Drugs and Pharmacies
1. Senate Bill 1992 (Overbey)
House Bill 2139 (Shepard)
This bill is an initiative of the Tennessee Pharmacists Association. It does several things:
a) It revises the definition of the “practice of pharmacy” in the Pharmacy Practice Act
by adding the following language: “provision of patient care services and activities
pursuant to a collaborative pharmacy practice agreement”.
b) A collaborative pharmacy practice agreement is defined to be a written signed
agreement between one or more pharmacists and one or more prescribers that
provides for collaborative pharmacy practice.
c) Collaborative pharmacy practice involves the practice of pharmacy under such an
agreement to provide patient care services and achieve optimal medication use and
desired patient outcomes. Under such an agreement, pharmacists may be allowed to
prescribe prescription drugs when required to carry out a medical order or perform
other activities under the agreement.
d) A collaborative pharmacy practice agreement must define the nature and scope of
patient care services which are to be provided by the pharmacist. Any patient care
services provided by a pharmacist must be documented in the patient’s record and
communicated to the prescriber within 3 business days.
e) A collaborative practice agreement entered into by an advanced practice nurse or
physician assistant must also be signed by that person’s supervising physician.
f) A prescriber who enters into a collaborative practice agreement must be available for
consultation with the pharmacist as needed.
g) A collaborative practice agreement must be maintained at the places of practice of the
prescriber and of the pharmacist and must be reviewed and renewed at least
biennially.
h) The Board of Pharmacy, in consultation with the Board of Medical Examiners and the
Board of Osteopathic Examination, is authorized to promulgate rules establishing
minimum standards for provisions to be included in a collaborative practice
agreement.
2. Senate Bill 2296 (McNally)
House Bill 1787 (Kane)
This bill, known as the Fair Disclosure of State Funded Payments for Pharmacists’
Services Act, amends the section of the Code dealing with pharmacy benefits managers (PBMs).
It applies only to PBMs funded by state dollars, i.e., TennCare and the state employees health
program.
When seeking payment for pharmacist services under such a program, a PBM must
itemize by individual claim:
a) the amount actually paid or to be paid to the pharmacy for the pharmacist services;
b) the identity of the pharmacy paid; and
c) the prescription number or other identifier of the pharmacist services.
The bill does not:
a) require a PBM to set specific fees, rates, or schedules for payment for pharmacist
services;
b) prohibit a PBM from charging for any services in addition to pharmacist services; or
c) require a PBM to pay a pharmacy more on a claim than the amount disclosed.
The term “pharmacist services” is defined to mean “products, goods, or services provided
by a pharmacy to individuals who reside or are employed in Tennessee
3. Senate Bill 2055 (Niceley)
House Bill 2227 (Hall)
This bill prohibits a person from obtaining a Schedule II or III controlled substance from
an out-of-state pharmacy.
4. Senate Bill 1716 (Niceley)
House Bill 2158 (Roach)
This bill amends Tennessee’s criminal code to make robbery of a pharmacy a Class B
felony and to make aggravated robbery of a pharmacy a Class A felony. Such robbery becomes
aggravated robbery when the robber uses or displays a deadly weapon or when the pharmacist
(or other person on the premises of the pharmacy) suffers serious bodily injury or death during
the robbery.
5. Senate Bill 1630 (Norris)
House Bill 1426 (McCormick)
This bill (and the next two bills) are Haslam Administration bills. This bill does several
things:
a) Information from the Controlled Substance Monitoring Database, when placed in a
patient’s medical record, is subject to disclosure under the same terms as other
information in the patient’s medical records.
b) Persons engaged in the analysis of information in the Database may publish aggregate
unidentifiable personal data derived from the Database for the purpose of educational
outreach.
6. Senate Bill 1631 (Norris)
House Bill 1427 (McCormick)
This Administration bill authorizes prescribers to prescribe naloxone hydrochloride (an
opioid antagonist) to persons at risk of experiencing an opiate-related drug overdose or to a
family member or friend in a position to assist someone who has experienced such an overdose.
If this is done in good faith through the exercise of reasonable care, the prescriber and the person
who administers the opioid antagonist are immune from civil liability and disciplinary action.
The Department of Health is required to create an online education program to educate the public
on opioid antagonists.
7. Senate Bill 1632 (Norris)
House Bill 1428 (McCormick)
This Administration bill requires the Board of Pharmacy to consult with the Department
of Health regarding drugs to be dispensed at local health departments or clinics. Current law
requires the Board to approve these drugs by rule – a cumbersome requirement which has
become unworkable.
8. Senate Bill 2284 (Dickerson)
House Bill 1737 (Sexton)
This bill modifies current law with respect to the dispensing of a Schedule III or IV
controlled substance by a pharmacy. The prescription for such a drug cannot be filled or refilled
more than 2 months after the date of the prescription (current law is 6 months) and cannot be
refilled more than 4 times (current law is 5 times). This may be a “caption” bill.
9. Senate Bill 2316 (McNally)
House Bill 1664 (Ramsey)
This bill removes the words “or are dispensed” from the definition of “pain management
clinic” because these clinics are no longer allowed to dispense controlled substances.
