Tennessee Pharmacy Bill Threatens Mental Health Meds Access

A Tennessee psychiatrist is sounding the alarm about proposed state legislation that could sever mental health treatment access for more than 137,000 of the state’s most vulnerable residents. 

The warning comes from Dr. Dovile Paulauskas, Chief Medical Officer of the McNabb Center, a community mental health provider serving 26 counties across the state. Paulauskas’ concerns center on legislation that its supporters have framed as a consumer protection measure.

Rehab services in The Volunteer State often live up to the nickname, as community members gladly give their time and effort to aid those in recovery. But Paulauskas warns that the pending legislation might complicate treatment for many residents, including veterans and family members.

What the FAIR Rx Act Would Do to Mental Health Care

SB2040/HB1959, known as the “Freedom, Access, and Integrity in Registered Pharmacy (FAIR Rx) Act,” would prohibit pharmacy benefit managers from having any ownership or beneficial interest in or control over a pharmacy license or a pharmacy itself. Supporters argue the bill eliminates conflicts of interest in the prescription drug industry. 

But for community mental health providers like the McNabb Center, the bill portends immediate and severe consequences.

The McNabb Center partners with Genoa Healthcare. This community pharmacy specifically serves people with severe persistent mental illness (SPMI). Patients often have schizophrenia, bipolar disorder, or substance use disorders. If the bill passes, all Genoa pharmacies and 100+ other community pharmacies statewide might be required to shut their doors. Over 137,000 people, more than 70% of whom depend on low-cost insurance programs like Medicare or Medicaid, stand to lose immediate access.

The Mental Health & Addiction Connection

For people managing co-occurring disorders or starting medical detox, continuity isn’t a convenience. It’s a clinical lifeline.

Dr. Paulauskas explains that missing even a single dose can destabilize a patient’s mental state and trigger a psychiatric crisis. For individuals with substance use disorders, a gap in medication access may push them back to using drugs, risking relapse or overdose.

The Genoa model is built to serve those with dual diagnoses. Pharmacists co-located within mental health clinics function as part of the care team, not as a separate vendor. 

Paulauskas describes a recent example. A patient from a group home arrived at Genoa agitated and confused. She believed she needed her medications immediately. A pharmacist who knew her well calmed her down and arranged safe transportation back to her group home. A potential medical emergency was resolved through trust and coordination which, Dr. Paulauskas notes, doesn’t happen at a drive-through window.

Specialized Services That Can’t Be Replaced Overnight

Genoa pharmacies go well beyond filling prescriptions. Community pharmacists manage mental health crises, handle prior authorizations, coordinate deliveries and administer all sorts of medications. Genoa alone dispenses 640,000+ prescriptions every year, many of them packaged and delivered for free.

Financial support is equally critical. When patients lack adequate coverage, Genoa connects them with grants and payment plans. That way, people don’t have to choose between medication and basic needs. This is often a lifeline for many SPMI patients who cycle in and out of insurance coverage.

For people receiving residential or outpatient mental health treatment, this coordination undergirds all forms of counseling, including cognitive (CBT) and dialectical behavior therapy (DBT), trauma-informed care and medication-assisted treatment (MAT).

Tennessee Already Under Strain

Paulauskas notes that Tennessee’s behavioral health system is already operating under significant pressure. The resulting gaps in care can drive people with undertreated conditions into emergency rooms, inpatient psychiatric units, and crisis services while costs mount.

Bill sponsors say the legislation won’t force pharmacies to close, but require companies to restructure their business models. For community mental health providers, however, the distinction between closure and forced divestiture may matter little if the integrated model that serves SPMI patients can’t survive the transition intact.

Finding Comprehensive Mental Health Treatment

If you or a family member are managing a serious mental illness, substance use disorder, or co-occurring condition, connecting with behavioral health treatment is critical no matter your location. Browse our directory or call 800-908-4823 (Sponsored) to get started.

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Courtney Myers, MS

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Courtney Myers has more than 15 years of experience in online writing and editing. Since graduating from N.C. State University with an MS in Technical Communication, she’s helped clients improve their visibility and reach through expert-level content creation. She specializes in addiction recovery and behavioral healthcare topics.

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Peter Lee, PhD

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Peter W.Y. Lee is a writer and historian of American history during the Cold War. His primary focus is the relationship between youth and popular culture and its impact on U.S. society during the twentieth century. He has published widely on how the public has used popular culture as a mechanism to address political and social shifts throughout time