The Tennessee Medical Advisory Committee (MAC) met on February 10th to discuss evolving clinical policies and utilization trends impacting the state’s workers’ compensation program. Healthesystems attended the meeting to gain insights on developing regulatory changes and emerging utilization trends in Tennessee.

The Bureau’s Medical Director recapped a January 5, 2026, discussion with ODG about potential updates to Tennessee’s Medical Treatment Guidelines (MTGs). Of interest, proposed changes would shift physical therapy guidance away from visit and duration-based limits and toward a focus on functional improvement.

Additional proposals included updates to spine care, psychological evaluations, sacroiliac fusion criteria, and clarification of ODG guidance on post-surgical cold therapy for shoulder procedures.

ODG was receptive, and revisions are expected in a future release, though no formal MTG action was taken at this meeting.

The Committee also addressed operational challenges with peer-to-peer reviews, particularly the need to improve timely communication between providers and physicians conducting utilization review.

The Medical Director shared new Workers’ Compensation Research Institute (WCRI) findings showing state-to-state variation in joint replacement utilization. Tennessee’s rate is approximately 11 joint replacements per 1,000 claims, compared to 4 in Texas and 16 in Louisiana. Tennessee’s early revision rate – repeat joint replacement within two years – was 5.5%, compared to the national average of 4%.

Effectively, injured workers in Tennessee are requiring repeat surgeries sooner than average. The committee also noted that temporary disability following joint replacement averages about 48 weeks, nearly one-year post-surgery.

The next MAC meeting is scheduled for May 5, 2026.