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Executive Orders in Response to COVID‑19: Pharmacy-Specific Provisions

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Updated September 29, 2020

Governor Bill Lee has issued several Executive Orders to promote the health and well-being of Tennesseans during the COVID-19 pandemic. As the situation evolves, Executive Order No. 14 has been repealed and others have been issued. Shown below are all pharmacy-specific Executive Order provisions that are currently in effect in Tennessee.

TPA will update this page as needed to reflect future Executive Orders. To see all Executive Orders issued by Governor Lee, click here.


Executive Orders in Response to the COVID-19 Pandemic:PHARMACY-SPECIFIC PROVISIONS

PHARMACY PRACTICE RULE SUSPENSIONS 

  • Suspension of the Pharmacist-to-Technician Ratio (Extended until 10/30/20) – The provisions of Tenn. Comp. R. & Regs. 1140-02-.02(7) are hereby suspended so that there is no restriction on the ratio of pharmacy technicians to pharmacists while this Order is in effect. All statutes and rules regarding the supervision of a pharmacy technician by a licensed pharmacist remain in full force and effect, including, but not limited to, the requirement that a licensed pharmacist supervise, direct, and verify the accuracy of all pharmacy technician functions pursuant to Tenn. Comp. R. & Regs. 1140-02-.02(9).
  • Refills of Maintenance Medications up to 90 DaysEXPIRED 9/29/20) – The provisions of Tennessee Code Annotated, Section 63-10-207(a) and (c), are hereby suspended to allow a pharmacist to dispense up to a 90-day supply of maintenance prescriptions without proper authorization to persons as is necessary to respond to and prevent the spread of COVID-19 in Tennessee, subject to all other provisions of Tennessee Code Annotated, Sections 63-10-207 and 63-1-164. CLICK HERE for information about prescriber ID for emergency prescriptions. (NO CONTROLLED SUBSTANCES)
  • Remote Verification of Prescriptions (Extended until 10/30/20) – The relevant provisions of Tennessee Code Annotated, Title 63, Chapter 10, and Tenn. Comp. R. & Regs. 1140-02-.01 through Tenn. Comp. R. & Regs. 1140-02-.02 are hereby suspended to the extent necessary to allow pharmacy technicians and pharmacists to complete computer-based processing of prescriptions at alternative locations, including from the residence of the pharmacy technician or pharmacist. Such computer-based processing shall be conducted utilizing adequate security to ensure all aspects of the Health Insurance Privacy and Accountability Act of 1996 are followed. No laws pertaining to licensed pharmacy practice sites, the storage of drugs, record keeping, or dispensing processes are waived or limited by this Order.
  • Authorization for Pharmacists to Provide Telehealth or Telemedicine Services (Extended until 10/30/20) – The provisions of Tennessee Code Annotated, Section 63-1-155(a)(1), are hereby suspended to the extent necessary to allow telehealth or telemedicine services to be provided by any provider licensed under Title 63, regardless of the provider’s authority to diagnose. This suspension does not otherwise alter or amend any licensee’s scope of practice or record keeping requirements.

LICENSURE CHANGES

  • Suspension of Fees and Notary Requirements for Initial License Applicants
    • Fees EXPIRED 6/30/20 – The relevant provisions of Tennessee Code Annotated, Titles 9, 63, and 68, and related rules are hereby suspended to the extent necessary to suspend the requirements that applicants for an initial license pursuant to Titles 63 or 68 pay fees, including any state regulatory fee, as part of the application process. This suspension will apply to initial application fees due to the Department of Health between March 12, 2020, and May 31, 2020. Fees already collected will not be refunded. The deadline to pay initial application fees originally due during this period is hereby extended to June 30, 2020; provided, however, that licenses and fees shall return to their original schedules in subsequent years.
    • Notary Requirements (Extended until 10/30/20): The relevant provisions of Tennessee Code Annotated, Titles 63 and 68, and related rules, are hereby suspended to the extent necessary to suspend the requirements that license applicants submit notarized application documents and instead allowing applicants to declare, certify, verify, or state under penalty of perjury that each document submitted is a true and correct copy of what it purports to be. Such declarations, certifications, verification, and statements must be signed and dated.
  • Granting of Licenses, Registrations, or Certificates for Retired or Out-of-Practice Healthcare Professionals – EXPIRED 9/30/20 – The provisions of Tennessee Code Annotated, Titles 63 and 68, and related rules and policies are hereby suspended to the extent necessary to give the Commissioner of Health the authority to grant a license, certificate, or registration to a healthcare professional, such as a retired healthcare professional, who has been out of practice for a period of time without requiring that individual to demonstrate continued competency or submit to an interview before a licensing board or other licensing authority, provided that the individual satisfies all other requirements for licensure, certification, or registration.
  • Suspension of Continuing Education Requirements (Extended for entire calendar year) – The provisions of Tennessee Code Annotated, Titles 63 and 68, and related rules and policies are hereby suspended to the extent necessary to suspend the requirement that individuals complete or submit proof of completing continuing education requirements or otherwise demonstrate continuing competence as a condition of reinstating a license, certification, or registration. The Commissioner of Health shall reasonably extend the deadline for these requirements as necessary to respond to the effects of COVID-19.
  • Expiration of Health Care Professionals and Facilities LicensesEXPIRED 8/29/20  – The relevant provisions of Tennessee Code Annotated, Titles 63 and 68, and related rules are hereby suspended to the extent necessary to extend the current expiration dates for health care professionals and facilities to renew their license, certificate, or registration set to expire between March 12, 2020, and May 31, 2020, during which time the holder of each license, certification, or registration may continue to legally operate or practice their profession. No fines or penalties shall be assessed or collected if the holder of such license, certification, or registration practices or operates during this extended period. Any renewal application received by the Tennessee Department of Health by August 31, 2020, shall be accepted as timely. When each license, certificate, or registration is renewed, its new expiration date shall be twenty-four (24) months after the expiration date it had prior to this Order.
  • Out-of-State Licensed Health Care Professionals (Extended until 10/30/20) – The relevant provisions of Tennessee Code Annotated, Titles 63 and 68, and related rules are hereby suspended to the extent necessary to give the Commissioner of Health the discretion to allow a health care professional who is licensed in another state, and who would otherwise be subject to licensing requirements under Title 63 or Title 68, to engage in the practice of such individual’s profession in Tennessee, if such individual is a health care professional who is assisting in the medical response to COVID-19, including treating routine or other medical conditions. The Commissioner of Health shall provide the requisite form for practicing under this Paragraph on the Department of Health’s Health Professional Boards webpage.