10. Senate Bill 2000 (Yager)
House Bill 1939 (Dunn)
This bill does several things:
a) Before a prescription for an opioid or benzodiazepine may be filled by a pharmacist,
the person picking up the drug (unless known to the pharmacist) must present
“suitable identification.” The pharmacist must require the person picking up the drug
to provide a signature and (if the person is unknown to the pharmacist) the pharmacist
must confirm that the identification and the signature match. The person picking up
the drug and the person for whom the prescription was written do not have to be the
same person.
b) When an opioid or benzodiazepine is dispensed by mail or delivery service, the
recipient must sign to confirm receipt.
c) The definition of “pain management clinic” is revised so that it reads as follows:
(6)(A) “Pain management clinic” means a privately-owned
clinic, facility or office in which any health care provider licensed
under this title provides chronic non-malignant 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 facility qualifies as
a pain management clinic under this subdivision (6)(A), the entire
clinic, facility, or office caseload of patients who received medical
care services from all medical doctors, osteopathic physicians,
advanced practice nurses and physician assistants who serve in the
clinic, facility or office shall be counted;
(B) “Pain management clinic” also means a privatelyowned clinic, facility, or office that advertises in any medium for
pain management services and in which one (1) or more employees
or contractors prescribe or dispense opioids, benzodiazepines,
barbiturates, or carisoprodol. This subdivision (6)(B) does not
apply to any licensed healthcare provider who practices
interventional pain management under §63-6-244 and who does
not provide chronic non-malignant pain treatment to a majority of
patients in a clinic, facility, or office for ninety (90) days or more
in a twelve month period; and
11. Senate Bill 1832 (Yager)
House Bill 1466 (Ramsey)
This bill provides that a pharmacy must require a person picking up a prescribed drug
which is an opioid, benzodiazepine, barbiturate, or carisoprodol (more than 7 days supply) to
present a valid government-issued identification containing that person’s photograph (unless the
person is known to the pharmacist).
The pharmacy must maintain a record of each sale, including the following information:
name, address, ID type and number, prescription number, and initials or code of the pharmacist
or pharmacist’s employee. Couriers delivering one of the above drugs dispensed by out-of-state
pharmacies must obtain the printed name and signature of the person taking possession of the
drug.
When a minor who does not have a valid ID seeks to pick up one of the above drugs, the
pharmacist shall use professional judgment in determining whether to dispense the drug to that
minor.
12. Senate Bill 2520 (Haile)
House Bill 2485 (Ragan)
This bill deals with dextromethorphan. No person may supply to a minor any drug or
mixture containing any quantity of this substance. Unless a purchaser appears to be at least 35
years old, the seller must obtain ID from the purchaser of a drug or mixture containing this
substance.
13. Senate Bill 2547 (Hensley)
House Bill 2400 (Doss)
This bill gives the Commissioner of Health a role in staffing the Controlled Substance
Monitoring Database, along with the Executive Director of the Board of Pharmacy.
14. Senate Bill 2302 (McNally)
House Bill 1657 (Sexton)
This bill allows a pain management clinic to dispense a non-narcotic Schedule V
controlled substance in a quantity limited to an amount which is adequate to treat the patient for
30 days.
15. Senate Bill 1663 (Kelsey)
House Bill 1512 (Shipley)
This bill does numerous things:
a) A prescriber who applies to register with the Board of Pharmacy to gain the authority
to prescribe controlled substances must supply a fingerprint sample and submit to a
criminal history records check by the TBI.
b) A prescriber’s profile on the Department of Health website must state whether that
person prescribes controlled substances.
c) If a health care practitioner is found by his/her licensing board to have violated a
statute, rule or order involving the unauthorized prescription or dispensing of
controlled substances, the minimum civil penalty shall be $10,000 per violation and
the person’s license shall be suspended for at least 6 months.
d) A health care practitioner who works at a pain management clinic must notify his/her
licensing board within 10 days of starting work and of ending work at the clinic.
e) A pain management clinic may be adjudged a public nuisance if it has been the site of
two or more occurrences of certain specified assault or theft crimes.
f) New requirements are imposed by section 8 of the bill on wholesalers of drugs, who
must:
1) take reasonable measures to identify their customers, understand the normal
transactions of those customers, and identify suspicious transactions of their
customers;
2) establish internal policies and procedures for identifying suspicious orders and
transactions;
3) assess orders for greater than 5,000 unit doses of any controlled substance in a
month to determine whether the order is reasonable;
4) report to the Controlled Substance Monitoring Database Committee any
regulated transaction involving an extraordinary quantity of a listed chemical,
an uncommon method of payment or delivery, or any other circumstance
which leads the wholesaler to believe the chemical may be used in violation of
the law; and
5) in the event of theft or other loss of controlled substances, report such theft or
loss to the Controlled Substance Database Monitoring Committee.
g) Section 10 defines the term “medical practitioner” to include physicians, dentists,
nurses, chiropractors, psychologists, social workers, and physician assistants. Section
9 prohibits such medical practitioners from dispensing Schedule II or III controlled
substances. Excepted from this prohibition are drugs dispensed as samples or in
connection with a surgical procedure (14-day supply) or in a clinical trial or to a
patient of a licensed health care facility.
16. Senate Bill 2274 (Dickerson)
House Bill 2153 (Armstrong)
This bill would tie the granting of a certificate of need for a nonresidential substitutionbased treatment center for opiate addiction to approval by the local legislative body.