Criminal Law - 4

SB412 / HB306 Assault against a health care provider. Category Criminal Law Sponsors Sen. Mark Green / Rep. JoAnne Favors Description Adds health care provider to the list of persons where if an assault or an aggravated assault is committed while acting in the discharge of the provider's duty then the maximum fine shall be $5,000 and $15,000 respectively. Amendment HOUSE AMENDMENT 1, SENATE JUDICIARY COMMITTEE AMENDMENT 1 (004169) changes the definition of "health care provider" for purposes of this section from "any person or entity performing services regulated pursuant to title 63 or title 68, chapter 11" to "a person who is licensed, certified or otherwise authorized or permitted by the laws of this state to administer health care in the ordinary course of business in the practicing of a profession." SENATE JUDICIARY COMMITTEE AMENDMENT 2 (006291) rewrites the bill. Allows any misdemeanor level assault conviction to also be punishable by a fine up to $5,000. Allows certain aggravated assault convictions to also be punishable by a fine up to $15,000. Fiscal Note (Dated: February 15 2013) Not Significant. Senate Status 04/11/2013 - Set for Senate Floor 04/15/13. House Status 03/25/2013 - House passed with amendment 1. SB675 / HB531 Lynn's Law. Category Criminal Law Sponsors Sen. / Rep. Description Enacts "Lynn's Law" and defines abuse or neglect of an adult to include a caretaker who knowingly abandons or fails to pick up an adult if the caretaker knows the adult is unable to care for himself without assistance. Amendment SENATE AMENDMENT 1, HOUSE CIVIL JUSTICE COMMITTEE AMENDMENT 1 (004292) substitutes the language "fails to provide transportation for an adult" in the definition of abuse or neglect for the language "fails to pick up an adult". The language expressly including a relative that resides with, or in the same building with, the adult or regularly visits the adult in the definition of caretaker is removed. The language describing a relative is removed. SENATE AMENDMENT 2, HOUSE CIVIL JUSTICE COMMITTEE AMENDMENT 2 (004995) defines caretaker to mean an individual or institution who has assumed the duty to provide for the care of the adult by contract or agreement and to include a parent, spouse, adult child, or other relative, both biological or by marriage, who resides with or in the same building with or regularly visits the adult and who knows or reasonably should know of the adult's mental or physical dysfunction or advanced age and knows or reasonably should know that the adult is unable to adequately provide for the adult's own care. Fiscal Note (Dated: March 10 2013) Increased State Expenditures - $14,200/Incarceration. Senate Status 04/11/2013 - Senate passed with amendments 1 (004292) and 2 (004995). Amendment 1 (004292) substitutes the language "fails to provide transportation for an adult" in the definition of abuse or neglect for the language "fails to pick up an adult". The language expressly including a relative that resides with, or in the same building with, the adult or regularly visits the adult in the definition of caretaker is removed. The language describing a relative is removed. Amendment 2 (004995) defines caretaker to mean an individual or institution who has assumed the duty to provide for the care of the adult by contract or agreement and to include a parent, spouse, adult child, or other relative, both biological or by marriage, who resides with or in the same building with or regularly visits the adult and who knows or reasonably should know of the adult's mental or physical dysfunction or advanced age and knows or reasonably should know that the adult is unable to adequately provide for the adult's own care. House Status 04/11/2013 - House Finance Committee recommended. Sent to House Calendar & Rules. SB1113 / HB1182 DHS to investigate reports of elder abuse within 24 hours. Category Criminal Law Sponsors Sen. James F. Kyle Jr. / Rep. Jr. Description Requires the department of humans services to initiate investigation of reports of elder abuse or neglect within 24 hours, instead of as soon as practical. Fiscal Note (Dated: March 10 2013) Increased State Expenditures - $594,000/One-time - $6,909,100/Recurring. Senate Status 03/20/2013 - Senate Health & Welfare Committee deferred to 03/272013. House Status 03/19/2013 - House Health Subcommittee deferred to 01/01/2014. SB1363 / HB1294 Creates offense of prescription drug fraud. Category Criminal Law Sponsors Sen. / Rep. William G. Lamberth Description Creates offense of prescription drug fraud, which is using fraud or forgery to obtain a controlled substance and adds the theft of identifying information used to prescribe a controlled substance to offense of identity theft. Provides that the term "victim" shall also include the person whose personal identifying information was obtained, a physician, nurse practitioner, or other health care provider whose personal identifying information was unlawfully used. Fiscal Note (Dated: March 4 2013) Not Significant. Senate Status 03/18/2013 - Senate passed. House Status 03/28/2013 - House passed. Executive Status 04/02/2013 - Sent to governor.

Government Organization - 6

SB336 / HB806 Sunset-health services and development agency. Category Government Organization Sponsors Sen. / Rep. Judd Matheny Description Extends the health services and development agency to June 30, 2017. Establishes qualifications for each of the agency's six members. Fiscal Note (Dated: February 4 2013) Not Significant. Senate Status 03/11/2013 - Senate passed. House Status 03/25/2013 - House passed. Executive Status 04/02/2013 - Sent to governor. SB364 / HB790 Sunset- TN state veterans' home board. Category Government Organization Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Extends the state veterans' home board to June 30, 2014. Amendment Senate amendment 1 (006170) rewrites the bill. Adds a termination date of June 30, 2013 to the Tennessee state veterans' home board. Requires the division of state audit to return to the Tennessee state veterans' home board in 2014 for the purpose of conducting a limited audit to review actions taken to address the issues raised in the findings of the September, 2012 audit report for the board. Fiscal Note (Dated: February 11 2013) Not Significant. Senate Status 04/08/2013 - Senate passed with amendment 1 (006170), which rewrites the bill. Adds a termination date of June 30, 2013 to the Tennessee state veterans' home board. Requires the division of state audit to return to the Tennessee state veterans' home board in 2014 for the purpose of conducting a limited audit to review actions taken to address the issues raised in the findings of the September, 2012 audit report for the board. House Status 04/11/2013 - House concurred in Senate amendment 1. Executive Status 04/11/2013 - Sent to the speakers for signatures. SB368 / HB827 Creation of conflict of interest policies. Category Government Organization Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Requires each board, commission, committee, or other governmental entity to adopt and implement rules and regulations to create a conflict of interest policy for board members. Specifies that the policy shall mandate annual written disclosures of financial interests, other possible conflicts of interest, and an acknowledgement by board members that they have read and understand all aspects of the policy. Fiscal Note (Dated: March 22 2013) Not Significant. Senate Status 01/31/2013 - Referred to Senate Government Operations. House Status 02/07/2013 - Referred to House Government Operations. SB390 / HB802 Health related boards to assess a fee on licenses Category Government Organization Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Requires each regulatory board and health related board to assess a state regulatory fee on licensees. Fiscal Note (Dated: March 17 2013) Other Fiscal Impact - To the extent any health-related regulatory board does not currently assess a regulatory fee, there will be a recurring increase in state revenue of an unknown amount. Any such recurring increase is unknown because such regulatory fees shall be established as part of the general appropriations act pursuant to Tenn. Code Ann. § 4-3-1011(b)(2). Otherwise, the fiscal impact of this bill is considered not significant. Senate Status 03/26/2013 - Taken off notice in Senate Health & Welfare Committee. House Status 04/03/2013 - Taken off notice in House Health Committee. SB717 / HB583 Restructuring of certain agencies. Category Government Organization Sponsors Sen. Mike Bell / Rep. Judd Matheny Description Revises various provisions governing the structure of Tennessee commission on historic preservation, the state historian and historical commission, and the drycleaner environmental response board. Amendment HOUSE STATE GOVERNMENT COMMITTEE AMENDMENT 1 (004789) rewrites the bill. Section 1 changes the membership of the Historical Commission from 24 members to 18 and specifies that there will be five members from each grand division and three at large members. Specifies that no two members can be appointed from the same county. Allows the governor to appoint the chairman of the commission instead of the chairman being selected by the commission and staggers terms of members of commission. Vacates current membership upon effective date of this act. Section 2 revises provision related to the Board of Accountancy. Adds specific duties of the executive director role of the board for more clarity. Allows the executive director to be subject to "performance review and other general requirements" of state employees. Allows the commissioner, after consultation with the board, to dismiss the executive director for cause. Sections 3 and 4 revise provisions related to the Advisory Committee for Geology and Soil Scientist Advisory Committee. This amendment combines the funds for these two committees. Section 5 allows the governor to appoint the chair of the Health Services and Development Agency instead of board election. Section 6 through 38 deals with the Dry Cleaner Environmental Response Board. This amendment deletes the Dry Cleaner Environmental Response Board and gives the duties of the board to the commissioner of the department of environment and conservation. Allows the commissioner to appoint an advisory committee when needed. SENATE GOVERNMENT OPERATIONS COMMITTEE AMENDMENT 1 (006750) rewrites the bill. Changes the composition, membership, and terms of the Tennessee historical commission. Changes certain responsibilities regarding the board of accountancy. Changes the "geologists fund" to the "geologist and soil scientist regulatory fund." Deletes provisions regarding the agricultural hall of fame, board of governors and the drycleaner environmental response board. (11 pp.) SENATE GOVERNMENT OPERATIONS COMMITTEE AMENDMENT 2 (006798) adds new language immediately preceding Section 2 of the bill. Requires the historical commission to have an executive director who shall be appointed by the governor. Requires the commission to submit to the governor three candidates. Authorizes the executive director to create positions and employ personnel needed to conduct affairs. Allows for all reimbursement of travel expenses that are in accordance with the regulations of the department of finance and administration and approved by the attorney general. Fiscal Note (Dated: March 19 2013) Increase State Expenditures - $2,810,300/One-Time - Net Impact - $154,100/ Recurring - Other Fiscal Impact - The Governor's proposed FY13-14 budget accounts for the Criminal Justice Coordinating Council transferring from the Department of Finance and Administration to the Department of Correction, in an amount equal to $227,500. Senate Status 04/11/2013 - Set for Senate Floor 04/16/13. House Status 04/09/2013 - House Government Operations Committee recommended. Sent to House Finance. SB1119 / HB1008 Creates three new select joint committees. Category Government Organization Sponsors Sen. James F. Kyle Jr. / Rep. Mike Turner Description Creates the select oversight committee on corrections, the select committee on children and youth, and the select oversight committee on TennCare and specifies membership and duties of each select committee. (22 pp.) Fiscal Note (Dated: March 2 2013) Increase State Expenditures - $30,000/One-Time - $527,800/Recurring. Senate Status 02/08/2013 - Referred to Senate Government Operations. House Status 03/06/2013 - Failed in House State Government Subcommittee.

