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STATE OF TENNESSEE
OFFICE OF THE ATTORNEY GENERAL
January 3, 2025
Opinion No. 25-001
Requirements for High-Risk Prescribers under Tenn. Code Ann. §§ 68-1-128(c)(3)(A)-(D)
Ouestion
Tennessee Code Annotated § 68-1-128(c) requires the Tennessee Department of Health to
identify high-risk prescribers of controlled substances. Once identified by the Department, Tenn.
Code Ann. § 68-1-128(c)(3) requires the Department to forward the prescriber's information to the
appropriate licensing board. The statute states that the licensing board shall notify the prescriber
of his or her high-risk status and as applicable, require the prescriber to undertake a series of
remedial steps defined in Tenn. Code Ann. §§ 68-1-128(c)(3)(A)-(D). Are those remedial steps
optional or required?
Opinion
The remedial steps set out in Tenn. Code Ann. §§ 68-1-128(c)(3)(A)-(D) are required, if
relevant to the prescriber's practice. They are not optional.
ANALYSIS
Tennessee Code Annotated § 68-1-128 is part of the constellation of statutes that Tennessee
uses to regulate controlled substances. The statute generally deals with health care providers that
prescribe controlled substances and contains a subset of provisions addressing frequent or high-
risk prescribers. Id. High-risk prescribers are identified based on clinical outcomes, including
patient overdoses. Id. § 68-1-128(c)(1). By contrast, frequent prescribers are identified by the
volume of controlled substances prescribed. Id. § 68-1-128(a)(1)(A)-(B).
As a general matter, Section 68-1-128(c) lays out a series of requirements for regulators in
dealing with high-risk prescribers. Id. §§ 68-1-128(c)(1)-(3). It begins at a high level of
generality by tasking the Department of Health with identifying high-risk prescribers, and from
there, with increasing specificity, adds requirements that either the Department or a prescriber's
licensing board must take.
The law commands that a high-risk prescriber shall be subject to selected chart review
and investigation by the [Department of Health]. Id. § 68-1-128(c)(1). And that the department
shall submit the high-risk prescriber's information to the board that issued the prescriber's license
for appropriate action. Id. § 68-1-128(c)(2).
The statute offers further instruction for what the pertinent licensing board must do once it
receives the high-risk prescriber's information. Section 68-1-128(c)(3) directs that [u]pon](ViewImageLocal?handle=hein.sag/sagtn0186&div=1&collection=&method=preview&ext=.png&size=3)