and in this section shall be retroactively applied to the rule as soon as reasonably possible, in no event later than ninety (90) days after the effective date of the rule. For the purposes of this provision, an emergency rule is one that must be adopted immediately in order to:

1.  Meet an imminent threat to public health, safety, or welfare;

2.  Prevent a loss of Commission or member state funds;

3.  Meet a deadline for the promulgation of an administrative rule that is established by federal law or rule; or

4.  Protect public health and safety.

M.  The Commission or an authorized committee of the Commission may direct revisions to a previously adopted rule or amendment for purposes of correcting typographical errors, errors in format, errors in consistency, or grammatical errors. Public notice of any revisions shall be posted on the website of the Commission. The revision shall be subject to challenge by any person for a period of thirty (30) days after posting. The revision may be challenged only on grounds that the revision results in a material change to a rule. A challenge shall be made in writing, and delivered to the chair of the Commission prior to the end of the notice period. If no challenge is made, the revision will take effect without further action. If the revision is challenged, the revision may not take effect without the approval of the Commission.

Section 10. Oversight, Dispute Resolution, and Enforcement

A.  Oversight

1.  The executive, legislative, and judicial branches of state government in each member state shall enforce this Compact and take all actions necessary and appropriate to effectuate the Compact's purposes and intent. The provisions of this Compact and the rules promulgated hereunder shall have standing as statutory law.

2.  All courts shall take judicial notice of the Compact and the rules in any judicial or administrative proceeding in a member state pertaining to the subject matter of this Compact which may affect the powers, responsibilities or actions of the Commission.

3.  The Commission shall be entitled to receive service of process in any such proceeding, and shall have standing to intervene in such a proceeding for all purposes. Failure to provide service of process to the Commission shall render a judgment or order void as to the Commission, this Compact, or promulgated rules.

B.  Default, Technical Assistance, and Termination

1.  If the Commission determines that a member state has defaulted in the performance of its obligations or responsibilities under this Compact or the promulgated rules, the Commission shall:

a.  Provide written notice to the defaulting state and other member states of the nature of the default, the proposed means of curing the default and/or any other action to be taken by the Commission; and

b.  Provide remedial training and specific technical assistance regarding the default.

2.  If a state in default fails to cure the default, the defaulting state may be terminated from the Compact upon an affirmative vote of a majority of the member states, and all rights, privileges and benefits conferred by this Compact may be terminated on the effective date of termination. A cure of the default does not relieve the offending state of obligations or liabilities incurred during the period of default.

3.  Termination of membership in the Compact shall be imposed only after all other means of securing compliance have been exhausted. Notice of intent to suspend or terminate shall be given by the Commission to the governor, the majority and minority leaders of the defaulting state's legislature, and each of the member states.

4.  A state that has been terminated is responsible for all assessments, obligations, and liabilities incurred through the effective date of termination, including obligations that extend beyond the effective date of termination.

5.  The Commission shall not bear any costs related to a state that is found to be in default or that has been terminated from the Compact, unless agreed upon in writing between the Commission and the defaulting state.

6.  The defaulting state may appeal the action of the Commission by petitioning the U.S. District Court for the District of Columbia or the federal district where the Commission has its principal offices. The prevailing member shall be awarded all costs of such litigation, including reasonable attorney's fees.

C.  Dispute Resolution

1.  Upon request by a member state, the Commission shall attempt to resolve disputes related to the Compact that arise among member states and between member and non-member states.

2.  The Commission shall promulgate a rule providing for both mediation and binding dispute resolution for disputes as appropriate.

D.  Enforcement

1.  The Commission, in the reasonable exercise of its discretion, shall enforce the provisions and rules of this Compact.

2.  By majority vote, the Commission may initiate legal action in the United States District Court for the District of Columbia or the federal district where the Commission has its principal offices against a member state in default to enforce compliance with the provisions of the Compact and its promulgated rules and bylaws. The relief sought may include both injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing member shall be awarded all costs of such litigation, including reasonable attorney's fees.

3.  The remedies herein shall not be the exclusive remedies of the Commission. The Commission may pursue any other remedies available under federal or state law.

Section 11. Date of Implementation of the Interstate Commission for Physical Therapy Practice and Associated Rules, Withdrawal, and Amendment

A.  The Compact shall come into effect on the date on which the Compact statute is enacted into law in the tenth member state. The provisions, which become effective at that time, shall be limited to the powers granted to the Commission relating to assembly and the promulgation of rules. Thereafter, the Commission shall meet and exercise rulemaking powers necessary to the implementation and administration of the Compact.

B.  Any state that joins the Compact subsequent to the Commission's initial adoption of the rules shall be subject to the rules as they exist on the date on which the Compact becomes law in that state. Any rule that has been previously adopted by the Commission shall have the full force and effect of law on the day the Compact becomes law in that state.

C.  Any member state may withdraw from this Compact by enacting a statute repealing the same.

1.  A member state's withdrawal shall not take effect until six (6) months after enactment of the repealing statute.

2.  Withdrawal shall not affect the continuing requirement of the withdrawing state's physical therapy licensing board to comply with the investigative and adverse action reporting requirements of this act prior to the effective date of withdrawal.

D.  Nothing contained in this Compact shall be construed to invalidate or prevent any physical therapy licensure agreement or other cooperative arrangement between a member state and a non-member state that does not conflict with the provisions of this Compact.

E.  This Compact may be amended by the member states. No amendment to this Compact shall become effective and binding upon any member state until it is enacted into the laws of all member states.

Section 12. Construction and Severability

This Compact shall be liberally construed so as to effectuate the purposes thereof. The provisions of this Compact shall be severable and if any phrase, clause, sentence or provision of this Compact is declared to be contrary to the constitution of any party state or of the United States or the applicability thereof to any government, agency, person or circumstance is held invalid, the validity of the remainder of this Compact and the applicability thereof to any government, agency, person or circumstance shall not be affected thereby. If this Compact shall be held contrary to the constitution of any party state, the Compact shall remain in full force and effect as to the remaining party states and in full force and effect as to the party state affected as to all severable matters.

Acts 2016, ch. 810, § 1.

Compiler's Notes. Acts 2016, ch. 810, which enacted this part, provides that the compact will come into effect on the date on which the compact statute is enacted into law in the tenth member state.  The act provides that the chair of the board of physical therapy shall notify the government operations committees of the senate and house of representatives within 30 days of the date the compact comes into effect as provided in the compact.

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

Chapter 14
Dispensing Opticians

63-14-101. Board — Creation — Composition — Appointments — Organization — Duties.

  1. There is hereby created a board to be known as “board of dispensing opticians,” referred to as “board” in this chapter, constituted as set out and with the duties and powers provided in this chapter.
    1. The board shall consist of five (5) members. No member shall be eligible to serve more than three (3) consecutive terms. All appointments shall be made for a term of four (4) years, and members of the board shall serve until their successors are appointed and qualified.
    2. The governor shall make appointments to the board not later than thirty (30) days after the expiration of the term of office of any member. Members of the board may be appointed by the governor from lists of qualified persons submitted by interested optician groups including, but not limited to, the Tennessee Dispensing Opticians Association, and the governor shall consult with the interested optician groups to determine qualified persons to fill the positions. No person shall be eligible for appointment to the board unless the person shall have been a resident of this state and engaged in the practice as a dispensing optician within this state for not less than five (5) years immediately preceding the time of such appointment by the governor; however, no person shall be eligible to appointment who is in any way connected with or interested in any school of optometry, optometric school or the optical or optometric department of any institution of learning or the wholesale optical or optometric supply business. In the event of a vacancy on the board, the governor shall appoint a new member to serve the unexpired term; provided, that such appointment, if not effective within sixty (60) days of the vacancy, shall be filled by the board.
    3. In making appointments to the board, 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.
  2. The board shall convene and organize by selecting from among its members a chair and a secretary-treasurer and shall adopt rules and regulations governing the examination of applicants, the enforcement of this chapter and shall establish a code of ethics and standards of practice for dispensing opticians in this state and such other rules and regulations as may be necessary for the proper carrying out of this chapter. The chair and secretary-treasurer thus elected shall serve for a period of two (2) years or until their successors are appointed and qualified.
    1. The board shall provide for meetings at least once each year for the purpose of receiving applications and giving examinations as provided in this chapter and may meet at such other times and places as the board shall designate from time to time by rules and regulations regularly adopted.
    2. The board may administer oaths, summon witnesses and take testimony in all matters relating to its duties.
    3. A majority of the board shall constitute a quorum for the transaction of any and all business that may be lawfully transacted by the board.
  3. The board shall determine the nature and character of the examination to be given applicants for license to practice as dispensing opticians and is empowered to issue licenses with respect to all persons who shall satisfactorily pass the examination as determined in accordance with the rules and regulations of the board. Each license shall be signed by the chair of the board and attested by the secretary-treasurer under its adopted seal. Each license issued by the board to any such applicant shall be signed by the members of the board, and such license exclusively shall be evidence of the right and authority of the person to whom it is issued to practice as dispensing optician within this state.
  4. The board shall not discriminate in the issuance of any license pursuant to this chapter. “Discrimination” means any direct or indirect act or practice of exclusion, distinction, restriction, segregation, limitation, refusal, denial or any other act or practice of differentiation or preference in the treatment of a person or persons because of race, creed, color, religion, sex, age or national origin.

Acts 1955, ch. 98, § 1; impl. am. Acts 1955, ch. 160, § 1; Acts 1979, ch. 66, § 1; T.C.A., § 63-1401; Acts 1984, ch. 937, § 50; 1988, ch. 1013, § 52; 1989, ch. 351, § 1; 1998, ch. 1107, § 1; 2001, ch. 234, § 3; 2015, ch. 96, § 3.

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 §§ 63-1-13163-1-133, 68-1-101.

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

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

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.

NOTES TO DECISIONS

1. Constitutionality.

This act is not unconstitutional as denying citizens inherent right to earn their livelihood in a private field of work so as to deprive them of a valuable property right without due process of law, because the field is a proper subject for regulation as being related to the public health and the field of healing arts even though not constituting a profession. Tennessee Board of Dispensing Opticians v. Eyear Corp., 218 Tenn. 60, 400 S.W.2d 734, 1966 Tenn. LEXIS 550 (1966).

The general assembly under its police power may constitutionally regulate the conduct of preparing lenses for betterment of the eyes. Tennessee Board of Dispensing Opticians v. Eyear Corp., 218 Tenn. 60, 400 S.W.2d 734, 1966 Tenn. LEXIS 550 (1966).

2. Injunctive Relief.

Board of dispensing opticians has at least de facto authority to maintain suit to enjoin unlicensed corporation from engaging in practice as dispensing opticians. Tennessee Board of Dispensing Opticians v. Eyear Corp., 218 Tenn. 60, 400 S.W.2d 734, 1966 Tenn. LEXIS 550 (1966).

3. Intent of General Assembly.

In enacting this chapter the general assembly clearly felt and it was their intention that the statute had a direct and real connection with the health and welfare of the general public and the purpose of the statute was to protect such health and welfare. Tennessee Board of Dispensing Opticians v. Eyear Corp., 218 Tenn. 60, 400 S.W.2d 734, 1966 Tenn. LEXIS 550 (1966).

4. Out-of-State Opticians.

Where dispensing opticians in Georgia were not dispensing in Tennessee but were advertising in Tennessee news media, the court held that there was no jurisdiction to enjoin, since the act applied solely to the activity of dispensing opticals in Tennessee. Tennessee Board of Dispensing Opticians v. Roy H. Park, Broadcasting of Tennessee, Inc., 512 S.W.2d 579, 1973 Tenn. App. LEXIS 262 (Tenn. Ct. App. 1973).

63-14-102. “Practice of dispensing opticians” defined — Prohibited practices.

  1. “Practice of dispensing opticians” means the preparation, adaptation and dispensing of lenses, spectacles, eye glasses and optical devices to the intended user thereof on the written prescription of a physician or optometrist duly licensed to practice the physician's or the optometrist's profession and the dispensing of frames as a unit or individually to the intended user thereof.
  2. A person registered under this chapter is specifically prohibited from engaging in the practice of ocular refraction, orthoptics, visual training, prescribing contact lenses or the prescribing of subnormal vision aids or telescopic spectacles.
  3. Nothing in this section shall be construed to authorize or permit any dispensing optician to claim to be able to, or to offer, undertake or attempt, by any means or method, to examine or exercise eyes, fit contact lenses or diagnose, treat, correct, relieve, operate or prescribe for any human ailment, deficiency, deformity, disease, injury, pain or physical condition; however, dispensing opticians may fit contact lenses in the presence of and under the direct supervision of a licensed optometrist or ophthalmologist.
  4. Nor shall anything in this section or in this chapter be construed to require the licensing of persons, firms or corporations that are wholesale suppliers to opticians, optometrists or ophthalmologists, of lenses, spectacles, eye glasses or optical devices or to prevent such persons, firms or corporations from the preparation of lenses, spectacles, eye glasses or optical devices, defined to be the surfacing, fabrication or finishing of any substance or material used or to be used for the correction of human vision, or the adaptation of such lenses, spectacles, eye glasses or optical devices, defined to be the mounting of such a prepared substance or material to frames or to other devices designed to be worn by the user thereof, as long as such preparation or adaptation is done under the written order of an ophthalmologist or optometrist only and as long as such lenses, spectacles, eye glasses or optical devices so prepared or adapted are delivered directly to an ophthalmologist, optometrist or dispensing optician, and as long as such persons, firms or corporations do not engage in advertising as to the price of either the finished product or any part thereof.

Acts 1955, ch. 98, § 2; 1963, ch. 243, § 1; 1968, ch. 555, § 1; 1972, ch. 760, § 1; 1974, ch. 663, § 1; T.C.A., § 63-1402.

Cross-References. Licensed physicians or optometrists exempt, § 63-14-110.

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

NOTES TO DECISIONS

1. Intent of Legislature.

It was the intention of the legislature that if any of the elements of preparation, adaption and/or dispensing was brought about by one not qualified to do these different things, there would be a violation of the statute. Tennessee Board of Dispensing Opticians v. Eyear Corp., 218 Tenn. 60, 400 S.W.2d 734, 1966 Tenn. LEXIS 550 (1966).

2. Entity Engaged in Business of Selling Eyeglasses.

An entity engaged primarily in the business of selling eyeglasses and frames is a retail store or other commercial establishment as defined by T.C.A. § 63-8-113(c)(6) which prohibits optometrists from practicing or offering to practice optometry in, or in conjunction with, any retail store or other commercial establishment where merchandise is displayed or offered for sale. LensCrafters, Inc. v. Sundquist, 33 S.W.3d 772, 2000 Tenn. LEXIS 688 (Tenn. 2000).

63-14-103. Qualifications — Examinations — Display of license — Unlawful acts.

    1. Any person who is a citizen of the United States and of good moral character, and who is eighteen (18) years of age or over and who has satisfactorily completed not less than two (2) years of the prescribed course of a school for dispensing opticians recognized by the board or who has had practical training and experience of a grade and character satisfactory to the board as an apprentice or student under the supervision of a dispensing optician, optometrist or ophthalmologist licensed by the state for a period of not less than three (3) years or the equivalent amount of time under the supervision of such licensed professionals of another state that has dispensing opticianry licensure criteria at least as strict as Tennessee shall be entitled to make application to the board for examination.
    2. The form of application shall be prescribed by the board, and each applicant shall pay the fee provided in § 63-14-107 for the privilege of taking the examination.
    3. If, in the opinion of the board, the applicant possesses the qualifications prescribed in this section and successfully passes the examination, in the judgment of the board, a license to practice as dispensing optician in this state shall be issued to the applicant by the board upon payment of the license fee as provided in § 63-14-107.
  1. Applicants may be examined by the board upon matters pertaining to dispensing opticians and practical subjects, such as practical optic neutralization of lenses, frame measuring and adjustments, pupilary distances and such other subjects essential to the practice as dispensing opticians as the board may prescribe.
  2. Every licensee shall cause such licensee's license to be displayed conspicuously in the office or establishment operated and conducted by the licensee or the office or establishment in which such licensee is employed, and each year, as the license is renewed, such renewal license shall be displayed in the same manner until revoked or suspended by the board as provided in § 63-14-104.
  3. It is unlawful for any person to practice or offer to practice as a dispensing optician as an employee of any person not engaged primarily in the practice as dispensing optician as a licensee under this chapter or of any firm or corporation not engaged primarily in the practice of dispensing opticians under the actual and personal supervision of partners, officers, managers or stockholders who possess valid unrevoked licenses as dispensing opticians entitled to practice within this state in accordance with this chapter.
  4. It is unlawful for any dispensing optician licensed to practice such dispensing optician's profession in accordance with this chapter to be employed by, perform any work in or have any financial interest, directly or indirectly, in the operation of any establishment or place of business that undertakes or attempts to engage in the business of a dispensing optician in violation of this chapter or that advertises in any way that would conflict with this chapter in regard to advertising by a licensed dispensing optician.
  5. It is lawful for any apprentice dispensing optician or student dispensing optician to perform any of the services or do any of the acts included in the definition of dispensing optician contained in this chapter; provided, that such apprentice dispensing optician or student dispensing optician does so under the direct supervision, direction and control of a dispensing optician, optometrist or ophthalmologist licensed by the state or the equivalent amount of time under the supervision of such licensed professionals of another state that has dispensing opticianry licensure criteria at least as strict as Tennessee and practicing in strict accordance with all of the terms and provisions of this chapter; and provided further, that a licensed dispensing optician inspects the finished glasses and fits them to the face of the patient.
  6. It is unlawful for a dispensing optician to publish or display, or cause or permit to be published or displayed, in any newspaper or by radio, television, window display, poster, sign or any other means or media any statement or advertisement concerning ophthalmic lenses, frames, eyeglasses, spectacles, contact lenses or any other optical devices or materials, or parts thereof, that is fraudulent or of a character tending to deceive or mislead the public, including, but not limited to, statements or advertisements of bait, premiums, gifts or other similar nature.
  7. It is unlawful for a dispensing optician to publish or display, or cause or permit to be published or displayed, in any newspaper or by radio, television, window display, poster, sign or any other means or media any statement or advertisement of or reference to the price or prices of any ophthalmic lenses, frames, eyeglasses, spectacles, contact lenses or any other optical devices or materials, or parts thereof, unless such is consistent with the following standards deemed to protect the consumer interest:
    1. Any statement advertising the price of ophthalmic lenses, eyeglasses, spectacles or contact lenses shall, to the extent applicable, be accompanied by a further readily legible statement identifying the lens as single vision, bifocal or trifocal and as clear or tinted and specifying the type of material, the name of the manufacturer, the manufacturer's identifying name or number of the lens and the country of manufacture;
    2. Any statement advertising the price of ophthalmic frames shall be accompanied by a further readily legible statement specifying the type of material, the name of the manufacturer, the manufacturer's identifying name or number of the frame and the country of manufacture;
    3. The price so advertised shall be in effect for a period of not less than seven (7) days, and each advertisement shall set forth the expiration date, if any, of the advertised price. During such time, the item so advertised shall be available to all persons at the advertised price. Any advertised price discounts shall not be limited to any particular group or classification but shall be advertised as being available to all persons; and
    4. Any such advertisements quoting a price or prices shall contain a readily legible statement that the quoted price or prices “Does Not Include Professional Services of an Examining Optometrist or Physician.”
  8. Advertising by a dispensing optician shall be subject further to such rules or regulations, not inconsistent with the foregoing, as may be adopted from time to time by the board in protecting the consumer interest.

Acts 1955, ch. 98, § 3; impl. am. Acts 1971, ch. 161, § 3; Acts 1977, ch. 284, § 1; 1981, ch. 122, § 1; T.C.A., § 63-1403; Acts 1992, ch. 905, §§ 1-3; 1997, ch. 463, §§ 1, 2.

Cross-References. Advertisement pertaining to board certification and specialty, § 63-1-145.

Display of license or registration certificate, §  63-1-109.

Licensing, §§  63-1-10363-1-112.

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

Law Reviews.

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

63-14-104. Revocation or suspension of license.

  1. It is unlawful for a dispensing optician to act as the agent or representative of any physician or optometrist on any account. The board has the power and it is hereby its duty to suspend for a specified period of time to be determined by the board in its discretion or to revoke or otherwise discipline any person holding a certificate to practice as a dispensing optician in this state whenever the dispensing optician is found guilty of any of the following acts or offenses:
    1. Fraud in procuring a license;
    2. Immoral, unprofessional or dishonorable conduct;
    3. Habitual intoxication or addiction to the use of drugs;
    4. Conviction of felony;
    5. Use of comparative statements or claims concerning the professional excellence or abilities of any person or group of persons licensed to practice their profession under the laws of the state;
    6. Failure to renew annual certificate required under §§ 63-14-106 and 63-14-107;
    7. Offering discounts or inducements to prospective patrons by means of coupons or otherwise to perform professional services; provided, that nothing in this section shall be construed to prohibit the giving of a discount on either merchandise or services to charitable institutions; or
    8. Division of fees or agreement to split or divide the fee received for professional services with any person for bringing or referring a customer.
  2. 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 1955, ch. 98, § 4; T.C.A., § 63-1404; Acts 1997, ch. 463, § 3; 2018, ch. 745, § 32.

Amendments. The 2018 amendment added (b).

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

Cross-References. Advertisement pertaining to board certification and specialty, § 63-1-145.

Grounds for license denial, suspension or revocation, § 63-6-214.

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

Law Reviews.

Survey of Tennessee Constitutional Law in 1976-77, I. Freedom of Speech and Press (Kenneth L. Penegar), 46 Tenn. L. Rev. 120 (1978).

NOTES TO DECISIONS

1. Constitutionality.

Not all restrictions on advertising by dispensing opticians, such as reasonable regulation of its time, place or manner, are violative of the right of free speech, but only its complete prohibition. Horner-Rausch Optical Co. v. Ashley, 547 S.W.2d 577, 1976 Tenn. App. LEXIS 229 (Tenn. Ct. App. 1976).

2. Out-of-State Opticians.

Where dispensing opticians in Georgia were not dispensing in Tennessee but were advertising in Tennessee news media, the court held that there was no jurisdiction to enjoin, since the act applied solely to the activity of dispensing opticals in Tennessee. Tennessee Board of Dispensing Opticians v. Roy H. Park, Broadcasting of Tennessee, Inc., 512 S.W.2d 579, 1973 Tenn. App. LEXIS 262 (Tenn. Ct. App. 1973).

3. Advertising.

Dispensing opticians who are largely dispensers of standardized products are not sufficiently professional to justify a prohibition against advertising. Horner-Rausch Optical Co. v. Ashley, 547 S.W.2d 577, 1976 Tenn. App. LEXIS 229 (Tenn. Ct. App. 1976).

The mere possibility of overconsumption, which exists whenever there is advertising and which has not been shown to be an especially real or potentially harmful problem, is outweighed by the substantial benefit that would accrue from advertising in the form of lower prices and wider availability of services to low income groups. Horner-Rausch Optical Co. v. Ashley, 547 S.W.2d 577, 1976 Tenn. App. LEXIS 229 (Tenn. Ct. App. 1976).

63-14-105. License not required for employees.

Nothing contained in this chapter shall be construed so as to require an employee of a licensed physician or licensed optometrist to secure a license under this chapter or otherwise be subject to this chapter, so long as the employee remains an employee of the licensed physician or the licensed optometrist entitled to practice that profession within this state. Nothing contained in this chapter shall be construed to prohibit a licensed physician or licensed optometrist from employing a licensed dispensing optician as defined in this chapter.

Acts 1955, ch. 98, § 5; T.C.A., § 63-1405.

63-14-106. License renewal — Continuing education — Retirement.

  1. The board shall, in its discretion, renew such licensee's certificate of fitness upon application made in due form and upon payment of all required fees. Every licensed dispensing optician must, on or before December 31 of each year, submit satisfactory proof of the licensee's attendance at an education program or programs approved or conducted by the board which consists of the minimum number of hours established by the board under subdivision (a)(1) for the period beginning the preceding January 1:
    1. The minimum number of hours of attendance at education programs so required shall be prescribed by the board by February 1 of each year, but shall not be less than three (3) clock hours nor exceed twelve (12) clock hours in any calendar year;
    2. The board may, in its sole discretion, waive the annual education requirement in cases of certified illness, disability or other undue hardships;
    3. The board shall annually arrange for or approve a program or programs of continuing education sufficient to meet the minimum education requirements under this section;
    4. The board is authorized to adopt such rules and regulations as it may deem necessary or appropriate for establishing an approved program or programs of continuing education pursuant to this section, including, but not limited to, those describing the substantive content of all courses or other forms of education that will satisfy the annual education requirement provided in this section;
    5. The board is authorized to use such portion of the annual renewal fees as it deems necessary or proper to provide for continuing education programs and is further authorized to treat an appropriate amount of such renewal fees collected as state funds for the purpose of accepting any funds made available for the promulgation and maintenance of programs of continuing education;
    6. Failure to meet the minimum continuing education requirements shall be deemed a violation of this chapter, for which disciplinary action pursuant to § 63-14-111(a) may be taken; and
    7. The board shall reinstate a license that was suspended or revoked for failure to meet the continuing education requirements and issue a renewal certificate upon payment of all fees due, payment of a further sum to be set by the board and submission of satisfactory proof that within six (6) months following the date of suspension or revocation the dispensing optician attended the required minimum hours of continuing education programs to make up such deficiency.
    1. Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board shall deem necessary.
    2. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.

Acts 1955, ch. 98, § 6; 1976, ch. 402, § 1; 1976, ch. 406, § 4; 1976, ch. 470, § 1; 1979, ch. 66, § 2; T.C.A., § 63-1406; Acts 1986, ch. 675, § 9; 1989, ch. 523, § 21; 1997, ch. 463, §§ 4, 5.

Cross-References. Licensing, §§ 63-1-10363-1-112.

Retirement, § 63-1-111.

63-14-107. Examination — Renewal — Fees.

  1. Each year, each and every licensed dispensing optician shall pay to the secretary-treasurer of the board an annual renewal fee to be fixed by the board. The secretary of the board shall notify the holder of each license that the renewal fee is due, and the failure to pay such renewal fee by any license holder at the expiration of sixty (60) days after the renewal fee was due constitutes a violation of this chapter.
  2. All applicants for licensure shall include with their application a nonrefundable application fee to be set by the board. Applicants who are accepted for examination shall pay an examination fee as set by the board prior to taking the examination, and the examination fee shall be paid in a manner prescribed by the board. Any applicant failing to pass the examination may apply to take a successive examination by submitting to the board a successive application for examination, which shall be accompanied by an examination fee as set by the board. The fee required to be paid by all persons successfully passing the examination shall be fixed annually by the board, and no license or certificate shall be issued until the fee has been fully paid. All such licenses shall be subject to renewal upon the same terms and conditions as prescribed in this chapter with respect to the issuance of original licenses and renewals thereof.
  3. All applicants for apprenticeship shall include with their application a nonrefundable fee, to be set by the board.
    1. Notwithstanding any provision of 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 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 this subsection (d).

Acts 1955, ch. 98, § 6; 1976, ch. 402, § 1; 1976, ch. 406, § 4; 1976, ch. 470, § 1; 1979, ch. 66, § 2; T.C.A., § 63-1406; Acts 1989, ch. 360, §§ 46-48; 1989, ch. 523, §§ 22-26; 1990, ch. 785, § 1.

Cross-References. License renewals, §  63-1-107.

63-14-108. Disposition of fees — Board expenditures and compensation.

  1. All fees coming into the possession 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 shall be made by the board until allotment for the expenditure has been made by the commissioner. Such allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
  3. Each member of the board shall receive one hundred dollars ($100) per diem expenses when actually engaged in the discharge of each member's official duties and all legitimate and necessary expenses incurred in attending the meetings of the board. Each member shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 1955, ch. 98, § 6; impl. am. Acts 1959, ch. 9, § 3; impl. am. Acts 1961, ch. 97, § 3; 1976, ch. 806, § 1(118); 1981, ch. 122, § 2; T.C.A., § 63-1407; Acts 1998, ch. 1107, § 2.

Cross-References. Disposition of fines and penalties, operating expenses, §  63-1-113.

Funds, deposits and disbursements, § 63-1-137.

63-14-109. Secretary — Investigators — Administrative support.

    1. The secretary shall keep an accurate record of the minutes of the meetings of the board and shall keep an accurate and complete register showing the names and addresses of all persons to whom licenses or certificates to practice as dispensing opticians have been issued by the board.
    2. The secretary of the board shall be paid a salary not to exceed five hundred dollars ($500) per year, in addition to per diem and mileage allowances and necessary expenses as fixed and approved by the board. 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.
  1. The board will employ such investigators as are deemed necessary to effectually carry out this chapter and shall be represented by the attorney named to represent the state regulatory and registration boards.
  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 1955, ch. 98, § 6; 1976, ch. 806, § 1(118); T.C.A., § 63-1408; Acts 1984, ch. 937, §§ 49, 51; 1997, ch. 463, §§ 7, 8.

63-14-110. Penalties.

    1. Any person who practices as a dispensing optician as defined in this chapter without first complying with this chapter or who violates any of this chapter commits a Class B misdemeanor.
    2. Each time any person practices as a dispensing optician without meeting all the requirements of this chapter and of any other law, a compliance with which may hereafter be prescribed as a condition precedent to the practice of such profession, constitutes a separate offense.
    3. All fines for offenses for the violation of this chapter shall be paid over to the board and shall be paid to the state treasurer as all other funds received by the board.
  1. Nothing in this chapter shall be construed as applying to physicians or optometrists licensed under the laws of this state to practice their professions, nor shall such licensed physicians or optometrists be subject to the jurisdiction of the board created by this chapter.

Acts 1955, ch. 98, § 7; T.C.A., § 63-1409; Acts 1989, ch. 591, § 112.

Cross-References. Disposition of fines and penalties, operating expenses, §  63-1-113.

Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, recovery, § 63-1-134.

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

63-14-111. Suspension or revocation of license — Injunction.

  1. The board of dispensing opticians may suspend or revoke the license of, or otherwise discipline, any dispensing optician who is found guilty by the board of the violation of this chapter or of the code of ethics and standards of practice for dispensing opticians established by the board in accordance with this chapter; provided, that in all proceedings for suspension or revocation of license, the holder of the license is given fifteen (15) days' notice of the charges made against the holder and is entitled to be heard in person, by counsel, or both.
  2. The penalty for first violations of § 63-14-103(g)-(i) is suspension of the offender's license for a period of time to be set by the board after a proper hearing. A second suspension may be grounds for revocation of the license by the board.
  3. The board is thereby authorized to proceed in any of the courts of this state by injunction to restrain any continued violation of this chapter or of any rule or regulation of the code of ethics and standards of practice for dispensing opticians legally adopted or established by the board in accordance with this chapter. Any dispensing optician whose license is suspended or revoked under this chapter has the right to a review in the circuit or chancery court of the county in which such dispensing optician resides or has a place of business, in the manner provided by title 27, chapter 9.

Acts 1955, ch. 98, § 8; 1977, ch. 284, § 2; T.C.A., § 63-1410; Acts 1997, ch. 463, § 6.

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

Law Reviews.

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

NOTES TO DECISIONS

1. Injunctive Relief.

Unlicensed corporation could be enjoined from engaging in practice of dispensing opticians and from advertising in manner prohibited by § 63-14-104. Tennessee Board of Dispensing Opticians v. Eyear Corp., 218 Tenn. 60, 400 S.W.2d 734, 1966 Tenn. LEXIS 550 (1966).

2. Out-of-State Opticians.

Where dispensing opticians in Georgia were not dispensing in Tennessee but were advertising in Tennessee news media, the court held that there was no jurisdiction to enjoin, since the act applied solely to the activity of dispensing opticals in Tennessee. Tennessee Board of Dispensing Opticians v. Roy H. Park, Broadcasting of Tennessee, Inc., 512 S.W.2d 579, 1973 Tenn. App. LEXIS 262 (Tenn. Ct. App. 1973).

Chapter 15
[Reserved]

Chapter 16
Nursing Home Administrators

63-16-101. Chapter definitions.

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

  1. “Board” means the board of examiners for nursing home administrators;
  2. “Division” means the division of health related boards in the department of health;
  3. “Nursing home” means any institution or facility defined as such pursuant to Tennessee state law or the rules and regulations for nursing homes promulgated by the department. “Nursing home” applies equally to Christian Science sanatoria and services therein;
  4. “Nursing home administrator” means any individual responsible for planning, organizing, directing or controlling the operation of a nursing home or who in fact performs such functions, whether or not such functions are shared by one (1) or more other people;
  5. “Practice of nursing home administration” means the planning, organizing, directing or controlling the operation of a nursing home; and
  6. “Single state agency” means the department of health.

Acts 1970, ch. 565, § 1; T.C.A., § 63-1601; Acts 1985, ch. 120, § 14.

Cross-References. Deficient nursing homes, title 68, ch. 11, part 8.

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

Patient transfers, title 68, ch. 11, part 7.

Registry of persons who have abused or intentionally neglected elderly or vulnerable individuals, title 68, ch. 11, part 10.

Rights of nursing home residents and patients, and members of the public regarding nursing homes, title 68, ch. 11, part 9.

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

63-16-102. Board of examiners — Composition.

  1. There is hereby created the board of examiners for nursing home administrators, which shall consist of eight (8) members to be appointed by the governor as follows:
    1. Four (4) members shall be representatives of the nursing home industry, three (3) of whom may be appointed from lists of qualified persons submitted to the governor by interested healthcare groups including, but not limited to, the Tennessee Health Care Association, and one (1) of whom shall be a nursing home administrator who may be appointed from lists of qualified persons submitted by interested hospital groups, including, but not limited to, the Tennessee Hospital Association;
    2. One (1) member shall be a hospital administrator who may be appointed from lists of qualified persons submitted by interested hospital groups, including, but not limited to, the Tennessee Hospital Association;
    3. One (1) member shall be a physician who may be appointed from a list of qualified physician nominees submitted by interested medical groups, including, but not limited to, the Tennessee Medical Association;
    4. One (1) member shall be a nurse representative who may be appointed from lists of qualified persons submitted by interested nursing groups, including, but not limited to, the Tennessee Nurses Association; and
    5. One (1) member shall be a consumer representative.
    1. Each member shall serve for three (3) years, except that initially three (3) members shall be appointed for a term of three (3) years, three (3) members for a term of two (2) years, and two (2) members for a term of one (1) year. At the expiration of a member's term, each interested group may submit lists of qualified persons to the governor for appointment to that vacancy in the same manner as provided for initial appointments in subsection (a). Any vacancy occurring on the board prior to the expiration of a member's term may also be filled by the governor for the unexpired term from lists of qualified persons submitted by the interested groups as provided for initial appointments in subsection (a).
    2. In making appointments to the board, 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. The governor shall consult with interested medical groups, including, but not limited to, the nominating associations for the respective classifications listed in subsection (a) to determine qualified persons to fill the positions. This subdivision (b)(3) shall not apply to the appointment of the consumer representative member.
  2. The commissioner of health or the commissioner's designated representative shall serve as an ex officio member and as the executive officer of the board.
  3. The governor may remove any member for misconduct, incapacity, incompetence or neglect of duty after the member so charged has been served with a written statement of charges and has been given an opportunity to be heard.
  4. Each member shall be reimbursed for actual expenses incurred in the performance of the member's official duties, in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter. In addition, each member shall be compensated fifty dollars ($50.00) per day for the member's services. All vouchers for the expenditure of any funds shall be signed by the executive officer of the board.
    1. The board shall meet at least annually and a majority of the board shall constitute a quorum.
      1. Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year shall be removed as a member of the board in accordance with subsection (d).
      2. The executive officer of the board shall promptly notify, or cause to be notified, the appointing authority of any member who fails to satisfy the attendance requirement as prescribed in subdivision (f)(2)(A).
  5. The division, as provided for in § 68-1-101, is the administrative agency for the board of examiners for nursing home administrators.

Acts 1970, ch. 565, § 2; 1971, ch. 81, § 4; 1972, ch. 574, §§ 1, 2; 1976, ch. 806, § 1(121); 1979, ch. 118, § 1; 1980, ch. 587, § 1; T.C.A., § 63-1602; Acts 1983, ch. 40, § 1; 1988, ch. 1013, § 54; 1990, ch. 1042, §§ 3-5; 2012, ch. 721, §§ 3, 4; 2016, ch. 611, § 3.

Compiler's Notes. Acts 1990, ch. 1042, § 6 provided that the amendment by that act, which amended subdivisions (a)(1) and (2) and deleted former subdivision (a)(3), shall not be interpreted to authorize the appointment of either a registered lobbyist or a nonresident of the state of Tennessee to any regulatory board affected by the amendment.

The board of examiners for nursing home administrators, created by this section, terminates June 30, 2022. See §§ 4-29-112, 4-29-243.

Cross-References. Meetings, director of health-related licensing division as ex officio member, § 63-1-133.

Law Reviews.

Selected Tennessee Legislation of 1983 (N. L. Resener, J. A. Whitson, K. J. Miller), 50 Tenn. L. Rev. 785 (1983).

Attorney General Opinions. Delegation of Governor’s appointing authority to private entities for purpose of submitting lists for appointments to state licensing boards or agencies.  OAG 10-67, 2010 Tenn. AG LEXIS 73 (5/17/10).

63-16-103. Duties of the board.

It is the function and duty of the board to:

  1. Develop, impose and enforce standards that must be met by individuals in order to receive a license as a nursing home administrator, which standards are designed to ensure that nursing home administrators are individuals who are of good character and otherwise suitable and who, by training or experience in the field of institutional administration, are qualified to serve as nursing home administrators;
  2. Develop and apply appropriate techniques, including examinations and investigations, for determining whether an individual meets such standards;
  3. Issue a license to individuals determined, after the application of such techniques, to meet such standards and authorize the state licensing board to revoke or suspend licenses previously issued in any case where the individual holding any such license is determined by the board to have substantially failed to conform to the requirements of such standards;
  4. Establish and carry out procedures designed to ensure that individuals licensed as nursing home administrators will, during any period that they serve as such, comply with the requirements of such standards;
  5. Receive, investigate and take appropriate action with respect to any charge or complaint filed with the board to the effect that any individual licensed as a nursing home administrator has failed to comply with the requirements of such standards;
  6. Conduct a continuing study and investigation of nursing homes and administrators of nursing homes within the state with a view to the improvement of standards imposed for the licensing of such administrators and of procedures and methods for the enforcement of such standards with respect to administrators of nursing homes who have been licensed as such;
  7. Conduct or cause to be conducted courses of instruction and training sufficient to meet the requirements of this chapter. In lieu thereof, the board may approve courses conducted by other groups or organizations;
  8. Have the authority to adopt, promulgate and enforce rules and regulations necessary for the proper performance of its duties; and
  9. The single state agency has the authority to receive and disburse federal funds pursuant to § 1908(e)(1) of the Social Security Act (42 U.S.C. 1396g(e)(1)).

Acts 1970, ch. 565, § 3; T.C.A., § 63-1603; Acts 1985, ch. 120, § 15.

63-16-104. Qualifications for licensure.

    1. An applicant for a license shall submit evidence of good moral character and suitability prescribed by the board and that the applicant:
      1. Is at least eighteen (18) years of age;
      2. Is a citizen of the United States or legally in this country;
      3. Has completed preliminary education satisfactory to the board; and
      4. Has paid a nonrefundable application fee as set annually by the board no later than fifty (50) days in advance of the next scheduled examination.
    2. Such applicant, upon notification by the board that the applicant has fulfilled the requirements for admission and upon payment of an examination fee as set annually by the board shall be admitted to the examination.
    3. No applicant for license as a nursing home administrator shall be admitted to such licensing examination, nor be entitled to a license or to be certified to the state licensing board for issuance of a license as a nursing home administrator, unless the applicant has graduated from a high school or secondary school approved by the state in which the school is located or has submitted a certificate indicating that the applicant has obtained high school or secondary school equivalency, such certificate being duly certified by state educational authorities.
  1. The board has the authority to grant a temporary license, not to exceed six (6) months, to an individual applying for licensure to fill a position of nursing home administrator that unexpectedly becomes vacant. To receive a temporary license, the individual must either be licensed in another state or meet the majority of the board's standards for licensure. If the individual holding a temporary license must take the board required examination to be fully licensed and fails to achieve the required scores, the temporary license shall be revoked.

Acts 1970, ch. 565, § 4; impl. am. Acts 1971, ch. 161, § 3; Acts 1976, ch. 444, § 1; 1981, ch. 464, § 1; T.C.A., § 63-1604; Acts 1987, ch. 247, §§ 1, 2, 8; 1989, ch. 523, §§ 83, 84.

Cross-References. Licensure, §§  63-1-10363-1-112.

Law Reviews.

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

63-16-105. Examination for license.

  1. The board shall determine the subjects of examination for applicants for licensure as nursing home administrators. The board shall also determine the scope, content and format of such an examination, which in any examination shall be the same for all candidates; however, all examinations must include testing of the applicant's proficiency in the rules and regulations of health and safety.
  2. Any applicant having failed to achieve a passing grade, score or level of proficiency as determined by the board on such examination is not prohibited from taking successive examinations; provided, that such applicant pays the examination fee set by the board pursuant to § 63-16-104 for each successive examination.

Acts 1970, ch. 565, § 5; 1976, ch. 444, § 2; 1981, ch. 464, § 2; T.C.A., § 63-1605; Acts 1987, ch. 247, § 3.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-16-106. License issuance and registration.

  1. An applicant for a license as a nursing home administrator shall be certified to the division for issuance of a license certifying that the applicant has met the requirements of the law, rules and regulations entitling the applicant to practice as a nursing home administrator who has:
    1. Complied with the requirements of § 63-16-104 and the standards provided in § 63-16-104; and
    2. Passed the examination provided for in § 63-16-105.
  2. The license must be registered annually as required by the state licensing board pursuant to § 63-1-107.

Acts 1970, ch. 565, § 6; T.C.A., § 63-1606.

Cross-References. Licensure, §§  63-1-10363-1-112.

63-16-107. Certificates of registration — Renewal of registration — Continuing education.

    1. Each individual who is initially issued a license as a nursing home administrator is deemed registered with the board and shall be issued a certificate of registration.
    2. Certificates of registration expire each odd-numbered year.
    3. Each licensed nursing home administrator shall submit an application to the board for a new certificate of registration and submit, along with any information requested by the board, a biennial renewal fee as set by the board.
    4. Although the license renewal is on a biennial basis, continuing education is required on an annual basis.
    5. The board shall promulgate, in accordance with the procedures of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, such rules as shall be necessary to prescribe programs of continuing education for nursing home administrators and to designate the levels of participation required in programs of continuing education. As a prerequisite for renewal of registration, an individual shall submit to the board satisfactory proof of attendance and participation in such programs.
  1. Upon receipt of such application for registration and the registration fee, the board shall issue a certificate of registration to such nursing home administrator unless the board finds reason to deny the same pursuant to § 63-16-108, under the rules and regulations developed by the board.
    1. If a nursing home administrator fails to renew the nursing home administrator's license and pays the biennial renewal fee after renewal becomes due, the license of such person is automatically revoked without further notice or hearing unless renewal is made and all fees are paid prior to the expiration of sixty (60) days from the date such renewal becomes due.
    2. Any person whose license is automatically revoked as provided in this section may have the license reinstated by the board in its discretion upon good cause being shown, upon payment of all past due renewal fees and upon the further payment of a nonrefundable sum as set by the board.
  2. Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person files with the board an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board deems necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
  3. The commissioner of health shall notify the board of all cases in which a nursing home is sanctioned by suspension of admissions or imposition of a civil monetary penalty or in which the commissioner determines that the quality of care provided to residents is seriously inadequate due to acts or omissions of the administrator. In all such cases, the license or certificate of registration of any person who has engaged in the practice of nursing home administration at that facility during the year preceding the imposition of sanctions or the commissioner's finding of inadequacy shall not be renewed by the board, until the board has reviewed all information compiled by regulatory agencies pertaining to the quality of care rendered at facilities under the person's administration. Following such review, the board may renew the license or certificate of registration only upon an affirmative finding that the person can be expected to satisfactorily discharge the duties of an administrator in the future, in a manner that assures an adequate level of care for nursing home residents.
    1. Notwithstanding any provision of 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 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 this subsection (f).

Acts 1970, ch. 565, § 7; 1973, ch. 166, § 6; 1981, ch. 464, § 3; T.C.A., § 63-1607; Acts 1983, ch. 40, § 2; 1987, ch. 247, §§ 4-6; 1987, ch. 312, § 6; 1989, ch. 360, §§ 52-54; 1989, ch. 523, §§ 85, 86.

Cross-References. Licensure, §§  63-1-10363-1-112.

Law Reviews.

Selected Tennessee Legislation of 1983 (N. L. Resener, J. A. Whitson, K. J. Miller), 50 Tenn. L. Rev. 785 (1983).

63-16-108. Suspension or revocation of license or registration — Discipline — Reissuance of license or registration.

  1. The license and/or registration of any person practicing or offering to practice nursing home administration or the license of a nursing home administrator holding a provisional license may be revoked or suspended, or the licensee be disciplined in accordance with this section upon decision and after due hearing by the board in any of the following cases:
    1. Upon proof that the licensee is unfit or incompetent by reasons of negligence, habits or other causes;
    2. Upon proof that the licensee has willfully or repeatedly violated this chapter or the rules or regulations promulgated in accordance therewith; or willfully or repeatedly acted in a manner inconsistent with the health and safety of the patients in the home in which the licensee is the administrator;
    3. Upon proof that the licensee is guilty of fraud or deceit in the practice of nursing home administration; or
    4. Upon proof that the licensee has been convicted of a felony in a court of competent jurisdiction, either within or without this state.
  2. The members of the board have jurisdiction to hear all charges brought under this section against persons licensed and registered as nursing home administrators or nursing home administrators holding a provisional license and, upon such hearing, shall determine the charges upon their merits. The board or hearing officer designated as such by the board, acting in an official capacity, has the authority to issue subpoenas, compel the attendance of witnesses, administer oaths and take testimony concerning all matters within the jurisdiction of the board. The board is not bound by the strict rules of evidence in the conduct of its proceedings, but any determinations made shall be founded upon sufficient legal evidence to sustain them.
  3. If the board determines that a person is guilty of the charges, the board may direct revocation of the person's license and/or revoke the person's registration, suspend the person from practice or otherwise discipline the licensee.
  4. In all disciplinary proceedings of a licensee, the holder shall be given thirty (30) days' written notice of the hearing. The Uniform Administrative Procedures Act, compiled in title 4, chapter 5, apply to all disciplinary proceedings of the board and all regulations promulgated pursuant to this chapter.
  5. If the board suspends the licensee, it may also specify conditions to be met by the licensee during the period of suspension in order to entitle the licensee to again qualify for the license. The board may, in its discretion, after hearing, hold the case under advisement and make a recommendation as to the requirements to be met by the licensee in order to avoid suspension, revocation or other disciplinary actions. In such cases the board shall enter an order accordingly and notify the licensee by registered mail. If the licensee complies with such order and proves that fact to the satisfaction of the board, the board may enter an order showing satisfactory compliance in dismissing the case because of such compliance.
  6. The board may, in its discretion, certify for licensure and/or registration any person whose license and/or registration has been revoked. Application for the reissuance of a license and/or registration shall not be made prior to one (1) year after revocation, and shall be made in such manner as the board may direct. Any licensee or applicant for a license aggrieved by the action of the board may have such action reviewed pursuant to title 27, chapter 9.
  7. 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 1970, ch. 565, § 8; 1980, ch. 587, §§ 2, 3; T.C.A., § 63-1608; Acts 2018, ch. 745, § 33.

Amendments. The 2018 amendment added (g).

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

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

Grounds for license denial, suspension or revocation, §  63-6-214.

Law Reviews.

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

63-16-109. Reciprocity.

The board may approve and authorize issuance of a nursing home administrator license without examination to any person who holds a current license as a nursing home administrator from another jurisdiction, upon payment of a nonrefundable application fee as set annually by the board and upon proper registration and payment of the annual fee provided in this chapter, if the board finds that the applicant's personal qualifications and education are at least substantially equivalent to the licensure standards in this state.

Acts 1970, ch. 565, § 9; 1981, ch. 464, § 4; T.C.A., § 63-1609; Acts 1986, ch. 719, § 1; 1987, ch. 247, § 7; 1989, ch. 523, § 87.

63-16-110. Certain religious groups exempt.

  1. Nothing in this chapter or the rules and regulations thereunder shall be construed to require an applicant for a license who is certified by a recognized church or religious denomination that teaches reliance on spiritual means alone for healing to demonstrate proficiency in any medical techniques or to meet any medical educational qualifications or medical standards not in accordance with remedial care and treatment provided in such institutions.
  2. Such administrative practice is limited to institutions certified by such church or denominations for the care and treatment of the sick in accordance with its teachings.

Acts 1970, ch. 565, § 10; T.C.A., § 63-1610.

63-16-111. Penalties.

  1. It is unlawful for any person to sell or fraudulently obtain or furnish any license or aid or abet therein or practice as a nursing home administrator, under cover of any license or registration illegally or fraudulently obtained, or practice as a nursing home administrator or offer to practice unless the person is duly licensed and registered to so practice under this chapter, or practice as a nursing home administrator during the time the person's licensure registration issued under this chapter shall be suspended or revoked, or otherwise violate this chapter or any rule or regulation adopted and promulgated by the board pursuant to this chapter.
  2. No nursing home in the state may operate unless it is under the supervision of an administrator who holds a currently valid nursing home administrator license and registration or provisional license issued pursuant to this chapter.
    1. Any person convicted of violating this section shall be fined not less than fifty dollars ($50.00) and not more than two hundred fifty dollars ($250).
    2. For the purposes of this section, each day's operation constitutes a separate offense.
  3. It is the duty of the district attorneys general in the various districts throughout the state to assist the board by prosecuting any person the board has reasonable cause to believe is violating any provisions of this chapter or any rule or regulation adopted and promulgated by the board pursuant to this chapter.

Acts 1970, ch. 565, § 11; T.C.A., § 63-1611.

Compiler's Notes. The penalty provisions in this section may have been affected by the Criminal Sentencing Reform Act of 1989. See §§ 39-11-114, 40-35-110, 40-35-111.

