If you test positive for TB does that automatically mean you have it?!

There is always the possibility of a false positive result in people infected with bacteria similar to the TB bacteria. However, if correctly interpreted, a positive TB skin test does indicate infection. After a positive test, a physical examination and chest x-ray are done to rule out active TB. If these are OK, the person is diagnosed with latent TB infection and may be recommended to receive treatment so that it does not escalate into an active infection. Unless there is some concern that the test was not performed correctly, there would be no reason to repeat the test. Vaccination status has nothing to do with it, at least for US-born persons, as there are no TB vaccines in general use in the US. There is a vaccine called BCG that is used in many other countries that can confuse the TB skin test results. However, even in someone vaccinated with BCG, a positive TB test is considered positive, especially if the vaccination were given many years previously, as the reactivity wanes over time.

Dr, public health

No. It could be a false-positive test. Usually if this happens, you go back in to your doctor for another test. After that one, an answer is more definitive.

I work in the healthcare profession as a firefighter/EMT, and I'm required to get tested for TB annually.

No. It just means that you've been EXPOSED to it. It is hard to get TB these days with the vacinations we get here in the USA. You can still get it though if your immune system is really bad like if you have AIDS or going through some tough chemotherapy.