Government Regulation - 2

SB463 / HB1051 Programs for older Tennesseans. Category Government Regulation Sponsors Sen. Ken Yager / Rep. Steve McDaniel Description Makes the provision of a home care ombudsman by area agencies on aging subject to appropriations. Deletes an outreach program to Medicare eligible Tennesseans. Removes the prohibition on the commission on aging and disability to exercise any control or authority over the administration of programs for home and community based long-term care that are operating on the basis of federal waivers in effect on June 19, 2001. Fiscal Note (Dated: March 25 2013) Increase State Expenditures - $835,600. Senate Status 03/06/2013 - Senate Health & Welfare Committee deferred to 03/13/2013. House Status 02/20/2013 - Referred to House Health Subcommittee. SB730 / HB409 UAPA - filing of rules with the secretary of state. Category Government Regulation Sponsors Sen. / Rep. Curtis G. Johnson Description Requires additional information be submitted by state agencies upon the filing of rules with the secretary of state, including a written justification for the proposed rule to be promulgated and an impact analysis. Specifies that the written justification include a clearly defined description of the objective of the proposed action, a demonstration of necessity for the proposed action, identification and explanation of expected benefits and beneficiaries of the proposed action, and an explanation of alternative actions considered, in addition to other information required. Also specifies the information that should be included with the impact analysis. Fiscal Note (Dated: March 8 2013) Increase State Expenditures - $128,100/FY13-14 - $240,100/FY14- 15 and Subsequent Years. Senate Status 02/08/2013 - Referred to Senate Government Operations. House Status 02/05/2013 - Referred to House State Government Subcommittee.

