HB 927 clarifies that certain health insurance benefits (like dental or vision coverage, called "excepted benefits") do not need to be included in standard health insurance plans unless state law explicitly requires them. This affects health insurance providers and policyholders in Tennessee by removing an obligation to cover these specific benefits as part of standard coverage. The bill specifies that excepted benefits are exempt from requirements to cover specific people, providers, treatments, or conditions unless mandated by law. It applies to new or renewed insurance policies on or after July 1, 2025.
SB 449, the "Fertility Treatment and Contraceptive Protection Act," establishes legal rights for individuals in Tennessee to access fertility treatments and contraception without state prohibition. It defines "fertility treatment" broadly to include procedures like in vitro fertilization, genetic testing of embryos, and medication for fertility, while defining "contraception" to cover methods such as birth control pills, emergency contraceptives, and sterilization. The law explicitly states that Tennessee law does not prohibit these activities, overriding conflicting state laws. This act takes effect on July 1, 2025, directly affecting all residents seeking these health services within the state.
HB 1198 requires Tennessee health insurers and TennCare to allow patients to try biosimilar drugs (cost-effective copies of brand-name medications) before covering the original branded drug. It amends state law to permit health carriers to mandate a biosimilar trial for equivalent branded prescriptions, removing prior requirements for generic drug trials. The bill also directs TennCare’s pharmacy committee to consider biosimilar drugs when recommending medications for the state’s preferred drug list. These changes aim to reduce prescription drug costs by increasing biosimilar adoption, as stated in the bill’s legislative findings.
HB 37 requires insurers offering health plans to Tennessee state employees to treat FDA-approved non-opioid pain medications equally with opioids on their preferred drug lists (PDL). It prohibits insurers from discouraging coverage for non-opioid options used for pain management, though it allows insurers to prefer one opioid over another or one non-opioid over another. This applies specifically to state employee group insurance plans covered under Tennessee Code Annotated sections 56-7-3801 to 56-7-3803. The law, effective January 1, 2026, aims to expand access to non-opioid pain treatments without mandating their preference.
HB 959 updates Tennessee's licensure rules for marriage and family therapists. It allows students in accredited programs to use titles like "marital therapy intern" while supervised, and clarifies that associate license holders must use "associate licensed marriage and family therapist" or "AMFT" (not implying full licensure). The bill creates specific pathways for associate licensure, requiring a 9-month exam deadline and supervised practice under approved supervisors, while defining "approved supervisor" to include AAMFT-approved professionals. These changes directly affect therapy students, trainees, and practitioners seeking licensure in Tennessee.
HB 843 declares Perry County Community Hospital in Linden and Decatur County General Hospital in Parsons as "necessary providers" of healthcare services for federal critical access hospital (CAH) designation eligibility under Section 1820 of the Social Security Act. This enables both hospitals to qualify for federal CAH status, which provides crucial financial support and resources to sustain operations in rural areas. The bill directly affects these two specific hospitals, ensuring they can access federal benefits to continue serving vulnerable rural communities in Perry and Decatur counties. It requires the Tennessee Department of Health and Health Facilities Commission to facilitate the federal designation process.
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 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 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.
