HB 638 prohibits healthcare providers participating in Tennessee's TennCare or CoverKids programs from denying services to enrollees solely because they refuse vaccines or immunizations. The bill requires the TennCare bureau to withhold reimbursement from providers who violate this rule and mandates the director to create implementing rules, including administrative review processes. Exceptions apply to oncology and organ transplant specialists. This law directly affects providers serving TennCare/CoverKids members and takes effect July 1, 2025.
HB 150 requires Tennessee's TennCare program to reimburse air ambulance services operating in the state at 67.5% of the federal Medicare rate for covered emergency or nonemergency transports to TennCare recipients. This applies to both public and private air ambulance providers with a Tennessee base of operations that bill for these services. The bill amends Tennessee Code Sections 71-5-165 and related provisions to establish this specific reimbursement rate. It directly affects air ambulance providers serving TennCare patients within Tennessee. The policy change takes effect upon becoming law for transports occurring on or after that date.
HB 1280 creates a $250 million "medical expense relief fund" within Tennessee's general fund to help the next of kin or estate of a decedent who was enrolled in TennCare at the time of death pay their unpaid medical debt and expenses. The Department of Human Services would administer the fund, setting application procedures, eligibility criteria (considering debt amount and need), and determining whether grants go to next of kin, the estate, or directly to creditors. Funds would be used solely for covering the decedent's medical costs, including unpaid TennCare benefits or premiums. The bill requires DHS to establish reporting mechanisms and submit annual reports to legislative committees, but it does not appropriate funds until the state budget act includes specific funding.
HB 364 ("Emma's Bill") changes Tennessee's TennCare program to require health officials to consider a patient's overall medical condition - not just cost - when deciding what care is medically necessary. It directly affects TennCare patients (especially those with complex needs like mobility issues, cognitive challenges, or life-support equipment) and the Tennessee Department of Health (the "bureau" managing TennCare). The bill adds specific factors to review, including mobility, communication ability, need for constant nursing supervision, and reliance on ventilators or life-sustaining equipment, even if more expensive care is needed. This overrides the previous rule that required choosing the "least costly alternative" for all decisions. The law takes effect July 1, 2025.
HB 173 sets new minimum (100%) and maximum (120%) reimbursement rates for rural hospitals providing services to TennCare patients, directly affecting rural hospitals with 49 or fewer beds located outside urbanized areas. The bill requires these rates to be calculated based on each hospital's current federal Medicare reimbursement rates. It amends Tennessee Code to define "rural hospital" and mandates that TennCare's reimbursement levels align with Medicare rates for routine inpatient care. The director may seek federal waivers to implement this without expanding Medicaid eligibility.
HB 1084 creates a state grant program to reimburse local schools (including public charter and private schools) and medical first responders for purchasing anti-choking devices. The program covers one device per school cafeteria and one device per emergency vehicle used by medical first responders, starting July 1, 2025. It limits total reimbursements to $500,000 and requires annual reports to the legislature detailing applications, awards, and funds used. The program expires on July 1, 2028, and requires separate legislative funding approval to operate.
HB 1158 would allow TennCare enrollees in Part A of the Katie Beckett program (children with disabilities requiring long-term care) to use their allocated funds for home and community-based services through health reimbursement arrangements. The bill requires the TennCare director to take necessary actions, including seeking federal waiver amendments, to enable this option. It directly affects families enrolled in the Katie Beckett program who currently access care funding through traditional methods. The policy change aims to provide greater flexibility in how these funds are utilized for care services.
HB 195 establishes separate reimbursement rates for ambulance services under Tennessee's TennCare program. Urban ambulance providers will be reimbursed at 67.5% of Medicare rates, while rural ambulance providers will receive 100% of Medicare rates for services to TennCare recipients. The bill also authorizes emergency medical equipment grants for for-profit rural ambulance service providers. These changes directly affect ambulance companies operating in rural or urban areas that bill TennCare. The policy aims to address cost disparities between service areas while maintaining existing billing frameworks.
HB 693 eliminates a requirement that could force insured patients to pay administrative fees for pharmacist-provided hormonal contraceptives when their pharmacy benefit already covers the cost. The bill directly affects insured patients using pharmacy benefits for hormonal contraceptives and pharmacists who dispense these medications. Key provisions amend Tennessee law to change language from "shall prohibit" to "must not prohibit" fees, ensuring patients cannot be charged extra for covered contraceptives. This change applies to all pharmacists authorized under Tennessee law who provide hormonal contraceptives to insured patients. The law takes effect July 1, 2025.
SB 1377, the Voluntary Portable Benefit Plan Act, allows businesses to voluntarily contribute to portable benefit plans for independent contractors. These plans, administered by third-party providers chosen by the contractor, cover health, disability, unemployment, life insurance, and retirement benefits. Contributions can be made directly by the business or by withholding a portion of the contractor’s pay, but only with a clear written opt-in agreement and the ability to opt out at any time. The bill amends Tennessee law to ensure these contributions cannot be used to determine a worker’s employment classification as an employee or independent contractor.
