HB 411, known as "Lucca's Law," requires Tennessee's TennCare program to cover medically necessary treatments for children with PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) and PANS (pediatric acute-onset neuropsychiatric syndrome). It mandates that all TennCare-managed care organizations (MCOs) provide coverage for specific treatments - including antibiotics, behavioral therapy, immunomodulating medicines, plasma exchange, and IVIG therapy - without higher co-pays or delays, and prohibits denial based on prior treatment or diagnosis changes. The law also requires MCOs to use "autoimmune encephalitis" coding for billing until specific PANDAS/PANS codes are established. This directly affects pediatric patients with these conditions and their families, ensuring consistent access to covered care under TennCare.
HB 858 requires Tennessee's insurance commissioner to study how easily patients and doctors can request exceptions to step therapy rules online. The study will assess whether insurers' processes are accessible without unnecessary barriers for those seeking coverage for cancer treatments. The commissioner must submit findings and recommendations by December 2025. This bill affects insurers and healthcare providers who handle step therapy requests but does not change current coverage requirements. It becomes effective January 1, 2026.
HB 979 establishes a new licensure process for anesthesiologist assistants in Tennessee, directly affecting these healthcare professionals and hospitals that employ them. The bill amends Tennessee Code Sections 63-1-160(g) and related provisions in Titles 47, 63, and 68, removing restrictions that previously limited hospitals from employing certain licensed physicians for specific medical services. This change updates hospital staffing rules to align with current healthcare practices. The law became effective on July 1, 2025, following the Governor's signature on May 21, 2025.
SB 231 requires Tennessee health insurance plans to cover speech therapy specifically for stuttering, including both habilitative (helping learn or improve communication skills) and rehabilitative (helping restore lost skills) services. The law prohibits annual visit limits, prior authorization, restrictions based on the cause of stuttering, and excludes utilization review for these services, while mandating coverage for both in-person and telehealth options. This requirement applies to health benefit plans renewing or issuing policies on or after July 1, 2025. The bill directly affects insured individuals seeking speech therapy for stuttering and insurers offering health coverage in Tennessee.
SB 881 removes limits on penalties for pharmacy benefits managers (PBMs) that fail to pay pharmacies promptly under Tennessee law. It requires PBMs to pay "clean claims" (complete, error-free claims) within 30 days for paper submissions and 14 days for electronic submissions, with interest accruing for late payments. The bill establishes tiered penalties: failing to pay 95% of clean claims triggers up to $10,000 in fines, 85% triggers $10,000-$100,000, and 60% triggers $100,000-$200,000. This directly affects PBMs (like those managing prescription drug benefits) and pharmacies that rely on timely payments from them.
SB 644 modifies Tennessee's nursing regulations to expand access to practical nursing programs at public colleges. It requires the Board of Nursing to allow students meeting high school diploma or equivalent qualifications to enroll in these programs and permits them to take the NCLEX-PN exam upon completion. The bill also mandates a minimum of 1,296 clock hours for practical nursing programs and requires public colleges to offer pre-nursing courses starting in high school. These changes directly affect prospective practical nurses and public institutions of higher education governed by the Tennessee Board of Regents.
SB 890 requires Tennessee health insurance companies to create two digital systems: one allowing healthcare providers to access patient electronic health records and another for processing prior authorization requests (like insurance approvals for treatments). It also shortens the timeline for certain health insurance actions by changing the requirement from 10 working days to 10 calendar days. This law directly affects health insurance entities, healthcare providers, and patients by improving access to medical records and streamlining authorization processes. The bill takes effect on July 1, 2025.
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 1241 expands Tennessee's definition of child abuse to include children under 18 who witness another child being abused in their household or domestic violence against a family member in their home. This change directly affects minors in households experiencing abuse, as it now classifies their exposure as abuse under state law. The bill also requires that children placed in foster care due to abuse cannot be reunited with parents unless the parent follows their court-ordered plan and the child receives mental health counseling. These provisions apply to cases handled under Tennessee's child welfare system, specifically in Title 37 (child protective services) and related statutes.
HB 495 sets maximum fees healthcare providers and third-party record release companies can charge when providing medical records to patients or other requesters. For paper copies, fees are capped at $25 for the first five pages, then 50 cents per page after that. For electronic copies, fees are limited to $5 for up to ten pages (25 cents per page after), with specific caps for radiology images and mailing costs. The bill requires providers to offer records electronically when available and prohibits third parties from exceeding these fee limits.
