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Legal Guidance


The TMA offers aggressive pursuit of physician rights in every legal and regulatory forum, as well as personal access to a multitude of legal services including the online Law Guide. Our health care lawyers advocate in court, represent medicine before state and federal regulatory boards and committees, and offer legal and compliance guidance*, hospital medical staff bylaw review, and more. Members may pose medico-legal, state regulatory or practice management questions to the TMA by phone, fax or e-mail. This is a members-only benefit and our staff can only respond to issues submitted by TMA members. The TMA Legal Department cannot provide legal advice or representation to individual members or practices.

 

*Due to its tax-exempt status, the TMA cannot provide legal advice or representation to individual members.

 

Law Guide Directory 
TMA’s popular guide to TN health law and practice management for members. This guide is our signature resource for medico-legal information.

Law Guide 

No Surprises Act
Congress passed the NSA in Dec. 2020, and it will apply to all insurance plans (including ERISA plans) except for Medicare, Medicaid and TRICARE. TMA created a series of articles to discuss these rules. 

No Surprises Act

 

 

Doctor Shopping Guide 
This guide helps physicians with meeting their responsibility to report drug-seeking patients under Tennessee law.

Download the Guide

Opioid Resource Center
Complimenting the Doctor Shopping Guide (see left), our Opioid Resource Center includes Federal and State guidelines, patient-facing posters and pocket cards, education links and member-only guidance.

View the Toolkit
 

ERISA Physician Toolkit 
TMA’s new Employment Retirement Income Security Act Toolkit is full of samples for filing appeals, claims and complaints. It also gives resource descriptions to help you with what you need.

ERISA Toolkit

TMA Contingency Plan
Our Physician Contingency Plan helps protect our members and their patients in the event of an unexpected inability to continue practice.

View the Plan

 

Guide to 2015 Credentialing Law

The Tennessee General Assembly passed a law in 2015 that allows physicians to be reimbursed for services provided to health plan members during the physicians’ credentialing process. TMA members need to be aware of some nuances of this new law in order to take advantage of its benefits.

Guide to 2015 Credentialing Law

Treatment of Minors Guide
TMA created this resource based on logging years of calls to the legal department from pediatric and other medical practices with questions regarding the treatment of minor patients and the rights and duties of parents and guardians for minors under their legal responsibility.


Treatment of Minors Guide

 

Physician Employment Contract Checklist

Our Physician Employment Contract Checklist can help physicians avoid common pitfalls when signing an employment contract. 

Physician Employment Contract Checklist

 

Medical Audit Toolkit

This toolkit provides practical information and tips to guide physicians in anticipating medical audits, responding to auditor's requests for medical records, and appealing erroneous audit findings. 

Medical Audit Toolkit

 

Annual Wellness Visit Resources

These physician and patient-specific guides explain how third parties are interfering with Medicare Annual Wellness Visits and next steps if this happens to your patients.

Physician Guide

Patient Guide

Guide to BCBS Professional Agreement

The TMA legal department has developed a summary guide to the BlueCross BlueShield of Tennessee, Inc. Professional Agreement (or Contract). The resource gives members an executive summary of the provisions of the Agreement, an analysis of some terms, and discussion of potential pitfalls in this or any managed care contract.

Guide to BCBS Professional Agreement

 

Retiring Physician Manual

A guide for physicians that are considering retirement from medical practice.

Retiring Physician Guide

 

Guide to the 2019 Provider Stability Act

This brief document helps physicians and medical practices understand how to comply with the Healthcare Provider Stability Act, a first-of-its-kind law that requires more transparency and limits changes to reimbursement rates in contracts between health insurance companies and healthcare providers.

Guide to 2019 Provider Stability Act

 

Tennessee Healthcare Innovation Initiative (Payment Reform)

TMA has advocated since 2012 to improve the design and implementation of the state's move from fee-for-service to a payment model based on episodes of care.

More Info

Collaborating Physician Toolkit

Our toolkit will help you stay in compliance with regulations governing your role as a physician collaborating with an advanced practice nurse or physician assistant.