Cross-References. Penalties, §  63-1-123.

Law Reviews.

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

63-16-112. Enjoining violations.

The board may cause to be instituted a civil action in any court of competent jurisdiction for injunctive relief to prevent any violation of any provision of this chapter or any rule or regulation adopted and promulgated by the board pursuant to this chapter.

Acts 1970, ch. 565, § 12; T.C.A., § 63-1612.

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

63-16-113. Disposition of fines and receipts — Budgetary allotments.

  1. All fines for the offenses of the violation of this chapter and fees received from all sources and purposes shall be paid to the board and shall become part of its receipts. All moneys received by the board shall be paid into the general fund of the state.
  2. The commissioner of finance and administration shall make such allotments out of the general fund as may be necessary for the implementation of this chapter. Such allotments shall be disbursed under the general budgetary laws of Tennessee.

Acts 1970, ch. 565, § 13; T.C.A., § 63-1613; modified.

Cross-References. Disposition of fines and penalties, operating expenses, §  63-1-113.

Funds, deposits and disbursements, §  63-1-137.

License and registration fees, §   63-1-112.

63-16-114. Temporary administration following unexpected loss of administrator.

Notwithstanding this chapter to the contrary, a nursing home licensed in Tennessee may be administered on a temporary basis after the unexpected loss of an administrator in accordance with title 68, chapter 11, part 2.

Acts 1994, ch. 813, § 2.

63-16-115. Cost of prosecution — Witnesses — Subpoenas.

  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.
    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.
      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.
    3. 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.
    4. 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. 438, § 3.

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

Attorney General Opinions. The board of examiners for nursing home administrators 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).

Chapter 17
Licensure Act for Communication Disorders and Sciences

Part 1
Speech Language Pathologists and Audiologists

63-17-101. Short title.

This chapter shall be known and may be cited as the “Licensure Act for Communication Disorders and Sciences.”

Acts 1973, ch. 93, § 1; T.C.A., § 63-1701; Acts 1994, ch. 849, § 5; 1995, ch. 481, § 25.

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

Occupation tax on audiologists and speech pathologists, title 67, ch. 4, part 17.

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

Attorney General Opinions. Authority of unlicensed retailer to make ear impressions or sell hearing aids, OAG 97-168, 1997 Tenn. AG LEXIS 181 (12/16/97).

NOTES TO DECISIONS

1. Construction with Other Statutes.

Neither the language of chapter 17 of this title nor its legislative history impliedly revoked chapter 15 of this title. Levy v. State Board of Examiners for Speech Pathology & Audiology, 578 S.W.2d 646, 1978 Tenn. App. LEXIS 329 (Tenn. Ct. App. 1978).

63-17-102. Purpose.

It is the purpose and intent of the general assembly by this enactment to safeguard the public health, safety and welfare, to protect the public from being misled by incompetent, unscrupulous and unauthorized persons and to protect the public from unprofessional conduct by qualified speech language pathologists and audiologists and hearing instrument specialists, by providing regulatory authority over persons offering speech language pathology, audiology and hearing instrument dispensing services to the public.

Acts 1973, ch. 93, § 2; T.C.A., § 63-1702; Acts 1994, ch. 849, § 5; 1995, ch. 481, §§ 34, 37.

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

NOTES TO DECISIONS

1. Scope of Board's Authority.

The delegation of authority pursuant to §§ 63-17-105 and 63-17-110 to establish minimum requirements to be licensed in the field requires the board to make a determination within the confines of this section — to safeguard the public health, safety, welfare, etc. — and within the ambit of the broad definitional requirements of § 63-17-103. Levy v. State Board of Examiners for Speech Pathology & Audiology, 578 S.W.2d 646, 1978 Tenn. App. LEXIS 329 (Tenn. Ct. App. 1978).

63-17-103. Chapter definitions.

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

    1. “Audiologist” means one who practices audiology or one holding oneself out to the public by any title or description of services incorporating the words “audiologist,” “audiology,” “audiological,” “hearing center,” “hearing clinic,” “hearing clinician,” “hearing therapist” or any similar titles or descriptions of service;
    2. Nothing in this chapter shall prevent or prohibit any hearing instrument specialist from employing and using such terms as “hearing aid center,” “hearing aid clinic,” “hearing instrument center,” “hearing instrument clinic” or any similar titles or descriptions of services, so long as the word “aid” or “instrument” is incorporated in any such title or description of service and insofar as such terms do not connote qualifications or education for which the hearing instrument specialist does not have valid credentials or do not imply rehabilitative or professional services that the hearing instrument specialist is not qualified to offer;
  1. “Board” means the board of communications disorders and sciences;
  2. “Person” means any individual, organization or corporate body except that only individuals can be licensed under this chapter;
    1. “Practice of audiology” means the nonmedical application of principles, methods and procedures for the assessment of the auditory and vestibular systems, including the interpretation of behavioral and physiologic measures, and the design and implementation of programs of hearing conservation and preservation and programs of habilitation and rehabilitation for auditory and vestibular disorders including the assessment, selection, fitting and sale of amplification systems or other assistive devices and technologies;
    2. Nothing in this chapter shall prevent a person licensed under part 2 of this chapter as a hearing instrument dispenser from engaging in the practice of measuring, testing, appraisal, prediction, counseling and instructions related to fitting, usage and dispensing of hearing instruments;
    1. “Practice of speech language pathology” means the nonmedical application of principles, methods and procedures for the measurement, testing, assessment, prediction, counseling or instruction related to the development and disorders of speech, voice, language or oral, pharyngeal and laryngeal sensorimotor competencies for the purpose of assessing, preventing, treating, ameliorating or modifying such disorders and conditions in individuals and groups of individuals;
    2. The practice of speech language pathology shall include the use of rigid and flexible endoscopes to observe the pharyngeal and laryngeal areas of the throat in order to observe, collect data and measure the parameters of communication and swallowing for the purpose of functional assessment and rehabilitation planning. A speech language pathologist who uses an endoscope shall meet all of the following conditions:
      1. Obtain written verification from a board certified otolaryngologist that the speech language pathologist is competent in the proper and safe use of an endoscope. The otolaryngologist's determination of competency shall be based on the speech language pathologist's training in the proper use of endoscopes, the successful completion of a university course or other educational program of at least fifteen (15) hours on endoscopy and the successful performance of at least twenty-five (25) endoscopic procedures under the supervision of an otolaryngologist or another speech language pathologist who has successfully performed at least fifty (50) endoscopic procedures and has been approved in writing by a board-certified otolaryngologist to provide that supervision. The speech language pathologist shall maintain this written verification on file at all times at the primary practice location of the speech language pathologist;
      2. Not perform a procedure utilizing an endoscope unless the patient has been referred to the speech language pathologist by an otolaryngologist or other qualified physician for the performance of the procedure;
      3. Perform only nonoperative procedures with an endoscope;
      4. Have protocols in place for emergency medical backup for every setting in which the speech language pathologist performs a procedure using an endoscope:
  1. If the procedure is performed in a community setting such as a physician's office, a physician shall be on the premises and provide onsite supervision; and
  2. If the procedure is performed in an institutional setting such as a hospital or nursing home, a physician shall provide general supervision and be readily available in the event of an emergency, including, but not limited to, physical presence at the institution or availability by telephone; and

Send to the referring physician in a timely manner a report and visual recording of each endoscopic procedure performed upon referral of that physician. If the referring physician is not an otolaryngologist, the speech language pathologist shall also provide a visual recording of the endoscopic procedure to an otolaryngologist, if directed to do so by the referring physician;

“Speech language pathologist” means one who practices speech pathology, one who holds out to the public by any title or description of services incorporating the words “speech language pathologist,” “speech pathologist,” “speech pathology,” “speech therapy,” “speech correction,” “speech correctionist,” “speech therapist,” “speech clinic,” “speech clinician,” “language pathologist,” “language pathology,” “language therapist,” “logopedics,” “logopedist,” “communicology,” “communicologist,” “asphasiologist,” “voice therapy,” “voice therapist,” “voice pathology,” “voice pathologist” or “phoniatrist” or any similar titles or description of services; and

“Speech language pathology assistant” means any person who meets minimum qualifications that the board may establish for speech language pathology assistants, which qualifications are less than those established by this chapter as necessary for licensure as a speech language pathologist and who works under the supervision of a licensed speech language pathologist.

Acts 1973, ch. 93, § 3; T.C.A., § 63-1703; Acts 1989, ch. 269, § 1; 1994, ch. 849, §§ 1, 2; 1995, ch. 481, §§ 26-28, 32, 33; 2005, ch. 330, § 1; 2007, ch. 324, § 1.

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

NOTES TO DECISIONS

1. Scope of Board's Authority.

The delegation of authority pursuant to §§ 63-17-105 and 63-17-110 to establish minimum requirements to be licensed in the field requires the board to make a determination within the confines of § 63-17-102 — to safeguard the public health, safety, welfare, etc. — and within the ambit of the broad definitional requirements of this section. Levy v. State Board of Examiners for Speech Pathology & Audiology, 578 S.W.2d 646, 1978 Tenn. App. LEXIS 329 (Tenn. Ct. App. 1978).

63-17-104. Board.

    1. There is hereby created a board of communications disorders and sciences.
    2. The board shall consist of seven (7) members who are appointed by the governor, who are residents of this state, five (5) of whom are currently practicing as speech language pathologists or audiologists and who have been engaged in rendering services, teaching or research in speech language pathology or audiology for a period of at least five (5) years, one (1) of whom shall be a consumer member who is not affiliated with the profession of speech language pathology and audiology and one (1) physician licensed by this state whose medical specialty is otolaryngology.
    3. Of the six (6) nonphysician members of the board, at least two (2) shall be audiologists and at least two (2) shall be speech language pathologists, the fifth member shall be either a speech language pathologist or audiologist and the sixth member shall be a consumer. The five (5) nonphysician members engaged in rendering services, teaching or research in speech language pathology or audiology shall hold an active and valid license in this state.
  1. The members of the board shall serve until the expiration of the term for which they have been appointed or until their successors are qualified. Their appointments shall be made as follows:
    1. Initially, of the six (6) nonphysician members of the board, two (2) shall be appointed for a term of one (1) year, two (2) members shall be appointed for a term of two (2) years and two (2) members shall be appointed for a term of three (3) years. The consumer member shall be appointed for a term of three (3) years. All appointments made thereafter shall be for a term of three (3) years;
    2. The physician member of the board may be selected by the governor from lists of qualified nominees submitted by interested otolaryngology groups including, but not limited to, the Tennessee Academy of Otolaryngology and shall serve for a term of three (3) years. The governor shall consult with such interested groups to determine qualified persons to fill the position. If for any reason a vacancy occurs in the office of a physician member of the board, an appointment shall be made as provided in this section, and the person so appointed shall serve for the remainder of the unexpired term; and
    3. In making appointments to the board, 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.
    1. The board shall reorganize annually and select a chair and a secretary. Four (4) members of the board constitute a quorum to do business.
    2. The board shall hold at least one (1) regular meeting each year. Additional meetings may be held upon call of the chair or after the written request of any two (2) members of the board.
    3. All meetings of the board shall be open and public, except that the board may hold executive sessions:
      1. To prepare, approve, grade or administer examinations; and
      2. Upon the request of an applicant who fails an examination, to prepare a response indicating the cause of the applicant's failure.
    4. No person shall be appointed to serve more than two (2) consecutive terms.
    5. When a vacancy in the office of one (1) of the five (5) nonphysician members engaged in rendering services, teaching or research in speech language pathology or audiology occurs, interested audiology and speech pathology groups including, but not limited to, the Tennessee Association of Audiologists and Speech Language Pathologists may submit lists of qualified nominees to be considered for the vacancy. The governor shall consult with such interested groups to determine qualified persons to fill the vacancy.

Acts 1973, ch. 93, § 4; T.C.A., § 63-1704; Acts 1988, ch. 1013, § 55; 1992, ch. 814, § 3; 1994, ch. 849, § 6; 1995, ch. 481, §§ 29, 41; 2012, ch. 697, §§ 1, 2.

Compiler's Notes. The board created by this section is assigned to the division of health related boards in the department of health for all administrative, fiscal, inspectional, clerical and secretarial functions by § 68-1-101.

The board of communication disorders and sciences, created by this section, terminates June 30, 2021. See §§ 4-29-112, 4-29-242.

Cross-References. State examining boards, general provisions, title 4, ch. 19.

63-17-105. Powers and duties of board.

  1. The board is authorized to:
    1. Administer, coordinate and enforce this chapter, evaluate the qualifications of applicants, supervise the examination for applicants, and may issue subpoenas, examine witnesses and administer oaths and shall investigate persons engaging in practices that violate this chapter;
    2. Conduct such hearings and keep such records and minutes as shall be necessary to an orderly dispatch of business;
    3. Adopt and publish responsible rules and regulations, including, but not limited to, regulations that establish ethical standards of practice and may amend or repeal the same; and
    4. Govern and control every person who holds a license or is registered to practice in the field of communication disorders and sciences in this state by the rules of professional conduct adopted by the board.
  2. The conferral or enumeration of specific powers elsewhere in this chapter shall not be construed as a limitation of the general powers conferred by this section.

Acts 1973, ch. 93, § 5; T.C.A., § 63-1705; Acts 1995, ch. 481, § 38; 2005, ch. 330, § 2.

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

NOTES TO DECISIONS

1. Scope of Board's Authority.

The delegation of authority pursuant to this section and § 63-17-110 to establish minimum requirements to be licensed in the field requires the board to make a determination within the confines of § 63-17-102 — to safeguard the public health, safety, welfare, etc. — and within the ambit of the broad definitional requirements of § 63-17-103. Levy v. State Board of Examiners for Speech Pathology & Audiology, 578 S.W.2d 646, 1978 Tenn. App. LEXIS 329 (Tenn. Ct. App. 1978).

63-17-106. Compensation of board.

The board members shall receive no compensation for their services, but may receive fifty dollars ($50.00) per diem when actually engaged in the discharge of their official duties and, in addition, shall be reimbursed for all travel and other necessary expenses. 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.

Acts 1973, ch. 93, § 6; 1976, ch. 806, § 1(122); 1981, ch. 167, § 1; T.C.A., § 63-1706.

63-17-107. Employees of board.

  1. The board shall employ and, at its pleasure, discharge, a secretary and such attorneys, inspectors, clerks and any other employees it deems necessary and shall outline their duties and fix their compensation.
  2. The amount of per diem and travel expenses shall be paid in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 1973, ch. 93, § 7; 1976, ch. 806, § 1(122); T.C.A., § 63-1707.

63-17-108. Seal — Records as evidence.

  1. The board shall adopt a seal by which it shall authenticate its proceedings.
  2. Copies of the proceedings, records and acts of the board and certificates purporting to relate the facts concerning such proceedings, records and acts, signed by the secretary and authenticated by the seal, shall be prima facie evidence in all courts of the state.

Acts 1973, ch. 93, § 8; T.C.A., § 63-1708.

63-17-109. Disposition of fees — Allotment of funds.

  1. All fees coming into the custody of the board, including examination fees, license fees, renewal fees, fines, penalties and other payments, 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 of the general fund for proper expenditures of the board, and no expenditure shall be made by the board until allotment for the expenditure has been made by the commissioner. Such allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.

Acts 1973, ch. 93, § 9; T.C.A., § 63-1709; modified.

Cross-References. Disposition of fines and penalties, operating expenses, §  63-1-113.

Funds, deposits and disbursements, §  63-1-137.

License and registration fees, § 63-1-112.

63-17-110. License requirements — Qualifications of applicants — Provisional license.

  1. Any person wishing to practice or represent such person as a speech language pathologist or audiologist in this state shall obtain a license from the board. Unless such person obtains a license, it is unlawful for such person to practice or represent such person as a speech language pathologist or audiologist as defined in § 63-17-103; and if that person so practices or represents, the person shall be considered to have violated this chapter.
  2. To be eligible for licensure by the board as a speech language pathologist or audiologist, the applicant must:
    1. Be of good moral character, be eighteen (18) years of age or older and possess at least a master's degree in the area of speech language pathology or audiology obtained from educational institutions approved by the board according to the regulations duly adopted under this chapter;
    2. Pass an examination covering the areas of speech language pathology, audiology and speech and hearing services approved by the board. The board determines the scope of the examinations. Written examinations may be supplemented by such oral examinations as the board determines. An applicant who fails the examination may be reexamined at a subsequent examination upon payment of another examination fee; and
    3. Submit evidence of the completion of the educational, clinical experience and employment requirements prescribed by the rules and regulations adopted pursuant to this chapter.
    1. A person who has completed the educational requirements for licensure as a speech language pathologist and has received at least a master's degree from an approved educational institution may apply for and receive from the board a provisional license to practice as a clinical fellow during the person's period of supervised clinical experience. The board may adopt rules to establish standards and procedures to govern provisional licenses and the provisional license fee.
    2. Until such time as the board has adopted rules to establish standards and procedures to govern provisional licenses, the provisions of Rules and Regulations of the State of Tennessee, Rule 1370-01-.10, governing registration of clinical fellows, apply to persons seeking a provisional license to practice as a clinical fellow during the period of supervised clinical experience.
    3. Any person who, on May 8, 2019, has been registered as a clinical fellow pursuant to Rules and Regulations of the State of Tennessee, Rule 1370-01-.10, is deemed to have a provisional license for the same period of time that the person's registration would be effective under that rule.
  3. A person who applies for licensure as an audiologist on or after January 1, 2009, shall possess a doctoral degree from an accredited educational program approved by the board. The doctoral degree may be a doctor of audiology degree (Au.D.) or other doctoral degree approved by the board. In addition to possessing a doctoral degree, the applicant shall meet the other requirements of subsection (b), except that the doctoral degree shall be in lieu of the master's degree previously required of applicants.
  4. The requirement to have a doctoral degree shall not apply to audiologists who were licensed in this or any other state prior to January 1, 2009.

Acts 1973, ch. 93, § 10; T.C.A., § 63-1710; Acts 1994, ch. 849, § 7; 2007, ch. 177, § 1; 2019, ch. 318, § 1.

Amendments. The 2019 amendment added (c) and redesignated former (c) and (d) as present (d) and (e), respectively.

Effective Dates. Acts 2019, ch. 318, § 3. May 8, 2019.

Cross-References. Licensure, §§  63-1-10363-1-112.

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

Law Reviews.

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

NOTES TO DECISIONS

1. Scope of Board's Authority.

The delegation of authority pursuant to § 63-17-105 and this section to establish minimum requirements to be licensed in the field requires the board to make a determination within the confines of § 63-17-102 — to safeguard the public health, safety, welfare, etc. — and within the ambit of the broad definitional requirements of § 63-17-103. Levy v. State Board of Examiners for Speech Pathology & Audiology, 578 S.W.2d 646, 1978 Tenn. App. LEXIS 329 (Tenn. Ct. App. 1978).

63-17-111. Examination of applicants.

  1. Each person desiring to obtain a license from the board shall make application to the board upon a form and in such a manner as the board prescribes in regulations adopted pursuant to this chapter. Each applicant shall be examined by the committee and shall pay to the board, at least thirty (30) days prior to the date of the examination, the examination fee prescribed by the board, which fee will not be refunded.
  2. The board may examine by written or oral examination or by both. The examination shall be given at least twice a year at the time and place and under such supervision as the board may determine. Standards for acceptable performance shall be determined by the board.
  3. The board may waive the written examination if the applicant has successfully passed a comparable examination.
  4. The board may examine or direct the applicant to be examined for knowledge in whatever theoretical or applied fields in speech language pathology or audiology as it deems appropriate. It may examine the candidate with regard to the candidate's professional skills and the candidate's judgment in the utilization of speech language pathology or audiology techniques and methods.
  5. The board shall grade the written examination or direct it to be graded and keep the written examination papers for at least one (1) year.
  6. The board shall keep an accurate transcript of the oral examination and keep such transcripts as part of its records for at least one (1) year following the date of examination.
  7. A speech language pathologist or audiologist who holds an American Speech and Hearing Association (ASHA) certification or equivalent, or holds a doctor of audiology degree (Au.D.) from an accredited institution of higher learning and has passed the examination required for licensure under § 63-17-110(b)(2) or is licensed in another state and who has made application to the board for a license in this state may perform activities and services of a speech language pathology or audiological nature without a valid license pending disposition of application.

Acts 1973, ch. 93, § 11; T.C.A., § 63-1711; Acts 1994, ch. 849, §§ 8, 14; 1995, ch. 481, § 39; 2001, ch. 288, § 1; 2003, ch. 172, § 1.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-17-112. Issuance of license.

The board shall issue a license to all applicants who meet the requirements of this chapter and who pay to the board the initial license fee.

Acts 1973, ch. 93, § 12; T.C.A., § 63-1712.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-17-113. Reciprocity.

The board shall waive the examination and grant a license to an applicant who presents proof of current licensure in a state that has standards equivalent to those of this state.

Acts 1973, ch. 93, § 13; T.C.A., § 63-1713.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-17-114. Exemptions.

Nothing in this part shall be construed to:

  1. Prevent a qualified person licensed in this state under any other law from engaging in the profession for which such person is licensed;
  2. Restrict or prevent activities of a speech language pathology or audiology nature or the use of the official title of the position for which they were employed on the part of the following persons:
    1. Persons who hold a valid and current credential as a speech and hearing specialist issued by the department of education; and
    2. Speech language pathologists or audiologists employed by federal governmental agencies; provided, that such persons are performing such activities solely within the confines of, or under the jurisdiction of, the organization in which they are employed and do not offer to render speech language pathology or audiology services as defined in § 63-17-103, to the public outside of the institutions or organizations in which they are employed. However, such persons may, without obtaining a license under this chapter, consult or disseminate their research findings and scientific information to other such accredited academic institutions or governmental agencies. They also may offer lectures to the public for a fee, monetary or otherwise, without being licensed under this chapter;
  3. Restrict the activities and services of a student or a speech language pathology intern in speech language pathology pursuing a course of study leading to a degree in speech language pathology at an accredited or approved college or university or an approved clinical training facility; provided, that these activities and services constitute a part of the student's supervised course of study and that such persons are designated by such title as “speech language pathology intern,” “speech language pathology trainee” or other such title clearly indicating the training status appropriate to the student's level of training;
  4. Restrict the activities and services of a student of audiology or intern in audiology pursuing a course of study leading to a degree in audiology at an accredited or approved college or university or an approved clinical training facility; provided, that these activities and services constitute a part of the student's supervised course of study and that such person is designated by such title as “audiology intern,” “audiology trainee” or other such title clearly indicating the training status appropriate to the student's level of training;
    1. Restrict a person from another state from offering such person's speech language pathology or audiology services in the state; provided, that such services are performed for no more than five (5) days in any calendar year and that such person meets the qualifications and requirements stated in the section on qualifications and does not sell hearing instruments;
    2. However, a person from another state who is licensed or certified as a speech language pathologist by a similar board of another state, territory of the United States or of a foreign country or province and whose standards are equivalent to, or higher than, at the date of such person's certification or licensure, the requirements of this chapter and regulations duly adopted pursuant to this part or a person who meets the qualifications and requirements and resides in a state or territory of the United States or a foreign country or province that does not grant certification or license to speech language pathologists may also offer speech language pathology services in this state for a total of not more than thirty (30) days in any calendar year without being licensed under this law;
  5. Prevent the activities and services of a speech language pathologist obtaining the pathologist's year of paid professional experience; provided, that such person is under the supervision of a speech language pathologist licensed under this chapter or a speech language pathologist certified under the American Speech and Hearing Association (ASHA). A licensed or ASHA certified speech language pathologist shall not supervise more than three (3) speech language pathologists with a provisional license at any one (1) time;
  6. Restrict the activities and services of an audiologist obtaining the audiologist's year of paid professional experience; provided, that such person is under the supervision of a licensed or ASHA certified audiologist. A licensed or ASHA certified audiologist shall not supervise more than three (3) unlicensed audiologists at any one (1) time;
  7. Restrict the activities and services of a person performing audiometric tests under the direct supervision of a physician licensed to practice by the state board of medical examiners; and
  8. Permit any person licensed by this chapter to practice medicine in any form or in any of its branches. Nothing in this chapter shall be construed as applying to physicians licensed under chapters 1 and 6 of this title.

Acts 1973, ch. 93, §§ 14, 22; T.C.A., §§ 63-1714, 63-1722; 63-17-122; Acts 1994, ch. 849, §§ 9, 15; 1995, ch. 481, §§ 31, 42, 43; 2019, ch. 318, § 2.

Amendments. The 2019 amendment, in (6), substituted “Prevent” for “Restrict” in the first sentence and, in the second sentence, deleted “unlicensed” following “more than three (3)”, and inserted “with a provisional license” at the end.

Effective Dates. Acts 2019, ch. 318, § 3. May 8, 2019.

Cross-References. Licensure, §§  63-1-10363-1-112.

63-17-115. Fees.

  1. The amount of fees prescribed in connection with a license as a speech language pathologist or audiologist shall be determined by the board.
  2. An applicant wishing to be licensed in both speech language pathology and audiology shall pay the examination fee for each license. Such individual, however, is required to pay only one (1) initial license fee and only one (1) renewal or delinquency fee; provided, that the applications for the two (2) licenses are submitted simultaneously.
  3. The fees shall be fixed by the board and shall be set forth with the regulations that are duly adopted under this chapter.
  4. Every person to whom a license is issued shall, as a condition precedent to its issuance and in addition to any application, examination or other fee, pay the prescribed initial license fee. The board may, by regulation, provide for the waiver where the license is issued less than forty-five (45) days before the date on which it will expire.

Acts 1973, ch. 93, § 15; 1976, ch. 496, § 1; T.C.A., § 63-1715; Acts 1989, ch. 523, § 63; 1994, ch. 849, § 10.

Cross-References. License and registration fees, §  63-1-112.

63-17-116. Expiration of licenses — Renewal — Retirement.

  1. Each licensed speech language pathologist or audiologist shall pay to the board a fee for a license renewal. The secretary of the board shall notify each licensed speech language pathologist and audiologist each year that such fee is due.
  2. When any licensed speech language pathologist or audiologist fails to register and pay the registration fee within sixty (60) days after registration becomes due, as provided in this section, the license of such person is automatically revoked at the expiration of the sixty (60) days after the registration was required, without further notice or hearing. Any person whose license is automatically revoked as provided in this section may make application in writing to the board for the reinstatement of such license or certificate, and, upon good cause being shown, the board, in its discretion, may reinstate such license upon payment of current renewal fee and upon further payment of a sum to be set by the board.
  3. A suspended license is subject to expiration and shall be renewed as provided in this chapter, but such renewal does not entitle the licensee while the license remains suspended and, until it is reinstated, to engage in the licensed activity or in any other activity or conduct in violation of the order or judgment by which the license was suspended.
  4. A license revoked on disciplinary grounds is subject to expiration as provided in this section, but it may be renewed. If it is reinstated after its expiration, the licensee, as a condition of reinstatement, shall pay a reinstatement fee in an amount equal to the renewal fee in effect on the last preceding regular renewal date before the date on which it is reinstated, plus the delinquency fee, if any, accrued at the time of its revocation.
  5. A person who fails to renew a license within the five (5) years after its expiration may not renew it and it may not be restored, reissued or reinstated thereafter; but, such person may apply for and obtain a new license if such person meets the requirements of this chapter.
  6. Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this chapter if such person files with this board an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board deems necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.
    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 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 this subsection (g).

Acts 1973, ch. 93, § 17; 1981, ch. 167, § 2; T.C.A., § 63-1716; Acts 1986, ch. 675, § 11; 1989, ch. 360, §§ 55-57; 1989, ch. 523, § 64; 1994, ch. 849, § 11.

Cross-References. Licensure, §§ 63-1-10363-1-112.

Retirement, §  63-1-111.

63-17-117. Denial, revocation and suspension of licenses.

  1. The board may refuse to issue a license or may suspend or revoke the license of any licensee if the licensee has been found guilty of unprofessional conduct that has endangered or is likely to endanger the health, welfare or safety of the public. Such unprofessional conduct may include:
    1. Obtaining the license by means of fraud, misrepresentation or concealment of material facts;
    2. Being guilty of unprofessional conduct as defined by the rules established by the board or violating the code of ethics adopted and published by the board;
    3. Violating any lawful order, rule or regulation rendered or adopted by the board; or
    4. Violating any provisions of this chapter.
  2. The board shall deny an application for, suspend or revoke or impose probationary conditions upon a license as ordered by the board in any decision made after a hearing as provided in this chapter. One (1) year from the date of revocation of a license under this chapter, application may be made to the board for reinstatement. The board has discretion to accept or reject an application for reinstatement and may require an examination for such reinstatement.
  3. A plea or verdict of guilty or a conviction following a plea of nolo contendere made to a charge of a felony or of any offense involving moral turpitude is deemed to be a conviction within the meaning of this chapter. However, an action taken under this subsection (c) shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title.

Acts 1973, ch. 93, § 17; T.C.A., § 63-1717; Acts 2018, ch. 745, § 34.

Amendments. The 2018 amendment added the second sentence in (c).

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

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

63-17-118. Charges against licensees and applicants.

  1. Any person, including the board or any member thereof, may prefer charges against any licensee or applicant for license. Such charges shall be in writing and shall be sworn to by the person or persons making them. The charges, unless made by the board, shall be preferred by delivering them to the secretary of the board, who shall furnish all members of the board with a copy. All charges, unless dismissed by the board, shall be heard within a reasonable time after the date upon which they were preferred. The time and place of the hearings shall be fixed by the board.
  2. The complaint shall be in writing and shall include, but not be limited to, the following:
    1. The name of the licensee or the applicant, the licensee's or applicant's last known address and the number of the licensee's or applicant's license, if known;
    2. The nature of the charges, which, if true, would constitute grounds upon which disciplinary action may be taken;
    3. A statement to inform the respondent that the respondent may but need not be represented by counsel and that the respondent is entitled to the issuance of subpoenas to compel the attendance of witnesses, the production of books, documents or other evidence relevant to the matter to be heard;
    4. The date and time set for the hearing of the charges and the place where the hearing is to be held; and
    5. The date of the signing of the complaint, which shall be signed by the chair and secretary of the board.
  3. A copy of the complaint shall be served upon the person against whom preferred, whether personally or by registered or certified mail, addressed to the person at the person's last known address as the same appears on the records of the board, at least twenty (20) days before the time fixed for the hearing. Where such personal service cannot be made or where registered or certified mail is returned undelivered, the secretary-treasurer of the board may cause a brief notice to the licensee to be published in a newspaper of general circulation in the county of the licensee's last known address, or, if no newspaper is published in the county, the notice may be published in an adjoining county. If the address is in some state, territory or country other than this state, then the notice may be published in Davidson County. Proof of service or of publication shall be filed with the secretary-treasurer and shall be recorded by the secretary-treasurer in the minutes of the board.
    1. The board shall not be bound by strict rules of procedure or by the laws of evidence in the conduct of proceedings, but the determination shall be based upon sufficient legal evidence to sustain it.
    2. The proceeding at the hearing shall be either stenographically or mechanically transcribed.
    3. Oral evidence shall be taken only upon oath or affirmation administered by any member of the board.
    4. Every party to a disciplinary hearing shall have the right to call and examine witnesses and to introduce documentary evidence relevant to the issues of the case.
    5. After the hearing, the board shall consider all the evidence offered and shall decide the issue based upon such evidence. If the decision is for the respondent, the board shall dismiss the proceeding and it shall be so stated in the order entered in the matter.
    6. If the board determines from the evidence and proofs submitted that the respondent is guilty of the charge or charges set forth in the complaint, it may take such action and impose such penalties provided in this chapter as it may deem proper.
  4. Any action of or ruling or order made or entered by the board is subject to review by the courts of this state in the same manner and subject to the rulings, orders and findings of other quasi-judicial bodies and to the same powers and conditions as now provided by law in regard to Tennessee, where not otherwise specifically provided.

Acts 1973, ch. 93, § 18; T.C.A., § 63-1718.

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

Review of boards and commissions generally, title 27, ch. 9.

63-17-119. 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 engaging in any act or practice that constitutes an offense against 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 1973, ch. 93, § 19; T.C.A., § 63-1719.

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

63-17-120. Assistance of district attorneys general.

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. 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 1973, ch. 93, § 20; T.C.A., § 63-1720.

Law Reviews.

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

63-17-121. Penalties.

A violation of this chapter is a Class B misdemeanor.

Acts 1973, ch. 93, § 21; T.C.A., § 63-1721; Acts 1989, ch. 591, § 112.

Cross-References. Penalties, §   63-1-123.

Penalties for violation of statute, rule or order, recovery, §  63-1-134.

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

63-17-122. [Reserved.]

63-17-124. Continuing education.

The board has the authority to promulgate rules in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, establishing mandatory continuing education. The board's rules shall require a minimum of ten (10) hours per year of continuing education.

Acts 1994, ch. 849, § 3.

63-17-125. Return of purchased hearing instruments.

  1. Within thirty (30) days of the date of delivery, any purchaser of a hearing instrument from an audiologist licensed by the board to practice the assessing, selecting, fitting or dispensing or engaging in the sale of hearing instruments to the human ear is entitled to return the hearing instrument for any reason; provided, that such instrument is returned in satisfactory condition, and such purchaser shall pay only reasonable charges for the hearing instrument and related services. Such return privileges apply only to a first-time purchaser of a hearing instrument.
  2. Charges to be imposed upon return of a hearing instrument as provided in subsection (a) shall be clearly stated in the bill of sale.
  3. This section shall not be construed to supersede any duly promulgated regulation issued by the federal trade commission.

Acts 1994, ch. 849, § 12; 1995, ch. 481, § 30.

63-17-126. Standards of conduct.

When engaging in assessment, selection, fitting and sale of amplification systems or other assistive devices and technologies, a licensed audiologist shall perform such activities in compliance with the highest standards of professional conduct specifically prescribed for such activities by the United States food and drug administration, the Academy of Dispensing Audiologists, the American Academy of Audiology, the American Speech-Language-Hearing Association and the council for licensing hearing instrument specialists. Through promulgation of rules, publication and distribution of pamphlets, and/or other appropriate means, the board shall periodically notify and update all licensed audiologists concerning the applicable standards of conduct enforced pursuant to this section.

Acts 1994, ch. 849, § 13; 1995, ch. 481, § 40.

63-17-127. Inactive licenses to perform pro bono services.

The board shall establish by rule an inactive license category that allows audiologists and speech language pathologists to perform services without compensation only for those persons receiving services from organizations that have received a determination of exemption under § 501(c)(3) of the Internal Revenue Code (26 U.S.C. § 501(c)(3)). Such inactive license category shall not authorize any other practice of audiology or speech language pathology.

Acts 1997, ch. 345, § 5.

63-17-128. Registration as a speech language pathology assistant.

  1. No person shall engage in practice as a speech language pathology assistant unless that person has first registered with the board.
  2. A person who desires to register as a speech language pathology assistant shall provide proof that the person meets the minimum qualifications established by the board for speech language pathology assistants in its rules and shall pay the registration fees set by the board. The minimum qualifications previously established by the board in its rules shall remain in effect unless and until amended by the board.
  3. Registration shall be valid for two (2) years. Each person registered as a speech language pathology assistant shall renew the person's registration biennially if that person desires to continue practicing as a speech language pathology assistant. The board may utilize the renewal system as described in § 63-1-107.
  4. The amount of the fees required to be paid by speech language pathology assistants in connection with their registration shall be determined by the board.
  5. Sections 63-17-117 — 63-17-120 shall apply to speech language pathology assistants in the same way they apply to speech language pathologists.
  6. The board's rules shall require that each registered speech language pathology assistant obtain the minimum number of hours of continuing education each year that the board deems necessary to ensure the continued competence of the speech language pathology assistant.
  7. The board shall adopt rules to implement this section in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2005, ch. 330, § 3.

Part 2
Hearing Instrument Specialists

63-17-201. Part definitions.

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

  1. “Apprentice licensee applicant” means any person who is registered with the council and, who is engaged in an approved licensing program and who is sponsored by a hearing instrument specialist duly licensed in this state. The apprentice licensee applicant shall meet the qualifications of § 63-17-207;
  2. “Apprentice program” means sixty (60) classroom hours of prescribed coursework under the direct supervision of a hearing instrument specialist, with such coursework pertaining to all aspects of hearing instrument dispensing;
  3. “Board” means the board of communication disorders and sciences created by § 63-17-104;
  4. “Council” means the council for licensing hearing instrument specialists;
  5. “Division” means the division of health related boards in the department of health;
  6. “Hearing instrument” means any instrument or device designed for or represented as aiding, improving or correcting defective human hearing and any parts, attachments or accessories of such an instrument or device;
  7. “Licensed hearing instrument specialist” means any person licensed by this part who has passed a council-approved psychometrically-sound examination for hearing instrument specialists;
  8. “Practice of dispensing and fitting hearing instruments” includes the evaluation or measurement of the powers or range of human hearing by means of an audiometer for the consequent selection or adaptation for sale of hearing instruments intended to compensate for hearing loss, including the appropriate instructions, consultations, suggestions, recommendations or opinions related to this practice, including the making of an impression of the ear, or an ear mold; and
  9. “Sell” or “sale” includes any transfer of title or of the right to use by lease, bailment or any other contract, either oral or written, except wholesale sales to distributors or dispensers.

Acts 1995, ch. 481, § 3.

63-17-202. Council for licensing hearing instrument specialists.

  1. There is hereby created a council within the board to be known as the council for licensing hearing instrument specialists, with the duties and powers as provided in § 63-17-203.
    1. The council shall consist of five (5) members, to be appointed by the governor. Such members shall possess the following qualifications:
      1. Three (3) members shall be qualified hearing instrument specialists and fitters of hearing instruments who have been duly licensed as such in Tennessee, and who are certified by the National Board for Certification — Hearing Instrument Sciences. Such members may be appointed from lists of qualified persons submitted to the governor by interested audiology groups including, but not limited to, the Tennessee Hearing Aid Society. The governor shall consult with such interested groups to determine qualified persons to fill the positions;
      2. One (1) member shall be a physician who has been duly licensed to practice medicine in Tennessee, and who has received certification from the American Council of Otolaryngology. The member may be appointed 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 interested groups to determine a qualified person to fill the position; and
      3. One (1) member shall be a person who has been a user of hearing instruments for a period of at least five (5) years preceding that person's appointment to the council and who shall never have been engaged in the practice of hearing instrument dispensing and fitting, audiology or medicine.
    2. In order that the terms may be appropriately staggered, initial appointments to the council are for the following terms: one (1) member appointed pursuant to subdivision (b)(1)(A) shall be appointed to a term of one (1) year; one (1) member appointed pursuant to subdivision (b)(1)(A) shall be appointed for a term of two (2) years; one (1) member appointed pursuant to subdivision (b)(1)(A) shall be appointed for a term of four (4) years; the member appointed pursuant to subdivision (b)(1)(B) shall be appointed to a term of three (3) years; and the member appointed pursuant to subdivision (b)(1)(C) shall be appointed to a term of four (4) years. Thereafter, each member appointed to the council shall be appointed to a term of five (5) years. No person is eligible to serve successive terms on the council; provided, that those members appointed to a one- or two-year term under this subsection (b) are eligible to succeed themselves for one (1) successive five-year term. In the event of a vacancy on the council, the governor shall appoint a person qualified under the appropriate subdivision of this subsection (b) to fill the unexpired vacancy. The initial appointments to the council shall include the current and immediate past board chair of the licensing board of hearing aid dispensers. In making appointments to the council, the governor shall strive to ensure that at least one (1) person serving on the council is sixty (60) years of age or older and that at least one (1) person serving on the council is a member of a racial minority.
  2. Each member of the council shall receive fifty dollars ($50.00) per diem expenses when actually engaged in the discharge of such member's official duties and, in addition, shall be reimbursed for attending any meeting of the council within this state, in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  3. Such council shall be administratively attached to the board of communications disorders and sciences and the division of health related boards.

Acts 1995, ch. 481, § 4; 2012, ch. 718, § 3.

Compiler's Notes. The council for licensing hearing instrument specialists, created by this section, terminates June 30, 2022. See §§  4-29-112, 4-29-243.

63-17-203. Powers and duties of the council.

The powers and duties of the council are to:

  1. Supervise and administer qualifying examinations to test the knowledge and proficiency of applicants for a license;
  2. License persons who apply to the council and who are qualified to practice the fitting of hearing instruments;
  3. Purchase and maintain or rent audiometric equipment and facilities necessary to carry out the examination of applicants for license;
  4. Issue and renew licenses, under the name of the board;
  5. Deny, suspend or revoke licenses pursuant to this part;
  6. Appoint representatives to conduct or supervise the examination of applicants for license;
  7. Designate the time and place for examining applicants for license;
  8. Make and publish rules and regulations not inconsistent with the laws of this state that are necessary to carry out this part. All rules relating to hearing instrument specialists shall be initiated and adopted by a majority of the members of the council and then shall be approved by a majority of the members of the board;
  9. Require an annual calibration of audiometric equipment;
  10. Provide all examinations required by this part. The council may contract with organizations to conduct examinations;
  11. Establish minimum requirements of test procedure and test equipment to be used in the fitting of hearing instruments and also the retention of records of all fittings;
  12. Inspect the facilities or records, or both, of persons who practice the fitting and selling of hearing instruments, upon a showing of probable cause of a violation of this part;
  13. Require lists, set standards and approve programs for trainees as provided in § 63-17-207;
  14. Prescribe regulations requiring continuing education as a prerequisite for renewal of licenses to practice; and
  15. Employ a consultant to assist the council in its duties.

Acts 1995, ch. 481, § 5; 2016, ch. 811, § 1.

63-17-204. Meetings.

  1. The council shall meet at least once each year at a place and time determined by the chair. The council shall also meet at such other times and places as may be appropriate to carry out the purposes of this part.
    1. Any member who misses more than fifty percent (50%) of the scheduled meetings in a calendar year shall be removed as a member of the council.
    2. The presiding officer of the council shall promptly notify, or cause to be notified, the appointing authority of any member who fails to satisfy the attendance requirement as prescribed in subdivision (b)(1).

Acts 1995, ch. 481, § 6; 2016, ch. 612, § 3.

63-17-205. License required.

  1. No person shall engage in the sale of or practice of dispensing and fitting hearing instruments or display a sign or in any other way advertise or hold out to be a hearing instrument specialist unless direct hands-on testing and follow-up services are provided to persons to whom the hearing instrument specialist has dispensed and/or sold a hearing instrument, and such person holds a current, unsuspended, unrevoked license issued by the council as provided in this part.
  2. The license required by this section shall be kept conspicuously posted in the specialist's principal office or place of business at all times.

Acts 1995, ch. 481, § 7.

Cross-References. Licensing, §§  63-1-10363-1-112.

63-17-206. Construction — Application.

  1. This part shall not be construed to prevent any person who is a physician licensed to practice by the board of medical examiners from treating or fitting hearing instruments to the human ear.
  2. It is lawful for any person, who meets the requirements of §§ 63-17-205 and 63-17-207 and, who is listed as an apprentice licensee applicant with the council and who is under the direct supervision of a sponsoring licensed hearing instrument specialist to perform any of the services or acts included in the definition of hearing instrument dispensing and fitting as contained in this part; provided, that such person does so under the direct supervision of the licensed hearing instrument specialist and with the licensed dispenser making final selection and fitting to the client. No licensed dispenser shall supervise more than two (2) such apprentice licensee applicants or apprentice licensees combined at the same time.
  3. This part shall not be construed to prevent any person who is an audiologist licensed by the board from practicing audiology as defined in § 63-17-103, nor to prevent any person who is a speech-language pathologist licensed by the board from practicing speech-language pathology as defined in § 63-17-103.

Acts 1995, ch. 481, § 8.

63-17-207. Preliminary application requirements — Fees.

  1. An applicant for a license shall:
    1. Be at least eighteen (18) years of age; and
    2. Have an education equivalent to two (2) years of accredited college level coursework or national board for certification in hearing instrument sciences (NBC-HIS) board certification.
  2. Such applicant shall pay a nonrefundable application fee as set by the council no later than forty-five (45) days in advance of the next scheduled examination.

Acts 1995, ch. 481, § 9; 2019, ch. 323, § 1.

Amendments. The 2019 amendment added “or national board for certification in hearing instrument sciences (NBC-HIS) board certification” at the end of (a)(2).

Effective Dates. Acts 2019, ch. 323, § 2. May 8, 2019.

Cross-References. Licensing, §§  63-1-10363-1-112.

63-17-208. Apprentice license.

  1. Applicants who meet the requirements of § 63-17-207 with respect to age and education may apply for an apprentice license.
  2. The apprentice licensee shall function under the direct supervision of the sponsoring licensed hearing instrument specialist for a period of at least three (3) months after submitting an application, and during such three-month period, the sponsoring licensed dispenser must make the final selection and fitting of the hearing instrument.
  3. During the apprentice period, the apprentice licensee shall complete sixty (60) classroom hours of prescribed coursework.
  4. The apprentice license will remain in effect no longer than one (1) year and cannot be renewed.
  5. Applicants for an apprentice license shall pay the council a nonrefundable fee as set by the council.

Acts 1995, ch. 481, § 10; 2016, ch. 811, §§ 2-4.

Cross-References. Licensing, §§  63-1-10363-1-112.

63-17-209. Examination.

  1. Upon the payment of an examination fee as set by the council, an applicant for a license who is notified by the council that the applicant has fulfilled the requirements of § 63-17-207 shall appear at a time, place and before such persons as the council may designate to be examined by written and practical tests in order to demonstrate that such applicant is qualified to practice the fitting of hearing instruments.
  2. The council shall give at least one (1) examination of the type prescribed in this section each year and such additional examinations as the volume of applications may make appropriate.

Acts 1995, ch. 481, § 11; 2016, ch. 811, § 5.

63-17-210. Examination requirements.

  1. The examination provided in § 63-17-209 shall consist of:
    1. Tests of knowledge in the following areas as they pertain to the fitting of hearing instruments:
      1. Basic physics of sound;
      2. The human hearing mechanism, including the science of hearing and the causes and rehabilitation of abnormal hearing and hearing disorders; and
      3. Structure and function of hearing instruments;
    2. Tests of proficiency in the following techniques as they pertain to the fitting of hearing instruments:
      1. Pure tone audiometry, including air conduction testing and bone conduction testing;
      2. Live voice or recorded voice speech audiometry, including speech reception threshold testing and speech discrimination testing;
      3. Effective masking;
      4. Recording and evaluation of audiograms and speech audiometry to determine hearing instrument candidacy;
      5. Selection and adaption of hearing instruments and testing of hearing instruments;
      6. Taking earmold impressions; and
      7. Other skills as may be required for the fitting of hearing instruments; and
    3. Tests of knowledge of the provisions and requirements of this part.
  2. The tests under this section shall not include questions requiring a medical or surgical education.

Acts 1995, ch. 481, § 12.

63-17-211. Provisions for fees.

    1. Upon payment of an initial license fee as determined by the council, the council shall issue a license to each applicant who passes the examination. Such initial license shall expire as provided by rules and regulations promulgated by the board.
    2. During the second year of a biennial renewal period, the initial license fee shall be one-half (½) of the biennial renewal fee.
  1. The council may, in its discretion, license as a hearing instrument specialist, without examination, on the payment of a fee as set by the council, an applicant who is a hearing instrument specialist, certified, registered or licensed under the laws of another state or country, if the applicant's qualifications for certification, registration or licensure meet the licensure requirements in force in this state upon the date of the specialist's application for certification, registration or licensure in this state.

Acts 1995, ch. 481, § 13.

Cross-References. Licensing, §§  63-1-10363-1-112.

63-17-212. Notification of change of address.

Each licensee shall notify the council of any change of address of the licensee's place of business, within thirty (30) days of such change. Failure to give such notice shall be deemed just cause for disciplinary action by the council.

Acts 1995, ch. 481, § 14.

63-17-213. Registry of license holders — Review of qualifications.

The council shall issue, under the board's name, all licenses approved by the council, and the board and shall maintain a registry of all license holders. It is the duty of the council to review and approve the qualifications of applicants for certification or renewal as hearing instrument specialists.

Acts 1995, ch. 481, § 15.

Cross-References. Licensing, §§  63-1-10363-1-112.

63-17-214. Renewal — Fees — Retirement.

    1. Each licensed hearing instrument specialist shall pay to the council a biennial renewal fee as set by the council, payable in advance, for the ensuing two (2) years.
    2. The council shall notify each licensee that such renewal is due.
  1. As a condition of renewal, the licensee shall be reexamined by the council and shall pay a reexamination fee as set by the council or shall submit verification of compliance of continuing education requirements as may be set by the council. The reexamination shall consist of all of the areas required pursuant to § 63-17-210.
  2. When any licensed hearing instrument specialist fails to pay the license fee within sixty (60) days after it becomes due, as provided in this section, the license of such person is automatically revoked at the expiration of the sixty (60) days after the renewal fee was required, without further notice or hearing.
  3. Any person whose license is automatically revoked as provided in § 63-17-219 may make application in writing to the council for the reinstatement of such license; and, upon good cause being shown, the council, in its discretion, may reinstate such license upon payment of all past due renewal fees and upon further payment of a sum set by the council.
  4. Any person licensed to practice by this part who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this part if such person files with this council an affidavit on a form to be furnished by the council, which affidavit states the date on which such person retired from such practice and such other facts as tend to verify such retirement as the council deems necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the council as provided by this part and shall meet other requirements as may be set by the council.
    1. Notwithstanding this part 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 council 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 twenty-five cents (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 (f).

Acts 1995, ch. 481, § 16.

Cross-References. Licensing, §§ 63-1-10363-1-112.

Retirement, §  63-1-111.

63-17-215. Expenses of board and council paid by fees.

The fees relating to the practice of dispensing hearing instruments shall be set by the board in an amount sufficient to pay all of the expenses of the council, as well as all of the expenses of the board that are directly attributable to the performance of its duties pursuant to this part. Expenditures of the council for investigations and disciplinary actions shall be the financial responsibility of the licensees who are regulated by such council.

Acts 1995, ch. 481, § 17.

Cross-References. Disposition of fines and penalties, § 63-1-113.

Fund, deposits and disbursements, § 63-1-137.

63-17-216. Sale of hearing instruments.

