Tenn. Comp. R. & Regs. 1155 — Podiatric Medical Examiners

Chapter 1155-01 Rules of Procedure for Hearing Contested Cases

Tenn. Comp. R. & Regs. 1155-01 Rules of Procedure for Hearing Contested Cases

RULES

OF TENNESSEE STATE BOARD OF PODIATRIC MEDICAL EXAMINERS

For Rules of Procedure for Hearing Contested Cases see Rules of the Secretary of State, Chapter 1360-1-7.

Authority: T.C.A. §4-509. Administrative History: Original chapter filed November 22, 1978; effective January 8, 1979.

Chapter 1155-02 General Rules and Regulations Governing the Practice of Podiatry

Tenn. Comp. R. & Regs. 1155-02-.01 DEFINITIONS - As used in this chapter and in chapters 1155-03 and 1155-04, the following terms and acronyms shall have the following meanings ascribed to them:

(1) Advertising - Includes, but is not limited to, business solicitation, with or without limiting qualifications, in a card, sign, or device issued to a person; in a sign or marking in or on any building, or in any newspaper, magazine, directory, or other printed matter. Advertising also includes business solicitations communicated by individual, radio, video, television broadcasting, direct mail or any other means designed to secure public attention.

(2) Advertisement - Informational communication to the public in any manner to attract public attention to the practice of a podiatrist or podiatry medicine.

(3) Applicant - Any individual seeking licensure by the Board who has submitted an official application and paid the application fee.

(4) American Podiatric Medical Association - When the acronym APMA appears in these rules, it is intended to mean American Podiatric Medical Association.

(5) Board - The Tennessee Board of Podiatric Medical Examiners.

(6) Board Administrative Office - The office of the administrator assigned to the Board located at 665 Mainstream Drive, Nashville, TN 37243.

(7) Board Designee - Any person who has received a written delegation of authority from the Board to perform Board functions subject to review and ratification by the full Board where provided by these rules.

(8) Closed Files - An administrative action which renders an incomplete or denied file inactive.

(9) Department - Tennessee Department of Health.

(10) Division - The Division of Health Related Boards, Tennessee Department of Health, from which the Board receives administrative support.

(11) Fee - Money, gifts, services, or anything of value offered or received as compensation in return for rendering services; also, the required application fees.

(12) Good Moral Character - The quality of being highly regarded in personal behavior and professional ethics.

(13) He/she Him/her - When “he” appears in the text of these rules, the word represents both the feminine and masculine genders.

(14) HRB - When the acronym HRB appears in the text of these rules, the HRB represents Health Related Boards.

(15) License - Document issued to an applicant who successfully completes the licensure process. The license takes the form of an “artistically designed” license as well as other versions bearing an expiration date.

(16) National Board - Means the National Board of Podiatric Medical Examiners.

(17) Person - Any individual, firm, corporation, partnership, organization, or body politic.

(18) Podiatrist - Means one who examines, diagnoses, or treats medically, mechanically, or surgically, the ailments of the human foot, ankle and soft tissue structures extending no higher than the distal tibial metaphyseal flair, including the use and prescribing of drugs and medications, but excluding the direct applications of general anesthesia by a podiatrist and the amputation of the foot. A podiatrist may perform Achilles tendon repair, subject to the provisions of T.C.A. § 63-3-101, but may not perform surgery on Pilon fractures or tibial fractures which do not enter the ankle joint.

(19) Registrant - Any person who has been lawfully issued a license.

(20) Use of Title or Description - To hold oneself out to the public as having a particular status by means of stating on signs, mailboxes, address plates, stationary, announcements, business cards, or other means of professional identification.

(21) Written Evidence - Includes, but is not limited to, written verification from supervisors or other professional colleagues familiar with the applicant’s work.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-107, 63-3-101, 63-3-103, 63-3-105, 63-3-106, 63-3-107, 63- 3-108, 63-3-109, 63-3-110, 63-3-111, 63-3-115, 63-3-116 63-3-119, 63-3-125, and 63-3-201.
Administrative History: Original rule filed October 3, 1990; effective November 17, 1990. Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed March 19, 2001; effective June 2, 2001. Amendment filed July 22, 2002; effective October 5, 2002. Amendment filed March 23, 2007; effective June 6, 2007.

Tenn. Comp. R. & Regs. 1155-02-.02 SCOPE OF PRACTICE

(1) Any person who possesses a valid and current license in Podiatry issued by the Board has the right to use the title licensed podiatrist. No other person shall assume this title on any work, letter, sign, figure, advertisement, or device to indicate that the person using the same is a licensed podiatrist. The work performed includes offering advice and services to the public.

(2) Universal Precautions for the Prevention of HIV Transmission - The Board adopts, as if fully set out herein, rules 1200-14-03-.01 through 1200-14-03-.03 inclusive, of the Department of Health and as they may from time to time be amended, as its rule governing the process for implementing universal precautions for the prevention of HIV transmission for health care workers under its jurisdiction.

(3) A licensed podiatrist may perform ankle surgery subject to the provisions of T.C.A. § 63-3- 101. Those licensees intending to perform such ankle surgery shall maintain their proof of compliance with T.C.A. § 63-3-101 at their practice location, as it may be inspected by the Board or its authorized representative.

(4) A licensed podiatrist may order diagnostic tests from licensed medical laboratories and may receive results of such tests, provided the need for such tests is relevant to the practice of podiatry.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-101, 63-3-106, 63-3-107, 63-6-117, and 68-11-222.
Administrative History: Original rule filed March 7, 1989; effective April 21, 1989. (Formerly 1155-02- .01) Amendment filed October 3, 1990; effective November 17, 1990. Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed October 28, 1999; effective January 11, 2000. Amendment filed March 19, 2001; effective June 2, 2001. Amendment filed April 26, 2006; effective July 10, 2006.

Tenn. Comp. R. & Regs. 1155-02-.03 ) Amendment filed October 3, 1990; effective November 17, 1990. Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed April 26, 2006; effective July 10, 2006.

Amendment filed May 5, 2006; effective July 19, 2006. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-02-.04 QUALIFICATION FOR LICENSURE

(1) To qualify for licensure in podiatry, all applicants must:

(a) Provide evidence of good moral character and professional ethics (rule 1155-02-.05);

(b) Provide proof of being at least 18 years of age;

(c) Graduate from a podiatric medical college accredited by the Council on Podiatric Medical Education and the American Podiatric Medical Association. The educational requirements must be completed prior to the date of application;

(d) Successfully complete all examinations required by rule 1155-02-.08; and (e) Complete at least a one-year residency program approved by the Council on Podiatric Medical Education or its successor organization.

(2) Licensure by Reciprocity. All reciprocity applicants must complete the requirements for licensure in paragraph (1) of this rule.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-105, 63-3-106, 63-3-109, 63-3-110, 63-3-111, 63-3-113, and 63-3-114.
Administrative History: Original rule filed March 7, 1989; effective April 21, 1989. (Formerly

Tenn. Comp. R. & Regs. 1155-02-.05 PROCEDURES FOR LICENSURE - To become licensed as a podiatrist in Tennessee, a person must comply with the following procedures and requirements:

(1) Licensure by Examination (a) An application packet shall be requested from the board’s administrative office.

(b) An applicant shall respond truthfully and completely to every question or request for information contained in the application form and submit it along with all documentation and fees required by the form and these rules to the Board’s administrative office. It is the intent of this rule that all steps necessary to accomplish the filing of the required documentation be completed prior to filing an application and that all documentation be filed simultaneously.

(c) Applications will be accepted throughout the year. Supporting documents requested in these instructions must be received in the board office within 60 days of receipt of the application or the file will be closed.

(d) An applicant shall submit with his application a signed passport type photograph taken within the preceding 12 months. (The photo is to be signed by the applicant.)

(e) It is the applicant’s responsibility to request that a graduate transcript from his degree granting institution, pursuant to T.C.A. § 63-3-110, be submitted directly from the school to the board’s administrative office. The institution granting the degree must have been accredited at the time the degree was granted. The transcript must show that the degree has been conferred and carry the official seal of the institution and reference the name under which the applicant has applied for licensure. The educational requirements contained in these rules must be completed prior to the date of the application for licensure.

(f) An applicant shall submit evidence of good moral character. Such evidence shall be three recent (within the preceding 12 months) original letters, two of which must be from licensed podiatrists, medical doctors or osteopathic physicians attesting to the applicant’s personal character and professional ethics on the signator’s letterhead.

(g) An applicant shall submit proof of being eighteen (18) years of age or older. Acceptable proof is a notarized copy of the applicant’s birth certificate, driver’s license, or voter registration card.

(h) An applicant shall submit evidence of having completed at least a one (1) year residency program approved by the Council on Podiatric Medical Education or its successor organization on forms approved by the Board directly to the Board office.

(i) An applicant shall request that his/her scores from Parts I and II of the National Board of Podiatric Medical Examiners (NBPME) examinations be sent directly to the Board’s administrative office from the testing agency.

(j) An applicant shall request that his/her scores, if taken in another state, from Part III of the NBPME examinations (formerly known as the Podiatric Medical Licensing Examination for States [PMLexis]) be sent directly to the Board’s administrative office from the Federation of Podiatric Medical Boards.

(k) An applicant shall disclose the circumstances surrounding any of the following:

Conviction of any criminal law violation of any country, state or municipality, except minor traffic violations.
The denial of licensure application by any other state or the discipline of licensure in any state.
Loss or restriction of licensure.
Any civil suit judgment, civil suit settlement or pending civil suit in which the applicant was/is a party defendant including, without limitation, actions involving malpractice, breach of contract, antitrust activity or any other civil action remedy recognized under the country’s or state’s statutory common, or case law.

(l) An applicant shall cause to be submitted to the Board’s administrative office directly from the vendor identified in the Board’s licensure application materials, the result of a criminal background check.

(m) If an applicant holds or has ever held a license to practice as a podiatrist in any other state, the applicant shall cause to be submitted the equivalent of a Tennessee Certificate of Endorsement (verification of license) from each such licensing board which indicates the applicant holds or held an active license and whether it is in good standing presently or was at the time it became inactive.

(n) When necessary, all required documents shall be translated into English and such translation and original document shall be certified as to authenticity by the issuing source. Both versions must be submitted.

(o) Personal resumes are not acceptable and will not be reviewed.

(p) Application review and licensure decisions shall be governed by rule 1155-02-.07.

(q) The burden is on the applicant to prove by a preponderance of the evidence that his course work, supervision, and experience are equivalent to the Board’s requirements.

(2) Licensure by Reciprocity. All reciprocity applicants must complete the procedures for licensure in paragraph (1) of this rule.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-109, 63-3-110, 63-3-111, 63-3-114, and 63-3-119.
Administrative History: Original rule filed March 7, 1989; effective April 21, 1989. (Formerly 1155-02- .04) Amendment filed October 3, 1990; effective November 17, 1990. Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed May 5, 2006; effective July 19, 2006. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-02-.06 FEES

(1) The fees are as follows:

(a) Academic License fee - A non-refundable fee to be paid by all applicants for an academic license. This fee pays for licensure during the postgraduate training period and the initial period of full licensure.

(b) Application fee - A non-refundable fee to be paid by all applicants for licensure except applicants for an academic license, and must be paid each time an application for licensure is filed.

(d) Renewal fee - A non-refundable fee to be paid by all licensees. This fee also applies to individuals who reactivate a retired or lapsed license.

(e) Replacement license fee - A non-refundable fee to be paid when an individual requests a replacement for a lost or destroyed “artistically designed” license.

(f) State Regulatory fee - To be paid by all individuals at the time of application and with all renewal applications.

(2) All fees shall be established by the Board. Fees may be reviewed and changed at the discretion of the Board.

(3) All fees must be submitted to the board’s administrative office by certified, personal check or money order. Checks or money orders are to be made payable to the Board of Registration in Podiatry.

(4) Fee Schedule: Amount (a) Academic License $440.00 (b) Application $440.00 (c) Renewal (biennial) $275.00 (d) Late Renewal $150.00 (e) Replacement License $ 25.00 (f) State Regulatory (biennial) $ 10.00

History

Authority: T.C.A. §§ 4-3-1011, 4-5-202, 4-5-204, 63-1-103, 63-1-107, 63-3-106, 63-3-106(1), 63-3-109, 63-3-111, 63-3-112, 63-3-114, 63-3-115, and 63-3-116.
Administrative History: Original rule filed March 7, 1989; effective April 21, 1989. (Formerly 1155-02-.05) Amendment filed October 3, 1990; effective November 17, 1990. Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed December 13, 2000; effective February 26, 2001. Amendment filed December 16, 2002; effective March 1, 2003. Amendment filed August 25, 2009; effective November 23, 2009. Amendment filed April 24, 2017; effective July 23, 2017.

Tenn. Comp. R. & Regs. 1155-02-.07 APPLICATION REVIEW, APPROVAL, DENIAL, INTERVIEWS

This rule determines the procedure the Board shall use to make decisions for applicants seeking to practice podiatry pursuant to this chapter and for applicants seeking to operate x-ray equipment for diagnostic purposes in podiatrists’ offices pursuant to Chapter 1155-03.

(1) An application packet shall be requested from the Board’s administrative office.

(2) Review of all applications to determine whether or not the application file is complete may be delegated to the Board’s administrator.

(3) If an application is incomplete when received in the Board’s administrative office, a deficiency letter will be sent to the applicant notifying him of the deficiency. The requested information must be received in the Board’s administrative office on or before the sixtieth (60th) day after the applicant’s receipt of the notification.

(a) Such notification shall be sent certified mail, return receipt requested, from the Board’s administrative office.

(b) If the requested information is not received on or before the sixtieth (60th) day prior to the examination, the application file shall become inactive and the applicant notified.

No further board action will take place until the application is completed pursuant to the rules governing the application process.

(4) An individual who has a complete application, application fees, and all supporting documents on file in the Board’s administrative office at least sixty (60) days prior to the examination date will be scheduled and notified to take the examination.

(5) If a completed application has been denied and ratified as such by the Board or its designee, the action shall become final and the following shall occur:

(a) A notification of the denial shall be sent by the Board’s administrative office by certified mail, return receipt requested. Specific reasons for denial will be stated, such as incomplete information, unofficial records, examination failure, or other matters judged insufficient for licensure, and such notification shall contain all the specific statutory or

rule authorities for the denial.

(b) The notification, when appropriate, shall also contain a statement of the applicant’s right to request a contested case hearing under the Tennessee Administrative Procedures Act (T.C.A. §§ 4-5-301, et seq.) to contest the denial and the procedure necessary to accomplish that action.

(c) An applicant has a right to a contested case hearing only if the licensure denial is based on subjective or discretionary criteria.

(d) An applicant may be granted a contested case hearing if licensure denial is based on an objective, clearly defined criteria only if after review and attempted resolution by the Board’s administrative staff, the licensure application cannot be approved and the reasons for continued denial present a genuine issue of fact and/or law which is appropriate for appeal. Such request must be made in writing to the Board within thirty (30) days of the receipt of the notice of denial from the Board.

(6) The Board or its designee may delay a decision on eligibility to take the examination for any applicant for whom the board wishes additional information for the purpose of clarifying information previously submitted. This request is to be in writing and sent by certified mail, return receipt requested. The applicant’s response must be made and received at the Board’s administrative office within sixty (60) days from the date of the official review of the application or the application will be closed.

(7) If the Board finds it has erred in the issuance of a license, the board will give written notice by certified mail of its intent to revoke the license. The notice will allow the applicant the opportunity to meet the requirements of licensure within thirty (30) days from the date of receipt of the notification. If the applicant does not concur with the stated reason and the intent to revoke the license, the applicant shall have the right to proceed according to rule 1155-02-.07(5).

(8) Whenever requirements for examination are not completed sixty (60) days before the date of the examination, a written notification will be mailed to the applicant and the application file will become inactive. An applicant whose file has become inactive shall subsequently be considered for licensure only upon completion of his application and payment of all appropriate fees.

(9) Abandonment of Application (a) An application shall be deemed abandoned and closed if the application has not been completed by the applicant within sixty (60) days from the date it was initially reviewed.

(b) The above action must be ratified by the Board.

(10) If an applicant requests one means for licensure, and wishes to change that application to a different means of obtaining licensure, a new application, with supporting documents and appropriate fee(s) must be submitted, i.e., reciprocity to examination.

(11) An applicant who holds a license in good standing in another state and indicates an intended residence outside the State of Tennessee but proposes to practice intermittently within the physical boundaries of the State of Tennessee, shall in the discretion of the Board be issued a Locum Tenens license.

(a) To obtain a Locum Tenens license, an applicant shall compile the following and when completed, submit them to the Board Administrative Office:

A Board approved application form;
An applicant shall submit with the application the application fee as provided in

rule 1155-02-.06(4)(b) and the state regulatory fee as provided in rule 1155-02- .06(4)(f).

If an applicant has ever held a license to practice podiatry in any other state or Canada, the applicant shall submit or cause to be submitted the equivalent of a Tennessee Certificate of Endorsement from each such licensing board which indicates the applicant either holds a current active podiatric license and whether it is in good standing, or has held a podiatric license which is currently inactive and whether it was in good standing at the time it became inactive;
All applicants shall disclose the following events and provide any additional documentation, proof or explanation that explains the event(s):

(i) Conviction of any criminal law violation of any country, state, or municipality, except minor traffic violations.

(ii) The denial of licensure application by any other state or the discipline of licensure in any state.

(iii) Loss or restriction of hospital privileges.

(iv ) Any other civil suit judgment or civil suit settlement in which the applicant was a party defendant including, without limitation, actions involving malpractice, breach of contract, antitrust activity or any other civil action remedy recognized under any country’s or state’s statutory, common, or case law.

(v) Failure of any podiatric licensure examination.

Any applicant for any type of licensure authorized by this rule shall cause to be submitted to the Board’s administrative office directly from the vendor identified in the Board’s licensure application materials, the result of a criminal background check.

(b) Any podiatrist holding a Locum Tenens license shall notify the Board of the location and duration of each Tennessee practice as soon as reasonably possible under the circumstances before that practice occurs.

(c) All Locum Tenens licenses must be renewed, inactivated, or retired according to the same procedures as active unrestricted licenses.

(d) Each Locum Tenens practice must be no more than ninety (90) days in duration.

(e) An applicant may obtain a maximum of two Locum Tenens licenses per lifetime.

(f) All Locum Tenens licenses are subject to discipline for the same causes and pursuant to the same procedures as active unrestricted licenses.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 4-5-301, 63-3-106, 63-3-109, 63-3-110, 63-3-111, 63-3-112, 63-3- 114, 63-3-115, 63-3-119, and 63-3-125.
Administrative History: Original rule filed March 7, 1989; effective April 21, 1989. (Formerly 1155-02-.06) Amendment filed October 3, 1990; effective November 17, 1990. Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed December 13, 2000; effective February 26, 2001. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-02-.08 EXAMINATIONS

All applicants for licensure by examination and reciprocity must successfully complete the examinations described in paragraphs (1), (2) and (3) of this rule.

(1) Parts I and II of the National Board of Podiatric Medical Examiners (NBPME) examinations.

(a) The Board adopts as its passing scores for Parts I and II the NBPME’s recommended passing score as determined by the criterion-referenced method approved by the NBPME.

(b) The passing scores for Parts I and II are to be achieved independently of each other and shall not be combined together for an average passing score.

