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.
HB 1244 requires pharmacy benefits managers (PBMs) in Tennessee to pay pharmacies for prescription claims within 30 days for paper submissions and 14 days for electronic submissions if the claim is "clean" (complete, error-free, and without missing documentation). The bill removes previous caps on aggregate penalties for PBMs that fail to meet these payment deadlines, imposing tiered fines up to $200,000 for failing to process 60% of clean claims annually. It also mandates 1% monthly interest on overdue payments and defines key terms like "clean claim" to standardize processing requirements. This directly affects PBMs and pharmacists, ensuring faster reimbursement for prescription services under Tennessee’s insurance laws.
HB 296 requires Tennessee health insurance plans to cover speech therapy for stuttering without annual limits, prior authorization, or restrictions based on the type of stuttering. It applies to all health benefit plans that renew or issue policies on or after July 1, 2025, directly affecting insurance companies and policyholders seeking speech therapy services. The law mandates coverage for both habilitative and rehabilitative speech therapy services, including telehealth options, without visit limits or medical necessity requirements. This implementation follows requirements originally proposed in Senate Bill 231 of the 114th General Assembly.
SB 1414, effective May 5, 2025, strengthens Tennessee's alignment with the federal 340B drug discount program by prohibiting drug manufacturers from restricting access to 340B drugs or imposing unfair requirements on participating entities. The bill directly affects 340B entities (such as community health centers and hospitals) and their contracted pharmacies, banning actions like denying 340B drug access, demanding extra health data, or applying stricter audit rules than for non-340B providers. Key provisions require manufacturers to comply with federal 340B rules and prohibit interference with 340B entities' drug choices or contracts. Violations carry a $50,000 civil penalty per violation, enforceable by the state commissioner or attorney general. The law explicitly states it does not override applicable federal 340B regulations.
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.
HB 1203 allows Tennessee healthcare licensing boards to issue licenses with conditions requiring applicants to participate in a board-approved peer assistance program. This applies to healthcare providers whose medical conditions might affect their ability to practice competently, but the "private advocacy order" itself is not considered a license restriction. The order is confidential and not a public record, unless the provider fails to maintain participation, triggering disciplinary action. The bill amends Tennessee Code Annotated Title 63 to establish this process for conditional licensing.