  1. Any person who engages in the practice of dispensing and fitting hearing instruments shall deliver to each person supplied with a hearing instrument, by the dispensing person's or at the dispensing person's order or direction, a bill of sale that contains each of the following:
    1. The signature of the licensed hearing instrument specialist, the address of the specialist's regular place of business and the specialist's license number and license expiration date;
    2. The make and model of the hearing instrument supplied, and the amount charged for the hearing instrument and whether the hearing instrument is new, used or rebuilt;
    3. A clear statement of the terms of sale, including the provisions required by § 63-17-217; and
    4. The name and address of the council and a statement that the council will receive complaints on any matter relating to the fitting and dispensing of hearing instruments.
  2. Any sale of a hearing instrument is subject to the same conditions and provisions as are prescribed by the United States food and drug administration and the federal trade commission.
  3. Any hearing aid that is sold, fitted or dispensed to a consumer in this state shall be clearly and permanently marked with:
    1. The name of the manufacturer or distributor or the model name or number;
    2. The serial number; and
    3. The year of manufacture.

Acts 1995, ch. 481, § 18; 2003, ch. 70, § 1.

63-17-217. Return of purchased hearing instruments.

  1. Within thirty (30) days of the date of delivery, any purchaser of a hearing instrument from a licensee is entitled to return the hearing instrument for any reason; provided, that such instrument is returned in satisfactory condition and such purchaser pays only reasonable charges for the hearing instrument and related services. Such return privileges apply only to a first time purchaser of a hearing instrument.
  2. Charges to be imposed upon return of a hearing instrument as provided in subsection (a) shall be clearly stated in the bill of sale.
  3. This section shall not be construed to supersede any duly promulgated regulation issued by the federal trade commission.

Acts 1995, ch. 481, § 19.

63-17-218. Liability of sponsors.

Any person sponsoring an apprentice licensee and/or apprentice licensee applicant under this part shall be held responsible for the acts or omissions of the sponsor's apprentice licensee and/or apprentice licensee applicant within the course and scope of the licensee's or applicant's employment, during the apprenticeship, as well as the sponsor's employees.

Acts 1995, ch. 481, § 20.

63-17-219. Causes of denial, revocation or suspension — Costs of prosecution — Witnesses — Subpoenas.

  1. Subject to the due process requirements of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, any person registered under this part may have such license denied, revoked or suspended for a fixed period to be determined by the council for any of the following causes:
    1. Conviction of an offense involving moral turpitude. The record of such conviction or certified copy thereof from the clerk of the court where such conviction occurred or by the judge of such court is sufficient evidence to warrant revocation or suspension;
    2. Securing a license under this part through fraud or deceit;
    3. Unethical conduct, gross and/or repeated acts of ignorance or inefficiency in the conduct of such person's practice;
    4. Knowingly practicing while suffering with a contagious or infectious disease;
    5. Use of a false name or alias in the practice of the profession; and
    6. Violating any of this part.
    1. The council shall promulgate rules governing the assessment of costs against a licensee or other person found by the council to have violated any provision of this chapter. The costs assessed by the council 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 council 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.
      1. Any elected officer of the council or any duly appointed or elected chair has the authority to administer oaths to witnesses. Upon probable cause being established, the council, by a vote of two thirds (2/3) of the members to which the council 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 council shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.
        1. A licensee or person served by subpoena shall have thirty (30) days to request in writing a hearing before the council 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 council votes upon the request to quash or modify the subpoena. A majority vote of the members to which the council is entitled shall be required to quash or modify a subpoena.
        2. A motion to appeal from a decision by the council 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.
      3. If any witness fails or refuses to obey a subpoena issued by it, the council 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 council and give testimony or produce books, records or papers as ordered; and any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
      4. Each witness who appears before the council by order of the council 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 council in the same manner as all other expenses of the council are paid.
    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.
      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.
        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.
      3. 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, and any failure to obey the court order may be punished by the court issuing the order as a civil contempt.
      4. 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 1995, ch. 481, § 21; 1999, ch. 434, § 3; 1999, ch. 443, § 3.

Code Commission Notes.

Acts 1999, ch. 434, § 3 and ch. 443, § 3 each amended this section by adding provisions assigning identical powers to both the council for hearing instrument specialists and the board of communication disorders and sciences. The version in Acts 1999, ch. 434, § 3, assigning those powers to the council, was added as (b). The version in Acts 1999, ch. 443, § 3, assigning those powers to the board, was added as (c).

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

Grounds for license denial, suspension or revocation, §   63-6-214.

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

Attorney General Opinions. The board of communications disorders and sciences and its council for hearing instrument specialists 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).

63-17-220. Hearing before council required.

  1. Except as otherwise provided by § 63-17-214, no license issued pursuant to this part may be suspended, revoked, denied or renewal denied without a hearing before the council or its duly authorized trial examiner, if requested by the certificate holder or applicant, on due notice.
  2. Any action of the council taken pursuant to this part shall be in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1995, ch. 481, § 22.

63-17-221. Penalties council may enforce by seeking court injunction.

  1. A violation of this part is a Class B misdemeanor.
  2. The council, with the approval of the board, may seek to enforce any provision of this part by petitioning a court of appropriate jurisdiction for an injunction to enjoin continuing violations of this part or by any other appropriate proceeding. No such proceeding is barred by any proceeding had or pending pursuant to § 63-17-214 or by the imposition of any fine or term of imprisonment pursuant thereto.

Acts 1995, ch. 481, § 23.

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

Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, recovery, §  63-1-134.

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

63-17-222. Licensed hearing aid dispenser eligible for hearing instrument specialist license.

  1. Upon July 1, 1995, any person who is a trainee, apprentice or who has entered into a training program to become a licensed hearing aid dispenser shall be eligible to receive a license as a hearing instrument specialist; provided, that such person complies with all of the requirements of chapter 15 of this title [repealed], as it existed upon July 1, 1995.
  2. Upon July 1, 1995, any person who is a licensed hearing aid dispenser shall be eligible to receive a license as a hearing instrument specialist. Any person who is a licensed hearing aid dispenser upon July 1, 1995, who wishes to obtain a license as a hearing instrument specialist shall submit a request to the council to receive the appropriate license as a hearing instrument specialist. No additional fee shall be imposed upon persons for the issuance of a license as a hearing instrument specialist pursuant to this subsection (b).

Acts 1995, ch. 481, § 24.

Compiler's Notes. Acts 1995, ch. 481, § 1 repealed chapter 15 of this title, effective July 1, 1995. For new provisions concerning hearing instrument specialists, see this part.

63-17-123. [Reserved.]

Chapter 18
Massage Licensure Act of 1995

63-18-101. Short title.

This chapter shall be known and may be cited as the “Massage Licensure Act of 1995.”

Acts 1995, ch. 480, § 2; T.C.A. § 63-18-201.

Compiler's Notes. Former §§ 63-18-10163-18-114 (Acts 1979, ch. 431, §§ 1-14; T.C.A. §§ 63-1801 — 63-1813; Acts 1982, ch. 628, §§ 1-3; 1994, ch. 901, § 4), concerning massage registration, was repealed by Acts 1995, ch. 480, § 1, effective October 1, 1995. For new law, see this chapter. Former § 63-18-114 had been previously transferred to § 63-18-111(a)(5) in 1986.

Cross-References. Adult-oriented establishment registration, title 7, ch. 51, part 11.

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

Massage or exposure of erogenous areas prohibited, § 39-17-918.

Practice of aesthetics, § 62-4-102.

Attorney General Opinions. Advertising and treatment by massage therapists, OAG 95-033, 1995 Tenn. AG LEXIS 27 (4/6/95).

Effect of this part (now chapter) on prior city or county ordinances regulating massage, OAG 96-028, 1996 Tenn. AG LEXIS 18 (2/28/96).

A city ordinance which requires that massage operators or bathers obtain a permit before conducting a massage institute, bathhouse, or similar business in the city, does not apply to persons or establishments required to be licensed under the Massage Licensure Act of 1995, T.C.A. § 63-18-201, or who are otherwise regulated by law and, therefore, the ordinance does not violate the act, OAG 01-114, 2001 Tenn. AG LEXIS 105 (7/16/01).

63-18-102. Chapter definitions.

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

  1. “Board” means the massage licensure board;
  2. “Compensation” means the payment, loan, advance, donation, contribution, deposit or gift of money or anything of value;
  3. “Massage/bodywork/somatic” means the manipulation of the soft tissues of the body with the intention of positively affecting the health and well being of the client;
  4. “Massage establishment” means a place of business held out to the public wherein massage is practiced; and
  5. “Massage therapist” means a person who practices massage for compensation and is licensed by the board.

Acts 1995, ch. 480, § 3; 1996, ch. 1059, § 1; 1997, ch. 130, § 1; T.C.A. § 63-18-202.

63-18-103. Tennessee massage licensure board.

  1. There is hereby created the Tennessee massage licensure board.
  2. The board shall be composed of seven (7) members who are residents of the state. Except for the two (2) citizen members, each member shall have at least five (5) years current experience in the practice of massage. Persons with a conflict of interest are ineligible for membership on the board.
  3. All members shall be appointed by the governor. Initial appointments to the board shall be as follows:
    1. Three (3) members shall serve terms of one (1) year; and
    2. Four (4) members shall serve terms of two (2) years.
  4. Except for two (2) members who shall be citizen members with no direct or indirect financial interest in massage, all board members shall be duly licensed or eligible to be licensed by the board.
    1. Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the board:
      1. Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the board shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the board, prior to serving as a member of the board. This subdivision (e)(1)(A) shall apply to all persons appointed or otherwise named to the board after July 1, 2010;
      2. No person who is a member of the board shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the board during such person's period of service as a member of the board. This subdivision (e)(1)(B) shall apply to all persons appointed or otherwise named to the board after July 1, 2010, and to all persons serving on the board on such date who are not registered as lobbyists; and
      3. No person who serves as a member of the board shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the board for one (1) year following the date such person's service on the board ends. This subdivision (e)(1)(C) shall apply to persons serving on the board as of July 1, 2010, and to persons appointed to the board subsequent to such date.
    2. A person who violates this subsection (e) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (e). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  5. Subsequent appointees to the board shall have the professional qualifications required by their predecessors and shall be appointed to five-year terms. Each member shall serve until such member's successor is appointed and qualified, unless such board member is no longer competently performing the duties of office. Any vacancy on the board shall be filled by the governor for the balance of the unexpired term. The governor may remove members of the board from office for cause.
  6. For each day engaged in the business of the board, a member shall receive as compensation one hundred dollars ($100) and shall also receive actual expenses to be paid in accordance with the comprehensive travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  7. The members of the board shall elect annually a chair and a secretary/treasurer.
  8. The board shall meet as frequently as shall be reasonably necessary to implement this chapter. Four (4) or more members of the board shall constitute a quorum for the purpose of transacting board business.
  9. For administrative purposes, the board shall be attached to the division of health related boards as defined in § 68-1-101, referred to as “division” in this chapter, which shall supply support.

Acts 1995, ch. 480, § 4; T.C.A. § 63-18-203; Acts 2004, ch. 729, § 2; 2008, ch. 801, §§ 1, 2; 2010, ch. 997, §§ 3, 4.

Compiler's Notes. The massage licensure board, created by this section, terminates June 30, 2022. See §§ 4-29-112, 4-29-243.

Acts 2008, ch. 801, § 4 provided that the act, which changed the amount of experience required for board members from three (3) years to (5) five years and changed the length of terms for subsequent board members from two-year terms to five-year terms, shall apply to members of the massage licensure board serving on April 23, 2008.

Acts 2010, ch. 997, § 5 provided that the provisions of the act prohibiting citizens who have a direct or indirect financial interest in massage from serving on the board shall apply to all citizen member appointments made to the board after July 1, 2010.

63-18-104. License required.

  1. Persons or massage establishments engaged in massage for compensation shall be licensed by the massage licensure board.
  2. Any person or establishment who advertises or engages in massage for compensation without a current valid license from the massage licensure board commits a Class B misdemeanor. It is unlawful to use the word “massage” or any other term that implies massage technique or method when advertising a service by a person who is not licensed under this chapter or another chapter of state law.
  3. The practice of reflexology shall not be subject to the licensure requirements of this chapter. For the purposes of this chapter, “reflexology” means the application of specific pressures to reflex points in the hands and feet only.

Acts 1995, ch. 480, § 5; 2000, ch. 676, § 1; T.C.A. § 63-18-104; Acts 2005, ch. 232, § 3.

Cross-References. Licensure, §  63-1-10363-1-112.

Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, recovery, §   63-1-134.

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

63-18-105. License requirements — Issuance.

  1. The board shall establish procedures and criteria for the issuance of licenses to persons and establishments engaged in massage for compensation.
  2. No person or establishment shall be issued a license until the applicant and each person engaged in massage at such massage establishment has provided evidence satisfactory to the board that:
    1. The applicant is eighteen (18) years of age or older;
    2. The applicant has not been convicted of the offense of prostitution or sexual misconduct;
    3. The applicant has:
      1. Successfully completed the curriculum or curricula of one (1) or more post-secondary academic institutions for massage, bodywork or somatic therapy as defined by board regulations, totaling five hundred (500) hours or more, such institutions being approved by the board pursuant to § 63-18-115, and either authorized by the Tennessee higher education commission, or its equivalent in other states, or approved, or under the governance of, the Tennessee board of regents;
      2. Received a passing score on a competency examination approved by the board;
        1. Any person who has completed a program of study as required by subdivision (b)(3)(A) in a post-secondary academic institution located in Tennessee and receives a diploma or certificate prior to September 1, 2005, shall be issued a license without completing the examination requirement of this section;
        2. Any person who meets the requirements of subdivision (b)(3)(C)(i) shall have until January 1, 2006, to apply for such a license;
        3. Persons licensed under this subdivision (b)(3)(C) shall not be considered to have national certification and shall not hold themselves out to be nationally certified; and
    4. All required fees have been paid.
  3. Notwithstanding the requirements of this part, no establishment license is required for the office of a physician licensed under chapter 4, 6, or 9 of this title if a massage for compensation is provided within that office by a licensed massage therapist.

Acts 1995, ch. 480, § 6; 1996, ch. 1059, § 2; 1997, ch. 51, § 1; 1997, ch. 475, §§ 1, 2; 2001, ch. 251, § 1; 2003, ch. 137, § 1; T.C.A. § 63-18-205; Acts 2004, ch. 729, § 3; 2005, ch. 232, §§ 1, 4; 2006, ch. 737, § 1; 2019, ch. 357, § 1.

Amendments. The 2019 amendment added (c).

Effective Dates. Acts 2019, ch. 357, § 2. May 10, 2019.

Cross-References. Licensure, §  63-1-10363-1-112.

63-18-106. Investigation — Inspection — Revocation of license.

In order to effectuate this chapter, the board or its authorized representative is empowered to conduct an investigation of persons engaged in massage or massage establishments and to inspect the license of practitioners and establishments for compliance. The refusal of a practitioner or establishment to permit inspections shall be grounds for revocation, suspension or refusal to issue a license pursuant to this chapter.

Acts 1995, ch. 480, § 7; T.C.A. § 63-18-206.

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

Licensure, §  63-1-10363-1-112.

63-18-107. Enjoining violation.

The board has the power and authority to enter into any court of this state having proper jurisdiction to seek an injunction against any person or massage establishment not in compliance with this chapter and is further empowered to enter into any such court to enforce this chapter in order to ensure compliance with such provisions.

Acts 1995, ch. 480, § 8; T.C.A. § 63-18-207.

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

63-18-108. Grounds for denial, revocation, or suspension of license or other discipline.

  1. The board is authorized to deny, restrict or condition any application for licensure or revoke, suspend or otherwise discipline the license of a massage therapist or an establishment, if the applicant, licensee or holder of an establishment license upon proof:
    1. Is guilty of fraud in the practice of massage or fraud or deceit in the licensee's admission to the practice of massage;
    2. Has been convicted in a court of competent jurisdiction of an offense that constitutes a felony or a misdemeanor under the laws of this state;
    3. Is engaged in the practice of massage under a false or assumed name or is impersonating another practitioner of a like or different name;
    4. Abuses or is addicted to the habitual use of intoxicating liquors, drugs or stimulants to such an extent as to incapacitate such person's performance of professional duties;
    5. Is guilty of fraudulent, false, misleading or deceptive advertising or for prescribing medicines or drugs or practicing any licensed profession without legal authority. The licensee may not diagnose or imply or advertise, in any way, services for a condition that would require a diagnosis;
    6. Is guilty of willful negligence in the practice of massage or has been guilty of employing, allowing or permitting any unlicensed person to perform massage in such licensee's establishment;
    7. Has violated this chapter or any substantive rule promulgated under the authority of this chapter;
    8. Has been convicted of sexual misconduct, assignation or the solicitation or attempt thereof;
    9. Has violated or attempted to violate, directly or indirectly, or has 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 to this chapter;
    10. Has practiced as a licensed massage therapist in an unlicensed massage establishment;
    11. Is mentally incompetent; or
    12. Is guilty of unethical or unprofessional conduct.
  2. 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 1995, ch. 480, § 9; 2003, ch. 137, § 2; T.C.A. § 63-18-202; Acts 2006, ch. 737, §§ 2, 3; 2010, ch. 871, §§ 1-4; 2018, ch. 745, § 35.

Amendments. The 2018 amendment added (b).

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

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

63-18-109. Accusation — Hearing.

  1. Charges relative to a violation of this chapter may be presented by any person, or the board may, on its own motion, direct the chair of the board to present charges. An accusation may be filed with the chair of the board, charging any licensed massage therapist with any of the offenses enumerated in § 63-18-108.
  2. The board shall provide an applicant denied issuance of a license or a practitioner whose license is suspended, revoked or not renewed a hearing on such suspension, revocation or nonrenewal, which hearing shall be conducted pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Upon a decision of the board to refuse to issue, revoke or not to renew a license, the practitioner or establishment shall be prohibited from engaging in massage until the board's decision is overturned.

Acts 1995, ch. 480, § 10; T.C.A. § 63-18-209.

63-18-110. Exemptions.

  1. Any person granted an exemption under this chapter is effective only to the extent that the bona fide practice of the profession or business that is licensed, certified or registered under the laws of this state overlaps into the field comprehended by this chapter, and exemptions under this chapter are only for those activities that are performed in the course of the bona fide practice of the business or profession of the person exempted.
  2. Persons exempt under subsection (a) include, but are not limited to any branch of medicine, nursing, osteopathy, chiropractic, podiatry, and also barbers, cosmetologists, athletic trainers, physical and occupational therapists and any student of an institution described in § 63-18-105(b)(3)(A) or public school of this state; provided, that the student does not hold out as a licensed massage therapist and does not receive compensation for massage.
  3. Nothing in this chapter shall apply to massage therapists licensed in other states or countries or meeting standards set forward in § 63-18-105 when providing educational programs or services for a period of time not to exceed thirty (30) days within a calendar year.

Acts 1995, ch. 480, § 11; T.C.A. § 63-18-210; Acts 2005, ch. 232, § 2.

63-18-111. Authorization to promulgate rules, regulations and fees.

  1. The board is hereby authorized to promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, such rules and regulations as are necessary to implement this chapter.
  2. The board may adopt reasonable rules and regulations regarding personal cleanliness of massage therapists and the sanitary condition of towels, linens, creams, lotions, oils and other materials, facilities and equipment used in the practice of massage.
  3. All fees for licensure, renewal of licensure and all other related matters shall be set by the board.
  4. All education and other requirements for licensure in this chapter shall be set by the board.
  5. The board may adopt rules and regulations for ethics.
  6. All continuing education and other requirements for renewal of licensure not enumerated in this chapter shall be set by the board.
  7. The board is authorized to set an application fee for all continuing education courses submitted to the board for approval.

Acts 1995, ch. 480, § 12; 1996, ch. 1059, § 3; T.C.A. § 63-18-211; Acts 2008, ch. 801, § 3.

Compiler's Notes. Acts 2008, ch. 801, § 4 provided that the act, which added subsection (g), shall apply to members of the massage licensure board serving on April 23, 2008.

63-18-112. Reciprocity.

The board may, at its discretion, grant licensure to any person who is licensed or registered in another state or country with standards as stringent as those required by this chapter.

Acts 1995, ch. 480, § 13; T.C.A. § 63-18-212.

63-18-113. Tax.

Notwithstanding law to the contrary, the act of a duly licensed massage therapist in performing a massage shall be deemed to be medically therapeutic in nature and shall not be subject to the collection of any form of state or local taxation regulations not also imposed on other medically therapeutic activities. Additionally, a massage performed on or before October 1, 1995, by a person who becomes licensed in accordance with this chapter shall also not be subject to the collection of any form of state or local tax not also imposed on other medically therapeutic activities.

Acts 1995, ch. 480, § 14; 1996, ch. 1059, § 4; T.C.A. § 63-18-213.

63-18-114. Massage therapists are not primary care providers.

No person licensed by the massage licensure board shall ever be referred to as a primary care provider nor be permitted to use such designation.

Acts 1995, ch. 480, § 15; T.C.A. § 63-18-214.

63-18-115. Powers and duties of the board.

In addition to the powers and duties granted to or imposed upon it by other provisions of this chapter, the board shall have the following powers and duties:

  1. Prescribe the minimum curricular and minimum standards for schools of massage therapy and for courses of training that prepare individuals for licensure under this chapter;
  2. Approve such schools and courses as meet the requirements of this chapter and the rules and regulations of the board;
  3. Issue certificates of approval to such schools and courses that meet the requirements of this chapter and the rules and regulations of the board;
  4. Conduct hearings for disciplinary action against schools or courses that fail to meet the minimum requirements of this chapter and the rules and regulations of the board; and
  5. Annually publish passage rates for each school of massage therapy, based upon the results of each student's success in taking a national examination approved by the board. Schools that fail to achieve an overall passing rate of seventy percent (70%) shall be required to submit a remedial plan to be approved by the board.

Acts 2004, ch. 729, § 1; 2005, ch. 232, § 5.

63-18-116. Authority to issue license — Qualifications — Rules and regulations.

  1. The board is authorized to issue a license to practice massage therapy to an applicant who:
    1. Meets the qualifications set forth in § 63-18-105(b)(1) and (2); and
    2. Has been certified by the National Certification Board for Therapeutic Massage and Bodywork for the five-year period immediately preceding application for licensure and can submit documentation satisfactory to the board that the applicant has engaged in the practice of massage therapy in another state for the five-year period immediately preceding application for licensure, and who either:
      1. Has met the qualifications set forth in § 63-18-105(b)(3), but is unable, because the educational institution either was not state approved or is no longer in existence, to produce a transcript to document compliance; or
      2. Graduated from a qualified massage school or course prior to October 1, 1995.
  2. The board is authorized to promulgate rules that are necessary to effectuate this section.

Acts 2006, ch. 737, § 4.

Chapter 19
Physician Assistants

Part 1
Physician Assistants Act

63-19-101. Short title.

This part shall be known and may be cited as the “Physician Assistants Act.”

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-201.

Compiler's Notes. Former part 1 (Acts 1980, ch. 719, §§ 1-9, 12; T.C.A., §§ 63-1901 — 63-1910; Acts 1983, ch. 168, §§ 2-10), concerning physician assistants, was repealed by Acts 1985, ch. 376, § 2.

NOTES TO DECISIONS

1. Standard of Care.

Recognized standard of acceptable professional practice for physician assistants is that of physician assistants, not physicians. Accordingly, the Supreme Court of Tennessee agrees with those authorities who differentiate between the standard of care that must be met by physicians and the standard of care which must be met by physician assistants. Cox v. M.A. Primary & Urgent Care Clinic, 313 S.W.3d 240, 2010 Tenn. LEXIS 553 (Tenn. June 21, 2010).

Grant of summary judgment in favor of a clinic and supervising physician in the patient's action for injuries allegedly suffered as a result of a physician assistant's failure to diagnose her condition was appropriate because the professional standard of care applicable to physician assistants was distinct from that applicable to physicians and the patient introduced no expert proof as to any violation of the applicable standard of care. It was illogical to impose significant limitations on physician assistants and yet at the same time hold them to the same standard of care imposed upon their supervisors. Cox v. M.A. Primary & Urgent Care Clinic, 313 S.W.3d 240, 2010 Tenn. LEXIS 553 (Tenn. June 21, 2010).

63-19-102. Part definitions.

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

  1. “Board” means the board of medical examiners, created by § 63-6-101;
  2. “Committee” means the board of medical examiners' committee on physician assistants, established by § 63-19-103;
  3. “Orthopedic physician assistant” (OPA-C) means an individual who renders service in collaboration with a licensed orthopedic physician or surgeon and who has been licensed by the committee on physician assistants and the board of medical examiners pursuant to this chapter as an orthopedic physician assistant;
  4. “Physician” means a person lawfully licensed to practice medicine and surgery pursuant to chapter 6 of this title, osteopathic medicine pursuant to chapter 9 of this title, or podiatry pursuant to chapter 3 of this title; and
  5. “Physician assistant” means an individual who renders services, whether diagnostic or therapeutic, that are acts constituting the practice of medicine or osteopathic medicine and, but for §§ 63-6-204 and 63-9-113, could only be performed by a licensed physician.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-202; Acts 1988, ch. 906, § 1; 1992, ch. 604, §§ 1, 2; 1994, ch. 901, § 4; 1995, ch. 337, § 1; 1996, ch. 771, § 5; 1997, ch. 207, § 5; 2016, ch. 946, § 3; 2018, ch. 610, § 4.

Compiler's Notes. Acts 1994, ch. 901, § 4 purported to substitute “osteopathic medicine” for “osteopathy” in (3); however, the language in (3) already read “osteopathic medicine,” and the amendment, therefore, was deemed to have no effect.

Amendments. The 2018 amendment substituted “in collaboration with” for “under the supervision of” in the definition of “orthopedic physician assistant”.

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

NOTES TO DECISIONS

1. Negligence Per Se.

In a medical-malpractice wrongful-death action brought by the decedent's husband, the trial court's finding that Tenn. Comp. R. & Regs. 0880-2-.18(7) could not support the husband's claim of claim of negligence per se was improper. The regulation constituted a standard of care and the trial court erred in denying the husband's motion to amend the complaint to allege a claim of negligence or negligence per se based on the breach of that standard, T.C.A. §§ 63-19-102(5), 63-19-106(a)(2). Watkins v. Affiliated Internists, P.C., — S.W.3d —, 2009 Tenn. App. LEXIS 892 (Tenn. Ct. App. Dec. 29, 2009).

2. Physician Assistant.

Grant of summary judgment in favor of a clinic and supervising physician in the patient's action for injuries allegedly suffered as a result of a physician assistant's failure to diagnose her condition was appropriate because the professional standard of care applicable to physician assistants was distinct from that applicable to physicians and the patient introduced no expert proof as to any violation of the applicable standard of care. It was illogical to impose significant limitations on physician assistants and yet at the same time hold them to the same standard of care imposed upon their supervisors, T.C.A. § 63-19-102(5). Cox v. M.A. Primary & Urgent Care Clinic, 313 S.W.3d 240, 2010 Tenn. LEXIS 553 (Tenn. June 21, 2010).

63-19-103. Committee on physician assistants.

  1. To assist the board of medical examiners in the performance of its duties, there is hereby established the committee on physician assistants. The committee shall consist of five (5) members appointed by the governor, each of whom shall be a resident of this state and each of whom shall be a physician assistant who meets the criteria for licensure as established by this part.
  2. Initial appointments to the committee shall be made as follows: two (2) members shall be appointed to terms of four (4) years, one (1) member shall be appointed to a term of three (3) years, one (1) member shall be appointed to a term of two (2) years, and one (1) member shall be appointed to a term of one (1) year. Each regular appointment thereafter shall be for a term of four (4) years. Any vacant term shall be filled by the governor for the balance of the unexpired term. No member shall serve more than two (2) consecutive four-year terms and each member shall serve on the committee until a successor is appointed. In making appointments to the committee, the governor shall strive to ensure that at least one (1) person serving on the committee is sixty (60) years of age or older and that at least one (1) person serving on the committee is a member of a racial minority.
  3. While engaged in the business of the committee, members thereof shall receive a per diem of one hundred dollars ($100) and shall also receive compensation for actual expenses to be paid in accordance with comprehensive travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  4. The committee shall elect a chair and secretary from among its members at the first meeting held in each fiscal year. A committee meeting may be called upon reasonable notice in the discretion of the chair and shall be called at any time upon reasonable notice by a petition of three (3) committee members to the chair.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-203; Acts 1988, ch. 906, § 2; 1988, ch. 1013, § 56; 1997, ch. 207, §§ 1, 5.

Compiler's Notes. The board of medical examiners' committee on physician assistants, 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.

63-19-104. Powers and duties of committee.

  1. The committee has the duty to:
    1. Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are reasonably necessary for the performance of the duties of the physician assistants, including, but not limited to, rules that specify the acts and offenses that subject the license holder to disciplinary action by the committee pursuant to subdivision (a)(7);
    2. Set fees, subject to the maximum limitations prescribed by this part, relative to the examination, licensure and licensure renewal of physician assistants in an amount sufficient to pay all of the expenses of the committee as well as all of the expenses of the board that are directly attributable to the performance of its duties pursuant to this part and establish and collect a late renewal fee from those physician assistants who fail to renew their licenses in a timely manner;
    3. Review and approve or reject the qualifications of each applicant for initial licensure as a physician assistant;
    4. Biennially review and approve or reject the qualifications of each applicant for biennial licensure renewal. The committee shall condition approval for renewal on the receipt of evidence satisfactory to the committee of the applicant's successful completion, within a two-year period prior to the application for license renewal, of one hundred (100) hours of continuing medical education approved by the American Academy of Physician Assistants or the American Medical Association. The two-year period within which an applicant must have obtained the required continuing medical education hours shall be the most recent two-year period utilized by the National Commission on Certification of Physician Assistants to determine whether that person has obtained sufficient continuing medical education hours to maintain that person's professional certification. The committee may, in its discretion, waive or modify the continuing medical education requirement in cases of retirement, illness, disability or other undue hardship;
    5. Issue, in the board's name, all approved physician assistant licenses and renewals;
    6. Collect or receive all fees, fines and moneys owed pursuant to this part and to pay the same into the general fund of the state. For the purpose of implementing subdivision (a)(2), all fees, fines and moneys collected pursuant to the regulation of physician assistants shall be so designated; and
    7. Deny, suspend or revoke the license of, or to otherwise discipline by a fine, not to exceed five hundred dollars ($500), or by reprimand, a license holder who is guilty of violating any of the provisions of this part or who is guilty of violating the rules of the board promulgated pursuant to subdivision (a)(1). When sanctions are imposed on a license holder pursuant to this subdivision (a)(7), the license holder may, in addition, be required to pay the actual and reasonable costs of the investigation and prosecution of the case, including the costs incurred and assessed for the time of the prosecuting attorney or attorneys, the investigator or investigators and any other persons involved in the investigation, prosecution and hearing of the case. The committee may limit, restrict or impose one (1) or more conditions on a license at the time it is issued, renewed or reinstated or as a sanction imposed at the conclusion of a disciplinary hearing.
  2. Any actions taken under this section shall only be effective after adoption by majority vote of the members of the committee and after adoption by a majority vote of the members of the board at the next board meeting at which administrative matters are considered following the adoption by the committee.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-204; Acts 1988, ch. 906, § 3; 1989, ch. 194, § 1; 1995, ch. 16, §§ 1-3; 1997, ch. 207, §§ 2-5; 2000, ch. 584, §§ 1, 2.

63-19-105. Qualifications and licensure.

  1. No person shall represent to be or function as a physician assistant under this part unless such person holds a valid physician assistant license or temporary license issued by the board. The board shall license no person as a physician assistant unless:
    1. The person is a graduate of a physician assistant training program accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association or its successor accrediting agency; and
    2. The person has successfully completed the examination of the National Commission on the Certification of Physician Assistants. A graduate of a physician assistant training program accredited by the Committee on Allied Health Education and Accreditation of the American Medical Association or its successor accrediting agency may receive a temporary license from the board allowing such individual to function as a physician assistant under this part:
      1. For a period of fifteen (15) months immediately following graduation to allow the person an opportunity to attempt the examination; and
      2. For a period of one (1) additional year thereafter in which to attempt and successfully complete the examination if the person is not successful on the first attempt; or
    3. Alternatively to subdivisions (a)(1) and (2), the person qualified as a physician assistant prior to April 26, 1983, and thereafter continued to represent to be or functioned as a physician assistant; and
    4. Notwithstanding subdivision (a)(3), the board shall not license any person as a physician assistant after July 1, 1991, unless such person meets the requirements of subdivisions (a)(1) and (2); provided, that the board may continue to issue license renewals to any person who was licensed as a physician assistant pursuant to subdivision (a)(3) prior to July 1, 1991.
    1. An individual licensed, registered or certified as a physician assistant in another jurisdiction may be licensed as a physician assistant by the board if such individual meets the requirements and standards of this part. Notwithstanding the requirements of subdivisions (a)(1)-(4), the board shall license an individual licensed, registered or certified as a physician assistant in another jurisdiction if such individual is a graduate of a physician assistant training program that was accredited by the accrediting committee of the American Medical Association at the time such individual graduated from the program, and such individual has practiced in that jurisdiction for a period of ten (10) consecutive years immediately prior to seeking certification in this state. Any reasonable expense incurred by the committee or the board in verifying the licensure, registration or certification by another jurisdiction of an applicant for licensure hereunder shall be charged to and paid by the applicant.
    2. While an individual's application is pending, the board may issue a temporary license to that individual if the individual is licensed, registered or certified as a physician assistant in another jurisdiction; provided, that the board finds that the application is complete. The temporary license will allow the individual to function as a physician assistant under this chapter. A temporary license issued under this subdivision (b)(2) shall be valid for a period of six (6) months and is not renewable.
  2. The board or the committee may require that an applicant for licensure as a physician assistant appear before the board or the committee to answer any questions regarding the applicant's fitness for licensure.
    1. The committee on physician assistants may authorize any of its members or its consultant to conduct a review of the qualifications of an applicant for a license to practice as a physician assistant in this state and to make an initial determination as to whether the applicant has met all the requirements for licensure. If the committee member or committee consultant determines that the applicant has met all the requirements for licensure, the applicant is then authorized to practice as a physician assistant in this state until the committee and the board of medical examiners make a final decision on the application for licensure. The committee may authorize the use of this procedure with respect to applicants for license renewal or reinstatement as well. In no event shall the temporary authorization issued pursuant to a determination made by the committee member or committee consultant be effective for longer than a six-month period measured from the date of issuance. This process shall not be utilized by the applicant more than once.
    2. If temporary authorization pursuant to subdivision (d)(1) is issued to an applicant for a license to practice as a physician assistant in this state and if the subsequent decision of the committee on physician assistants and the board of medical examiners is to deny the application based upon a good faith determination that the applicant has not, in fact, complied with all the requirements for licensure, then the doctrine of estoppel shall not apply against the state based upon its issuance of temporary authorization and its subsequent denial of licensure.
  3. Any person who possesses a certificate or temporary certificate issued by the board shall be deemed to possess a license or temporary license, respectively. At the time of renewal, a certificate holder who is approved for renewal shall receive a license from the board rather than a renewal of the certificate.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-205; Acts 1989, ch. 194, § 2; 1991, ch. 122, §§ 1-3, 6; 1993, ch. 247, § 1; 1995, ch. 16, §§ 4, 5; 1996, ch. 738, § 2; 1997, ch. 207, §§ 5, 6.

63-19-106. Authorized services — Collaboration.

    1. A physician assistant is authorized to perform selected medical services only in collaboration with a licensed physician.
    2. Collaboration requires active and continuous overview of the physician assistant's activities to ensure that the physician's directions and advice are in fact implemented, but does not require the continuous and constant physical presence of the collaborating physician. The board and the committee shall adopt, by September 19, 1999, regulations governing the collaborating physician's personal review of historical, physical and therapeutic data contained in the charts of patients examined by the physician assistant.
    3. The range of services that may be provided by a physician assistant shall be set forth in a written protocol, jointly developed by the collaborating physician and the physician assistant. The protocol shall also contain a discussion of the problems and conditions likely to be encountered by the physician assistant and the appropriate treatment for these problems and conditions. The physician assistant shall maintain the protocol at the physician assistant's practice location and shall make the protocol available upon request by the board of medical examiners, the committee on physician assistants or the authorized agents of the board or the committee.
    4. A physician assistant may perform only those tasks that are within the physician assistant's range of skills and competence, that are within the usual scope of practice of the collaborating physician and that are consistent with the protection of the health and well-being of the patients.
    5. The physician assistant may render emergency medical service in accordance with guidelines previously established by the collaborating physician pending the arrival of a responsible physician in cases where immediate diagnosis and treatment are necessary to avoid disability or death.
  1. A physician assistant shall, at all times, practice in collaboration with a licensed physician who has control of and responsibility for the services provided by the physician assistant and the duty of assuring that there is a proper collaboration with the physician and that the activities of the physician assistant are otherwise appropriate.
  2. Any rules that purport to regulate the collaboration of physician assistants with physicians shall be jointly adopted by the board of medical examiners and the committee on physician assistants.
  3. A physician assistant practicing in collaboration with a licensed podiatrist:
    1. Shall not provide services that are outside of the scope of practice of a podiatrist as set forth in § 63-3-101;
    2. Shall comply with the requirements of and any rules adopted pursuant to this section and § 63-19-107 governing the collaboration with a physician assistant; and
    3. May prescribe only drugs that are rational to the practice of podiatry.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-206; Acts 1994, ch. 722, § 1; 1995, ch. 358, § 2; 1996, ch. 659, § 3; 1998, ch. 842, § 4; 1999, ch. 33, § 1; 2015, ch. 189, § 1; 2016, ch. 946, § 4; 2018, ch. 610, §§ 5-13.

Amendments. The 2018 amendment, effective July 1, 2018, in (a), substituted “in collaboration with” for “under the supervision of” in (1); substituted “Collaboration” for “Supervision” in (2) and substituted “collaborating” for “supervising” throughout; rewrote (b) which read: “A physician assistant shall function only under the control and responsibility of a licensed physician.  There shall, at all times, be a physician who is answerable for the actions of the physician assistant and who has the duty of assuring that there is proper supervision and control of the physician assistant and that the assistant's activities are otherwise appropriate.”; substituted “collaboration of physician assistants with” for “supervision of physician assistants by” in (c); in (d), in the introductory language, substituted “practicing in collaboration with” for “supervised by” and substituted “collaboration with” for “supervision of” in (2).

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

Cross-References. Emergency medical services, title 68, ch. 140, part 5.

TennCare enabling provisions, §§ 71-5-10271-5-106, 71-5-134.

NOTES TO DECISIONS

1. Liability.

In a medical malpractice suit, summary judgment in favor of the doctor was improper as the patient's expert's testimony established a genuine issue of material fact under Tenn. Code Ann. § 29-26-115(a)(2) as to whether the patient suffered injuries as a proximate result of the doctor's omission in supervising his assistant and diagnosing the patient with cardiomyopathy, which resulted in a worsening condition, unwarranted pain and suffering, and resulting surgery. Cox v. M.A. Primary & Urgent Care Clinic, — S.W.3d —, 2009 Tenn. App. LEXIS 35 (Tenn. Ct. App. Jan. 30, 2009), rev'd, 313 S.W.3d 240, 2010 Tenn. LEXIS 553 (Tenn. June 21, 2010).

2. Compliance.

It was not the Legislature's intent to set forth two distinct duties, and the second sentence referencing the specific regulations merely elaborates on the broader general goal intended by the Legislature and sets forth how this broader goal of active and continuous overview of the physician assistant's activities is to be specifically accomplished; by presenting evidence demonstrating the doctor's compliance with the regulations referenced in the second sentence, he sufficiently proved that he maintained active and continuous overview of the physician assistant's activities sufficient for a grant of summary judgment. Buman v. Alycia D. Gibson, P.A., — S.W.3d —, 2014 Tenn. App. LEXIS 485 (Tenn. Ct. App. Aug. 11, 2014), appeal denied, Human v. Gibson, — S.W.3d —, 2015 Tenn. LEXIS 233 (Tenn. Mar. 12, 2015).

Trial court properly reversed the Drug Enforcement Administration (DEA) charges filed against a physician assistant (PA) because the interpretation of the Physician Assistants Act by the Department of Health was contrary to law and improperly placed the duty on the PA to determine whether a supervising physician was in compliance with an unwritten requirement that the physician be registered with the DEA to be able to supervise a physician assistant who prescribed controlled substances. Tenn. Dep't of Health v. Sparks, — S.W.3d —, 2019 Tenn. App. LEXIS 439 (Tenn. Ct. App. Sept. 6, 2019), appeal denied, — S.W.3d —, 2020 Tenn. LEXIS 30 (Tenn. Jan. 15, 2020).

Trial court did not err in awarding a physician assistant attorney fees and costs because the facts were not sufficient for the Department of Health to charge Sparks with a violation; the Physician Assistants Act does not include a requirement that a supervising physician be registered with the Drug Enforcement Administration, and the statutes governing health-related boards require them to give notice of changes in the applicable laws prior to bringing charges for enforcement. Tenn. Dep't of Health v. Sparks, — S.W.3d —, 2019 Tenn. App. LEXIS 439 (Tenn. Ct. App. Sept. 6, 2019), appeal denied, — S.W.3d —, 2020 Tenn. LEXIS 30 (Tenn. Jan. 15, 2020).

Trial court properly reversed the Drug Enforcement Administration (DEA) charges the Tennessee Board of Medical Examiners'  Committee on Physician Assistants filed against a physician assistant (PA) because to the extent the PA inadvertently prescribed controlled substances without the appropriate delegated authority due to her supervising physician not possessing a DEA registration, the error, if any, would be with the supervising physician. Tenn. Dep't of Health v. Sparks, — S.W.3d —, 2019 Tenn. App. LEXIS 439 (Tenn. Ct. App. Sept. 6, 2019), appeal denied, — S.W.3d —, 2020 Tenn. LEXIS 30 (Tenn. Jan. 15, 2020).

3. Negligence Per Se.

Legislature definitively set forth what is required of a physician supervising a physician's assistant and therefore, it is not the place of the court to impose additional burdens on a supervising physician; the Legislature has specifically set forth how negligence of supervising physicians is to be defined under the statute. Buman v. Alycia D. Gibson, P.A., — S.W.3d —, 2014 Tenn. App. LEXIS 485 (Tenn. Ct. App. Aug. 11, 2014), appeal denied, Human v. Gibson, — S.W.3d —, 2015 Tenn. LEXIS 233 (Tenn. Mar. 12, 2015).

4. Standard of Care.

Grant of summary judgment in favor of a clinic and supervising physician in the patient's action for injuries allegedly suffered as a result of a physician assistant's failure to diagnose her condition was appropriate because the professional standard of care applicable to physician assistants was distinct from that applicable to physicians and the patient introduced no expert proof as to any violation of the applicable standard of care. It was illogical to impose significant limitations on physician assistants and yet at the same time hold them to the same standard of care imposed upon their supervisors, T.C.A. § 63-19-106(b). Cox v. M.A. Primary & Urgent Care Clinic, 313 S.W.3d 240, 2010 Tenn. LEXIS 553 (Tenn. June 21, 2010).

5. Scope of Practice.

Executor suggested that summary judgment was improper because wound care was not within the doctor's usual scope of practice, as he stated only five percent of his practice involved wound care, and this was not “usual” as set forth in the statute; the fact that a physician is only spending five percent of his time on wound care is not significant, and the fact that a physician assistant's job has a much higher percentage of wound care, thereby freeing up the physician for more complex medical tasks, demonstrates the statute is accomplishing the legislature's intended goals. Buman v. Alycia D. Gibson, P.A., — S.W.3d —, 2014 Tenn. App. LEXIS 485 (Tenn. Ct. App. Aug. 11, 2014), appeal denied, Human v. Gibson, — S.W.3d —, 2015 Tenn. LEXIS 233 (Tenn. Mar. 12, 2015).

63-19-107. Practices for collaboration with physician assistants.

A licensed physician collaborating with physician assistants shall comply with the following practices:

  1. More than one (1) physician may collaborate with the same physician assistant; provided, each physician assistant shall have a primary collaborating physician and may have additional alternate collaborating physicians who shall collaborate with the physician assistant in the absence or unavailability of the primary collaborating physician. Each physician assistant shall notify the committee of the name, address, and license number of the physician assistant's primary collaborating physician and shall notify the committee of any change in such primary collaborating physician within fifteen (15) days of the change. The number of physician assistants for whom a physician may serve as the collaborating physician shall be determined by the physician at the practice level, consistent with good medical practice. The collaborating physician shall designate one (1) or more alternate physicians who have agreed to accept the responsibility of collaborating with the physician assistant on a prearranged basis in the collaborating physician's absence;
    1. In accordance with rules adopted by the board and the committee, a collaborating physician may delegate to a physician assistant working in collaboration with the physician the authority to prescribe and/or issue legend drugs and controlled substances listed in Schedules II, III, IV, and V of title 39, chapter 17, part 4. The rules adopted prior to March 19, 1999, by the board and the committee governing the prescribing of legend drugs by physician assistants shall remain effective after March 19, 1999, and may be revised from time to time as deemed appropriate by the board and the committee. The board and the committee may adopt additional rules governing the prescribing of controlled substances by physician assistants. A physician assistant to whom is delegated the authority to prescribe and/or issue controlled substances must register and comply with all applicable requirements of the drug enforcement administration;
      1. A physician assistant to whom the authority to prescribe legend drugs and controlled substances has been delegated by the collaborating physician shall file a notice with the committee containing the name of the physician assistant, the name of the licensed physician collaborating with the physician assistant who has responsibility for and control of prescription services rendered by the physician assistant and a copy of the formulary describing the categories of legend drugs and controlled substances to be prescribed and/or issued, by the physician assistant. The physician assistant shall be responsible for updating this information;
      2. Notwithstanding any other rule or law, a physician assistant 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. Any physician assistant to whom the authority to prescribe controlled drugs has been delegated by the collaborating physician may only prescribe or issue a Schedule II or III opioid listed on the formulary for a maximum of a nonrefillable, 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 (2)(B)(iii) shall not apply to prescriptions issued in a hospital, a nursing home licensed under title 68, or inpatient facilities licensed under title 33;
    2. The prescriptive practices of physician assistants and the collaborating physicians with whom such physician assistants are rendering services shall be monitored by the board and the committee. As used in this section, “monitor” does not include the regulation of the practice of medicine or the regulation of the practice of a physician assistant, but may include site visits by members of the board and committee;
    3. Any complaints against physician assistants and/or collaborating physicians shall be reported to the director of the division of health related boards, the committee on physician assistants and the board of medical examiners, as appropriate;
      1. Every prescription order issued by a physician assistant 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 physician assistant, and the physician assistant shall sign each prescription order so written. Where the preprinted prescription pad contains the names of more than one (1) physician, the physician assistant shall indicate on the prescription which of those physicians is the physician assistant'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 physician assistant 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 physician assistant, 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 physician assistant 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;
      3. Any typed or computer-generated prescription order for a drug issued by a physician assistant 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 physician assistant, 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 physician assistant 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;
      4. Nothing in this section shall be construed to prevent a physician assistant from issuing a verbal prescription order;
      5. (a)  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;
        1. (v)  (a)  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 (2)(E)(v)(a ) 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;
    4. No drugs shall be dispensed by a physician assistant except under the control and responsibility of the collaborating physician;
    5. [Deleted by 2018 amendment.]
    6. A physician assistant authorized to prescribe drugs under this subdivision (2), who provides services in a free or reduced fee clinic under the Volunteer Healthcare Services Act, compiled in chapter 6, part 7 of this title, may arrange for required personal review of the physician assistant'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 (2)(H), “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;
    7. A physician assistant authorized to prescribe drugs under this subdivision (2), who provides services in a community mental health center as defined in § 33-1-101, may arrange for the required personal review of the physician assistant's charts by a collaborating physician, with the same authority to render prescriptive services that the physician assistant 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 (2)(I), “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;
  2. The patient of any physician receiving services from that physician assistant shall be fully informed that the individual is a physician assistant and/or a sign shall be conspicuously placed within the office of the physician indicating that certain services may be rendered by a physician assistant;
  3. A physician who does not normally provide patient care is not authorized to collaborate with or utilize the services of a physician assistant; and
    1. A physician assistant 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 subdivision (5)(A) 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);
    2. For purposes of this subdivision (5), “direct supervision” is defined as being physically present in the same building as the physician assistant at the time the invasive procedure is performed;
    3. This subdivision (5) shall not apply to a physician assistant 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 1985, ch. 376, § 1; T.C.A., § 63-19-207; Acts 1994, ch. 722, § 2; 1996, ch. 659, §§ 4, 5; 1998, ch. 842, §§ 5-7; 1999, ch. 33, §§ 2, 3; 2000, ch. 584, § 3; 2002, ch. 527, § 1; 2004, ch. 678, § 10; 2005, ch. 12, § 8; 2008, ch. 1035, §§ 8, 9; 2010, ch. 795, §§ 7, 18; 2012, ch. 961, § 3; 2013, ch. 74, § 8; 2013, ch. 396, § 2; 2016, ch. 769, § 2; 2018, ch. 610, §§ 14-24; 2018, ch. 883, § 9; 2019, ch. 183, § 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 non-prescription 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.

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 2018 amendment by ch. 610 substituted “A licensed physician collaborating with” for “A licensed physician supervising”; in (1), substituted “collaborate with” for “supervise” twice and substituted “collaborating” for “supervising” throughout; in (2), substituted “a collaborating physician may delegate to a physician assistant working in collaboration with the physician” for “a supervising physician may delegate to a physician assistant working under the physician's supervision” in (A); substituted “collaborating physician” for “supervising physician” throughout (B); substituted “collaborating with the physician assistant who has responsibility for and control of prescription services rendered by the physician assistant” for “having supervision, control and responsibility for prescription services rendered by the physician assistant” in (B)(i); in (C), substituted “collaborating” for “supervision by”, “with” for “under” and “services” for “service” and inserted “the” preceding “committee”; in (D) and (E)(i), substituted “collaborating” for “supervising” throughout; substituted “the control and responsibility of the collaborating physician” for “the supervision, control and responsibility of the supervising physician” in (F); substituted “collaborating” for “supervising” in (H); and substituted “collaborate with” for “supervise” in (4).