TENNCARE AND STATE INSURANCE REGULATIONS

  • TennCare Changes (Extended until 10/30/20) – The Division of TennCare is hereby authorized to create policies or modify existing policies as is necessary to ensure that members of the TennCare and CoverKids programs continue to receive medically necessary services without disruption during this state of emergency.
  • Tennessee Department of Commerce and InsuranceEXPIRED 8/29/20 – Pursuant to Tennessee Code Annotated, Section 58-2-107(e)(2), I hereby direct the Tennessee Department of Health and the Tennessee Department of Commerce and Insurance to continue working with health insurance plans operating in the state to identify and remove any burdens to responding to COVID-19 and improve access to treatment options and medically necessary screening and testing for COVID-19.

OTHER

  • Certificate of Need RequirementsEXPIRED 9/30/20 – The provisions of Tennessee Code Annotated, Section 68-11-1607, are hereby suspended to the extent necessary to allow hospitals and nursing homes that would otherwise be subject to certificate of need requirements to temporarily increase their number of licensed hospital beds at any location or temporarily establish hospital, nursing home, and diagnostic services at any location, if necessary for the treatment of COVID-19 patients, as well as to the extent necessary to facilitate activity authorized by the provisions of this Order and any subsequent order concerning COVID-19.
  • Suspension of Certain Required Health Care Facility Inspections (Extended until 10/30/20 *Does NOT apply to pharmacy sites* ) – The provisions of Tennessee Code Annotated, Section 68-11-210(a)(l), are hereby suspended to the extent necessary to suspend the requirement that the Department of Health conduct inspections of facilities applying for licensure if the applicant facility is physically located in the same location as another licensed facility where patients have been seen within the thirty (30) days preceding the submission of the application. In instances where the Department of Health elects to not inspect a facility applying for licensure, such provisions requiring a facility applying for licensure to be inspected are hereby suspended.
  • Patients in Temporary ResidencesEXPIRED 8/29/20 – The provisions of Tennessee Code Annotated, Section 68-11-201(20), are hereby suspended to the extent necessary to allow health care professionals who would otherwise be subject to licensing requirements to provide localized treatment of patients in temporary residences.
  • Alternate Testing Site Allowance (Extended until 10/30/20) – The provisions of Tenn. Comp. R. & Regs. 1200-06-03-.16 are suspended to allow testing for COVID-19 at alternate testing sites without prior approval by the Medical Laboratory Board; provided, that laboratories shall notify the Medical Laboratory Board of any such alternate testing sites.
  • Medication Administration Certificates for Department of Intellectual and Development Disabilities PersonnelEXPIRED 9/30/20 – Tenn Comp. R. & Regs. 0465-01-03.04(4)(a) and (b) are hereby suspended to the extent necessary to grant the Department of Intellectual and Developmental Disabilities the discretion to extend the medication administration certification of unlicensed personnel when necessary to provide for continuity of care.
TPA has created a Practice-Based Resource Page for pharmacists and pharmacy professionals which specifically focuses on COVID-19, including state and national resources, patient-specific handouts, and other important information. This is a very fluid situation, and TPA will continue to update the COVID-19 Practice-Based Resource Page with additional resources and information as it becomes available.
Visit TPA’s COVID-19 Practice-Based Resource Page