Health Care - 22

SB98 / HB470 Accounting of long-term care expenditures. Category Health Care Sponsors Sen. Lowe Finney / Rep. Lois M. DeBerry Description Requires the bureau of TennCare to report to the general assembly and make available to interested persons a separate accounting of long-term care expenditures for nursing facility services and home and community-based services made under the CHOICES long-term health care program, including prior fiscal year actual expenditures and projected current fiscal year expenditures no later than February 1 of each year. Fiscal Note (Dated: February 3 2013) Not Significant. Senate Status 01/30/2013 - Referred to Senate Commerce & Labor Committee. House Status 02/05/2013 - Referred to House Health Subcommittee. SB177 / HB171 Employee review if neglect is committed. Category Health Care Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Requires certain adult day care and child care employees to submit to a review to determine if person has committed abuse or "neglect," instead of "gross neglect," of a child or adult. (Part of Administration Package) Fiscal Note (Dated: February 23 2013) Not Significant. Senate Status 03/25/2013 - Senate passed. House Status 03/11/2013 - House passed. Executive Status 04/08/2013 - Signed by governor. SB192 / HB186 Various changes to health care law - broadly captioned. Category Health Care Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Requires a court to notify a public hospital or a treatment resource before committing a criminal defendant to such a hospital or resource. Adds "deliver" to the list of unlawful activities regarding the release of information by an insurance or carrier that provides for the physical or mental health of patients. Reduces the time from 30 days to 15 days for an enrollee and applicant for TennCare to notify the bureau of any material change regarding the person's TennCare application. Broadly captioned. (Part of Administration Package) Fiscal Note (Dated: March 15 2013) Not Significant. Senate Status 01/31/2013 - Referred to Senate Judiciary. House Status 03/20/2013 - Taken off notice in House Civil Justice Subcommittee. SB252 / HB429 Pharmacy to check id for delivery of controlled substance. Category Health Care Sponsors Sen. Mark Green / Rep. Joe Pitts Description Requires a pharmacist or pharmacist's agent prior to dispensing a valid prescription drug for any controlled substance to check the identification of the person taking possession of the controlled substance. Requires signature of person taking possession of the controlled substance as confirmation of receipt. Fiscal Note (Dated: February 23 2013) Not Significant. Senate Status 03/20/2013 - Senate Health & Welfare Committee deferred to 03/27/2013. House Status 03/19/2013 - Taken off notice in House Criminal Justice Subcommittee. SB257 / HB1019 Replaces current universal do not resuscitate order statute. Category Health Care Sponsors Sen. / Rep. Description Replaces current do not resuscitate order with a new provision authorizing physician orders for scope of treatment (POST). Defines POST as written orders on an approved form that specifies whether in the event of cardiac or respiratory arrest, cardiopulmonary resuscitation should or should not be attempted and specifies other medical interventions that are to be provided or withheld. Authorizes nurse practitioners or clinical nurse specialists to issue a POST under certain circumstances. Establishes a POST to be valid and in effect until revoked. Requires health care facilities to communicate the existence of the POST. Empowers the board for licensing health care facilities to promulgate rules and create forms regarding procedures for withholding resuscitative services. Removes civil and criminal liability for health care providers acting in good faith for decisions regarding a POST. Amendment House amendment 1 (003505) authorizes a physician assistant, in addition to a nurse practitioner or clinical nurse specialist, to issue a POST for a patient with whom such physician assistant has a bona fide nurse-patient relationship in the circumstances described above in the bill summary. Clarifies, in regard to the circumstances for such a nurse or physician assistant to issue a POST, that either the patient is a resident of a licensed nursing home or ICF/MR facility or the patient is a hospital patient and is in the process of being discharged from the nursing home or hospital or transferred to another facility at the time the POST is being issued. Deletes the provisions of the bill that are described in the bill summary under the heading LIVING WILLS AND POWER OF ATTORNEYS FOR HEALTH CARE. Fiscal Note (Dated: February 12 2013) Not Significant. Senate Status 04/04/2013 - Senate passed. House Status 03/21/2013 - House passed with amendment 1. Executive Status 04/10/2013 - Sent to governor. SB258 / HB344 Adds "computed tomography" to healthcare services-CON. Category Health Care Sponsors Sen. Rusty Crowe / Rep. Michael Harrison Description Adds "computed tomography" to the list of healthcare services requiring a certificate of need before the service is initiated. Fiscal Note (Dated: March 20 2013) Increase State Revenue - Exceeds $45,000/Recurring - Increase State Expenditures - $4,600/One-Time - Exceeds $118,800/Recurring. Senate Status 02/04/2013 - From the Senate floor, recalled from Senate Commerce & Labor Committee and re-referred to Senate Health & Welfare Committee. House Status 02/05/2013 - Referred to House Health Subcommittee. SB290 / HB854 Removes medical imaging equipment from certificate of need. Category Health Care Sponsors Sen. Mark Green / Rep. Cameron Sexton Description Removes the requirement to have a certificate of need for magnetic resonance imaging and positron emission tomography. Redefines major medical major equipment to not include any medical imaging equipment, including but not limited to, magnetic resonance imaging, computed tomography, and positron emission tomography equipment. Fiscal Note (Dated: March 18 2013) Decrease State Revenue - Exceeds $45,700 - Increase State Expenditures - Exceeds $1,166,700 - Increase Federal Expenditures - Exceeds $1,041,900 - Increase Local Expenditures - Exceeds $54,700. Senate Status 02/04/2013 - From the Senate floor, recalled from Senate Commerce & Labor Committee and re-referred to Senate Health & Welfare Committee. House Status 03/26/2013 - Taken off notice in House Health Subcommittee. SB407 / HB536 Health Care Compact. Category Health Care Sponsors Sen. Mae Beavers / Rep. Description Enacts Health Care Compact, which specifies that each member state may suspend by legislation the operation of all federal laws, rules, regulations, and orders regarding health care that are inconsistent with the laws and regulations adopted by the member state pursuant to this compact. Specifies that a member state that keeps such federal law in effect is responsible for the associated funding obligations in its state. Specifies that each member states has the right to federal monies up to an amount equal to its current year funding level, funded by congress as mandatory spending and not subject to annual appropriation, to support the exercise of member state authority under this compact. Specifies that this funding will not be conditional on any action of or regulation, policy, law, or rule being adopted by the member state. Creates Interstate Advisory Health Care Commission. Sunsets the Health Care Compact on June 30, 2014. Amendment HOUSE INSURANCE & BANKING COMMITTEE AMENDMENT 1, SENATE GOVERNMENT OPERATIONS AMENDMENT 1 (002948) expressly states that nothing in the proposed legislation may be interpreted or construed as requiring the state of Tennessee to make any particular expenditure of funds for any purpose or as authorizing participation by the state of Tennessee in any Health Care Choice Compact under § 1333 of the Patient Protection and Affordable Care Act, Public Law 111-148. SENATE GOVERNMENT OPERATIONS AMENDMENT 1 TO 1 (003786) corrects a drafting error, changing an incorrect reference to TCA 68-1-2601 to TCA 68-1-2501. HOUSE INSURANCE & BANKING COMMITTEE AMENDMENT 2 (003463) corrects a drafting error, changing an incorrect reference to TCA 68-1-2601 to TCA 68-1-2501. Fiscal Note (Dated: February 11 2013) Not Significant. Senate Status 03/26/2013 - Taken off notice in Senate Health & Welfare Committee. House Status 02/19/2013 - Failed in House Insurance & Banking Committee. The bill failed after the committee had adopted amendments 1 and 2. SB430 / HB342 Nursing home privilege tax extended. Category Health Care Sponsors Sen. Doug Overbey / Rep. Michael Harrison Description Extends the nursing home privilege tax for one year. Renames such tax the nursing home annual assessment fee. Amendment Senate Health and Welfare Committee amendment 1, House Health Committee amendment 1 (003112) replaces "nursing home privilege tax" with "nursing home assessment fee." Fiscal Note (Dated: February 12 2013) Other Fiscal Impact - Prevents the loss of $82,300,000 in state revenue and $156,250,700 in federal matching funds - Revenue recognition in the amount of $82,300,000 in state revenue is included in the Governor's proposed FY13-14 budget. Senate Status 04/11/2013 - Set for Senate Floor 04/16/13. House Status 04/10/2013 - Set for House Floor 04/15/13. SB431 / HB345 Issuance of certificates of need for new nursing home beds. Category Health Care Sponsors Sen. Doug Overbey / Rep. Michael Harrison Description Extends the current moratorium on the issuance of certificates of need for new nursing home beds until June 30, 2014. Fiscal Note (Dated: February 18 2013) Other Fiscal Impact - The state will forgo nursing home bed tax revenue and avoid paying increased state and federal reimbursement expenditures arising from Medicaid enrollees utilizing long term care services. Senate Status 03/11/2013 - Senate passed. House Status 04/10/2013 - Set for House Floor 04/15/13. SB441 / HB544 Annual Coverage Assessment Act of 2013. Category Health Care Sponsors Sen. Doug Overbey / Rep. Michael Harrison Description Creates the Annual Coverage Assessment Act of 2013. Establishes process for annual coverage assessments to be applied on covered hospitals. Requires such assessment to not be used to reduce or eliminate state funding to the Tenncare program. Establishes procedure to impose and collect the assessment. Specifies the amount of the assessment. (15 pp.) Fiscal Note (Dated: February 11 2013) Increase State Revenue - $449,800,000/FY13-14/ - Maintenance of Coverage Trust Fund Increase State Expenditures - $449,800,000/FY13-14/ - Maintenance of Coverage Trust Fund - Increase Federal Expenditures - $842,576,800/FY13- 14/ Maintenance of Coverage Trust Fund - Revenue recognition in the amount of $449,800,000 is included in the Governor's proposed FY13-14 budget. Corresponding non- recurring appropriations in the amount of $1,292,376,800 ($449,800,000 in state funds and $842,576,800 in federal matching funds) are also included. Senate Status 04/03/2013 - Senate passed. House Status 03/28/2013 - House passed. Executive Status 04/10/2013 - Sent to governor. SB499 / HB518 Revises the membership of the child fatality prevention team. Category Health Care Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Decreases number of members of the Board for Licensing Health Care Facilities from 19 to 18, removing the chair of the Public Health Council, which was terminated in 2008. Specifies that one member of the child fatality prevention team be a representative from a professional organization working to prevent abuse of children, rather than the president of the state professional society on the abuse of children. Requires that conflict of interest disclosures for certain persons associated with an MCO that participates in TennCare be made to the TennCare Bureau, instead of the health commissioner. Fiscal Note (Dated: March 2 2013) Not Significant. Senate Status 03/25/2013 - Senate passed. House Status 03/21/2013 - House passed. Executive Status 04/08/2013 - Signed by governor. SB530 / HB78 Order issued concerning a nursing home within 12 days. Category Health Care Sponsors Sen. Steven Dickerson / Rep. Description Changes the amount of time an order must be issued following an administrative hearing concerning a nursing