The 2018 amendment by ch. 883, effective January 1, 2019, deleted former (2)(G) which read: “Any written, printed or computer-generated prescription order for a Schedule II controlled substance prepared by a physician assistant who is authorized by law to prescribe a drug must be legibly printed or typed as a separate prescription. The written, printed or computer-generated prescription order must contain all information otherwise required by law. The prescribing physician assistant must sign the written, printed or computer-generated prescription order on the day it is issued;”.

The 2019 amendment added (2)(I).

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

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. Legend drugs, §§ 53-10-104, 53-10-105.

Pharmacy, title 63, ch. 10.

Physician assistants, §§ 63-19-106, 63-19-107.

TennCare enabling provisions, §§ 71-5-10271-5-106, 71-5-134.

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).

NOTES TO DECISIONS

1. Registration.

Trial court properly reversed the Drug Enforcement Administration (DEA) charges the Tennessee Board of Medical Examiners'  Committee on Physician Assistants filed against a physician assistant (PA) because to the extent the PA inadvertently prescribed controlled substances without the appropriate delegated authority due to her supervising physician not possessing a DEA registration, the error, if any, would be with the supervising physician. Tenn. Dep't of Health v. Sparks, — S.W.3d —, 2019 Tenn. App. LEXIS 439 (Tenn. Ct. App. Sept. 6, 2019), appeal denied, — S.W.3d —, 2020 Tenn. LEXIS 30 (Tenn. Jan. 15, 2020).

Trial court properly reversed the Drug Enforcement Administration (DEA) charges filed against a physician assistant (PA) because the interpretation of the Physician Assistants Act by the Department of Health was contrary to law and improperly placed the duty on the PA to determine whether a supervising physician was in compliance with an unwritten requirement that the physician be registered with the DEA to be able to supervise a physician assistant who prescribed controlled substances. Tenn. Dep't of Health v. Sparks, — S.W.3d —, 2019 Tenn. App. LEXIS 439 (Tenn. Ct. App. Sept. 6, 2019), appeal denied, — S.W.3d —, 2020 Tenn. LEXIS 30 (Tenn. Jan. 15, 2020).

2. Attorney's Fees.

Trial court did not err in awarding a physician assistant attorney fees and costs because the facts were not sufficient for the Department of Health to charge Sparks with a violation; the Physician Assistants Act does not include a requirement that a supervising physician be registered with the Drug Enforcement Administration, and the statutes governing health-related boards require them to give notice of changes in the applicable laws prior to bringing charges for enforcement. Tenn. Dep't of Health v. Sparks, — S.W.3d —, 2019 Tenn. App. LEXIS 439 (Tenn. Ct. App. Sept. 6, 2019), appeal denied, — S.W.3d —, 2020 Tenn. LEXIS 30 (Tenn. Jan. 15, 2020).

63-19-108. Unlicensed medical practice by assistants.

Any physician assistant rendering professional services inconsistent with this part shall be considered to be practicing medicine without a license and shall be subject to appropriate legal action by the board of medical examiners.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-208; Acts 1988, ch. 906, § 4.

63-19-109. Unprofessional conduct by physician supervising physician assistant.

When any licensed physician utilizes the services of a physician assistant or orthopedic physician assistant inconsistent with this chapter, it constitutes grounds for a finding of unprofessional conduct; and the physician is subject to disciplinary action by the board of medical examiners in accordance with § 63-6-214, the board of osteopathic examination in accordance with § 63-9-111, or the board of podiatric medical examiners in accordance with § 63-3-119. Such disciplinary action includes, but is not limited to, the suspension of privileges to utilize a physician assistant or an orthopedic physician assistant or the suspension or revocation of a physician's license to practice medicine, osteopathic medicine, or podiatry in Tennessee.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-209; Acts 1992, ch. 604, § 3; 2016, ch. 946, § 5.

63-19-110. Exemptions.

  1. Nothing in this part shall be construed to:
    1. Modify or supersede any existing laws relating to other paramedical professions or services;
    2. Permit a physician assistant to:
      1. Measure the powers or range of human vision, or determine the refractive state of the human eye or the scope of its functions in general or prescribe or direct the use of ophthalmic lenses or prisms to remedy or relieve defects of vision or muscular anomalies;
      2. Prescribe or fit or adapt contact lenses to or for the human eye;
      3. Practice chiropractic or to analyze or palpate the articulations of the spinal column for the purposes of giving a spinal adjustment; or
    3. Prohibit a physician assistant from testing visual acuity or performing routine vision screening.
  2. Nothing in this part applies to registered nurses or licensed practical nurses utilized by a physician under § 63-6-204 or § 63-9-113, or to technicians, other assistants or employees of a physician not rendering services as a physician assistant and who perform delegated tasks in the office of a physician or to students enrolled in physician assistant training programs accredited by the committee on Allied Health Education and Accreditation of the American Medical Association.

Acts 1985, ch. 376, § 1; T.C.A, § 63-19-210; Acts 1988, ch. 906, § 5; 1991, ch. 122, § 4; 1992, ch. 604, § 4.

63-19-111. Administrative proceedings.

All administrative proceedings for disciplinary action against a license holder under this part shall be conducted by the board in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-211; Acts 1997, ch. 207, § 5.

63-19-112. [Reserved.]

Any person licensed by the board as a physician assistant who has retired or may retire from such practice in this state is not required to biennially renew the person's license as required by this part, if such person files with the board an affidavit on a form to be furnished by the board, which affidavit states the date on which the person retired from practice and any other facts, as the board considers necessary, that tend to verify such retirement. If such person thereafter reengages in practice in this state, such person shall apply for licensure by the board as provided by this part and shall not be liable for payment of licensure renewal fees that accrued during the period of retirement.

Acts 1985, ch. 376, § 1; T.C.A., § 63-19-213; Acts 1997, ch. 207, § 5.

63-19-114. Use of title “physician assistant” or abbreviations “PA” or “PA-C.”

Any person who holds a valid license or temporary license from the board shall have the right to use the title “physician assistant” or the abbreviations “PA” or “PA-C.” No other person may assume that title or use such abbreviations, or any words, signs, letters, or devices to indicate that the person using them is a physician assistant; provided, that this section shall not apply to public accountants or certified public accountants, and nothing in this section shall prevent a public accountant from using the abbreviation “P.A.”

Acts 1991, ch. 122, § 5; 1997, ch. 207, § 5.

63-19-115. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.

A physician assistant licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of medical examiners and its committee on physician assistants may issue a special volunteer license, as defined in § 63-1-201, to qualified applicants without fee or charge. Such license shall be for a period of two (2) years and may be renewed on a biennial basis.

Acts 2004, ch. 579, § 9.

Part 2
Orthopedic Physician Assistants

63-19-201. Jurisdiction — Duties of the committee.

  1. Licensed orthopedic physician assistants shall be under the jurisdiction of the committee on physician assistants created by § 63-19-103 and the board of medical examiners.
  2. The committee on physician assistants has the duty to:
    1. Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are reasonably necessary for the performance of the duties of orthopedic physician assistants, including, but not limited to, rules that specify the acts and offenses that subject the license holder to disciplinary action by the committee pursuant to subdivision (b)(7);
    2. Set fees relative to the examination, licensure and licensure renewal of orthopedic physician assistants in an amount sufficient to pay all of the expenses of the committee, as well as all of the expenses of the board that are directly attributable to the performance of its duties pursuant to this part and to establish and collect a late renewal fee from those orthopedic physician assistants who fail to renew their licenses in a timely manner;
    3. Review and approve or reject the qualifications of each applicant for initial licensure as an orthopedic physician assistant;
    4. Biennially review and approve or reject the qualifications of each applicant for biennial licensure renewal. The committee shall condition approval for renewal on the receipt of evidence satisfactory to the committee of the applicant's successful completion of sixty (60) hours of continuing medical education approved by the American Medical Association or other appropriate professional association. The committee may, in its discretion, waive or modify the continuing medical education requirement in cases of retirement, illness, disability or other undue hardship;
    5. Issue, in the board's name, all approved orthopedic physician assistant licenses and renewals;
    6. Collect or receive all fees, fines and moneys owed pursuant to this part and pay the fees, fines and moneys into the general fund of the state. For the purpose of implementing subdivision (b)(2), all fees, fines and moneys collected pursuant to the regulation of orthopedic physician assistants shall be so designated; and
    7. Deny, suspend or revoke the license of, or otherwise discipline by a fine not to exceed five hundred dollars ($500), or by reprimand, a license holder who is guilty of violating any provisions of this part or who is guilty of violating the rules of the board promulgated pursuant to subdivision (b)(1). When sanctions are imposed on a licensee pursuant to this subdivision (b)(7), the licensee may, in addition, be required to pay the actual and reasonable costs of the investigation and prosecution of the case, including the costs incurred and assessed for the time of the prosecuting attorney or attorneys, the investigator or investigators and any other persons involved in the investigation, prosecution and hearing of the case. The committee may limit, restrict or impose one (1) or more conditions on a license at the time it is issued, renewed or reinstated or as a sanction imposed at the conclusion of a disciplinary hearing.
  3. The governor shall appoint one (1) certified orthopedic physician assistant to serve as a voting member of the committee on physician assistants with regard to all matters that pertain to orthopedic physician assistants. Each person appointed to this seat on the committee shall serve a term of four (4) years and shall be eligible for reappointment. A vacancy in this position shall be filled for the balance of the unexpired term.
  4. Any actions taken under this section shall only be effective after adoption by majority vote of the members of the committee on physician assistants and after adoption by a majority vote of the members of the board of medical examiners at the next board meeting at which administrative matters are considered following the adoption by the committee.
  5. For the purposes of this part, unless the context requires otherwise, “physician” means a person lawfully licensed to practice orthopedic medicine and surgery pursuant to chapter 6 of this title, osteopathic medicine pursuant to chapter 9 of this title, or podiatry pursuant to chapter 3 of this title.

Acts 1995, ch. 337, § 3; 1997, ch. 207, §§ 5, 7, 8; 2016, ch. 946, § 6.

63-19-202. Licensure requirement.

  1. No person shall claim to be or function as an orthopedic physician assistant unless such person holds a valid orthopedic physician assistant license issued by the board.
  2. The board shall license no person as an orthopedic physician assistant unless:
    1. The person is a graduate of an orthopedic physician assistant training program deemed adequate by the committee on physician assistants and the board of medical examiners; and
    2. The person has successfully completed the examination of the National Board for Certification of Orthopedic Physician Assistants; or
    3. Alternatively to the requirements of subdivisions (b)(1) and (2), the person may be licensed as an orthopedic physician assistant if the person has successfully completed the examination of the National Board for Certification of Orthopedic Physician Assistants and was performing services as an orthopedic physician assistant in this state on May 30, 1995.
  3. The board or the committee may require that an applicant for licensure as an orthopedic physician assistant appear before the board or the committee to answer any questions regarding the applicant's fitness for licensure.

Acts 1995, ch. 337, § 4; 1997, ch. 207, § 5.

Attorney General Opinions. Constitutionality and construction of subdivision (b)(3)'s alternative licensure provision, OAG 98-059 (3/9/98).

63-19-203. Collaboration with orthopedic physician assistant.

  1. A licensed orthopedic physician assistant is authorized to perform services only in collaboration with a licensed orthopedic physician or surgeon within the specialty of orthopedic medicine and surgery, or in collaboration with a licensed podiatrist.
  2. Collaboration between a collaborating physician and a licensed orthopedic physician assistant shall require active and continuous overview by the collaborating physician to ensure that the physician's directions, orders, and advice are in fact being implemented, but does not require the constant physical presence of the collaborating physician. The collaborating physician shall, however, make a personal review of historical, physical, and therapeutic data on all patients and their condition and so certify by personal signature in a timely manner.
  3. An orthopedic physician assistant collaborating with a licensed podiatrist:
    1. Shall not provide services that are outside of the scope of practice of a podiatrist as set forth in § 63-3-101; and
    2. Shall comply with the requirements of and any rules adopted pursuant to §§ 63-19-203 — 63-19-205 governing collaboration with a physician assistant.

Acts 1995, ch. 337, § 5; 1997, ch. 207, § 5; 2016, ch. 946, §§ 7, 8; 2018, ch. 610, §§ 25-28.

Amendments. The 2018 amendment substituted “in collaboration with” for “under the supervision of” twice in (a); in (b), substituted “Collaboration between a collaborating physician and a” for “Supervision of the” at the beginning and substituted “collaborating” for “supervising” throughout; in (c), substituted “collaborating with” for “supervised by” in the introductory language and substituted “collaboration with” for “the supervision of” in (2).

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

63-19-204. Standard of care.

  1. The licensed orthopedic physician assistant shall function in accordance with written policies and procedures involving management of care that have been established by the collaborating physician and the orthopedic physician assistant.
  2. With respect to follow-up care rendered in a clinic, hospital, nursing home or patient's home and in similar situations where a therapeutic regimen, policy or protocol has been established by the collaborating physician, the licensed orthopedic physician assistant may check and record the patient's progress within the confines of the written regimen, policy or protocol and report the patient's progress and changes to the physician after each visit. When a new problem arises, the collaborating physician shall undertake personal review of the patient's problem or complaint.
  3. The orthopedic physician assistant may render emergency services in accordance with guidelines previously established by the collaborating physician, pending the arrival of a responsible physician in cases where immediate diagnosis and treatment are necessary to avoid disability or death.

Acts 1995, ch. 337, § 6; 1997, ch. 207, § 5; 2018, ch. 610, § 29.

Amendments. The 2018 amendment substituted “collaborating physician” for “supervising physician” throughout the section.

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

63-19-205. Practices of collaborating physician.

A licensed physician who is collaborating with orthopedic physician assistants shall comply with the following practices:

  1. No one (1) collaborating physician shall collaborate with more than two (2) licensed orthopedic physician assistants at any one time;
  2. More than one (1) physician may collaborate with the same licensed orthopedic physician assistant;
  3. The collaborating physician shall designate one (1) or more alternate physicians who have agreed to accept the responsibility of collaborating with the orthopedic physician assistant on a prearranged basis in the absence of the collaborating physician;
  4. The licensed orthopedic physician assistant shall render services and care commensurate with such orthopedic assistant's education, training and experience;
  5. The licensed orthopedic physician assistant shall not make any definitive diagnosis or prescribe any treatment program independent of the collaborating physician;
  6. Pre-signed prescriptions shall not be used by the licensed orthopedic physician assistant. Medications dispensed by the licensed orthopedic physician assistant shall be approved by the collaborating physician; and
  7. The patient of any physician receiving services from a licensed orthopedic physician assistant shall be fully informed that the individual is a licensed orthopedic physician assistant and/or a sign shall be conspicuously placed within the office of the physician indicating that certain services may be rendered by a licensed orthopedic physician assistant.

Acts 1995, ch. 337, § 7; 1997, ch. 207, § 5; 2016, ch. 946, § 9; 2018, ch. 610, §§ 30-32.

Amendments. The 2018 amendment substituted “collaborating physician” for “supervising physician”, “collaborating with” for “supervising” and “collaborate with” for “supervise” throughout the section.

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

63-19-206. Unauthorized practice.

Any licensed orthopedic physician assistant rendering services inconsistent with this part shall be considered to be practicing medicine without a license and shall be subject to appropriate legal action by the board of medical examiners.

Acts 1995, ch. 337, § 8; 1997, ch. 207, § 5.

63-19-207. Unauthorized utilization of services.

When a licensed orthopedic physician or surgeon utilizes the services of a licensed orthopedic physician assistant inconsistent with this part, it shall constitute grounds for a finding of unprofessional conduct, and the physician shall be subject to disciplinary action by the board of medical examiners. Such disciplinary action may include, but is not limited to, the suspension of privileges to utilize a licensed orthopedic physician assistant or the revocation or suspension of the license of the orthopedic physician or surgeon.

Acts 1995, ch. 337, § 9; 1997, ch. 207, § 5.

63-19-208. Scope.

  1. Nothing in this part shall be construed to modify or supersede any existing laws or rules pertaining to any other allied health professionals, professions, or services.
  2. Nothing in this part shall permit a licensed orthopedic physician assistant to:
    1. Practice chiropractic or analyze or palpate the articulations of the spinal column for the purposes of giving a spinal adjustment; or
    2. Measure the powers or range of human vision, or determine the refractive state of the human eye or the scope of its functions in general, or prescribe or direct the use of opthalmic lenses or prisms to remedy or relieve defects of vision or muscular anomalies or prescribe or fit or adapt contact lenses to or for the human eye.
  3. This part does not apply to other physician extenders, physician assistants, family nurse practitioners, registered nurses, licensed practical nurses, technologists, technicians and other assistants or employees that perform delegated services in a medical setting.

Acts 1995, ch. 337, § 10; 1997, ch. 207, § 5.

63-19-209. Retired orthopedic physician assistant.

Any person licensed by the board as an orthopedic physician assistant who has retired from such practice in this state shall not be required to biennially renew such person's license as required by this part, if such person files an affidavit on a form furnished by the board. Such affidavit shall state the date on which the person retired from practice and any other information deemed necessary by the board. If such person decides to reengage in practice in this state, such person shall apply for licensure as provided by this part and shall not be liable for payment of licensure renewal fees that accrued during the period of retirement.

Acts 1995, ch. 337, § 11; 1997, ch. 207, § 5.

63-19-210. Correct title.

Any person who holds a valid license from the board of medical examiners under this part may use the title “orthopedic physician assistant” or the abbreviation “OPA-C” or “OPA,” but such person shall not use the title “physician assistant” or the abbreviation “PA” or “PA-C.”

Acts 1995, ch. 337, § 12; 1996, ch. 771, § 6; 1997, ch. 207, § 5.

63-19-113. Licensure renewal by retired physician assistants.

Chapter 20
[Reserved]

Chapter 21
[Reserved]

Chapter 22
Professional Counselors, Marital and Family Therapists, and Clinical Pastoral Therapists

Part 1
Professional Counselors, Marital and Family Therapists

63-22-101. Creation of board — Composition — Members — Terms — Compensation — Meetings — Administrative functions.

  1. There is hereby created the board for professional counselors, marital and family therapists and clinical pastoral therapists, referred to as the “board” in this chapter.
    1. The board shall consist of five (5) members who shall be appointed by the governor.
      1. Members of the board may be appointed from lists of qualified persons submitted by interested counseling and therapy groups including, but not limited to, the Tennessee Counseling Association, the Tennessee Association for Marriage and Family Therapy, the Tennessee Association of Pastoral Therapists, and the Tennessee Licensed Professional Counselors Association.
      2. In making appointments to the board, the governor shall consult with interested counseling and therapy groups including, but not limited to, the organizations listed in subdivision (b)(2)(A) to determine qualified persons to fill the positions.
    2. The fifth member shall be a citizen-at-large appointed by the governor.
    3. All board members shall be resident citizens of Tennessee.
    4. Board candidates shall be licensed or certified prior to nomination except for the fifth member who shall be a citizen-at-large.
    1. Each member of the board shall serve for a term of five (5) years.
    2. With the exception of the citizen-at-large member, a board member who vacates the member's seat may be replaced by a person from the same profession as that of the vacating member.
    3. A vacancy of the citizen-at-large board position shall be replaced by a person appointed by the governor.
    4. Members whose terms of office have expired shall continue to serve until their replacements are named.
    5. In making appointments to the board, 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.
  2. A majority of the members to which the board is entitled constitutes a quorum.
  3. Each member of the board shall receive fifty dollars ($50.00) per diem expenses when actually engaged in the discharge of the member's official duties and all legitimate and necessary expenses incurred in attending the meetings of the board. Each member shall be reimbursed for travel expenses in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  4. The board shall choose one (1) of its members president, one (1) vice president and one (1) secretary-treasurer thereof, at each annual meeting, held in July, at such place as may be selected or designated by the board. The board may meet more often if necessary, in the discretion of the board, at such times and places as it may deem proper, for the examination of applicants and for the transaction of any business that may come before it.
    1. The administrative functions and duties of the board are vested in the division of health related boards, referred to as “division” in this chapter. The division shall employ such persons as may be necessary for the effective and efficient discharge of the duties of the board.
    2. Such administrative assistants and other employees shall be reimbursed for travel expenses in accordance with the provisions of the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
  5. In making appointments to the board, the governor should consider the importance of geographical diversity to this board. Whenever practicable, the governor shall strive to ensure that members on the board are from each of the three (3) grand divisions of the state.

Acts 1984, ch. 933, § 2; 1985, ch. 77, § 1; 1988, ch. 1013, § 57; 1991, ch. 141, §§ 1-3; 1991, ch. 421, §§ 1-4; 1997, ch. 485, §§ 1-3; 2000, ch. 832, §§ 1, 2; 2015, ch. 86, §§ 3-5.

Compiler's Notes. The board for professional counselors, marital and family therapists, and clinical pastoral therapists, created by this section, terminates June 30, 2023. See §§ 4-29-112, 4-29-244.

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

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

63-22-102. Powers and duties of board.

The board shall:

  1. Adopt rules and regulations in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as are necessary to carry out and make effective this part;
  2. Review the credentials of licensure of applicants to determine if they are eligible for licensure, upon payment of a nonrefundable fee as set by the board;
  3. Prepare or select and administer examinations to applicants for licensure;
  4. License as professional counselors applicants who satisfy the requirements of §§ 63-22-104, 63-22-107 and 63-22-110 and establish by rule any additional qualifications of the applicants necessary for the practice of professional counseling as provided in this part;
  5. Review the credentials for licensure of marital and family therapy applicants to determine if they are eligible for licensure upon payment of a nonrefundable review fee as set by the board;
  6. Prepare or select and administer examinations to marital and family therapist applicants for licensure;
  7. License as marital and family therapists applicants who satisfy the requirements of §§ 63-22-106, 63-22-107 and 63-22-108 or § 63-22-103;
  8. Set continuing education requirements for renewal of licenses and certificates;
  9. Renew, revoke and reinstate licenses and certificates as described in §§ 63-22-108 and 63-22-110;
  10. Review the credentials of clinical pastoral therapist applicants to determine if they are eligible for certification upon payment of a nonrefundable review fee as set by the board;
  11. Prepare or select and administer examinations to clinical pastoral therapy applicants for certification; and
  12. Certify clinical pastoral therapists who satisfy the requirements of § 63-22-203.

Acts 1984, ch. 933, § 3; 1989, ch. 523, § 99; 1991, ch. 141, § 4; 1991, ch. 421, § 5; 1995, ch. 318, § 1; 1997, ch. 485, § 4.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-22-103. Reciprocity — Licensure without examination — Licensure by endorsement.

  1. The board may license without examination a marital and family therapist applicant who is licensed in another state if the applicant's qualifications meet the licensure requirements under this part. The board may license by endorsement an applicant who is a clinical member of the American Association for Marriage and Family Therapy if that person otherwise meets the requirements of this part.
  2. The board may enter into a reciprocal agreement with any other state that licenses, certifies or registers marital and family therapists, if the board finds that such state has substantially the same or higher licensure requirements than Tennessee.

Acts 1984, ch. 933, § 4; 1991, ch. 141, § 5; 1991, ch. 421, § 6.

63-22-104. Professional counselors — Fees — Qualifications.

An applicant for licensure as a professional counselor shall pay the board a nonrefundable fee as set by the board and shall satisfy the board that the applicant:

  1. Is at least eighteen (18) years of age;
  2. Is of good moral character;
    1. Has obtained a minimum of sixty (60) graduate hours in counseling or a closely related field and which includes a master's degree in counseling; and
    2. Has completed a supervised field experience as either a practicum or internship that includes a minimum of five hundred (500) clock hours of training, at least three hundred (300) of which must be completed in a mental health or community agency setting. This field experience must be supervised by an individual with at least a master's degree in counseling, social work, psychology or psychiatry;
  3. Has had at least two (2) years of professional experience of a type judged to be acceptable by the board subsequent to being granted a master's degree and has not violated § 63-22-110;
  4. Has passed the examination offered by the National Board for Certified Counselors (NBCC) or such other examination approved by the board; and
  5. Has met any additional criteria of the board established by rule.

Acts 1984, ch. 933, § 5; 1989, ch. 523, § 100; 1991, ch. 421, §§ 8-10; 1995, ch. 318, § 2.

Cross-References. Licensure, §§  63-1-10363-1-112.

63-22-105. [Reserved.]

An applicant for licensure as a marital and family therapist shall pay the board a nonrefundable fee as set by the board and shall satisfy the board that the applicant:

  1. Is at least eighteen (18) years of age;
  2. Is of good moral character;
  3. Has met standards set by the board no less stringent than the American Association for Marriage and Family Therapy's standards for a clinical member so long as such standards specify a minimum of a master's level degree; and
  4. Shall pass such examination as may be administered by the board. Applicants shall bear the fee for testing in addition to the review fee and application fee.

Acts 1984, ch. 933, § 7; 1985, ch. 77, § 2; 1989, ch. 523, § 102; 1991, ch. 141, § 6.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-22-107. Educational requirements and examinations.

  1. On and after July 1, 1991, an applicant for licensure as a professional counselor shall meet the requirements of §§ 63-22-104 and 63-22-110 and, in addition, shall pass an examination as adopted and administered by the board.
  2. Effective July 1, 1991, no additional certificates for professional counselors shall be issued by the board. Those persons so certified as professional counselors on or before June 30, 1991, may retain their certification indefinitely by meeting current renewal requirements and may upgrade from certification to licensure by any of the following methods:
    1. Complying with this part;
    2. Becoming certified by the National Board for Certified Counselors (NBCC); or
    3. Verifying, to the board's satisfaction, that such person has had five (5) prior years' work experience as a certified professional counselor in this state or another state with certification standards that are at least the equivalent of those of this state.
  3. An applicant for licensure on or after July 1, 1991, as a licensed marital and family therapist, shall meet the requirements of § 63-22-103(a) or § 63-22-106, and, in addition, shall pass such examinations as may be administered by the board. After July 1, 1991, no additional marital and family therapist certifications will be issued. Those persons so certified as of July 1, 1991, as marital and family therapists may maintain certification or may upgrade from certification to licensure by any of the following methods:
    1. By acquiring the minimum standards provided in § 63-22-106(3);
    2. By receiving two hundred (200) hours clinical supervision from not more than two (2) supervisors deemed qualified by the board; or
    3. By validating fifteen (15) years of clinical practice while maintaining certification by continuing a practice of marital and family therapy.
  4. On or after July 1, 1995, an applicant for licensure as a professional counselor designated as a mental health service provider shall meet the requirements of §§ 63-22-104, 63-22-110 and 63-22-120.
  5. Until June 30, 1997, a currently licensed professional counselor who wishes to obtain designation as a mental health service provider may do so by documenting both training and experience relative to the diagnosis, treatment, appraisal and assessment of mental disorders or by documenting training and experience in teaching these courses for a minimum of three (3) years as a university professor. The training and experience documented must be substantially equivalent to that required for new licensed professional counselors designated as mental health service providers.
  6. Any licensed professional counselor who does not wish to secure designation as a mental health service provider may maintain a professional counselor license, but is ineligible to appraise, assess, diagnose or treat conditions attributable to a mental disorder.

Acts 1984, ch. 933, § 8; 1985, ch. 77, § 3; 1991, ch. 141, § 7; 1991, ch. 421, § 12; 1995, ch. 318, § 3.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-22-108. Renewal, revocation and reinstatement of licenses or certificates — Fees — Disposition of funds — Operating expenses — Retirement.

  1. Each and every license or certificate holder shall pay to the secretary-treasurer of the board a renewal fee to be fixed by the board and shall submit verification of compliance of continuing education requirements as may be set by the board. The secretary of the board shall notify the holder of each license or certificate that the renewal fee is due, and the failure to pay such renewal fee by any license or certificate holder at the expiration of sixty (60) days after the renewal fee is due constitutes a violation of this part. Any license or certificate not renewed within sixty (60) days of the renewal date shall be revoked without further notice, but may be reinstated, if continuing education requirements have been met, upon payment of all past due renewal fees and a penalty per license or certificate.
  2. All fees coming into the possession of the board shall be paid by the board to the state treasurer and become a part of the general fund.
  3. The commissioner of finance and administration shall make allotments out of the general fund for the proper expenditures of the board and no expenditure shall be made by the board until allotment for the expenditure has been made by the commissioner. Such allotments for the operation of the board shall be disbursed under the general budgetary laws of the state.
  4. Any person licensed to practice by this chapter who has retired or may hereafter retire from such practice in this state shall not be made to register as required by this part if such person shall file with this board an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this part and shall meet other requirements as may be set by the board.
    1. Notwithstanding this part 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 (e)(1).

Acts 1984, ch. 933, § 9; 1985, ch. 77, § 4; 1986, ch. 675, § 12; 1989, ch. 360, §§ 58-61; 1989, ch. 523, § 103; 1991, ch. 141, § 8; 1991, ch. 421, § 13.

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

Licensure, §§  63-1-10363-1-112.

63-22-109. [Obsolete.]

Code Commission Notes.

Former § 63-22-109 (Acts 1984, ch. 933, § 10; 1989, ch. 591, § 112; 1991, ch. 141, § 9; 1991, ch. 421, § 14), concerning certification requirements and penalties for violations, was so amended by 1991, chs. 141 and 421 as to be rendered obsolete, and the remaining provisions have thus been deleted. For new law, see § 63-22-117.

63-22-110. Denial, withholding, restricting or revoking licensure or certification — Disciplinary actions — Unprofessional conduct.

  1. The board has the power to:
    1. Deny an application for a license to any applicant who applies for the same through reciprocity or otherwise;
    2. Permanently or temporarily withhold issuance of a license or certificate;
    3. Suspend, limit or restrict a previously issued license or certificate for such time and in such manner as the board may determine;
    4. Reprimand or take such action in relation to disciplining an applicant or license or certificate holder as the board in its discretion may deem proper; or
    5. Permanently revoke a license or certificate.
  2. The grounds upon which the board shall exercise such power includes, but is not limited to, the following:
    1. Conviction of a felony;
    2. Using fraud or deception in applying for a license or certificate or in taking an examination required by this part;
    3. Violating the rules and regulations adopted by the board, except that a violation of A.11.b of the 2014 American Counseling Association Code of Ethics, or any similar or successor provision, shall not be grounds upon which the board shall exercise its powers pursuant to subsection (a); provided, however, that a violation of A.11.b shall be a ground for the board to exercise these powers in cases involving an individual seeking or undergoing counseling where the individual was in imminent danger of harming themselves or others; or
    4. Engaging in professional misconduct, unethical or unprofessional conduct, including, but not limited to, willful acts, negligence and conduct likely to deceive, defraud or harm the public or engaged in such conduct.
  3. The board has the power to:
    1. Deny an application for a license to any marital and family therapist applicant who applies for the same through reciprocity or otherwise where the applicant does not meet the standards in this part;
    2. Permanently or temporarily withhold issuance of a marital and family therapist license where the applicant does not meet the standards in this part;
    3. Suspend, limit or restrict a previously issued license or certificate for such time and in such manner as the board may determine;
    4. Reprimand or take such action in relation to disciplining an applicant or license holder or certificate holder as the board in its discretion may deem proper; or
    5. Permanently revoke a license or certificate.
  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 1984, ch. 933, § 11; 1991, ch. 141, §§ 11, 12; 1991, ch. 421, § 16; 2016, ch. 926, § 2; 2018, ch. 745, § 36.

Amendments. The 2018 amendment added (d).

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

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

63-22-111. Reinstatement of revoked license or certificate.

A person whose license or certificate has been revoked by the board is not eligible to apply for reinstatement earlier than one (1) year from the date of revocation.

Acts 1984, ch. 933, § 12; 1991, ch. 141, § 13; 1991, ch. 421, § 17.

63-22-112. [Repealed.]

Compiler's Notes. Former § 63-22-112 (Acts 1984, ch. 933, § 13), concerning the advisory council to the board, was repealed by Acts 1985, ch. 77, § 5.

63-22-113. Exemptions.

  1. This part does not apply to a person if the person is preparing for the practice of marital and family therapy under qualified supervision in a training institution or facility or supervisory arrangement recognized and approved by the board; provided, that such person is designated by such titles as “marital therapy intern,” “family therapy trainee” or others clearly indicating such training status.
  2. Nothing in this part shall be construed to prevent qualified members of other professional groups as defined by the board, including, but not limited to, licensed clinical social workers, licensed psychologists, licensed psychological examiners, licensed senior psychological examiners, certified psychological assistants, psychiatric nurses, physicians, attorneys at law or members of the clergy from doing or advertising that they perform the work of a marital and family therapy nature consistent with the accepted standards of their respective professions, nor to prevent alcohol and drug abuse counselors licensed under § 68-24-605 or operating under qualified supervision while seeking such certification from doing counseling consistent with the accepted standards of that profession.

Acts 1984, ch. 933, § 14; 1985, ch. 77, § 6; 1990, ch. 760, § 1; 1991, ch. 141, § 14; 1991, ch. 421, § 18; 1992, ch. 830, § 2; 2001, ch. 334, § 13; 2009, ch. 186, § 8.

63-22-114. Confidentiality.

The confidential relations and communications between licensed marital and family therapists, licensed professional counselors or certified clinical pastoral therapists and clients are placed upon the same basis as those provided by law between attorney and client, and nothing in this part shall be construed to require any such privileged communication to be disclosed. However, nothing contained within this section shall be construed to prevent disclosures of confidential communications in proceedings arising under title 37, chapter 1, part 4 concerning mandatory child abuse reports.

Acts 1990, ch. 760, § 2; 1991, ch. 421, § 20; 1993, ch. 152, § 1; 1997, ch. 485, § 5.

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

Attorney General Opinions. Privileged communications to psychologists/therapists and their agents, OAG 92-74, 1992 Tenn. AG LEXIS 72 (12/29/92).

63-22-115. Marital therapy and counseling services — Definitions — Prohibited conduct — Penalty.

  1. As used in this section, unless the context clearly requires a different meaning:
    1. “Advertise” means, but is not limited to, the issuing or causing to be distributed any card, sign or device to any person, or the causing, permitting or allowing any sign or marking on or in any building or structure, or in any newspaper or magazine or, in any directory, or on radio or television or by advertising by any other means designed to secure public attention;
    2. “Approved supervisor” means a licensed marital and family therapist, psychologist or psychiatrist who is either an American Association for Marriage and Family Therapy-approved supervisor or a board-approved marriage and family supervisor;
    3. “Board-approved marriage and family supervisor” means a person who gives to the board evidence of:
      1. Five (5) years full-time experience in marriage and family therapy practice and supervision;
      2. Thirty-six (36) hours of supervision specifically in the skill of providing marriage and family therapy supervision; and
      3. A recommendation for board-approved supervisor status from a supervisor who provided supervision of the supervision referred to in subdivision (a)(3)(B);
    4. “Licensed marital and family therapist” means a person to whom a license has been issued pursuant to this part, which license is in force and not suspended or revoked as of the particular time in question;
    5. “Marital and family therapy” means the diagnosis and treatment of cognitive, affective and behavioral problems and dysfunctions within the context of marital and family systems. Marital and family therapy involves the professional application of psychotherapeutic family systems theories and techniques in the delivery of services to individuals in the context of family systems theory and practice, couples and families;
    6. “Person” means any individual, firm, corporation, partnership, organization or body politic;
    7. “Practice of marital and family therapy” means the rendering of professional marital and family therapy to individuals, couples and family groups, singly or in groups, whether such services are offered directly to the general public or through organizations, either public or private, for a fee;
    8. “Recognized educational institution” means any educational institution that is recognized by the board and by a nationally or regionally recognized educational or professional accrediting body;
    9. “Supervision” means the direct clinical review, for the purpose of training or teaching, by an approved supervisor of a marriage and family therapist's interaction with clients. The purpose of supervision shall be to promote the development of the practitioner's clinical skills. Supervision may include, without being limited to, the review of case presentations, audiotapes, videotapes and direct observation; and
    10. “Use a title or description of” means to hold oneself out to the public as having a particular status by means of stating on signs, mailboxes, address plates, stationery, announcements, business cards or other instruments of professional identification.
  2. Except as specifically provided in § 63-22-113, commencing July 1, 1991, no person who is not licensed or certified as a marital and family therapist under this part shall:
    1. Advertise the performance of marital and family therapy or counseling service by such person; or
    2. Use a title or description such as “licensed or certified marital or marriage therapist, counselor, advisor, or consultant,” or any other name, style or description denoting that the person is a marital and family therapist or practices marital and family therapy.
  3. Any person who engages in any unlawful act enumerated in this section commits a Class B misdemeanor.
  4. In addition to the foregoing, the department of health may institute appropriate proceedings, in law or equity, to enjoin any person from engaging in any unlawful act enumerated in this section, such action or proceeding to be brought in the circuit or chancery court of the county in which the unlawful act occurs or in which the defendant resides.
  5. Nothing in this section shall be construed as permitting any person licensed or certified as a marital and family therapist to engage in the practice of “licensed psychological examiner,” “licensed senior psychological examiner,” “certified psychological assistant,” “licensed psychologist” or “licensed social worker,” as defined in the laws of this state.
  6. Nothing in this section, except subsection (b), applies to any person regulated by the board of nursing.
  7. Nothing in this section permits any person certified or licensed as a marital and family therapist to perform psychological testing intended to measure and/or diagnose mental illness. Consistent with each therapist's formal education and training, licensed marital and family therapists may administer and utilize appropriate assessment instruments that measure and/or diagnose, cognitive, affective and behavioral problems and dysfunctions of individuals in the context of marital and family systems, couples and families as part of the therapy process or in the development of a treatment plan.

Acts 1991, ch. 141, § 10; 2001, ch. 334, § 14; 2008, ch. 1016, § 5.

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

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

63-22-116. Reciprocal agreements.

  1. The board may license, without examination, a professional counselor applicant who is currently licensed in another state if the applicant's qualifications meet the licensure requirements under this part.
  2. The board may enter into a reciprocal agreement with any other state that licenses, certifies or registers professional counselors, if the board finds that such state has substantially the same or higher licensure requirements than Tennessee. This agreement shall provide that the board shall license any resident of another state who is currently licensed, certified or registered by that state, if such resident has met the same or higher requirements as provided for in this part.

Acts 1991, ch. 421, § 7; 1995, ch. 318, § 4.

63-22-117. Prohibited activities — Penalties — Exceptions to limitations.

    1. Except as specifically provided elsewhere in this part, commencing July 1, 1991, it is an offense for any person to engage in any of the following acts:
      1. Representing or advertising such person as, or using a title or description such as, “licensed professional counselor” without being duly licensed according to this part;
      2. Making use of any title, words, letters or abbreviations, or any combination thereof, that may reasonably be confused with licensure provided by this part to denote a standard of professional or occupational competence, without being duly licensed under this part; and
      3. Performing activities that may reasonably be construed to fall within the defined scope of practice of persons licensed under this part who are designated as mental health service providers as defined in § 63-22-122 without being duly licensed hereunder.
    2. Any person who engages in any unlawful act enumerated in this section commits a Class B misdemeanor.
    3. In addition to the foregoing, the department of health may institute appropriate proceedings, in law or equity, to enjoin any person from engaging in any unlawful act enumerated in this section, such action or proceeding to be brought in the circuit or chancery court of the county in which the unlawful act occurs or in which the defendant resides.
  1. Nothing in this part shall be construed as permitting any person licensed or certified as a professional counselor or designated as a mental health service provider under this chapter to engage in the practice of licensed psychological examiner, licensed senior psychological examiner, certified psychological assistant, licensed psychologist, licensed social worker, psychiatric nurse, law or medicine.
  2. This part does not apply to the person if the person is preparing for the practice of professional counseling or the practice permitted to a person designated as a mental health service provider pursuant to this chapter under qualified supervision.
  3. Nothing in this chapter shall be construed as limiting the ministry, activities or services of a rabbi, priest, minister of the gospel or others authorized by a regularly organized and functioning religious body in performing the ordinary duties or functions of the clergy; nor shall anything in this chapter apply to or be construed as limiting the activities or services of Christian Science practitioners. Nor shall any rabbi, priest, or minister who offers counseling services, even if fees are charged, be subject to the limitations of this chapter, as long as they do not hold themselves out as certified or licensed professional counselors.

Acts 1991, ch. 421, § 15; 2000, ch. 832, §§ 3-5; 2001, ch. 334, § 15; 2008, ch. 1016, § 6.

Cross-References. Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, recovery, §  63-1-134.

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

63-22-118. Applicability of part.

  1. The provisions of this part, except those contained in § 63-22-122, shall not apply to any persons regulated by the board of nursing or the state board of education, nor to professional counselors employed in community/human service agencies and working directly under the supervision of a licensed professional counselor nor to nurses licensed under chapter 7 of this title.
  2. Nothing in this part shall be construed to prevent members of other professional groups, including, without limitation, licensed social workers, psychologists, psychiatrists and other physicians, attorneys or members of the clergy, from performing or advertising that they provide or offer counseling services consistent with the accepted standards of their respective professions; provided, that none of such persons shall violate § 63-22-117.

Acts 1991, ch. 421, § 19.

63-22-119. Applicability of chapter 11 of this title.

Notwithstanding this part to the contrary, any person licensed pursuant to this part and chapter 11 of this title shall be subject to the limitations of chapter 11 of this title.

Acts 1991, ch. 421, § 21.

63-22-120. Requirements for licensure.

A professional counselor licensed under this part and designated as a mental health service provider must have:

  1. Met all qualifications for licensure as a professional counselor as stated in §§ 63-22-104 and 63-22-110;
  2. Completed a minimum of nine (9) graduate semester hours of coursework specifically related to diagnosis, treatment, appraisal and assessment of mental disorders; and
  3. Completed the two (2) years of post-master's supervised experience required for licensure in a clinical setting that provides substantial opportunities to diagnose, treat, appraise and assess mental disorders.

Acts 1995, ch. 318, § 7.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-22-121. Temporary licenses.

    1. A temporary license may be issued by the board for a licensed professional counselor designated as a mental health service provider applicant who has completed the academic coursework and training required for the license sought and who has successfully passed the examination required by the board.
    2. A temporary license obtained pursuant to this section authorizes an applicant to perform the functions specified in § 63-22-122(5), for which the applicant is seeking licensure under qualified supervision.
    3. In order to receive a temporary license, an applicant must submit to the board a completed application for a temporary license with the applicant's completed application for the desired license and all appropriate fees.
    4. If an applicant is granted a temporary license, the license shall remain valid until the board grants or denies the license application.
    5. No person shall be issued more than one (1) temporary license, nor shall any temporary license be valid for more than three (3) years.
    6. The applicant shall notify the board and present supporting documentation demonstrating the satisfactory completion of the required post-master's supervised experience in a clinical setting. The board shall then grant or deny the license application based on satisfactory completion of all requirements for licensure, including an oral examination.
    1. A temporary license may be issued by the board to a marital and family therapist applicant who has completed the academic course work and training required for the license sought; provided, that in order to retain such temporary license, the applicant must take the written examination required by the board the first time it is scheduled following issuance of the temporary license. The applicant must successfully pass the exam within two (2) years following issuance of the temporary license.
    2. A temporary license obtained pursuant to this section authorizes the applicant to engage in the practice of marital and family therapy, as defined by § 63-22-115(a)(7), under the supervision of an approved supervisor, as defined by § 63-22-115(a)(2) and (a)(9).
    3. In order to receive a temporary license, the applicant must submit to the board the following:
      1. A completed application for a temporary license;
      2. Satisfactory evidence of an agreement with an approved supervisor under whose supervision the applicant intends to practice; and
      3. All appropriate fees.
    4. A temporary license shall be nonrenewable and shall be valid for a period of not more than three (3) years. Within such three-year period, the applicant must submit to the board an application for the regular license and must present supporting documentation demonstrating the satisfactory completion of the required amount of post-master's degree supervised experience in a clinical setting under an approved supervisor. The board shall then grant or deny the application for the regular license, based on satisfactory completion of all requirements for licensure, including the oral examination. If the board approves or denies the application for the regular license or if the board revokes the temporary license for any reason, then the temporary license shall cease to be valid and must be returned to the board.
    5. The holder of a temporary license as a marital and family therapist shall not represent such temporary licensee to be a licensed marital and family therapist. The holder of such a license may only represent such temporary licensee to be a “marital therapy intern,” a “family therapy trainee” or such other title designation that clearly reflects trainee status and temporary licensure.

Acts 1996, ch. 798, § 1; 1997, ch. 167, § 1.

Cross-References. Licensure, §§  63-1-10363-1-112.

63-22-122. Part definitions.

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

  1. “Appraisal activities” means selecting, administering, scoring and interpreting instruments designed to assess an individual's aptitudes, achievements or interests, which are used to understand, measure or facilitate such individual's normal human growth and development, but does not include the use of projective techniques in the assessment of personality, nor the use of psychological or clinical tests designed to identify or classify abnormal or pathological human behavior, nor the use of individually administered intelligence tests. Consistent with each counselor's formal education and training, licensed professional counselors may administer and utilize appropriate assessment instruments that measure and/or diagnose problems and/or dysfunctions within the context of human growth and development as part of the counseling process or in the development of a treatment plan;
  2. “Counseling” means assisting an individual, through the counseling relationship, in a manner intended to facilitate normal human growth and development, using a combination of mental health and human development principles, methods and techniques, to achieve mental, emotional, physical, social, moral, educational, spiritual and/or career development and adjustment throughout the life span;
  3. “Licensed professional counselor” means a person licensed under this part who is professionally trained in counseling and guidance services designed to facilitate normal human growth and development through individual, family or group counseling, educational procedures, assessment, consultation and research and who assists individuals by the practice of counseling with their personal, social, career or educational development as they pass through life stages;
  4. “Practice of counseling” means rendering or offering to render to individuals, groups, organizations or the general public any service involving the application of principles, techniques, methods or procedures of the counseling profession, including appraisal activities, counseling, consulting and referral activities. Nothing in this section shall be construed to permit the treatment of any mental, emotional or adjustment disorder other than marital problems, parent-child problems, child and adolescent antisocial behavior, adult antisocial behavior, other specified family circumstances, other interpersonal problems, phase of life problems, other life circumstance problems, occupational problems and uncomplicated bereavement, except as provided in subdivision (5); and
  5. “Practice of counseling as a mental health service provider” means the application of mental health and human development principles in order to:
    1. Facilitate human development and adjustment throughout the life span;
    2. Prevent, diagnose, and treat mental, emotional or behavioral disorders and associated disorders that interfere with mental health;
    3. Conduct assessments and diagnoses for the purpose of establishing treatment goals and objectives within the limitations prescribed in subdivision (1); and
    4. Plan, implement and evaluate treatment plans using counseling treatment interventions. “Counseling treatment interventions” means the application of cognitive, affective, behavioral and systemic counseling strategies that include principles of development, wellness and pathology that reflect a pluralistic society. Nothing in this definition shall be construed to permit the performance of any act that licensed professional counselors designated as mental health service providers are not educated and trained to perform, nor shall it be construed to permit the designation of testing reports as “psychological.”

Acts 1991, ch. 421, § 15; 1995, ch. 318, §§ 5, 6.

Compiler's Notes. Former § 63-22-150 was transferred to § 63-22-122 by the authority of the Code Commission in 2017.

Part 2
Clinical Pastoral Therapy

63-22-201. Part definitions.

The following definitions shall apply in this part, unless the context clearly requires a different meaning:

  1. “Advertise” means, but is not limited to, business solicitations, with or without limiting qualifications, in a card, sign or device issued to a person, in a sign or marking in or on any building or in any newspaper, magazine, directory or other printed matter. Advertising also includes business solicitations communicated by individual, radio, video or television broadcasting or other means designed to secure public attention;
  2. [Deleted by 2019 amendment.]
  3. [Deleted by 2019 amendment.]
  4. [Deleted by 2019 amendment.]
  5. “Certified clinical pastoral therapist” means a person who has met the qualifications for certified clinical pastoral therapist and holds a current, unsuspended or unrevoked certificate that has been lawfully issued by the board;
  6. “Clinical pastoral education” means program of training designed to acquaint students of theology and practicing clergy with the clinical method of learning, increase skills in the arts of pastoral care and facilitate integration of a professional pastoral identity. Programs typically occur in general medical, psychiatric or penal institutions;
  7. “Clinical pastoral therapy” means the diagnosis and treatment, from a clinical pastoral perspective, of the psychodynamics, interpersonal dynamics and spiritual dynamics of persons experiencing emotional behavioral or relational distress or dysfunction. Clinical pastoral therapy involves the integration and professional application of resources and techniques from the religious community's traditions of pastoral care and counsel along with recognized principles, methods and procedures of the contemporary psychotherapy community in the delivery of counseling and psychotherapeutic services to individuals, couples, families and groups;
  8. “Licensed clinical pastoral therapist” means a person who has met the qualifications for a licensed clinical pastoral therapist and who holds a current, unsuspended or unrevoked license that has been issued lawfully by the board;
  9. “Practice of clinical pastoral therapy” means the rendering of professional clinical pastoral therapy to individuals, couples, families or groups, either offered directly to the general public by an individual operating independently of any institution, organization or agency, through mental health clinics or agencies, whether public or private or through hospitals, whether public or private, for a fee, excluding volunteer hours;
  10. “Recognized educational institution” means any educational institution that is accredited by a nationally or regionally recognized educational accrediting body;
  11. “Supervision” means the direct clinical review, for the purpose of training or teaching, by a board-approved supervisor, of a clinical pastoral therapist's interaction with clients. The purpose of supervision shall be to promote the development of the practitioner's clinical skills. Supervision may include, without being limited to, the review of case presentations, audiotapes, videotapes and direct observation; and
  12. “Use a title or description of” means to hold oneself out to the public as having a particular status by means of stating on signs, mailboxes, address plates, stationery, announcements, business cards or other instruments of professional identification.

Acts 1997, ch. 485, § 6; 2003, ch. 250, §§ 1, 12; 2016, ch. 955, § 3; 2019, ch. 233, §§ 1, 2.

Compiler's Notes. Acts 1997, ch. 485, § 6 enacted this part, effective January 1, 1998, except for the purpose of making appointments to the board, for which purpose this part took effect June 13, 1997.

