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 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.
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.
HB 179 modifies Tennessee's criminal abortion law by adding exceptions that exempt certain abortions from criminal prosecution. It specifies that performing an abortion is not a crime if it is necessary to protect the pregnant person's physical or mental health, or if the pregnancy resulted from rape or incest (as defined in Tennessee law). The bill amends Title 39, Chapter 15 of Tennessee Code, reclassifying such abortions as non-criminal under these specific circumstances. This change takes effect July 1, 2025, directly affecting licensed physicians performing abortions and pregnant individuals in these defined situations.
House Joint Resolution 91 is a symbolic resolution expressing the Tennessee General Assembly's support for the SREB Crisis Recovery Network. It directly supports Tennessee schools, districts, and postsecondary institutions by endorsing a regional network that provides long-term, specialized counseling services after crises like natural disasters, school shootings, or public emergencies. The resolution recognizes that schools often lack sustained mental health resources, especially in rural areas, and highlights the network’s role in deploying trained counselors to aid recovery for students, teachers, and communities over extended periods. This is a non-binding statement of support, not a law imposing new requirements.
HB 295 would add doula services to Tennessee's TennCare Medicaid program, allowing certified doulas to provide covered support for pregnant individuals. The bill requires the Tennessee Department of Health to create a verification process for doulas who complete approved training programs covering pregnancy, childbirth, and postpartum care. This includes verifying knowledge of anatomy, emotional support strategies, comfort techniques, and community resources. The policy change would directly affect TennCare beneficiaries seeking doula support and certified doulas aiming to provide covered services. The bill does not change eligibility but expands covered services under TennCare.