(2) Part III of the NBPME examinations (formerly known as the Podiatric Medical Licensing Examination for States [PMLexis]).

(a) The Board adopts as its passing score for Part III the NBPME’s recommended passing score as determined by the criterion-referenced method approved by the NBPME.

(b) An applicant for licensure shall successfully complete Parts I and II before applying to the Board to take Part III.

(3) Jurisprudence examination.

(a) The Board shall include a jurisprudence examination with all applications for licensure that are mailed from the Board’s administrative office, or the applicant may obtain the jurisprudence examination from the Board’s Internet web page that can be accessed at www.Tennessee.gov/health.

(b) The applicant shall include a completed jurisprudence examination when his/her completed application for licensure is returned to the Board’s administrative office.

(d) The scope and content of the examination shall be determined by the Board but limited to statutes and regulations governing the practice of podiatry (T.C.A. §§ 63-3-101, et seq., and Chapter 1155-02 of the Official Compilation, Rules and Regulations of the State of Tennessee) and the American Podiatric Medical Association (APMA) Code of Ethics. Copies of the applicable statutes, regulations, and the APMA Code of Ethics are available upon request from the Board’s administrative office.

(e) The format of the examination shall be “open-book.”

Correctly answering ninety percent (90%) of the examination questions shall constitute successful completion of the jurisprudence exam.

(4) Any applicant whose most recent satisfactory NBPME examination score is more than five (5) years old and who has practiced podiatry with an unencumbered license in another state during the three (3) year period immediately preceding the application shall not be required to take Part III of the NBPME examination for licensure. All other applicants whose most recent satisfactory examination score is more than five (5) years old shall be required to take Part III of the NBPME examination for licensure.

(5) The Board’s administrative office will notify applicants in writing within forty-five (45) days of the date the written test scores are made available to the Board.

(6) Re-Examination (a) Applicants who fail Part III of the NBPME examinations shall be entitled to retake the next regularly scheduled examination upon sending a written request to the Board’s administrative office at least sixty (60) days prior to the examination.

(b) Applicants who fail to successfully complete the jurisprudence examination must continue to retake the examination until it has been successfully completed before the application will be deemed complete and presented to the Board for consideration.

(c) If an applicant neglects, fails or refuses to take the examination or fails to pass the examination for licensure under these rules within 12 months after being deemed eligible to sit for the state examination, the application file will be closed. However, such an applicant may thereafter make a new application accompanied by the required fee and supporting documents. The applicant shall meet the requirements in effect at the time of the new application.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-109, 63-3-111, 63-3-112, and 63-3-114.
Administrative History: Original rule filed February 4, 1988; effective March 20, 1988. (Formerly 1155- 02-.07) Amendment filed October 3, 1990; effective November 17, 1990. Amendment filed December 20, 1990; effective February 3, 1991. Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed December 13, 2000; effective February 26, 2001. Amendment filed April 26, 2006; effective July 10, 2006. Amendment filed May 5, 2006; effective July 19, 2006. Amendment filed August 9, 2007; effective October 23, 2007. Amendment filed January 20, 2012; effective April 19, 2012. Amendments filed May 7, 2019; effective August 5, 2019.

Tenn. Comp. R. & Regs. 1155-02-.09 LICENSURE RENEWAL

(1) Renewal Application (a) The due date for renewal is the last day of the month in which a licensee’s birthday falls pursuant to the Division of Health Related Board’s biennial birthdate renewal system as contained as the expiration date on renewal certificates.

(b) Methods of Renewal 1. Internet Renewals - Individuals may apply for renewal and pay the necessary fees via the Internet. The application to renew can be accessed at: https://apps.tn.gov/hlrs/ 2. Paper Renewals - For individuals who have not renewed their license online via the Internet, a renewal application form will be mailed to each individual licensed by the Board to the last address provided to the Board. Failure to receive such notification does not relieve the licensee from the responsibility of meeting all requirements for renewal.

(c) A license issued pursuant to these rules is renewable by the expiration date. To be eligible for renewal an individual must submit to the Division of Health Related Boards on or before the expiration date the following:

A completed and signed renewal application form.
The renewal and state regulatory fees as provided in rule 1155-02-.06.

(d) To be eligible for renewal an individual must have completed the continuing education requirements provided in rule 1155-02-.12 and who so indicates completion by signing the renewal application. An individual who fails to obtain continuing education hours, pursuant to rule 1155-02-.12 may be subject to disciplinary action by the board.

(e) Licensees who fail to comply with the renewal rules or notification received by them concerning failure to timely renew shall have their licenses processed pursuant to rule

Tenn. Comp. R. & Regs. 1155-02-.11 RETIREMENT AND REACTIVATION OF LICENSE

(1) A person who holds a current license and does not intend to practice as a “licensed podiatrist” may apply to convert an active license to inactive (“retired”) status. An individual who holds a retired license will not be required to pay the renewal fee.

(2) A person who holds an active license may apply for retired status in the following manner:

(a) Obtain, complete, and submit to the Board’s administrative office an affidavit of retirement form.

(b) Submit any documentation which may be required to the Board’s administrative office.

(3) A licensee whose license has been retired may re-enter active status by doing the following:

(a) Obtain complete and submit to the Board’s administrative office a reactivation/reinstate-ment application.

(b) Pay the licensure renewal fees and state regulatory fees as provided in rule 1155-02- .06. If retirement reactivation is requested prior to the expiration of one year from the date of retirement, the Board will require payment of the late renewal fee and past due renewal fees.

(d) Retake and pass the Board’s oral exam if the license has been retired for five (5) years or more.

(e) An individual who has a podiatry license that has been retired for at least twelve (12) months shall submit to a criminal background check and cause the results to be submitted to the Board office before the license can be reactivated.

(4) Licensure reactivation applications shall be treated as licensure applications, and review decisions shall be governed by rule 1155-02-.07.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-115, and 63-3-116.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999. Amendment filed March 23, 2007; effective June 6, 2007. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-02-.12 CONTINUING EDUCATION

(1) The Board requires each licensed podiatrist to complete fifteen (15) clock hours of continuing education each calendar year (January 1 – December 31).

(a) Twelve (12) hours of the fifteen (15) clock hour requirement shall be clinical, scientific, or related to patient care. If the licensee is performing ankle surgery pursuant to T.C.A. § 63-3-101(b)(1), ten (10) of these twelve (12) hours shall pertain to the ankle surgery.

(b) Unless exempt under T.C.A. § 63-1-402(c), all podiatrists holding a current Tennessee license shall complete a minimum of two (2) hours of continuing education biennially related to controlled substance prescribing, which must include instruction in the Department’s treatment guidelines on opioids, benzodiazepines, barbiturates, and carisoprodol and may include topics such as medicine addiction, risk management tools, and other topics approved by the Board.

(c) Ten (10) hours of the fifteen (15) clock hour requirement must be completed in the traditional “lecture/classroom” format.

(d) Five (5) hours of the fifteen (15) clock hour requirement may be completed in any of the following multi-media formats:

The Internet 2. Closed circuit television 3. Satellite broadcasts 4. Correspondence courses 5. Videotapes 6. CD-ROM 7. DVD 8. Teleconferencing 9. Videoconferencing 10. Distance learning (2) Acceptable continuing education shall consist of courses provided or sponsored by the APMA, APMA approved colleges of podiatric medicine, state, regional (zone), national and affiliated specialty groups, the U.S. federal government, or other education programs approved by the Board.

(3) Course Approval (a) Courses to be offered for credit toward the required continuing education hours must, unless otherwise provided pursuant to 1155-02-.12(2), receive prior approval from the Board.

(b) Prior approval of a course may be obtained by submitting the following information to the Board’s administrative office at least forty-five (45) days prior to the scheduled date of the course.

A course description or outline;
Names of all lecturers;
Brief resume of all lecturers;
Number of hours of educational credit requested;
Date of course;
How certification of attendance is to be documented.

(4) Documentation (a) Each licensee must retain proof of attendance and completion of all continuing education requirements. This documentation must be retained for a period of four years from the end of the calendar year in which the continuing education was acquired. This documentation must be produced for inspection and verification, if requested in writing by the Board during its verification process.

(b) Each licensee must, within thirty (30) days of a request from the Board, provide evidence of continuing education requirements. Such evidence must be by submission of one or more of the following:

Certificates verifying the licensee’s attendance at continuing education program(s). The certificate must include the following: continuing education program’s sponsor, date, clock hours awarded (continuing education units must be converted to clock hours), program title, licensee’s name, license number and social security number.
An original letter on official stationery from the continuing education program’s sponsor indicating, date, clock hours awarded (CE units must be converted to clock hours), program title, licensee’s name, license number and social security number.

(c) If a person submits documentation for training that is not clearly identifiable as appropriate continuing education, the Board will request a written description of the training and how it applies to the practice of podiatry. If the Board determines that the training cannot be considered appropriate continuing education, the individual will be given ninety (90) days to replace the hours not allowed. Those hours will be considered replacement hours and cannot be counted during the next renewal period.

(5) Persons who are full-time residents in a graduate training program approved by the Council on Podiatric Medical Education and individuals who have been students of a Podiatry College during the year they obtain their Tennessee license shall be exempt from the CME requirements during that calendar year.

(6) Continuing education credit will not be allowed for the following:

(a) Regular work activities, administrative staff meetings, case staffing/reporting, etc.

(b) Membership in, holding office in, or participation on boards or committees, business meetings of professional organizations, or banquet speeches.

(7) Revocation of license for non-compliance with continuing education:

(a) If the continuing education requirement is not met, a letter is issued to the last known address of the individual requiring him to show cause why his license should not be revoked for failure to comply with the continuing education requirements.

(b) The licensee has 30 days from the date of notification to respond to the show cause letter and prepare for any hearing on the matter (8) Continuing Education for Reactivation of Retired or Revoked License.

(a) Reactivation of Retired Licensure 1. An individual whose license has been retired for less than one year will be required to fulfill continuing education requirements as outlined in this rule as a prerequisite to reinstatement. Those hours will be considered replacement hours and can not be counted toward meeting the calendar year end requirement.

Any individual requesting reactivation of a license which has been retired for one or more years must submit, along with the reactivation request, verification which indicates the attendance and completion of fifteen (15) hours of continuing education for each year in which the license was retired or the equivalent of this state’s requirement multiplied by the number of years in retirement. The continuing education hours must have been begun and successfully completed before the date of reinstatement.

(b) Reactivation of Revoked License.

No person whose license has been revoked for failure to comply with continuing education may have his license reinstated without complying with all the requirements. The required clock hours of continuing education must have been begun and completed before the date of reinstatement.

(9) Violations (a) Any licensee who falsely certifies attendance and completion of the required hours of continuing education requirements may be subject to disciplinary action.

(b) Any licensee who fails to show compliance with the required continuing education hours in response to the notice contemplated by subparagraph (7)(a) above may be subject to disciplinary action.

(10) Waiver of Continuing Education (a) The Board may grant a waiver of the need to attend and complete the required hours of continuing education if it can be shown to the Board that the failure to comply was not attributed to or was beyond the physical capabilities of the person seeking the waiver.

(b) Waivers will be considered only on an individual basis and may be requested by submitting the following items to the Board’s administrative office:

A written request for a waiver which specifies what requirements are sought to be waived and a written and signed explanation of the reason for the request.
Any documentation which supports the reason for the waiver requested or which is subsequently requested by the Board.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-107, 63-1-402, 63-3-101, 63-3-106, 63-3-109, 63-3-115, 63- 3-116, and 63-3-119.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999. Amendment filed August 23, 2001; effective November 6, 2001. Amendment filed July 22, 2002; effective October 5, 2002. Amendment filed April 26, 2006; effective July 10, 2006. Amendment filed March 23, 2007; effective June 6, 2007. Amendment filed August 9, 2007; effective October 23, 2007. Amendment filed January 20, 2012; effective April 19, 2012. Amendments filed January 31, 2017; effective May 1, 2017.

Tenn. Comp. R. & Regs. 1155-02-.13 PROFESSIONAL ETHICS

Immoral, unprofessional, unethical, or dishonorable conduct shall include, but not be limited to, the following:

(1) Conduct designed to, or likely to, deceive or harm the public.

(2) Being a party to or aiding and abetting the violation of these regulations or the laws of the State of Tennessee regulating the practice of podiatry.

(3) The intentional or negligent use of any false, fraudulent or forged statement, writing or document, or the use of any fraudulent, deceitful, dishonest, or immoral practice in connection with any of the licensing requirements of T.C.A. §§ 63-3-101, et seq.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-101, 63-3-106, 63-3-109, and 63-3-119.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999.

Tenn. Comp. R. & Regs. 1155-02-.14 ACADEMIC LICENSE

(1) An application for an academic license will be considered only after an individual has completed all the requirements for full and unrestricted licensure except postgraduate education and the examination requirements of paragraphs (2) and (3) of rule 1155-02-.08.

(2) An academic license authorizes the licensee to engage in the practice of podiatric medicine and surgery as part of a postgraduate educational program.

(3) A completed application must be approved by the Board or Board designee prior to the issuance of an academic license.

(4) To obtain an academic license a person must comply with the following procedures and requirements:

(a) An application packet shall be requested from the Board’s administrative office.

(b) An applicant shall respond truthfully and completely to every question or request for information contained in the application form and submit it along with all fees required by the form and these rules to the Board’s administrative office.

(d) An applicant shall submit with his application a signed passport type photograph taken within the preceding 12 months. (The photo is to be signed by the applicant.)

(e) It is the applicant’s responsibility to request a transcript pursuant to T.C.A. § 63-3-110 which must be submitted directly from the school to the Board’s administrative office.

The podiatric institution granting the degree of Doctor of Podiatric Medicine must have been accredited at the time the degree was granted. The transcript must show that the degree has been conferred. The educational requirements contained in these rules must be completed prior to the date of application for licensure.

(f) An applicant shall submit evidence of good moral character. Such evidence shall be three recent (within the preceding 12 months) original letters, two of which must be from licensed podiatrists, medical doctors or osteopathic physicians, attesting to the applicant’s personal character and professional ethics on the signator’s letterhead.

(h) An applicant shall submit verification of enrollment in an approved minimum one (1) year residency program on a form provided by the Board that must be completed and returned to the Board’s administrative office.

(i) Official verification that the residency program is approved by the Council on Podiatric Medical Education of the APMA, submitted by the APMA directly to the Board’s administrative office on a form provided by the Board; or, official verification that the preceptorship program is approved by an accredited College of Podiatric Medicine, sent directly by the school to the Board’s administrative office on a form provided by the Board.

(j) An applicant shall request that his/her scores from Parts I and II of the National Board of Podiatric Medical Examiners (NBPME) examinations be sent directly to the Board’s administrative office from the testing agency.

(k) An applicant shall disclose the circumstances surrounding any of the following:

Conviction of any criminal law violation of any country, state or municipality, except minor traffic violations.
The denial of licensure application by any other state or the discipline of licensure in any state.
Loss or restriction of licensure.
Any civil suit judgment or civil suit settlement in which the applicant was a party defendant including, without limitation, actions involving malpractice, breach of contract, antitrust activity or any other civil action remedy recognized under the country’s or state’s statutory common, or case law.

(m) If an applicant holds or has ever held a license to practice as a podiatrist in any other state, the applicant shall cause to be submitted the equivalent of a Tennessee Certificate of Endorsement (verification of license) from each such licensing board which indicates that the applicant holds or held an active license and whether it is in good standing presently or was at the time it became inactive.

(n) When necessary, all required documents shall be translated into English, and such translation and original document shall be certified as to authenticity by the issuing source. Both versions must be submitted.

(o) Personal resumes are not acceptable and will not be reviewed.

(p) Application review and licensure decisions shall be governed by rule 1155-02-.07.

(5) If an academic license holder terminates or is discharged from a residency program, the academic license shall become null and void.

(6) An academic license holder who enters a different residency program shall reapply for a new academic license by submitting a new application, fee and all supporting documents.

(7) The disciplinary provisions for Podiatry license shall also apply to the holder of an academic license.

(8) An academic license holder may be approved for a permanent license when he/she successfully completes the post-graduate educational program and the examination requirements of paragraphs (2) and (3) of rule 1155-02-.08.

History

Authority: §§ 4-5-202, 4-5-204, 63-3-106, 63-3-109, 63-3-110, 63-3-111, 63-11-113, and 63-3-114.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999. Amendment filed May 5, 2006; effective July 19, 2006. Amendments filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1200-10-01-.10 .

(f) Licensees whose licenses have expired as a result of the licensee’s failure to renew pursuant to rule 1200-10-01-.10 may be reinstated upon meeting the conditions as provided in rule 1155-02-.09(2).

(2) Reinstatement of an Expired License (a) Reinstatement of a license that has expired as a result of failure to timely renew in accordance with rule 1200-10-01-.10 may be accomplished upon meeting the following conditions:

Payment of all past due renewal fees; and 2. Payment of the late renewal fee provided in rule 1155-02-.06.
Compliance with continuing education requirements pursuant to Rule 1155-02- .12.

(b) An individual who has a podiatry license that has been expired for at least twelve (12) months shall submit to a criminal background check and cause the results to be submitted to the Board office before the license can be reinstated.

(c) Renewal issuance decisions pursuant to this rule may be made administratively, upon review by the board or the board’s designee.

(d) Anyone submitting a signed renewal form or letter which is found to be untrue may be subjected to disciplinary action as provided in rule 1155-02-.15.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-107, 63-3-106, 63-3-109, 63-3-115, 63-3-116, 63-3-115, 63- 3-116, and 63-3-119.
Administrative History: Original rule filed August 21, 1990; effective October 5, 1990. (Formerly 1155-02-.08) Amendment filed October 3, 1990; effective November 17, 1990.Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed July 22, 2002; effective October 5, 2002. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-02-.15 DISCIPLINARY ACTIONS, CIVIL PENALTIES, ASSESSMENT OF COSTS, AND SUB-

POENAS.

(1) Upon a finding by the Board that a podiatrist has violated any provision of the Tennessee Code Annotated §§ 63-3-101, et seq., or the rules promulgated thereto, the Board may impose any of the following actions separately or in any combination deemed appropriate to the offense.

(a) Advisory Censure - This is a written action issued to the podiatrist for minor or near infractions. It is informal and advisory in nature and does not constitute a formal disciplinary action.

(b) Formal censure or reprimand - This is a written action issued to a podiatrist for one time and less severe violation(s). It is a formal disciplinary action.

(c) Probation - This is a formal disciplinary action which places a podiatrist on close scrutiny for a fixed period of time. This action may be combined with conditions which must be met before probation will be lifted and/or which restrict the individual’s activities during the probationary period.

(d) Licensure Suspension - This is a formal disciplinary action which suspends an individual’s right to practice for a fixed period of time. It contemplates the reentry of the individual into the practice under the licensure previously issued.

(e) Revocation for Cause. This is the most severe form of disciplinary action which removes an individual from the practice of the profession and terminates the license previously issued. The Board, in its discretion, may allow reinstatement of a revoked license upon conditions and after a period of time it deems appropriate. No petition for reinstatement and no new application for licensure from a person whose license was revoked shall be considered prior to the expiration of at least one year unless otherwise stated in the Board’s revocation order.

(f) Conditions - These include any action deemed appropriate by the board to be required of an individual disciplined during any period of probation or suspension or as a prerequisite to the lifting of probation or suspension or the reinstatement of a revoked certificate or license.

