SB 676 requires gender clinics receiving state funding to offer both gender transition and detransition procedures, and mandates that insurers covering transition procedures must also cover detransition. It applies to all gender clinics licensed in Tennessee and insurance providers offering such coverage. The bill also mandates clinics to report detailed statistics on gender transition procedures (including patient age, procedure type, and diagnoses) to the Department of Health monthly, with annual public reports starting in 2025. These requirements aim to increase transparency around gender healthcare services while imposing specific obligations on covered providers.
SB 225 requires Tennessee health insurers to reimburse chiropractic physicians at the same rate as medical doctors for identical services, amending Tennessee Code Annotated Titles 56 and 63. It prohibits insurers from using separate payment codes or methodologies for chiropractic services compared to physician services, ensuring equal reimbursement based on nationally recognized coding systems like the CPT book. This applies to private health insurance plans but excludes TennCare, CoverKids, and government-provided insurance. The bill aims to eliminate reimbursement disparities for chiropractors offering equivalent services to medical doctors. It was scheduled to take effect July 1, 2025, but failed in committee on March 25, 2025.
SB 579 would provide eligible Tennessee workers 12 weeks of job-protected leave for recovery after living organ donation surgery, with leave counted toward employment seniority. It prohibits insurers from denying coverage or charging more for life, disability, or long-term care insurance solely because someone is a living organ donor. The bill also requires the Tennessee Department of Health to create and post public educational materials about living organ donation by July 2025, covering benefits, risks, and insurance impacts. This bill directly affects living organ donors, employers, and insurance providers in Tennessee.
SB 898 creates a pilot program to improve maternal health care for pregnant TennCare recipients diagnosed with hypertension or diabetes through remote patient monitoring. The program provides participants with devices to track blood pressure and glucose levels, transmitting data securely to healthcare providers for real-time monitoring and support during pregnancy and up to three months postpartum. Administered by the Bureau of TennCare, it requires at least 300 participants across multiple counties and mandates that a technology vendor (selected by the bureau) deliver devices, provide training, and coordinate with healthcare teams. The pilot must be operational within 180 days of contracting with a managed care organization and technology vendor.
SB 1414, effective May 5, 2025, strengthens Tennessee's alignment with the federal 340B drug discount program by prohibiting drug manufacturers from restricting access to 340B drugs or imposing unfair requirements on participating entities. The bill directly affects 340B entities (such as community health centers and hospitals) and their contracted pharmacies, banning actions like denying 340B drug access, demanding extra health data, or applying stricter audit rules than for non-340B providers. Key provisions require manufacturers to comply with federal 340B rules and prohibit interference with 340B entities' drug choices or contracts. Violations carry a $50,000 civil penalty per violation, enforceable by the state commissioner or attorney general. The law explicitly states it does not override applicable federal 340B regulations.
SB 437 requires most health insurance plans in Tennessee to cover mental health and substance abuse services through a specific integrated care model called the Psychiatric Collaborative Care Model (PCCM), effective July 1, 2025. This model involves primary care providers, care managers, and psychiatric consultants working together to coordinate patient treatment using validated tools and regular assessments. Insurance plans may deny coverage only if they comply with existing state and federal mental health parity laws (including the MHPAEA) and medical necessity standards. The requirement applies to TennCare and CoverKids programs when services are deemed medically necessary by program guidelines.
SB 440 clarifies that standalone dental and vision insurance plans (known as "excepted benefits") are not required to cover specific medical treatments, services, or conditions unless state law explicitly mandates it. This change directly affects health insurance plans offering these stand-alone benefits, removing an implied obligation to cover certain medical needs under those plans. The law applies to all new or renewed insurance policies issued on or after July 1, 2025, ensuring clarity for insurers and policyholders. It does not alter existing coverage requirements for standard health insurance plans.
SB 299 amends Tennessee's medical cannabis commission membership requirements to include a patient caregiver (or former caregiver of a deceased patient) and a subject matter expert in cannabis cultivation, processing, distribution, or medical prescription. The bill also updates the commission's reporting duties to explicitly allow it to provide policy recommendations to the legislature alongside its findings. These changes, effective April 15, 2025, directly affect how the commission is structured and the scope of its advice to lawmakers on medical cannabis policy.
SB 436 requires Tennessee's Medicaid program (TennCare) to consider using biosimilar drugs - cost-saving, FDA-approved versions of biologic medications - as part of its drug coverage strategy. It also allows health insurers to require patients to try a biosimilar before covering a branded drug, and directs the state's pharmacy advisory committee to factor biosimilar use into recommendations for the state drug formulary. The bill amends multiple Tennessee Code sections governing drug coverage, pharmacy practices, and formulary decisions. These changes aim to reduce prescription drug costs by expanding the use of biosimilars while maintaining FDA safety and efficacy standards. The bill directly affects TennCare patients, health insurers, and the state's drug formulary decision-making process.
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.
