SB 907 would exempt certain high-cost prescription drugs from Tennessee's business tax on sales receipts. The bill specifically targets prescription medicines where the 30-day supply cost exceeds the Medicare Part D specialty tier threshold for 2025, as determined by the federal Centers for Medicare and Medicaid Services. It also extends the tax exemption to services related to preparing, storing, handling, administering, educating patients about, and monitoring these exempted drugs. This change would apply to pharmacies and other entities selling these medications starting July 1, 2025.
SB 2575 prohibits Tennessee insurers from denying, conditioning, or charging higher rates for Medicare supplement policies to people under 65 who qualify for Medicare due to disability or end-stage renal disease (called "non-age eligible persons"). It requires insurers to offer these policies with the same benefits and pricing as for those 65+ if applicants meet specific criteria, such as applying within 60 days of their birthday or enrolling in Medicare Part B by 2027. Insurers must use a weighted average premium rate (based on all Medicare supplement policyholders aged 65+) for these applicants and cannot impose waiting periods or exclusions for preexisting conditions. The law takes effect January 1, 2027, applying to new or renewed policies after that date.
SB 1797 prohibits managed care organizations (MCOs) in Tennessee from unilaterally suspending, denying, terminating, or otherwise ending contracts with qualified nursing facilities participating in the TennCare program. The bill directly affects nursing homes certified to provide Medicaid nursing care and MCOs that contract with them. Key provisions require MCOs to report concerns about facility performance to the Bureau of TennCare (not to act independently), and grant the bureau exclusive authority to determine termination - only allowing MCOs to act if the bureau has authorized termination, suspended payments for fraud, or if the facility was excluded from Medicare/Medicaid. The bill ensures nursing facilities cannot be removed from TennCare networks without bureau approval, maintaining service continuity for Medicaid beneficiaries during reviews.
SB 1805 increases payments to ambulance service providers participating in Tennessee's TennCare program by raising the reimbursement rate from 67.5% to 110% of Medicare's allowable charges. It directly affects ambulance providers who serve TennCare patients by changing how they are paid for services. The bill also removes the "Ground Ambulance Service Provider Assessment Act" from state law. These changes take effect July 1, 2026, and focus on adjusting payment rates and eliminating a separate assessment requirement.
HB 2046 directs the first $150 million in health insurance tax revenue (starting July 2026) to access federal matching funds for specific healthcare providers. It will reimburse physicians, nurse practitioners, and physician assistants who provide services like office visits, women’s health care, or anesthesia under TennCare. Reimbursement will cover up to 110% of Medicare rates for these services. This applies to TennCare payments for care provided on or after July 2026.
SB 2036, the "Stabilizing Healthcare Access with Reimbursement Protections (SHARP) Act," requires most Tennessee health insurance companies to annually increase in-network reimbursement rates and annual benefit maximums for individual and group plans by at least the previous year's inflation rate (CPI-U), capped at 4%. It directly affects health insurers and in-network healthcare providers, excluding ERISA-covered plans, small plans (under 100 enrollees), Medicare Advantage, and TennCare. Insurers must file compliance documentation with the Insurance Commissioner by April 1 each year, with the commissioner prioritizing enforcement in areas with provider shortages. Optional catch-up adjustments for frozen rates (5+ years) are allowed up to 20%, with special consideration for rural and small providers.
HB 2005, the "TennCare Buy-In Act," proposes a new health coverage option for Tennesseans aged 18-64 who are not eligible for Medicare or other TennCare programs. It requires eligible individuals to pay monthly premiums based on household income (as a percentage of the federal poverty level), with lower or waived premiums for those below certain income thresholds. The program would provide full TennCare benefits - including managed care through existing networks - excluding non-emergency medical transportation. Enrollment would be administered by the Department of Finance and Administration, with annual renewals and strict premium payment requirements to maintain coverage.
SB 1852, the "TennCare Buy-In Act," creates a new health coverage option for Tennesseans aged 18 to 64 who are not eligible for Medicare or other TennCare programs. Eligible individuals must meet income requirements (based on federal poverty level), pay a monthly premium that increases with income, and not be incarcerated or enrolled in other TennCare categories. The program uses Tennessee's existing TennCare managed care networks to provide comprehensive health benefits, excluding non-emergency transportation, with premiums due monthly and failure to pay risking coverage termination and a three-month re-enrollment lockout. Enrollment requires an application through online, mail, or in-person channels, with eligibility determined within 60 days and annual renewal required.
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.
SB 2080 directs the first $150 million in tax revenue from Tennessee's health maintenance organization tax (starting July 1, 2026) to draw down federal funds for specific healthcare providers. It requires reimbursement for physicians, advanced practice registered nurses, and physician assistants who treat TennCare patients for evaluation, obstetrics/gynecology, or anesthesia services using designated medical billing codes. Reimbursement must cover up to 110% of the current Medicare rate for those services. The bill applies to TennCare reimbursements for services provided on or after July 1, 2026.