(g) Civil penalty - A monetary disciplinary action assessed by the Board pursuant to paragraph (5) of this rule.

(2) Once ordered, probation, suspension, revocation, assessment of a civil penalty, or any other condition of any type of disciplinary action may not be lifted unless and until the licensee petitions, pursuant to paragraph (3) of this rule, and appears before the Board after the period of initial probation, suspension, revocation, or other conditioning has run and all conditions placed on the probation, suspension, revocation, have been met, and after any civil penalties assessed have been paid.

(3) Order of Compliance - This procedure is a necessary adjunct to previously issued disciplinary orders and is available only when a petitioner has completely complied with the provisions of a previously issued disciplinary order, including an unlicensed practice civil penalty order, and wishes or is required to obtain an order reflecting that compliance.

(a) The Board will entertain petitions for an Order of Compliance as a supplement to a previously issued order upon strict compliance with the procedures set forth in subparagraph (b) in only the following three (3) circumstances:

When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued reflecting that compliance; or 2. When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued lifting a previously ordered suspension or probation; or 3. When the petitioner can prove compliance with all the terms of the previously issued order and is seeking to have an order issued reinstating a license previously revoked.

(b) Procedures 1. The petitioner shall submit a Petition for Order of Compliance, as contained in subparagraph (c), to the Board’s Administrative Office that shall contain all of the following:

(i) A copy of the previously issued order; and (ii) A statement of which provision of subparagraph (a) the petitioner is relying upon as a basis for the requested order; and (iii) A copy of all documents that prove compliance with all the terms or conditions of the previously issued order. If proof of compliance requires testimony of an individual(s), including that of the petitioner, the petitioner must submit signed statements from every individual the petitioner intends to rely upon attesting, under oath, to the compliance. The Board’s consultant and administrative staff, in their discretion, may require such signed statements to be notarized. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, the petition.

The Board authorizes its consultant and administrative staff to make an initial determination on the petition and take one of the following actions:

(i) Certify compliance and have the matter scheduled for presentation to the Board as an uncontested matter; or (ii) Deny the petition, after consultation with legal staff, if compliance with all of the provisions of the previous order is not proven and notify the petitioner of what provisions remain to be fulfilled and/or what proof of compliance was either not sufficient or not submitted.

If the petition is presented to the Board the petitioner may not submit any additional documentation or testimony other than that contained in the petition as originally submitted.
If the Board finds that the petitioner has complied with all the terms of the previous order an Order of Compliance shall be issued.
If the petition is denied either initially by staff or after presentation to the Board and the petitioner believes compliance with the order has been sufficiently proven the petitioner may, as authorized by law, file a petition for a declaratory order pursuant to the provisions of T.C.A. § 4-5-223 and rule 1200-10-01-.11.

Petitioner’s Mailing Address:

Petitioner’s E-Mail Address:

Telephone Number:

Attorney for Petitioner:

Attorney’s Mailing Address:

Attorney’s E-Mail Address:

Telephone Number:

The petitioner respectfully represents, as substantiated by the attached documentation, that all provisions of the attached disciplinary order have been complied with and I am respectfully requesting: (circle one)

An order issued reflecting that compliance; or 2. An order issued reflecting that compliance and lifting a previously ordered suspension or probation; or 3. An order issued reflecting that compliance and reinstating a license previously revoked.

Note – You must enclose all documents necessary to prove your request including a copy of the original order. If any of the proof you are relying upon to show compliance is the testimony of any individual, including yourself, you must enclose signed statements from every individual you intend to rely upon attesting, under oath, to the compliance. The Board’s consultant and administrative staff, in their discretion, may require such signed statements to be notarized. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, this petition.

Respectfully submitted this the day of , 20 .

Petitioner’s Signature (4) Order Modifications - This procedure is not intended to allow anyone under a previously issued disciplinary order, including an unlicensed practice civil penalty order, to modify any findings of fact, conclusions of law, or the reasons for the decision contained in the order. It is also not intended to allow a petition for a lesser disciplinary action, or civil penalty other than the one(s) previously ordered. All such provisions of Board orders were subject to reconsideration and appeal under the provisions of the Uniform Administrative Procedures Act (T.C.A. §§ 4-5-301, et seq.). This procedure is not available as a substitute for reconsideration and/or appeal and is only available after all reconsideration and appeal rights have been either exhausted or not timely pursued. It is also not available for those who have accepted and been issued a reprimand.

(a) The Board will entertain petitions for modification of the disciplinary portion of previously issued orders upon strict compliance with the procedures set forth in subparagraph (b) only when the petitioner can prove that compliance with any one or more of the conditions or terms of the discipline previously ordered is impossible. For purposes of this rule the term “impossible” does not mean that compliance is inconvenient or impractical for personal, financial, scheduling or other reasons.

(b) Procedures 1. The petitioner shall submit a written and signed Petition for Order Modification on the form contained in subparagraph (c) to the Board’s Administrative Office that shall contain all of the following:

(i) A copy of the previously issued order; and (ii) A statement of why the petitioner believes it is impossible to comply with the order as issued; and (iii) A copy of all documents that proves that compliance is impossible. If proof of impossibility of compliance requires testimony of an individual(s), including that of the petitioner, the petitioner must submit signed and notarized statements from every individual the petitioner intends to rely upon attesting, under oath, to the reasons why compliance is impossible.

No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, the petition.

The Board authorizes its consultant and administrative staff to make an initial determination on the petition and take one of the following actions:

(i) Certify impossibility of compliance and forward the petition to the Office of General Counsel for presentation to the Board as an uncontested matter; or (ii) Deny the petition, after consultation with legal staff, if impossibility of compliance with the provisions of the previous order is not proven and notify the petitioner of what proof of impossibility of compliance was either not sufficient or not submitted.

If the petition is presented to the Board the petitioner may not submit any additional documentation or testimony other than that contained in the petition as originally submitted.
If the petition is granted a new order shall be issued reflecting the modifications authorized by the Board that it deemed appropriate and necessary in relation to the violations found in the previous order.
If the petition is denied either initially by staff or after presentation to the Board and the petitioner believes impossibility of compliance with the order has been sufficiently proven the petitioner may, as authorized by law, file a petition for a declaratory order pursuant to the provisions of T.C.A. § 4-5-223 and rule 1200- 10-01-.11.

Petitioner’s Mailing Address:

Petitioner’s E-Mail Address:

Telephone Number:

Attorney for Petitioner:

Attorney’s Mailing Address:

Attorney’s E-Mail Address:

Telephone Number:

The petitioner respectfully represents that for the following reasons, as substantiated by the attached documentation, the identified provisions of the attached disciplinary order are impossible for me to comply with:

Note – You must enclose all documents necessary to prove your request including a copy of the original order. If any of the proof you are relying upon to show impossibility is the testimony of any individual, including yourself, you must enclose signed and notarized statements from every individual you intend to rely upon attesting, under oath, to the reasons why compliance is impossible. No documentation or testimony other than that submitted will be considered in making an initial determination on, or a final order in response to, this petition.

Respectfully submitted this the day of , 20 .

Petitioner’s Signature (5) Civil Penalties (a) Purpose - The purpose of this rule is to set out a schedule designating the minimum and maximum civil penalties which may be assessed pursuant to T.C.A. § 63-1-134.

(b) Schedule of Civil Penalties 1. A Type A civil penalty may be imposed whenever the Board finds the person who is required to be licensed or certified by the Board guilty of a willful and knowing violation of the Podiatry Examiners Practice Act or regulations promulgated pursuant thereto, to such an extent that there is, or is likely to be, an imminent substantial threat to the health, safety and welfare of an individual patient or the public. For purposes of this section, a Type A penalty shall include, but not be limited to, a person who willfully and knowingly is or was practicing as a podiatrist without a license from the Board.

A Type B civil penalty may be imposed whenever the Board finds the person required to be licensed by the Board guilty of a violation of the Podiatry Examiners Practice Act or regulations promulgated pursuant thereto in such manner as to impact directly on the care of patients or the public.
A Type C civil penalty may be imposed whenever the Board finds the person required to be licensed, permitted, or authorized by the board guilty of a violation of the Podiatry Examiners Practice Act or regulations promulgated pursuant thereto, which are neither directly detrimental to the patients or public, nor directly impact their care, but have only an indirect relationship to client care or the public.

(c) Amount of Civil Penalties 1. Type A civil penalties shall be assessed in the amount of not less than $500 and not more than $1,000.

Type B civil penalties may be assessed in the amount of not less than $100 and not more than $500.
Type C civil penalties may be assessed in the amount of not less than $50 and not more than $100.

(d) Procedures for Assessing Civil Penalties 1. The Division of Health Related Boards may initiate a civil penalty assessment by filing a Memorandum of Assessment of Civil Penalty. The Division shall state in the memorandum the facts and law upon which it relies in alleging a violation, the proposed amount of the civil penalty and the basis for such penalty. The Division may incorporate the Memorandum of Assessment of Civil Penalty with a Notice of Charges which may be issued attendant thereto.

Civil Penalties may also be initiated and assessed by the Board during consideration of any Notice of Charges. In addition, the Board may, upon good cause shown, assess type and amount of civil penalty which was not recommended by the Division.
In assessing the civil penalties pursuant to these rules the Board may consider the following factors:

(i) Whether the amount imposed will be a substantial economic deterrent to the violator;

(ii) The circumstances leading to the violation;

(iii) The severity of the violation and the risk of harm to the public;

(iv) The economic benefits gained by the violator as a result of noncompliance; and (v) The interest of the public.

All proceedings for the assessment of civil penalties shall be governed by the contested case provisions of T.C.A. Title 4, Chapter 5.

(6) Assessment of costs in disciplinary proceedings shall be as set forth in T.C.A. §§ 63-1-144 and 63-3-126.

(7) Subpoenas (a) Purpose - Although this rule applies to persons and entities other than podiatrists, it is the Board’s intent as to podiatrists that they be free to comprehensively treat and document treatment of their patients without fear that the treatment or its documentation will be unduly subjected to scrutiny outside the profession.

Consequently, balancing that intent against the interest of the public and patients to be protected against substandard care and activities requires that persons seeking to subpoena such information and/or materials must comply with the substance and procedures of these rules.

It is the intent of the Board that the subpoena power outlined herein shall be strictly proscribed. Such power shall not be used by the division or board investigators to seek other incriminating evidence against podiatrists when the division or board does not have a complaint or basis to pursue such an investigation. Thus, unless the division or its investigators have previously considered, discovered, or otherwise received a complaint from either the public or a governmental entity, then no subpoena as contemplated herein shall issue.

(b) Definitions - As used in this chapter of rules the following words shall have the meanings ascribed to them:

Probable Cause (i) For Investigative Subpoenas - shall mean that probable cause, as defined by case law at the time of request for subpoena issuance is made, exists that a violation of the Podiatry Practice Act or rules promulgated pursuant thereto has occurred or is occurring and that it is more probable than not that the person(s), or items to be subpoenaed possess or contain evidence which is more probable than not relevant to the conduct constituting the violation.

(ii) The utilization of the probable cause evidentiary burden in proceedings pursuant to this rule shall not in any way, nor should it be construed in any way to establish a more restrictive burden of proof than the existing preponderance of the evidence in any civil disciplinary action which may involve the person(s) or items that are the subject of the subpoena.

Presiding Officer - For investigative subpoenas shall mean any elected officer of the board, or any duly appointed or elected chairperson of any panel of the board.

(c) Procedures 1. Investigative Subpoenas (i) Investigative Subpoenas are available only for issuance to the authorized representatives of the Tennessee Department of Health, its investigators and its legal staff.

(ii) An applicant for such a subpoena must either orally or in writing notify the Board’s Unit Director of the intention to seek issuance of a subpoena. That notification must include the following:

(I) The time frame in which issuance is required so the matter can be timely scheduled; and (II) A particular description of the material or documents sought, which must relate directly to an ongoing investigation or contested case, and shall, in the instance of documentary materials, be limited to the records of the patient or patients whose complaint, complaints, or records are being considered by the division or board.

I. In no event shall such subpoena be broadly drafted to provide investigative access to podiatry records of other patients who are not referenced in a complaint received from an individual or governmental entity, or who have not otherwise sought relief, review, or board consideration of a podiatrist’s conduct, act, or omission.

II. If the subpoena relates to the prescribing practices of a licensee, then it shall be directed solely to the records of the patient(s) who received the pharmaceutical agents and whom the board of pharmacy or issuing pharmacy(ies) has so identified as recipients; and (III) Whether the proceedings for the issuance are to be conducted by physical appearance or electronic means; and (IV) The name and address of the person for whom the subpoena is being sought or who has possession of the items being subpoenaed.

(iii) The Board’s Unit Director shall cause to have the following done:

(I) In as timely a manner as possible arrange for either an elected officer of the board, or any duly appointed or elected chairperson of any panel of the board, to preside and determine if issuing the subpoena should be recommended to the full Board; and (II) Establish a date, time and place for the proceedings to be conducted and notify the presiding officer, the applicant and the court reporter; and (III) Maintain a complete record of the proceedings including an audio tape in such a manner as to:

I. Preserve a verbatim record of the proceeding; and II. Prevent the person presiding over the proceedings and/or signing the subpoena from being allowed to participate in any manner in any disciplinary action of any kind, formal or informal, which may result which involves either the person or the documents or records for which the subpoena was issued.

(iv) The Proceedings (I) The applicant shall do the following:

I. Provide for the attendance of all persons whose testimony is to be relied upon to establish probable cause; and II. Produce and make part of the record copies of all documents to be utilized to establish probable cause; and III. Obtain, complete and provide to the presiding officer a subpoena which specifies the following:

A. The name and address of the person for whom the subpoena is being sought or who has possession of the, items being subpoenaed; and B. The location of the materials, documents or reports for which production pursuant to the subpoena is sought if that location is known; and C. A brief, particular description of any materials, documents or items to be produced pursuant to the subpoena; and D. The date, time and place for compliance with the subpoena.

IV. Provide the presiding officer testimony and/or documentary evidence which in good faith the applicant believes is sufficient to establish that probable cause exists for issuance of the subpoena as well as sufficient proof that all other reasonably available alternative means of securing the materials, documents or items have been unsuccessful.

(II) The Presiding Officer shall do the following:

I. Have been selected only after assuring the Board’s Unit Director that he or she has no prior knowledge of or any direct or indirect interest in or relationship with the person(s) being subpoenaed and/or the licensee who is the subject of the investigation; and II. Commence the proceedings and swear all necessary witnesses; and III. Hear and maintain the confidentiality, if any, of the evidence presented at the proceedings and present to the full board only that evidence necessary for an informed decision; and IV. Control the manner and extent of inquiry during the proceedings and be allowed to question any witness who testifies; and V. Determine based solely on the evidence presented in the proceedings whether probable cause exists and if so, make such recommendation to the full board; and VI. Not participate in any way in any other proceeding whether formal or informal which involves the matters, items or person(s) which are the subject of the subpoena. This does not preclude the presiding officer from presiding at further proceedings for consideration of issuance of subpoenas in the matter.

(III) The Board shall do the following:

I. By a vote of two thirds (2/3) of the board members issue the subpoena for the person(s) or items specifically found to be relevant to the inquiry, or quash or modify an existing subpoena by a majority vote; and II. Sign the subpoena as ordered to be issued, quashed or modified.

Post-Notice of Charges Subpoenas - If the subpoena is sought for a contested case being heard with an Administrative Law Judge from the Secretary of State’s office presiding, this definition shall not apply and all such post-notice of charges subpoenas should be obtained from the office of the Administrative Procedures Division of the Office of the Secretary of State pursuant to the Uniform Administrative Procedures Act and rules promulgated pursuant thereto.

(d) Subpoena Forms 1. All subpoena shall be issued on forms approved by the Board.

The subpoena forms may be obtained by contacting the Board’s Administrative Office.

(e) Subpoena Service - The service of a subpoena issued by the Board shall be made by the sheriff of the county of residence of the licensee or person upon whom the subpoena is served.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 4-5-217, 4-5-223, 4-5-311, 63-1-107, 63-1-122, 63-1-144, 63-3- 106, 63-3-115, 63-3-116, 63-3-119, 63-3-120, 63-3-123, and 63-3-126.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999. Amendment filed July 26, 2000; effective October 9, 2000. Amendment filed July 22, 2002; effective October 5, 2002. Amendment filed September 15, 2004; effective November 29, 2004. Amendment filed March 17, 2005; effective May 31, 2005.

Tenn. Comp. R. & Regs. 1155-02-.16 LICENSE

(1) Display of License -Every person licensed by the Board in this state shall display his license in a conspicuous place in his office and, whenever required, exhibit such license to the Board or its authorized representatives.

(2) Replacement License - A license holder whose “artistically designed” license has been lost or destroyed may be issued a replacement document upon receipt of a written request in the Board administrative office. Such request shall be accompanied by an affidavit (signed and notarized) stating the facts concerning the loss or destruction of the original document, a recent passport type photograph and the required fee pursuant to rule 1155-02-.06.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-106, 63-3-109, and 63-1-113.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999.

Tenn. Comp. R. & Regs. 1155-02-.17 CHANGE OF ADDRESS AND/OR NAME

(1) Change of Name - An individual registered with the Board shall notify the Board in writing within thirty (30) days of a name change and will provide both the old and new names. A request for name change must also include a copy of the official document involved and reference the individual’s profession, board, and license number.

(2) Change of Address - Each person holding a license who has had a change of address or place of employment, shall file in writing with the Board his current address, giving both old and new addresses. Such requests shall be received in the Board’s administrative office no later than 30 days after such change is effective and must reference the individual’s name, profession, and license number.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-108, and 63-3-109.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999.

Tenn. Comp. R. & Regs. 1155-02-.18 MEDICAL RECORDS

(1) Purpose (a) To recognize that medical records are an integral part of the practice of podiatrists as defined in T.C.A. § 63-3-101.

(b) To give podiatrists, their professional and non-professional staff, and the public direction about the content, transfer, retention, and destruction of those records.

(2) Applicability. This rule regarding medical records shall apply only to those records, the information for which was obtained by podiatrists or their supervisees, for purposes of services provided in any clinical setting other than a hospital as defined by T.C.A. § 68-11- 302(4), a hospital emergency room, or hospital outpatient facility.

(3) Medical Records (a) Duty to Create and Maintain Medical Records - As a component of the standard of care and of minimal competency, a podiatrist must cause to be created and cause to be maintained a medical record for every encounter between a patient and either the podiatrist or licensed member of the podiatrist’s staff. All imaging studies and interpretations of such studies are considered to be part of the patient’s medical records. For purposes of this Rule, a patient is defined as a person for whom the podiatrist has undertaken to diagnose or treat or for whom the podiatrist has participated in such diagnosis or treatment.

(b) Notice - Any notice required by these rules to be provided to a patient shall be issued within thirty (30) days of the date of the event that triggers the notice requirement, and shall be accomplished by mailing to the last known address of the patient.

(c) Content - In order to meet the minimum level of competency required of podiatrists, the medical records required by this rule shall:

Be recorded in such a manner as to be legible to an ordinary reasonable person, including those persons who are not licensed healthcare professionals;
Include all information and documentation listed in T.C.A. § 63-2-101(c)(4);
Contain such additional information that is necessary to insure that a subsequent reviewing or treating physician can both ascertain the basis for the diagnosis, treatment plan, and outcomes, and provide continuity of care for the patient.