home from 10 to 12 days. Deletes authorization for a demonstration project that was supposed to be completed and reported on by 2006. Fiscal Note (Dated: March 20 2013) Not Significant. Senate Status 02/05/2013 - Referred to Senate Health & Welfare Committee. House Status 01/30/2013 - Referred to House Health Subcommittee. SB582 / HB317 Pharmacy Practice Act - compounding and dispense redefined. Category Health Care Sponsors Sen. Ferrell Haile / Rep. David Shepard Description Revises the definitions of "compounding" and "dispense" in the Pharmacy Practice Act. Amendment SENATE AMENDMENT 1, AS AMENDED, revises the compounding activities added by the bill, as described in the above bill summary in (1) and (2), to instead add the following to the activities that constitute "compounding" for purposes of pharmacy practice: (1) The preparation, mixing, assembling, packaging or labeling of a drug or device for use in a practitioner's office for administration to the prescribing practitioner's patients when the product is not commercially available upon receipt of an order from the prescriber; (2) The preparation, mixing, assembling, packaging or labeling of a drug or device for use in a licensed health care facility for administration to a patient 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; (3) The preparation, mixing, assembling, packaging or labeling of a drug or device for use by emergency medical services for administration to 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 (4) For use by a licensed veterinarian for administration to their non-human patient or patients or for dispensing to non- human 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. Additionally, this amendment requires a pharmacy located outside of this state, prior to initial licensure in this state as a compounding pharmacy, to have an inspection by the regulatory or licensing agency of the state in which the pharmacy practice site is physically located. Such pharmacies must provide a copy of the most recent inspection, which must have been within the previous 12 months. Similarly, 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, which must have been within the previous 12 months. The board of pharmacy may 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. Any compounding pharmacy having an active Tennessee license must notify the board within 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. Any pharmacies engaged in sterile compounding must comply with relevant Pharmacopeia (USP) guidelines as adopted by the board by rule or policy. Any pharmacies engaging in sterile compounding must quarterly report to the board the quantity of sterile compounded products dispensed in a defined time period, in accordance with rules or policies adopted by the board. SENATE AMENDMENT 2 (005749) exempts hospital pharmacies compounding for inpatients of a hospital from the requirement that sterile compounding pharmacies quarterly report the quantity of sterile compounded products dispensed. However, the executive director of the board may request this information from a hospital pharmacy for cause, and the hospital pharmacy would be required to respond in a timely manner as defined by the executive director. Fiscal Note (Dated: March 10 2013) Not Significant. Senate Status 04/04/2013 - Senate passed with amendment 1, as amended, and amendment 2. House Status 04/11/2013 - House passed. Executive Status 04/11/2013 - Sent to the speakers for signatures. SB604 / HB290 Implementation of the Affordable Care Act. Category Health Care Sponsors Sen. Lowe Finney / Rep. Craig Fitzhugh Description Authorizes the department of finance and administration to cooperate with the appropriate federal department in any reasonable manner as to implement the Patient Protection and Affordable Care Act to either the extent required or permitted by law. Fiscal Note (Dated: March 2 2013) Increase Federal Expenditures - $418,207,600/FY13-14 - $1,000,100,900/FY14-15. Senate Status 03/27/2013 - Failed in Senate Commerce & Labor Committee (2 ayes, 7 noes). House Status 03/27/2013 - House Insurance & Banking Subcommittee deferred 01/01/14. SB746 / HB865 Contracts between residents and assisted-care living facilities. Category Health Care Sponsors Sen. / Rep. Cameron Sexton Description Requires assisted-care living facilities to enter into a contract with each resident which sets forth the services and accommodations to be provided by the facility, the rates of charge, the rights, duties, and obligations of each resident, and other matters deemed appropriate by both parties. Fiscal Note (Dated: March 10 2013) Increase State Expenditures - $41,100/FY13-14/Board for Licensing Health Care Facilities - $73,600/FY14-15 and Subsequent Years/ - Board for Licensing Health Care Facilities. Senate Status 03/20/2013 - Senate Health & Welfare Committee deferred to 03/27/2013. House Status 03/26/2013 - Taken off notice in House Health Subcommittee. SB804 / HB937 Prohibits Medicaid expansion under new federal health care law. Category Health Care Sponsors Sen. Brian K. Kelsey / Rep. Description Prohibits the state from establishing, facilitating, implementing, or participating in any new expansion of the medical assistance program, also known as Medicaid, pursuant to the Patient Protection and Affordable Care Act. Amendment Senate Commerce & Labor Committee amendment 1 (005948) rewrites the bill. Prohibits the Governor from making any decision or obligating the state in any way with regard to the expansion of the medical assistance program, also known as the Medicaid program, pursuant to the Patient Protection and Affordable Care Act, as interpreted by the United States Supreme Court, to be unconstitutional when applied to states as a mandatory expansion, unless authorized by the General Assembly. Fiscal Note (Dated: February 26 2013) Forgone State Revenue - $418,207,600/TennCare/FY13-14 - $1,000,100,900/TennCare/FY14-15. Senate Status 04/11/2013 - Senate Finance, Ways & Means Committee deferred to 04/15/2013. House Status 03/27/2013 - House Insurance & Banking Subcommittee deferred 01/01/14. SB818 / HB686 Defines "medical directive" to mean the same as "advance directive". Category Health Care Sponsors Sen. Lowe Finney / Rep. Description Includes "medical directive" as an alternative term for "advance directive". Fiscal Note (Dated: March 3 2013) Not Significant. Senate Status 02/08/2013 - Referred to Senate Judiciary. House Status 02/06/2013 - Referred to House Civil Justice Subcommittee. SB884 / HB1073 Surrogates can seek mental health treatment. Category Health Care Sponsors Sen. / Rep. Barrett Rich Description Authorizes surrogates under the Tennessee Health Care Decisions Act to apply for voluntary admission to a public or private hospital for diagnosis, observation, and treatment of a mental illness or serious emotional disturbance. Establishes that no person may be admitted by a surrogate for more than 21 consecutive days unless a petition has been filed or unless the individual meets certain criteria. Authorizes surrogates to apply for release by filing a written application with the chief officer and to allow the release of confidential information. Amendment House amendment 1 (004236) replaces "person" with "individual" wherever it appears. Adds an individual acting as an agent under the Tennessee Health Care Decisions Act, or an individual designated under TCA 68-11-1806(a) to the list of people who may apply for voluntary admission. Replaces a person's surrogate with an individual acting as an agent under the Tennessee Health Care Decisions Act, or an designated under TCA 68-11-1806(a) when requesting a release from inpatient services or a disclosure of confidential information. Fiscal Note (Dated: February 18 2013) Not Significant. Senate Status 04/10/2013 - Senate passed. House Status 04/08/2013 - House passed with amendment 1 (004236), which replaces "person" with "individual" wherever it appears. Adds an individual acting as an agent under the Tennessee Health Care Decisions Act, or an individual designated under TCA 68-11-1806(a) to the list of people who may apply for voluntary admission. Replaces a person's surrogate with an individual acting as an agent under the Tennessee Health Care Decisions Act, or an designated under TCA 68-11-1806(a) when requesting a release from inpatient services or a disclosure of confidential information. Executive Status 04/10/2013 - Sent to the speakers for signatures. SB1048 / HB575 Certain nursing homes may relocate licensed beds in new facility. Category Health Care Sponsors Sen. Brian K. Kelsey / Rep. Description Permits existing licensed and operating nursing homes which have been in operation for at least 10 years to relocate 30 or less of its licensed beds to a new licensed nursing home that is part of a continuing care retirement community under certain conditions. Amendment SENATE AMENDMENT 1 (003895) changes the length of time a nursing home must have been operating from 10 years to 20 years. Requires the original facility and the new separately licensed nursing home to be not-for-profit corporations and affiliated through common management instead of requiring that the new nursing home be licensed to an entity affiliated by common ownership or control with that of the original facility. Requires that the original facility is certified for participation in the Medicare program, but is not and was not certified for the Medicaid program, within the 10 years, instead of the 12 months, preceding the filing of a certificate of need application for moving the beds. Fiscal Note (Dated: February 15 2013) Increase State Revenue - Exceeds $3,000/HSDA - Increase State Expenditures - Exceeds $3,000/HSDA. Senate Status 03/18/2013 - Senate passed with amendment 1. House Status 04/01/2013 - House passed. Executive Status 04/08/2013 - Sent to governor. SB1245 / HB1094 Alternate payment plan for certain nursing homes. Category Health Care Sponsors Sen. Joey Hensley / Rep. Steve McDaniel Description Authorizes a special alternate payment plan for certain nursing homes that are delinquent in payments of the annual nursing home tax for more than two years and who are the sole licensed nursing home located in an economically distressed county. Amendment SENATE HEALTH & WELFARE AMENDMENT 1, HOUSE HEALTH COMMITTEE AMENDMENT 1 (004225) rewrites the bill. Refers to the annual nursing home assessment fee instead of the annual nursing home privilege tax. Requires, instead of authorizes, the Commissioner of Health to initiate proceedings before the Board for Licensing Health Care Facilities if a nursing home is more than 90 days, instead of 60 days, delinquent in paying an installment of the annual nursing home assessment fee. In cases where a licensed nursing home is delinquent on assessment fees beginning July 1, 2009, and ending June 30, 2012, and is currently participating in a payment plan, the Commissioner is authorized to reduce the amount of penalties and interest due for that time period to 25 percent of the total assessment fee outstanding balance as of June 30, 2012. The assessment fee outstanding balance is calculated as the total assessment fees owed not including any penalties and interest, less any payments made by the facility, beginning July 1, 2009 and ending July 30, 2012. SENATE FINANCE AMENDMENT 1 (006628) specifies that subdivision (c)(7)(C) shall terminate on July 1, 2015, unless re-enacted or extended by the general assembly prior to such date. Fiscal Note (Dated: March 2 2013) Forgone State Revenue - $971,700. Senate Status 04/08/2013 - Senate Finance, Ways & Means Committee recommended with amendment. Sent to Senate Calendar Committee. House Status 04/10/2013 - House Finance Committee recommended. Sent to House Calendar & Rules. SB1294 / HB1092 Durable power of attorney for health care. Category Health Care Sponsors Sen. Bo Watson / Rep. Susan M. Lynn Description Prohibits certain employees or operators of treating health care institutions from being designated as the attorney in fact to make health care decisions under a durable power of attorney for health care. Fiscal Note (Dated: March 10 2013) Not Significant. Senate Status 04/01/2013 - Senate passed. House Status 04/04/2013 - House passed. Executive Status 04/11/2013 - Sent to governor. Judiciary - 3

