HB 484 requires health insurers and TennCare to cover biomarker testing for diagnosis, treatment, or monitoring of diseases starting January 1, 2026. It applies to all health benefit plans (including private insurance) and TennCare plans, mandating coverage when tests are supported by FDA approvals, clinical guidelines, or evidence-based standards. The bill specifies that insurers must approve or deny prior authorization requests within 24-72 hours and provide clear appeal processes for patients. This policy directly affects patients needing biomarker tests (e.g., for cancer treatment) and insurers managing coverage for these tests.
HB 29 requires health insurance companies to reimburse chiropractic physicians at the same rate as medical doctors for identical services, using the same payment methodology. It prohibits insurers from creating separate chiropractic codes or rates to avoid this requirement, applying to standard medical coding systems like CPT. The law directly affects chiropractors and insurers, but excludes state Medicaid (TennCare), CoverKids, and government-provided insurance. Key provisions mandate equal reimbursement calculations based on nationally recognized codes, with no impact on existing payment structures for exempt programs. The bill takes effect July 1, 2025.
SB 1389 prohibits healthcare providers participating in Tennessee's TennCare or CoverKids programs from refusing to treat patients solely because they decline vaccines or immunizations. It requires the state to stop reimbursing providers who violate this rule and mandates the TennCare director to create implementing regulations. The law excludes oncology and organ transplant specialists from the prohibition. The bill takes effect July 1, 2025, with rules to be established under state administrative procedures.
HB 867 creates a pilot program for pregnant TennCare recipients with hypertension or diabetes, using remote patient monitoring to improve maternal health outcomes. The program requires technology vendors to provide devices that track blood pressure, glucose, and other health data, deliver devices directly to participants, and train them on use - ensuring functionality without broadband access. A nursing team and healthcare provider must monitor data, provide health coaching, and establish emergency protocols. The pilot aims to serve at least 300 participants across selected counties and must launch within 180 days of vendor contracts. The bill is currently pending review by the Finance, Ways, and Means Committee.
HB 870 prohibits insurers, pharmacy benefits managers, and third-party administrators from altering health plan coverage terms based on whether a patient qualifies for financial or product assistance for prescription drugs. The bill requires insurers to calculate enrollees' out-of-pocket costs using standard methods, including amounts paid by others on the enrollee's behalf, and explicitly bans conditioning coverage on drug assistance availability. It directly affects health plan enrollees and the entities managing prescription drug benefits in Tennessee. The law applies to health plans entered into, amended, or renewed on or after January 1, 2026, and amends multiple sections of Tennessee's health insurance code.
HB 201 requires Tennessee's TennCare program to reimburse ambulance services at specific rates: 67.5% of Medicare's rate for emergency transports and 100% for nonemergency transports. It directly affects public and private ambulance providers operating in Tennessee that bill for services to TennCare recipients. The bill amends Tennessee law to set these reimbursement levels based on existing Medicare payment standards for participating providers. This policy change ensures ambulance services receive minimum payment rates aligned with federal Medicare benchmarks. The bill is currently under review by the Finance, Ways, and Means Subcommittee.
HB 295 would add doula services to Tennessee's TennCare Medicaid program, allowing certified doulas to provide covered support for pregnant individuals. The bill requires the Tennessee Department of Health to create a verification process for doulas who complete approved training programs covering pregnancy, childbirth, and postpartum care. This includes verifying knowledge of anatomy, emotional support strategies, comfort techniques, and community resources. The policy change would directly affect TennCare beneficiaries seeking doula support and certified doulas aiming to provide covered services. The bill does not change eligibility but expands covered services under TennCare.
HB 310 creates a legal presumption that post-traumatic stress disorder (PTSD) diagnosed in law enforcement officers or emergency medical responders (like EMTs and paramedics) was incurred while performing job duties, making it automatically eligible for workers' compensation coverage. This applies to those diagnosed after responding to specific incidents, shifting the burden to employers to prove otherwise. The bill amends Tennessee workers' compensation laws (TCA Title 7, Chapter 51 and Title 50, Chapter 6) to explicitly include these professions under the presumption, removing prior exclusions of "firefighter" language. It directly affects first responders who develop PTSD in the line of duty, streamlining their access to benefits starting July 1, 2025.
HB 782 creates a new pilot PACE (Programs of All-Inclusive Care for Elderly) program in one Tennessee grand division without an existing PACE program as of 2024, while allowing current PACE providers in counties with a 2020 census population of 366,200-366,300 to expand into contiguous counties meeting specific population thresholds (12,700-12,800, 32,800-32,875, or 108,600-108,700). It requires applicants to submit service area maps, market analyses proving unmet need, and CMS compliance certifications, and mandates annual reports to legislative leaders. The bill directly affects elderly Tennesseans eligible for PACE care (meeting federal CMS criteria) and PACE providers seeking to expand services. It became effective May 21, 2025, after Governor approval.
HB 717 creates the "Caring for Caregivers Act," establishing a pilot program that provides financial grants to family caregivers of individuals with Alzheimer's disease or related dementia. It directly affects caregivers who provide unpaid care to eligible family members living in private homes (not facilities) and incur eligible expenses like home modifications, medical equipment, or respite care. The program offers up to $6,000 annually per caregiver, with eligibility based on household income not exceeding $37,000 (adjusted annually for inflation) and requiring the care recipient to need assistance with at least two activities of daily living. The pilot runs from July 2025 through December 2028, funded through initial appropriations and dedicated state funds.