(d) Transfer 1. Inapplicability of Notice Requirements - None of the notice requirements of this subparagraph (d) are required for patients who have had fewer than three (3) office encounters with the podiatrist or his licensed supervisees over the eighteen (18) month period that immediately precedes the event that would otherwise trigger the notice.

Records of Podiatrists upon Death or Retirement - When a podiatrist retires or dies while in practice, patients seen by the podiatrist in his office during the immediately preceding eighteen (18) months shall be notified by the podiatrist, or his authorized representative, urged to find a new podiatrist, and informed that upon authorization copies of the patient’s medical records will be sent to the new podiatrist or other physician.
Records of Podiatrists upon Departure from a Group - The responsibility for notifying patients of a podiatrist who leaves a group practice for any reason other than death shall be governed by the podiatrist’s employment contract. If the employment contract does not address the notification issue, the group shall be responsible for notifying the podiatrist’s patients that the podiatrist has departed from the group.

(i) Whoever is responsible for the notification must notify patients seen by the podiatrist in his office during the eighteen (18) months immediately preceding his departure.

(ii) Those patients shall also be notified of the podiatrist’s new address and offered the opportunity to have copies of their medical records forwarded to the departing podiatrist at his new practice. A group shall not withhold the medical records of any patient who has authorized their transfer to the departing podiatrist or any other podiatrist or other physician.

(iii) The choice of podiatrist in every case should be left to the patient, and the patient should be informed that upon authorization his records will be sent to the podiatrist or other physician of the patient’s choice.

Sale of a Podiatry Practice - A podiatrist or the estate of a deceased podiatrist may sell the elements that comprise his practice, which include the goodwill of the practice and the opportunity to take over the patients of the seller by purchasing the medical records. Therefore, the transfer of medical records of patients upon the sale of a podiatry practice is subject to the following:

(i) The podiatrist (or the estate) must ensure that all medical records are transferred to another podiatrist, other physician, or entity that is held to the same standards of confidentiality as provided in these rules.

(ii) Patients seen by the podiatrist in his office during the immediately preceding eighteen (18) months shall be notified that the podiatrist (or the estate) is transferring the practice to another podiatrist, other physician, or entity who will retain custody of their medical records and that at their written request copies of their records will be sent to another podiatrist, other physician, or entity of their choice.

Failure to Adequately Provide for Transfer of Records or Notice to Patients. It shall be a prima facie violation of T.C.A. § 63-3-119(a)(4) and (10) for a podiatrist to depart from his group, retire, or sell his practice without making provision for the security or transfer of patient medical records, or otherwise establish a secure method of patient access to his medical records.

(e) Retention of Medical Records - Medical records shall be retained for a period of not less than seven (7) years from the podiatrist’s or his supervisees’ last professional contact with the patient except for the following:

Medical records for incompetent patients, other than those who are incompetent solely because they are minors, shall be retained until at least one (1) year after the patient’s death.
Medical records of minors shall be retained for a period of not less than one (1) year after the minor reaches the age of majority or ten (10) years from the date of the podiatrist’s or his supervisees’ last professional contact with the patient, whichever is longer.
Notwithstanding the foregoing, no medical record involving services which are currently under dispute shall be destroyed until the dispute is resolved.

(f) Destruction of Medical Records 1. No medical record shall be singled out for destruction other than in accordance with established office operating procedures.

Medical records shall be destroyed only in the ordinary course of business according to established office operating procedures that are consistent with these rules.
Physical copies of medical records may be destroyed by burning, shredding, or other method that safeguards patient protected health information from any use or disclosure that is in violation of any state or federal laws or regulations.
Any recordable and erasable media device upon which electronic medical records have been stored must be rendered inaccessible, cleaned, or scrubbed by overwriting the data, degaussing the media (using magnetic field to neutralize the data stored on magnetic media), or other method that safeguards patient protected health information. Simply discarding a data storage device without rendering the data stored upon it inaccessible, cleaned, or scrubbed does not constitute compliance with this rule.
When medical records are destroyed, the time, date and circumstances of the destruction shall be recorded and maintained for future reference. The record of destruction need not list the individual patient medical records that were destroyed but shall be sufficient to identify which group of destroyed records contained a particular patient’s medical records.

(4) In addition to the requirements of this rule, podiatrists must also comply with the Health Insurance Portability and Accountability Act (HIPAA) and the regulations promulgated thereto. Failure to comply with HIPAA shall constitute violation of this rule.

(5) Mandatory Release of Patient Records (a) Upon request from a patient or the patient’s authorized representative, an individual registered with this Board shall provide a complete copy of the patient’s records or a summary of such records which were maintained by the provider.

(b) It shall be the provider’s option as to whether copies of the records or a summary will be given to the patient.

(6) Violations - Violation of any provision of these rules is grounds for disciplinary action pursuant to T.C.A. §§ 63-3-119(a)(4), 63-3-119(a)(8), and 63-3-119(a)(10).

(7) This rule shall be applied prospectively. A podiatrist shall not be found to be in violation of this rule if the violation occurred before the effective date of this rule.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-2-101, and 63-2-102.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999. Amendments filed May 7, 2019; effective August 5, 2019.

Tenn. Comp. R. & Regs. 1155-02-.19 BOARD MEETINGS, OFFICERS, CONSULTANTS, RECORDS, DECLARATORY

ORDERS, ADVISORY RULINGS AND SCREENING PANELS.

(1) Board Meetings (a) The time, place, and frequency of Board meetings shall be at the discretion of the Board, except at least one meeting shall be held annually.

(b) Special meetings are called at the discretion of the Board chairman or at the written request from two (2) members of the Board.

(d) All meetings of the Board shall be open to the public.

(2) The Board shall elect from its members the following officers:

(a) Chairman - who shall preside at all Board meetings, appoint committees and correspond with other board members when appropriate.

(b) Secretary - who along with the Board administrator shall be responsible for correspondence from the Board and the execution of all official documents which require the seal of the Board to be affixed.

(3) The Board has the authority to select a Board consultant who shall serve as a consultant to the Division and who is vested with the authority to do the following acts:

(a) Recommend whether and what type disciplinary actions should be instituted as the result of complaints received or investigations conducted by the Division.

(b) Undertake any other matter authorized by a majority vote of the Board.

(4) Records and Complaints (a) All requests, applications, notices, other communications and correspondence shall be directed to the board’s administrative office. Any requests or inquiries requiring a board decision or official Board action, except documents relating to disciplinary actions or hearing requests, must be received fourteen (14) days prior to a scheduled Board meeting and will be retained in the Board’s administrative office and presented to the Board at the Board meeting.

(b) All records of the Board, except those made confidential by law, are open for inspection and examination, under the supervision of an employee of the Division at the Board’s administrative office during normal business hours.

(d) Complaints made against a licensee become public information only upon the filing of a notice of charges by the Department of Health.

(e) All complaints should be directed to the Tennessee Department of Health, Office of Investigations, 665 Mainstream Drive, 2nd Floor, Suite 201, Nashville, TN 37243.

(5) Declaratory Orders - The Board adopts, as if fully set out herein, rule 1200-10-01-.11, of the Division of Health Related Boards and as it may from time to time be amended, as its rule governing the declaratory order process. All declaratory order petitions involving statutes, rules or orders within the jurisdiction of the Board shall be addressed by the Board pursuant to that rule and not by the Division. Declaratory Order Petition forms can be obtained from the Board’s administrative office.

(6) Advisory Rulings - Any person who is affected by any matter within the jurisdiction of the Board and who holds a license or certificate issued pursuant to Chapter 3 of Title 63 of the Tennessee Code Annotated, may submit a written request for an advisory ruling subject to the limitations imposed by T.C.A. § 63-3-202(b)(2). The procedures for obtaining and issuance of advisory rulings are as follows:

(a) The licensee or certificate holder shall submit the request to the Board Administrative Office on the form contained in paragraph (6)(e) providing all the necessary information; and (b) The request, upon receipt, shall be referred to the Board’s administrative staff for research, review and submission of a proposed ruling to the Board for its consideration at the next meeting after the draft ruling has been approved by the Board’s consultant and advisory attorney; and (c) The Board shall review the proposed ruling and either make whatever revisions or substitutions it deems necessary for issuance or refer it back to the administrative staff for further research and drafting recommended by the Board; and (d) Upon adoption by the Board the ruling shall be transmitted to the requesting licensee or certificate holder. The ruling shall have only such effect as is set forth in T.C.A. § 63-3- 202(b)(2).

(e) Any request for an advisory ruling shall be made on the following form, a copy of which may be obtained from the Board’s Administrative Office:

Board of Podiatric Medical Examiners Request for Advisory Ruling Date: ___________________________________ Licensee or Certificate Holder Name: ___________________________________ Licensee or Certificate Holder Mailing Address: ___________________________________ ___________________________________ ___________________________________ ___________________________________ Licensee or Certificate Holder E-Mail Address: ___________________________________ License or Certificate Holder Number: ___________________________________ 1. The specific question or issue for which the ruling is requested: ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ 2. The facts that gave rise to the specific question or issue: ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ 3. The specific statutes and/or rules which are applicable to the question or issue: ______________________________________________________ ______________________________________________________ ______________________________________________________ ______________________________________________________ Licensee or Certificate Holder Signature ____________________________________ Mail or Deliver to: Administrator Board of Podiatric Medical Examiners 665 Mainstream Drive Nashville, Tennessee 37243 (7) Screening Panels - The Board adopts, as if fully set out herein, rule 1200-10-01-.13, of the Division of Health Related Boards and as it may from time to time be amended, as its rule governing the screening panel process.

(8) Stays and Reconsiderations - The Board authorizes the member who chaired the Board for a contested case to be the agency member to make the decisions authorized pursuant to rule

Tenn. Comp. R. & Regs. 1360-04-01-.18 regarding petitions for reconsiderations and stays in that case.

History

Authority: T.C.A. §§ 4-5-107, 4-5-202, 4-5-204, 4-5-223, 4-5-224, 63-1-117, 63-1-123, 63-1-124, 63-1- 138, 63-3-103, 63-3-104, 63-3-106, 63-3-119, 63-3-202, and 63-3-212.
Administrative History: Original rule filed November 10, 1998; effective January 14, 1999. Amendment filed October 28, 1999; effective January 11, 2000. Amendment filed March 23, 2007; effective June 6, 2007. Amendment filed August 9, 2007; effective October 23, 2007.

Tenn. Comp. R. & Regs. 1155-02-.20 CONSUMER RIGHT-TO-KNOW REQUIREMENTS

(1) Malpractice Reporting Requirements - The threshold amount below which medical malpractice judgments, awards or settlements in which payments are awarded to complaining parties need not be reported pursuant to the “Health Care Consumer Right-To- Know Act of 1998” shall be ten thousand dollars ($10,000).

(2) Criminal Conviction Reporting Requirements - For purposes of the “Health Care Consumer Right-To-Know Act of 1998,” the following criminal convictions must be reported:

(a) Conviction of any felony; and (b) Conviction or adjudication of guilt of any misdemeanor, regardless of its classification, in which any element of the misdemeanor involves any one or more of the following:

Sex.
Alcohol or drugs.
Physical injury or threat of injury to any person.
Abuse or neglect of any minor, spouse or the elderly.
Fraud or theft.

(c) If any misdemeanor conviction reported under this rule is ordered expunged, a copy of the order of expungement signed by the judge must be submitted to the Department before the conviction will be expunged from any profile.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-51-101, et seq., and Public Chapter 373 of the Public Acts of 1999.
Administrative History: Original rule filed October 28, 1999; effective January 11, 2000.

Tenn. Comp. R. & Regs. 1155-02-.21 PODIATRIC PROFESSIONAL CORPORATIONS AND PODIATRIC PROFESSION-AL

LIMITED LIABILITY COMPANIES.

(1) Podiatric Professional Corporations (PPC) – Except as provided in this rule Podiatric Professional Corporations shall be governed by the provisions of Tennessee Code Annotated, Title 48, Chapter 101, Part 6.

(a) Filings – A PPC need not file its Charter or its Annual Statement of Qualifications with the Board.

(b) Ownership of Stock – With the exception of the health care professional combinations specifically enumerated in Tennessee Code Annotated, § 48-101-610 only the following may form and own shares of stock in a foreign or domestic PPC doing business in Tennessee:

Podiatrists, orthotists, prosthetists, and pedorthists licensed pursuant to Tennessee Code Annotated Title 63, Chapter 3 or licensed in another state; and/or 2. A foreign or domestic general partnership, PPC or PPLLC in which all partners, shareholders, members or holders of financial rights are either:

(i) Podiatrists, orthotists, prosthetists, and pedorthists licensed pursuant to Tennessee Code Annotated Title 63, Chapter 3 in Tennessee or podiatrists, orthotists, prosthetists, and pedorthists licensed by other states, or composed of entities which are directly or indirectly owned by such licensed podiatrists; and/or (ii) Professionals authorized by Tennessee Code Annotated, §§ 48-101-610, 48-248-401, or 48-249-1109 to either own shares of stock in a PPC or be a member or holder of financial rights in a PPLLC; and/or (iii) A combination of professionals authorized by subparts (i) and (ii).

(c) Officers and Directors of Podiatric Professional Corporations - 1. All, except the following officers, must be persons who are eligible to form or own shares of stock in a podiatric professional corporation as limited by T.C.A. § 48- 101-610(d) and subparagraph (1)(b) of this rule:

(i) Secretary;

(ii) Assistant Secretary;

(iii) Treasurer; and (iv) Assistant Treasurer.

With respect to members of the Board of Directors, only persons who are eligible to form or own shares of stock in a podiatric professional corporation as limited by T.C.A. § 48-101-610(d) and subparagraph (1)(b) of this rule shall be directors of a PPC.

(d) Practice Limitations 1. Engaging in, or allowing another podiatric incorporator, shareholder, officer, or director, while acting on behalf of the PPC, to engage in, podiatric practice in any area of practice or specialty beyond that which is specifically set forth in the charter may be a violation of the professional ethics enumerated in Rule 1155- 02-.13 and/or Tennessee Code Annotated, § 63-3-119(a)(4).

Nothing in these rules shall be construed as prohibiting any health care professional licensed pursuant to Tennessee Code Annotated, Title 63 from being an employee of or a contractor to a PPC.
Nothing in these rules shall be construed as prohibiting a PPC from electing to incorporate for the purposes of rendering professional services within two (2) or more professions or for any lawful business authorized by the Tennessee Business Corporations Act so long as those purposes do not interfere with the exercise of independent podiatric judgment by the podiatric incorporators, directors, officers, shareholders, employees or contractors of the PPC who are practicing podiatry as defined by Tennessee Code Annotated, § 63-3-101.
Nothing in these rules shall be construed as prohibiting a podiatrist from owning shares of stock in any type of professional corporation other than a PPC so long as such ownership interests do not interfere with the exercise of independent podiatric judgment by the podiatrist while practicing podiatry as defined by Tennessee Code Annotated, § 63-3-101.

(2) Podiatric Professional Limited Liability Companies (PPLLC) – Except as provided in this rule Podiatric Professional Limited Liability Companies shall be governed by either the provisions of Tennessee Code Annotated, Title 48, Chapters 248 or 249.

(a) Filings – Articles filed with the Secretary of State shall be deemed to be filed with the Board and no Annual Statement of Qualifications need be filed with the Board.

(b) Membership – With the exception of the health care professional combinations specifically enumerated in Tennessee Code Annotated, §§ 48-248-401 and 48-249- 1109 only the following may be members or holders of financial rights of a foreign or domestic PPLLC doing business in Tennessee:

Podiatrists, orthotists, prosthetists, and pedorthists licensed pursuant to Tennessee Code Annotated Title 63, Chapter 3 or licensed in other states; and/or 2. A foreign or domestic general partnership, PPC or PPLLC in which all partners, shareholders, members or holders of financial rights are either:

(i) Podiatrists, orthotists, prosthetists, and pedorthists licensed pursuant to Tennessee Code Annotated Title 63, Chapter 3 in Tennessee or podiatrists, orthotists, prosthetists, and pedorthists licensed by other states or composed of entities which are directly or indirectly owned by such licensed podiatrists; and/or (ii) Professionals authorized by Tennessee Code Annotated, §§ 48-101-610, 48-248-401 or 48-248-1109 to either own shares of stock in a PPC or be a member or holder of financial rights in a PPLLC; and/or (iii) A combination of professionals authorized by subparts (i) and (ii).

(c) Managers, Directors or Governors of a PPLLC 1. All, except the following managers, must be persons who are eligible to form or become members or holders of financial rights of a podiatric professional limited liability company as limited by T.C.A. § 48-248-401 and subparagraph (2)(b) of this rule:

(i) Secretary (ii) Treasurer 2. Only persons who are eligible to form or become members or holders of financial rights of a podiatric professional limited liability company as limited by T.C.A. § 48-248-401 and subparagraph (2)(b) of this rule shall be allowed to serve as a director, or serve on the Board of Governors of a PPLLC.

(d) Practice Limitations 1. Engaging in, or allowing another podiatrist member, officer, manager, director, or governor, while acting on behalf of the PPLLC, to engage in, podiatric practice in any area of practice or specialty beyond that which is specifically set forth in the articles of organization may be a violation of the professional ethics enumerated in Rule 1155-02-.13 and/or Tennessee Code Annotated, § 63-3-119(a)(4).

Nothing in these rules shall be construed as prohibiting any health care professional licensed pursuant to Tennessee Code Annotated, Title 63 from being an employee of or a contractor to a PPLLC.
Nothing in these rules shall be construed as prohibiting a PPLLC from electing to form for the purposes of rendering professional services within two (2) or more professions or for any lawful business authorized by the Tennessee Limited Liability Company Act or the Tennessee Revised Limited Liability Company so long as those purposes do not interfere with the exercise of independent podiatric judgment by the podiatrist members or holders of financial rights, governors, officers, managers, employees or contractors of the PPLLC who are practicing podiatry as defined by Tennessee Code Annotated, § 63-3-101.
Nothing in these rules shall be construed as prohibiting a podiatrist from being a member of any type of professional limited liability company other than a PPLLC so long as such membership interests do not interfere with the exercise of independent podiatric judgment by the podiatrist while practicing podiatry as defined by Tennessee Code Annotated, § 63-3-101.
All PPLLCs formed in Tennessee pursuant to Tennessee Code Annotated, §§ 48-248-104 or 48-249-1104, to provide services only in states other than Tennessee shall annually file with the Board a notarized statement that they are not providing services in Tennessee.

(3) Dissolution - The procedure that the Board shall follow to notify the attorney general that a PPC or a PPLLC has violated or is violating any provision of Title 48, Chapters 101, 248 or 249, shall be as follows but shall not terminate or interfere with the secretary of state’s

authority regarding dissolution pursuant to Tennessee Code Annotated, §§ 48-101-624, 48- 248-409, or 48-249-1122.

(a) Service of a written notice of violation by the Board on the registered agent of the PPC and/or PPLLC or the secretary of state if a violation of the provisions of Tennessee Code Annotated, Title 48, Chapters 101, 248 and/or 249 occurs.

(b) The notice of violation shall state with reasonable specificity the nature of the alleged violation(s).

(c) The notice of violation shall state that the PPC and/or PPLLC must, within sixty (60) days after service of the notice of violation, correct each alleged violation or show to the Board’s satisfaction that the alleged violation(s) did not occur.

