HB 411, known as "Lucca's Law," requires Tennessee's TennCare program to cover medically necessary treatments for children with PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) and PANS (pediatric acute-onset neuropsychiatric syndrome). It mandates that all TennCare-managed care organizations (MCOs) provide coverage for specific treatments - including antibiotics, behavioral therapy, immunomodulating medicines, plasma exchange, and IVIG therapy - without higher co-pays or delays, and prohibits denial based on prior treatment or diagnosis changes. The law also requires MCOs to use "autoimmune encephalitis" coding for billing until specific PANDAS/PANS codes are established. This directly affects pediatric patients with these conditions and their families, ensuring consistent access to covered care under TennCare.
HB 858 requires Tennessee's insurance commissioner to study how easily patients and doctors can request exceptions to step therapy rules online. The study will assess whether insurers' processes are accessible without unnecessary barriers for those seeking coverage for cancer treatments. The commissioner must submit findings and recommendations by December 2025. This bill affects insurers and healthcare providers who handle step therapy requests but does not change current coverage requirements. It becomes effective January 1, 2026.
HB 979 establishes a new licensure process for anesthesiologist assistants in Tennessee, directly affecting these healthcare professionals and hospitals that employ them. The bill amends Tennessee Code Sections 63-1-160(g) and related provisions in Titles 47, 63, and 68, removing restrictions that previously limited hospitals from employing certain licensed physicians for specific medical services. This change updates hospital staffing rules to align with current healthcare practices. The law became effective on July 1, 2025, following the Governor's signature on May 21, 2025.
SB 231 requires Tennessee health insurance plans to cover speech therapy specifically for stuttering, including both habilitative (helping learn or improve communication skills) and rehabilitative (helping restore lost skills) services. The law prohibits annual visit limits, prior authorization, restrictions based on the cause of stuttering, and excludes utilization review for these services, while mandating coverage for both in-person and telehealth options. This requirement applies to health benefit plans renewing or issuing policies on or after July 1, 2025. The bill directly affects insured individuals seeking speech therapy for stuttering and insurers offering health coverage in Tennessee.
SB 881 removes limits on penalties for pharmacy benefits managers (PBMs) that fail to pay pharmacies promptly under Tennessee law. It requires PBMs to pay "clean claims" (complete, error-free claims) within 30 days for paper submissions and 14 days for electronic submissions, with interest accruing for late payments. The bill establishes tiered penalties: failing to pay 95% of clean claims triggers up to $10,000 in fines, 85% triggers $10,000-$100,000, and 60% triggers $100,000-$200,000. This directly affects PBMs (like those managing prescription drug benefits) and pharmacies that rely on timely payments from them.
SB 644 modifies Tennessee's nursing regulations to expand access to practical nursing programs at public colleges. It requires the Board of Nursing to allow students meeting high school diploma or equivalent qualifications to enroll in these programs and permits them to take the NCLEX-PN exam upon completion. The bill also mandates a minimum of 1,296 clock hours for practical nursing programs and requires public colleges to offer pre-nursing courses starting in high school. These changes directly affect prospective practical nurses and public institutions of higher education governed by the Tennessee Board of Regents.
SB 890 requires Tennessee health insurance companies to create two digital systems: one allowing healthcare providers to access patient electronic health records and another for processing prior authorization requests (like insurance approvals for treatments). It also shortens the timeline for certain health insurance actions by changing the requirement from 10 working days to 10 calendar days. This law directly affects health insurance entities, healthcare providers, and patients by improving access to medical records and streamlining authorization processes. The bill takes effect on July 1, 2025.
HB 865 changes Tennessee nursing education rules to make practical nursing programs more accessible. It requires the Board of Nursing to allow students who meet high school diploma or equivalent standards to enroll in public college practical nursing programs. The bill also mandates that students completing these programs can take the national NCLEX-PN licensing exam immediately after graduation, without additional requirements. Additionally, it sets a minimum of 1,296 clock hours for program completion and allows early high school access to nursing curricula. This law, effective July 1, 2025, directly affects students pursuing practical nursing licenses at Tennessee public institutions.
HB 869 requires Tennessee health insurance companies to create two new digital systems: a "provider access API" to let doctors quickly retrieve patient records electronically, and a "prior authorization API" to speed up insurance approvals for treatments. It directly affects health insurance entities by mandating these technical standards under revised state laws in Titles 8, 47, 56, 63, and 68. The bill also shortens a deadline for insurers from 10 working days to 10 calendar days for certain patient record requests. This law aims to improve efficiency in healthcare coordination by standardizing electronic access to records and prior authorization processes.
SB 1241 expands Tennessee's definition of child abuse to include children under 18 who witness another child being abused in their household or domestic violence against a family member in their home. This change directly affects minors in households experiencing abuse, as it now classifies their exposure as abuse under state law. The bill also requires that children placed in foster care due to abuse cannot be reunited with parents unless the parent follows their court-ordered plan and the child receives mental health counseling. These provisions apply to cases handled under Tennessee's child welfare system, specifically in Title 37 (child protective services) and related statutes.
