Healthcare (Insurance)

in committee · Tennessee · House Mar 18, 2026

HB 1646: Insurance, Health, Accident - As introduced, requires health benefit plans entered into, amended, or renewed on or after January 1, 2027, to provide coverage for services related to acquired brain injury; requires the commissioner of commerce and insurance to promulgate rules to provide a process for an expedited appeal of an adverse determination related to such coverage. - Amends TCA Title 8; Title 56 and Title 71.

HB 1646 requires Tennessee health insurance plans to cover specific treatments for acquired brain injury (ABI) starting January 1, 2027. It mandates coverage for 15 evidence-based therapies - including cognitive rehabilitation, neurobehavioral therapy, community reintegration services, and vision therapy - without lifetime limits or unreasonable annual caps on sessions. The bill also directs the state insurance commissioner to create rules for an expedited appeal process if insurers deny coverage for these ABI-related services. This affects health insurers offering plans in Tennessee and directly benefits individuals with ABI who require these specialized treatments.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for 15 ABI therapies without caps and creates expedited appeal process, expanding patient access to critical care services.95% confidence

Sub-Topics Insurance

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in committee · Tennessee · House Mar 11, 2026

HB 1866: Insurance, Health, Accident - As introduced, creates the "Regulate Artificial Intelligence (AI) In Health Care Act." - Amends TCA Title 8, Chapter 27; Title 56 and Title 71.

HB 1866, the "Regulate Artificial Intelligence in Health Care Act," requires health insurance companies, pharmacy benefits managers, and state health programs like TennCare to have a licensed healthcare professional review any AI-driven decision to deny, delay, or modify medical care based on medical necessity. The bill prohibits using AI alone for such decisions without this human review, which must consider the patient’s medical history, the provider’s recommendation, and individual clinical circumstances. Violations would be treated as unfair claims practices, allowing affected patients to sue for actual damages, punitive damages, and attorney fees. The law would take effect on July 1, 2026, for most purposes.

Topics ✓ HealthcareSupports HealthcareRequires licensed healthcare review for AI-driven care denials/delays, protecting patient rights and ensuring human oversight in medical necessity decisions.95% confidence ✓ TechnologySupports TechnologyMandates human review for AI-driven healthcare decisions, protecting patients from automated errors - aligns with regulating tech for consumer protection in healthcare.90% confidence

Sub-Topics Insurance Prescription Drugs Artificial Intelligence

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in committee · Tennessee · House Mar 4, 2026

HB 1848: Insurance, Health, Accident - As introduced, prohibits an insurer from denying, conditioning the issuance or effectiveness of, or discriminating in the pricing of a medicare supplement policy if an applicant meets certain listed requirements, including a non-age eligible person who submits an application for enrollment in a medicare supplement policy with a different insurer within 60 days of such person's birthday and makes other related changes. - Amends TCA Title 56.

HB 1848 prohibits Tennessee insurers from denying or charging higher rates for Medicare supplement policies based on health status, specifically for "non-age eligible persons" under 65 who qualify for Medicare due to disability or end-stage renal disease. It requires insurers to offer these policies at the weighted average premium rate (calculated across all Medicare-eligible age groups) without waiting periods or preexisting condition exclusions. The law applies to applicants who submit applications within 60 days of their birthday when switching insurers, or during specified enrollment periods before January 2027. The bill takes effect January 1, 2027, affecting insurers and this specific group of Medicare beneficiaries.

Topics ✓ HealthcareSupports HealthcareProhibits insurers from denying/charging higher rates for Medicare supplements based on health status, ensuring access for disabled/ESRD patients without preexisting condition exclusions.95% confidence

Sub-Topics Insurance Medicare

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in committee · Tennessee · House Feb 4, 2026

HB 1993: Insurance, Health, Accident - As introduced, prohibits a health insurance issuer or managed health insurance issuer from reimbursing for testing services a medical laboratory that is eligible to participate as an in-network participating provider at a rate less than the CMS clinical laboratory fee schedule for medical labs in this state; permits a managed health insurance issuer to require such lab to meet the performance metrics required of in-network labs. - Amends TCA Title 56, Chapter 7, Part 23.