(d) The notice of violation shall state that, if the Board finds that the PPC and/or PPLLC is in violation, the attorney general will be notified and judicial dissolution proceedings may be instituted pursuant to Tennessee Code Annotated, Title 48.

(e) The notice of violation shall state that proceedings pursuant to this section shall not be conducted in accordance with the contested case provisions of the Uniform Administrative Procedures Act, compiled in Title 4, Chapter 5 but that the PPC and/or PPLLC, through its agent(s), shall appear before the Board at the time, date, and place as set by the Board and show cause why the Board should not notify the attorney general and reporter that the organization is in violation of the Act or these rules. The Board shall enter an order that states with reasonable particularity the facts describing each violation and the statutory or rule reference of each violation. These proceedings shall constitute the conduct of administrative rather than disciplinary business.

(f) If, after the proceeding the Board finds that a PPC and/or PPLLC did violate any provision of Title 48, Chapters 101 and/or 248 or these rules, and failed to correct said violation or demonstrate to the Board’s satisfaction that the violation did not occur, the Board shall certify to the attorney general and reporter that it has met all requirements of either Tennessee Code Annotated, §§ 48-101-624(1)-(3) and/or 48-248-409(1)-(3) and/or 48-249-101, et seq.

(4) Violation of this rule by any podiatrist individually or collectively while acting as a PPC or as a PPLLC may subject the podiatrist(s) to disciplinary action pursuant to Tennessee Code Annotated, § 63-3-119(4).

(5) The authority to own shares of stock or be members or holders of financial rights in a PPC or a PPLLC granted by statute or these rules to professionals not licensed in this state shall in no way be construed as authorizing the practice of any profession in this state by such unlicensed professionals.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 48-101-605, 48-101-608, 48-101-610, 48-101-618, 48-101-624, 48-101-628, 48-101-629, 48-101-630, 48-248-104, 48-248-202, 48-248-401, 48-248-404, 48-248-409, 48-248-501, 48-248-601, 48-248-602, 48-248-603, 48-249-101, et seq., 63-3-106, 63-3-110, and 63-3- 119.
Administrative History: Original rule filed September 15, 2004; effective November 29, 2004. Amendment filed March 23, 2007; effective June 6, 2007.

Tenn. Comp. R. & Regs. 1155-02-.22 ADVERTISING

(1) Policy Statement. The lack of sophistication on the part of many of the public concerning podiatric, orthotic, prosthetic, or pedorthic services, the importance of the interests affected by the choice of a health care provider regulated by the Board and the foreseeable consequences of unrestricted advertising by health care providers regulated by the Board which is recognized to pose special possibilities for deception, require that special care be taken by health care providers regulated by the Board to avoid misleading the public. The health care providers regulated by the Board must be mindful that the benefits of advertising depend upon its reliability and accuracy. Since advertising by health care providers regulated by the Board is calculated and not spontaneous, reasonable regulation designed to foster compliance with appropriate standards serves the public interest without impeding the flow of useful, meaningful, and relevant information to the public.

(2) Definitions (a) Advertisement. Informational communication to the public in any manner designed to attract public attention to the practice of a podiatrist, orthotist, prosthetist or pedorthist who is licensed to practice in Tennessee.

(b) Licensee - Any person holding a license to practice podiatry, orthotics, prosthetics, or pedorthics in the State of Tennessee. Where applicable this shall include partnerships and/or corporations.

(c) Material Fact - Any fact which an ordinary reasonable and prudent person would need to know or rely upon in order to make an informed decision concerning the choice of podiatrists, orthotists, prosthetists or pedorthists to serve his or her particular needs.

(d) Bait and Switch Advertising - An alluring but insincere offer to sell a product or service which the advertiser in truth does not intend or want to sell. Its purpose is to switch consumers from buying the advertised service or merchandise, in order to sell something else, usually for a higher fee or on a basis more advantageous to the advertiser.

(e) Discounted Fee - Shall mean a fee offered or charged by a person for a product or service that is less than the fee the person or organization usually offers or charges for the product or service. Products or services expressly offered free of charge shall not be deemed to be offered at a “discounted fee”.

(3) Advertising Fees and Services (a) Fixed Fees 1. Fixed fees may be advertised for any service.

It is presumed unless otherwise stated in the advertisement that a fixed fee for a service shall include the cost of all professional recognized components within generally accepted standards that are required to complete the service.

(b) Range of Fees. A range of fees may be advertised for services and the advertisement must disclose the factors used in determining the actual fee.

The discount fee is lower than the licensee’s customary or usual fee charged for the service; and 2. The licensee provides the same quality and components of service and material at the discounted fee that are normally provided at the regular, non-discounted fee for that service.

(d) Related Services and Additional Fees. Related services which may be required in conjunction with the advertised services for which additional fees will be charged must be identified as such in any advertisement.

(e) Time Period of Advertised Fees.

Advertised fees shall be honored during the entire time period stated in the advertisement.
If no time period is stated in the advertisement of fees, the advertised fee shall be honored for thirty (30) days from the advertisement’s last date of publication or until the next scheduled publication, whichever is later.

(4) Advertising Content. The following acts or omissions in the context of advertisement by any licensee shall constitute unethical and unprofessional conduct pursuant to Rule 1155-02-.13, and subject the licensee to disciplinary action pursuant to T.C.A. § 63-3-119(a)(16):

(a) Claims that the services performed, personnel employed, materials or office equipment used are professionally superior to that which is ordinarily performed, employed, or used, or that convey the message that one licensee is better than another when superiority of services, personnel, materials or equipment cannot be substantiated.

(b) The misleading use of an unearned or non-health degree in any advertisement.

(c) Failure to include in the advertisement the certifying board of the podiatrist, orthotist, prosthetist or pedorthist if the licensee claims to be certified.

(d) Failure to include in the advertisement the terms “podiatry,” “podiatrist,” “D.P.M.,”

“orthotist,” “orthotics,” “prosthetist,” “prosthetics,” “pedorthics” or “pedorthist” along with the licensee’s name when the licensee is an individual, or failure to include in the advertisement that the profession pertaining to the services being offered is podiatry, orthotics, prosthetics, or pedorthics when the practitioner is a licensee.

(e) Promotion of professional services which the licensee knows or should know are beyond the licensee’s ability to perform.

(f) Any appeals to an individual’s anxiety in an excessive or unfair manner.

(g) The use of any personal testimonial attesting to a quality of competency of a service or treatment offered by a licensee that is not reasonably verifiable.

(h) Utilization of any statistical data or other information based on past performances for prediction of future services, which creates an unjustified expectation about results that the licensee can achieve.

(i) The communication of personal identifiable facts, data, or information about a patient without first obtaining patient consent.

(j) Any misrepresentation of a material fact.

(k) The knowing suppression, omission or concealment of any material fact or law without which the advertisement would be deceptive or misleading.

(l) Statements concerning the benefits or other attributes of podiatric, orthotic, prosthetic, or pedorthic procedures or products that involve significant risks without including:

A realistic assessment of the safety and efficiency of those procedures or products; and 2. The availability of alternatives; and 3. Where necessary to avoid deception, descriptions or assessment of the benefits or other attributes of those alternatives.

(m) Any communication which creates an unjustified expectation concerning the potential results of any treatment.

(n) The use of “bait and switch” advertisements.

(o) Misrepresentation of a licensee’s credentials, training, experience, or ability.

(p) Failure to include the corporation, partnership or individual licensee’s name, address, and telephone number in any advertisement.

(q) After thirty (30) days of the licensee’s departure, the use of the name of any licensee formerly practicing at or associated with any advertised location or on office signs or buildings. This subparagraph shall not apply in the case of a retired or deceased former associate who practiced in association with one or more of the present occupants if the status of the former associate is disclosed in any advertisement or sign.

(r) Stating or implying that a certain licensee provides all services when any such services are performed by another licensee.

(s) Directly or indirectly offering, giving, receiving, or agreeing to receive any fee or other consideration to or from a third party for the referral of a patient in connection with the performance of professional services.

(5) Advertising Records and Responsibility (a) Each licensee who is a principal partner, or officer of a firm or entity identified in any advertisement, is jointly and severally responsible for the form and content of any advertisement. This provision shall also include any licensed professional employees acting as an agent of such firm or entity.

(b) Any and all advertisements are presumed to have been approved by the licensee named therein.

(c) A recording and/or copy of every advertisement communicated by electronic media, and a copy of every advertisement communicated by print media, and a copy of any other form of advertisement shall be retained by the licensee for a period of two (2) years from the last date of broadcast, posting or publication and be made available for review upon request by the Board or its designee.

(d) At the time any type of advertisement is placed, the licensee must possess and rely upon information which, when produced, would substantiate the truthfulness of any assertion, omission or representation of material fact set forth in the advertisement or public information.

(6) Severability. It is hereby declared that the sections, clauses, sentences and part of these rules are severable, are not matters of mutual essential inducement, and any of them shall be rescinded if these rules would otherwise be unconstitutional or ineffective. If any one or more sections, clauses, sentences or parts shall for any reason be questioned in court, and shall be adjudged unconstitutional or invalid, such judgment shall not affect, impair or invalidate the remaining provisions thereof, but shall be confined in its operation to the specific provision or provisions so held unconstitutional or invalid, and the applicability or invalidity of any section, clause, sentence or part in any instance shall not be taken to affect or prejudice in any way its applicability or validity in any other instance.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, and 63-3-119.
Administrative History: Original rule filed April 26, 2006; effective July 10, 2006.

Tenn. Comp. R. & Regs. 1155-02-.23 TAMPER-RESISTANT PRESCRIPTIONS

(1) Purpose.

This rule is designed to implement the law requiring that licensed osteopathic physicians have all written, typed, or computer-generated prescriptions issued on tamper-resistant prescription paper.

(2) Definitions.

The following definitions are applicable to this rule:

(a) “Drug” shall have the same meaning as set forth in T.C.A. § 63-10-204(16).

(b) “Prescriber” means an individual licensed in Tennessee as a medical doctor, podiatrist, advanced practice nurse with a certificate of fitness to prescribe, dentist, optometrist, osteopathic physician, or physician’s assistant.

(d) “Tamper-resistant prescription” means a written prescription order with features that are designed to prevent unauthorized copying, erasure, modification, and use of counterfeit prescription forms.

(3) Tamper-Resistant Prescription Requirements.

(a) A prescriber shall ensure that all handwritten, typed, or computer-generated prescription orders are issued on tamper-resistant prescriptions. Tamper-resistant prescriptions shall contain the following features:

Either a void or illegal pantograph or a watermark designed to prevent copying;
Either quantity check-off boxes with refill indicators or a uniform, non-white background color designed to prevent erasure or modification; and 3. Security features and descriptions listed on the prescriptions designed to prevent use of counterfeit forms.

(4) Security Measures and Recordkeeping.

(a) Each prescriber shall undertake adequate safeguards and security measures to ensure against loss, improper destruction, theft, or unauthorized use of the tamper-resistant prescriptions in the prescriber’s possession.

(5) Use of Tamper-Resistant Prescriptions.

(a) Facsimile Prescription Transmission.

Prescriptions sent by facsimile transmission are not required to be placed on tamper-resistant prescription paper.
If a prescriber transmits a prescription order to a pharmacy by facsimile transmission, the prescriber or someone designated by the prescriber shall document in the patient’s medical record the name of the drug, strength, quantity prescribed, and the method by which the prescription has been transmitted.

(b) Electronic Prescription Transmission.

Prescriptions sent by electronic transmission are not required to be placed on tamper-resistant prescription paper.
If a prescriber transmits a prescription order to a pharmacy by electronic transmission, the prescriber shall document that the prescription was transmitted electronically in the patient’s file and in accordance with the applicable laws and rules for each of the prescribers’ respective professions as well as applicable federal laws and rules.

History

Authority: Chapter 1035 of the Public Acts of 2008 and T.C.A. §§ 53-10-401, 63-3-106(1), and 63-3-127. [effective October 1, 2008 for TennCare prescriptions and July 1, 2009 for non-TennCare prescriptions].
Administrative History: Public necessity rule filed June 25, 2009; effective through December 7, 2009. Public necessity rule filed June 25, 2009 expired; on December 8, 2009, the rule reverted to its prior status. Emergency rule filed December 21, 2009; effective through June 19, 2010. Original rule filed March 22, 2010; effective June 20, 2010.

Tenn. Comp. R. & Regs. 1155-02-.24 MINIMUM DISCIPLINE FOR OPIOID PRESCRIBING

(1) If the board or committee finds that its licensee has prescribed, dispensed, or administered opioids in a manner that violates the board’s or committee’s statutes or rules (for example, by prescribing in a manner that constitutes gross healthcare liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence), the board or committee shall make a finding that the licensee engaged in a significant deviation or pattern of deviation from sound medical judgement. For purposes of such a finding, sound medical judgment is the equivalent to the standard of care as defined in T.C.A. § 63-1-122.

(2) Having made such a finding, the minimum discipline that the board or committee assesses shall include the following:

(a) Reprimand;

(b) Successful completion of a board or committee approved intensive continuing education course or program regarding treatment with opioids;

(c) A restriction against prescribing opioids for at least six (6) months, and until successful completion of the required continuing education;

(d) One or more Type A civil penalties;

(e) Proof to the licensee’s board or committee that they have notified any physicians, podiatrists, advanced practice registered nurses, or physician assistants with whom they collaborate of the discipline; and (f) Where the licensee is a physician or podiatrist, a restriction against collaborating with any advanced practice registered nurses or physician assistants for issuing opioids during the period in which the licensee is restricted from prescribing opioids.

(3) The prescribing boards and committee recognize that a higher level of minimum discipline is required for those licensees who have been disciplined for opioid-related prescribing violations but continue to violate the standard of care. As set out in paragraph (1) of this rule, the following findings are synonymous, though the boards or committee may have used one or more sets of language to describe a violation. If a licensee commits an order violation in which the prior order contains one or more of the following findings, the licensee has committed an opioid-related order violation for purposes of paragraph (5) of this rule:

(a) That the licensee had prescribed, dispensed, or administered opioids in a manner that constituted gross healthcare liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence;

(b) That the licensee engaged in a significant deviation or pattern of deviation from sound medical judgement related to the issuance of opioids;

(d) That the licensee had dispensed, prescribed or administered opioids not in the course of professional practice, or not in good faith to relieve pain and suffering or not to cure an ailment, physical infirmity or disease;

(e) That the licensee was unfit or incompetent by reason of negligence, habits or other cause related to the licensee’s prescribing or issuance of opioids; or (f) That the licensee violated the rules of the licensing entity with regard to prescribing or issuance of opioids.

(4) If within one (1) year from the date a licensee’s opioid-prescribing privileges are reinstated, having been restricted by an opioid-related order, that licensee’s board or committee finds that, during that year the licensee had prescribed, dispensed, or administered opioids in a manner that violates the board’s or committee’s statutes or rules (for example, by prescribing in a manner that constitutes gross healthcare liability or a pattern of continued or repeated health care liability, ignorance, negligence or incompetence), the board or committee shall make a finding that the licensee re-engaged in a significant deviation or pattern of deviation from sound medical judgement such that they are a repeat offender. For purposes of such a finding, sound medical judgment is the equivalent to the standard of care as defined in T.C.A. § 63-1-122.

(5) If the licensee commits an opioid-related order violation within one year of the opioid-related order, or if the licensee is found to be a repeat offender, the minimum discipline that the board or committee assesses shall include the following:

(a) Probation;

(b) Successful completion of a practice monitoring program which shall include at a minimum:

Board or committee approval of the monitor or monitoring program;
Quarterly reports to the board or committee which include the practice monitor’s findings with regard to the licensee’s:

(i) Non-opioid prescribing practices;

(ii) Medical record keeping;

(iii) Pain management;

(iv) Opioid treatment practices—where the practice monitoring is longer than the restriction against prescribing opioids; and (v) Compliance with the practice monitor’s recommendations, including completion of any additional education recommended by the practice monitor;

(c) A restriction against prescribing opioids for twice the amount of time that was assessed in the initial board or committee order, and for no less than one (1) year;

(d) One or more Type A civil penalties totaling at least twice the amount that was assessed in the initial board or committee order;

(e) Proof to the licensee’s board or committee that they have notified any physicians, podiatrists, advanced practice registered nurses, or physician assistants with whom they collaborate of the discipline; and (f) Where the licensee is a physician or podiatrist, a restriction against collaborating with any advanced practice registered nurses or physician assistants during the period in which the licensee is restricted from prescribing opioids.

(6) Nothing in this rule shall prohibit the board or committee from taking action in excess of the minimum disciplinary action outlined herein. Each case shall be judged independently and may result in additional discipline including other restrictions or a higher level of discipline, including revocation, where appropriate. Further, nothing in this rule shall prohibit the board or committee from taking disciplinary action against a licensee based on a finding that the licensee violated the practice act in manners additional to those outlined in paragraph (1) above, suggesting a need for a higher level of discipline.

History

Authority: T.C.A. § 63-1-162.
Administrative History: Emergency rule filed March 29, 2019; effective through September 25, 2019. Original rule filed May 14, 2019; effective August 12, 2019.

Chapter 1155-03 General Rules Governing Podiatry X-Ray Operators

Tenn. Comp. R. & Regs. 1155-03-.01 SCOPE OF PRACTICE AND CERTIFICATION

(1) Scope of Practice - Any person who applies x-rays to human beings for diagnostic purposes in a podiatrist’s office in Tennessee must be certified by the Board of Podiatric Medical Examiners.

(a) Only those individuals that are qualified by training and experience may obtain a certificate to practice as x-ray operators in a podiatrist’s office and must do so under the supervision of a duly licensed podiatrist.

(b) Each person certified by the Board must practice only in the “foot/ankle” specialty area.

Practicing radiography beyond the scope of certification is grounds for decertification.

(d) Certificates issued by the Board are subject to being disciplined for the same causes, to the same extent and pursuant to the same procedures as issued podiatry licenses.

(e) Under no circumstances may a person certified pursuant to this chapter perform any procedure utilizing contrast media or any invasive radiological procedure.

(2) Certification - Individuals desiring certification must submit a notarized application on a form prescribed by the Board. This application must have a recent photograph properly attached and must be accompanied by a non-refundable fee as provided in Rule 1155-03-.06.

(a) The applicant must be at least eighteen (18) years of age; and (b) The applicant must possess a high school diploma or its equivalent and comply with either Rule 1155-03-.02 or 1155-03-.03; and (c) The applicant must be free from physical and mental impairment that interferes with the performance of duties or otherwise constitutes a hazard to the health or safety of patients.

(d) An applicant shall cause to be submitted to the Board’s administrative office directly from the vendor identified in the Board’s certification application materials, the result of a criminal background check.

History

Authority: T.C.A. §§ 4-3-1011, 4-5-202, 4-5-204, 63-3-106, 63-3-119, and 63-3-125.
Administrative History: Original rule filed April 30, 1997; effective July 14, 1997. Repeal and new rule filed September 14, 1999; effective January 28, 2000. Amendment filed December 13, 2000; effective February 26, 2001. Repeal and new rule filed August 23, 2001; effective November 6, 2001. Amendment filed May 5, 2006; effective July 19, 2006.

Tenn. Comp. R. & Regs. 1155-03-.02 EDUCATION, TRAINING, AND EXAMINATION REQUIREMENTS

(1) Education Requirement-The applicant shall cause to be submitted to the Board’s administrative office official verification of attendance and successful completion of six (6) contact hours of didactic instruction in the field of x-ray operation.