SB222 / HB126 Punitive damage awards based on vicarious liability. Category Judiciary Sponsors Sen. Brian K. Kelsey / Rep. Description Authorizes the award of punitive damages in a civil action against a defendant based on vicarious liability when the act was committed by a person employed in a management capacity while acting within the scope of employment, the defendant was reckless in hiring or supervising the employee and that recklessness was the proximate cause of the act that caused injury, or the defendant authorized or approved the act with knowledge that the act may result in loss or injury. Amendment SENATE AMENDMENT 1 (003064) replaces "subdivision" in Section 1(g)(2) of the bill with "subsection." SENATE AMENDMENT 2 (004090) adds the language "one or more of the following has occurred:" between the language "clear and convincing evidence that" and the colon ":" in subdivision (g)(1) of the amendatory language of Section 1. HOUSE AMENDMENT 1 (004651) revises the provision described above in the bill summary to specify that, in regard to circumstances warranting the award of punitive damages, that the defendant authorized, ratified or approved the act or omission with knowledge or conscious "or reckless" disregard that the act or omission may result in the loss or injury. Fiscal Note (Dated: February 12 2013) Not Significant. Senate Status 04/01/2013 - Senate concurred in House amendment 1. House Status 03/28/2013 - House passed with amendment 1 (004651), which revises the provision described above in the bill summary to specify that, in regard to circumstances warranting the award of punitive damages, that the defendant authorized, ratified or approved the act or omission with knowledge or conscious "or reckless" disregard that the act or omission may result in the loss or injury. Executive Status 04/08/2013 - Sent to governor. SB555 / HB692 Provisions to court appointed guardians and conservators. Category Judiciary Sponsors Sen. Doug Overbey / Rep. Description Revises various provisions relative to court appointed guardians and conservators to care for persons with disability. Amendment SENATE AMENDMENT 1, HOUSE CIVIL JUSTICE COMMITTEE AMENDMENT 1 (004915) specifies that the bill does not supersede the Adult Protection Act or the orders of a court pursuant to such act. Includes an institution where a respondent is living in the notice requirement for appointment of a fiduciary. Any person, institution, or residential provider having care or custody of the respondent is included in the notice requirement imposed on the guardian ad litem relative to appointment of a conservator. Specifies that a guardian ad litem may be appointed by a court in any proceeding and that a guardian ad litem must be appointed on the filing of a petition for appointment of a fiduciary unless the respondent is represented by counsel who has made an appearance on behalf of the respondent. If the respondent is represented by counsel, then the court may, depending on the best interests of the respondent, choose to continue the services of the guardian ad litem or waive appointment or terminate the services of the guardian ad litem. Specifies that mental health law means court ordered involuntary commitment for care and treatment pursuant to Title 33. Specifically identifies the provisions that are amended by changing the language "disabled person" to "person with a disability". Changes "must" to "shall" and corrects a typographical error in Section 24 of the bill. Adds a district public guardian as described by Tenn. Code Ann. § 34-7-104 to the list of persons the court should consider for appointment as a conservator in current law. Adds to current law that the court is required to explain in the court's order naming the conservator the reasoning for appointing a person other than the specific persons listed. SENATE AMENDMENT 2, HOUSE CIVIL JUSTICE COMMITTEE AMENDMENT 2 (005172) specifies that the closest relative or relatives of a respondent for purposes of serving the notice of a hearing on a petition for appointment of a fiduciary are as such persons are described in interstate succession law. Fiscal Note (Dated: February 19 2013) Not Significant. Senate Status 03/25/2013 - Senate passed with amendments 1 and 2. House Status 04/11/2013 - House deferred to 04/17/2013. SB1053 / HB1244 Future damages - trier of fact must specify amounts. Category Judiciary Sponsors Sen. Brian K. Kelsey / Rep. Description Eliminates requirement that the trier of fact must specify, on an annual basis, the amount of future damages and the periods over which such future damages will accrue. Fiscal Note (Dated: February 8 2013) Not Significant. Senate Status 02/21/2013 - Senate passed. House Status 04/03/2013 - House Civil Justice Committee recommended. Sent to House Calendar & Rules.

