HB 1280 creates a $250 million "medical expense relief fund" within Tennessee's general fund to help the next of kin or estate of a decedent who was enrolled in TennCare at the time of death pay their unpaid medical debt and expenses. The Department of Human Services would administer the fund, setting application procedures, eligibility criteria (considering debt amount and need), and determining whether grants go to next of kin, the estate, or directly to creditors. Funds would be used solely for covering the decedent's medical costs, including unpaid TennCare benefits or premiums. The bill requires DHS to establish reporting mechanisms and submit annual reports to legislative committees, but it does not appropriate funds until the state budget act includes specific funding.
HB 364 ("Emma's Bill") changes Tennessee's TennCare program to require health officials to consider a patient's overall medical condition - not just cost - when deciding what care is medically necessary. It directly affects TennCare patients (especially those with complex needs like mobility issues, cognitive challenges, or life-support equipment) and the Tennessee Department of Health (the "bureau" managing TennCare). The bill adds specific factors to review, including mobility, communication ability, need for constant nursing supervision, and reliance on ventilators or life-sustaining equipment, even if more expensive care is needed. This overrides the previous rule that required choosing the "least costly alternative" for all decisions. The law takes effect July 1, 2025.
HB 173 sets new minimum (100%) and maximum (120%) reimbursement rates for rural hospitals providing services to TennCare patients, directly affecting rural hospitals with 49 or fewer beds located outside urbanized areas. The bill requires these rates to be calculated based on each hospital's current federal Medicare reimbursement rates. It amends Tennessee Code to define "rural hospital" and mandates that TennCare's reimbursement levels align with Medicare rates for routine inpatient care. The director may seek federal waivers to implement this without expanding Medicaid eligibility.
HB 1084 creates a state grant program to reimburse local schools (including public charter and private schools) and medical first responders for purchasing anti-choking devices. The program covers one device per school cafeteria and one device per emergency vehicle used by medical first responders, starting July 1, 2025. It limits total reimbursements to $500,000 and requires annual reports to the legislature detailing applications, awards, and funds used. The program expires on July 1, 2028, and requires separate legislative funding approval to operate.
HB 1158 would allow TennCare enrollees in Part A of the Katie Beckett program (children with disabilities requiring long-term care) to use their allocated funds for home and community-based services through health reimbursement arrangements. The bill requires the TennCare director to take necessary actions, including seeking federal waiver amendments, to enable this option. It directly affects families enrolled in the Katie Beckett program who currently access care funding through traditional methods. The policy change aims to provide greater flexibility in how these funds are utilized for care services.
HB 693 eliminates a requirement that could force insured patients to pay administrative fees for pharmacist-provided hormonal contraceptives when their pharmacy benefit already covers the cost. The bill directly affects insured patients using pharmacy benefits for hormonal contraceptives and pharmacists who dispense these medications. Key provisions amend Tennessee law to change language from "shall prohibit" to "must not prohibit" fees, ensuring patients cannot be charged extra for covered contraceptives. This change applies to all pharmacists authorized under Tennessee law who provide hormonal contraceptives to insured patients. The law takes effect July 1, 2025.
SB 1377, the Voluntary Portable Benefit Plan Act, allows businesses to voluntarily contribute to portable benefit plans for independent contractors. These plans, administered by third-party providers chosen by the contractor, cover health, disability, unemployment, life insurance, and retirement benefits. Contributions can be made directly by the business or by withholding a portion of the contractor’s pay, but only with a clear written opt-in agreement and the ability to opt out at any time. The bill amends Tennessee law to ensure these contributions cannot be used to determine a worker’s employment classification as an employee or independent contractor.
HB 62 authorizes Tennessee athletic trainers to use dry needling for preventing, treating, and rehabilitating athletic injuries, directly affecting licensed athletic trainers in the state. The bill requires the Board of Athletic Trainers to establish minimum competency standards that practitioners must demonstrate to safely perform dry needling. It clarifies that this practice does not constitute acupuncture under existing law. The policy change expands athletic trainers' scope of practice with specific safety safeguards, effective March 28, 2025.
SB 569 prevents pharmacies from charging administrative fees for hormonal contraceptives when a patient's insurance covers the cost and includes pharmacy benefits. It directly affects insured patients seeking hormonal contraceptives and pharmacists who previously might have charged such fees. The bill amends Tennessee law to remove language allowing pharmacies to require these fees, ensuring patients covered by insurance do not face additional costs. The law takes effect July 1, 2025, and applies to all pharmacies in Tennessee.
HB 1074 removes two notification requirements related to prior authorization for healthcare services in Tennessee. It eliminates the obligation for healthcare providers to inform patients when communicating with insurers about missing information for prior authorization requests, and it removes the requirement for utilization review organizations to notify patients when providers fail to submit needed information within seven days. The bill directly affects patients, healthcare providers, and insurance entities by changing communication protocols during the prior authorization process. These changes amend Tennessee Code Sections 63-1-171(b) and 56-6-705(a), effective upon becoming law (Public Chapter 125, enacted April 8, 2025).