(a) The instruction shall include, but not be limited to, radiographic imaging equipment, principles of radiographic exposure, radiation safety and protection, patient care and positioning, radiographic quality, radiographic film processing, radiographic image protection, and quality control methods.

(b) The six (6) contact hours of didactic instruction may be obtained by attending a course on x-ray operation provided or sponsored by the American Podiatric Medical Association (APMA), a state or regional affiliate of the APMA, an affiliated specialty group, the United States government, or a Board-approved course on x-ray operation.

Requests for approval of coursework must be received in the Board’s administrative office at least forty-five (45) days prior to commencement of the course.

(c) Verification of successful completion of the requirements of this paragraph must be sent directly to the Board by the course provider.

(2) Training Requirement-The applicant shall cause to be submitted to the Board’s administrative office official verification of successful completion of at least sixty (60) hours of supervised clinical experience.

(a) The supervised clinical experience shall include, but not be limited to, training in radiographic methodology, technique, patient care and positioning, equipment maintenance, darkroom, x-ray processing, radiation protection and x-ray quality control.

(b) The x-ray operator, while attaining the supervised clinical experience, may take x-rays only in the presence of the supervising licensed podiatrist or a certified podiatric x-ray operator.

(c) Verification of successful completion of the requirements of this paragraph must be sent directly to the Board by the supervising licensed podiatrist on a form provided by the Board.

(3) Examination Requirement (a) In order to be certified pursuant to this Chapter, the applicant must successfully complete an examination approved by the Board and shall achieve a minimum score of 70. Examination scores obtained by an applicant in order to apply for certification shall be effective for five (5) years from the date that the applicant took the examination or the last part of the examination, should the examination be given in multiple parts.

(b) The examination administered by the Tennessee Podiatric Medical Association (TPMA) at its annual meeting and the Podiatric Medical Assistant, Certified (PMAC) examination given by the American Society of Podiatric Medical Assistants are two (2) examinations deemed adequate to meet the requirement of subparagraph (3)(a).

(4) Application review, approval, denial, and interview decisions shall be governed by Rule 1155- 02-.07.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, and 63-3-125.
Administrative History: Original rule filed April 30, 1997; effective July 14, 1997. Repeal and new rule filed September 14, 1999; effective January 28, 2000. Repeal and new rule filed August 23, 2001; effective November 6, 2001. Amendment filed August 21, 2002; effective November 4, 2002. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-03-.03 RECIPROCITY

(1) Reciprocity based on certification in another state - An applicant requesting certification as a podiatry x-ray operator in Tennessee based on certification in another state must be duly certified or licensed in another state, provided that state's requirements substantially meet or exceed Tennessee's requirements and further provided the applicant's certification or license in the other state is current and in good standing. To receive such certification an applicant must:

(a) Submit a completed and notarized application form as supplied by the Board, a recent photograph and the non-refundable application fee as specified in 1155-03-.06; and (b) Cause to be submitted directly to the Board Administrative Office official verification of current certification/licensure from the other state; and (c) Submit a copy of the statutes and rules governing x-ray operators from each state in which the applicant holds certification/licensure.

(2) Reciprocity based on certification from a Tennessee licensing board - An applicant requesting certification as a podiatry x-ray operator in Tennessee based on certification from a Tennessee licensing board must be duly certified to take extremities x-rays by the Tennessee Board of Medical Examiners or the Tennessee Board of Osteopathic Examination, or must be duly certified by the Tennessee Board of Chiropractic Examiners as a chiropractic x-ray technologist. To receive such certification an applicant must:

(3) Reciprocity based on certification from the American Registry of Radiological Technologists - An applicant requesting certification as a podiatry x-ray operator in Tennessee based on certification from the American Registry of Radiological Technologists must be currently registered as a registered technologist (RT). To receive such certification an applicant must:

(a) Submit a completed and notarized application form as supplied by the Board, a recent photograph and the non-refundable application fee as specified in 1155-03-.06; and (b) Provide evidence of current registration from the American Registry of Radiological Technologists as a registered technologist (RT).

(4) Application review, approval, denial, and interview decisions shall be governed by 1155-2-.07.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, and 63-3-125.
Administrative History: Original rule filed April 30, 1997; effective July 14, 1997. Repeal and new rule filed September 14, 1999; effective January 28, 2000. Amendment filed December 13, 2000; effective February 26, 2001. Repeal and new rule filed August 23, 2001; effective November 6, 2001. Amendment filed June 1, 2004; effective August 15, 2004.

Tenn. Comp. R. & Regs. 1155-03-.04 CONTINUING EDUCATION

(1) Each person certified by the Board must biennially complete four (4) hours of radiological related continuing education in courses provided or sponsored by the APMA, a state or regional affiliate of the APMA, an affiliated specialty group, the United States government, or other courses approved by the Board.

(2) Each licensee must retain proof of attendance and completion of all continuing education requirements. This documentation must be retained for a period of four (4) years from the end of the biennial time period in which the continuing education was required. This documentation must be produced for inspection and verification, if requested in writing by the Board during its verification process. The Board will not maintain continuing education files.

(3) The individual must, within thirty (30) days of a request from the Board, provide evidence of continuing education activities. Certificates verifying the individual’s attendance or original letters from course providers are such evidence.

(4) The individual is exempt from the continuing education requirements for the calendar year that he/she completed the education and training requirements pursuant to Rule 1155-03-.02.

(5) Violations (a) Any person who falsely attests to attendance and completion of the required hours of continuing education may be subject to decertification.

(b) Any person who fails to obtain the required continuing education hours may be subject to decertification.

(c) Education hours obtained as a result of compliance with the terms of a Board order in any disciplinary action shall not be counted toward the continuing education hours required to be obtained by paragraph (1) of this rule.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, and 63-3-125.
Administrative History: Original rule filed April 30, 1997; effective July 14, 1997. Repeal and new rule filed September 14, 1999; effective January 28, 2000. Amendment filed December 13, 2000; effective February 26, 2001. Repeal and new rule filed August 23, 2001; effective November 6, 2001. Amendment filed August 21, 2002; effective November 4, 2002.

Tenn. Comp. R. & Regs. 1155-03-.05 RENEWAL

(1) The due date for renewal is the last day of the month in which a certificate holder’s birthday falls pursuant to the Division of Health Related Board’s biennial birthdate renewal system as contained as the expiration date on renewal certificates.

(2) Methods of Renewal (a) Internet Renewals - Individuals may apply for renewal and pay the necessary fees via the Internet. The application to renew can be accessed at: https://apps.tn.gov/hlrs/ (b) Paper Renewals - For individuals who have not renewed their certificate online via the Internet, a renewal application form will be mailed to each individual certified by the Board to the last address provided to the Board. Failure to receive such notification does not relieve the certificate holder from the responsibility of meeting all requirements for renewal.

(3) A certificate issued pursuant to these rules is renewable by the expiration date. To be eligible for renewal an individual must submit to the Division of Health Related Boards on or before the expiration date the following:

(a) A completed and signed renewal application form.

(b) The renewal and state regulatory fees as provided in Rule 1155-03-.06.

(4) To be eligible for renewal an individual must have completed the continuing education requirements provided in Rule 1155-03-.04 and must indicate completion by signing the renewal application. An individual who fails to obtain continuing education hours, pursuant to

Rule 1155-03-.04, may be subject to disciplinary action by the Board.

(5) Certificate holders who fail to comply with the renewal rules or notification received by them concerning failure to timely renew shall have their certification processed pursuant to Rule

Tenn. Comp. R. & Regs. 1200-10-01-.10 .

(6) Certificate holders whose certificates have expired as a result of the certificate holder’s failure to renew pursuant to Rule 1200-10-01-.10 may be reinstated upon meeting the conditions as provided in Rule 1155-03-.05 (7).

(7) Reinstatement of a certificate that has expired as a result of failure to timely renew in accordance with Rule 1200-10-1-.10 may be accomplished upon meeting the following conditions:

(a) Payment of all past due renewal fees;

(b) Payment of the late renewal fee provided in Rule 1155-03-.06; and (c) Compliance with continuing education requirements pursuant to Rule 1155-03-.04.

(d) An individual who has a certificate that has been expired for at least twelve (12) months shall submit to a criminal background check and cause the results to be submitted to the Board office before the certificate can be reinstated.

(8) Renewal decisions shall be governed by Rule 1155-02-.07.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-107, 63-1-116, 63-3-106, 63-3-115, and 63-3-125.
Administrative History: Original rule filed April 30, 1997; effective July 14, 1997. Repeal and new rule filed September 14, 1999; effective January 28, 2000. (Formerly 1155-03-.04). Amendment filed December 13, 2000; effective February 26, 2001. Repeal and new rule filed August 23, 2001; effective November 6, 2001. Amendment filed July 22, 2002; effective October 5, 2002. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-03-.06 FEES

Amounts (1) Application $50.00 (2) Renewal (biennial) $30.00 (3) Late Renewal $20.00 (4) State Regulatory (biennial) $10.00

History

Authority: T.C.A. §§ 4-3-1011, 4-5-202, 4-5-204, 63-3-106, and 63-3-125.
Administrative History: Original rule filed April 30, 1997; effective July 14, 1997. (Formerly 1155-03-.05) Repeal and new rule filed September 14, 1999; effective January 28, 2000. Amendment filed December 13, 2000; effective February 26, 2001. Repeal and new rule filed August 23, 2001; effective November 6, 2001.

Tenn. Comp. R. & Regs. 1155-03-.07 RETIREMENT AND REACTIVATION

(1) A person who holds a current certificate and does not intend to practice as a certified podiatric x-ray operator may apply to convert an active certificate to inactive (“retired”) status. An individual who holds a retired certificate will not be required to pay the renewal fee.

(2) A person who holds an active certificate may apply for retired status in the following manner:

(a) Obtain, complete, and submit to the Board’s administrative office an affidavit of retirement form.

(b) Submit any documentation which may be required to the Board’s administrative office.

(3) A podiatric x-ray operator whose certificate has been retired may re-enter active status by doing the following:

(a) Obtain complete and submit to the Board’s administrative office a reactivation/reinstatement application.

(b) Pay the renewal fees and state regulatory fees as provided in Rule 1155-03-.06. If retirement reactivation is requested prior to the expiration of one (1) year from the date of retirement, the Board will require payment of the late renewal fee and past due renewal fees.

(c) Submit verification of successful completion of continuing education hours for the period of retirement, pursuant to Rule 1155-03-.04.

(d) An individual having a certificate that has been retired for at least twelve (12) months shall submit to a criminal background check and cause the results to be submitted to the Board office before the certificate can be reactivated.

(4) Certificate reactivation applications shall be treated as certificate applications, and review decisions shall be governed by Rule 1155-2-.07.

History

Authority: T.C.A. §§ 4-3-1011, 4-5-202, 4-5-204, 63-1-107, 63-1-111, 63-3-106, and 63-3-125.
Administrative History: Original rule filed April 30, 1997; effective July 14, 1997. (Formerly 1155-03-.06) Repeal and new rule filed September 14, 1999; effective January 28, 2000. Amendment filed December 13, 2000; effective February 26, 2001. Repeal and new rule filed August 23, 2001; effective November 6, 2001. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-03-.08 DISCIPLINARY ACTION

Any violation of this chapter could result in disciplinary action against the x-ray operator and the supervising podiatrist, pursuant to Rule 1155-2-.15.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, and 63-3-125.
Administrative History: Original rule filed September 14, 1999; effective January 28, 2000. Amendment filed December 13, 2000; effective February 26, 2001. Repeal and new rule filed August 23, 2001; effective November 6, 2001.

Tenn. Comp. R. & Regs. 1155-03-.09 CHANGE OF ADDRESS AND/OR NAME

(2) Change of Address - Each person holding a certificate who has had a change of address or place of employment shall file in writing with the Board his current address, giving both old and new addresses. Such requests shall be received in the Board’s administrative office no later than thirty (30) days after such change is effective and must reference the individual’s name, profession, and certificate number.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, and 63-3-125.
Administrative History: Original rule filed April 30, 1997; effective July 14, 1997. (Formerly 1155-03-.07) New rule filed September 14, 1999; effective January 28, 2000. Amendment filed December 13, 2000; effective February 26, 2001. Repeal and new rule filed August 23, 2001; effective November 6, 2001.

Chapter 1155-04 General Rules Governing Orthotists, Prosthetists, and Pedorthists

Tenn. Comp. R. & Regs. 1155-04-.01 ORTHOTISTS

(1) An “orthotist” is an allied health professional who is specifically trained and educated to provide or manage the provision of a custom-designed, fabricated, modified and fitted external orthosis to an orthotics patient, based on a clinical assessment and a prescription from a health care practitioner authorized by law to write such prescriptions, to restore physiological function or cosmesis.

(2) An “orthosis” is a custom-designed, fabricated, fitted or modified device to correct, support or compensate for a neuro-musculoskeletal disorder or acquired condition. “Orthosis” does not include fabric or elastic supports, corsets, arch supports, low-temperature plastic splints, trusses, elastic hoses, canes, crutches, soft cervical collars, dental appliances, or other similar devices that are carried in stock and sold without modification as “over-the-counter” items by a drug store, department store, corset shop, or surgical supply facility.

(3) “Orthotics” is the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting, or servicing an orthosis under an order from a licensed health care practitioner authorized by law to issue such an order for the correction or alleviation of neuromuscular or musculoskeletal dysfunction, disease, injury, or deformity.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-201, and 63-3-202.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.02 PROSTHETISTS

(1) A “prosthetist” is an allied health professional who is specifically trained and educated to provide or manage the provision of a custom-designed, fabricated, modified, and fitted external limb prosthesis to a prosthetic patient, based on a clinical assessment and a prescription from a health care practitioner authorized to write such prescriptions, to restore physiological function or cosmesis.

(2) A “prosthesis” is a custom-designed, fabricated, fitted, or modified device to replace an absent external limb for purposes of restoring physiological function or cosmesis.

“Prosthesis” does not include artificial eyes, ears, or dental appliances, cosmetic devices or other devices that do not have a significant impact on the musculoskeletal functions of the body.

(3) “Prosthetics” is the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting, or servicing a prosthesis under an order from a licensed health care practitioner authorized by law to issue such order.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-201, and 63-3-202.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.03 PEDORTHISTS

(1) A “pedorthist” is an allied health professional who is specifically trained and educated to measure, design, fabricate, fit or service a pedorthic device, based on a clinical assessment and a prescription from a health care practitioner authorized to write such prescriptions, for the support or correction of disabilities caused by neuro-musculoskeletal diseases, injuries, or deformities.

(2) The term “pedorthic device” includes therapeutic footwear, foot orthoses for use at the ankle or below, and modified footwear made for therapeutic purposes, as prescribed by a licensed health care practitioner authorized by law to issue such prescription. “Pedorthic device” does not include non-therapeutic accommodative inlays or non-therapeutic accommodative footwear, shoe modifications made for non-therapeutic purposes, unmodified, over-thecounter shoes, or prefabricated foot care products.

(3) “Pedorthics” is the science and practice of evaluating, measuring, designing, fabricating, assembling, fitting, adjusting, or servicing a pedorthic device under an order from a licensed health care practitioner authorized by law to issue such order for the correction or alleviation of neuromuscular or musculoskeletal dysfunction, disease, injury, or deformity.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-201, and 63-3-202.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.04 RESTRICTIONS ON THE PRACTICE OF ORTHOTISTS, PROSTHETISTS, AND

PEDORTHISTS.

(1) A licensed orthotist, prosthetist or pedorthist may provide care or services only if the care or services are provided pursuant to an order from a licensed health care practitioner authorized to issue such an order.

(2) A licensed orthotist, prosthetist, or pedorthist must provide services at a facility which has appropriate clinical and laboratory space and equipment to allow that licensee to provide comprehensive orthotic, prosthetic, or pedorthic care.

(3) The scope of practice of a licensed orthotist, prosthetist, or pedorthist does not include the right to diagnose a medical problem or condition or the right to give medical advice as to the nature, cause, or treatment for the problem or condition for which the orthosis, prosthesis, or pedorthic device is being dispensed. However, the scope of practice of a licensed orthotist, prosthetist, or pedorthist does include the right to provide information or demonstration regarding the proper use and care of the device and to make adjustments to the device as needed.

(4) An individual holding a certification from the American Board for Certification in Orthotics, Prosthetics and Pedorthics (ABC) as an orthotic assistant, prosthetic assistant, or prostheticorthotic assistant may perform orthotic and/or prosthetic duties and related tasks set forth by the 2012 ABC Scope of Practice (version effective April 2012) for certified orthotic and prosthetic assistants (www.abcop.org/maintain-certification/Documents/Scope%20of%20 Practice.pdf). However, a certified assistant may not deliver a definitive custom-made prosthesis or orthosis or perform an initial evaluation of a patient.

(5) A licensed orthotist, prosthetist, or pedorthist may utilize one or more non-certified persons to assist in the performance of minor repairs of devices which have been previously dispensed to a patient.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-201, 63-3-202, 63-3-206, 63-3-207, and 63-3-214.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006. Amendments filed July 10, 2018; effective October 8, 2018.

Tenn. Comp. R. & Regs. 1155-04-.05 NECESSITY OF LICENSURE AND REGISTRATION OF RESIDENCY

(1) On and after January 1, 2008, except as provided in Tennessee Code Annotated, Title 63,

Chapter 3, Sections 205, 208 and 209, no person shall practice orthotics, prosthetics, or pedorthics in Tennessee, or hold himself or herself out as being able to practice such professions, or dispense an orthosis, prosthesis, or pedorthic device, unless such person is licensed or registered in accordance with the requirements of this chapter.

(2) Pursuant to T.C.A. § 63-3-209(2)(B), persons seeking to provide services in Tennessee as a resident in an orthotics and/or prosthetics residency program shall register with the Board, on a form notice available through the Board, at least thirty (30) days before providing such services, and the notice shall include the following information:

(a) The full name of the resident;

(b) The date of birth of the resident;

(d) The mailing and physical address of the resident;

(e) The home telephone or cell phone number of the resident;

(f) Any other health related licenses, certificates, or permits the resident holds in Tennessee or any another state;

(g) The name and address of the facility or facilities where the residency is to be completed;

(h) The name of the resident’s direct supervisor who accepts responsibility for the services provided by the resident and written acknowledgment on signed letterhead from the supervisor accepting such responsibility;

(i) Proof of a completed orthotics and/or prosthetics education program as described in

Rule 1155-04-.06;

(j) Proof of a baccalaureate degree (or proof of successfully completing the number of semester hours which is equivalent to four years of study at a four-year college or university), as described in Rule 1155-04-.06;

(k) Proof of successful completion of all examinations required by Rule 1155-04-.08; and (l) Payment of the ten dollar ($10) Orthotic/ Prosthetic Residency Registration Fee.

(3) Orthotic and prosthetic residents already in a clinical residency when Rule 1155-04-.05(2) takes effect shall register with the Board, on a form notice available through the Board, within sixty (60) days of Rule 1155-04-.05(2) taking effect, and such notice shall include all the information listed in Rule 1155-04-.05(2).

(4) Registration under this rule shall authorize only such practice in Tennessee as is authorized by and under the supervision of the residency program, which must be accredited by the National Commission on Orthotic and Prosthetic Education. Termination from the residency program terminates the registration and any authority to practice in Tennessee. The director of the residency program shall immediately notify the Board in writing of any registrant’s termination from the program.