Labor Law - 1

SB699 / HB1321 Employers cannot use certain credit reports for employment purposes. Category Labor Law Sponsors Sen. Reginald Tate / Rep. Karen D. Camper Description Prohibits an employer from using the credit report or credit history of an employee or applicant for employment to deny employment, discharge an employee or determine compensation of the terms, conditions or privileges of employment. Permits the credit report or credit history of the employee or applicant to be used if information in the credit report is substantially job-related and disclosed in writing to the employee or applicant. Allows the commissioner of labor and workforce development to assess a civil penalty to an employer who violates this section. Fiscal Note (Dated: March 14 2013) Increase State Revenue - Exceeds $500. Senate Status 03/19/2013 - Senate Commerce & Labor Committee deferred to next meeting. House Status 03/20/2013 - Taken off notice in House Consumer & Human Resources Subcommittee.

Professions & Licensure - 2

SB955 / HB541 Practitioners under indictment for sale of controlled substances. Category Professions & Licensure Sponsors Sen. Randy McNally / Rep. David Shepard Description Requires a health care practitioner to report to the practitioner's licensing board within seven calendar days when the practitioner is under state or federal indictment for an offense involving the sale or dispensing of controlled substances. Encourages the district attorney and appropriate federal attorneys to promptly notify a practitioner's licensing board. Requires the licensing board to conduct an expedited review of the practitioners alleged conduct within 15 days of receiving a report of an indictment. Fiscal Note (Dated: February 19 2013) Not Significant. Senate Status 02/25/2013 - Senate passed. House Status 04/01/2013 - House passed. Executive Status 04/08/2013 - Sent to governor. SB976 / HB1211 Prescribing restriction for nurse practitioners, physician assistants. Category Professions & Licensure Sponsors Sen. Randy McNally / Rep. David Shepard Description Prohibits a nurse practitioner or physician assistant from prescribing schedules II, III, and IV controlled substances unless such prescription is specifically authorized by the formulary or approved after consultation with the supervising physician. Establishes a nurse practitioner or physician assistant may only prescribe or issue an opioid or benzodiazepine for a maximum 30 day non-refillable course of treatment unless specifically approved after consultation with the supervising physician. Fiscal Note (Dated: March 1 2013) Not Significant. Senate Status 03/26/2013 - Taken off notice in Senate Health & Welfare Committee. House Status 03/26/2013 - Taken off notice in House Criminal Justice Subcommittee.

Property & Housing - 1 SB391 / HB1221 Life estate to exist on the date of creation. Category Property & Housing Sponsors Sen. Steve Southerland / Rep. David B. Hawk Description Requires that when determining eligibility for medical assistance a life estate is deemed to exist on the date of creation instead of on the date of registration. Fiscal Note (Dated: March 17 2013) Other Fiscal Impact - According to the Bureau of TennCare, $15,314,545 was collected in estate recoveries for long-term care in 2012. The number of TennCare enrollees who would utilize an unrecorded transfer to avoid estate collections cannot be quantified with certainty. Lost estate recoveries will be experienced as foregone revenue that would have reimbursed the state and federal government long-term care expenditures. Senate Status 01/31/2013 - Referred to Senate Judiciary. House Status 02/27/2013 - Referred to House Civil Justice Subcommittee.

Public Finance - 1

SB470 / HB389 Prohibition against accepting certain federal funds. Category Public Finance Sponsors Sen. Frank Niceley / Rep. Dennis Powers Description Prohibits any department from accepting or entering into a contract with any federal funding source if such a contract is conditioned upon unreasonably demanding or intrusive conditions. Requires state agencies to submit at least twenty days prior to applying for federal funds a written report that details such restrictions to the executive director of the fiscal review committee and the directors of the office of legislative budget analysis. Fiscal Note (Dated: March 18 2013) Increase State Expenditures - $10,000/One-Time $208,400/Recurring - Other Fiscal Impact - A recurring reduction of federal funding to multiple state departments and agencies reasonably estimated to exceed $284,436,000 per year. This amount was based on information provided by the , the Board of Regents, the Department of Intellectual Disabilities, and the Department of Mental Health. The actual reduction in federal funding could be substantially more than $284,436,000 per year. Senate Status 04/11/2013 - Senate Finance, Ways & Means Committee deferred to 04/15/2013. House Status 03/20/2013 - House State Government Subcommittee deferred to 2014.

Taxes Business - 1

SB191 / HB185 Extends nursing home bed tax. Category Taxes Business Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Extends the levy of the nursing home tax of $2,225 per licensed bed per year from June 30, 2013, to June 30, 2015. (Part of Administration Package) Fiscal Note (Dated: February 15 2013) Other Fiscal Impact - Prevents the loss of $82,300,000 in state revenue and $156,250,700 in federal matching funds. - Revenue recognition in the amount of $82,300,000 in state revenue is included in the Governor's proposed FY13-14 budget. Senate Status 04/08/2013 - Taken off notice in Senate Finance, Ways & Means Committee. House Status 03/13/2013 - House Finance Subcommittee deferred to last calendar.

