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.