Amendments. The 2019 amendment deleted the definition of “Approved supervisor” which read, “(2) ‘Approved supervisor’ means a person who is a licensed clinical pastoral therapist and one (1) of the following:“(A) A diplomate of the American Association of Pastoral Counselors;“(B) A fellow of the American Association of Pastoral Counselors who is under the supervision of a supervisor;“(C) A diplomate of the College of Pastoral Supervision and Psychotherapy;“(D) A fellow of the College of Pastoral Supervision and Psychotherapy who is under the supervision of a supervisor; or“(E) A board-approved clinical pastoral therapy supervisor;”; deleted the definition of “Approved training program” which read, “(3) ‘Approved training program’ means a clinical training program accredited by the American Association of Pastoral Counselors or by the College of Pastoral Supervision and Psychotherapy;”;  deleted the definition of “Board-approved clinical pastoral therapy supervisor” which read, “(4) ‘Board-approved clinical pastoral therapy supervisor' means a person who gives the board evidence of:“(A) Five (5) years' full-time experience in clinical pastoral therapy practice and supervision;“(B) One hundred twenty-five (125) hours of supervision specifically in the skill of providing supervision to clinical pastoral therapists; and“(C) A recommendation for board-approved supervisor status from a supervisor who had provided the supervision referred to in subdivision (4)(B);”; redesignated former (5) through (12) as present (2) through (9); and in the definition of “Supervision” substituted “board-approved supervisor” for “approved supervisor”.

Effective Dates. Acts 2019, ch. 233, § 6. April 30, 2019.

63-22-202. Prohibited acts by nonlicensed therapists — Penalties.

  1. Except as specifically provided in § 63-22-204, beginning January 1, 2004, no person who is not licensed as a clinical pastoral therapist under this part shall:
    1. Advertise that the performance of clinical pastoral therapy services is by a licensed clinical pastoral therapist; or
    2. Use the title “licensed clinical pastoral therapist” to denote that the person is a licensed clinical pastoral therapist.
  2. Any person who engages in any unlawful act enumerated in this section commits a Class B misdemeanor.
  3. The department of health may institute appropriate proceedings, in law or equity, to enjoin any person from engaging in any unlawful act enumerated in this section, such action or proceeding to be brought in the circuit or chancery court of the county in which the unlawful act occurs or in which the defendant resides.
  4. Nothing in this section shall be construed as permitting any person certified as a clinical pastoral therapist to engage in the practice of licensed psychological examiner, licensed senior psychological examiner, certified psychological assistant, licensed psychologist, or licensed social worker, as defined in the laws of this state.
  5. Nothing in this section, except in subsection (b), applies to any person regulated by the board of nursing.
  6. Nothing in this section shall be construed as permitting a certified clinical pastoral therapist to prescribe medications or to interpret psychological tests intended to measure and/or diagnose mental illness.
  7. Certified clinical pastoral therapists shall establish and maintain effective working relationships with an interdisciplinary network of professionals, including at least one (1) psychologically oriented physician, usually a psychiatrist, with an unlimited license to practice the healing arts in Tennessee, in order to make provision for referral for the diagnosis and treatment of medical or mental conditions falling outside the scope of clinical pastoral therapy as defined in § 63-22-201.

Acts 1997, ch. 485, § 7; 2001, ch. 334, § 16; 2003, ch. 250, §§ 2, 3; 2008, ch. 1016, § 7.

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

Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, § 63-1-134.

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

63-22-203. Application for license — Fees — Qualifications.

An applicant for licensure as a licensed clinical pastoral therapist shall pay the board a nonrefundable fee as set by the board and shall satisfy the board that the applicant:

  1. Is at least eighteen (18) years of age;
  2. Is of good moral character;
  3. Has met the educational standards set by the board, which shall include:
    1. The completion of a course of studies consisting of a minimum of sixty (60) graduate semester hours in a curriculum approved by the board, of which a minimum of nine (9) graduate semester hours must relate specifically to the diagnosis and treatment of mental disorders, and the awarding of a master's or doctoral degree from a recognized educational institution; and
    2. The completion of a supervised clinical experience within the academic degree program as either a practicum or internship that includes experience in the assessment, diagnosis, and treatment of the psychodynamics, interpersonal dynamics, and spiritual dynamics of persons experiencing emotional, behavioral, relational, or spiritual distress or dysfunction. The experience required under this subdivision (3)(B) must be conducted under the supervision of a board-approved supervisor;
  4. Has provided a minimum of one thousand four hundred (1,400) hours of pastoral therapy with individuals, couples, families, or groups while receiving a minimum of two hundred seventy (270) hours of supervision of such therapy under board-approved supervision; and
  5. Has passed examinations as approved by the board.

Acts 1997, ch. 485, § 8; 2003, ch. 250, § 4; 2016, ch. 955, § 1; 2019, ch. 233, § 3.

Amendments. The 2019 amendment, in the last sentence of (3)(B), substituted “under” for “by”, “must” for “shall” and “a board-approved” for “an approved”.

Effective Dates. Acts 2019, ch. 233, § 6. April 30, 2019.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-22-204. Exclusions from part.

  1. Nothing in this chapter shall be construed as limiting the ministry, activities or services of a rabbi, priest, minister of the gospel or others authorized by a regularly organized and functioning religious body in performing the ordinary duties or functions of the clergy, nor shall anything in this chapter apply to or be construed as limiting the activities or services of Christian Science practitioners. Nor shall any rabbi, priest or minister who offers counseling services, even if fees are charged, shall be subject to the limitations of this part, as long as they do not hold themselves out as licensed pastoral therapists or licensed pastoral counselors and as long as they do not purport to provide the integration and professional application of resources and techniques from the religious community's traditions of pastoral care and counsel along with recognized principles, methods and procedures of clinical psychotherapy.
  2. This part does not apply to a person if the person is preparing for the practice of clinical pastoral therapy under qualified supervision in a training institution or facility or supervisory arrangement recognized and approved by the board; provided, that such person is designated by such titles as “pastoral therapy intern,” “pastoral therapy trainee” or others clearly indicating such training status.
  3. Nothing in this part shall be construed to prevent qualified members of other professional groups as defined by the board, including, but not limited to, licensed clinical social workers, licensed psychologists, licensed psychological examiners, licensed senior psychological examiners, certified psychological assistants, psychiatric nurses, physicians or attorneys at law, from performing or advertising that they provide or offer counseling services consistent with the accepted standards of their respective professions nor to prevent alcohol and drug abuse counselors licensed under § 68-24-605 or operating under qualified supervision while seeking such licensure from doing counseling consistent with the accepted standards of such profession.

Acts 1997, ch. 485, § 9; 1998, ch. 818, § 1; 2001, ch. 334, § 17; 2003, ch. 250, § 5.

63-22-205. Reciprocal agreements — License by endorsement.

  1. The board may enter into a reciprocal agreement with any other state that licenses, certifies or registers clinical pastoral therapists, if the board finds that such state has substantially the same or higher licensure requirements than Tennessee. This agreement shall provide that the board may license without examination any resident of another state who is currently licensed, certified or registered by the state, if that resident has met the same or higher requirements as provided in this part.
  2. The board may license by endorsement a clinical pastoral therapist applicant who is a fellow or diplomate of the American Association of Pastoral Counselors if that person otherwise meets the requirements of this chapter.
  3. The board may also license by endorsement a clinical pastoral therapist applicant who is:
    1. Certified as a clinical member of the American Association of Pastoral Counselors;
    2. Can document five (5) years of full-time practice in pastoral therapy subsequent to AAPC certification; and
    3. Otherwise meets the requirements of this chapter.

Acts 1997, ch. 485, § 10; 2003, ch. 250, §§ 6-10.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-22-206. License of certain applicants prior to January 1, 2006 — Documentation.

  1. Until January 1, 2006, applicants who fulfill at least one (1) of the following conditions shall be entitled to receive a license as a licensed clinical pastoral therapist:
    1. Hold current certification as a clinical pastoral therapist. Such certification must be lawfully issued by the board and not be suspended or revoked;
    2. Document satisfaction of the requirements of § 63-22-203(1)-(4) only;
    3. Document current active status as a fellow or diplomate of AAPC and being actively engaged in the practice of pastoral psychotherapy for at least five (5) years prior to January 1, 2003; or
    4. Document having received a graduate theological degree from a recognized educational institution and being currently licensed in Tennessee as a psychologist designated as a health service provider, a professional counselor designated as a mental health service provider, a marital and family therapist, a clinical social worker or an alcohol and drug abuse counselor and, in addition, document being actively engaged in the practice of clinical pastoral therapy for at least five (5) years prior to January 1, 2003.
  2. Persons who qualify for licensure as a clinical pastoral therapist pursuant to this section shall provide satisfactory proof to the board of such qualification. The board shall issue a license as a licensed clinical pastoral therapist to those persons who meet the qualifications of subsection (a) and who submit required proof of such qualifications.

Acts 1997, ch. 485, § 11; 2003, ch. 250, § 11.

63-22-207. Issuance of license.

A person who is certified as a certified clinical pastoral therapist on June 3, 2003, shall be issued a license as a licensed clinical pastoral therapist when such person's certification is renewed or upon request of such person before the expiration of such person's current certification.

Acts 2003, ch. 250, § 13.

63-22-208. Temporary license.

  1. The board is authorized to issue a temporary license to a clinical pastoral therapist applicant who has completed the academic course work and supervised clinical experience for the license sought; provided, that in order to retain the temporary license, the applicant shall take the written examination required by the board the first time it is scheduled following issuance of the temporary license unless granted an extension by the board after submitting a written request to the board and making a showing of good cause as determined by the board. The applicant must successfully pass the exam within two (2) years following issuance of the temporary license unless the applicant receives a good cause extension by the board. An applicant may only receive one (1) good cause extension from the board.
  2. A temporary license obtained pursuant to this section authorizes the applicant to engage in the practice of clinical pastoral therapy under the supervision of a board-approved supervisor.
  3. In order to receive a temporary license, the applicant must submit to the board the following:
    1. A completed application for a temporary license;
    2. Satisfactory evidence of an agreement with a board-approved supervisor; and
    3. All required fees.
  4. A temporary license shall be nonrenewable and shall be valid for a period of not more than three (3) years. A temporary license may be extended beyond the three-year period at the discretion of the board if an applicant shows good cause for an extension as determined by the board. Only one (1) extension may be granted by the board for an applicant to extend the length of the applicant's temporary license. Within the period of temporary licensure, the applicant shall submit to the board an application for the regular license and shall present supporting documentation demonstrating the satisfactory completion of the required supervised clinical experience. The board shall then grant or deny the application for the regular license, based on satisfactory completion of all requirements for licensure. If the board approves or denies the application for the regular license or if the board revokes the temporary license for any reason, then the temporary license shall cease to be valid and shall be returned to the board.
  5. The holder of a temporary license as a clinical pastoral therapist shall not represent himself or herself to be a licensed clinical pastoral therapist. The holder of a temporary license as a clinical pastoral therapist may only represent himself or herself to be a “pastoral therapy intern,” a “pastoral therapy trainee,” or such other title designation that clearly reflects trainee status and temporary licensure.

Acts 2016, ch. 955, § 2; 2019, ch. 233, §§ 4, 5.

Amendments. The 2019 amendment substituted “under the supervision of a board-approved supervisor” for “under the supervision of an approved supervisor” in (b); and substituted “a board-approved supervisor” for “an approved supervisor” in (c)(2).

Effective Dates. Acts 2019, ch. 233, § 6. April 30, 2019.

Part 3
Conscientious Objections to Provision of Counseling or Therapy Services

63-22-301. Part definitions.

For purposes of this part, “counseling or therapy services” means assisting an individual, who is seeking or engaged in the counseling relationship in a private practice setting, in a manner intended to facilitate normal human growth and development, using a combination of mental health and human development principles, methods, and techniques, to achieve mental, emotional, physical, social, moral, educational, spiritual, or career development and adjustment throughout the individual's life span.

Acts 2016, ch. 926, § 1.

Code Commission Notes.

Acts 2016, ch. 926, § 1 enacted this part with one section. By authority of the Code Commission, the section was codified as multiple sections. Subsection (c) was codified as § 63-22-301 and  subsections (a), (b), and (d) were codified as § 63-22-302.

63-22-302. Conscientious objections — Referrals to other providers — Liability.

  1. No counselor or therapist providing counseling or therapy services shall be required to counsel or serve a client as to goals, outcomes, or behaviors that conflict with the sincerely held principles of the counselor or therapist; provided, that the counselor or therapist coordinates a referral of the client to another counselor or therapist who will provide the counseling or therapy.
  2. The refusal to provide counseling or therapy services as described in subsection (a) shall not be the basis for:
    1. A civil cause of action; or
    2. Criminal prosecution.
  3. Subsections (a) and (b) shall not apply to a counselor or therapist when an individual seeking or undergoing counseling is in imminent danger of harming themselves or others.

Acts 2016, ch. 926, § 1.

Code Commission Notes.

Acts 2016, ch. 926, § 1 enacted this part with one section. By authority of the Code Commission, the section was codified as multiple sections. Subsection (c) was codified as § 63-22-301 and  subsections (a), (b), and (d) were codified as § 63-22-302.

63-22-106. Marital and family therapists — Fees — Qualifications.

Chapter 23
Social Workers

63-23-101. Board — Creation — Renamed as board of social worker licensure — Membership.

  1. There is created the board of social worker licensure. On and after July 1, 2008, the former board of social worker certification and licensure is renamed and shall be known as the board of social worker licensure.
    1. On and after July 1, 2008, the board shall consist of eleven (11) members, one (1) of whom shall be a representative of the public, having neither a direct nor an indirect association with the social work profession, and each of the remainder shall be social workers who possess the qualifications specified in §§ 63-23-102 — 63-23-105. The board shall at all times be composed of two (2) licensed baccalaureate social workers, two (2) licensed master's social workers, three (3) licensed advanced practice social workers and three (3) licensed clinical social workers, all of whom shall be residents of the state, and who shall be appointed by the governor.
    2. In order to transition to the eleven-member board with new licensure classifications, appointments to the board on and after July 1, 2008, shall be made in the following manner:
      1. A licensed advanced practice social worker shall be appointed to the board as a new member for a five-year term;
      2. A licensed advanced practice social worker shall be appointed to the board as a new member for a four-year term;
      3. A licensed baccalaureate social worker shall be appointed to the board as a new member for a five-year term;
      4. A licensed baccalaureate social worker shall be appointed to the board as a new member for a four-year term;
      5. A certified master social worker whose term expires in 2008 shall be replaced by the appointment of a licensed advanced practice social worker for a three-year term;
      6. A certified master social worker whose term expires in 2008 shall be replaced by the appointment of a licensed master's social worker for a five-year term;
      7. Two (2) independent practitioners whose terms expire in 2009 shall be replaced by the appointment of two (2) licensed clinical social workers for five-year terms;
      8. A certified master social worker whose term expires in 2009 shall be replaced by the appointment of a licensed master's social worker for a five-year term;
      9. An independent practitioner whose term expires in 2010 shall be replaced by the appointment of a licensed clinical social worker for a five-year term; and
      10. The member of the public who is not directly or indirectly engaged in social work whose term expires in 2011 shall be replaced by a member of the public for a five-year term.
    3. The social worker members may be appointed by the governor from lists of nominees submitted by interested social worker groups, including, but not limited to, the Tennessee chapter of the National Association of Social Workers. The governor shall consult with the interested social worker groups to determine qualified persons to fill positions on the board.
    4. All board members, except the member of the public who is not directly or indirectly engaged in social work, shall be duly licensed or eligible to be licensed by the board. Subsequent appointees to the board shall possess the professional qualifications required by their predecessors as required in this section and shall be appointed to five-year terms.
    5. Members shall serve until their successors are appointed and qualified. Any vacancy occurring on the board shall be filled by the governor for the balance of the unexpired term. A board member is eligible for reappointment.
    6. In making appointments to the board, 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.
  2. For each day engaged in the business of the board, members shall receive as compensation fifty dollars ($50.00) and shall also receive actual expenses to be paid in accordance with the comprehensive travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  3. The members of the board shall annually elect a chair and a secretary.
  4. The board shall meet as frequently as reasonably necessary to implement this chapter. Six (6) or more members of the board constitute a quorum for transacting board business.
  5. For administrative purposes, the board shall be attached to the division of health related boards, as defined in § 68-1-101, referred to as “division” in this chapter.

Acts 1984, ch. 1003, § 1; 1988, ch. 1013, § 58; 1994, ch. 691, §§ 3-6; 2008, ch. 1016, § 1; 2014, ch. 601, § 3; 2017, ch. 211, § 3.

Compiler's Notes. The board of social work licensure, created by this section, terminates June 30, 2026. See §§ 4-29-112, 4-29-247.

Amendments. The 2017 amendment, in (b)(3), substituted “may be appointed” for “shall be appointed” in the first sentence, and substituted “with the interested social worker groups” for “with such interested groups” in the second sentence.

Effective Dates. Acts 2017, ch. 211, § 4. April 28, 2017.

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

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

63-23-102. Practice of baccalaureate social work — Licensing requirements.

  1. The practice of baccalaureate social work is the professional application of social work theory, knowledge, methods, principles, values and ethics and the professional use of self to restore or enhance social, psychosocial or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. The practice of baccalaureate social work is basic generalist practice that includes interviewing, assessment, planning, intervention, evaluation, case management, mediation, supportive counseling, direct nonclinical practice, information and referral, problem solving, client education, advocacy, community organization, supervision of employees, and the development, implementation, and administration of policies, programs and activities. Baccalaureate social workers are not qualified to diagnose or treat mental illness nor provide psychotherapy services. A social worker at this level shall not provide services to clients in exchange for direct payment or third-party reimbursement. A social worker at this level shall work in or for an agency or organization and may not practice privately or independently. Licensed baccalaureate social workers shall not engage in advanced social work practice or in clinical social work practice or hold themselves out as a licensed master's social worker, a licensed advance practice social worker or a licensed clinical social worker. A social worker may not prescribe medication or interpret psychological tests.
    1. To obtain a license to engage in the practice of baccalaureate social work, an applicant must provide evidence satisfactory to the board that the applicant has:
      1. Submitted a written application in the form prescribed by the board;
      2. Paid all applicable fees specified by the board relative to the licensure process;
      3. Attained the age of majority;
      4. Graduated and received a baccalaureate degree in social work from a council on social work education approved program; and
      5. Successfully passed the association of social work board's bachelor's licensing exam.
    2. Any baccalaureate social worker who graduated before 1980 or who has graduated from a council on social work education accredited program since 1980 may apply for licensure as a baccalaureate social worker without examination until December 31, 2010.
  2. No person shall, by verbal claim, advertisement, letterhead, card or in any other way represent that the person is a licensed baccalaureate social worker unless the person possesses a valid license issued pursuant to subsection (b).
  3. A violation of subsection (c) is a Class A misdemeanor.
  4. The board shall establish regulations for the issuance of temporary licenses to baccalaureate social workers who hold a baccalaureate degree in social work granted by any college, university, or school of social work that has applied for, but has not yet received, accreditation by the council on social work education.

Acts 1984, ch. 1003, § 1; 1989, ch. 523, § 88; 1989, ch. 591, §§ 1, 6; 2006, ch. 658, § 1; 2008, ch. 1016, § 1.

Cross-References. Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, §  63-1-134.

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

63-23-103. Practice of licensed master social work — Licensing requirements.

  1. The practice of licensed master's social work is the professional application of social work theory, knowledge, methods, principles, values and ethics and the professional use of self to restore or enhance social, psychosocial or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. The practice of master's social work requires the application of specialized knowledge and advanced practice skills in the areas of assessment, treatment planning, implementation and evaluation, case management, mediation, counseling, supportive counseling, direct practice, information and referral, supervision of employees, consultation, education, research, advocacy, community organization and the development, implementation, and administration of policies, programs and activities. The practice of master's social work may include the practice activities of a licensed baccalaureate social worker. The practice of master's social work may include the practice of clinical social work under the clinical supervision of a licensed clinical social worker as an avenue for licensure as a clinical social worker. A social worker at this level shall not provide services to clients in exchange for direct payment or third-party reimbursement. Licensed master's social workers shall engage only in supervised practice in or for an agency or organization and may not practice privately or independently. Licensed master's social workers may not hold themselves out as a licensed advance practice social worker or a licensed clinical social worker. A social worker may not prescribe medication or interpret psychological tests.
    1. To obtain a license to engage in the practice as a licensed master's social worker an applicant must provide evidence satisfactory to the board that the applicant has:
      1. Submitted a written application in a form prescribed by the board or via online application;
      2. Paid all applicable fees specified by the board relative to the licensure process;
      3. Attained the age of majority;
      4. Graduated and received a master's degree in social work from a council on social work education approved program or has received a doctorate or Ph.D. in social work; and
      5. Successfully passed the association of social work board's master's licensing exam.
    2. Any person possessing a CMSW certificate at the time of implementation of this law will automatically become a licensed master's social worker without meeting any additional requirements.
    3. Any MSW who graduated before 1980 or who has graduated from a council on social work education accredited program since 1980 may apply for licensure without examination until December 31, 2010.
  2. No person shall, by verbal claim, advertisement, letterhead, card or in any other way represent that the person is a licensed master's social worker unless the person possesses a valid license issued pursuant to subsection (b).
  3. A violation of subsection (c) is a Class A misdemeanor.
  4. The board shall establish regulations for the issuance of temporary licenses for master's social workers who hold the degree of master's in social work granted by any college, university, or school of social work that has applied for, but has not yet received, accreditation by the council on social work education. This practice activity shall be applicable toward meeting the provisions and requirements of § 63-23-104(b) or § 63-23-105(b).

Acts 2008, ch. 1016, § 1; 2014, ch. 949, § 12.

Compiler's Notes. Former § 63-23-103 (Acts 1984, ch. 1003, § 1; 1986, ch. 617, §§ 1, 2; 1989, ch. 523, § 89; 1989, ch. 591, §§ 1, 6; 1990, ch. 913, § 1; 2006, ch. 658, §§ 2, 3), concerning independent practitioners of social work, was repealed by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

Cross-References. Licensure, §§ 63-1-10363-1-112.

Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, § 63-1-134.

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

63-23-104. Practice of advanced social work — Licensing requirements.

  1. The practice of advanced social work as a nonclinical social worker is the professional application of social work theory, knowledge, methods, principles, values and ethics and the professional use of self to restore or enhance social, psychosocial or biopsychosocial functioning of individuals, couples, families, groups, organizations and communities. Advanced master's or doctorate social work practice requires the application of specialized knowledge and advanced practice skills in the areas of education, research, advocacy, community organization, mediation, consultation, assessment, treatment planning, implementation and evaluation, case management, counseling, supportive counseling, direct practice, information and referral, supervision, and the development, implementation, and administration of policies, programs and activities. The nonclinical advanced practice of social work may occur independently outside the jurisdiction of an agency or organizational setting in which the social worker assumes responsibility and accountability for the nature and quality of the services provided to clients, pro bono or in exchange for direct payment or third-party reimbursement. The practice of advanced social work as a nonclinical social worker may include the practice activities of a licensed baccalaureate social worker or licensed master's social worker, or both. The practice of advanced master's or doctorate social work may include the practice of clinical social work under the clinical supervision of a licensed clinical social worker as an avenue for licensure as a clinical social worker without the benefit of direct payments or third-party reimbursements for clinical practice. Practice at this level may include the provision of supervision for licensed or temporarily licensed master's social workers seeking to become licensed advanced practice social workers. Licensed advanced practice social workers may not hold themselves out as a licensed clinical social worker. A social worker may not prescribe medication or interpret psychological tests.
    1. To obtain a license to engage in the practice as a licensed advanced practice social worker an applicant must provide evidence satisfactory to the board that the applicant has:
      1. Submitted a written application in a form prescribed by the board or via online application;
      2. Paid all applicable fees specified by the board relative to the licensure process;
      3. Attained the age of majority;
      4. Graduated and received a master's degree in social work from a council on social work education approved program or has received a doctorate or Ph.D. in social work;
      5. Practiced for no less than two (2) years as a licensed master's social worker or temporarily licensed master's social worker under the supervision of a licensed advanced practice social worker or licensed clinical social worker; and
      6. Successfully passed the association of social work board's advanced generalist licensing exam.
    2. Any graduate who graduated before 1980 or who has graduated from a council on social work education accredited program since 1980 may apply for licensure without meeting the requirements of subdivisions (b)(1)(E) and (F) until December 31, 2010. The applicant must provide a work history of not less than three (3) years and a professional reference. Applicants who hold the current credentials of ACSW or DCSW from the National Association of Social Workers may submit documentation of these credentials in lieu of work history and professional reference.
  2. No person shall, by verbal claim, advertisement, letterhead, card or in any other way represent that the person is a licensed advanced practice social worker unless the person possesses a valid license issued pursuant to subsection (b).
  3. A violation of subsection (c) is a Class A misdemeanor.

Acts 2008, ch. 1016, § 1; 2014, ch. 949, § 13.

Compiler's Notes. Former § 63-23-104, relating to renewal of certificates or licenses and continuing education requirements, was transferred to § 63-23-106 by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

Cross-References. Licensure, §§ 63-1-10363-1-112.

Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, § 63-1-134.

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

63-23-105. Practice of advanced master's or doctorate social work as licensed clinical social worker — Licensing requirements.

  1. The practice of advanced master's or doctorate social work as a licensed clinical social worker is a specialty within the practice of social work that requires the application of social work theory, knowledge, methods, principles, values, ethics, and the professional use of self to restore or enhance social, psychosocial or biopsychosocial functioning of individuals, couples, families, groups or persons who are adversely affected by social or psychosocial stress or health impairment. The practice of clinical social work requires the application of specialized clinical knowledge and advanced clinical skills in the areas of assessment, diagnosis and treatment of mental, emotional and behavioral disorders, conditions and addictions, including severe mental illness in adults and serious emotional disturbances in children, case management, direct practice, information and referral, clinical and nonclinical supervision, and the development, implementation, and administration of policies, programs and activities. Treatment methods include the provision of individual, marital, couple, family, and group therapy, mediation, counseling, supportive counseling, advanced case management, direct practice and psychotherapy. Clinical social workers are qualified to use the Diagnostic and Statistical Manual of Mental Disorders (DSM), the International Classification of Diseases (ICD), and other diagnostic classification systems in assessment, diagnosis, treatment planning and other activities. The advanced practice of clinical social work may occur outside the jurisdiction of an agency or organizational setting in which the social worker assumes responsibility and accountability for the nature and quality of the services provided to clients, pro bono or in exchange for direct payment or third-party reimbursement. Practice at this level may include the provision of supervision for licensed or temporarily licensed master's social workers seeking advanced licensure as an advanced practice social worker or as a licensed clinical social worker. Licensed clinical social workers may engage in both independent clinical and agency-based, nonclinical, macro social work practice. A social worker may not prescribe medication or interpret psychological tests. The practice of advanced master's or doctorate social work as a licensed clinical social worker may include the practice activities of a licensed baccalaureate social worker, licensed master's social worker and/or licensed advanced practice social worker.
  2. To obtain a license to engage in the practice independently as a licensed clinical social worker an applicant must provide evidence satisfactory to the board that the applicant has:
    1. Submitted a written application in a form prescribed by the board or via online application;
    2. Paid all applicable fees specified by the board relative to the licensure process;
    3. Attained the age of majority;
    4. Graduated and received a master's degree in social work from a council on social work education approved program or has received a doctorate or Ph.D. in social work;
    5. Worked for not less than two (2) years as a licensed master's social worker, or temporarily licensed master's social worker under the supervision of a licensed clinical social worker or, if the applicant is from another state, has worked for not less than two (2) years prior to the date of application under the supervision of a person who possesses educational and experiential qualifications that meet or exceed the requirements for licensure in this state as a licensed clinical social worker; and
    6. Successfully passed the association of social work board's clinical licensing exam.
  3. No person shall practice independently as a clinical social worker or act as, or represent the person to be, a licensed clinical social worker as defined in this section unless the person possesses a valid license issued pursuant to subsection (b).
  4. A violation of subsection (c) is a Class A misdemeanor.

Acts 2008, ch. 1016, § 1; 2014, ch. 949, § 14.

Compiler's Notes. Former § 63-23-105, relating to retirement of persons certified or licensed to practice social work, was transferred to § 63-23-107 by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

Cross-References. Licensure, §§ 63-1-10363-1-112.

Penalties, §  63-1-123.

Penalties for violation of statute, rule or order, § 63-1-134.

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

NOTES TO DECISIONS

1. Health Care Provider.

Plaintiffs' allegations met the definition of a health care liability action, as they alleged that the social worker, who was considered a health care provider, was negligent in providing services to their child, and expert testimony would be required to prove the allegations; plaintiffs failed to provide pre-suit notice or file a certificate of good faith, and dismissal with prejudice was warranted. Ellithorpe v. Weismark, 479 S.W.3d 818, 2015 Tenn. LEXIS 827 (Tenn. Oct. 8, 2015).

63-23-106. Renewal of licenses — Continuing education requirements.

  1. All persons who are licensed to practice social work shall renew their licenses as follows:
    1. Biennial licensure renewal fees in an amount established by the board shall accompany each renewal application;
    2. If any holder of a license fails to renew the license within sixty (60) days of expiration, the license of the person shall be automatically revoked without further notice or hearing unless specifically requested; and
    3. Notwithstanding any provision of this chapter to the contrary, the division of health related boards, 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 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 biennial fee and modified in no other manner, except that the proportional fee shall be rounded off to the nearest quarter of a dollar (25¢). 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 subdivision (a)(3).
  2. In accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, the board shall promulgate rules to establish continuing education requirements for persons seeking renewal of social work licenses.

Acts 1984, ch. 1003, § 1; 1989, ch. 360, § 62; 1989, ch. 523, § 90; 1990, ch. 913, § 2; T.C.A. § 63-23-104; Acts 2008, ch. 1016, § 1.

Compiler's Notes. Former § 63-23-106, relating to denial, suspension or revocation of certificates or licenses, was transferred to § 63-23-108 by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

63-23-107. Retirement.

Any person licensed to practice social work in this state who has retired or may hereafter retire from such practice is not required to maintain that person's licensure as required by this chapter; provided, that the person files with the board an affidavit on a form, prescribed by the board, which affidavit states the date on which the person retired from the practice and such other facts as are required by the board. If the person thereafter reengages in the practice of social work, the person shall renew that person's license with the board as provided by this chapter.

Acts 1984, ch. 1003, § 1; T.C.A. § 63-23-105; Acts 2008, ch. 1016, § 1.

Compiler's Notes. Former § 63-23-107, relating to privileged communications, was transferred to § 63-23-109 by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

Cross-References. Retirement, § 63-1-111.

63-23-108. Denial, suspension or revocation of licenses.

  1. The board has the power, which is its duty, to deny, suspend or revoke any license, or to otherwise discipline, an applicant or holder of a license who is found guilty by the board of one (1) or more of the following:
    1. Willful or repeated violation of any provisions of this chapter or any rules of the board;
    2. Fraud or deceit in procuring or attempting to procure a license, presenting to the board dishonest or fraudulent evidence of qualification, or fraud or deception in the process of examination for the purpose of securing a license;
    3. Willful failure to display a license;
    4. Fraud, deception, misrepresentation, dishonest or illegal practices in or connected with the practice of social work;
    5. Circulating knowingly untrue, fraudulent, misleading or deceptive advertising;
    6. Gross health care liability, or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence in the course of practice;
    7. Unprofessional or unethical conduct, or engaging in practices in connection with the practice of social work that are in violation of the standards of professional conduct, as defined in this section or prescribed by the rules of the board;
    8. Incapacity or impairment that prevents a licensee from engaging in the practice of social work with reasonable skill, competence, and safety to the public;
    9. Conduct reflecting unfavorably upon the profession of social work;
    10. Willful making of any false statement as to material in any oath or affidavit that is required by this chapter;
    11. Revocation by another state of a license or certificate to practice in that state in which case the record of the revocation shall be conclusive evidence;
    12. Conviction of a felony under federal or state law involving use, misuse, possession or sale of any controlled substance or controlled substance analogue;
    13. Conviction of a felony in the courts of this state or any other state, territory or country that, if committed in this state, would be a felony:
      1. The record of conviction in a court of competent jurisdiction is sufficient evidence for disciplinary action to be taken as may be considered proper by the board. For the purpose of this chapter, a conviction is considered to be a conviction that has been upheld by the highest appellate court having jurisdiction, or a conviction upon which the time for filing an appeal has passed; and
      2. A record of conviction upon charges that involve unlawful practice. Based upon the record of conviction, without any other testimony, the board may take temporary disciplinary action even though an appeal for review by a higher court may be pending;
    14. Permitting or allowing another to use the license for the purpose of treating or offering to treat patients;
    15. Engaging in practice under a false or assumed name, or the impersonation of another practitioner of a like, similar or different name;
    16. Employing or permitting any person who does not hold a license to practice social work in this state to perform work that, under this chapter, can lawfully be done only by persons holding the license and permitted by law to practice social work in this state; or
    17. Addiction to the habitual use of intoxicating liquors, narcotics or other stimulants to such an extent as to incapacitate the applicant or holder from the performance of the applicant's or holder's professional obligations and duties.
  2. The board may on its own motion cause to be investigated any report indicating that a license holder is or may be in violation of this chapter. Any person who in good faith reports to the board any information that a license holder is or may be in violation of this chapter is not subject to suit for civil damages as a result of the good faith report.
  3. All administrative proceedings for disciplinary action against a licensee undertaken pursuant to this chapter shall be conducted in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  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 1984, ch. 1003, § 1; T.C.A. § 63-23-106; Acts 2008, ch. 1016, § 1; 2012, ch. 798, § 47; 2012, ch. 848, § 80; 2018, ch. 745, § 37.

Compiler's Notes. Former § 63-23-108, relating to rules and regulations, was transferred to § 63-23-110 by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

Amendments. The 2018 amendment added (d).

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

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

63-23-109. Privileged communications.

  1. The confidential relations and communications between a client and licensed social worker as defined in this chapter, are placed upon the same basis as those provided by law between licensed psychologists, licensed psychological examiners, licensed senior psychological examiners, certified psychological assistants and client, and nothing in this chapter shall be construed to require any such privileged communication to be disclosed.
  2. Nothing contained 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.

Acts 1984, ch. 1003, § 1; 1990, ch. 913, § 3; 2001, ch. 334, § 18; T.C.A. § 63-23-107; Acts 2008, ch. 1016, § 1.

Compiler's Notes. Former § 63-23-109, relating to reciprocity, was transferred to § 63-23-111 by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

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

Rule Reference. This section is referred to in the Advisory Commission Comments under Rule 501 of the Tennessee Rules of Evidence.

Textbooks. Tennessee Law of Evidence (2nd ed., Cohen, Paine and Sheppeard), Rule 501; §§ 501.8, 501.14.

Law Reviews.

Should Tennessee Bury the Dead Man Statute As Arkansas Has? (W. Dent Gitchel), 18 Mem. St. U.L. Rev. 195 (1989).

Toward a Unified Approach to Privileges and Relevancy (Thomas F. Guernsey), 17 Mem. St. U.L. Rev. 1 (1986).

NOTES TO DECISIONS

1. Privileges Compared.

The psychologist-client privilege under T.C.A. § 63-11-213, and the social worker-client privilege, are placed on the same basis as the attorney-client privilege by the Tennessee Code. Kirchner v. Mitsui & Co. (U.S.A.), Inc., 184 F.R.D. 124, 1998 U.S. Dist. LEXIS 20241 (M.D. Tenn. 1998).

63-23-110. Rules and regulations.

The board is authorized to promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, such rules as are necessary to implement this chapter.

Acts 1984, ch. 1003, § 1; T.C.A. § 63-23-108; Acts 2008, ch. 1016, § 1.

Compiler's Notes. Former § 63-23-110, relating to a special volunteer license, was transferred to § 63-23-112 by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

63-23-111. Reciprocity.

The board may, at its discretion, grant a social worker license without examination, to any person residing or employed in the state who has not previously failed the examination given by the board and who at the time of application is licensed by another state whose standards, in the opinion of the board, are as stringent as those required by this chapter.

Acts 1984, ch. 1003, § 1 T.CA. § 63-23-109, Acts 2008, ch. 1016, § 1.

Compiler's Notes. Former § 63-23-111, relating to the criteria for use of title of social worker, was transferred to § 63-23-113 by Acts 2008, ch. 1016, § 1, effective July 1, 2008.

63-23-112. Special volunteer license for practice in free health clinic — Exemption from fees — Renewal.

A person licensed pursuant to this chapter under a special volunteer license who is a medical practitioner, as defined by § 63-1-201, engaged in practice at a free health clinic shall not be subject to license fees under this chapter. The board of social worker licensure may issue a special volunteer license, as the license is defined in § 63-1-201, to qualified applicants without fee or charge. The license shall be for a period of two (2) years and may be renewed on a biennial basis.

Acts 2004, ch. 579, § 8; T.C.A. § 63-23-110, Acts 2008, ch. 1016, § 1.

63-23-113. Criteria for use of title of social worker.

  1. A social worker is an individual who:
    1. Has received a baccalaureate or master's degree in social work from an accredited social work program approved by the council on social work education;
    2. Has received a doctorate or Ph.D. in social work; or
    3. Is a current licensed social worker, as set forth in §§ 63-23-102 — 63-23-105.
  2. No person shall hold out to be a social worker unless the person:
    1. Has received a baccalaureate or master's degree in social work from an accredited social work school or program;
    2. Has received a doctorate or Ph.D. in social work; or
    3. Is a current licensed social worker, as set forth in §§ 63-23-102 - 63-23-105.
  3. No government entities, public or private agencies, business or organizations in the state shall use the title social worker, or any form of the title, for volunteer or employment positions or within contracts for services, documents, manuals, or reference material, effective July 1, 2005, unless the volunteers or employees in those positions meet the criteria set forth in this section.
  4. Any individual meeting the qualifications provided for in 42 CFR 483 may practice as a qualified social worker, as defined in those regulations, in any nursing home licensed in the state and shall not be required to meet the requirements of subsections (a)-(c). Any such individual may not use the title social worker, except in connection with the activities of the nursing home.

Acts 2005, ch. 469, § 1; T.C.A. § 63-23-111, Acts 2008, ch. 1016, § 1.

Chapter 24
Athletic Trainers

63-24-101. Chapter definitions.

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

  1. “Athletic injury” means any injury sustained by a person as a result of such person's participation in exercises, sports, games, or recreation requiring physical strength, agility, flexibility, range of motion, speed, or stamina, or comparable athletic injury that prevents such person from participating in such activities;
  2. “Athletic trainer” means a person with specific qualifications as set forth in this chapter, who, upon the advice, consent and oral or written prescriptions or referrals of a physician licensed under this title, carries out the practice of prevention, recognition, evaluation, management, disposition, treatment, or rehabilitation of athletic injuries, and, in carrying out these functions the athletic trainer is authorized to use physical modalities, such as heat, light, sound, cold, electricity, or mechanical devices related to prevention, recognition, evaluation, management, disposition, rehabilitation, and treatment; an athletic trainer shall practice only in those areas in which such athletic trainer is competent by reason of training or experience that can be substantiated by records or other evidence found acceptable by the board in the exercise of the board's considered discretion; and
  3. “Board” means the board of athletic trainers.

Acts 1983, ch. 361, § 2; T.C.A., § 63-6-301; Acts 1993, ch. 361, § 1; 2000, ch. 694, § 1; 2006, ch. 872, § 1.

Cross-References. State board of medical examiners, title 63, ch. 6, part 1.

Law Reviews.

Selected Tennessee Legislation of 1983 (N. L. Resener, J. A. Whitson, K. J. Miller), 50 Tenn. L. Rev. 785 (1983).

63-24-102. Board — Establishment and appointment — Terms — Officers — Meetings — Reimbursement.

  1. There is established the board of athletic trainers to consist of five (5) members. Of the five (5) members:
    1. Three (3) members shall be athletic trainers licensed in the state;
    2. One (1) member shall be a physician licensed in the state; and
    3. One (1) member shall be a representative of the public who is not an athletic trainer and is not commercially or professionally associated with the health care industry.
    1. Members of the board shall be appointed by the governor. The Tennessee Athletic Trainers Society and the Tennessee Medical Association may each supply a list to the governor of at least three (3) nominees for each appointment or vacancy on the board in their respective categories. The governor may make an appointment from the lists.
      1. Each licensed athletic trainer appointed to serve on the board shall:
        1. Reside in the state for at least five (5) years immediately preceding appointment and at all times thereafter;
        2. Be currently licensed in good standing as a licensed athletic trainer in this state;
        3. Be currently engaged in the practice of athletic training as a licensed athletic trainer; and
        4. Have been licensed as an athletic trainer in the state for no fewer than five (5) years.
      2. Each physician appointed to serve on the board shall:
        1. Reside in the state for at least five (5) years immediately preceding appointment and at all times thereafter;
        2. Be currently licensed in good standing in the state; and
        3. Have been licensed as a physician in the state for no fewer than five (5) years.
      3. The representative of the public appointed to serve on the board shall:
        1. Reside in the state for at least five (5) years immediately preceding appointment and at all times thereafter;
        2. Have no direct or indirect financial interest in health care services;
        3. Have never been, or while serving on the board be, an athletic trainer or enrolled in any health care educational program; and
        4. Not be a member or employee of any board of control of any public or private health care group or organization.
    2. Members of the board shall serve one (1) four-year term and may be reappointed. Any board member may be removed by the governor after notice and a hearing for incompetence, neglect of duty, malfeasance in office or moral turpitude. Vacancies on the board created by the expiration of a term of office or for any other reason shall be filled by the governor in the same manner as the original appointment. Appointed members shall serve until their replacement has been appointed and has agreed to serve. In making appointments to the board, the governor shall strive to ensure that at least one (1) person serving on the board is a member of a racial minority.
    1. Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the board:
      1. Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the board shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the board, prior to serving as a member of the board. This subdivision (c)(1)(A) shall apply to all persons appointed or otherwise named to the board after July 1, 2010;
      2. No person who is a member of the board shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the board during such person's period of service as a member of the board. This subdivision (c)(1)(B) shall apply to all persons appointed or otherwise named to the board after July 1, 2010, and to all persons serving on the board on such date who are not registered as lobbyists; and
      3. No person who serves as a member of the board shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the board for one (1) year following the date such person's service on the board ends. This subdivision (c)(1)(C) shall apply to persons serving on the board as of July 1, 2010, and to persons appointed to the board subsequent to such date.
    2. A person who violates this subsection (c) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (c). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  2. The chair and vice chair of the board shall be chosen from one (1) of the three (3) athletic trainer members and elected by the board. The chair shall preside over all meetings and business of the board. The vice chair shall preside over the meetings and business of the board in the absence of the chair and shall be responsible for signing the approved minutes of the board. The length of the terms of the elected officers shall be determined by rules duly promulgated by the board.
  3. The board, for administrative purposes, shall meet at least annually and at such other times as necessary to conduct the business of the board at the call of the chair. For purposes of conducting board business, a majority of the members of the board shall constitute a quorum.
  4. 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, and other official business of the board, and necessary expenses for traveling and subsistence while attending 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.
  5. The board shall receive its administrative, legal and investigative support from the division of health related boards.

Acts 1983, ch. 361, § 3; T.C.A., § 63-6-302; Acts 1985, ch. 280, § 1; 2000, ch. 694, § 1; 2006, ch. 872, § 2; 2010, ch. 998, § 2.

Compiler's Notes. The board of athletic trainers, created by this section, terminates June 30, 2022. See §§ 4-29-112, 4-29-243.

63-24-103. Licensure requirement.

  1. No person shall represent themselves or claim to be an athletic trainer or perform, for compensation, any of the activities of an athletic trainer as defined in this chapter without first obtaining a license under this chapter.
  2. Nothing in this chapter shall be construed to prevent any person from serving as a student-trainer, or any similar position if such service is not primarily for compensation and is carried out under the supervision of an athletic trainer duly licensed as defined in this chapter and a physician licensed under this title. Such supervision will be provided under the guidelines of the National Athletic Trainers' Association (NATA) Board of Certification, Inc. and/or approved by the board.
    1. Persons who are certified by the board as athletic trainers on May 9, 2000, may practice as licensed athletic trainers, provided such persons meet all of the other requirements of this chapter.
    2. Upon the expiration of an athletic trainer's certificate, the board shall issue a license to replace such certificate, provided the athletic trainer has met all of the other requirements of this chapter.

Acts 1983, ch. 361, §§ 4, 10; T.C.A., §§ 63-6-303, 63-24-109; Acts 1989, ch. 591, § 112; 2000, ch. 694, § 1.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-24-104. Qualifications of applicants — Reciprocity.

  1. An applicant for an athletic trainer license must possess the following qualifications:
    1. Have met the athletic training curriculum requirements of a college or university approved by the board and give proof of graduation; and
    2. Satisfactorily completed all of the National Athletic Trainers' Association (NATA) Board of Certification, Inc. qualifications and be certified as an athletic trainer in good standing by the NATA Board of Certification, Inc., and/or approved by the board.
  2. An out-of-state applicant must possess the stated qualifications of subsection (a). Upon receipt of the initial athletic trainer licensure fee, the board may grant, without examination, a license to any qualified nonresident athletic trainer who holds a valid license or certificate issued by another state and whose qualifications are deemed by the board to be at least equivalent to those required for licensure in this state; provided, that such other state extends the same privilege to qualified athletic trainers who are residents of this state. An out-of-state applicant from a state not having a licensure or certification act will be eligible to take the jurisprudence examination if certified by the NATA Board of Certification, Inc., and approved by the board.

Acts 1983, ch. 361, § 5; T.C.A., § 63-6-304; Acts 1985, ch. 280, § 2; 1993, ch. 361, §§ 2, 3; 2000, ch. 694, § 1.

63-24-105. Licensure — Renewal — Retirement.

    1. An applicant for an athletic trainer license must submit an application to the board on forms prescribed by the board and submit the examination fee required by this chapter.
    2. The applicant is entitled to an athletic trainer's license if the applicant possesses the qualifications enumerated in § 63-24-104; completes and passes the certification requirements and examination of the National Athletic Trainers' Association Board of Certification, Inc. or its equivalent as determined by the board; completes the jurisprudence examination administered and/or selected by the board, to its satisfaction; pays the licensure fee as set in § 63-24-106; and has not committed an act that constitutes grounds for denial of a license under § 63-24-107.
  1. Any person who is issued initial licensure as an athletic trainer is deemed to be registered as such for two (2) years, or to the next even-numbered year immediately following conclusion of the initial two (2) calendar years. Thereafter, such person shall biennially apply to the board for certificate renewal and shall submit such information as may be requested by the board. Upon making an application for renewal, such person shall pay a renewal fee as prescribed pursuant to § 63-24-106.
  2. Any person licensed to practice by this chapter, who has retired or may hereafter retire from such practice in this state, shall not be made to register as required by this chapter if such person files with the board, an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice and such other facts as tend to verify such retirement as the board deems necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration, with the board as provided by this chapter, and shall meet other requirements as may be set by the board.
  3. Notwithstanding any provision of this chapter to the contrary, the division of health related boards, with the approval of the commissioner of health, 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¢). 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 (d).
  4. Any person who possesses a certificate or temporary certificate issued by the board shall be deemed to possess a license or temporary license, respectively. At the time of renewal, a certificate holder who is approved for renewal shall receive a license from the board rather than a renewal of the certificate.

Acts 1983, ch. 361, § 6; T.C.A., § 63-6-305; Acts 1985, ch. 280, §§ 3, 6; 1986, ch. 675, § 13; 1989, ch. 360, §§ 63, 64; 1993, ch. 361, § 4; 2000, ch. 694, § 1.

Cross-References. Licensure, §§  63-1-10363-1-112.

Retirement, §  63-1-111.

63-24-106. Fees.

  1. The board shall, by duly promulgated rules, establish the following fees:
    1. Athletic trainer application-examination fee;
    2. Initial athletic trainer licensure fee;
    3. Biennial licensure renewal fee;
    4. Late renewal fee;
    5. Licensure restoration fee; and
    6. Fee for obtaining a duplicate of licensure.
  2. The board is hereby authorized, by duly promulgated rules, to specify the conditions and circumstances, if any, under which one (1) or more of the fees in subsection (a) may be refunded in whole or in part.

Acts 1983, ch. 361, § 7; T.C.A., § 63-6-306; Acts 1985, ch. 280, § 4; 1989, ch. 523, § 48; 2000, ch. 694, § 1.

Cross-References. License and registration fees, §  63-1-112.

63-24-107. Denial, suspension or revocation of licensure.

  1. The board has the power and duty to:
    1. Deny, restrict or condition a license to any applicant who applies for the license through reciprocity or otherwise;
    2. Permanently or temporarily withhold issuance of a license;
    3. Suspend, limit or restrict a previously issued license for such time and in such manner as the board may determine;
    4. Reprimand, suspend, revoke or take such other disciplinary action in relation to an applicant or license holder as the board in its discretion may deem proper; or
    5. Permanently revoke a license.
  2. The grounds upon which the board shall exercise such power include, but are not limited to, circumstances in which the person has:
    1. Violated standards of practice as determined by the board;
    2. Practiced athletic training for compensation without holding an active license under this chapter;
    3. Used or attempted to use an athletic trainer license that has been suspended or revoked;
    4. Obtained or attempted to obtain an athletic trainer license by misleading statements, fraud or deceit or knowing misrepresentation;
    5. Used the title “athletic trainer” without being licensed under this chapter;
    6. Violated or conspired to violate this chapter, or rules and regulations promulgated pursuant to this chapter; or
    7. Been convicted of a felony for the commission of an offense that bears directly on the person's fitness to practice competently, as determined by the board.
  3. 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 1983, ch. 361, § 8; T.C.A., § 63-6-307; Acts 2000, ch. 694, § 1; 2006, ch. 872, § 4; 2016, ch. 719, § 6; 2018, ch. 745, § 38.

Compiler's Notes. Acts 2016, ch. 719, § 11 provided that this act, which added (b)(7), took effect on April 6, 2016, and shall apply to actions instituted by state entities on or after April 6, 2016.

Amendments. The 2018 amendment added (c).

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

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

63-24-108. Hearings — Procedure — Reissuance of licenses.

