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.
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.
SB 569 prevents pharmacies from charging administrative fees for hormonal contraceptives when a patient's insurance covers the cost and includes pharmacy benefits. It directly affects insured patients seeking hormonal contraceptives and pharmacists who previously might have charged such fees. The bill amends Tennessee law to remove language allowing pharmacies to require these fees, ensuring patients covered by insurance do not face additional costs. The law takes effect July 1, 2025, and applies to all pharmacies in Tennessee.
SB 1063 removes two notification requirements related to prior authorization for healthcare services in Tennessee. It eliminates the requirement for healthcare providers to notify patients when communicating with insurance companies about missing information for prior authorization, and it removes the requirement for insurance companies to notify patients when additional information is needed from the patient or provider. The bill directly affects healthcare providers, insurance companies, and patients by reducing administrative steps in the prior authorization process. These changes amend Tennessee Code sections 63-1-171 and 56-6-705, effective April 3, 2025.
SB 577 amends Tennessee's TennCare program by shortening the time frame for implementing the annual coverage assessment from seven days to five days. It also establishes limits on hospital payments under specific circumstances, directly affecting TennCare administrators and participating hospitals. The bill changes the timing requirement in Tennessee Code Annotated Section 71-5-2005(d)(2)(D) and became effective April 3, 2025, after being signed by the Governor.
HB 584 extends the expiration date of Tennessee's annual limit on new nursing home beds from June 30, 2025, to June 30, 2029. The bill maintains the current cap of 125 new nursing home beds per fiscal year that the Health Facilities Commission can approve through its certificate of need process. This change directly affects nursing home operators seeking to expand their facilities and the commission responsible for reviewing such requests. The bill does not alter the 125-bed limit but only extends the period during which it remains in effect.
HB 1157, the "Restore Trust in Public Health Messaging Act," requires Tennessee's Department of Health, local health departments, and state executive branch to ensure all public communications about FDA-regulated products (like medications) accurately reflect the FDA-approved or FDA-authorized labels. It prohibits promoting information that conflicts with these labels, including general product categories unless universally true or properly qualified. The law mandates an internal compliance review by July 2025, annual reporting to state officials starting in 2026, and a complaint process for violations with potential penalties. This directly affects state health agencies' public messaging about medical products, aiming to align communications with federal FDA standards.
SB 318, the "Tennessee Genomic Security and End Organ Harvesting Act," prohibits Tennessee health insurers from covering organ transplants sourced from the People's Republic of China or performed there, effective January 1, 2026. It also bans medical and research facilities from using genetic sequencing equipment or software produced by or linked to "foreign adversaries" (defined as nations on U.S. sanctions lists), requiring replacement within 180 days. The bill restricts storage of genetic sequencing data to U.S. geographic locations and prohibits remote access from outside the U.S. without state health commissioner approval. These provisions directly affect health insurers, hospitals, and research facilities operating in Tennessee.
HB 395, the "Tennessee Genomic Security and End Organ Harvesting Act," prohibits Tennessee health insurers from covering organ transplants or post-transplant care if the organ was sourced from China or procured through sale/donation originating in China. It also bans medical and research facilities from using genetic sequencing equipment or software produced by entities linked to "foreign adversaries" (specifically targeting China per the bill's context), requiring replacement within 180 days. Additionally, the bill mandates that all genetic sequencing data must be stored within the United States, with remote access from outside the country prohibited without approval from the state health commissioner. The law takes effect on January 1, 2026, directly affecting health insurers, hospitals, and research facilities operating in Tennessee.
