Position on Governor Haslam's TN Together Initiative
Published: Thursday, February 8, 2018 4:15 pm
The Tennessee Medical Association Board of Trustees has adopted the following position on Governor Haslam's TN Together plan for addressing the state's opioid abuse epidemic. Our position is based on a thorough review of the proposed legislation and feedback from member physicians in various medical specialties and practice environments across the state.
Our proposed solution: Remove the "acute care" definition to avoid conflicts with the "chronic non-malignant pain" definition already in state law, clarify "healthcare practitioners" instead as prescribers and dispensers, and give physicians some flexibility to determine reasonable exceptions to cookie-cutter labels.
Our proposed solution: Remove the "acute care" definition and the associated CSMD checks from the bill, change existing state law to allow for more physician extenders to help perform worthwhile CSMD checks on abused medicines, and exempt doctors who prescribe and dispense in the same location from performing redundant CSMD checks at dispensing.
Our proposed solution: Continue to limit dispensing instead of prescribing. Allow doctors to write the prescription they feel medically appropriate after checking the CSMD and restrict the initial fill to seven days at the pharmacy. Add a provision to the bill that requires insurance companies to pay for alternative (non-opioid) pain management treatments.
In addition to these and other specific changes, TMA advocates for a sunset date of 2021 on HB 1831 to allow all stakeholders to evaluate the law's effectiveness and determine specific areas worthy of long-term investment using valuable state resources.
TMA has worked with the General Assembly for years on solutions to address this public health crisis. It is encouraging that Governor Haslam is dedicating more funding for prevention, treatment and law enforcement. We have advocated annually for increased state funding for drug treatment programs, and we must give law enforcement resources to deal with the deadly rise in heroin and fentanyl.
TMA's primary focus in the ongoing opioid abuse epidemic remains educating healthcare providers and reducing initial supply, where physicians have direct influence on patient safety and quality of care.
We applaud Tennessee's physicians for their leadership on this issue and look forward to working with state lawmakers to make sure doctors have input in important amendments to HB 1831.