  1. Any person whose application is denied is entitled to a hearing before the board if the person submits a written request to the board. Disciplinary proceedings shall be conducted in accordance with the contested case provisions of the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  2. On application, the board may reissue a license to a person whose license has been cancelled or revoked, but the application may not be made prior to the expiration of a period of six (6) months after the order of cancellation or revocation has become final, and application shall be made in the manner and form as the board may require.
    1. Any person who practices in this state without having first complied with this chapter commits a Class B misdemeanor for each instance of such practice. Each day any person practices without first obtaining a valid license or renewing a license constitutes a separate offense.
    2. The board, in addition to the powers and duties expressed in this chapter with respect to the grant, denial and discipline of licensure 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 whose license has been suspended or revoked by action of the board, to enjoin the person from continuing to practice within this state. 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. 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 subdivision (c)(2), have the power to assess the criminal penalties.

Acts 1983, ch. 361, § 9; T.C.A., § 63-6-308; Acts 2000, ch. 694, § 1; 2006, ch. 872, § 5.

Cross-References. Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, § 63-1-134.

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

63-24-109. [Transferred.]

Compiler's Notes. Former § 63-24-109 was transferred to § 63-24-103(c) in 1990.

63-24-110. Exemptions.

  1. No provision of this chapter shall be construed so as to limit or prevent any person duly licensed or certified under the laws of this state from practicing the profession for which the person was licensed or certified.
  2. This chapter shall not be construed to apply to any person engaging in the practice of athletic training while employed for such purpose by a non-Tennessee post secondary educational institution or professional athletic organization that is temporarily present in this state for an athletic competition or exhibition.
  3. The board shall have the authority to assess civil penalties commensurate with those assessable under § 63-1-134 against persons who have knowingly employed, contracted for or otherwise utilized unlicensed persons in the practice of athletic training, with or without compensation.
  4. Nothing in this chapter shall be construed as applying to physicians duly licensed under this title who employ or contract for services provided by persons in the physician's office assisting in the care of patients and rendered under the supervision, control and responsibility of the licensed physician.

Acts 1983, ch. 361, §§ 12, 13; T.C.A., § 63-6-310; Acts 1985, ch. 280, § 5; 2000, ch. 694, § 1; 2006, ch. 872, § 6.

63-24-111. Powers and duties of board — Budget.

  1. The board has the power and duty to:
    1. Promulgate all rules that are reasonably necessary for the performance of its duties, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5;
    2. License athletic trainers in compliance with this chapter;
    3. Prescribe application forms for licensure and conduct, or select a licensure examination and establish the prerequisites, if any, for admission to the examination. The board is authorized to enter into a contract or agreement with an examination service and/or select an intermediary between the board and the examination service to process applicants for the examination;
    4. Establish fees, in addition to those enumerated in § 63-24-106, that are necessary for the operation of the board, in accordance with § 9-4-5117;
    5. Establish guidelines and standards for athletic trainers in the state that are not inconsistent with the other provisions of this chapter, and the grounds upon which disciplinary action may be taken, in addition to those causes enumerated in § 63-24-107;
    6. Establish all requirements for mandatory continuing education as a condition of continued licensure, including a mechanism for waiver of the requirements in cases of undue hardship; and
    7. Issue advisory private letter rulings to any affected licensed practitioner or license holder who makes a request regarding any matters within the board's primary jurisdiction. The private letter ruling shall only affect the person making the inquiry, and shall have no precedential value for any other inquiry or future contested case that might come before the board. Any dispute regarding a private letter ruling may be resolved pursuant to the declaratory order provisions of § 4-5-223, if the board chooses to do so.
  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 that the commissioner may deem proper for the necessary and proper expenses of the board. No expenditure shall be made by the board, unless and until the allotment has been made by the commissioner. The allotment shall be disbursed under the general budgetary laws of the state.

Acts 2006, ch. 872, § 3.

Compiler's Notes. Acts 2006, ch. 872, § 7 provided that the rules currently governing the practice of athletic trainers to the extent they are consistent with the act shall remain in effect until such time as the board may promulgate their replacements. The duties of the board of medical examiners that are contained in the currently existing rules shall be assumed by the board of athletic trainers created by the act.

Chapter 25
Dietetics/Nutrition Practice Act

63-25-101. Short title.

This chapter shall be known and may be cited as the “Dietetics/Nutrition Practice Act.”

Acts 1987, ch. 384, § 2.

63-25-102. Legislative findings.

The general assembly finds that the application of scientific knowledge relating to food is important in the treatment of illness and disease and the attainment and maintenance of health. There are currently no clear means for the public to identify the qualifications of persons providing dietetic services and nutritional care for infants, children, pregnant females, elderly persons, poor persons, overweight persons, chronically and terminally ill persons and fitness enthusiasts. Consumers and patients are becoming increasingly concerned about their diets and nutrition as well as the effectiveness of the information and services being offered to the public. The general assembly further finds that in order to protect the public health, safety and welfare, it is necessary to define the qualifications and requirements for persons offering certain dietetic and nutritional advice and services to the public. It is the purpose of this chapter to restrict the use of certain titles to persons who are professionally qualified to use them, thereby ensuring that persons practicing the profession of dietetics and nutrition meet minimum standards of proficiency and competency acquired through adequate training and experience.

Acts 1987, ch. 384, § 3.

63-25-103. Chapter definitions.

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

  1. “Board” means the board of dietitian/nutritionist examiners;
  2. “Department” means the department of health;
  3. “Dietetics/nutrition practice” means the integration and application of scientific principles of food, nutrition, biochemistry, physiology, management and behavioral and social sciences in achieving and maintaining health through the life cycle and in the treatment of disease. Methods of practice include, but are not limited to, nutritional assessment, development, implementation and evaluation of nutrition care plans, nutritional counseling and education, and the development and administration of nutrition care standards and systems;
  4. “Dietitian” and “nutritionist” may be used interchangeably;
  5. “Dietitian/nutritionist” means a health care professional practicing dietetics/nutrition and licensed under this chapter; and
  6. “Division” means the division of health related boards within the department.

Acts 1987, ch. 384, § 4.

63-25-104. Prohibited representations — License required — Construction.

  1. It is unlawful for any person to engage in the practice of dietetics/nutrition, to act or represent such person to be a dietitian or a nutritionist or to use such titles as “dietitian/nutritionist,” “licensed dietitian,” “licensed nutritionist,” or such letters as “L.D.,” “L.N.,” or any facsimile thereof, or any word, letters or title indicating or implying that such person is a dietitian/nutritionist, unless such person holds a license and otherwise complies with this chapter and the rules and regulations adopted by the board.
  2. Nothing in this chapter shall be construed to affect, prevent or restrict:
    1. Persons qualified and licensed to practice other health professions from engaging in the practice of dietetics/nutrition when incidental to the practice of their profession. This chapter shall in no way apply to persons licensed to practice medicine or osteopathic medicine pursuant to chapters 6 and 9 of this title;
    2. Students enrolled in an approved academic program in dietetics, if such practice constitutes a part of a supervised course of study and such student is designated by title clearly indicating such student's status as a student or trainee;
    3. A dietitian serving in the armed forces or the public health service of the United States or employed by the veterans administration from engaging in the practice of dietetics; provided, that such practice is related to such service or employment;
    4. Persons performing the activities and services of a nutrition educator in the employment of a federal, state, county or municipal agency or an elementary or secondary school or accredited degree granting educational institution, insofar as such activities and services are part of a salaried position;
    5. Federal, state, county or local employees involved with nutrition-related programs, including, but not limited to, the cooperative extension service, child nutrition programs and Project Headstart from engaging in the practice of dietetics/nutrition within the discharge of their official duties; provided, that any such person engaging in dietetic/nutrition practice outside the scope of such official duty must be licensed as provided in this section;
    6. Persons employed in a hospital or nursing home as defined in § 68-11-201 and subject to licensure by the Tennessee board for licensing health care facilities; or
      1. Persons who do not hold themselves out to be licensed and/or registered dietitians/nutritionists of the right to provide services and information related to nonmedical nutrition while:

        Conducting classes or disseminating information related to non-medical nutrition.

        Employed by or operating a business that sells health products, including dietary supplements, food or food materials, or provides nonmedical nutritional information or distributes nutritional literature; or

        Employed by or operating a health food store;

        Employed by or operating a health weight loss or fitness program;

      2. “Nonmedical” means engaging in any practice that does not constitute the practice of medicine, osteopathy, chiropractic, dentistry or podiatry.

Acts 1987, ch. 384, § 5; 1994, ch. 901, § 4.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-25-105. Development of therapeutic dietary regimens.

No therapeutic dietary regimen may be developed unless pursuant to the appropriate orders and/or referral of licensed practitioners of medicine, osteopathy, chiropractic, dentistry or podiatry when incidental to the practice of their respective professions.

Acts 1987, ch. 384, § 6.

63-25-106. Board of dietitian/nutritionist examiners.

  1. There is hereby created the board of dietitian/nutritionist examiners to consist of five (5) members appointed by the governor, each of whom shall be a resident of this state and shall have had at least five (5) years' experience in the actual practice or teaching of dietetics and/or nutrition. Appointments may be made from lists of qualified persons submitted to the governor by interested dietitian/nutritionist, hospital and medical groups, including, but not limited to, the Tennessee Dietetic Association, the Tennessee Hospital Association, and the Tennessee Medical Association, and shall represent such areas of practice as administrative dietetics, clinical dietetics, dietetic education, community nutrition and consultation and private practice. The governor shall consult with such interested groups to determine qualified persons to fill the positions.
  2. Of the initial appointments to the board, two (2) members shall be appointed for a term of three (3) years, two (2) members for a term of two (2) years, and one (1) member for a term of one (1) year. All regular appointments thereafter shall be for terms of three (3) years each. No member shall be eligible for appointment for more than two (2) consecutive terms, and each member shall serve on the board until a successor is appointed. Vacancies shall be filled by appointment of the governor for the unexpired term. In making appointments to the board, 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. The board shall organize annually and select a chair and a secretary. A quorum of the board shall consist of three (3) members, and meetings of the board shall be held as frequently as its duties may require. The division shall perform administrative functions for the board.
  4. Each member of the board shall receive compensation for services in an amount determined by the department, not to exceed fifty dollars ($50.00) per diem when actually engaged in the discharge of their official duties, and, in addition, shall be reimbursed for all travel expenses in accordance with the comprehensive state travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.

Acts 1987, ch. 384, § 7; 1988, ch. 1013, § 59; 2012, ch. 722, § 3.

Compiler's Notes. The board of dietitian/nutritionist examiners, created by this section, terminates June 30, 2022. See §§ 4-29-112, 4-29-243.

63-25-107. Powers and duties of board.

In addition to the powers granted elsewhere in this chapter, the board has the duty to:

  1. Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are reasonably necessary for the performance of the various duties imposed upon the board in the proper administration of this chapter;
  2. Set fees, after consultation with the department and subject to the maximum limitations prescribed in this chapter, relative to the application, examination, licensing and renewal thereof in amounts sufficient to pay all of the expenses of the board directly attributable to the performance of its duties pursuant to this chapter;
  3. Review and approve or reject the qualifications of applicants for licensure and to issue, in the board's name, all approved licenses, certificates and permits;
  4. Collect or receive all fees, fines and moneys owed pursuant to this chapter and to pay the same into the general fund of the state. For purposes of implementing subdivision (2), the board shall designate any such fees, fines or moneys collected pursuant to the regulation of dietitians/nutritionists; and
  5. Deny, suspend or revoke the license of or to otherwise discipline by an administrative penalty not to exceed five hundred dollars ($500), or by reprimand, a license holder who is guilty of violating any provisions of this chapter or who is guilty of violating the rules and regulations of the board duly promulgated pursuant to this chapter.

Acts 1987, ch. 384, § 8.

63-25-108. Applications for licensure.

An applicant for licensure as a dietitian/nutritionist shall file a written application on forms provided by the department or via online application showing to the satisfaction of the board that such person:

  1. Is of good moral character;
  2. Has received a baccalaureate or post-baccalaureate degree from a regionally accredited college or university that provides a major course of study in human nutrition, food and nutrition, dietetics, or food systems management, or an equivalent major course of study as approved by the board;
  3. Has successfully completed a planned continuous preprofessional experience in nutrition practice of not less than nine hundred (900) hours under the supervision of a registered dietitian, or successfully completed a program of supervised clinical experience approved by the commission on dietetic registration of the American Dietetic Association; and
  4. Has passed the national examination prepared and administered by the commission on dietetic registration of the American Dietetic Association.

Acts 1987, ch. 384, § 9; 2014, ch. 949, § 15.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-25-109. Issuance of licenses — Temporary permits.

  1. The board may, in its discretion, issue a license to an applicant upon such person providing evidence of current registration as a registered dietitian and upon payment of a licensing fee. The board may further waive the examination, education or experience requirements of this chapter and grant a license to an applicant who shall present proof of current licensure, certification or registration as a dietitian under the laws of another state, the District of Columbia, or territory of the United States, if, in the board's opinion, the educational and experiential qualifications and requirements were substantially equivalent to those required for licensure in this state.
    1. The board may, in its discretion, issue temporary permits to practice dietetics/nutrition to an applicant upon submission of satisfactory evidence that such person:
      1. Has successfully completed the academic and experiential requirements to be licensed as a dietitian/nutritionist;
      2. Has applied for or taken a licensing examination;
      3. Is awaiting notification of examination results; and
      4. Has paid the fee required for temporary permits.
    2. Temporary permits expire one (1) year from the date of issuance and may be renewed for a period not to exceed six (6) months upon submitting to the board a satisfactory explanation of the applicant's failure to become licensed within the one-year term.

Acts 1987, ch. 384, §§ 10, 11.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-25-110. Disciplinary action.

  1. The board is empowered to deny or refuse to renew a license, or suspend or revoke a license or permit, or issue orders to cease and desist from certain conduct or to otherwise lawfully discipline an applicant, a licensee, a permittee or a person found guilty of violating any provisions of this chapter when such person has:
    1. Attempted or obtained licensure by fraud or misrepresentation;
    2. Engaged in unethical or unprofessional conduct, including, but not limited to, willful acts, negligence or a pattern of continued and repeated health care liability, negligence or incompetence in the course of professional practice;
    3. Engaged in habitual intoxication or personal misuse of any drug, narcotic, controlled substance or controlled substance analogue so as to adversely affect the person's ability to practice;
    4. Been convicted of a felony or any offense under state or federal laws involving moral turpitude;
    5. Violated any lawful order, rule or regulation rendered or adopted by the board; or
    6. Violated any provision of this chapter.
  2. All administrative proceedings for disciplinary action against a license holder or permittee shall be conducted by the board in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
  3. 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.
    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.
      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.
    3. 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.
    4. 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.
  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 1987, ch. 384, § 12; 1999, ch. 441, § 3; 2012, ch. 798, § 48; 2012, ch. 848, § 81; 2018, ch. 745, § 39.

Amendments. The 2018 amendment added (e).

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

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

Licensure, §§ 63-1-10363-1-112.

Attorney General Opinions. The board of dietitian/nutritionist examiners 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).

63-25-111. Fees.

For the purpose of implementing this chapter, the board, by duly promulgated rule, shall establish fees for applications, examinations, renewals, reciprocity and other related matters.

Acts 1987, ch. 384, § 13; 1989, ch. 523, § 214.

Cross-References. License and registration fee, § 63-1-112.

Licensure, §§ 63-1-10363-1-112.

63-25-112. Failure to renew license or pay fee — Revocation and reinstatement of license.

  1. A licensee who fails to renew the licensee's license and to pay the biannual renewal fee after renewal becomes due shall have the license automatically revoked without further notice of hearing, unless renewal is made and all fees paid prior to the expiration of sixty (60) days from the date such renewal becomes due.
  2. Any person whose license is automatically revoked as provided in this section may have the license reinstated by the board in its discretion for good cause being shown, upon payment of all past-due renewal fees and upon the further payment of a nonrefundable sum as set by the board.

Acts 1987, ch. 384, § 13; 1989, ch. 523, § 215.

Cross-References. License and registration fee, § 63-1-112.

Licensure, §§ 63-1-10363-1-112.

63-25-113. Retirees.

Any person licensed to practice by this chapter, who has retired or may hereafter retire from such practice in this state, shall not be made to register as required by this chapter if such person files with this board an affidavit on a form to be furnished by the board, which affidavit states the date on which such person retired from such practice, and such other facts as tend to verify such retirement as the board deems necessary. If such person reengages in such practice in this state, such person shall apply for licensure with the board as provided by this chapter, and shall meet other requirements as may be set by the board.

Acts 1987, ch. 384, § 13.

Cross-References. Retirement, § 63-1-111.

Chapter 26
Electrologists Practice Act

63-26-101. Short title.

This chapter shall be known and may be cited as the “Electrologists Practice Act.”

Acts 1988, ch. 896, § 3; 1993, ch. 342, § 1; T.C.A., § 62-34-201.

Compiler's Notes. Acts 1993, ch. 342, § 1 transferred this chapter, formerly title 62, chapter 34, part 2, and reenacted it without change, effective October 1, 1993.

63-26-102. Chapter definitions.

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

  1. “Commissioner” means the commissioner of health and includes designees of the commissioner of health;
  2. “Electrologist” means any person practicing electrolysis for the permanent removal of hair;
  3. “Electrology” means the art and practice relating to the removal of hair from the normal skin of the human body by application of an electric current to the hair papilla by means of a needle or needles so as to cause growth inactivity of the hair papilla and thus permanently remove the hair;
  4. “Electrology instructor” means an electrologist who is licensed by the commissioner to practice and teach electrology;
  5. “Electrolysis” means the process by which the hair is removed from the normal skin by the application of an electric current to the hair root by means of a needle or needles, whether the process employs direct electric current or short wave alternating electric current or combination of both, or by FDA approved laser beam process designated for permanent hair removal; and
  6. “School” means an electrology school teaching the art of electrology.

Acts 1988, ch. 896, § 4; 1993, ch. 342, § 1; T.C.A., § 62-34-202; Acts 2009, ch. 456, §§ 1, 37.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

63-26-103. Prohibited practices.

  1. This chapter does not authorize the use of roentgen rays and radium for diagnostic and therapeutic purposes, or the use of electricity for purposes of skin cauterization, removal of warts, moles or other skin deformities.
  2. Electronic tweezers or nonneedle methods are prohibited within the practice of electrology, except as provided in this chapter.

Acts 1988, ch. 896, § 5; 1993, ch. 342, § 1; T.C.A., § 62-34-203.

63-26-104. [Reserved.]

63-26-106. Personnel.

Subject to appropriations for that purpose, the director of the division of health related boards shall employ and supervise all administrative personnel necessary to conduct the functions of this chapter.

Acts 1988, ch. 896, § 8; 1993, ch. 342, § 1; T.C.A., § 62-34-206; Acts 2009, ch. 456, § 4.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

63-26-107. Cumulative deficit of the board of electrolysis examiners — Disposition of fees — Expenditures.

  1. Any cumulative deficit of the board of electrolysis examiners remaining on June 23, 2009, shall be transferred to the account created in subsection (b) to be eliminated through payment of fees assessed on persons regulated pursuant to this chapter.
  2. All fees collected by the commissioner pursuant to this chapter shall be deposited by the state treasurer in a separate account exclusively for the electrolysis program established in this chapter, and shall be used by the commissioner to defray expenses necessary to administer this chapter. Unexpended and unobligated fees remaining in this account at the end of any fiscal year shall not revert to the general fund but shall be used to eliminate the cumulative deficit of the board of electrolysis examiners remaining on June 23, 2009. Upon elimination of the deficit, unexpended and unobligated fees remaining in this account shall not revert to the general fund but shall remain available for the purposes set forth in this chapter. Penalties imposed by the commissioner shall be deposited into the state general fund.

Acts 1988, ch. 896, § 9; 1993, ch. 342, § 1; T.C.A., § 62-34-207; Acts 2009, ch. 456, § 5.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Funds, deposits and disbursements, § 63-1-137.

License and registration fees, § 63-1-112.

63-26-108. Powers and duties of commissioner of health.

  1. The commissioner of health shall:
    1. Promulgate such rules and regulations as are necessary and reasonable for the enforcement of this chapter;
    2. Establish continuing education requirements;
    3. Establish standards for the training and practice of electrolysis;
    4. Maintain a list of all current licensed electrologists, licensed electrolysis schools and training centers, and licensed electrology instructors; and
    5. Adopt a code of ethics governing the practice of electrology by licensees under this chapter.
  2. In no event shall this chapter be interpreted as conferring on the commissioner the authority or jurisdiction to regulate the practice of medicine or osteopathy by persons licensed under chapter 6 or 9 of this title, or to regulate the activities of those persons employed by such licensed physicians, and who perform services under the supervision and control of licensed physicians or osteopaths who have made an evaluation of the patient and who have supervised a diagnostic screening with respect to the patient, unless such employees or agents are holding themselves out to be licensed electrologists. It is the specific intent of the general assembly that the regulation of the practice of medicine or osteopathy falls within the sole and exclusive purview of the licensing boards designated under chapter 6 and 9 of this title. Further, the commissioner shall have no jurisdiction or authority to regulate in any manner the practice of electrology by individuals licensed under chapter 6 or 9 of this title.

Acts 1988, ch. 896, § 10; 1993, ch. 342, § 1; T.C.A., § 62-34-208; Acts 1995, ch. 420, § 3; 2009, ch. 456, §§ 6-8.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Attorney General Opinions. A physician or registered nurse may be a member of a professional limited liability company (PLLC) “for the practice of electrolysis” only if the physician or the registered nurse holds a license to practice electrology; however, a medical doctor may be member of a PLLC for the practice of medicine and engage, in that capacity, in the practice of activities that would otherwise constitute the practice of electrology and may also employ a registered nurse who is not licensed as an electrologist to perform electrology services under the doctor's supervision and control, OAG 01-002, 2001 Tenn. AG LEXIS 4 (1/4/01).

63-26-109. Setting of fees.

The commissioner shall set fees for applications, examinations, renewals, reciprocity, school licensure and other related matters.

Acts 1988, ch. 896, § 11; 1989, ch. 523, § 213; 1993, ch. 342, § 1; T.C.A., § 62-34-209; Acts 2009, ch. 456, § 9.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Funds, deposits and disbursements, § 63-1-137.

License and registration fees, § 63-1-112.

63-26-110. Civil liability.

A person who acts in good faith shall not be civilly liable for providing information to the commissioner or a designee of the commissioner on any matter relative to the practice of electrolysis. This section shall apply to any person who acts in good faith to provide information to a designee of the commissioner in the course of an investigation of the practice of electrolysis.

Acts 1988, ch. 896, § 12; 1993, ch. 342, § 1; T.C.A, § 62-34-210; Acts 2009, ch. 456, § 10.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

63-26-111. Qualifications of applicants.

An applicant for a license to be an electrologist must:

  1. Be at least eighteen (18) years of age;
  2. Be of good moral character;
  3. Have been graduated by an accredited high school or have completed equivalent recognized education;
  4. Have completed an electrology education program that is approved under this chapter, which includes:
    1. At least one hundred fifty (150) hours of electrolysis theory and at least three hundred fifty (350) hours of clinical practice taught by a licensed electrology instructor;
    2. An electrology education program in any other state that the commissioner determines is substantially equivalent to that required by subdivision (4)(A); or
      1. At least six hundred (600) hours of electrology practice taught by a dermatologist approved by the commissioner who has documented continuing education in electrology theory and practice;
      2. Applicants who satisfy the educational requirements for licensure under this subdivision (4)(C) shall be eligible for practice as an electrologist only under the direct supervision and control of a dermatologist approved by the commissioner, and shall receive a limited license that bears an endorsement to that effect, upon passing the state board examination, payment of all prescribed fees and the satisfying of license renewal fees and requirements;
      3. The dermatologist shall notify the commissioner or the commissioner's designee as to each student who begins the training program pursuant to this subdivision (4)(C);
      4. The dermatologist shall also notify the commissioner or the commissioner's designee when an electrologist is no longer under the supervision and control of such dermatologist; and
      5. Hours of training and experience received by applicants after January 1, 1989, may be applied to the experience provisions of this subdivision (4)(C);
  5. Have successfully passed an examination approved by the commissioner;
  6. Have paid all fees required by this chapter; and
  7. Have submitted an application to the commissioner on a prescribed form.

Acts 1988, ch. 896, § 13; 1990, ch. 872, § 1; 1993, ch. 342, § 1; T.C.A., § 62-34-211; Acts 2009, ch. 456, §§ 11-17.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-26-112. Qualifications to be instructor.

To be eligible for licensing as an electrology instructor, in addition to the requirements of the registered electrologist, an applicant shall have:

  1. Practiced electrolysis actively for at least five (5) of the last ten (10) years prior to the application;
  2. Successfully passed an examination for an electrology instructor license that consists of written and verbal sections covering theoretical and clinical studies;
  3. Paid an examination fee set by the commissioner; and
  4. Submitted to the commissioner at least thirty (30) days before the examination is administered an approved form for application for license.

Acts 1988, ch. 896, § 14; 1993, ch. 342, § 1; T.C.A., § 62-34-212; Acts 2009, ch. 456, §§ 18-20.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-26-113. Examinations.

  1. Examinations for qualified applicants shall be offered at least once a year at the times and places determined by the commissioner or the commissioner's designee.
  2. Completed applications for examination must be received by the commissioner thirty (30) days prior to the examination date.
  3. The commissioner or the commissioner's designee shall notify each qualified applicant of the time and place of examination.
  4. The commissioner shall select an examination in which the testing and grading systems are recognized as standard in the field of professional licensure examinations.

Acts 1988, ch. 896, § 15; 1990, ch. 872, § 2; 1993, ch. 342, § 1; T.C.A., § 62-34-213; Acts 2009, ch. 456, § 21.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

63-26-114. Reexamination.

  1. If a candidate fails a part or parts of an examination, the candidate may retake a failed section of the examination or retake a subsequent examination, after paying the reexamination fee and submitting the commissioner-approved form for reexamination at least thirty (30) days prior to reexamination date.
  2. If, after two (2) attempts, the examination is not passed, the complete examination may be taken again only after the candidate:
    1. Completes an additional electrolysis education program that the commissioner recommends; and
    2. Pays the full examination fee.

Acts 1988, ch. 896, § 16; 1993, ch. 342, § 1; T.C.A., § 62-34-214; Acts 2009, ch. 456, §§ 22, 38.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

63-26-115. Licensing without examination.

  1. Without the required examination, the commissioner shall approve as a licensed electrologist any person meeting the provisions of § 63-26-111(1)-(3), (6) and (7) and who has actively been engaged in the practice of electrology in this state for a period of six (6) months or more prior to making application for licensure.
  2. Payment of the scheduled registration fee to the commissioner shall accompany an application.
    1. Except as provided in subdivision (c)(2), no electrologist shall be registered by the commissioner to practice without examination, unless a recognized out-of-state license is valid and acceptable.
    2. The commissioner is authorized to register an electrologist to practice in this state without taking the required examination, even if an out-of-state license has not been issued, to a person who provides proof satisfactory to the commissioner that:
      1. The person requesting a license has practiced electrology five (5) years or more in a state that does not require a license for practice; and
      2. The person is a certified electrologist; or
      3. The person requesting a license meets requirements as determined by rules adopted by the commissioner.
  3. The commissioner shall require satisfactory documentation of any prior continuous electrolysis practice.

Acts 1988, ch. 896, § 17; 1989, ch. 360, § 65; 1993, ch. 342, § 1; T.C.A., § 62-34-215; Acts 2006, ch. 742, § 1; 2009, ch. 456, § 23.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-26-116. Licensing of instructors without examination.

  1. The commissioner shall approve as a licensed electrology instructor without the required examination any person who meets the waiver requirements in § 63-26-115 and who has taught electrology for at least three (3) consecutive years prior to June 30, 1989.
  2. The commissioner shall require satisfactory documentation of prior continuous teaching in electrology.
  3. Application for an electrology teaching license shall be made on a form provided by the commissioner.
  4. Payment of the scheduled fee for an electrology instructor license shall accompany an application.

Acts 1988, ch. 896, § 18; 1989, ch. 360, § 66; 1993, ch. 342, § 1; T.C.A., § 62-34-216; Acts 2009, ch. 456, § 24.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-26-117. Waiver of examination.

  1. The commissioner may grant a waiver of examination; provided, that the applicant:
    1. Provides adequate evidence that an electrology license was acquired after passing an electrology examination in another state, and that the examination was substantially equivalent to the examination for which the applicant seeks waiver in this state;
    2. Became licensed in another state after meeting other requirements that are substantially equivalent to the requirements of this chapter;
    3. Pays the appropriate application and license fees; and
    4. Submits the required application form for licensing.
  2. The commissioner may grant a waiver of examination for an electrology instructor license; provided, that the applicant:
    1. Furnishes proof that the applicant has met the requirements of subdivisions (a)(1) and (2);
    2. Has filed an application for a license; and
    3. Has paid the required license fee.
  3. The commissioner or a designee of the commissioner shall have the discretion to grant a waiver of examination to an applicant; provided, that a written explanation of the waiver is provided to the applicant and made available to persons requesting a copy of the explanation.

Acts 1988, ch. 896, § 19; 1993, ch. 342, § 1; T.C.A., § 62-34-217; Acts 2009, ch. 456, §§ 25, 39.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

63-26-118. Issuance of license — Display — Changes.

  1. The commissioner shall issue a license to an applicant meeting the requirements of this chapter for the license designation as an electrologist, or an electrology instructor, or an approved school teaching electrology.
  2. All licenses issued by the commissioner must be conspicuously displayed at the site of use.
  3. All licensees shall keep the commissioner informed of any changes of address.

Acts 1988, ch. 896, § 20; 1993, ch. 342, § 1; T.C.A., § 62-34-218; Acts 2009, ch. 456, § 26.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Licensure, §§ 63-1-10363-1-112.

Attorney General Opinions. A physician or registered nurse may be a member of a professional limited liability company (PLLC) “for the practice of electrolysis” only if the physician or the registered nurse holds a license to practice electrology; however, a medical doctor may be member of a PLLC for the practice of medicine and engage, in that capacity, in the practice of activities that would otherwise constitute the practice of electrology and may also employ a registered nurse who is not licensed as an electrologist to perform electrology services under the doctor's supervision and control, OAG 01-002, 2001 Tenn. AG LEXIS 4 (1/4/01).

63-26-119. Authority over educational programs — Fraudulent or deceptive promotions.

  1. In addition to other powers and duties, the commissioner has the authority to:
    1. Set standards by which an electrology education program may be approved;
    2. Review with the state board of education and the Tennessee higher education commission a progressive electrology education program in the state;
    3. Evaluate the need for such programs in the geographical area in which the electrology program will be located;
    4. Approve and license institutions in this state that meet the requirements of the electrology education program;
    5. Maintain a list of the institutions offering electrology education programs approved by the commissioner; and
    6. Remove an institution from the list of institutions that offer approved electrology education if the institution:
      1. Is guilty of fraud or deceit in obtaining or attempting to obtain approval;
      2. Acts in a manner not consistent with generally accepted standards for the practice of electrology;
      3. Violates standards set under this chapter and fails to correct the violation in a reasonable time after notice has been given;
      4. No longer operates a program that is approved under this chapter; or
      5. Promotes electrology in a manner that the commissioner determines is unreasonable, misleading or fraudulent.
  2. The commissioner shall monitor fraudulent or deceptive promotion of permanent hair removal procedures.

Acts 1988, ch. 896, § 21; 1993, ch. 342, § 1; T.C.A., § 62-34-219; Acts 2009, ch. 456, §§ 27-29; 2019, ch. 459, § 54.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Acts 2019, ch. 459, § 55 provided that the division of consumer affairs in the department of commerce and insurance shall coordinate with the attorney general and reporter to transfer all documents, information, systems, and other material deemed relevant to the operation of the division of consumer affairs of the office of the attorney general and reporter.

Amendments. The 2019 amendment deleted “and report such promotions to the division of consumer affairs of the department of commerce and insurance” following “procedures” at the end of (b).

Effective Dates. Acts 2019, ch. 459, § 56. September 30, 2019.

Cross-References. Display of license or registration certificate, § 63-1-109.

Grounds for license denial, suspension or revocation, § 63-6-214.

Licensure, §§ 63-1-10363-1-112.

63-26-120. Renewal of licenses — Revocation and reinstatement.

  1. Each licensed electrologist and each licensed electrology instructor shall pay the scheduled annual renewal fee to the commissioner, payable in advance, for the following year on or before December 31 of each year that such renewal fee is due.
  2. Each licensed electrology school shall pay the scheduled annual renewal fee to the commissioner, payable in advance, for the following year on or before December 1 of each year that such renewal fee is due.
  3. The commissioner shall renew the license of each licensee who meets the specified requirements for renewal or for registration.
  4. When any electrologist licensee, electrology instructor licensee, or licensed electrology school shall fail to register and pay the annual registration fee within sixty (60) days after such registration becomes due, the license of such person or school shall be automatically revoked without further notice or hearing.
  5. Any person or school whose license is automatically revoked may make application in writing to the commissioner for the reinstatement of such license, and upon good cause being shown, the commissioner, in the commissioner's discretion, may reinstate such license upon payment of all past-due renewal fees and upon payment of the scheduled reinstatement fee.

Acts 1988, ch. 896, § 22; 1993, ch. 342, § 1; T.C.A., § 62-34-220; Acts 2009, ch. 456, § 30.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

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

License and registration fees, § 63-1-112.

License renewals, § 63-1-107.

Penalty for practicing without license, § 63-26-127.

63-26-121. Retirement from practice.

Any licensee who has retired, or may hereafter retire from practice in this state, shall not be made to register if such person files with the commissioner an affidavit on a form to be furnished by the commissioner. The affidavit shall state the date on which the person retired from practice and any other facts the commissioner deems necessary to verify the retirement. If such person thereafter reengages in practice in this state, then such person shall apply for registration with the commissioner and meet any other requirements as may be prescribed by the commissioner.

Acts 1988, ch. 896, § 23; 1993, ch. 342, § 1; T.C.A., § 62-34-221; Acts 2009, ch. 456, § 31.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Retirement, § 63-1-111.

63-26-122. Unlawful practice.

It is unlawful for any person to practice or attempt to practice electrology in this state, unless such person has been issued a valid and current license to practice electrology. This section does not apply to a student who is practicing electrolysis as part of an approved electrolysis education program.

Acts 1988, ch. 896, § 22; 1993, ch. 342, § 1; T.C.A., § 62-34-222.

Attorney General Opinions. A physician or registered nurse may be a member of a professional limited liability company (PLLC) “for the practice of electrolysis” only if the physician or the registered nurse holds a license to practice electrology; however, a medical doctor may be member of a PLLC for the practice of medicine and engage, in that capacity, in the practice of activities that would otherwise constitute the practice of electrology and may also employ a registered nurse who is not licensed as an electrologist to perform electrology services under the doctor's supervision and control, OAG 01-002, 2001 Tenn. AG LEXIS 4 (1/4/01).

63-26-123. Grounds for suspending, revoking or denying a license.

  1. The commissioner has the authority to suspend, revoke or otherwise deny a license whenever a licensee is found guilty of any of the following acts or offenses:
    1. Fraud in procuring a license;
    2. Conviction of a felony;
    3. Habitual intoxication or addiction to the use of narcotic drugs or controlled substances or controlled substance analogues;
    4. Immoral, unprofessional, unethical or dishonorable conduct; or
    5. 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 electrology by such person.
  2. 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 1988, ch. 896, § 25; 1993, ch. 342, § 1; T.C.A., § 62-34-223; Acts 2009, ch. 456, § 32; 2012, ch. 848, § 82; 2018, ch. 745, § 40.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Amendments. The 2018 amendment added (b).

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

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

63-26-124. Administrative procedures.

All proceedings shall be in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1988, ch. 896, § 26; 1993, ch. 342, § 1; T.C.A., § 62-34-224.

63-26-125. Enjoining prohibited practices.

The commissioner is authorized and empowered to petition any circuit or chancery court having jurisdiction to enjoin any person who is practicing or attempting to practice electrology without possessing a valid license to practice, and to enjoin any person, firm or corporation from performing any act or rendering any service that constitutes the practice of electrology.

Acts 1988, ch. 896, § 27; 1993, ch. 342, § 1; T.C.A., § 62-34-225; Acts 2009, ch. 456, § 33.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

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

63-26-126. Assistance of district attorneys general.

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

Acts 1988, ch. 896, § 28; 1993, ch. 342, § 1; T.C.A., § 62-34-226; Acts 2009, ch. 456, § 34.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

63-26-127. Penalties — Disposition of fines.

  1. Any person who practices electrology without a license commits a Class C misdemeanor.
  2. Each violation of this chapter constitutes a separate offense.
  3. All civil penalties for a violation of this chapter shall be paid to the commissioner and given to the state treasurer as provided in § 63-26-107.

Acts 1988, ch. 896, § 29; 1989, ch. 591, § 113; 1993, ch. 342, § 1; T.C.A., § 62-34-227; Acts 2009, ch. 456, §§ 35, 40.

Compiler's Notes. Acts 2009, ch. 456, § 41 provided that all rules and regulations filed by the board of electrolysis in the office of secretary of state on June 23, 2009, shall be deemed to be rules and regulations of the commissioner of health. The secretary of state is authorized and directed to change any references to the board of electrolysis to references to the commissioner of health in rules and regulations promulgated by the board of electrolysis pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. The rules and regulations of the board of electrolysis that were properly promulgated pursuant to title 4, chapter 5 shall remain in effect until subsequently amended or repealed.

Cross-References. Funds, deposits and disbursements, § 63-1-137.

License and registration fees, § 63-1-112.

Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, § 63-1-134.

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

63-26-105. [Reserved.]

Chapter 27
Respiratory Care Practitioner Act

63-27-101. Short title.

This chapter shall be known and may be cited as the “Respiratory Care Practitioner Act.”

Acts 1986, ch. 610, § 1; T.C.A. § 63-6-401; Acts 1998, ch. 1106, § 55.

63-27-102. Chapter definitions.

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

  1. “Board” means the board of respiratory care;
  2. “Certified respiratory therapist” means any person who has obtained the credential “certified respiratory therapist” (CRT) or the credential “certified respiratory therapy technician” (CRTT) from the National Board for Respiratory Care;
  3. “Division” means the division of health related boards as defined by § 68-1-101;
      1. “Practice of respiratory care” means, under the supervision, control and responsibility of a licensed physician, the therapy, management, education and instruction, rehabilitation, diagnostic testing evaluation, and care of patients with deficiencies and abnormalities that affect the cardiorespiratory system and associated aspects of other system functions. “Practice of respiratory care” also means, under the supervision, control and responsibility of a licensed physician, the performance of cardiorespiratory research, cardiorespiratory health promotion and disease prevention, and community wellness and education programs. “Practice of respiratory care” includes, under the supervision, control and responsibility of a licensed physician:
  1. The administration of pharmacologic agents and medical gasses necessary to diagnose, implement treatment, promote disease prevention, and provide rehabilitation to the cardiorespiratory system. In no event, however, shall a respiratory care practitioner prescribe controlled substances of any kind;
  2. The performance of specific diagnostic and testing techniques employed in the medical management of patients to assist in diagnosis, patient and family education, monitoring, treatment, maintenance of patient health status, and cardiorespiratory research including, but not limited to, pulmonary function testing, hemodynamic and physiologic monitoring and diagnosis of cardiac function, and specimen collection and analysis;
  3. The establishment and maintenance of the airways, bronchopulmonary hygiene, and cardiopulmonary resuscitation, and cardiac and respiratory life support; and
  4. The receipt and implementation of written and verbal physician orders and the development and implementation of care plans and protocols;

The practice of respiratory care may be performed in an inpatient or outpatient setting, clinic, hospital, nursing home facility, private dwelling, or other place deemed appropriate or necessary;

Registered respiratory therapists, certified respiratory therapists, and respiratory assistants who have been issued a license or certificate by the board, pursuant to the authority of § 63-27-104(a)(1), shall be exempt from any licensing, certification or permit requirements of the Tennessee Medical Laboratory Act, compiled in title 68, chapter 29, as amended, for medical laboratory personnel or medical laboratory trainees insofar as they engage in performing blood gases and PH analyses;

“Registered respiratory therapist” means any person who has obtained the credential “registered respiratory therapist” (RRT) from the National Board for Respiratory Care;

“Respiratory assistant” or “assistant” means any person certified as such pursuant to this chapter, who has:

Received on-the-job training equivalent to at least one thousand (1,000) hours of clinical training in respiratory care, during an eighteen (18) consecutive month period; provided, that such training shall have been received under supervision of either a:

Registered respiratory therapist;

Certified respiratory therapist; or

Licensed physician experienced in respiratory care; and

Passed a board-approved examination for respiratory assistants. The National Board for Respiratory Care (NBRC) entry level examination, as provided to the board by the NBRC, by contract, is the examination accepted by the board. This examination will not grant the respiratory assistant the NBRC credential. In addition, the board reserves the right to write its own state board examination or contract with other national testing organizations; and

“Respiratory care practitioner” means a registered respiratory therapist, a certified respiratory therapist, or a respiratory assistant licensed under this chapter.

Acts 1986, ch. 610, § 1; 1987, ch. 192, §§ 12, 13; T.C.A., § 63-6-402; Acts 1998, ch. 1106, §§ 1-4, 25-30, 50, 55; 2000, ch. 621, §§ 1-3; 2002, ch. 662, § 1.

63-27-103. Board of respiratory care.

  1. A board is created, which shall be known as the board of respiratory care. This board shall consist of eight (8) members, who shall be appointed by the governor in the manner and for the terms of office as provided in this section.
  2. The board shall be composed of four (4) members who are respiratory care practitioners holding a credential from the National Board for Respiratory Care, at least two (2) of whom shall be registered respiratory therapists; one (1) member who is a currently practicing physician having expertise in pulmonary medicine; one (1) member who is a hospital administrator; one (1) member who is a hospital employee licensed as a registered respiratory therapist; and one (1) citizen member who is not commercially or professionally associated with the health care field.
  3. Each member of the board shall:
    1. Be a resident of Tennessee for at least one (1) year immediately preceding appointment and during the member's term;
    2. Be currently licensed in good standing in Tennessee, in the case of a professional member; and
    3. Have had at least three (3) years of experience in that profession (in the case of a professional member).
  4. The governor may consider for appointment to the board the names of qualified persons recommended by interested respiratory care groups, including, but not limited to, the professional organizations for each profession represented on the board. The Tennessee Society for Respiratory Care may submit a list of three (3) names for each position to be filled by a respiratory care practitioner. The Tennessee Medical Association may submit a list of three (3) names for the position to be filled by a physician having expertise in pulmonary medicine. The Tennessee Hospital Association (THA), an association of hospitals and health systems, may submit a list of three (3) names for the position to be filled by a hospital administrator and a list of three (3) names for the position to be filled by a hospital employee licensed as a registered respiratory therapist. The governor shall consult with the interested respiratory care groups to determine qualified persons to fill the positions.
  5. Each member shall serve a term of three (3) years, except that initially the members of the council on respiratory care shall become members of the board and shall remain members of the board until their terms on the council on respiratory care would have expired. The governor shall stagger the terms of the remaining members appointed to the board, so that the terms of either two (2) or three (3) members shall expire each year. A vacancy occurring on the board shall be filled by the board itself for the unexpired term of that member. At or before the expiration of a member's term, an organization named in subsection (d) may submit three (3) names to the governor for appointment to that position. Each member shall serve until a successor is appointed. Members are eligible for reappointment to successive terms.
  6. In making appointments to the board, the governor shall strive to ensure that at least one (1) member is sixty (60) years of age or older, that at least one (1) member is a member of a racial minority, and that the gender balance of the board reflects the gender balance of the state's population.
  7. Each member shall be reimbursed for actual expenses incurred in the performance of official duties on the board, and in addition thereto, shall be entitled to a per diem of fifty dollars ($50.00) for each day's services in conducting the business of the board. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  8. Annually, the board shall choose a chair and a secretary from among its members.
  9. The board shall hold at least one (1) regular meeting each year and such other meetings as the board determines necessary to conduct its business.
  10. A majority of the members of the board shall constitute a quorum for the transaction of business. No action of the board shall be valid unless approved by a majority of members present at a meeting at which there is a quorum.
  11. The governor has the power to remove from office any member of the board for neglect of duties required by this chapter, for malfeasance in office, for incompetence, or for unprofessional conduct.
  12. The board shall deposit all moneys received by the board into the state treasury, and the department shall make such allotments out of the board's account in the general fund as the department deems proper for the necessary expenses of the board.
  13. The division shall provide administrative, investigatory, and clerical services to the board as are necessary to implement and enforce this chapter.
  14. On and after January 1, 1999, the board shall assume and fulfill all powers and duties heretofore assigned to the council on respiratory care and the board of medical examiners, and the rules heretofore adopted by the council on respiratory care and the board of medical examiners shall become the rules of the board on January 1, 1999, without further action by the board. The board shall consult with respiratory care professional organizations in the development of any additional regulations.

Acts 1986, ch. 610, § 1; 1988, ch. 1013, § 44; 1993, ch. 86, § 1; T.C.A. § 63-6-403; Acts 1998, ch. 1106, §§ 24, 28, 29, 55; 2000, ch. 621, § 3; 2012, ch. 630, § 3.

Compiler's Notes. The board of respiratory care, created by this section, terminates June 30, 2022. See §§ 4-29-112, 4-29-243.

63-27-104. Powers of board.

  1. In addition to the powers elsewhere in this chapter, the board has the duty to:
      1. Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are reasonably necessary for the performance of the various duties imposed upon the board by this chapter. Except as otherwise specifically provided by this subdivision (a)(1)(A), all rules relating exclusively to registered respiratory therapists, certified respiratory therapists or respiratory assistants shall be initiated and adopted by a majority of the members of the board. Subject to the limitations contained in this section, all rulemaking authority delegated by this chapter shall be vested in the board. The board shall conduct at least one (1) public hearing each year, and shall undertake such other activities as shall be reasonably necessary, to solicit comments from license and certificate holders and the public concerning policies of the board relating to respiratory care, as well as any problems existing within the practice of respiratory care that may affect the public;
      2. Within the maximum limitations established elsewhere in this chapter, fees relating to the practice of respiratory care shall be set by the board in an amount sufficient to pay all of the expenses of the board;
    1. Issue, under the board's name, all licenses approved by the board and to maintain a registry of all license holders. It is the duty of the board to review and approve the qualifications of applicants for licensure or renewal as registered respiratory therapists, certified respiratory therapists or respiratory assistants. The board may limit, restrict, or impose one (1) or more conditions on a license at the time it is issued, renewed, reactivated, or reinstated; and
    2. Collect or receive all fees, fines and moneys owed pursuant to this chapter and to pay the same into the general fund of the state.
  2. The board is authorized to issue advisory private letter rulings to any person licensed under this chapter who makes such a request regarding any matters within the board's primary jurisdiction. Such private letter ruling shall affect only 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.

Acts 1986, ch. 610, § 1; T.C.A. § 63-6-404; Acts 1998, ch. 1106, §§ 5-7, 27-29, 31, 32, 55; 2000, ch. 621, §§ 2-5.

63-27-105. Practice of respiratory care — License renewal.

  1. In order to safeguard life, health and property and promote public welfare by requiring that only properly qualified persons shall practice respiratory care in this state, any person practicing respiratory care shall be licensed as provided in this chapter, and it is unlawful for any person to practice or offer to practice respiratory care unless such person has been duly licensed under this chapter, except as provided in this section.
    1. A person seeking licensure as a registered respiratory therapist or a certified respiratory therapist must be at least eighteen (18) years of age and of good moral character, must pay the required fees set by the board, and must meet the requirements of subdivisions (b)(1)(A) or (b)(1)(B):
      1. A person applying for licensure as a registered respiratory therapist shall provide evidence satisfactory to the board that such person has successfully completed a respiratory care educational program accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) in collaboration with the Committee on Accreditation for Respiratory Care (CoARC), or their successor organizations, and has successfully passed the National Board for Respiratory Care registry examination for advanced respiratory therapists; and
      2. A person applying for licensure as a certified respiratory therapist shall provide evidence satisfactory to the board that the person has successfully completed a respiratory care educational program accredited by the CAAHEP in collaboration with the CoARC, or their successor organizations, and has successfully passed the National Board for Respiratory Care certification examination for entry level respiratory therapists.
    2. After January 1, 2000, no person may be licensed as a respiratory assistant if that person has not been previously licensed as a respiratory assistant in Tennessee. However, persons who have been licensed as respiratory assistants may continue to renew their licenses indefinitely so long as they meet all the requirements for renewal.
    1. Each respiratory care practitioner licensed pursuant to this chapter shall biennially apply to the board for renewal of the license and shall pay a renewal fee set by the board. A respiratory care practitioner who fails to renew the license by the date of expiration of the license shall not continue to practice respiratory care in the state.
    2. A respiratory care practitioner who fails to timely renew the license may seek reinstatement of the license 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.
  2. A person licensed to practice as a certified respiratory therapist may upgrade the license to registered respiratory therapist if the person furnishes evidence satisfactory to the board that the person meets all the requirements to be licensed as a registered respiratory therapist. A person licensed to practice as a respiratory assistant may upgrade the license to certified respiratory therapist or registered respiratory therapist if the person furnishes evidence satisfactory to the board that the person meets all the requirements to be licensed as a certified respiratory therapist or registered respiratory therapist. A person may not hold more than one (1) Tennessee license to practice respiratory care at the same time.

Acts 1986, ch. 610, § 1; 1989, ch. 360, §§ 25, 26; 1989, ch. 523, § 50; T.C.A. § 63-6-405; Acts 1998, ch. 1106, §§ 8, 27-29, 33, 34, 44-46, 55; 2000, ch. 621, §§ 2, 3; 2002, ch. 662, §§ 2, 3.

Cross-References. Individuals applying for certification between July 1, 1986 and June 30, 1987, § 63-27-113.

Licensure, §§ 63-1-103 — 63-1- 112.

63-27-106. Registered respiratory therapist.

