HB 2569 requires Tennessee hospitals to offer specific vaccinations to inpatients aged 50 or older before discharge. During flu season (October 1-March 1), hospitals must provide influenza vaccines to all patients 50+; pneumococcal vaccines must be offered year-round to the same age group. This bill lowers the age threshold from 65 to 50 for both requirements, directly affecting patients 50+ admitted to hospitals. The policy aims to increase vaccination rates among this demographic, aligning with CDC recommendations and requiring hospitals to provide these vaccines unless medically contraindicated or vaccine is unavailable. The law takes effect July 1, 2026.
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.
HB 2313 authorizes Tennessee's Department of Health to establish a voluntary, home-based mental health program for children from birth to age five and their families. It directly affects families facing stressors like poverty, trauma, or parental mental health challenges by providing evidence-based home visits from licensed clinicians. Key provisions include home-based therapy, care coordination to connect families with services, developmental assessments, and strict quality standards to ensure program effectiveness. The program must prioritize at-risk families, coordinate with existing services, and report annually on outcomes and funding to the legislature.
SB 2153 would authorize Tennessee’s Department of Health to create a voluntary home visiting program for children aged birth to five and their families. The program provides evidence-based, home-based support through licensed clinicians to improve child mental health, reduce abuse/neglect risks, and strengthen family stability for families facing stressors like poverty or trauma. It requires care coordination to connect families with medical, housing, and social services, and mandates contracting with qualified nonprofit providers trained in trauma-informed practices. The bill also requires annual reports to the legislature tracking families served, outcomes, and funding sources, with implementation pending committee action.
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 1061 prohibits out-of-network ambulance providers from charging patients extra fees (balance billing) for emergency ambulance services covered under their health insurance plan. It directly affects patients using emergency ambulance services who are enrolled in health benefit plans, ensuring they pay no more than the lesser of their in-network copay, the ambulance bill, or 325% of the Medicare rate for similar services in their area. The bill requires health insurers to count patient payments toward their deductibles and out-of-pocket limits, and bans providers from asking patients to waive these protections. The law takes effect July 1, 2025, for health plans issued or renewed on or after that date.
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.
