HB 484 requires health insurers and TennCare to cover biomarker testing for diagnosis, treatment, or monitoring of diseases starting January 1, 2026. It applies to all health benefit plans (including private insurance) and TennCare plans, mandating coverage when tests are supported by FDA approvals, clinical guidelines, or evidence-based standards. The bill specifies that insurers must approve or deny prior authorization requests within 24-72 hours and provide clear appeal processes for patients. This policy directly affects patients needing biomarker tests (e.g., for cancer treatment) and insurers managing coverage for these tests.
HB 29 requires health insurance companies to reimburse chiropractic physicians at the same rate as medical doctors for identical services, using the same payment methodology. It prohibits insurers from creating separate chiropractic codes or rates to avoid this requirement, applying to standard medical coding systems like CPT. The law directly affects chiropractors and insurers, but excludes state Medicaid (TennCare), CoverKids, and government-provided insurance. Key provisions mandate equal reimbursement calculations based on nationally recognized codes, with no impact on existing payment structures for exempt programs. The bill takes effect July 1, 2025.
SB 2279 requires Tennessee's Department of Health to publish all inspection criteria used for pain management clinics on its website, making compliance standards transparent for clinics. It mandates that the department publicly share the criteria for identifying "high-risk" prescribers (based on patient overdose rates) and remove such designations after prescribers complete required training. The bill also exempts pain management specialists from the high-risk prescriber list and allows them to temporarily cover for medical directors without counting toward the four-clinic limit for medical directors. These changes directly affect pain management clinics, prescribers, and pain management specialists by clarifying regulatory expectations and providing pathways to address high-risk designations.
SB 1389 prohibits healthcare providers participating in Tennessee's TennCare or CoverKids programs from refusing to treat patients solely because they decline vaccines or immunizations. It requires the state to stop reimbursing providers who violate this rule and mandates the TennCare director to create implementing regulations. The law excludes oncology and organ transplant specialists from the prohibition. The bill takes effect July 1, 2025, with rules to be established under state administrative procedures.
HB 372, the "Tennessee Medicaid Modernization and Access Act of 2025," aligns TennCare’s reimbursement rates for key healthcare services - obstetrics/gynecology, primary care, outpatient mental health, and substance use disorder treatment - with either the Medicare fee schedule or average commercial rates in Tennessee, whichever is higher. This change directly affects healthcare providers who serve Medicaid patients and Medicaid beneficiaries, particularly in rural and underserved areas, by ensuring providers receive fairer compensation. The bill requires annual reviews to update rates based on Medicare or commercial benchmarks and mandates new annual reports on fiscal impacts and access improvements. It does not automatically appropriate funds but requires future budget allocations to cover implementation costs.
SJR 565 is a resolution designating March 2026 as "Endometriosis Awareness Month" in Tennessee. It does not create new laws or policies but aims to promote public and healthcare education about endometriosis, a chronic condition affecting approximately 1 in 10 women of childbearing age. The resolution highlights key issues like delayed diagnosis (averaging 10 years), symptoms including pelvic pain and infertility, and the need for greater awareness to improve early detection. This symbolic measure directly affects Tennessee residents by encouraging community engagement and education efforts during March 2026.
This Tennessee House Joint Resolution 1143 formally recognizes April 2026 as National Donate Life Month to honor organ, eye, and tissue donors and transplant recipients. The resolution highlights the urgent need for more donors, noting that thousands of Tennesseans are currently on the transplant waiting list and that thirteen people die daily while waiting for organs. It encourages citizens to register as donors through DonateLifeTN.org or at driver services centers, emphasizing that one donor can save up to seventy-five lives. The bill serves as a commemorative acknowledgment rather than creating new legal requirements or funding changes.
HB 867 creates a pilot program for pregnant TennCare recipients with hypertension or diabetes, using remote patient monitoring to improve maternal health outcomes. The program requires technology vendors to provide devices that track blood pressure, glucose, and other health data, deliver devices directly to participants, and train them on use - ensuring functionality without broadband access. A nursing team and healthcare provider must monitor data, provide health coaching, and establish emergency protocols. The pilot aims to serve at least 300 participants across selected counties and must launch within 180 days of vendor contracts. The bill is currently pending review by the Finance, Ways, and Means Committee.
HB 870 prohibits insurers, pharmacy benefits managers, and third-party administrators from altering health plan coverage terms based on whether a patient qualifies for financial or product assistance for prescription drugs. The bill requires insurers to calculate enrollees' out-of-pocket costs using standard methods, including amounts paid by others on the enrollee's behalf, and explicitly bans conditioning coverage on drug assistance availability. It directly affects health plan enrollees and the entities managing prescription drug benefits in Tennessee. The law applies to health plans entered into, amended, or renewed on or after January 1, 2026, and amends multiple sections of Tennessee's health insurance code.
HB 201 requires Tennessee's TennCare program to reimburse ambulance services at specific rates: 67.5% of Medicare's rate for emergency transports and 100% for nonemergency transports. It directly affects public and private ambulance providers operating in Tennessee that bill for services to TennCare recipients. The bill amends Tennessee law to set these reimbursement levels based on existing Medicare payment standards for participating providers. This policy change ensures ambulance services receive minimum payment rates aligned with federal Medicare benchmarks. The bill is currently under review by the Finance, Ways, and Means Subcommittee.