  1. The knowledge and skills for performing the functions of a registered respiratory therapist shall be acquired by academic and clinical preparation in a respiratory care program approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or its successor organization or other accrediting organization recognized by the board or by registry from the National Board for Respiratory Care. Registered respiratory therapists may assume primary clinical responsibility for all respiratory care modalities. Such modalities shall include, but are not limited to, accepting telephone and verbal orders and responsibilities involving the supervision of certified respiratory therapists and respiratory assistants.
  2. Under the supervision of a physician, a registered respiratory therapist may be required to exercise considerable independent clinical judgment in the respiratory care of patients. The registered respiratory therapist must also be capable of serving as a technical resource person to the physician regarding current practices in respiratory care and to the hospital staff regarding effective and safe methods for administering respiratory care.

Acts 1986, ch. 610, § 1; 1987, ch. 192, § 1; T.C.A. § 63-6-406; Acts 1998, ch. 1106, §§ 27-29, 53, 55; 2000, ch. 621, §§ 2, 3.

Cross-References. Applicants for certification between July 1, 1986 and June 30, 1987, § 63-27-113.

63-27-107. Certified respiratory therapist.

  1. The knowledge and skills for performing the functions of a certified respiratory therapist shall be acquired by academic and clinical preparation in a respiratory care program approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or its successor organization or other accrediting organization recognized by the board or by certification from the National Board for Respiratory Care. Under the supervision of a physician, certified respiratory therapists may assume clinical responsibility for specified respiratory care modalities involving the application of well-defined therapeutic techniques.
  2. The certified respiratory therapist's role shall not require the exercising of independent, clinical judgment; however, the certified respiratory therapist may be expected to adjust or modify therapeutic techniques within well-defined procedures based on a limited range of patient responses. Therefore, the effective use of the certified respiratory therapist, especially in the critical care setting, shall require the supervision of a physician experienced in respiratory care. The certified respiratory therapist may accept telephone or verbal orders and responsibilities involving the supervision of respiratory care therapists and respiratory assistants.

Acts 1986, ch. 610, § 1; 1987, ch. 192, § 2; T.C.A. § 63-6-407; Acts 1998, ch. 1106, §§ 28, 53, 55; 2000, ch. 621, § 2.

Cross-References. Applicants for certification between July 1, 1986 and June 30, 1987, § 63-27-113.

63-27-108. Respiratory assistants.

  1. The knowledge and skills for performing the functions of a respiratory assistant shall be acquired through compliance with the requirements of § 63-27-102(4).
  2. The assistant's role shall not include the exercising of independent, clinical judgment. The assistant may be expected to adjust or modify therapeutic techniques within well-defined procedures based on a limited range of patient responses. Therefore, the use of the assistant requires the supervision of a registered respiratory therapist, certified respiratory therapist, or physician experienced in respiratory care. No assistant shall be permitted to perform the functions for which the assistant is certified on a critical care patient being maintained on mechanical ventilation, unless the assistant possesses a certificate that indicates the assistant has passed the critical care section of the board approved examination for respiratory assistants.

Acts 1986, ch. 610, § 1; 1987, ch. 192, § 3; T.C.A. § 63-6-408; Acts 1998, ch. 1106, §§ 27-29, 55; 2000, ch. 621, §§ 2, 3.

Cross-References. Applicants for certification between July 1, 1986 and June 30, 1987, § 63-27-113.

63-27-109. Continuing education — Revocation of license — Retirement.

  1. Every licensed respiratory care practitioner shall obtain, during each calendar year, at least ten (10) hours of continuing professional respiratory care education that meets the guidelines established for such continuing education by the rules of the board. Each licensed practitioner shall maintain written proof of obtaining such continuing education for a period of at least three (3) years and shall, upon request, make such proof available to the board or the division.
  2. The board shall approve only those continuing education courses that conform with the guidelines established by the rules of the board. Providers of such courses shall also be approved by the board in accordance with guidelines established by the rules of the board. Course offerings approved for in-service training by the joint commission on accreditation of health care organizations and in-service training programs sponsored or conducted by the Tennessee Society of Respiratory Care shall be deemed to be approved courses.
  3. The rules of the board may establish exceptions from the requirements of this section in emergency or hardship cases. Such cases shall be individually reviewed and approved by the board.
  4. When any such person shall fail to renew that person's license and pay the renewal fee after renewal becomes due, the license of such person shall be automatically revoked without further notice or hearing unless renewal is made and all fees paid prior to the expiration of sixty (60) days from the date such renewal becomes due.
  5. Any person licensed to practice by this chapter, who has retired or may hereafter retire from such practice in this state, shall not be made to register as required by this chapter if such person shall file with the board, an affidavit on a form to be furnished by the board, which affidavit shall state the date on which such person retired from such practice and such other facts as shall tend to verify such retirement as the board shall deem necessary. If such person thereafter reengages in such practice in this state, such person shall apply for registration with the board as provided by this chapter and shall meet other requirements as may be set by the board.

Acts 1986, ch. 610, § 1; 1987, ch. 192, § 14; 1993, ch. 86, §§ 5, 6; T.C.A. § 63-6-409; Acts 1998, ch. 1106, §§ 9-12, 35-37, 55; 2000, ch. 621, § 6.

Cross-References. Certification renewal of individuals applying for certification between July 1, 1986 and June 30, 1987, § 63-27-113.

Grounds for license denial, suspension or revocation, § 63-6-214.

Licensure, §§ 63-1-103 — 63-1- 112.

63-27-110. Exemptions.

    1. Nothing in this chapter shall prohibit:
      1. Any person licensed or certified to practice any of the other health-related professions in this state under any other law from engaging in the practice for which such person is licensed or certified; or
      2. Persons employed as subsidiary workers who do not represent themselves to be registered respiratory therapists, certified respiratory therapists or assistants from assisting in the respiratory care of patients under the direction and supervision of a licensed physician.
    2. As used in this section, “subsidiary worker” means an individual who occasionally administers oxygen or other therapeutic gas under the orders of a licensed physician, osteopath or doctor of dentistry, and who is not involved in any other aspect of the direct delivery of respiratory care procedures or the administration of diagnostic tests of the cardio-respiratory function. “Subsidiary worker” does not include an individual who delivers and installs respiratory care equipment in hospitals, in the home and in alternate care sites.
  1. Nothing in this chapter shall be construed to apply to a registered nurse or to a licensed practical nurse employed by a licensed nursing home when such person is under the supervision of a registered nurse or a licensed physician, and so long as such licensed practical nurse does not maintain and manage life support systems.
  2. With respect to licensed health care professionals that lawfully engage in the practice of respiratory care within the scope of practice of their professions, the board may develop mechanisms and standards for ensuring the competency of such licensed professionals in their practice of respiratory care, and may recommend to the health-related board for each such profession that that board adopt, by rule or otherwise, mechanisms and standards for ensuring competency in the practice of respiratory care; provided, that the board has no authority to regulate a health care professional subject to regulation by another health-related board.
  3. Nothing in this chapter shall be construed as prohibiting the practice of respiratory care by students while they are under the supervision of instructors in any respiratory care educational program that has been approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), or its successor organization, so long as the students' activities are not performed for compensation and so long as the students wear an appropriate badge indicating their status as students.
  4. Nothing in this chapter shall prohibit self-care by the patient or the gratuitous care by a friend or member of the family who does not represent or hold out to be a respiratory care practitioner certified under this chapter.
  5. Nothing in this chapter shall prohibit an individual who holds a credential from the National Board for Respiratory Care entitled “certified pulmonary function technologist (CPFT)” or “registered pulmonary function technologist (RPFT)” from engaging in the performance of pulmonary function diagnostic testing.

Acts 1986, ch. 610, § 1; 1987, ch. 192, §§ 4-7; 1993, ch. 86, § 2; 1995, ch. 368, § 1; T.C.A. § 63-6-410; Acts 1998, ch. 1106, §§ 27, 29, 51, 52, 55, 58; 2000, ch. 621, §§ 3, 7, 8.

NOTES TO DECISIONS

1. Home Health Service.

Decedent did not receive health care services because delivery technicians who visited him could not act on behalf of home medical equipment provider's medical professionals. Kelley v. Apria Healthcare, LLC, — F. Supp. 2d —,  2017 U.S. Dist. LEXIS 15136 (E.D. Tenn. Feb. 3, 2017).

63-27-111. Prohibited practices — Criminal penalties.

  1. No person shall by verbal claim, advertisement, letterhead, card, or in any other way, claim to be a registered respiratory therapist, certified respiratory therapist or respiratory assistant unless such person possesses a valid license issued pursuant to this chapter.
  2. It is unlawful for any person to practice or offer to practice respiratory care unless such person has been duly licensed under this chapter, except as provided in § 63-27-110.
  3. Each violation of this section is a Class A misdemeanor.

Acts 1986, ch. 610, § 1; 1989, ch. 591, §§ 1, 6; 1998, ch. 1106, §§ 27-29, 38, 39, 55; 2000, ch. 621, §§ 2, 3.

Code Commission Notes.

The misdemeanors in this section have been designated as Class A misdemeanors by authority of § 40-35-110, which provides that an offense designated a misdemeanor without specification as to category is a Class A misdemeanor. See also § 39-11-114.

Cross-References. Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, recovery, § 63-1-134.

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

63-27-112. Disciplinary sanctions — Complaints of violations — Civil penalties — Use of witnesses.

  1. The board has the power to impose any of the disciplinary sanctions set forth in this section whenever the licensee is found guilty of violating this chapter or committing any of the following acts or offenses:
    1. Making false or misleading statements or committing fraud in procuring a license;
    2. Immoral, unethical, unprofessional or dishonorable conduct;
    3. Habitual intoxication or personal misuse of narcotics, controlled substances, controlled substance analogues or any other drugs or the use of alcoholic beverages or stimulants in such manner as to adversely affect the person's ability to practice respiratory care;
    4. Conviction of a felony or of any offense involving moral turpitude or of any violation of the drug laws of this state or of the United States;
    5. Violation or attempted violation, directly or indirectly, assisting in or abetting the violation of, or conspiring to violate, any provision of this chapter or any lawful order of the board or any criminal statute of this state;
    6. Gross health care liability, ignorance, negligence or incompetence in the course of professional practice;
    7. Making or signing in one's professional capacity any document that is known to be false at the time it is made or signed;
    8. Engaging in the practice of respiratory care when mentally or physically unable to safely do so;
    9. Making false statements or representations or being guilty of fraud or deceit in the practice of respiratory care;
    10. Having disciplinary action imposed by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed to practice respiratory care in this state; provided, further, that a certified copy of the order or other document memorializing the disciplinary action by the other state or territory shall constitute prima facie evidence of a violation of this section; or
    11. Any other unprofessional or unethical conduct specified in the rules of the board.
  2. Complaints alleging violations of this chapter, or any rule duly promulgated pursuant to § 63-27-104, shall be filed with the board, shall be referred by the board to the division for investigation, and shall be resolved by the board in accordance with this chapter and the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. A file shall be maintained on each such complaint filed with the board and shall reflect all activities taken by the board and division in response to such complaint.
  3. The board may impose one (1) or more of the following penalties for violations of this chapter or any rule duly promulgated pursuant to § 63-27-104:
    1. Denial of an application for licensure;
    2. Revocation or suspension of licensure;
    3. Imposition of an administrative fine not to exceed five hundred dollars ($500) for each count or separate offense;
    4. Placement of the certified respiratory therapist, respiratory assistant or registered respiratory therapist on probation for such length of time and subject to such conditions as the board may specify, including requiring the certified respiratory therapist, respiratory assistant or registered respiratory therapist to submit to treatment, to attend continuing education courses, or to work under the supervision of another certified respiratory therapist or registered respiratory therapist; or
    5. Issuance of a reprimand.
  4. The board shall be empowered to refuse to reinstate licensure or cause a license to be issued to a person it has deemed unqualified, until such time as it finds that such person has complied with all the terms and conditions set forth in the final order rendered pursuant to subsection (a) and that the respiratory assistant, certified respiratory therapist or registered respiratory therapist is capable of safely engaging in the delivery of respiratory care services.
  5. The chair of the board has the authority to administer oaths to witnesses and, upon probable cause being established, to issue subpoenas for the attendance of witnesses and the production of documents and records.
  6. 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 1986, ch. 610, § 1; 1987, ch. 192, § 8; T.C.A. § 63-6-412; Acts 1998, ch. 1106, §§ 13-15, 27-29, 40, 41, 55; 2000, ch. 621, §§ 2, 3, 9; 2002, ch. 662, §§ 4, 5; 2012, ch. 798, § 49; 2012, ch. 848, § 83; 2018, ch. 745, § 41.

Amendments. The 2018 amendment added (f).

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

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

Licensure, §§ 63-1-10363-1-112.

Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, recovery, § 63-1-134.

Attorney General Opinions. The board of respiratory care 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).

63-27-113. Required credentials for registered respiratory therapist.

Any person currently licensed as a registered respiratory therapist who has not obtained the credential “registered respiratory therapist (RRT)” from the National Board for Respiratory Care shall have until January 1, 2004, to obtain such credential in order to continue being licensed as a registered respiratory therapist in this state. If such person has not obtained such credential by January 1, 2004, such person's license shall be renewed as a certified respiratory therapist license when it is next renewed.

Acts 1986, ch. 610, § 1; 1987, ch. 192, § 11; T.C.A. § 63-6-413; Acts 1998, ch. 1106, §§ 16, 17, 27-29, 42, 55; 2000, ch. 621, §§ 2, 3; 2002, ch. 662, § 6.

Cross-References. Certification generally, § 63-27-105.

Certification renewal generally, § 63-27-109.

63-27-114. [Reserved.]

Blood gas analysis, and maintenance and quality assurance of a blood gas laboratory may not be performed by any practitioner licensed under this chapter unless:

  1. In the case of a registered respiratory therapist or certified respiratory therapist, the registered respiratory therapist or certified respiratory therapist:
    1. Has been trained in blood gas analysis as approved by the board;
    2. Has been granted a license by the board bearing the endorsement “ABG analyst”; and
    3. Holds either the NBRC credentials “CRT,” “CRTT” or “RRT” or has passed a board approved examination testing competency for blood gas analysis; and
  2. In the case of a respiratory assistant:
    1. Has been trained in blood gas analysis as approved by the board;
    2. Has been granted a license by the board bearing the endorsement “ABG analyst”; and
    3. Has passed a board approved examination testing competency for blood gas analysis. The National Board for Respiratory Care entry level examination, as provided to the board by the NBRC, by contract, is the examination accepted by the board. This examination will not grant the respiratory assistant the NBRC credential. In addition, the board reserves the right to write its own state council examination or contract with other national testing organizations.

Acts 1987, ch. 192, § 10; T.C.A. § 63-6-415; Acts 1998, ch. 1106, §§ 19, 20, 27-29, 43, 55; 2000, ch. 621, §§ 2, 3, 11; 2002, ch. 662, § 7.

63-27-116. Licenses for registered respiratory therapist and certified respiratory therapist — Temporary license — Reciprocity.

  1. The board may issue a temporary license to an individual applicant who has completed the required respiratory care educational program but who has not yet successfully completed the NBRC examination. A temporary license shall automatically expire one (1) year from its date of issuance and may not be renewed.
  2. The board may issue a license to practice respiratory care by endorsement to an applicant who is currently licensed to practice respiratory care under the laws of another state, territory or country if the qualifications of the applicant are deemed by the board to be equivalent to those required in this state.
    1. The board may authorize any of its members or its consultant to conduct a review of the qualifications of an applicant for a license or temporary license to practice respiratory care in this state and to make an initial determination as to whether the applicant has met all the requirements for a license or temporary license. If the board member or board consultant determines that the applicant has met all the requirements for a license or temporary license, the applicant is then authorized to practice respiratory care in this state until the board makes a final decision on the application for a license or temporary license. The board may authorize the use of this procedure with respect to applicants for license renewal or reinstatement as well. In no event shall the temporary authorization issued pursuant to a determination made by the board member or board consultant be effective for longer than a six (6) month period measured from the date of issuance. This process shall not be utilized by the applicant more than once.
    2. If temporary authorization, pursuant to this subsection (c), is issued to an applicant for a license to practice respiratory care in this state and if the subsequent decision of the board is to deny the application based upon a good faith determination that the applicant has not, in fact, complied with all the requirements for a license, then the doctrine of estoppel shall not apply against the state based upon its issuance of temporary authorization and its subsequent denial of licensure.

Acts 1993, ch. 86, § 3; 1996, ch. 738, § 1; T.C.A. § 63-6-416; Acts 1998, ch. 1106, §§ 21-23, 28, 29, 47, 49, 55; 2000, ch. 621, §§ 2, 3; 2002, ch. 662, § 8.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-27-117. Training for respiratory equipment delivery technicians.

As a part of its licensing and regulation of home medical equipment providers under § 68-11-226, the board for licensing health care facilities shall establish uniform standards to ensure the competency of persons who deliver and install respiratory equipment.

Acts 1993, ch. 86, § 4; T.C.A. § 63-6-417; Acts 1998, ch. 1106, §§ 28, 29, 54, 55.

63-27-115. Blood gas analysis — Performance of blood gas laboratory functions.

Chapter 28
Clinical Perfusionist Licensure Act

63-28-101. Short title.

This chapter shall be known and may be cited as the “Clinical Perfusionist Licensure Act.”

Acts 1999, ch. 239, § 1.

63-28-102. Chapter definitions.

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

  1. “Board” means the board of medical examiners, created by chapter 6 of this title;
  2. “Committee” means the committee for clinical perfusion;
  3. “Division” means the division of health related boards;
  4. “Extracorporeal circulation” means the diversion of a patient's blood through a heart-lung machine or a similar device that assumes the functions of the patient's heart, lungs, kidneys, liver or other organs;
  5. “Licensed clinical perfusionist” means a person licensed pursuant to this chapter;
  6. “Perfusion” means the functions necessary for the support, treatment, measurement or supplementation of the cardiovascular, circulatory or respiratory systems, or other organs, or a combination of such activities, and to ensure the safe management of physiologic functions by monitoring and analyzing the parameters of the systems under an order and under the supervision of a licensed physician, including:
    1. The use of extracorporeal circulation, long-term cardiopulmonary support techniques including extracorporeal carbon dioxide removal and extracorporeal membrane oxygenation and associated therapeutic and diagnostic technologies;
    2. Counterpulsation, ventricular assistance, autotransfusion, blood conservation techniques, myocardial and organ preservation, extracorporeal life support and isolated limb perfusion;
    3. The use of techniques involving blood management, advanced life support and other related functions; and
    4. In the performance of the acts described in this subdivision (6), the administration of:
      1. Pharmacological and therapeutic agents; or
      2. Blood products or anesthetic agents through the extracorporeal circuit or through an intravenous line as ordered by a physician;
    5. The performance and use of:
      1. Anticoagulation monitoring and analysis;
      2. Physiologic monitoring and analysis;
      3. Blood gas and chemistry monitoring and analysis;
      4. Hematological monitoring and analysis;
      5. Hypothermia and hyperthermia;
      6. Hemoconcentration and hemodilution; and
      7. Hemodialysis; and
    6. The observation of signs and symptoms related to perfusion services, the determination of whether the signs and symptoms exhibit abnormal characteristics and the implementation of appropriate reporting, clinical perfusion protocols or changes in, or the initiation of, emergency procedures;
  7. “Perfusion protocols” means perfusion-related policies and protocols developed or approved by a licensed health care facility or a physician through collaboration with administrators, licensed clinical perfusionists and other health care professionals; and
  8. “Provisional licensed clinical perfusionist” means a person provisionally licensed pursuant to this chapter.

Acts 1999, ch. 239, § 2.

63-28-103. License eligibility.

A person is eligible to make application to the committee and receive a license if such person is actively engaged in the practice of perfusion consistent with this chapter and if such person, on January 1, 2000, has at least four (4) years' experience, within the immediately preceding six (6) years, operating cardiopulmonary bypass systems during cardiac surgical cases in a licensed health care facility as the person's primary function.

Acts 1999, ch. 239, § 3.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-28-104. Committee to issue licenses.

The committee shall license by examination, or otherwise as provided in this chapter, all licensed clinical perfusionists in this state who meet the requirements of this chapter.

Acts 1999, ch. 239, § 4.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-28-105. Application — Qualification for examination.

  1. A candidate for a license to practice as a licensed clinical perfusionist shall submit an application accompanied by the required fees. The committee shall prescribe the form of the application and the dates by which applications and fees must be received.
  2. To qualify for the licensing examination, the applicant shall have successfully completed a perfusion education program approved by the committee. In approving perfusion education programs necessary for qualification for licensing examination, the committee shall approve only a program that has education standards established by the accreditation committee for perfusion education and approved by the Commission on Accreditation of Allied Health Education Programs (CAAHEP) or its successor.

Acts 1999, ch. 239, § 5.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-28-106. Competency examination.

  1. Except as otherwise provided in this chapter, to qualify for a license, an applicant shall pass a competency examination. The examination shall be prepared or approved by the committee and administered to qualified applicants at least once each calendar year. The examination prescribed by the committee may be or may include the complete examinations given by the American Board of Cardiovascular Perfusion (ABCP) or its successor organization.
  2. Not later than forty-five (45) days after the date on which a licensing examination is administered, the division shall notify each examinee of the results of the examination.
  3. The committee shall establish:
    1. A limit on the number of times an applicant who fails an examination may retake the examination;
    2. The requirements for reexamination; and
    3. The amount of any reexamination fee.

Acts 1999, ch. 239, § 6.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-28-107. Renewal of expired and unexpired licenses.

  1. A license to practice perfusion is valid for two (2) years. The committee may provide that licenses expire on various dates. A person may renew an unexpired license by submitting proof of compliance with the continuing professional education requirements prescribed by the committee and paying the required renewal fee to the committee before the expiration date of the license.
  2. If a person's license has been expired for not more than two (2) years, the person may renew the license by submitting proof, satisfactory to the committee, of compliance with the continuing professional education requirements prescribed by the committee and any penalty fee prescribed by the committee.
  3. If a person's license has been expired two (2) years or more, the person may not renew the license. The person may obtain a new license by submitting to reexamination and complying with the current requirements and procedures for obtaining a license.
  4. The committee may renew without reexamination an expired license of a person who was licensed in this state, moved to another state or states, and is currently licensed or certified and has been in practice in another state or states for the two (2) years immediately preceding the person's application to renew a license. The person shall pay the required fee as established by the committee. The committee shall not renew an expired license pursuant to this subsection (d) if such expired license is subject to a penalty or restriction in another state.
  5. The committee shall notify each license holder in writing of the license expiration date more than thirty (30) days before such date by notice to the license holder at the license holder's last known address according to the records of the committee.

Acts 1999, ch. 239, § 7.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-28-108. Provisional licenses.

  1. A license as a provisional licensed clinical perfusionist may be issued by the committee to a person who has successfully completed an approved perfusion education program, has made application to sit for the licensure examination, and upon such person filing an application, paying of the application fee and submitting evidence satisfactory to the committee of the successful completion of the education requirements as provided in this chapter.
  2. A provisional licensed clinical perfusionist shall be under the supervision and direction of a licensed clinical perfusionist at all times during which the provisional licensed clinical perfusionist performs perfusion. The committee may promulgate rules governing such supervision and direction. Such rules shall not require the immediate physical presence of the supervising licensed clinical perfusionist.
  3. A provisional license shall be valid for one (1) year from the date it is issued and may be renewed by the same procedures established for the renewal of licenses pursuant to this chapter, if the application for renewal is signed by a supervising licensed clinical perfusionist.
  4. If the person fails any portion of the licensure examination, such person shall surrender the person's provisional license to the committee.

Acts 1999, ch. 239, § 8.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-28-109. Waiver of examination and educational requirements.

On receipt of an application and application fee, the committee may waive the examination and educational requirements for an applicant who at the time of application:

  1. Is appropriately licensed or certified by another state, territory or possession whose requirements for the license or certificate are substantially equivalent to the requirements of this chapter, and such applicant is not under any restriction or encumbrance imposed by such state; or
  2. Holds a current certificate as a certified clinical perfusionist issued by the American Board of Cardiovascular Perfusion, or its successor.

Acts 1999, ch. 239, § 9.

63-28-110. Unauthorized use of professional title or designation.

  1. A person may not engage in or offer to engage in perfusion for compensation or use the title or represent or imply that the person has the title of “licensed clinical perfusionist” or “provisional licensed clinical perfusionist” or use the letters “LCP” or “PLCP” and may not use any facsimile of such titles in any manner to indicate or imply that the person is a licensed perfusionist or provisional licensed perfusionist unless the person holds an appropriate license issued pursuant to this chapter.
  2. A person may not use the title or represent or imply that such person has the title of “certified clinical perfusionist” or use the letters “CCP” and may not use any facsimile of such title in any manner to indicate or imply that such person is a certified clinical perfusionist by the American Board of Cardiovascular Perfusion unless the person holds a certificate as a certified clinical perfusionist issued by the American Board of Cardiovascular Perfusion.
  3. Any person who violates subsection (a) or (b) commits a Class B misdemeanor.

Acts 1999, ch. 239, § 10.

Cross-References. Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, § 63-1-123.

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

63-28-111. Persons exempted from compliance with this chapter.

This chapter shall not apply to:

  1. A person licensed as a health care professional in this state if:
    1. The person does not represent to the public, directly or indirectly, that the person is licensed pursuant to this chapter, and does not use any name, title or designation indicating that the person is licensed pursuant to this chapter; and
    2. The person limits the person's acts or practice to the scope of practice authorized by the appropriate licensing agency;
  2. A student enrolled in an accredited perfusion education program if the perfusion services performed are:
    1. An integral part of the student's course of study; and
    2. Performed under the direct supervision of a licensed clinical perfusionist assigned to supervise the student and who is on duty and immediately available in the assigned patient care area; or
  3. The practice of any legally qualified perfusionist employed by the United States government while in the discharge of the person's official duties.

Acts 1999, ch. 239, § 11.

63-28-112. Committee members — Term of office — Compensation — Removal.

  1. To assist the board of medical examiners in the performance of its duties, there is hereby established the committee for clinical perfusionists, composed of seven (7) members who are each appointed by the governor. The committee shall approve the examination required by this chapter. The chair of the committee shall be a perfusionist.
  2. The committee shall consist of four (4) perfusionist members, one (1) hospital administrator from a licensed healthcare facility in  Tennessee in which cardiac surgery is performed, one (1) licensed physician who shall be either a cardiac surgeon or a cardiac anesthesiologist, and one (1) public member. The public member shall be a resident of Tennessee for one (1) year and shall be a registered voter. The public member shall be a person who is not and never was a member of any medical profession or the spouse of a medical professional. The public member shall not be a member of, or a consultant to, any trade association in the field of health care. The public member shall not have or have had a material financial interest in either the provision of professional services specified by this chapter, or any activity or organization directly related to any licensed profession specified in this chapter. Perfusionist members may be appointed from lists of qualified persons submitted to the governor by interested perfusionist groups and the committee for clinical perfusionists. The governor shall consult with such groups and the committee to determine qualified persons to fill the positions. The members of the committee shall be appointed for terms of six (6) years, except those first appointed, of whom one (1) shall be appointed for a term of one (1) year, one (1) shall be appointed for a term of two (2) years, two (2) shall be appointed for a term of three (3) years, one (1) shall be appointed for a term of four (4) years, one (1) shall be appointed for a term of five (5) years and one (1) shall be appointed for a term of six (6) years. The perfusionist committee members shall be residents of the state of Tennessee for at least one (1) year, shall be United States citizens and shall meet all the requirements for licensing provided in this chapter. In making appointments to the committee, the governor shall ensure that the committee is representative of the environments in which perfusionists practice. The hospital administrator member and the physician member shall be residents of Tennessee. In making appointments to the committee, the governor shall strive to ensure that at least one (1) person serving on the committee is sixty (60) years of age or older and that at least one (1) person serving on the committee is a member of a racial minority. Of the total membership of the committee, no less than two (2) members shall be from each grand division of the state. In making the initial appointments to the committee, the perfusionist members shall not be required to be licensed but shall apply for a license from the committee within ninety (90) days of the issuance of licenses by the committee.
  3. If a member of the committee shall, during the member's term as a committee member, remove the member's domicile from the state of Tennessee, then the committee shall immediately notify the governor and the seat of that committee member shall be declared vacant. All such vacancies shall be filled by appointment in the same manner as provided in subsection (b).
  4. No member of the committee shall be entitled to any compensation for the performance of the member's official duties but shall receive compensation for travel expenses pursuant to the comprehensive travel regulations promulgated by the department of finance and administration and approved by the attorney general and reporter.
  5. A member of the committee may be removed by the governor, if the member:
    1. Does not have, at the time of appointment, the qualifications required for appointment to the committee;
    2. Does not maintain during service on the committee the qualifications required for appointment to the committee;
    3. Violates any provision of this chapter;
    4. Cannot discharge the member's duties for a substantial part of the term for which the member is appointed because of illness or disability; or
    5. Is absent from more than one-half (½) of the regularly scheduled committee meetings that the member is eligible to attend during a calendar year, unless the absence is excused by a majority vote of the committee.

Acts 1999, ch. 239, § 12; 2012, ch. 723, §§ 3, 4.

Compiler's Notes. The committee for clinical perfusionists, created by this section, terminates June 30, 2026. See §§  4-29-112, 4-29-247.

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

63-28-113. Committee chair and vice chair — Meetings — Quorum.

Not later than thirty (30) days after the governor appoints the initial members of the committee and annually thereafter, the committee shall meet and elect one (1) of its members as chair and one (1) of its members as vice chair. The committee shall meet annually or at any other time if called by the chair or a majority of the committee. A majority of the members of the committee shall constitute a quorum.

Acts 1999, ch. 239, § 13; 2009, ch. 75, § 1.

63-28-114. Committee powers and duties.

  1. The committee shall:
    1. Adopt and publish a code of ethics;
    2. Establish the qualifications and fitness of applicants for licenses, renewal of licenses and reciprocal licenses;
    3. Establish the grounds for revocation, suspension, or denial of a license;
    4. Establish the grounds for placing on probation a holder of a license;
    5. Establish the categories of fees and the amount of fees that may be imposed in connection with a license;
    6. Establish continuing professional education requirements for licensed clinical perfusionists and provisional licensed clinical perfusionists, the standards of which shall be at least as stringent as those of the American Board of Cardiovascular Perfusion or its successor agency for the license holder's professional duties; and
    7. Assist in such matters dealing with perfusion as the board may, in its discretion, direct.
  2. Any actions taken under this section shall only be effective after adoption by a majority vote of the members of the committee. The board of medical examiners, by a majority vote of its members at the next board meeting at which administrative matters are considered, may rescind or supersede any action taken by the committee.

Acts 1999, ch. 239, § 14.

63-28-115. Complaints.

  1. The committee shall keep an information file about each complaint filed with the committee. The committee's information file shall be kept current and contain a record for each complaint of:
    1. All persons contacted in relation to the complaint;
    2. A summary of findings made at each step of the complaint process;
    3. An explanation of the legal basis and reason for a complaint that is dismissed; and
    4. Other relevant information.
  2. If a written complaint is filed with the committee that the committee has authority to resolve, the committee at least as frequently as quarterly and until final disposition of the complaint shall notify the parties to the complaint of the status of the complaint unless the notice would jeopardize an ongoing investigation.
  3. The committee shall develop a form to standardize information concerning complaints made to the committee. The committee shall prescribe information to be provided to a person when the person files a complaint with the committee.
  4. The committee shall provide reasonable assistance to a person who wishes to file a complaint with the committee.

Acts 1999, ch. 239, § 15.

63-28-116. Rules for complaint investigation — Disposal of complaints.

  1. The committee shall promulgate rules pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, concerning the investigation of a complaint filed with the committee. The rules adopted pursuant to this section shall:
    1. Distinguish between categories of complaints;
    2. Ensure that complaints are not dismissed without appropriate consideration;
    3. Require that the board be advised of a complaint that is dismissed and that a letter be sent to the person who filed the complaint explaining the action taken on the dismissed complaint;
    4. Ensure that the person who filed the complaint has an opportunity to explain the allegations made in the complaint; and
    5. Prescribe guidelines concerning the categories of complaints that require the use of a private investigator and the procedures for the committee to obtain the services of a private investigator.
  2. The committee shall dispose of all complaints in a timely manner.

Acts 1999, ch. 239, § 16.

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

63-28-117. Revocation or suspension of licenses — Probation of licensees.

  1. The committee shall revoke or suspend a license, place on probation a person whose license has been suspended, or reprimand a license holder if there is proof of:
    1. Any violation of this chapter;
    2. Any violation of a rule or code of ethics adopted by the committee; or
    3. Unprofessional conduct, which includes, but is not limited to:
      1. Incompetence or gross negligence in carrying out usual perfusion functions;
      2. A conviction of practicing perfusion without a license or a provisional license;
      3. The use of advertising relating to perfusion in a way that violates state law;
      4. Procuring a license or provisional license by fraud, misrepresentation or mistake;
      5. Making or giving any false statement or information in connection with the application for a license or provisional license;
      6. Conviction of a felony or of any offense substantially related to the qualifications, functions and duties of a perfusionist, in which event the record of the conviction shall be conclusive evidence of such offense; or
      7. Impersonating an applicant or acting as proxy for an applicant in any examination required pursuant to this chapter for the issuance of a license.
  2. 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 1999, ch. 239, § 17; 2018, ch. 745, § 42.

Amendments. The 2018 amendment added (b).

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

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

63-28-118. Administrative rules.

The committee may promulgate administrative rules pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to administer this chapter.

Acts 1999, ch. 239, § 18.

Chapter 29
Midwifery

63-29-101. Findings of general assembly.

The general assembly recognizes the need for a person to have the freedom to choose the manner, cost, and setting for giving birth. The general assembly finds that access to prenatal care and delivery services is limited by the inadequate number of providers of such services and that the practice of midwifery may help to reduce this shortage. The general assembly also recognizes the need for the safe and effective delivery of newborn babies and the health, safety, and welfare of their mothers in the delivery process. The general assembly, in the interest of public health, promotes the regulation of the practice of midwifery in this state for the purpose of protecting the health and welfare of women and infants. The general assembly recognizes that midwifery is a profession in its own right and that it is not the practice of medicine.

Acts 2000, ch. 576, § 2.

Cross-References. Births, § 68-3-301 et seq.

63-29-102. Chapter definitions.

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

  1. “Antepartal” means occurring during pregnancy;
  2. “Board” means the board of osteopathic examiners of the department of health to which the council of certified professional midwifery reports;
  3. “Certified professional midwife (CPM)” means a person who has obtained national certification from the North American Registry of Midwives;
  4. “Consultation” means exchange of information and advice regarding the client condition and indicated treatment with a physician;
  5. “Council” means the council of certified professional midwifery;
  6. “CPM-TN” means certified professional midwife in Tennessee. A “CPM-TN” must be certified to practice midwifery by the North American Registry of Midwives;
  7. “Department” means the department of health;
  8. “Intrapartal” means occurring during the process of giving birth;
  9. “Midwife” means a person who is trained to give the necessary care and advice to women during pregnancy, labor, and the post-birth period, to conduct normal deliveries on the midwive's own responsibility and to care for the newly born infant. The midwife is able to recognize the warning signs of abnormal conditions requiring referral to and/or collaboration with a physician;
  10. “Midwifery” means the practice of attending low-risk women during pregnancy, labor and the post-birth period with the informed consent of the mother. The scope of midwifery shall include comprehensive care of the pregnant woman during the antepartal phase, intrapartal phase, and postpartal phase, and application of emergency care when necessary;
  11. “NARM” means the North American Registry of Midwives;
  12. “Physician” means a person who is duly licensed in the state of Tennessee to practice medicine by the state board of medical examiners or to practice osteopathy by the board; and
  13. “Postpartal” means occurring subsequent to birth.

Acts 2000, ch. 576, § 3.

63-29-103. Council established.

  1. There is hereby established a council of certified professional midwifery, which shall serve as a subcommittee of and report to the board.
  2. The council members shall be appointed by the commissioner of health. The council shall consist of six (6) members.
  3. Members shall be residents of Tennessee.
  4. Members shall consist of three (3) certified professional midwives, one (1) consumer who has no direct or indirect affiliation with the midwifery profession or industry, one (1) certified nurse midwife, and one (1) physician.
    1. Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the council:
      1. Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the council shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the council, prior to serving as a member of the council. This subdivision (e)(1)(A) shall apply to all persons appointed or otherwise named to the council after July 1, 2010;
      2. No person who is a member of the council shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the council during such person's period of service as a member of the council. This subdivision (e)(1)(B) shall apply to all persons appointed or otherwise named to the council after July 1, 2010, and to all persons serving on the council on such date who are not registered as lobbyists; and
      3. No person who serves as a member of the council shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the council for one (1) year following the date such person's service on the council ends. This subdivision (e)(1)(C) shall apply to persons serving on the council as of July 1, 2010, and to persons appointed to the council subsequent to such date.
    2. A person who violates this subsection (e) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (e). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  5. Members of the council shall serve without pay. Members shall be entitled to reimbursement for per diem and travel expenses.

Acts 2000, ch. 576, § 4; 2006, ch. 568, §§ 1, 2; 2010, ch. 1011, §§ 3, 4.

Compiler's Notes. The council of certified professional midwifery, created by this section, terminates June 30, 2022. See §§ 4-29-112, 4-29-243.

Acts 2010, ch. 1011, § 5 provided that the provision in the act prohibiting a consumer who has a direct or indirect affiliation with the midwifery profession or industry from serving on the council shall apply to all consumer appointments made to the council after July 1, 2010.

63-29-104. Members — Terms of office.

The terms of office of the members of the council shall be staggered four-year terms. In making the initial appointments, the commissioner shall appoint four (4) members to four-year terms, three (3) members to three-year terms and two (2) members to two-year terms. All subsequent terms shall be for a period of four (4) years. No member shall be appointed for more than two (2) consecutive terms.

Acts 2000, ch. 576, § 5.

63-29-105. Removal of council member for absenteeism.

When a council member is absent from three (3) consecutive meetings without excuse, that member shall be removed from office, and a new member shall be appointed by the commissioner of health. An absence shall be deemed excused if caused by a health problem or condition verified in writing by a physician, or by an accident or similar unforeseeable tragedy or event prior to or at the time of the next council meeting.

Acts 2000, ch. 576, § 6.

63-29-106. Election of chair and vice chair — Quorum — Meetings — Notice — Records.

  1. The council members shall elect annually from their membership a chair and vice chair.
  2. A quorum shall consist of a majority of the members.
  3. No final action shall be taken on any matter without a quorum and majority vote of the members present.
  4. The council shall meet at least once each year.
  5. Emergency meetings may be called by the chair with written notice to all members.
  6. Public notice shall be given for all meetings.
  7. All meetings are open to the public.
  8. All records are available to the public. Persons wishing to obtain copies of such records may request the same in writing from the council.

Acts 2000, ch. 576, § 7; 2006, ch. 568, § 3.

63-29-107. Responsibilities of council.

The council shall:

  1. Assist and advise the board and the department in developing rules with guidance from the Midwives Alliance of North America's Core Competencies and not inconsistent with the law. The rules shall include, but not be limited to, the allowable scope of midwifery practice regarding use of equipment, procedures, and administration of medication as prescribed by a physician;
  2. Make recommendations to the board and the department regarding:
    1. Certified professional midwifery;
    2. Applications and renewals;
    3. Development of forms for reporting and receiving certified professional midwifery forms as set forth in this chapter;
    4. Up-to-date files on all active CPM-TN in Tennessee including emergency plan guidelines; and
    5. Compilation of annual statistics on CPM-TN deliveries; and
  3. Educate the public and other providers of obstetrical care about the role of the CPM-TN.

Acts 2000, ch. 576, § 8.

63-29-108. Certification.

  1. A midwife who has met the standards set forth in this chapter may apply to the board for Tennessee certification. An application for Tennessee certification shall provide information as required by this section and as may be required by the board. Except for the American College of Nurse Midwives certified midwives and certified nurse midwives, a certificate under this chapter is required to practice midwifery for monetary compensation in which service has been offered for a fee. A certificate under this chapter is not required for certified nurse midwives who maintain their licensure as registered nurses pursuant to chapter 7 of this title.
  2. In order to receive certification as a CPM-TN, an applicant shall:
    1. Obtain certification from NARM and currently hold the title of CPM;
    2. Read, understand, and agree to practice under the guidelines set forth in this chapter and any rules promulgated pursuant to this chapter; and
    3. Have proof of current CPR certification including infant or neonatal resuscitation.

Acts 2000, ch. 576, § 9.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-29-109. Title — Term of initial certificate — Renewal — Denial of applications — Third party payment.

  1. A midwife who is certified under the standard found in § 63-29-108 may use the initials “CPM-TN.”
  2. An initial certificate is available for no more than a two-year period.
  3. The certificate is renewable pursuant to the division of health related boards' biennial birthdates renewal system.
  4. Renewal is available to the CPM who maintains current certification from NARM by complying with the continuing education requirement applicable to the CPM.
  5. Renewal is available to the CPM-TN whose certification from NARM remains in good standing and who has current CPR certification.
  6. The board may deny an application for certification only if the applicant is not in compliance with the standards in this chapter.
  7. A CPM-TN may receive third party payment from private agencies that provide coverage for maternity and obstetrical care. No managed care organization or insurance company shall require a patient to be served by a CPM-TN instead of a medical doctor or a nurse practitioner.

Acts 2000, ch. 576, § 10; 2006, ch. 568, § 4.

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

Licensure, §§ 63-1-10363-1-112.

63-29-110. Status.

Any CPM who is not practicing midwifery in Tennessee may be placed in inactive status by requesting such status in writing and submitting it to the council. Active status may be renewable by requesting a change of status from inactive to active in writing to the council and by fulfilling the requirements for renewal set forth in this chapter.

Acts 2000, ch. 576, § 11.

63-29-111. Reapplication after expiration of certificate.

Any CPM who does not seek inactive status and allows the certificate to expire after a sixty-day grace period must apply for a new certificate as prescribed in this chapter.

Acts 2000, ch. 576, § 12.

Cross-References. Licensure, §§ 63-1-10363-1-120.

63-29-112. Fees.

The application and renewal fees are to be set by the commissioner of health and shall not be less than that sum necessary to permit the council to recover its costs of operation.

Acts 2000, ch. 576, § 13.

Cross-References. License and registration fees, § 63-1-112.

63-29-113. Display of certificate.

The certificate shall be displayed at all times in a conspicuous place where the CPM-TN is practicing, when applicable.

Acts 2000, ch. 576, § 14.

Cross-References. Display of license or registration certificate, § 63-1-109.

63-29-114. Revocation or suspension of license — Appeals.

    1. A CPM-TN's license may be revoked or suspended for any of the grounds set forth in subdivision (a)(2), or for failing to follow the standards set forth in this section. Such action may occur only after investigations by the department. Any action on the certification shall be made by the council, subject to approval by the board.
    2. The board has the power to deny, revoke or suspend any certificate or to otherwise discipline a certificate holder upon proof that the person:
      1. Is guilty of fraud or deceit in procuring or attempting to procure a certificate to practice midwifery;
      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 midwifery 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.
  1. Any contested case hearing held pursuant to this section shall be conducted in compliance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2000, ch. 576, § 15; 2006, ch. 568, § 5.

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

63-29-115. Responsibilities of midwife.

  1. The CPM-TN may provide care for the low-risk client who is expected to have a normal pregnancy, labor, birth and postpartal phase in the setting of the mother's choice. The CPM-TN shall form a collaborative care plan with a physician for all clients.
  2. The CPM-TN shall ensure that the client has signed an informed consent form. This form shall include information to inform the client of the qualifications of the CPM-TN.
  3. For screening purposes only, the CPM-TN may order routine antepartal and postpartal laboratory analysis to be performed by a licensed laboratory. Abnormal findings would require a consultation with a physician.
  4. The CPM-TN shall develop an emergency plan that shall be signed by the client and placed in the client chart at the initial visit. The emergency plan shall include documentation of the initial consultation with the physician previously referenced in subsection (a). The documentation shall also include referral and transfer plans for the patient in the event of an emergency. A copy of the plan shall be sent to the named physicians.
  5. The CPM-TN shall determine the progress of labor and, when birth is imminent, shall be available until delivery is accomplished.
  6. The CPM-TN shall remain with the postpartal mother during the postpartal period until the conditions of the mother and newborn are stabilized.
  7. The CPM-TN shall instruct the parents regarding the requirements of § 68-5-202.
  8. The CPM-TN shall instruct the parents regarding the requirement of § 68-5-401.
  9. The CPM-TN shall maintain a birth certificate for each birth in accordance with the requirements of title 68. A copy of the birth certificate shall be filed with the department.
  10. The CPM-TN shall practice in compliance with the rules and regulations promulgated pursuant to this chapter.

Acts 2000, ch. 576, § 16; 2001, ch. 287, § 1.

63-29-116. Rules and regulations.

The board and department, with assistance and advice from the council, are authorized to promulgate rules and regulations to effectuate the purposes of this chapter. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 2000, ch. 576, § 17.

Chapter 30
Reflexology Practitioners Registration Act of 2001

63-30-101. Short title.

This chapter shall be known and may be cited as the “Reflexology Practitioners Registration Act of 2001.”

Acts 2001, ch. 389, § 2.

63-30-102. Chapter definitions.

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

  1. “Certification” means completion of a two hundred (200) hour reflexology only course offered by an institution approved by the Tennessee higher education commission or its equivalent in other states;
  2. “Client” means any person who engages the services of a reflexology practitioner;
  3. “Commissioner” means the commissioner of health or the commissioner's designee;
  4. “Department” means the department of health;
  5. “Division” means the division of health-related boards in the department of health;
  6. “Reflexology” means the application of specific pressures to reflex points in the hands and feet only;
  7. “Reflexology practitioner” or “reflexologist” means any person who engages in the practice of reflexology for compensation and who has completed a study of the principles of reflexology, anatomy and physiology generally included in a regular course of study of reflexology; and
  8. “Registration” means satisfying the requirements for registration by the department of health.

Acts 2001, ch. 389, § 3; 2004, ch. 465, § 1.

63-30-103. Registration.

  1. No person shall engage in the practice of reflexology unless such person has registered with the division of health-related boards.
  2. No person shall be registered to practice reflexology unless such person completes all necessary application forms and can demonstrate to the satisfaction of the division that such person complies with the criteria specified in this chapter.
  3. Any person who desires registration as a certified reflexologist shall submit an application to the division on the prescribed forms. The application shall be accompanied by:
    1. Documentation of completion of a two hundred (200) hour reflexology only course offered by an institution approved by the Tennessee higher education commission or its equivalent in other states;
    2. Proof that the applicant has attained eighteen (18) years of age;
    3. Two (2) character references stating that the applicant is of good moral character;
    4. A statement certifying that the applicant has not been convicted of a felony under the laws of this state or any other state for the commission of an offense that bears directly on the applicant's fitness to practice competently, as determined by the division. However, such determination shall be subject to the applicable provisions of the Fresh Start Act that are compiled in chapter 1, part 1 of this title; and
    5. All required fees.

Acts 2001, ch. 389, § 4; 2004, ch. 465, §§ 2, 3; 2016, ch. 719, § 7; 2018, ch. 745, § 43.

Compiler's Notes. Acts 2016, ch. 719, § 11 provided that this act, which amended (c)(4), took effect on April 6, 2016, and shall apply to actions instituted by state entities on or after April 6, 2016.

Amendments. The 2018 amendment added the second sentence in (c)(4).

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

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-30-104. [Reserved.]

This chapter shall not apply to the activities or services of physicians, chiropractors, physical therapists, occupational therapists, athletic trainers, cosmetologists, registered nurses, massage therapists, or members of other professions licensed, certified, or registered by the state who may, on occasion, apply pressure to specific reflex points in the hands and feet in the course of their work.

Acts 2001, ch. 389, § 6.

63-30-106. Registration of applicants from another state.

The division shall register an individual from another state who applies for registration, pays the applicable fees, meets or exceeds the requirements established by this chapter, and who has no imposed or pending disciplinary actions in any state.

Acts 2001, ch. 389, § 7.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-30-107. Use of title.

Reflexologists registered by the state may hold themselves out as “registered certified reflexologists” and may use the title or the initials “RCR” following the person's name in connection with the profession. No person may use the title “registered certified reflexologist” or the initials “RCR” unless registered in accordance with this chapter.

Acts 2001, ch. 389, § 8.

63-30-108. Unauthorized practice — Violations — Penalties.

  1. Except as provided in subsection (b), any person who advertises or engages in reflexology for compensation without registering with the division pursuant to this chapter commits a Class C misdemeanor, punishable by a fine only. It is unlawful to use the word “reflexology” or any other term that implies reflexology technique or method when advertising a service by a person who is not registered under this chapter.
  2. This section shall not apply to licensed massage therapists who use reflexology techniques or methods or who advertise reflexology as a service offered to massage therapy clients.
  3. The division may, when it deems appropriate, seek such civil remedies at law or equity to restrain or enjoin any unauthorized practice or other violation of this chapter.

Acts 2001, ch. 389, § 9; 2002, ch. 637, §§ 1, 2.

Cross-References. Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, § 63-1-123.

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

63-30-109. Prohibited practices.

  1. A registered reflexologist may not use invasive procedures during the practice of reflexology.
  2. A registered reflexologist may not diagnose or treat for specific diseases, practice spinal or other joint manipulations, prescribe, administer, or adjust medication, or prescribe or administer vitamins.

Acts 2001, ch. 389, § 10.

63-30-110. Fees for registration — Renewal.

Fees for the registration of a certified reflexologist shall be determined by the division but shall not exceed the costs of investigations, disciplinary actions and administering the registration process for certified reflexologists. Registration shall be valid for two (2) years and shall be renewed biennially.

Acts 2001, ch. 389, § 11.

Cross-References. License and registration fees, § 63-1-123.

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

63-30-111. Revocation or suspension of registration — Civil penalties — Complaints.

  1. The registration of a certified reflexologist may be revoked or suspended by the division or the division may impose a civil penalty upon a finding that the person is guilty of any one (1) or more of the following:
    1. The practitioner is guilty of gross health care liability or incompetence;
    2. The practitioner's mental or physical health endangers public health or safety;
    3. The practitioner is guilty of false or deceptive advertising;
    4. The practitioner engages in unprofessional conduct;
    5. The practitioner falsifies any requirements for registration as set forth;
    6. The practitioner is convicted of a felony for the commission of an offense that bears directly on the practitioner's fitness to practice competently, as determined by the division;
    7. The practitioner is subject to disciplinary action in another state; or
    8. The unauthorized practice of reflexology.
  2. Any person may file with the department of health's office of investigations a written complaint against a registered reflexologist for any violation of this chapter.
  3. Complaints alleging violations of this chapter, or any rule duly promulgated pursuant to § 63-30-112, shall be filed with the division, and shall be resolved by the division in accordance with this chapter and the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. A file shall be maintained on each such complaint filed with the division and shall reflect all activities taken by the division in response to such complaint.
  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 2001, ch. 389, § 12; 2012, ch. 798, § 50; 2016, ch. 719, § 8; 2018, ch. 745, § 44.

