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Committee approves amendment to clarify medical-necessity rules and disciplinary oversight
Summary
An amendment to SB 171753, backed by the Tennessee Medical Association, passed unanimously in committee and defines medical-necessity determinations as part of the practice of medicine while recognizing emerging specialties and subjecting providers to discipline for failure to apply accepted standards.
Senator Hale presented an amendment to SB 171753, a TMA-backed bill, that (1) recognizes emerging medical specialties, (2) clarifies that providers should follow generally accepted criteria for medical-necessity determinations, and (3) makes such determinations subject to discipline by licensing boards when providers fail to apply appropriate standards.
As amended, the bill would place medical-necessity determinations within the licensing-boards' disciplinary oversight and allow boards to assess whether recognized clinical criteria and standards are being used. The sponsor said the amendment ensures practice reflects how patients actually receive care and enumerated three principal changes to the code.
The amendment was moved, seconded, and passed on voice and roll-call votes; the clerk recorded a unanimous committee tally (9 ayes). The committee placed the bill on the calendar.
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