By CLINT CUMMINS
2024 will (and already has been) a year focused on taking care of the medical community. Taking care in the sense of making sure our physicians and all healthcare providers feel supported, safe, and unthreatened – physically, legally, and financially. TMA, MMS, and MGMA have already travelled to Nashville on March 5 to advocate for better healthcare for Tennesseans and a better environment to practice medicine in our state. Still yet, calls to action will be submitted to our stakeholders to impact bills that affect our profession. This article was written March 7, so the status of these could be changed by the time you read this.
BENJAMIN MAUCK ACT (SB1709/HB1628)
This one hits home in a multitude of ways. We are all familiar with the tragedy that befell Dr. Benjamin Mauck, his family, his colleagues, and our entire community. The bill in his name seeks to increase the penalty for knowingly committing assault under these circumstances to a Class A misdemeanor punishable by 30 days in jail and a $5,000 fine, and aggravated assault to a Class C felony punishable by 90 days in jail and a $15,000 fine, respectively. If passed, the law would align Tennessee with 40 other states that have already established laws creating or increasing penalties for violence against healthcare workers. Critics have argued that the bill could unfairly single out the healthcare community and lead to other professions seeking similar protections. Our education on the bill centers around the unique intimacy and vulnerability of the healthcare setting, and that preemption of these crimes is the goal, more so than incarceration.
As I’ve shared with many of you, I have known Ben since fourth grade. I had the honor of traveling to Nashville on February 27 to reunite with his family as Ben’s older brother gave testimony during the Senate Judiciary Committee’s hearing of the bill. The bill passed and now moves on to Senate Finance, Ways, and Means Committee, before hopefully heading to a full House and Senate vote.
SCOPE OF PRACTICE/TEAM-BASED CARE
Scope of practice continues to be a prevailing issue in healthcare. Tennessee Medical Association, Memphis Medical Society and many other physician groups feel a physician-led team is still the best environment for patient care in our state because it does not compromise patient safety or quality of care. This year, SB2135/HB2727 is being carried to address scope for psychiatric nurse practitioners. The sponsors of the bill argue it is a means to increase access to behavioral health providers with prescribing authority. Physician groups and others argue that the proposal would effectively create a separate and unequal system of care for behavioral health patients in Tennessee: one where underserved communities receive medical care from practitioners who do not have the level of training and expertise of physicians, and one with a physician-led team that ensures the highest quality of care for patients with complex mental health diagnoses. The bill is set to be heard by the Senate Health and Welfare Committee on March 13.
TMA has submitted an alternative bill (SB2136/HB2318 – somewhat ironically with the same Senate sponsor) that seeks to maintain the physician-led, team-based model, while adding greater flexibility to those advanced practice providers who have more than three years of post-graduate experience. This bill was formulated through a TMA-led stakeholder group called the Collaborative Care Coalition that comprises multiple specialty advocacy groups.
INSURANCE RECOUPMENT REFORM (SB2328/HB2076)
Recoupment is the term used to define the process by which insurers correct payment errors. Current statute allows audits by insurers to go back as far as 18 months. This is highly damaging to medical practices and hospitals who run tight, cash-based organizations. Furthermore, the audit and recoupment process takes physicians and staff away from patient care, resulting in further financial consequences. TMA’s bill argues for a reduction in the timeframe of an audit and greater transparency from the insurers in the process. This bill is set to be heard by both the House Insurance Committee and the Senate Commerce and Labor Committee on March 12.
PHYSICIAN WELLNESS (SB734/HB628)
Some studies place the physician burnout rate as high as 63 percent. Currently in Tennessee, some health plans and hospital credentialing committees require physicians to disclose personal mental health information to practice at facilities or serve on panels. Unlike other professions, physicians who surrender their licenses or hospital privileges due to impairment must be reported to the National Practitioner Data Bank. These requirements serve as barriers to physicians seeking mental health treatment, ultimately contributing to reduced professional performance, high turnover rates, and the adverse consequences of medical errors. They can also be a deterrent to recruiting new providers to our state. This bill is set to be heard on March 13 by the House Health Committee.
These are the top priorities among hundreds of bills that will be filed and monitored by the advocacy team at TMA and other healthcare organizations. Other topics will include abortion trafficking, motorcycle helmets, required AED inclusion in schools, required electronic insurance card acceptance, parental rights, among many others.
Finally, I would like to give a special shoutout to the local leaders who volunteer their time to advocate on behalf of these issues. Physicians George Woodbury, MD, Dale Criner, MD, and Desiree Burroughs-Ray, MD lead the volunteer efforts locally that shape policy and facilitate conversations with our elected officials. The government relations department of TMA also works relentlessly in tracking hundreds of bills each year. Many more from the ranks of MGMA and local hospital leadership also lend their time and energy. Thank you!
And to the rest of you – I encourage you to get involved via these organizations or on your own as a constituent.