HB 1993 prohibits health insurance issuers and managed health insurance issuers from reimbursing non-network medical laboratories for testing services at rates below the federal CMS clinical laboratory fee schedule in Tennessee. It requires these insurers to pay eligible labs at the CMS rate while allowing them to mandate that non-network labs meet the same performance metrics required of in-network laboratories. This bill directly affects health insurance companies, medical laboratories (particularly non-network providers), and patients who select labs for testing under insurance plans, as it standardizes reimbursement rates and ties lab performance to payment. The policy changes take effect July 1, 2026, and amend Tennessee Code Annotated Title 56, Chapter 7, Part 23.

Topics ✓ HealthcareSupports HealthcareMandates minimum CMS reimbursement for medical labs, preventing underpayment and ensuring access to testing services.90% confidence

Sub-Topics Insurance

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in committee · Tennessee · House Mar 11, 2026

HB 1775: Insurance, Health, Accident - As introduced, requires that a health plan, or an insurer offering a health plan, include coverage for clinical genetic testing for an inherited gene mutation for an individual with a personal or family history of cancer that is recommended by a healthcare professional, and evidence-based cancer imaging for an individual with an increased risk of cancer as recommended by National Comprehensive Cancer Network clinical practice guidelines. - Amends TCA Title 4; Title 56 and Title 71.

HB 1775 requires Tennessee health plans and insurers to cover two specific cancer-related services without out-of-pocket costs: genetic testing for inherited cancer risks (for individuals with personal or family cancer history, as recommended by a doctor) and evidence-based cancer imaging (for high-risk individuals per National Comprehensive Cancer Network guidelines). This applies to all health plans issued, amended, or renewed on or after July 1, 2026. The bill directly affects insurers by mandating coverage and patients with cancer risk factors by removing cost barriers to these screenings. It does not alter existing health savings account rules but ensures these preventive services are fully covered under the plan.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage for cancer genetic testing and imaging without out-of-pocket costs, expanding access to preventive care for high-risk patients.95% confidence

Sub-Topics Insurance

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in committee · Tennessee · Senate May 26, 2026

SB 2081: Insurance Companies, Agents, Brokers, Policies - As enacted, expands the prohibition, from stage 4 advanced metastatic cancer or metastatic blood cancer to any cancer, against a health benefit plan that provides coverage for cancer requiring the use of a step therapy protocol before the health benefit plan provides coverage for an approved prescription drug to an enrollee who has received a diagnosis of cancer. - Amends TCA Title 8; Title 56; Title 63; Title 68 and Title 71.

SB 2081 expands a Tennessee law that prohibits health insurance plans from requiring step therapy (trying less expensive treatments first) before covering approved cancer drugs. It removes the current restriction that only applied to "stage 4 advanced metastatic cancer or metastatic blood cancer," instead applying the prohibition to **all cancer diagnoses**. This means cancer patients in Tennessee with insurance plans covering cancer treatment cannot be forced through step therapy protocols before accessing approved drugs. The law takes effect January 1, 2027, for new or renewed insurance policies.

Topics ✓ HealthcareSupports HealthcareExpands prohibition on step therapy for all cancer patients, ensuring faster access to approved drugs without prior authorization barriers.95% confidence

Sub-Topics Insurance Prescription Drugs

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in committee · Tennessee · Senate Apr 20, 2026

SB 1626: Insurance, Health, Accident - As introduced, requires that a health plan, or an insurer offering a health plan, include coverage for clinical genetic testing for an inherited gene mutation for an individual with a personal or family history of cancer that is recommended by a healthcare professional, and evidence-based cancer imaging for an individual with an increased risk of cancer as recommended by National Comprehensive Cancer Network clinical practice guidelines. - Amends TCA Title 4; Title 56 and Title 71.

