The 2018 legislative session is in full swing, and the Tennessee Medical Association looks to follow a banner year in 2017 with another round of successful advocacy in the Tennessee General Assembly.

TMA physician leaders and staff review hundreds of issues each year and ask for input from more than 9,000 members across the state to determine the most important and timely healthcare issues. The TMA Legislative Committee makes a recommendation for the board to approve prior to the start of the session each year; and by January, the state's largest professional organization for doctors is strategically pushing its agenda with lawmakers in Nashville.

There are only a handful of top priorities on the list this and every year, but TMA inevitably spends as much or more time, energy and resources protecting doctors from legislation that could harm the profession or our patients.

• TennCare Episodes of Care: Doctors have grown increasingly frustrated by the inconsistent, inaccurate and ineffective TennCare episodes of care payment model. TMA has long advocated for improvements - most recently meeting in January with TennCare representatives and officials from the Haslam administration - but the state has not addressed fundamental flaws in the design and implementation of the program and has given no indications that it intends to respond to physicians' concerns. TMA is prepared to ask the legislature to intervene. Learn more about TMA's position and related advocacy work at tnmed.org/episodes.

• Doctor of Medical Science: Sponsors have filed the updated version of a Doctor of Medical Science bill. The language is much improved from the 2017 version, which would have created a new academic degree for physician assistants and a pathway to giving PAs independent practice. The new bill does not give PAs independent practice but requires PAs to collaborate with a supervising physician in a team-based healthcare delivery model. TMA remains opposed to the legislation and is advocating for a different name to avoid patient confusion in a clinical setting.

• Balance Billing: TMA remains actively involved in the balance billing debate and is working with stakeholders toward a solution to "surprise medical bills" that is reasonable to physicians and patients. TMA opposes any effort that gives health insurance companies even more undue leverage to force providers to accept unfair contractual terms and proliferates the trend of narrow networks.
• Maintenance of Certification: In 2017, after years of complaints from members about the costly, burdensome and in many cases valueless maintenance of certification requirements, TMA helped pass legislation that prohibited MOC as a requirement for medical licensure in Tennessee. This year, TMA seeks to prohibit hospitals and health insurance companies from requiring MOC for physician credentialing or network participation, or at least give physicians options to the ABMS Board monopolies.

Tennessee's ongoing opioid abuse epidemic promises to be a hot topic of debate in the legislature. TMA will continue education efforts to help prescribers reduce initial prescriptions, as well as advocating for more funding for comprehensive drug treatment programs and more resources for law enforcement to counter the alarming rise of fentanyl and other illicit drugs that are contributing to the increase in accidental overdose deaths. We also look forward to getting more details and actively participating in the legislative process surrounding Governor Haslam's TN Together plan announced in late January.

As the largest professional organization for doctors in Tennessee, TMA is the conduit to make sure physicians have a unified, influential voice in important public policy decisions affecting the delivery of healthcare in Tennessee.

Dr. James Ensor practices internal medicine in Germantown and serves as 2017-2018 chair of the Tennessee Medical Association Board of Trustees. TMA is a voluntary, nonprofit professional organization for doctors, serving more than 9,000 members across Tennessee. Follow TMA's legislative progress at tnmed.org/legislative or on twitter @tnmed and @tnmedonthehill.

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Tennessee Medical Association