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.
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.
HB 865 changes Tennessee nursing education rules to make practical nursing programs more accessible. It requires the Board of Nursing to allow students who meet high school diploma or equivalent standards to enroll in public college practical nursing programs. The bill also mandates that students completing these programs can take the national NCLEX-PN licensing exam immediately after graduation, without additional requirements. Additionally, it sets a minimum of 1,296 clock hours for program completion and allows early high school access to nursing curricula. This law, effective July 1, 2025, directly affects students pursuing practical nursing licenses at Tennessee public institutions.
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.
HB 760 authorizes healthcare providers to prescribe bronchodilator rescue inhalers to specific "authorized entities" (like schools, childcare centers, restaurants, and sports venues) for emergency use during asthma or respiratory distress episodes. It requires these entities to store inhalers in accessible, unlocked locations and train designated staff to administer them under pre-approved protocols. The bill also encourages all public schools and charter schools to maintain at least two inhalers in secure, accessible locations (e.g., offices or nurse’s stations) for student emergencies. Crucially, it provides legal protection for staff and entities who follow the protocols, shielding them from liability unless there was intentional disregard for safety. The law became effective May 2, 2025, after Governor’s signature.
HJR 100 is a resolution urging Tennessee’s opioid abatement council and participating counties to allocate at least 25% of opioid settlement fund expenditures toward distributing and promoting overdose reversal medications like Narcan. It directly affects the state’s opioid abatement council and counties that joined the opioid settlement agreement. The resolution requires these entities to prioritize funding for initiatives that save lives through medication access, rather than other uses of the fund. This is a non-binding recommendation, not a new law, aimed at accelerating reductions in overdose deaths.
This resolution urges the U.S. Congress to require the Department of Veterans Affairs (VA) to include veterans who received certain COVID-19 treatments (administered under Emergency Use Authorization before full FDA approval) and anthrax vaccinations as qualifying exposures under the PACT Act. It directly affects veterans exposed to these treatments during service, potentially expanding their access to VA healthcare and benefits previously reserved for those with toxic exposures like burn pits. The resolution also calls for Congress to investigate the military's administration of these substances, including whether they were given without proper consent or approval. As a non-binding resolution, it does not change VA policy but advocates for legislative action to address veterans' health concerns.