Tenncare - 11

SB123 / HB329 Requires implementation of prepayment prevention solutions. Category Tenncare Sponsors Sen. Bill Ketron / Rep. Charles Curtiss Description Requires the TennCare program to implement certain prepayment prevention solutions to reduce health care fraud, waste and abuse. Fiscal Note (Dated: March 10 2013) Increased State Expenditures - $3,750,000/One-Time - $750,000/Recurring - Increased Federal Expenditures - $3,750,000/One-Time - $750,000/Recurring. Senate Status 03/20/2013 - Senate Health & Welfare Committee deferred to 03/27/2013. House Status 03/20/2013 - Taken off notice in House Insurance & Banking Subcommittee. SB190 / HB184 Revisions to Tennessee Medicaid False Claims Act. Category Tenncare Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Establishes that employees, contractors, and agents are entitled to relief under the Tennessee Medicaid False Claims Act for employment discrimination due to any effort of such person to stop a violation of the Act. Requires that relief includes reinstatement with the same seniority status the employee, contractor, or agent would have had but for the discrimination, two times the amount of back pay, interest on the back pay, and compensation for any special damages sustained as a result of the discrimination. (Part of Administration Package) Amendment House amendment 1 (003558) corrects a TCA cross-reference within the bill. Fiscal Note (Dated: February 19 2013) Increase State Expenditures - Not Significant - Other Fiscal Impact - Prevents the loss of approximately $3,700,000 in federal funds. According to the Bureau of TennCare, the state retains an additional ten percent over the federal match rate of Medicaid healthcare fraud collections if the state's collection efforts meet federal requirements. The changes made to the Act by the proposed legislation are in response to new federal false claims recovery program requirements and will enable the state to continue to retain the enhanced amount. Senate Status 03/27/2013 - Senate passed. House Status 03/21/2013 - House passed with amendment 1 (003558), which corrects a TCA cross- reference within the bill. Executive Status 04/11/2013 - Signed by governor. SB401 / HB561 Prepayment prevention solutions for TennCare. Category Tenncare Sponsors Sen. Steve Southerland / Rep. Description Requires the state to implement certain prepayment prevention solutions and predictive modeling and analytics technologies to reduce the amount of fraud, waste, and abuse related to Medicaid. Allows the state to contract for these services. Broadly captioned. Fiscal Note (Dated: March 17 2013) Increased State Expenditures - $3,750,000/One-Time - $750,000/Recurring - Increased Federal Expenditures - $3,750,000/One-Time - $750,000/Recurring. Senate Status 01/31/2013 - Referred to Senate Commerce & Labor Committee. House Status 02/06/2013 - Referred to House Insurance & Banking Subcommittee. SB429 / HB79 Annual actuarial study of TennCare - payments to providers. Category Tenncare Sponsors Sen. Doug Overbey / Rep. Curtis Halford Description Requires the annual actuarial study of TennCare to include an analysis of the effect of reduction of payments to providers on the provision of care. Fiscal Note (Dated: February 10 2013) Increase State Expenditures - Exceeds $25,000 - Increase Federal Expenditures - Exceeds $25,000. Senate Status 02/05/2013 - Referred to Senate Health & Welfare Committee. House Status 02/05/2013 - Referred to House Insurance & Banking Subcommittee. SB500 / HB519 Criminalizes unauthorized distribution of prescription drugs. Category Tenncare Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Creates a Class E felony for a person, other than a person authorized to issue or dispense prescriptions, to knowingly sell, deliver, or aid and abet a person in the sale or delivery of a drug and use TennCare benefits to obtain the drug. Fiscal Note (Dated: February 25 2013) Increase State Expenditures - Not Significant - Other Fiscal Impact - According to the Department of Finance and Administration, Office of Inspector General, increased state revenues could result due to increased restitution collections pursuant to Tenn. Code Ann. § 71-5-2601(b). Due to a number of unknown factors, an exact estimate of the amount of restitution cannot be quantified. Senate Status 03/27/2013 - Senate passed. House Status 04/08/2013 - House passed. Executive Status 04/11/2013 - Sent to governor. SB556 / HB397 Enterprise fraud program within the office of inspector general. Category Tenncare Sponsors Sen. Doug Overbey / Rep. Description Establishes an enterprise fraud program office within the office of inspector general to implement a fraud, waste, and abuse detection and prevention system across state agencies and programs. Requires the enterprise fraud program to initiate a project within one hundred twenty days of the effective date of this act to implement state-of-the-art fraud detection technology. Fiscal Note (Dated: March 16 2013) Increased State Expenditures - $9,000,000/FY14-15 - $1,500,000/FY15-16 and Subsequent Years - Other Fiscal Impact - Reduced state expenditures will occur in future fiscal years due to implementation of the automated fraud detection system. Due to many unknown factors, including the time required to develop the system, the identity of participating agencies, and the types of fraud targeted it is not possible to quantify the eventual recovery of investment that might occur as a result of implementing the system. Senate Status 03/27/2013 - Taken off notice in Senate Government Operations Committee. House Status 03/27/2013 - Taken off notice in House Insurance & Banking Subcommittee. SB824 / HB701 Director of commission of aging and disability - provide advice. Category Tenncare Sponsors Sen. John Stevens / Rep. Description Requires the executive director of the commission on aging and disability to provide advice and other appropriate support to the bureau of TennCare, with respect to home and community based services under the Long-Term Care Community Choices Act of 2008. Fiscal Note (Dated: March 7 2013) Not Significant. Senate Status 03/20/2013 - Senate Health & Welfare Committee deferred to 03/27/2013. House Status 03/26/2013 - Taken off notice in House Health Subcommittee. SB1197 / HB1090 Eligibility - income tax returns used to establish earnings. Category Tenncare Sponsors Sen. Jim Summerville / Rep. John C. Tidwell Description Requires all individuals in the application for medical assistance as a part of the TennCare program to produce a copy of the individual's most recent federal income tax return or other documentation to determine earnings. Fiscal Note (Dated: March 15 2013) Not Significant. Senate Status 03/26/2013 - Taken off notice in Senate Health & Welfare Committee. House Status 03/27/2013 - Taken off notice in House Insurance & Banking Subcommittee. SB1246 / HB1114 Select Oversight Committee on TennCare. Category Tenncare Sponsors Sen. Joey Hensley / Rep. Joe Carr Description Creates the Select Oversight Committee on TennCare. Establishes membership, meetings, reporting responsibilities, oversight responsibilities, and purpose of such committee. Requires such committee to receive and review copies of certain future legislative bills. Terminates such committee on June 30, 2018. Amendment Senate amendment 1, House Insurance and Banking Committee amendment 1 (004814) rewrites the bill. Places the Bureau of TennCare within the Department of Finance and Administration under the Tennessee Governmental Entity Review Law in the sunset cycle to terminate on June 30, 2015. Fiscal Note (Dated: March 6 2013) Increase State Expenditures - $10,000/One-Time - $133,800/Recurring/FY13-18. Senate Status 04/03/2013 - Senate passed with amendment 1. House Status 04/10/2013 - House Finance Committee recommended. Sent to House Calendar & Rules. SB1282 / HB1209 Implementation of critical access medication management. Category Tenncare Sponsors Sen. Ferrell Haile / Rep. David Shepard Description Requires TennCare managed care organizations to provide critical access medication management to critical prescription access patients. Requires TennCare to reimburse managed care organizations not less than $60.00 per person per month for the provision of critical access medication management services and require the managed care organization to reimburse terminal distributors of dangerous drugs at the same rate. Fiscal Note (Dated: March 19 2013) Increase State Expenditures - $12,784,300/FY13-14 - $25,568,600/FY14-15 and Subsequent Years - Increase Federal Expenditures - $24,271,600/FY13-14 - $48,543,200/FY14-15 and Subsequent Years. Senate Status 02/26/2013 - Referred to Senate Commerce & Labor Committee. House Status 02/27/2013 - Referred to House Insurance & Banking Subcommittee. SB1387 / HB82 Prohibits TN from participating in Medicaid expansion. Category Tenncare Sponsors Sen. Brian K. Kelsey / Rep. Jeremy Durham Description Establishes the "TennCare Fiscal Responsibility Act ". Prohibits Tennessee from participating in any Medicaid expansion authorized under the federal Patient Protection and Affordable Care Act. Fiscal Note (Dated: March 17 2013) Forgone State Revenue - $418,207,600/TennCare/FY13-14 - $1,000,100,900/TennCare/FY14-15 - Other Fiscal Impact - According to the Bureau of TennCare, the bill could jeopardize $6.34 billion federal Medicaid matching funds by prohibiting the state from extending eligibility to children up to 133 percent of the federal poverty level. If the state does not extend coverage eligibility for children up to 133 percent of the federal poverty level, then the state will not be compliant with 42 U.S.C. 1396a and could lose Medicaid funding pursuant to 42 U.S.C. 1396c. Senate Status 02/26/2013 - Referred to Senate Commerce & Labor Committee. House Status 02/05/2013 - Referred to House Insurance & Banking Subcommittee.

Tort Liability - 4

SB56 / HB1099 Doctrine of joint and several liability - civil actions. Category Tort Liability Sponsors Sen. Brian K. Kelsey / Rep. Jeremy Durham Description Requires the doctrine of joint and several liability to not be applied in civil actions governed by comparative fault. Requires a defendant to only be held liable for that defendant's attributed fault as determined by the court. Retains the doctrine of joint and several liability in certain civil conspiracy cases. Amendment SENATE AMENDMENT 1 (002914) specifies that this bill will not prevent parties from entering into a legally enforceable contract that allocates fault in a civil proceeding among the contracting parties. HOUSE AMENDMENT 1 (006401) adds an exception by authorizing parties to enter into legally enforceable contracts in which the parties agree to a specific allocation of fault between them. Deletes and rewrites subsection (b) of 29-11-107 of section 1. Specifies that joint and several liability remains in effect to apportion financial responsibility among manufacturers only in a product liability action based only on strict liability or breach of warranty. Fiscal Note (Dated: February 3 2013) Not Significant. Senate Status 04/11/2013 - Set for Senate Message Calendar 04/15/13. House Status 04/11/2013 - House passed with amendment 1 (006401), which adds an exception by authorizing parties to enter into legally enforceable contracts in which the parties agree to a specific allocation of fault between them. Deletes and rewrites subsection (b) of 29-11-107 of section 1. Specifies that joint and several liability remains in effect to apportion financial responsibility among manufacturers only in a product liability action based only on strict liability or breach of warranty. SB273 / HB967 Qualified protective orders in healthcare liability action. Category Tort Liability Sponsors Sen. Brian K. Kelsey / Rep. Jeremy Durham Description Requires the defendant in a legal action to return certain information to the healthcare provider or destroy any protected health information obtained by a qualified protective order at the end of the healthcare liability action litigation. Requires the qualified protective order to specify that participation by a treating healthcare provider is voluntary. Fiscal Note (Dated: February 14 2013) Not Significant. Senate Status 02/25/2013 - Senate passed. House Status 03/04/2013 - House passed. Executive Status 03/22/2013 - Enacted as Public Chapter 0023 effective July 1, 2013. SB274 / HB1058 Written expert testimony in health care liability action. Category Tort Liability Sponsors Sen. Brian K. Kelsey / Rep. Jeremy Durham Description Requires experts in health care liability action to provide testimony on written statement when the opposing party prevails on the basis of the failure of the party to offer any competent expert testimony. Amendment Senate Judiciary Committee amendment 1 (004366) requires an expert's signed written statement, relied upon in initiating a healthcare liability action, to be provided to the court as well as the prevailing party, rather than just the court. Authorizes the court-ordered provision of the signed written statement while the litigation is ongoing. Prohibits the signed written statement from being disclosed to other parties to the litigation and prohibits discovery of the signed written statement by the other parties to the ongoing litigation. Fiscal Note (Dated: February 10 2013) Not Significant. Senate Status 03/12/2013 - Failed in Senate Judiciary Committee (4-3-1) after adopting amendment 1 (004366). House Status 02/20/2013 - Referred to House Civil Justice Subcommittee. SB1184 / HB978 Limits recovery for medical costs - personal injury or wrongful death. Category Tort Liability Sponsors Sen. Jim Tracy / Rep. Ryan A. Haynes Description Phantom Damages Elimination Act. Relative to damages for personal injury or wrongful death, limits recovery for medical costs to amounts paid by or on behalf of the claimant, amounts necessary to satisfy unpaid charges for medical care, and amounts necessary to satisfy future medical charges. Fiscal Note (Dated: February 26 2013) Not Significant. Senate Status 03/19/2013 - Senate Judiciary Committee deferred to summer study. House Status 03/26/2013 - Taken off notice in House Civil Justice Subcommittee.