(5) Registrations shall expire twenty-four (24) months from the date of issuance and may be renewed only once, for good cause and subject to Board approval. Residency registrants shall submit to the Board written confirmation of residency status once every six (6) months, containing the signature of the direct supervisor who accepts responsibility for the services provided by that resident.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, 63-3-205, 63-3-208, 63-3-209, and 63-3-214.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006. Amendments filed July 10, 2018; effective October 8, 2018.

Tenn. Comp. R. & Regs. 1155-04-.06 QUALIFICATIONS FOR LICENSURE

(1) Orthotist – To qualify for a license to practice orthotics, a person shall:

(a) Complete an orthotics education program which is accredited by the Commission on Accreditation of Allied Health Education Programs or its successor organization; and (b) Possess a baccalaureate degree (or have successfully completed the number of semester hours which is equivalent to four [4] years of study at a four-year college or university). The curriculum of the program of study completed by such person must include mathematics, physics, biology, chemistry, anatomy, biomechanics, pathology and psychology courses; and (c) Successfully complete a clinical residency in orthotics. The majority of training must be devoted to services performed under the supervision of an orthotist licensed in Tennessee or a person in another state who has obtained certification from the American Board for Certification in Orthotics and Prosthetics, Inc. or the Board for Orthotist/Prosthetist Certification; and (d) Successfully complete all examinations required by Rule 1155-04-.08.

(2) Prosthetist – To qualify for a license to practice prosthetics, a person shall:

(a) Complete a prosthetic education program which is accredited by the Commission on Accreditation of Allied Health Education Programs or its successor organization; and (b) Possess a baccalaureate degree (or have successfully completed the number of semester hours which is equivalent to four (4) years of study at a four-year college or university). The curriculum of the program of study completed by such person must include math, physics, biology, chemistry, anatomy, biomechanics, pathology and psychology courses; and (c) Successfully complete a clinical residency in prosthetics. The majority of training must be devoted to services performed under the supervision of a prosthetist licensed in Tennessee or a person in another state who has obtained certification from the American Board for Certification in Orthotics and Prosthetics, Inc. or the Board for Orthotist/Prosthetist Certification; and (d) Successfully complete all examinations required by Rule 1155-04-.08.

(3) Pedorthist – To qualify for a license to practice pedorthics, a person shall:

(a) Possess a high school diploma or comparable credential approved by the Board; and (b) Successfully complete a pedorthics education program accredited by the Board for Certification in Pedorthics, or a pedorthics education program approved by the Board, which includes:

A basic curriculum of instruction in foot-related pathology of diseases, anatomy, and biomechanics;
A specific curriculum in pedorthics courses, including but not limited to lectures covering shoes, foot orthoses, and shoe modifications, pedorthics components and materials, training and functional capabilities, pedorthics performance evaluation, prescription considerations, etiology of disease processes necessitating use of pedorthics devices, medical management, and subject matter related to pediatric and geriatric problems; and 3. Lectures, demonstrations, and laboratory experiences related to the entire process of measuring and casting, fitting, fabricating, aligning, and completing pedorthic devices; and (c) Successfully complete a qualified work experience program or internship in pedorthics in accordance with the following standards and procedures:
The program or internship shall be no less than sixty (60) hours of work experience.
The program or internship shall be under the direct supervision of a currently licensed pedorthist, orthotist, or podiatrist.
Direct supervision, as used in this subparagraph, shall mean the requirement of the supervisor to direct, coordinate, review, inspect, and approve each act or service performed, and although the continuous and actual physical presence of the supervisor in the same room and at the same time as the intern is not mandatory, the continuous and actual presence of the supervisor within the physical confines of the practice location is required.
The program or internship shall include training in evaluating, measuring, designing, fabricating, assembling, fitting, adjusting, or servicing pedorthic devices; and (d) Successfully complete all examinations required by Rule 1155-04-.08.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.07 PROCEDURES FOR LICENSURE

(1) An applicant shall download a current application from the Board’s internet web page or shall obtain a current application packet from the Board’s administrative office, respond truthfully and completely to every question or request for information contained in the application form, and submit it, along with all documentation and fees required, to the Board’s administrative office. It is the intent of this rule that all steps necessary to accomplish the filing of the required documentation be completed prior to filing an application and that all materials be filed simultaneously.

(2) An applicant shall submit with his application a “passport” style photograph taken within the preceding twelve (12) months and attach it to the appropriate page of the application.

(3) An applicant shall have successfully completed the requirements of Rule 1155-04-.06 and cause the supporting documentation to be sent from the document’s issuer directly to the Board’s administrative office. If the applicant has an active license in good standing as an orthotist, prosthetist, or pedorthist in another state which has licensure requirements substantially similar to those set forth in these rules, the Board may choose to waive the submission of the documentation required by this chapter.

(4) An applicant shall disclose the circumstances surrounding any of the following:

(a) Conviction of a crime in any country, state, or municipality, except minor traffic violations;

(b) The denial of certification or licensure application by any other state or country, or the discipline of the certificate holder or licensee in any state or country;

(c) Loss, restriction, or voluntary surrender of certification or licensure privileges; and (d) Any judgment or settlement in a civil suit in which the applicant was a party defendant, including malpractice, unethical conduct, breach of contract, or any other civil action remedy recognized by the country’s or state’s statutory, common law, or case law.

(5) An applicant shall cause to be submitted to the Board’s administrative office directly from the vendor identified in the Board’s licensure application materials, the result of a criminal background check.

(6) When necessary, all required documents shall be translated into English and such translation, together with the original document, shall be certified as to authenticity by the issuing source. Both versions must be submitted simultaneously.

(7) If the applicant is licensed or was ever licensed as a health care professional in another state, the applicant shall cause the appropriate licensing Board in each state in which he holds or has held a license to send directly to the Board an official statement which indicates the condition of his license in such other state, including the date on which he was so licensed and under what provision such license was granted (i.e. certificate of clinical competence, examination, reciprocity, grandfathering, etc.).

(8) Application review, approval, denial, and interview decisions shall be made pursuant to Rule

Tenn. Comp. R. & Regs. 1155-04-.08 EXAMINATIONS

(1) In addition to the jurisprudence examination required by paragraph (4), an applicant for licensure as an orthotist, prosthetist, or pedorthist must successfully complete and make a passing score on the examination(s) approved and offered by the American Board for Certification in Orthotics and Prosthetics, Inc., the Board for Certification in Pedorthics, or other examination(s) approved by the board.

(2) Passing scores shall be determined by the testing agencies and/or exam providers.

(3) Examination fees shall be sent from the applicant directly to the testing agencies and/or exam providers.

(4) Jurisprudence examination. All applicants for licensure must successfully complete the Board’s jurisprudence examination as a prerequisite to licensure.

(b) The applicant shall include a completed jurisprudence examination when his/her completed application for licensure is returned to the Board’s administrative office.

(d) The scope and content of the examination shall be determined by the Board but limited to:

Statutes and regulations governing the practice of orthotics, prosthetics, or pedorthics (T.C.A. §§ 63-3-201 et seq., and Chapter 1155-04 of the Official Compilation, Rules and Regulations of the State of Tennessee); and 2. The following ethics documents, as applicable for the type licensure being sought:

(i) The Canons of Ethics of the American Board for Certification in Orthotics and Prosthetics, Inc.

(ii) The Code of Ethics of the Board for Orthotist/Prosthetist Certification.

(iii) The Code of Ethical Conduct of the Board for Certification in Pedorthics, Inc.

(e) Information regarding how to acquire copies of the applicable statutes, regulations and ethics documents is available upon request from the Board’s administrative office.

(f) The format of the examination shall be “open-book.”

(g) Correctly answering ninety percent (90%) of the examination questions shall constitute successful completion of the jurisprudence exam.

(h) Applicants who fail to successfully complete the jurisprudence examination must continue to retake the examination until it has been successfully completed before the application will be deemed complete and presented to the Board for consideration.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.09 FEES

All fees except the State Regulatory fee are non-refundable.

(1) Application $300.00 (2) Renewal (biennial) $160.00 (3) Late Renewal $100.00 (4) Reinstatement $300.00 (5) Duplicate or Replacement License $25.00 (6) Continuing Education Course Accreditation $50.00 (7) State Regulatory (biennial) $10.00 (8) Orthotic/Prosthetic Residency Registration $10.00

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-106(1), 63-3-202, 63-3-203, 63-3-205, and 63-3- 214.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006. Amendment filed August 25, 2009; effective November 23, 2009. Amendment filed April 24, 2017; effective July 23, 2017. Amendments filed July 10, 2018; effective October 8, 2018.

Tenn. Comp. R. & Regs. 1155-04-.10 RENEWAL OF LICENSURE

(1) The due date for renewal is the last day of the month in which a licensee’s birthday falls pursuant to the Division of Health Related Board’s biennial birthdate renewal system, which is the expiration date shown on the licensee’s renewal certificate.

(2) Methods of Renewal (a) Internet Renewals – Individuals may apply for renewal and pay the necessary fees via the Internet. The application to renew can be accessed at: https://apps.tn.gov/hlrs/ (b) Paper Renewals – For individuals who have not renewed their license online via the Internet, a renewal application form will be mailed to each individual licensed by the Board to the last address provided to the Board. Failure to receive such notification does not relieve the licensee from the responsibility of meeting all requirements for renewal.

(3) A license issued pursuant to these rules is renewable by the expiration date. To be eligible for renewal an individual must submit to the Division of Health Related Boards on or before the expiration date the following:

(a) A completed renewal application form; and (b) The renewal and state regulatory fees as provided in Rule 1155-04-.09.

(4) To be eligible for renewal an individual must have completed the continuing education requirements provided in Rule 1155-04-.12 and must attest to such completion on the renewal application. An individual who fails to obtain continuing education hours, pursuant to

Rule 1155-04-.12, may be subject to disciplinary action by the Board.

(5) Licensees who fail to comply with the renewal rules or notification received by them concerning failure to timely renew shall have their license processed pursuant to Rule 1200- 10-01-.10.

(6) Reinstatement of a license that has expired as a result of failure to timely renew in accordance with Rule 1200-10-01-.10 may be accomplished upon meeting the following conditions:

(a) Payment of all past due renewal and state regulatory fees;

(b) Payment of the late renewal fee provided in Rule 1155-04-.09; and (c) Compliance with continuing education requirements pursuant to Rule 1155-04-.12.

(d) An individual having a license that has been expired for at least twelve (12) months shall submit to a criminal background check and cause the results to be submitted to the Board office before the license can be reinstated.

(7) Renewal applications shall be treated as licensure applications, and shall be governed by

Rule 1155-02-.07.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-116, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-04-.11 RETIREMENT AND REACTIVATION

(1) A person who holds a current license and does not intend to practice as an orthotist, prosthetist or pedorthist may apply to convert an active license to retired (“inactive”) status.

An individual who holds a retired license will not be required to pay the renewal fee.

(2) A person who holds an active license may apply for retired status in the following manner:

(a) Obtain, complete, and submit to the Board’s administrative office an affidavit of retirement form; and (b) Submit any other documentation which may be required to the Board’s administrative office.

(3) A licensee whose license has been retired may re-enter active status by doing the following:

(a) Obtain, complete, and submit to the Board’s administrative office a reactivation application; and (b) Pay the renewal fees and state regulatory fees as provided in Rule 1155-04-.09. If reactivation is requested prior to the expiration of one (1) year from the date of retirement, the Board will require payment of the late renewal fee and past due renewal fees; and (c) Submit verification of successful completion of continuing education hours for the period of retirement, pursuant to Rule 1155-04-.12.

(d) An individual having a license that has been retired for at least twelve (12) months shall submit to a criminal background check and cause the results to be submitted to the Board office before the license can be reinstated.

(4) Reactivation applications shall be treated as licensure applications, and shall be governed by

Rule 1155-02-.07.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-1-116, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006. Amendment filed January 20, 2012; effective April 19, 2012.

Tenn. Comp. R. & Regs. 1155-04-.12 CONTINUING EDUCATION

(1) Each licensed orthotist, prosthetist and pedorthist must annually complete fifteen (15) hours of continuing education in courses applicable to his/her profession. At least six (6) hours of the continuing education each year must be obtained by each licensee from providers in the state of Tennessee. No more than seven (7) hours of the annual requirement shall be completed by any of the means listed in Rule 1155-02-.12(1)(d).

(a) A person who is licensed in more than one (1) profession under these rules shall annually complete a total of twenty (20) hours of continuing education.

(b) Of the twenty (20) hours required by subparagraph (a), six (6) hours shall be subjects pertaining to each profession in which he/she is licensed. For example, a person who is licensed as a orthotist and as a prosthetist is required to complete six (6) hours pertaining to orthotics and six (6) hours pertaining to prosthetics. The remaining eight (8) hours required could pertain to either orthotics or prosthetics.

(2) Acceptable continuing education shall consist of courses provided, approved, or sponsored by:

(a) The American Board for Certification in Orthotics and Prosthetics, Inc.;

(b) The Board for Orthotist/Prosthetist Certification;

(d) The Pedorthic Footwear Association;

(e) Tennessee Orthotic and Prosthetic Facilities, Inc.;

(f) The Tennessee Podiatric Medical Association; and (g) Any other entity whose education programs have been approved by the Board.

(3) Course Approval (a) Courses to be offered for credit toward the required continuing education hours must, unless provided, approved or sponsored by an entity listed in paragraph (2), receive prior approval from the Board.

(b) Prior approval of a course may be obtained by submitting the following information to the Board’s administrative office at least forty-five (45) days prior to the scheduled date of the course:

A course description or outline;
Names of all lecturers;
Brief resume of all lecturers;
Number of hours of educational credit requested;
Date and location of course or how to access the course electronically;
How certification of attendance is to be documented; and 7. The Continuing Education Course Accreditation Fee required to be paid pursuant to Rule 1155-04-.09.

(4) Each licensee must retain proof of attendance and completion of all continuing education requirements. This documentation must be retained for a period of four (4) years from the end of the calendar year in which the continuing education was required. This documentation must be produced for inspection and verification, if requested in writing by the Board during its verification process. The Board will not maintain continuing education files.

(5) Each licensee must, within thirty (30) days of a request from the Board, provide evidence of continuing education activities. Certificates verifying the individual’s attendance or original letters from course providers are such evidence.

(6) Licensees are exempt from the continuing education requirements for the calendar year that the requirements of Rule 1155-04-.06 were completed.

(7) Violations (a) Any person who falsely attests to attendance and completion of the required hours of continuing education may be subject to disciplinary action.

(b) Any person who fails to obtain the required continuing education hours may be subject to disciplinary action.

(8) Education hours obtained as a result of compliance with the terms of a Board order in any disciplinary action shall not be counted toward the continuing education hours required to be obtained by paragraph (1) of this rule.

History

Authority: T.C.A. §§ 63-3-202.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006. Amendments filed October 10, 2024; effective January 8, 2025.

Tenn. Comp. R. & Regs. 1155-04-.13 DISCIPLINARY ACTIONS, SUBPOENAS, DECLARATORY ORDERS, SCREENING

PANELS AND ADVISORY PRIVATE LETTER RULINGS.

(1) Disciplinary Actions – Licensed orthotists, prosthetists and pedorthists are subject to being disciplined by the Board for the same causes, to the same extent and pursuant to the same procedures provided in Rule 1155-02-.15 as licensed podiatrists.

(2) Subpoenas – Subpoena procedures shall be governed by Rule 1155-02-.15.

(3) Declaratory Orders – Declaratory order procedures shall be governed by Rule 1155-02-.19.

(4) Screening Panels – Screening panel procedures shall be governed by Rule 1155-02-.19.

(5) Advisory Private Letter Rulings – Advisory private letter rulings shall be governed by Rule

Tenn. Comp. R. & Regs. 1155-04-.14 ADVERTISING

Advertising shall be governed by Rule 1155-02-.22.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.15 CHANGE OF ADDRESS AND/OR NAME

(1) Change of Name – Licensees shall notify the Board in writing within thirty (30) days of a name change and shall provide both the old and new names. A request for name change must also include a copy of the official document involved and reference the individual’s profession and license number.

(2) Change of Address – A licensee who has had a change of address or place of employment shall file in writing with the Board his/her current address, giving both old and new addresses.

Such requests shall be received in the Board’s administrative office no later than thirty (30) days after such change is effective and must reference the licensee’s name, profession, and license number.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.16 REPEALED

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006. Repeal filed June 5, 2024; effective September 3, 2024.

Tenn. Comp. R. & Regs. 1155-04-.17 SALE OF OVER-THE-COUNTER AND OFF-THE-SHELF DEVICES

(1) “Over-the-counter device” means a prefabricated, mass-produced device that is prepackaged and requires no professional advice or judgment in either size selection or use, including fabric or elastic supports, corsets, generic arch supports and elastic hoses.

(2) “Off-the-shelf device” means a prefabricated prosthesis or orthosis sized or modified for use by the patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions and which does not require substantial clinical judgment and substantive alteration for appropriate use.

(3) The sale of over-the-counter and off-the-shelf devices by non-licensed persons is not prohibited by these rules.

(4) No person shall dispense or sell an over-the-counter device or an off-the-shelf device based upon an image of the customer’s limb captured by the person through a mold, cast, scanning device, digital appliance, or pressure sensitive device, unless the customer has first presented to that person a written prescription for that device from a health care practitioner authorized by law to write such a prescription.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.18 CUSTOM FABRICATED AND FITTED DEVICES

(1) “Custom fabricated and fitted device” means an orthosis, prosthesis, or pedorthic device which is fabricated to original measurements or a mold for use by a patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions and which requires substantial clinical and technical judgment in its design and fitting.

(2) “Custom fitted device” means a prefabricated orthosis, prosthesis, or pedorthic device sized or modified for use by the patient in accordance with a prescription from a health care practitioner authorized by law to write such prescriptions and which requires substantial clinical judgment and substantive alteration for appropriate use.

(3) Custom fabricated devices and custom fabricated and fitted devices must be dispensed by a licensed health care practitioner or by a person licensed under these rules in accordance with a prescription from a licensed health care practitioner.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.19 OTHER LICENSED HEALTH CARE PRACTITIONERS

Nothing in these rules shall be interpreted as limiting or restricting a health care practitioner licensed under any chapter of Title 63, Tennessee Code Annotated, from engaging in the full scope of practice allowed by such person’s license.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.20 PHARMACISTS, HOME MEDICAL EQUIPMENT PROVIDERS, AND ORTHOSIS

MANUFACTURERS.

(1) Nothing in these rules shall be interpreted as limiting or restricting individuals acting under the supervision and control of a pharmacist or pharmacy licensed under Title 63, or home medical equipment provider licensed under Title 68, from measuring, fitting or adjusting any non-custom fabricated and fitted device, including but not limited to over-the-counter devices or off-the-shelf devices, so long as such individual does not create a cast, mold or scan of a

part of the human body for the purpose of constructing a medical device to treat a patient’s medical condition and so long as such individual meets one of the following criteria for such device:

(a) Documented training from a manufacturer; or training from a licensed or certified orthotist, prosthetist, or pedorthist; or (b) Certification or registration as a fitter of orthotics, prosthetics, or pedorthics, from a nationally recognized board or association such as the Board for Orthotist/Prosthetist Certification (BOC), the Board of Certification for Pedorthists, the National Community Pharmacists Association (NCPA), or the American Board for Certification in Orthotics and Prosthetics (ABC); or (c) Direct supervision by a trained and experienced, or certified, or registered, fitter of orthotic, prosthetic, or pedorthic devices.

