2026 Legislative Update

This legislative session has been very busy, with TAPA working on three different pieces of legislation affecting PA practice in Tennessee. Below is an overview and update for each bill.

SB2243 (Johnson)/HB2555 (Lamberth) – Rural Health Transformation Program. This bill would implement changes that were promised to the federal government last year in Tennessee’s Rural Health Transformation (RHT) Program grant application. This bill addresses PA practice in our state and would move PAs to full Optimal Team Practice.

• The grant funding was awarded in December, and passage of this bill is necessary to prevent any claw back of funding by the federal government.
• Passage of this bill would also position Tennessee to be scored higher in future years under the RHT program, making the state eligible for a higher portion of the discretionary RHT funds.
• Finally, removing practice barriers will enhance PA practice in Tennessee and expand access to care for all patients across the state, improve outcomes, and strengthen the healthcare workforce.

Bill Status: TAPA was extremely disappointed to see SB 2243, which implemented the section of the governor’s RHT grant application regarding PAs, referred to the Senate Health and Welfare’s General Subcommittee. What does that mean? Referring the bill to General Sub is a maneuver to kill a piece of legislation. So, the bill is essentially dead for this year. This is a huge disappointment because the votes were there to get the bill out of committee.

This is a setback, not a defeat. There are still a lot of legislators who support this bill and want the funding tied to it from the federal government. Many legislators will be facing primary opponents this fall, and Tennesseans will be electing a new governor who will oversee the final four years of the RHT grant cycle. This summer and fall, TAPA will be meeting with legislative and gubernatorial candidates to explain to them why it is important to support this bill and the RHT program.

SB2155 (Watson)/HB2619 (Howell) - Patients First Act. This bill responds to longstanding concerns raised by patients, providers, and employers across our state. Too often, insurance decisions that affect access to care and financial stability are made through opaque processes, unilateral contract changes, and increasing use of automated systems with little accountability. This legislation puts reasonable guardrails in place to restore balance and trust in the health insurance system.

• The bill prohibits improper downcoding and ensures providers are paid for the services they actually provide to patients.
• The bill promotes fair reimbursement across provider types, prohibiting insurers from denying or reducing payment solely based on licensure classification when services are within a provider’s scope of practice and reimbursed for others. This provision prevents discriminatory reimbursement while preserving existing scope-of-practice laws.

Bill Status: HB 2619 easily passed through all of the House committees which debated this legislation. Unfortunately, it faced an uphill battle in the Senate. The Senate Commerce and Labor Committee debated SB2155 and, on a 4-5 vote, the bill failed to receive enough votes to pass out of the Senate committee. As such, the bill is dead for the year. However, these issues are not going away, so we expect them to be addressed in the next legislative session.

SB2548 (Reeves)/HB2044 (Marsh) – Certified Medical Assistants. This bill clarifies that PAs are permitted to delegate medication administration to a certified medical assistant (MA).

• The original enabling legislation allowed physicians and nurses to delegate medication administration to MAs, but it erroneously omitted PAs.
• In many practice settings, PAs work closely with MAs and routinely need to delegate tasks to these certified practitioners. This bill makes it clear that PAs have that authority in Tennessee.

Bill Status: SB2548 and HB2044 have both passed their respective chambers and has been signed into law by the governor.

If you are interested in meeting with your local legislators to help TAPA advocate for PAs, please reach out to the TAPA office at [email protected].