Workers Compensation - 2

SB200 / HB194 Workers compensation changes. Category Workers Compensation Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Makes various technical changes to present law concerning workers' compensation. Requires the administrator of the division of workers' compensation to have a minimum of seven years' credible experience in the field of workers' compensation, instead of five years of experience. Present law requires any settlement of a state employee's workers' compensation claim to be approved by either a claims commissioner or by the commissioner of labor and workforce development or the commissioner's designee. This bill instead requires that state employees' settlements be approved by either a claims commissioner or a workers' compensation specialist. Changes the time within which a state employee may file a claim for workers' compensation benefits with the claims commission from within 90 days of the filing of an impasse report identifying unresolved issues by a workers' compensation specialist to within 75 days of exhaustion of the benefit review process. Under present law, if any legal or administrative entity that is created by an agreement between governmental entities to pool their resources to provide workers' compensation coverage participates in the second injury fund and then ceases participation, either the second injury fund remains liable for a claim for injuries to an employee insured by the entity that occurred prior to the termination of participation and for which benefits had not been paid prior to the termination; provided, that the legal or administrative entity must promptly reimburse the second injury fund for the actual amount of any such benefits subsequently paid by the second injury fund; or, within 30 days of the cessation of such participation, the legal and administrative entity may elect to assume complete liability for the claim thereby releasing the second injury fund from any duty to defend or liability, but in either case, the recovery by any employee must not be reduced or defeated. This bill changes the time within which the legal or administrative entity that ceases participation in the second injury fund may elect to assume complete liability for a claim from within 30 days of the cessation of participation in the fund to within 45 days of such cessation. Under present law, a sole proprietor or partner in a business who devotes full time to the proprietorship or partnership and elects to be included in the definition of employee by filing written notice of the election with the division of workers' compensation at least 30 days before the occurrence of any injury or death is considered an "employee" for purposes of the injury or death being covered by workers' compensation. This bill requires that a sole proprietor or partner must file the notice of election to be covered as an employee at least 45 days before the injury date in order for the injury or death to be covered. Deletes the present law requirement that an insurer must file written notice with the division of workers' compensation, which must then notify the employer, whenever it appears that the amount of a workers' compensation claimant's medical benefits will exceed $5,000. Changes the time within which an employee must report an occupation disease to the employer, in order for the disease to be compensable as a workers' compensation injury, from within 30 days after the first distinct manifestation of the disease to within 45 days after the first distinct manifestation of the disease. Broadly captioned. (Part of Administration Package) Amendment SENATE AMENDMENT 1 (004568) deletes all language after the enacting clause. Effective upon becoming law for implementation purposes. Effective January 1, 2014, for all other purposes. Deletes and rewrites workers' compensation law. Separates the Division of Workers' Compensation (DWC) from the Department of Labor and Workforce Development, except for administrative matters only. Requires the Administrator of the DWC to be appointed by the Governor for a six-year term. Defines "maximum total benefits" for injuries occurring on, or after July 1, 2014, as 450 times 100 percent of the state's average weekly wage. Authorizes the Administrator to assess a fee up to $250 for an appeal of any utilization review decision. Authorizes certain civil penalties for violations of workers' compensation law. Decreases, from 15 to 7, the number of voting members on the medical payment committee. Requires the appointment of a medical advisory committee. Establishes an alternative dispute method for resolving claims with a workers' compensation mediator. Creates the Court of Workers' Compensation Claims composed of judges for the adjudication of claims. Requires the Governor to appoint three judges to serve six-year terms. Authorizes a workers' compensation judge to assess discretionary fees for depositions of medical experts. Authorizes an appeal to a panel of three judges, including one member of the Supreme Court of Tennessee. Replaces the workers' compensation specialist program with a mediator program to assist employees and employers to conduct alternative dispute resolutions. Establishes an ombudsman program to assist employees and employers that are not represented by an attorney in a claim. Authorizes the Administrator to charge a filing fee sufficient to offset the costs of administering the program. Requires an education and training program for mediators, judges, and ombudsmen. SENATE AMENDMENT 2 (004912) corrects typographical errors. SENATE AMENDMENT 3 (005511) specifies that chiropractors are included with treating physicians in the provisions of this bill as amended. HOUSE AMENDMENT 2 (005813) makes the same changes as Senate Amendments 2 and 3 and makes various technical changes to the bill. HOUSE AMENDMENT 14 (006816) revises the provisions regarding the division's review of the impact of this bill to require review by July 1, 2015, and annually thereafter, rather than by July 1, 2017 and annually thereafter through July 2020, and to require a report of the review's findings to the members of the general assembly. Schedules the division of workers' compensation in the sunset cycle for June 30, 2018. Fiscal Note (Dated: February 21 2013) Not Significant. Senate Status 04/11/2013 - Set for Senate Message Calendar 04/15/13. House Status 04/11/2013 - House passed with amendments 2 & 14. AMENDMENT 2 (005813) makes the same changes as Senate Amendments 2 and 3 and makes various technical changes to the bill. AMENDMENT 14 (006816) revises the provisions regarding the division's review of the impact of this bill to require review by July 1, 2015, and annually thereafter, rather than by July 1, 2017 and annually thereafter through July 2020, and to require a report of the review's findings to the members of the general assembly. Schedules the division of workers' compensation in the sunset cycle for June 30, 2018. Executive Status 02/28/2013 - Workers' Compensation Advisory Council recommended with three additional bill recommendations regarding an enactment date beginning in 2014, certain additional prior notice to be given to the council, and the council's inclusion to give advise for choosing certain persons. SB1275 / HB1159 Changes references from commissioner to administrator. Category Workers Compensation Sponsors Sen. Mark S. Norris / Rep. Gerald McCormick Description Changes references from "commissioner" to "administrator" throughout the Workers' Compensation Law, whenever the reference is to the commissioner of labor and workforce development in the code as supplements are issued and volumes are replaced. Amendment SENATE AMENDMENT 1 (004144) adds language to the original bill. Deletes chapter definition for "benefit review conference" from worker's compensation law. Requires a petition be filed rather than filing a request for review by the Department of Labor and Workforce Development. Makes technical corrections to workers' compensation law that will only be relevant upon passage of SB200 – HB194 of the 108th General Assembly. SENATE AMENDMENT 2 (004599) changes the effective date to July 1, 2014. Fiscal Note (Dated: February 27 2013) Not Significant. Senate Status 04/01/2013 - Senate passed with amendments 1 and 2. House Status 04/11/2013 - House passed. Executive Status 04/11/2013 - Sent to the speakers for signatures.

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