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 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.
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.
