Section 1200-34-01-.14 - UNLICENSED PAIN MANAGEMENT CLINICS(1) When the Department has reason to believe that a health care provider's office is operating as an unlicensed pain management clinic, such health care provider shall produce satisfactory evidence to the Department that the majority of its patient population is not receiving chronic nonmalignant pain treatment to avoid establishment of a rebuttable presumption that the clinic is operating as an unlicensed pain management clinic. For purposes of this determination, patients seen within the preceding twelve (12) months will be considered in determining the percentage of patients receiving chronic non-malignant pain treatment.(2) Upon request from the Department the health care provider's office shall produce medical records, business records, and any information responsive to the list below, within ten (10) business days. After initial review, the Department may ask for any necessary additional information to be produced within another ten (10) business days from the Department's request for additional information. Evidence which will be required by the Department during this process may, at the discretion of the Department, include:(a) A complete list of every patient seen at the clinic to include a listing of all dates during the preceding twelve (12) months when that patient was seen or treated;(b) A complete list of every patient seen at the clinic within the preceding twelve (12) months which delineates each patient's diagnosis as well as what was prescribed to that patient, the drug name, drug strength, number of pills to be dispensed, and number of days of intended use;(c) A complete list of all the billing codes which were submitted for each patient seen by the clinic as well as copies of the bills with remittances during the preceding twelve (12) months; and(d) A complete list of every clinic patient seen by the clinic during the preceding twelve (12) months who did not receive chronic non-malignant pain treatment with a description of the type of services that patient did receive.(3) After being provided any of the patient lists above, should the Department need to review charts of any of the clinic's patients to assist in making its determination, the clinic will be notified of the names and given ten (10) business days to produce those patients' charts.(4) Should the health care provider's office be unable to provide satisfactory evidence, the Department shall notify the clinic of such determination in writing. The clinic shall be prohibited from admitting any new patients to the practice, and all owners and practitioners who worked at the clinic shall be subject to revocation of their licenses.(5) The Commissioner may issue a determination, or at the Commissioner's discretion, may convene an advisory panel to meet regarding whether the clinic was operating as an unlicensed pain management clinic and to make a recommendation to the Commissioner prior to the Commissioner's determination. The Commissioner shall not be bound by the recommendation of the advisory panel.(6) The Department has discretion to await the Commissioner's determination and the recommendations of the Advisory Panel before proceeding against the health care practitioners at the clinic for providing services in an unlicensed pain management clinic.Tenn. Comp. R. & Regs. 1200-34-01-.14
Emergency rule filed May 25, 2017 and effective through November 21, 2017. The emergency rule expired on November 22, 2017 and reverted to its previous status. Original rules filed August 28, 2017; effective 11/26/2017.Authority: T.C.A. §§ 63-1-311, 63-1-315, and 63-1-317.