Compiler's Notes. Acts 2016, ch. 719, § 11 provided that this act, which amended (a)(6), took effect on April 6, 2016, and shall apply to actions instituted by state entities on or after April 6, 2016.

Amendments. The 2018 amendment added (d).

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

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

63-30-112. Rules and regulations.

The commissioner or the commissioner's designee may promulgate rules and regulations pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, to administer this chapter.

Acts 2001, ch. 389, § 13.

63-30-113. Advisory private letter rulings.

The division may issue advisory private letter rulings to any affected registrant who makes such a request regarding any matters within the division's primary jurisdiction. Such private letter ruling shall only affect the registrant making such inquiry, and shall have no precedential value for any other inquiry or future contested case to come before the division. Any dispute regarding a private letter ruling may, if the division chooses to do so, be resolved pursuant to the declaratory order provisions of § 4-5-223.

Acts 2001, ch. 389, § 14.

63-30-105. Application.

Chapter 31
Polysomnography

63-31-101. Chapter definitions.

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

  1. “Board” means the board of medical examiners;
  2. “Committee” means the polysomnography professional standards committee established by § 63-31-103;
  3. “Direct supervision” means that the polysomnographic technologist providing supervision must be present in the area where the polysomnographic procedure is being performed and immediately available to furnish assistance and direction throughout the performance of the procedure;
  4. “General supervision” means that the polysomnographic procedure is provided under a physician's overall direction and control, but the physician's presence is not required during the performance of the procedure;
  5. “Polysomnographic student” means a person who is enrolled in an educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP), as provided in § 63-31-106(b)(1), and who may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program;
  6. “Polysomnographic technician” means a person who has graduated from an accredited educational program described in § 63-31-106(b)(1) but has not yet passed the national certifying examination given by the board of registered polysomnographic technologists, who has obtained a temporary permit from the board, and who may provide sleep-related services under the general supervision of a licensed physician;
  7. “Polysomnographic technologist” means a person who is credentialed by the board of registered polysomnographic technologists and is licensed by the board to engage in the practice of polysomnography under the general supervision of a licensed physician;
  8. “Polysomnographic trainee” means a person who is enrolled in an accredited sleep technologist education program (A-STEP) that is accredited by the American Academy of Sleep Medicine and who may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program;
    1. “Practice of polysomnography” means the staging and scoring of sleep by continuous and simultaneous monitoring of the stages of sleep and wake through use of an electroencephalogram (EEG), an electroculogram (EOG) and a submental electromyogram (EMG), in conjunction with the recording and monitoring of other physiological variables, and the assignment of values for duration, frequency and type of event to each stage of sleep in which the event occurred. The following tasks are considered a part of the practice of polysomnography only when performed as part of the staging and scoring of sleep under the general supervision of a licensed physician:
      1. Monitoring and recording physiologic data during the evaluation of sleep-related disorders, including sleep-related respiratory disturbances, by applying the following techniques, equipment, and procedures:
  1. Continuous or bilevel positive airway pressure titration on spontaneously breathing patients using a mask or oral appliance; provided, that the mask or oral appliance does not extend into the trachea or attach to an artificial airway;
  2. Supplemental low flow oxygen therapy of less than six (6) liters per minute, utilizing nasal cannula or continuous or bilevel positive airway pressure during a polysomnogram;
  3. Capnography during a polysomnogram;
  4. Cardiopulmonary resuscitation;
  5. Pulse oximetry;
  6. Gastroesophageal pH monitoring;
  7. Esophageal pressure monitoring;
  8. Sleep staging, including surface electroencephalography, surface electrooculography, and surface submental electromyography;
  9. Surface electromyography;
  10. Electrocardiography;
  11. Respiratory effort monitoring, including thoracic and abdominal movement;
  12. Plethysmography blood flow monitoring;
  13. Snore monitoring;
  14. Audio or video monitoring;
  15. Body movement monitoring;
  16. Nocturnal penile tumescence monitoring;
  17. Nasal and oral airflow monitoring;
  18. Body temperature monitoring; and
  19. Monitoring the effects that a mask or oral appliance used to treat sleep disorders has on sleep patterns; provided, however, that the mask or oral appliance shall not extend into the trachea or attach to an artificial airway;

Observing and monitoring physical signs and symptoms, general behavior, and general physical response to polysomnographic evaluation and determining whether initiation, modification, or discontinuation of a treatment regimen is warranted;

Analyzing and scoring data collected during the monitoring described in subdivisions (9)(A)(i) and (ii) for the purpose of assisting a licensed physician in the diagnosis and treatment of sleep and wake disorders that result from developmental defects, the aging process, physical injury, disease, or actual or anticipated somatic dysfunction;

Implementation of a written or verbal order from a licensed physician that requires the practice of polysomnography; and

Education of a patient regarding the treatment regimen that assists the patient in improving the patient's sleep;

A licensed dentist shall make or direct the making and use of any oral appliance used to treat sleep disordered breathing and shall evaluate the structures of the patient's oral and maxillofacial region for purposes of fitting the appliance;

The practice of polysomnography shall take place only in a hospital, a stand-alone sleep laboratory or sleep center, or in the patient's home in accordance with a physician's order; provided, however, that the scoring of data and the education of patients may take place in settings other than in a sleep laboratory, sleep center or the patient's home; and

“Sleep-related services” means acts performed by polysomnographic technicians, polysomnographic trainees, polysomnographic students, and other persons permitted to perform those services under this chapter, in a setting described in subdivision (9)(C) that would be considered the practice of polysomnography if performed by a polysomnographic technologist.

Acts 2007, ch. 469, § 1; 2009, ch. 421, § 1.

63-31-102. Interpretation of chapter — Application.

  1. Nothing in this chapter shall be interpreted to limit or restrict a health care practitioner licensed under this title from engaging in the full scope of practice of the person's profession.
  2. Nothing in this chapter shall apply to diagnostic electroencephalograms conducted in accordance with the guidelines of the American Clinical Neurophysiology Society.

Acts 2007, ch. 469, § 1.

63-31-103. Polysomnography professional standards committee.

  1. To assist the board in the performance of its duties under this chapter, there is established the polysomnography professional standards committee.
  2. The committee shall consist of seven (7) members, who shall be appointed by the governor in the manner and for the terms of office as set forth in this section.
  3. The committee shall be composed of:
    1. Three (3) registered polysomnographic technologists;
    2. One (1) physician who is certified in sleep medicine by a national certifying body recognized by the American Academy of Sleep Medicine;
    3. One (1) person who is the director of an accredited, hospital-based sleep center;
    4. One (1) respiratory therapist who is also a registered polysomnographic technologist; and
    5. One (1) consumer member who is not commercially or professionally associated with the health care field, either directly or indirectly.
    1. Notwithstanding § 3-6-304 or any other law to the contrary, and in addition to all other requirements for membership on the committee:
      1. Any person registered as a lobbyist pursuant to the registration requirements of title 3, chapter 6 who is subsequently appointed or otherwise named as a member of the committee shall terminate all employment and business association as a lobbyist with any entity whose business endeavors or professional activities are regulated by the committee, prior to serving as a member of the committee. This subdivision (d)(1)(A) shall apply to all persons appointed or otherwise named to the committee after July 1, 2010;
      2. No person who is a member of the committee shall be permitted to register or otherwise serve as a lobbyist pursuant to title 3, chapter 6 for any entity whose business endeavors or professional activities are regulated by the committee during such person's period of service as a member of the committee. This subdivision (d)(1)(B) shall apply to all persons appointed or otherwise named to the committee after July 1, 2010, and to all persons serving on the committee on such date who are not registered as lobbyists; and
      3. No person who serves as a member of the committee shall be employed as a lobbyist by any entity whose business endeavors or professional activities are regulated by the committee for one (1) year following the date such person's service on the committee ends. This subdivision (d)(1)(C) shall apply to persons serving on the committee as of July 1, 2010, and to persons appointed to the committee subsequent to such date.
    2. A person who violates this subsection (d) shall be subject to the penalties prescribed in title 3, chapter 6.
    3. The bureau of ethics and campaign finance is authorized to promulgate rules and regulations to effectuate the purposes of this subsection (d). All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and in accordance with the procedure for initiating and proposing rules by the ethics commission to the bureau of ethics and campaign finance as prescribed in § 4-55-103.
  4. Initial appointments to the committee shall be made as follows: two (2) members shall be appointed to terms of four (4) years, two (2) members shall be appointed to terms of three (3) years, two (2) members shall be appointed to terms of two (2) years, and one (1) member shall be appointed to a term of one (1) year. Each regular appointment thereafter shall be for a term of four (4) years. Any vacant term shall be filled by the governor for the balance of the four-year term and each member shall serve on the committee until a successor is appointed. In making appointments to the committee, the governor shall strive to ensure that at least one (1) person serving on the committee is sixty (60) years of age or older and that at least one (1) person serving on the committee is a member of a racial minority. Each member of the committee shall be a resident of the state.
  5. The governor may consider for appointment to the committee the names of persons recommended by the professional organizations for each profession represented on the committee. The Tennessee Sleep Society may submit a list of three (3) names for each position to be filled by a polysomnographic technologist. The Tennessee Society for Respiratory Care may submit a list of three (3) names for the position to be filled by a respiratory therapist. The Tennessee Medical Association may submit a list of three (3) names for the position to be filled by a physician. The Tennessee Hospital Association (THA), an association of hospitals and health systems may submit a list of three (3) names for the position to be filled by a director of a hospital-based sleep center.
  6. While engaged in the business of the committee, members shall receive a per diem of one hundred dollars ($100) and shall also receive compensation for actual expenses to be paid in accordance with comprehensive travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
  7. The committee shall choose annually a chair and a secretary from among its members.
  8. The committee shall hold at least one (1) regular meeting each year and such other meetings as the committee deems necessary to conduct its business.
  9. A majority of the members of the committee shall constitute a quorum for the transaction of business. No action of the committee shall be valid unless approved by a majority of members present at a meeting at which there is a quorum.
  10. The governor has the power to remove from office any member of the committee for neglect of duties required by this chapter, for malfeasance in office, for incompetence, or for unprofessional conduct.
  11. All funds received by the committee shall be deposited into the state treasury, and the department of health shall make such allotments out of the committee's account in the general fund as the department deems proper for the necessary expenses of the committee.
  12. The division of health related boards shall provide administrative, investigatory, and clerical services to the committee as necessary to implement and enforce this chapter.

Acts 2007, ch. 469, § 1; 2010, ch. 996, §§ 3, 4.

Compiler's Notes. The polysomnographic professional standards committee, created by this section, terminated June 30, 2020, and is in its wind-up period, pursuant to the provisions of § 4-29-112. Wind-up is scheduled to be complete June 30, 2021. See § 4-29-112.

63-31-104. Powers of the committee.

The committee shall have the power to:

  1. Promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, all rules that are necessary for the implementation and administration of this chapter;
  2. Establish the fees to be paid for temporary permits and for initial licensure, renewal or reinstatement of a license, late renewal of a license, and replacement of a lost license, at a level that is adequate to pay all the expenses of implementing and administering this chapter, in accordance with § 63-1-137;
  3. Review and approve or reject the application of each person who applies for licensure as a polysomnographic technologist;
  4. Biennially review and approve or reject each application for license renewal;
  5. Issue, in the board's name, all temporary permits and all approved licenses and renewal of licenses;
  6. Collect or receive all fees, fines, and money owed pursuant to this chapter and pay the fees, fines and money into the general fund of the state;
  7. Deny, suspend, revoke, restrict, or impose one (1) or more conditions on a license, as the committee deems necessary or appropriate at the time a license is issued, renewed, or reinstated, or as a sanction imposed at the conclusion of a disciplinary hearing;
  8. Issue private advisory letter rulings to any person licensed under this chapter who makes a request for a ruling regarding any matter within the committee's jurisdiction; provided, however, that the ruling shall affect only the licensee making the inquiry and shall have no precedential value for any other contested case or inquiry before the committee;
  9. Develop a code of ethics for the practice of polysomnography in this state;
  10. Develop standards of care for the practice of polysomnography in this state;
  11. Develop standards for the educational and clinical training of polysomnographic technologists, including the evaluation of the accreditation status of educational programs in polysomnography;
  12. Develop criteria for the evaluation of applications for licensure submitted by registered polysomnographic technologists who are licensed in other states;
  13. Develop continuing education requirements that shall be met by licensed polysomnographic technologists; and
  14. Conduct disciplinary hearings in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, and impose whatever sanctions the committee deems appropriate on an applicant or licensee.

Acts 2007, ch. 469, § 1.

63-31-105. Board approval of committee actions.

All actions of the committee shall be approved by the board in order to become final actions. All actions of the committee shall be considered by the board at its next regular meeting after the committee has taken its actions.

Acts 2007, ch. 469, § 1.

63-31-106. Licensing requirement.

    1. On and after July 1, 2010, any person who is engaged in the practice of polysomnography shall be licensed as provided in this chapter. It shall be unlawful for any person to engage in the practice of polysomnography after July 1, 2010, unless the person has been duly licensed as a polysomnographic technologist under this chapter.
    2. Prior to July 1, 2010, any person who is engaged in the practice of polysomnography without being licensed under this chapter shall not be deemed to be in violation of this chapter or the Respiratory Care Practitioner Act, compiled in chapter 27 of this title.
  1. A person seeking licensure as a polysomnographic technologist shall be of good moral character, shall be at least eighteen (18) years of age, shall pay the fees established by the board for licensure, and shall present proof that the person meets all of the following requirements:
    1. Meet one (1) of the following educational requirements:
      1. Graduation from a polysomnographic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs;
      2. Graduation from a respiratory care educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs and completion of the curriculum for a polysomnography certificate established and accredited by the Committee on Accreditation for Respiratory Care of the Commission on Accreditation of Allied Health Education Programs;
      3. Graduation from an electroneurodiagnostic technologist educational program with a polysomnographic technology track that is accredited by the Commission on Accreditation of Allied Health Education Programs; or
      4. Successful completion of an accredited sleep technologist educational program (A-STEP) that is accredited by the American Academy of Sleep Medicine; provided, however, that this option shall not remain available after July 1, 2012, if there are at least four (4) polysomnographic technologist educational programs in this state, at least two (2) in the east grand division and one (1) each in the middle and west grand divisions that remain accredited by the commission on accreditation of allied health educational programs for two (2) years. If there are not four (4) such accredited educational programs by July 12, 2012, this option shall remain available until there are four (4) such programs that have been accredited for two (2) years;
    2. Pass the national certifying examination given by the board of registered polysomnographic technologists;
    3. Be credentialed by the board of registered polysomnographic technologists; and
    4. Meet any additional educational or clinical requirements established by the committee.
  2. Any person who is engaged in the practice of polysomnography on July 1, 2007, shall be eligible for licensure under this chapter without meeting the educational requirement of subdivision (b)(1); provided, that the person meets the requirements of subdivisions (b)(2)-(4).
  3. To be eligible for renewal of a license to engage in the practice of polysomnography, a polysomnographic technologist shall continue to be credentialed by the board of registered polysomnographic technologists.

Acts 2007, ch. 469, § 1.

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

Licensure, §§ 63-1-10363-1-112.

63-31-107. Classes exempt from licensing requirement — Temporary permit.

  1. The following persons may provide sleep-related services without being licensed as a polysomnographic technologist under this chapter:
    1. A polysomnographic technician may provide sleep-related services under the general supervision of a licensed physician for a period of up to one (1) year from the date of the person's graduation from one (1) of the accredited programs described in § 63-31-106(b)(1), and the board may in its sole discretion grant a one-time extension of up to three (3) months beyond this one-year period;
    2. A polysomnographic trainee may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program while actively enrolled in an accredited sleep technologist educational program (A-STEP) that is accredited by the American Academy of Sleep Medicine;
    3. A polysomnographic student may provide sleep-related services under the direct supervision of a polysomnographic technologist as a part of the person's educational program while actively enrolled in a polysomnographic educational program that is accredited by the Commission on Accreditation of Allied Health Education Programs (CAAHEP);
    4. A person who is credentialed in one (1) of the health-related fields accepted by the board of registered polysomnographic technologists may provide sleep-related services under the direct supervision of a polysomnographic technologist, for a period of up to one (1) year, while obtaining the clinical experience necessary to be eligible to sit for the examination given by the board of registered polysomnographic technologists; and
    5. Respiratory therapists who provide polysomnography services shall be credentialed as a registered polysomnographic technologist by the board of polysomnographic technologists, or as a sleep disorders specialist by the national board for respiratory care, or have undergone a standardized, uniform mechanism to document competency in polysomnography as approved by the Tennessee board of respiratory care with documentation of passage of this mechanism made available at the request of the board of respiratory care. The Tennessee board of respiratory care shall consult with the Tennessee board of medical examiners in the development of this mechanism. The consultation with the board of medical examiners shall be documented and the documentation, including any comments by the board of medical examiners regarding the mechanism developed by the board of respiratory care, shall be filed with the chairs of the health committee of the house of representatives and the health and welfare committee of the senate. Respiratory therapists are not required to have a second license as a polysomnographic technologist.
  2. Before providing any sleep-related services, a polysomnographic technician shall obtain a temporary permit from the board. While providing sleep-related services, the technician shall wear a badge that appropriately identifies the person as a polysomnographic technician.
  3. Before providing any sleep-related services, a polysomnographic trainee shall give notice to the board that the trainee is enrolled in an A-STEP educational program accredited by the American Academy of Sleep Medicine. Trainees shall wear a badge that appropriately identifies the trainee as a polysomnographic trainee while providing such services.
  4. Before providing any sleep-related services, a person who is obtaining clinical experience pursuant to subdivision (a)(4) shall give notice to the board that the person is working under the direct supervision of a polysomnographic technologist in order to gain the experience to be eligible to sit for the examination given by the board of registered polysomnographic technologists. The person shall wear a badge that appropriately identifies the person while providing such services.
  5. Polysomnographic students shall not receive compensation for the sleep-related services they provide and shall wear badges that appropriately identify them as students.

Acts 2007, ch. 469, § 1; 2009, ch. 421, § 2; 2013, ch. 236, § 55.

Cross-References. Licensure, §§ 63-1-10363-1-112.

63-31-108. Issuance, renewal and retirement of licenses — Display of license — Lost license — Change of address or name.

  1. Licenses shall be issued and renewed by the board pursuant to the biennial issuance and renewal system of the division of health related boards.
  2. Any person who has been issued a license to practice under this chapter who wishes to retire that license shall file with the committee an affidavit on a form to be furnished by the committee stating the date on which the person retired from practice and other facts that verify the retirement as the board deems necessary. Any such person who thereafter wishes to reenter practice shall request reinstatement of licensure.
  3. Any license issued by the board shall contain the name of the person to whom it is issued, the address of the person, the date and number of the license and other information that the board deems necessary. The address contained on the license shall be the address where all correspondence and renewal forms from the board shall be sent. Any person whose address changes shall, within thirty (30) days after the change in address, notify the board of the address change. The most recent address contained in the board's records for each license holder shall be the address deemed sufficient for purposes of service of process.
  4. Every person issued a license pursuant to this chapter shall either keep the license prominently displayed in the office or place in which the person practices or have it stored in a place from which it can be immediately produced upon request of a patient or representative of the department of health.
  5. Any person whose license has been lost may make application to the committee for a replacement. The application shall be accompanied by an affidavit setting out the facts concerning the loss of the original license.
  6. Any person whose name is changed by marriage or court order may surrender the person's license and apply to the board for a replacement license.

Acts 2007, ch. 469, § 1.

Cross-References. Display of license or registration certificate, § 63-1-109.

Licensure, §§ 63-1-10363-1-112.

63-31-109. Power of board to impose sanctions.

  1. The board has the power to impose any sanctions on a licensee, up to and including license revocation, if the licensee is found guilty of violating any of the provisions of this chapter or of committing any of the following acts or offenses:
    1. Making false or misleading statements or committing fraud in procuring a license;
    2. Moral turpitude;
    3. Habitual intoxication or personal misuse of narcotics, controlled substances, controlled substance analogues or any other drugs or the use of alcoholic beverages or stimulants in a manner that adversely affects the person's ability to practice polysomnography;
    4. Conviction of a felony or of any offense involving moral turpitude or any violation of the drug laws of this or any other state or of the United States;
    5. Violation or attempted violation, directly or indirectly, assisting in or abetting the violation of, or conspiring to violate, this chapter or any lawful order of the board or any criminal statute of this state;
    6. Gross health care liability, ignorance, negligence or incompetence in the course of professional practice;
    7. Making or signing in one's professional capacity any document that is known to be false at the time it is made or signed;
    8. Engaging in the practice of polysomnography when mentally or physically unable to safely do so;
    9. Making false statements or representations or being guilty of fraud or deceit in the practice of polysomnography when mentally or physically unable to safely do so;
    10. Having disciplinary action imposed by another state or territory of the United States for any acts or omissions that would constitute grounds for discipline of a person licensed to practice polysomnography in this state; provided, that a certified copy of the order or other document memorializing the disciplinary action by the other state or territory constitutes prima facie evidence of a violation of this section;
    11. Undertaking any duties that are outside the authorized scope of practice of a licensed polysomnographic technologist, as set forth in this chapter;
    12. Violating the code of ethics adopted by the committee for polysomnographic technologists;
    13. Use or attempted use of a polysomnographic procedure or equipment for which the licensee has not received sufficient education or training in the proper use of that procedure or equipment;
    14. Promoting the sale of services, drugs, devices, appliances, or goods to a patient to exploit the patient for financial gain;
    15. Willfully failing to file, or willfully impeding the filing of, any report or record that is required by law;
    16. Knowingly engaging in the practice of polysomnography with an unlicensed person, knowingly aiding an unlicensed person in the practice of polysomnography, or knowingly delegating a task involved in the practice of polysomnography to an unlicensed person;
    17. Knowingly failing to meet appropriate standards for the delivery of polysomnographic services;
    18. Breaching patient confidentiality;
    19. Paying or agreeing to pay any sum or providing any form of remuneration or material benefit to any person for bringing or referring a patient, or accepting or agreeing to accept any form of remuneration or material benefit from a person for bringing or referring a patient; or
    20. Any other unprofessional or unethical conduct specified in the rules of the board.
  2. 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 2007, ch. 469, § 1; 2012, ch. 798, § 51; 2012, ch. 848, § 84; 2018, ch. 745, § 45.

Amendments. The 2018 amendment added (b).

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

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

Grounds for license denial, suspension or revocation, §  63-6-214.

Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, § 63-1-134.

63-31-110. Violation.

Any person who engages in the practice of polysomnography in violation of this chapter is guilty of a Class B misdemeanor.

Acts 2007, ch. 469, § 1.

Cross-References. Penalties, § 63-1-123.

Penalties for violation of statute, rule or order, § 63-1-134.

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

63-31-111. Injunction against unlicensed practice — Jurisdiction of court.

  1. The board shall have the authority to petition any circuit or chancery court having jurisdiction over any person who is practicing without a license, or to whom a license has been denied, or whose license has been suspended or revoked by action of the board, to enjoin the person from continuing to practice within this state.
  2. Jurisdiction is conferred upon the circuit and chancery courts of this state to hear and determine all causes brought under subsection (a) and to exercise full and complete jurisdiction in the injunctive proceedings.

Acts 2007, ch. 469, § 1.

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

63-31-112. Screening panel for investigative and disciplinary process.

  1. The committee 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 resolution of complaints or diversion to professional peer review organizations or impaired professionals' associations or foundations of those cases that the board, through established guidelines, deems appropriate.
  2. The screening panel has the authority to administer oaths to witnesses.
  3. Members of a screening panel may be drawn from the membership of the committee or may be appointed by the committee. Noncommittee members shall meet the requirements of membership on the committee and may include a consumer member. A committee member serving on a panel shall not participate in a contested case involving any matter heard by the panel.

Acts 2007, ch. 469, § 1.

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

Screening panels, § 63-1-138.

63-31-113. Use of title “polysomnographic technologist” or abbreviation “PSGP”.

Any person who is licensed to engage in the practice of polysomnography in this state shall have the right to use the title “polysomnographic technologist” or the abbreviation “PSGP.” No other person may use that title or abbreviation or any other words or letters indicating that the person is a polysomnographic technologist.

Acts 2007, ch. 469, § 1.

63-31-114. Annual meeting of standards committee.

The polysomnographic professional standards committee shall conduct at least one (1) meeting in each of the years 2007-2010 to allow public discussion of new developments in the practice of polysomnography, including, but not limited to, the availability of accredited polysomnographic educational programs to persons in all parts of the state, the availability of other certification examinations and credentialing bodies, and the settings in which the practice of polysomnography may properly take place. The committee shall notify the Tennessee Sleep Society, the Tennessee Society for Respiratory Care, the Tennessee Medical Association, the Tennessee Hospital Association (THA), an association of hospitals and health systems, and any other person or organization that requests to be notified as to the time and place of the annual meeting.

Acts 2007, ch. 469, § 1.

Chapter 32
Health Care Consumer Right-to-Know Act of 1998

This chapter, title 63, chapter 32 was renumbered from title 63, chapter 51 by authority of the Code Commission in 2017.

63-32-101. Short title.

The title of this chapter is and may be cited as the “Health Care Consumer Right-to-Know Act of 1998.”

Acts 1998, ch. 1073, § 1; T.C.A § 63-51-101.

Compiler's Notes. Former § 63-51-101 was transferred to this section by the authority of the Code Commission in 2017.

63-32-102. Health care consumers.

  1. Health care is a valuable commodity, and the health care consumer needs to make informed decisions when making health care choices. Due to the current trends in health care, patients have a close relationship with their health care provider and must depend on the provider for most of their health care needs. Health care consumers need to know as much as possible before committing their health care to such provider. Likewise current trends make decisions about which managed care organizations to choose equally important to health care consumers. Because of the foregoing reasons and because of the increasing concerns over the quality of health care, the general assembly finds that a system should be established to provide public access to information about certain health care providers and managed care organizations in this state.
  2. For the purposes of this chapter, “provider” or “health care provider” means a physician, regulated pursuant to chapter 6 of this title; osteopathic physician, regulated pursuant to chapter 9 of this title; chiropractor, regulated pursuant to chapter 4 of this title; dentist, regulated pursuant to chapter 5 of this title; podiatrist, regulated pursuant to chapter 3 of this title; optometrist, regulated pursuant to chapter 8 of this title; dietitian or nutritionist, regulated pursuant to chapter 25 of this title; physician assistant, regulated pursuant to chapter 19 of this title; respiratory care practitioner, regulated pursuant to chapter 27 of this title; pharmacist, regulated pursuant to chapter 10 of this title; audiologist and speech pathology therapist, regulated pursuant to chapter 17 of this title; certified nurse practitioner, as such nurses are regulated pursuant to § 63-7-123; registered nurse anesthetist, regulated pursuant to chapter 7 of this title; social worker regulated pursuant to chapter 23 of this title; psychologist, regulated pursuant to chapter 11 of this title; professional counselor, marital and family therapist, and clinical pastoral therapist regulated pursuant to chapter 22 of this title; massage therapist, regulated pursuant to chapter 18 of this title; medical laboratory personnel, regulated pursuant to title 68, chapter 29; alcohol and drug abuse counselors, regulated pursuant to title 68, chapter 24; occupational therapist and physical therapist regulated pursuant to chapter 13 of this title; dispensing optician, regulated pursuant to chapter 14 of this title; electrologist, regulated pursuant to chapter 26 of this title; veterinarian, regulated by chapter 12 of this title; and nursing home administrator, regulated pursuant to chapter 16 of this title.

Acts 1998, ch. 1073, § 2; 1999, ch. 373, § 3; 2000, ch. 912, § 1; 2003, ch. 272, § 1; T.C.A § 63-51-102.

Compiler's Notes. Acts 2000, ch. 912, § 2 provided that the act shall not be construed to be an appropriation of funds and no funds shall be obligated or expended pursuant to the act unless such funds are specifically appropriated by the General Appropriations Fund.

Former § 63-51-102 was transferred to this section by the authority of the Code Commission in 2017.

63-32-103. Duties of division of health related boards.

It is the duty of the division of health related boards to compile, consolidate, manage and disseminate the information collected by entities of the department of health and the department of commerce and insurance as required by this chapter.

Acts 1998, ch. 1073, § 3; T.C.A § 63-51-103.

Compiler's Notes. Former § 63-51-103 was transferred to this section by the authority of the Code Commission in 2017.

63-32-104. Requirements.

  1. When collecting information or compiling reports intended to compare individual health care providers, the commissioner of health shall require that:
    1. Provider organizations that are representative of the target group for profiling shall be meaningfully involved in the development of all aspects of the profile methodology, including collection methods, formatting and methods and means for release and dissemination;
    2. The entire methodology for collecting and analyzing the data shall be disclosed to all relevant provider organizations and to all providers under review;
    3. Data collection and analytical methodologies shall be used that meet accepted standards of validity and reliability;
    4. The limitations of the data sources and analytic methodologies used to develop provider profiles shall be clearly identified and acknowledged, including, but not limited to, the appropriate and inappropriate uses of the data;
    5. To the greatest extent possible, provider-profiling initiatives shall use standard-based norms derived from widely accepted, provider-developed practice guidelines;
    6. Provider profiles and other information that have been compiled regarding provider performance shall be shared with providers under review prior to dissemination; provided, that an opportunity for corrections and additions of helpful explanatory comments shall be provided prior to publication; and provided, further, that such profiles shall only include data that reflect care under the control of the provider for whom such profile is prepared;
    7. Comparisons among provider profiles shall adjust for patient care-mix and other relevant risk factors and control for provider peer groups, when deemed appropriate by the respective board; and
    8. The quality and accuracy of provider profiles, data sources and methodologies shall be evaluated at least biannually.
  2. The department of health is authorized to charge a reasonable fee for any information, documents, or reports requested by the public that are not required as part of the implementation of this chapter. The fee shall be set per rules and regulations promulgated by the department in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1998, ch. 1073, § 4; T.C.A § 63-51-104.

Compiler's Notes. Former § 63-51-104 was transferred to this section by the authority of the Code Commission in 2017.

63-32-105. Information for public dissemination.

  1. Each board regulating a provider, as defined in § 63-32-102, shall collect the following information and provide to the department of health in order for the department to create individual profiles on licensees, in a format created by the department that shall be available for dissemination to the public:
    1. A description of any criminal convictions for felonies and, as determined by the board, serious misdemeanors, within the most recent ten (10) years. For the purposes of this subsection (a), a person shall be deemed to be convicted of a crime if such person was found or adjudged guilty by a court of competent jurisdiction. Misdemeanor convictions later expunged by a court of competent jurisdiction shall be stricken from the provider's profile;
    2. A description of any final board disciplinary actions within the most recent ten (10) years, which actions shall include final board action as defined by § 4-5-314, and reprimand action taken pursuant to a board practice act;
    3. A description of any final disciplinary actions of licensing boards in other states within the most recent ten (10) years;
    4. A description of revocation or involuntary restriction of hospital privileges for reasons related to competence or character that has been taken by the hospital's governing body or any other official action of the hospital after procedural due process has been afforded, or the resignation from or nonrenewal of medical staff membership or the restriction of privileges at a hospital taken in lieu of or in settlement of a pending disciplinary case related to competence or character in that hospital, all as taken pursuant to procedures promulgated by the board for licensing health care facilities. Only cases that have occurred within the most recent ten (10) years shall be disclosed by the department to the public;
      1. All health care liability court judgments, all health care liability arbitration awards in which a payment is awarded to a complaining party and all settlements of health care liability claims in which a payment is made to a complaining party beginning with reports for 1998 and each subsequent year; provided, such reports shall not be disseminated beyond the most recent ten-year period, but shall include the most recent ten-year period for which reports have been filed. Each provider licensing board shall set by rule adopted pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, a threshold amount below which judgments or settlements shall not be reportable; provided, such threshold shall, for chapter 6 or 9 of this title licensees, be set at seventy-five thousand dollars ($75,000), for doctors of chiropractic, regulated pursuant to chapter 4 of this title, be set at fifty thousand dollars ($50,000), for dentists, regulated pursuant to chapter 5 of this title, be set at twenty-five thousand dollars ($25,000), and for all other licensees under this title be set at ten thousand dollars ($10,000). Dispositions of paid claims shall be reported in a minimum of three (3) graduated categories indicating the level of significance of the award or settlement. Information concerning paid health care liability claims shall be put in context by comparing an individual licensee's health care liability judgment awards and settlements to the experience of other providers within the same specialty. Information concerning the existence of a court-sealed settlement shall be reported in cases involving such a settlement. Information concerning all settlements shall be accompanied by the following statement: “Settlement of a claim may occur for a variety of reasons which do not necessarily reflect negatively on the professional competence or conduct of the provider. A payment in settlement of a health care liability action or claim should not be construed as creating a presumption that health care liability has occurred.” Nothing in this subdivision (a)(5) shall be construed to limit or prevent the department from providing further explanatory information regarding the significance of categories in which settlements are reported;
      2. Pending health care liability claims shall not be disclosed by a board to the public. Nothing in this subdivision (a)(5) shall be construed to prevent a board from investigating and disciplining a licensee on the basis of health care liability claims that are pending;
    5. Names of medical schools or professional and training schools and dates of graduation;
    6. Graduate medical education or other graduate-level training;
    7. Specialty board certification as determined by the relevant board;
    8. Names of the hospitals where the licensee has privileges;
    9. Appointments to medical school faculties and indication as to whether a licensee has a responsibility for graduate medical education within the most recent ten (10) years;
    10. Information regarding publications in peer-reviewed medical literature;
    11. Information regarding professional or community service associations, activities and awards;
    12. The location of the licensee's primary practice setting;
    13. The identification of any translating services that may be available at the licensee's primary practice location;
    14. An indication of which managed care plans in which the licensee participates;
    15. An indication of TennCare plans in which the licensee participates;
    16. No information that is otherwise privileged under this title, and that is generated by any peer review program, provider health program, or impaired professionals program operated or administered by a provider association or foundation that such association has created for peer review purposes, shall be included in any profile unless such information is not contemplated by the particular title 63 statute as being privileged;
    17. For the profile of a holder of a certificate of fitness pursuant to § 63-7-123, the name of the holder's collaborating physician; and
    18. For any physician assistant licensed under § 63-19-105, the name of the assistant's collaborating physician.
  2. Each board shall provide individual licensees with a copy of their profiles prior to release to the public. A licensee shall be provided a reasonable time to correct factual inaccuracies that appear in such profile.
  3. A provider may elect to have the provider's profile omit certain information provided pursuant to subdivisions (a)(10)-(12), inclusive, concerning academic appointments and teaching responsibilities, publications in peer-reviewed journals and professional and community service awards. In collecting information for such profiles and in disseminating such profiles, each board shall inform providers that they may choose not to provide such information required pursuant to subdivisions (a)(10)-(12), inclusive.
  4. The department shall develop formats for dissemination of such information to the public, which, at a minimum shall include electronic media, including the world wide web of the internet, and a toll-free telephone line.
  5. On or before January 1, 1999, the division of health related boards of the department shall become a participant in the national practitioners databank.
  6. Individual profiles posted pursuant to § 63-32-107 shall not contain the licensee’s home address and social security number, unless such home address is provided by the licensee, along with a request that it be contained in the profile, as their official mailing or practice address. Notwithstanding this subsection (f), a record containing the home address of the licensee on file with the department of health concerning this chapter shall continue to remain a public record.

Acts 1998, ch. 1073, § 5; 1999, ch. 373, §§ 4, 5; 2000, ch. 589, § 1; 2006, ch. 663, §§ 1, 2; 2012, ch. 798, §§ 52, 53; 2014, ch. 898, § 1; T.C.A § 63-51-105; Acts 2017, ch. 334, § 8; 2018, ch. 610, § 33.

Compiler's Notes. Acts 1999, ch. 373, § 6 provided that the commissioner of health is authorized to set threshold amounts below which judgments or settlements shall not be reportable for providers covered under this chapter, by public necessity [now emergency] rulemaking pursuant to § 4-5-209 [now §  4-5-208].

Former § 63-51-105 was transferred to this section by the authority of the Code Commission in 2017.

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

Amendments. The 2017 amendment divided former (a)(18) into present (a)(18) and (19) by substituting “§ 63-7-123, the name of the holder's collaborating physician; and (19) For any physician assistant” for “§ 63-7-123 or any physician assistant”; and substituted “assistant's supervising physician” for “holder's or assistant's supervising physician” at the end of present (a)(19).

The 2018 amendment substituted “collaborating” for “supervising” in (a)(19).

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

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

Cross-References. Advisory committee for use of the Internet, title 12, ch. 3, part 11.

Electronic bidding, invitations to bid, requests for proposals and other solicitations, § 12-3-704.

Attorney General Opinions. Inclusion of health care provider information in provider profile, OAG 99-061, 1999 Tenn. AG LEXIS 38 (3/10/99).

63-32-106. Conviction of unlicensed provider—Report to relevant board.

The district attorney general for any court in which an unlicensed provider is convicted of being represented as a licensed provider shall, within one (1) week thereafter, report the same to the relevant board together with a copy of the court proceedings in the case.

Acts 1998, ch. 1073, § 6; T.C.A § 63-51-106.

Compiler's Notes. Former § 63-51-106 was transferred to this section by the authority of the Code Commission in 2017.

63-32-107. Publication of provider profiles — Certain restrictions.

The department of health, in implementing § 63-32-105 shall not disseminate a provider profile by electronic media, including the World Wide Web of the internet or toll-free telephone line before May 1, 1999. The department shall conduct a study of the impact of publication of provider profiles by electronic media on the personal safety of providers and their families, and shall report its findings to the government operations committees on or before October 1, 1998. The department shall include in such report a sample profile designed with safeguards recommended by the department pursuant to the aforementioned study. No later than January 1, 1999, and after public hearing, the board shall promulgate regulations to eliminate, to the extent practicable, the possibility that certain information contained in such profiles may jeopardize the personal safety of providers and their families.

Acts 1998, ch. 1073, § 7; T.C.A § 63-51-107.

Compiler's Notes. Former § 63-51-107 was transferred to this section by the authority of the Code Commission in 2017.

Attorney General Opinions. Inclusion of health care provider information in provider profile, OAG 99-061, 1999 Tenn. AG LEXIS 38 (3/10/99).

63-32-108. Assessment of costs.

The department of health shall assess boards of providers that they regulate for the costs reasonably associated with providing the services and information pursuant to this chapter. Further, the department shall provide the cost to the department of commerce and insurance that is associated with providing the services and information relative to the board of pharmacy and managed care organizations. The department of commerce and insurance shall assess the cost to the providers that the department regulates. These costs shall be assessed in compliance with § 9-4-5117 and § 56-1-310.

Acts 1998, ch. 1073, § 8; T.C.A § 63-51-108.

Compiler's Notes. Former § 63-51-108 was transferred to this section by the authority of the Code Commission in 2017.

63-32-109. Costs assessed against boards.

The costs assessed against each board of providers shall be paid from the separate account established pursuant to § 63-1-137 in the general fund for each board.

Acts 1998, ch. 1073, § 9; 1999, ch. 373, § 2; T.C.A § 63-51-109.

Compiler's Notes. Former § 63-51-109 was transferred to this section by the authority of the Code Commission in 2017.

63-32-110. Managed care organizations.

  1. Managed care organizations regulated pursuant to title 56, chapter 32, shall provide an accurate listing of provider information as required by this chapter to the department of health.
  2. A managed care organization shall report any addition or deletion of a provider from its panel of contracted members within twenty-one (21) business days of the date on which the managed care organization receives notice of the addition or deletion of a provider. The department shall cross-reference the change with the existing provider profile within seven (7) days of receipt of the information.
  3. The department of commerce and insurance, to the extent to which it already collects the data required by this chapter, shall forward the existing data and all subsequent data to the department in such manner as the commissioner of health shall direct after consultation with the commissioner of commerce and insurance.

Acts 1998, ch. 1073, § 10; T.C.A § 63-51-110.

Compiler's Notes. Former § 63-51-110 was transferred to this section by the authority of the Code Commission in 2017.

63-32-111. Annual report and provider profiles — Availability.

  1. The annual report required by § 56-32-110(b)(4) [repealed], and information required for a profile by this section shall be made available to consumers by the department of health through the World Wide Web of the internet or a toll-free telephone line. Such information shall be made available by May 1, 1999, and shall be updated by May 1 of each succeeding year.
  2. The information made available by the department pursuant to subsection (a) shall be based on reports filed with the department of commerce and insurance pursuant to § 56-32-110 [repealed], and shall include, to the extent practicable, the following:
    1. A description of the grievance review system;
    2. The total number of grievances handled through such grievance review system, and a compilation of the causes underlying the grievances filed;
    3. The ratio of the number of adverse decisions issued to the number of grievances received;
    4. The ratio of the number of successful grievance appeals to the total number of appeals;
    5. The average of:
      1. The number of enrollees at the beginning of the calendar year; and
      2. The number of enrollees at the end of the calendar year; and
    6. The number, amount and disposition of health care liability claims made by enrollees that resulted in settlements, court judgments and arbitration awards by the plans during the calendar year.
  3. For each year the reports are filed, the information described in subdivisions (b)(2)-(6) shall be shown for a period of five (5) consecutive calendar years. The information for more than five (5) calendar years shall not be required.
  4. The profile of managed care organizations regulated pursuant to title 56, chapter 32, maintained by the department shall include:
    1. The number of years in existence;
    2. A summary of the financial information, including profits or losses, as reported by the plan in its annual statement filed with the commissioner of commerce and insurance;
    3. The geographic plan area for which the plan is authorized;
    4. The composition of the provider network, including names, addresses and specialties of providers;
    5. Identification of those providers that have notified the plan that they are not accepting new patients;
    6. Measures of quality and consumer satisfaction if the commissioner of health determines by rule that such measures are valid and comparable among organizations;
    7. The certification and accreditation status of the organization, if any;
    8. Procedures governing access to specialists and emergency care services; and
    9. The information voluntarily submitted by the managed care organization to the commissioner relative to consumer satisfaction and quality standards or measures.

Acts 1998, ch. 1073, § 11; 2012, ch. 798, § 54; T.C.A § 63-51-111.

Compiler's Notes. Section 56-32-110 referred to in subsections (a) and (b) above was repealed by Acts 2010, ch. 980, § 27, effective January 1, 2011.

Former § 63-51-111 was transferred to this section by the authority of the Code Commission in 2017.

63-32-112. Hospitals.

  1. Hospitals regulated pursuant to title 68, chapter 11, shall provide an accurate listing of information as required by this act to the department of health.
  2. The information that the department shall disseminate shall include, but not be limited to:
    1. The corporate form of the facility, including whether the facility is publicly or privately owned, whether the facility is not-for-profit or for-profit, the nature of the ownership and management, and its affiliations with other corporate entities;
    2. Health care plans accepted by the hospital;
    3. Accreditation status; and
    4. The specialty programs that meet the guidelines established by the specialty societies or other appropriate bodies as determined by the commissioner.

Acts 1998, ch. 1073, § 12; T.C.A § 63-51-112.

Compiler's Notes. Former § 63-51-112 was transferred to this section by the authority of the Code Commission in 2017.

63-32-113. Intentional misrepresentations.

A provider who makes an intentional misrepresentation when providing information to the department of health that the department uses in a provider profile commits a violation of the practice act under which the provider is licensed or certified.

Acts 1998, ch. 1073, § 13; T.C.A § 63-51-113.

Compiler's Notes. Former § 63-51-113 was transferred to this section by the authority of the Code Commission in 2017.

63-32-114. Development of system for collection and dissemination of information.

  1. The initial development of a system for the collection and dissemination of information as provided under this chapter shall be contracted to an appropriate service provider by the department under compliance with title 12, chapters 3 and 4. The cost of such contract shall be paid from fees collected from providers regulated by the division of health related boards.
  2. In disseminating information under this chapter, the department of health is directed to use the department's existing toll-free telephone resources. The creation of an additional toll-free telephone line is not required by this chapter.

Acts 1998, ch. 1073, § 14; T.C.A § 63-51-114.

Compiler's Notes. Former § 63-51-114 was transferred to this section by the authority of the Code Commission in 2017.

63-32-115. Compiling and dissemination of information — Liability of the department of health.

  1. Under this chapter, the department of health only compiles information. The department shall not vouch for or assert the accuracy of any information it disseminates under this chapter. Before the department disseminates information to consumers under this chapter, the department shall permit each provider, hospital, or managed care organization, whose information is to be disseminated, the opportunity to review and correct any information the department proposes to disseminate. The department shall also allow a collaborating physician at any time the opportunity to review, accept, and update the existence of a collaborating relationship between the physician and a physician assistant licensed under § 63-19-105. The department shall also allow a collaborating physician at any time the opportunity to review, accept, and update the existence of a collaborating relationship between the physician and the holder of a certificate of fitness pursuant to § 63-7-123.
  2. On or after January 1, 2015, the collaborative relationship contained in the controlled substance database, as established in title 53, chapter 10, part 3, shall be used by the department to update provider profiles which have been established pursuant to this chapter.
  3. The department shall not be subject to any suit for damages concerning any information that the department disseminates that a provider, hospital, managed care organization, collaborating physician, or supervisory physician had the opportunity to correct, but did not correct.
  4. Nothing contained in this section shall repeal or override the confidentiality provisions contained in title 53, chapter 10, part 3, except to the extent that the department uses the information to update the existence of:
    1. A collaborating relationship between a physician and a holder of a certificate of fitness pursuant to § 63-7-123; or
    2. A collaborating relationship between a physician and a physician assistant licensed under § 63-19-105.

Acts 1998, ch. 1073, § 15; 2014, ch. 898, § 2; T.C.A § 63-51-115; Acts 2017, ch. 334, §§ 9-11; 2018, ch. 610, §§ 34-36.

Compiler's Notes. Former § 63-51-115 was transferred to this section by the authority of the Code Commission in 2017.

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

Amendments. The 2017 amendment, in (a), rewrote the present next to last sentence which read: “The department shall also allow a supervising physician at any time the opportunity to review, accept, and update the existence of a supervisory relationship between the physician and a physician assistant licensed under § 63-19-105.”, and added the last sentence; inserted “collaborating physician,” in (c); and rewrote (d) which read: “Nothing contained in this section shall repeal or override the confidentiality provisions contained in title 53, chapter 10, part 3, except to the extent that the department uses the information to update the existence of a supervisory relationship between a physician and a holder of a certificate of fitness pursuant to § 63-7-123 or a physician assistant licensed under § 63-19-105.”

The 2018 amendment substituted “a physician assistant licensed under § 63-19-105” for “the holder of a certificate of fitness pursuant to § 63-7-123” at the end of the fourth sentence in (a); substituted “collaborative relationship” for “supervisory relationship” in (b) and substituted “collaborating” for “supervisory” in (d)(2).

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

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

63-32-116. Public records.

No provision of this chapter shall be construed as restricting the status of any record as a public record for the purposes of title 10, chapter 7.

Acts 1998, ch. 1073, § 16; T.C.A § 63-51-116.

Compiler's Notes. Former § 63-51-116 was transferred to this section by the authority of the Code Commission in 2017.

63-32-117. Provision of information prior to licensure.

  1. Each licensed provider, as defined in § 63-32-102, must provide the information required by this chapter to be compiled into provider profiles by the department of health.
  2. Each provider, as defined in § 63-32-102, seeking licensure must provide the information required by this chapter before licensure will be granted.
  3. Before the issuance of the licensure renewal notice, the department shall send a notice to each licensed provider at the provider's last known address of record with the department regarding the requirements for information to be submitted by such provider pursuant to this chapter.
  4. Each provider who has submitted information pursuant to this chapter must update that information in writing or online by notifying the department within thirty (30) days after the occurrence of an event or the attainment of a status that is required to be reported. With respect to updated information required to be submitted pursuant to § 63-32-105, the department shall accept information updating a profile as it relates only to a physician licensed pursuant to chapter 6 or 9 of this title if the information is received within thirty (30) days of final payment in writing or online from either the provider or the provider's health care liability carrier and the carrier attests, in writing to the department, that it is the provider's health care liability carrier that has made the payment and that the carrier has confirmed in writing or online to the provider that the information has been reported to the department for purposes of updating the provider's profile.
  5. Failure by a provider to comply with these requirements to submit information and to update information constitutes a ground for disciplinary action under the respective practice act for that profession. For such failure to comply, the department or board may:
    1. Refuse to issue a license to any provider applying for initial licensure who fails to submit or update the required information;
    2. Refuse to renew a license to any provider who fails to submit or update the required information; and/or
    3. Process any licensed provider before the board who fails to submit and/or update the required information for formal disciplinary action, and may assess a penalty against the provider of up to fifty dollars ($50.00) for each day that the provider is not in compliance with this subsection (e).

Acts 1998, ch. 1073, § 17; 2009, ch. 48, § 1; 2012, ch. 798, § 55; 2014, ch. 898, § 3; T.C.A § 63-51-117.

Compiler's Notes. Former § 63-51-117 was transferred to this section by the authority of the Code Commission in 2017.

63-32-118. Violations.

Failure to comply with the requirements of this chapter by a person or entity required to submit or report information as required by this chapter constitutes a violation of the relevant practice or licensing statute and subjects the violator to appropriate enforcement or disciplinary action.

Acts 1998, ch. 1073, § 18; T.C.A § 63-51-118.

Compiler's Notes. Former § 63-51-118 was transferred to this section by the authority of the Code Commission in 2017.

63-32-119. Rules and regulations.

The commissioner of health is authorized to promulgate rules and regulations to effectuate the purposes of this chapter. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.

Acts 1998, ch. 1073, § 19; T.C.A § 63-51-119.

Compiler's Notes. Former § 63-51-119 was transferred to this section by the authority of the Code Commission in 2017.