Insurance Benefits for Autism Spectrum Disorder
Swiftly labeled by the insurance industry as mandate bills, legislators introduced at least four bills on this subject. The shared intent of these bills require insurance policies to provide benefits for neurological disorders for individuals diagnosed with autism spectrum disorder at age eight or younger. The coverage for behavioral therapy would be an annual maximum benefit of $50,000, adjusted annually to reflect changes in the consumer price index.
Status: At the request of the insurance industry, led by Blue Cross/Blue Shield, all mandate bills were placed on a special mandate calendar where they were all deferred by committee action until 2010.
Pneumococcal Conjugate Vaccine
SB 0004 by *McNally (HB 0247 by *Lynn)
Public Health - As introduced, requires the commissioner of health to require children under the age of 24 months enrolled or enrolling in a child care facility to receive the pneumococcal conjugate vaccine. This legislation introduced at the request of Wyeth Pharmaceuticals. It follows on the heels of similar language brought last year directed at the TN Dept of Health urging expedient issuance and implementation of rules relative to the administration of the vaccine and other vaccines.
Status: The Department of Health issued rules on March 27, 2009 with various effective dates, the earliest being July 1, 2010. Briefly, Rule Number 1200-14-01-.29: Immunization Against Certain Diseases Prior to School Attendance in Tennessee requires every nursery school, day care center, Head Start center, Kindergarten, or other pre-school, day care or grades Kindergarten through twelve of any public, private, or church related school obtain proof of adequate immunization against diphtheria, measles, pertussis, poliomyelitis, rubella, mumps, hepatitis B and tetanus prior to admitting a child.
Prohibition on Smoking in Cars in Presence of Children
When last reported no legislation had been filed pending approval from TMA Board on 1/31/2009. Since then, the TMA and the TNAAP board did vote to support this initiative. Proposed legislation results from efforts spearheaded by Knoxville Anti-Smoking Advocate, Gail Brabson, R.N. Legislation as detailed in draft form creates probable cause for a violation of the law solely upon a law enforcement officer's clear and unobstructed view of a person smoking in the presence of a child, even if the windows are open. However, no citation or warrant for arrest can be issued unless a person is stopped by a law enforcement officer for a separate violation of law and is issued a citation or warrant for arrest for the separate violation of law. Four states (Louisiana, Arkansas, Maine & California) have already enacted similar laws. Additionally, Illinois and Pennsylvania may introduce similar initiatives for consideration.
Status: Deferred until 2010. Legislators opposed to the measure and a lack of support from CHART and the American Cancer Society stalled legislation introduced by Representative Floyd & Senator Burchett (HB 0014 by *Floyd / SB 0495 by *Burchett) Bill Summary for *HB 0014/SB 0495
Fiscal Note for HB0014 / SB0495 filed under HB0014
Guns Gone Wild!
Legislators introduced 147 bills related to privacy of gun permit holders and where individuals can carry concealed weapons/guns. Tennesseans with gun carry permits may now carry their firearms into bars and restaurants. Interestingly, a group of Nashville-area restaurant owners has sought a court injunction on implementation of the state law.
Status: Tennesseans with gun carry permits may now carry their firearms into establishments that serve alcohol. Following an override of the Governor’s veto, a group of Nashville-area restaurant owners has sought a court injunction on implementation of the state law. Guns are also now allowed in our parks.
Release of Medical Test Results of Child to Parent
(SB 2089 by Beavers / HB 1762 by Shipley)
As introduced, requires the physician or hospital to provide the parent or guardian a copy of the written results of any medical test or procedure performed on the minor child within 24 hours of receiving a written request from the parent or guardian. The requesting party would be responsible for the reasonable costs of copying and mailing the child's restrictions, subject to the present law provisions governing charges for copying medical records. If bill had passed, The Department of Health faced possible loss of $6.5M in federal grant funds for non-compliance with Title X family planning regulations.
Status: Legislation failed in Senate Health & General Welfare Committee and remains stalled in House Budget Subcommittee. Bill sponsor may revive legislation in 2010.
Beware of Health Research Insights, Incorporated!
Legislation introduced and passed by General Assembly addresses fraudulent activity.
(SB 0549 by Norris / HB 0793 by Harwell)
A number of medical practices, including Old Harding Pediatrics in Nashville, TN, received letters Health Research Insights, Inc., based in Franklin, TN. HRI approaches self-insured businesses, such as Averitt Express, and convinces them that HRI could reduce their health care costs by recouping funds allegedly overpaid to physicians based on HRI’s proprietary "algorithm". HRI does not request or review clinical records before making written demands for alleged overpayment due to upcoding from physicians.To date, HRI’s reviews seem to focus on 99214 and 99215 and 99244 and 99245 office visits billed by MDs . These CPT codes represent codes billed for OVs that are the most extensive, time-consuming and
therefore highest reimbursed visits. The MD is given two choices to act upon within 15 days of the notice: Reimburse the amount HRI believes has been overpaid; or Submit copies of the patient’s records so that HRI coders can determine the accuracy of the claims.
No reasonable proof that HRI is entitled to physician records or payment is provided in its correspondence. If the physician does not act, the notice says HRI could file complaints against them with the U.S. Department of Labor. Medical practices have reported to the Tennessee Medical Association (TMA) that HRI follows up its letters with intimidating phone calls. TMA is considering its legal options to try to stop this business practice. TMA believes these practices by HRI harm physicians. TNAAP worked in conjunction with TMA and Blue Cross Blue Shield to pass legislation halting the illegal practices of HRI.
TN General Assembly Approves legislation Granting Nurse Practitioners/Physicians Assistants Authority to issue disability tags..
(SB 0939 by Watson / HB 0465 by Odom)
Proposed legislation to grant Nurse Practitioners and Physician Assistants Authority to sign death certificates failed in the Professional Occupations Subcommittee.
(SB 0938 by Watson / HB 0464 by Odom)
Menu Labeling Advocates Pull Plug on 2009 Effort;
Governor Vetoes Industry Efforts to Preempt State and Local Menu Labeling Initiatives
(SB 2314 by Kyle / HB 2319 by Turner M)
Food and Food Products - As introduced, enacts the "Tennessee Healthful Menu Act." - Amends TCA Title 68, Chapter 14 and Title 53, Chapter 8.
The General Assembly deferred legislation introduced on behalf of Governor Bredesen and the Tennessee Department Health to require full disclosure of the total number calories per serving as usually prepared and offered for sale on all restaurant menus. At the request of the Bredesen Administration, TNAAP joined the coalition on menu labeling – over 20 other groups involved in this effort.
Meanwhile, McDonald’s and TN Restaurant Association/Hospitality Assn all voiced opposition to the bill and filed preemption bills, citing pending federal legislation.
Status: Deferred until 2010.
TNAAP encourages Pediatricians to become involved in the legislative process by visiting their legislators on Capitol Hill. Be on the lookout for announcements for dates and times for TNAAP Day on the Hill Visits!
For more information or details of the bills, amendments and laws (Public Chapters), please see the Tennessee General Assembly's website at