SB 1626 requires Tennessee health insurance plans to cover clinical genetic testing for inherited cancer risks (for individuals with personal or family cancer history) and evidence-based cancer imaging (for high-risk individuals), as recommended by healthcare providers or National Comprehensive Cancer Network guidelines. This applies to all health insurers in Tennessee, directly affecting patients seeking these specific cancer prevention and early detection services. The law mandates that this coverage must be provided without cost-sharing (no deductibles, copays, or coinsurance). The requirement takes effect for plans issued, amended, or renewed on or after July 1, 2026.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for cancer genetic testing and imaging, expanding patient access to preventive care as recommended by medical guidelines.95% confidence

Sub-Topics Insurance

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in committee · Tennessee · Senate Mar 3, 2026

SB 1722: Insurance, Health, Accident - As introduced, prohibits a health insurance issuer or managed health insurance issuer from reimbursing for testing services a medical laboratory that is eligible to participate as an in-network participating provider at a rate less than the CMS clinical laboratory fee schedule for medical labs in this state; permits a managed health insurance issuer to require such lab to meet the performance metrics required of in-network labs. - Amends TCA Title 56, Chapter 7, Part 23.

SB 1722 requires Tennessee health insurance companies to pay non-network medical laboratories (that are eligible to join an insurance network) at least the federal Centers for Medicare & Medicaid Services (CMS) clinical laboratory fee schedule rate for covered lab tests. It also allows insurers to set the same performance standards for these non-network labs as they do for in-network providers. The law will take effect on July 1, 2026, and applies to health insurance and managed health insurance issuers in Tennessee.

Topics ✓ HealthcareSupports HealthcareMandates insurers pay non-network labs at CMS clinical lab fee schedule rate, ensuring fair reimbursement and supporting lab access to healthcare services.95% confidence

Sub-Topics Insurance Medicaid Medicare

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died · Tennessee · Senate Feb 2, 2026

SB 2020: Insurance, Health, Accident - As introduced, prohibits health insurance entities from downcoding reimbursement claims from healthcare professionals except in limited circumstances; makes certain other changes related to health insurance claim adjudication. - Amends TCA Title 56, Chapter 7.

SB 2020 would prevent Tennessee health insurance companies from reducing payments for healthcare services (downcoding) except in specific, limited situations, requiring them to provide the treating provider's identification and credentials when doing so. It extends the validity of prior authorizations for essential treatments like mental health care, cancer therapies, opioid medications, and preventive services, reducing the need for repeated approvals for patients. The bill also prohibits insurers from using artificial intelligence tools alone to deny care, mandating that licensed physicians must review and approve such decisions based on individual patient history. This legislation would directly affect healthcare providers, insurers, and patients in Tennessee by streamlining payment processes and ensuring medical decisions are made by qualified professionals.

Topics ✓ HealthcareSupports HealthcareProhibits insurer downcoding without provider ID transparency, extends prior authorizations for mental health/cancer care, and protects healthcare professionals' reimbursement - directly improving access and provider rights.95% confidence

Sub-Topics Insurance Mental Health Substance Abuse

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in committee · Tennessee · House Apr 8, 2025

HB 1319: Health Care - As enacted, extends the CoverKids program from June 30, 2025, to June 30, 2030. - Amends TCA Section 71-3-1113.

HB 1319 extends Tennessee's CoverKids program, which provides health insurance for children, by changing its expiration date from June 30, 2025, to June 30, 2030. It amends Tennessee Code Annotated Section 71-3-1113 to update this deadline. The bill directly affects low-income children and families enrolled in CoverKids, ensuring continued eligibility for coverage through 2030. This is a straightforward extension of an existing program, with no changes to eligibility criteria or funding structure. The bill became law on April 8, 2025.

Topics ✓ HealthcareSupports HealthcareExtends CoverKids program, ensuring continued health insurance coverage for low-income children through 2030 without eligibility or funding changes.92% confidence

Sub-Topics Insurance

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