(2) Nothing in these rules shall be interpreted as limiting or restricting individuals acting under the supervision and control of a pharmacist or pharmacy licensed under Title 63, or home medical equipment provider licensed under Title 68, from measuring, fitting or adjusting any non-custom fabricated and fitted pedorthic devices, including but not limited to diabetic shoes, provided such individual meets the criteria of either subparagraph (1)(b) or (1)(c) and so long as the individual does not create a cast, mold or scan of a part of the human body for the purpose of constructing a medical device to treat a patient’s medical problem.

(3) Nothing in these rules shall be interpreted as limiting or restricting the measuring, fitting or adjusting of an orthotic device by an employee or authorized representative of an orthosis manufacturer registered with the federal Food and Drug Administration, provided:

(a) Such employee or representative is supervised by a licensed health care professional authorized by law to prescribe, measure or fit such device, and who examines the patient to ensure that the device has been properly measured, fitted or adjusted by the employee or representative; and (b) The measuring, fitting or adjusting of such device occurs in the office of such licensed health care professional or in a health care facility.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.21 THERAPEUTIC FOOTWEAR

The following actions with respect to therapeutic footwear and medical devices for the foot and ankle must be performed by a health care practitioner licensed under Title 63 who is acting within his or her lawful scope of practice:

(1) Modifications or additions to the interior or exterior of footwear for therapeutic purposes, including but not limited to heel lifts, outflare heels, Thomas heels, full sole lifts, wedged soles, rocker bottom soles, metatarsal bars, metatarsal raises or inserts that have fillers as

part of their construction, toe fillers, and partial foot fillers;

(2) Permanent or temporary attachment of an orthosis to the footwear;

(3) Addition or modification of a removable or attached therapeutic foot device inside the shoe which was fabricated based on a cast, impression, mold, scan, or imprint;

(4) Creation of an image of a person’s foot or ankle through the use of a mold, cast, scanning device, digital appliance, pressure sensitive device or other similar device; and (5) Analysis, evaluation, measurement, assessment, or screening of a foot for the purpose of making a therapeutic recommendation.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-04-.22 PATIENT RECORDS

(1) Purpose – The purpose of this rule is:

(a) To recognize that patient records are an integral part of the practice of orthotists, prosthetists, and pedorthists as defined in T.C.A. § 63-3-201.

(b) To give orthotists, prosthetists, pedorthists, their professional and non-professional staff, and the public direction about the content, transfer, retention, and destruction of those patient records.

(2) Applicability – This rule regarding patient records shall apply only to those records, the information for which was obtained by orthotists, prosthetists, pedorthists, or their supervisees, for purposes of services provided in any clinical setting other than those provided in a hospital as defined by T.C.A. § 68-11-302(4), a hospital emergency room, or hospital outpatient facility.

(3) Patient Records – (a) Duty to Create and Maintain Records – As a component of the standard of care and of minimal competency, an orthotist, prosthetist, or pedorthist must cause to be created and cause to be maintained a patient record for every encounter between a patient and the orthotist, prosthetist, or pedorthist. For purposes of this Rule, a patient is defined as a person for whom the orthotist, prosthetist, or pedorthist has undertaken to treat or for whom the orthotist, prosthetist, or pedorthist has participated in treatment.

(b) Notice – Any notice to be provided to a patient required by these rules shall be issued within thirty (30) days of the date of the event that triggers the notice requirement, and shall be accomplished by mailing to the last known address of the patient.

(c) Content – In order to meet the minimum level of competency required of orthotists, prosthetists, and pedorthists, the patient records required by this rule shall:

Be recorded in such a manner as to be legible to an ordinary reasonable person, including those persons who are not licensed healthcare professionals;
Include all information and documentation listed in T.C.A. § 63-2-101(c)(4), to the extent applicable;
Contain such additional information that is necessary to ensure that a subsequent reviewing or treating healthcare professional can both ascertain the

basis for the treatment plan and outcomes, and provide continuity of care for the patient.

(d) Transfer – 1. Applicability of Notice Requirements – The notice requirements of this part are only required for patients who have either:

(i) Had three (3) or more office encounters with the orthotist, prosthetist, or pedorthist over the eighteen (18) month period that immediately precedes the event that would otherwise trigger the notice or (ii) Had their initial evaluation and treatment plan developed by the orthotist, prosthetist, or pedorthist.

Records of Orthotist, Prosthetist, or Pedorthist upon Death or Retirement – When an orthotist, prosthetist, or pedorthist retires or dies while in practice, patients who meet the requirements of 1155-04-.22(3)(d)1. shall be notified by the orthotist, prosthetist, or pedorthist, or his authorized representative; urged to find a new orthotist, prosthetist, or pedorthist; and informed that upon patient or patient’s representative’s authorization copies of the patient’s records will be sent to the new orthotist, prosthetist, or pedorthist.
Patient Records of Orthotist, Prosthetist, or Pedorthist upon Departure from a Group – The responsibility for notifying patients of an orthotist, prosthetist, or pedorthist who leaves a group practice for any reason other than death shall be governed by the employment or professional services contract of the orthotist, prosthetist, or pedorthist. If such contract does not address the notification issue, or if an employment or professional services contract does not exist, the group shall be responsible for notifying the patients of the orthotist, prosthetist, or pedorthist that the orthotist, prosthetist, or pedorthist has departed from the group.

(i) Whoever is responsible for the notification referenced in the immediately preceding paragraph must notify patients of the orthotist, prosthetist, or pedorthist who meet the requirements of 1155-04-.22(3)(d)1.

(ii) The orthotist, prosthetist, or pedorthist who is departing from a practice group must provide the practice group with his new practice address.

Failure to provide this information within two (2) weeks of the departure date from the practice group will relieve the practice group of any obligation to provide the new address of the orthotist, prosthetist, or pedorthist as set out in (iii) below.

(iii) These patients shall also be notified of the orthotist’s, prosthetist’s, or pedorthist’s new address, if known and provided by the departing orthotist, prosthetist, or pedorthist, and offered the opportunity to have copies of their patient records forwarded to the departing orthotist, prosthetist, or pedorthist at his new practice. A group shall not withhold the patient records of any patient who has authorized their transfer to the departing orthotist, prosthetist, or pedorthist or any other orthotist, prosthetist, or pedorthist.

(iv) The choice of orthotist, prosthetist, or pedorthist in every case should be left to the patient, and the patient should be informed that, upon authorization, his patient records will be sent to the orthotist, prosthetist, or pedorthist of the patient’s choice.

Sale of an Orthotist, Prosthetist, or Pedorthist’s Practice – An orthotist, prosthetist, or pedorthist or the estate of a deceased orthotist, prosthetist, or pedorthist, may sell the elements that comprise his practice, which include the goodwill of the practice and the opportunity to take over the patients of the seller by purchasing those records; provided that nothing herein shall be deemed to preclude the ultimate decision-making rights of the patient. Therefore, the transfer of patient records upon the sale of an orthotist, prosthetist, or pedorthist’s practice is subject to the following:

(i) The orthotist, prosthetist, or pedorthist (or the estate) must ensure that all patient records are transferred to another orthotist, prosthetist, or pedorthist or entity that is held to the same standards of confidentiality as provided in these rules.

(ii) Patients seen by the orthotist, prosthetist, or pedorthist who meet the requirements of 1155-04-.22(3)(d)1. shall be notified that the orthotist, prosthetist, or pedorthist (or the estate) is transferring the practice to another orthotist, prosthetist, or pedorthist, or entity who will retain custody of their patient records and that, upon written authorization by the patient or the patient’s representative, the copies of their patient records will be sent to another orthotist, prosthetist, or pedorthist.

Failure to Adequately Provide for Transfer of Patient Records or Notify Patients – It shall be a prima facie violation of T.C.A. § 63-3-204(b)(9) and (10) for a orthotist, prosthetist, or pedorthist to depart from his group, retire, or sell his practice without making written provisions for the security or transfer of patient records, or otherwise establish and memorialize in writing a secure method of patient access to his patient records.

(e) Retention of Records – Patient records shall be retained for a period of not less than seven (7) years from the orthotist’s, prosthetist’s, or pedorthist’s last professional contact with the patient except for the following:

Patient records for incompetent patients, other than those who are incompetent solely because they are minors, shall be retained at least until one (1) year after the patient’s death or alleviation of incompetency.
Patient records of minors shall be retained for a period of not less than one (1) year after the minor reaches the age of majority or ten (10) years from the date of the orthotist’s, prosthetist’s, or pedorthist’s last professional contact with the patient, whichever is longer.
Notwithstanding the foregoing, no patient record involving services which are currently under dispute shall be destroyed until the dispute is resolved.
Nothing herein shall be deemed to supersede any federal or state law or

regulation requiring providers to retain patient records for periods longer than the time stated above.

(f) Destruction of Records – 1. No patient record shall be singled out for destruction other than in accordance with established office operating procedures.

Patient records shall be destroyed only in the ordinary course of business according to established office operating procedures that are consistent with these rules.
Physical copies of patient records may be destroyed by burning, shredding, or other method that safeguards patient protected health information from any use or disclosure that is in violation of any state or federal laws or regulations.
Any recordable and erasable media device upon which electronic patient records have been stored must be rendered inaccessible, cleaned, or scrubbed by overwriting the data, degaussing the media (using magnetic field to neutralize the data stored on magnetic media), or other method that safeguards patient protected health information from any use or disclosure that is in violation of any state or federal laws or regulations. Simply discarding a data storage device without rendering the data stored upon it inaccessible, cleaned, or scrubbed does not constitute compliance with this rule.
When patient records are destroyed, the time, date and circumstances of the destruction shall be recorded and maintained for future reference. The record of destruction need not list the individual patient records that were destroyed but shall be sufficient to identify which group of destroyed patient records contained a particular patient’s records.

(4) In addition to the requirements of this rule, orthotists, prosthetists, and pedorthists must also comply with the Health Insurance Portability and Accountability Act (HIPAA) and the regulations promulgated thereto if such entity is considered a Covered Entity as defined by HIPAA. Failure to comply with HIPAA shall constitute violation of this rule unless the provider proves to the satisfaction of the Board that he is not required to comply with HIPAA.

(5) Mandatory Release of Patient Records – (a) Pursuant to T.C.A § 63-2-102 and upon request from a patient or the patient’s authorized representative, an individual registered with this Board shall provide a complete copy of the patient’s records or a summary of such records which were maintained by the provider. The provider may charge a reasonable fee for production of such records as authorized in T.C.A. § 63-2-102.

(b) It shall be the provider’s option as to whether copies of the patient records or a summary will be given to the patient, in accordance with T.C.A. § 63-2-101(a)(1).

(c) Requests for patient records shall be honored by the provider in accordance with timelines identified in T.C.A. § 63-2-101.

(d) Nothing herein shall be deemed to supersede any federal or state law or regulation.

(6) Violations – Violation of any provision of these rules is grounds for disciplinary action pursuant to T.C.A. §§ 63-3-204(b)(9) and 63-3-204(b)(10).

(7) This rule shall be applied prospectively. An orthotist, prosthetist, or pedorthist shall not be found to be in violation of this rule if the violation occurred before the effective date of this

rule.

History

Authority: T.C.A. §§ 63-3-201, 63-3-202, and 68-11-302.
Administrative History: New rule filed May 7, 2021; effective August 5, 2021.

Tenn. Comp. R. & Regs. 1155-02-.07 .

(9) The requirement for licensure under these rules shall not apply to:

(a) A person who is employed by any bureau, division, or agency of the federal government while in the discharge of the employee’s official duties;

(b) A student enrolled in an educational program at a college or university which will enable that student to obtain a license to practice orthotics, prosthetics, or pedorthics upon graduation from the program;

(c) A resident continuing such resident’s clinical education in a residency accredited by the National Commission on Orthotic and Prosthetic Education; and (d) A student in a qualified work experience program or internship in pedorthics.

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155-02-.19 .

History

Authority: T.C.A. §§ 4-5-202, 4-5-204, 63-3-106, 63-3-202, 63-3-203, and 63-3-205.
Administrative History: Original rule filed July 13, 2006; effective September 26, 2006.

Tenn. Comp. R. & Regs. 1155 — Podiatric Medical Examiners

Chapter 1155-01 Rules of Procedure for Hearing Contested Cases

Tenn. Comp. R. & Regs. 1155-01 Rules of Procedure for Hearing Contested Cases

Chapter 1155-02 General Rules and Regulations Governing the Practice of Podiatry

Tenn. Comp. R. & Regs. 1155-02-.01 DEFINITIONS - As used in this chapter and in chapters 1155-03 and 1155-04, the following terms and acronyms shall have the following meanings ascribed to them:

Tenn. Comp. R. & Regs. 1155-02-.02 SCOPE OF PRACTICE

Tenn. Comp. R. & Regs. 1155-02-.03 ) Amendment filed October 3, 1990; effective November 17, 1990. Repeal and new rule filed November 10, 1998; effective January 14, 1999. Amendment filed April 26, 2006; effective July 10, 2006.

Tenn. Comp. R. & Regs. 1155-02-.04 QUALIFICATION FOR LICENSURE

Tenn. Comp. R. & Regs. 1155-02-.05 PROCEDURES FOR LICENSURE - To become licensed as a podiatrist in Tennessee, a person must comply with the following procedures and requirements:

Tenn. Comp. R. & Regs. 1155-02-.06 FEES

Tenn. Comp. R. & Regs. 1155-02-.07 APPLICATION REVIEW, APPROVAL, DENIAL, INTERVIEWS

Tenn. Comp. R. & Regs. 1155-02-.08 EXAMINATIONS

Tenn. Comp. R. & Regs. 1155-02-.09 LICENSURE RENEWAL

Tenn. Comp. R. & Regs. 1155-02-.11 RETIREMENT AND REACTIVATION OF LICENSE

Tenn. Comp. R. & Regs. 1155-02-.12 CONTINUING EDUCATION

Tenn. Comp. R. & Regs. 1155-02-.13 PROFESSIONAL ETHICS

Tenn. Comp. R. & Regs. 1155-02-.14 ACADEMIC LICENSE

Tenn. Comp. R. & Regs. 1200-10-01-.10 .

Tenn. Comp. R. & Regs. 1155-02-.15 DISCIPLINARY ACTIONS, CIVIL PENALTIES, ASSESSMENT OF COSTS, AND SUB-

Tenn. Comp. R. & Regs. 1155-02-.16 LICENSE

Tenn. Comp. R. & Regs. 1155-02-.17 CHANGE OF ADDRESS AND/OR NAME

Tenn. Comp. R. & Regs. 1155-02-.18 MEDICAL RECORDS

Tenn. Comp. R. & Regs. 1155-02-.19 BOARD MEETINGS, OFFICERS, CONSULTANTS, RECORDS, DECLARATORY

Tenn. Comp. R. & Regs. 1360-04-01-.18 regarding petitions for reconsiderations and stays in that case.

Tenn. Comp. R. & Regs. 1155-02-.20 CONSUMER RIGHT-TO-KNOW REQUIREMENTS

Tenn. Comp. R. & Regs. 1155-02-.21 PODIATRIC PROFESSIONAL CORPORATIONS AND PODIATRIC PROFESSION-AL

Tenn. Comp. R. & Regs. 1155-02-.22 ADVERTISING

Tenn. Comp. R. & Regs. 1155-02-.23 TAMPER-RESISTANT PRESCRIPTIONS

Tenn. Comp. R. & Regs. 1155-02-.24 MINIMUM DISCIPLINE FOR OPIOID PRESCRIBING

Chapter 1155-03 General Rules Governing Podiatry X-Ray Operators

Tenn. Comp. R. & Regs. 1155-03-.01 SCOPE OF PRACTICE AND CERTIFICATION

Tenn. Comp. R. & Regs. 1155-03-.02 EDUCATION, TRAINING, AND EXAMINATION REQUIREMENTS

Tenn. Comp. R. & Regs. 1155-03-.03 RECIPROCITY

Tenn. Comp. R. & Regs. 1155-03-.04 CONTINUING EDUCATION

Tenn. Comp. R. & Regs. 1155-03-.05 RENEWAL

Tenn. Comp. R. & Regs. 1200-10-01-.10 .

Tenn. Comp. R. & Regs. 1155-03-.06 FEES

Tenn. Comp. R. & Regs. 1155-03-.07 RETIREMENT AND REACTIVATION

Tenn. Comp. R. & Regs. 1155-03-.08 DISCIPLINARY ACTION

Tenn. Comp. R. & Regs. 1155-03-.09 CHANGE OF ADDRESS AND/OR NAME

Chapter 1155-04 General Rules Governing Orthotists, Prosthetists, and Pedorthists

Tenn. Comp. R. & Regs. 1155-04-.01 ORTHOTISTS

Tenn. Comp. R. & Regs. 1155-04-.02 PROSTHETISTS

Tenn. Comp. R. & Regs. 1155-04-.03 PEDORTHISTS

Tenn. Comp. R. & Regs. 1155-04-.04 RESTRICTIONS ON THE PRACTICE OF ORTHOTISTS, PROSTHETISTS, AND

Tenn. Comp. R. & Regs. 1155-04-.05 NECESSITY OF LICENSURE AND REGISTRATION OF RESIDENCY

Tenn. Comp. R. & Regs. 1155-04-.06 QUALIFICATIONS FOR LICENSURE

Tenn. Comp. R. & Regs. 1155-04-.07 PROCEDURES FOR LICENSURE

Tenn. Comp. R. & Regs. 1155-04-.08 EXAMINATIONS

Tenn. Comp. R. & Regs. 1155-04-.09 FEES

Tenn. Comp. R. & Regs. 1155-04-.10 RENEWAL OF LICENSURE

Tenn. Comp. R. & Regs. 1155-04-.11 RETIREMENT AND REACTIVATION

Tenn. Comp. R. & Regs. 1155-04-.12 CONTINUING EDUCATION

Tenn. Comp. R. & Regs. 1155-04-.13 DISCIPLINARY ACTIONS, SUBPOENAS, DECLARATORY ORDERS, SCREENING

Tenn. Comp. R. & Regs. 1155-04-.14 ADVERTISING

Tenn. Comp. R. & Regs. 1155-04-.15 CHANGE OF ADDRESS AND/OR NAME

Tenn. Comp. R. & Regs. 1155-04-.16 REPEALED

Tenn. Comp. R. & Regs. 1155-04-.17 SALE OF OVER-THE-COUNTER AND OFF-THE-SHELF DEVICES

Tenn. Comp. R. & Regs. 1155-04-.18 CUSTOM FABRICATED AND FITTED DEVICES

Tenn. Comp. R. & Regs. 1155-04-.19 OTHER LICENSED HEALTH CARE PRACTITIONERS

Tenn. Comp. R. & Regs. 1155-04-.20 PHARMACISTS, HOME MEDICAL EQUIPMENT PROVIDERS, AND ORTHOSIS

Tenn. Comp. R. & Regs. 1155-04-.21 THERAPEUTIC FOOTWEAR

Tenn. Comp. R. & Regs. 1155-04-.22 PATIENT RECORDS

Tenn. Comp. R. & Regs. 1155-02-.07 .

Tenn. Comp. R. & Regs. 1155-02-.19 .

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