SB 676 requires gender clinics receiving state funding to offer both gender transition and detransition procedures, and mandates that insurers covering transition procedures must also cover detransition. It applies to all gender clinics licensed in Tennessee and insurance providers offering such coverage. The bill also mandates clinics to report detailed statistics on gender transition procedures (including patient age, procedure type, and diagnoses) to the Department of Health monthly, with annual public reports starting in 2025. These requirements aim to increase transparency around gender healthcare services while imposing specific obligations on covered providers.
SB 225 requires Tennessee health insurers to reimburse chiropractic physicians at the same rate as medical doctors for identical services, amending Tennessee Code Annotated Titles 56 and 63. It prohibits insurers from using separate payment codes or methodologies for chiropractic services compared to physician services, ensuring equal reimbursement based on nationally recognized coding systems like the CPT book. This applies to private health insurance plans but excludes TennCare, CoverKids, and government-provided insurance. The bill aims to eliminate reimbursement disparities for chiropractors offering equivalent services to medical doctors. It was scheduled to take effect July 1, 2025, but failed in committee on March 25, 2025.
SB 579 would provide eligible Tennessee workers 12 weeks of job-protected leave for recovery after living organ donation surgery, with leave counted toward employment seniority. It prohibits insurers from denying coverage or charging more for life, disability, or long-term care insurance solely because someone is a living organ donor. The bill also requires the Tennessee Department of Health to create and post public educational materials about living organ donation by July 2025, covering benefits, risks, and insurance impacts. This bill directly affects living organ donors, employers, and insurance providers in Tennessee.
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.
SB 898 creates a pilot program to improve maternal health care for pregnant TennCare recipients diagnosed with hypertension or diabetes through remote patient monitoring. The program provides participants with devices to track blood pressure and glucose levels, transmitting data securely to healthcare providers for real-time monitoring and support during pregnancy and up to three months postpartum. Administered by the Bureau of TennCare, it requires at least 300 participants across multiple counties and mandates that a technology vendor (selected by the bureau) deliver devices, provide training, and coordinate with healthcare teams. The pilot must be operational within 180 days of contracting with a managed care organization and technology vendor.
SB 706, the "TennCare Network Reporting Reform Act," requires Tennessee's Medicaid program (TennCare) to publicly report specific data about service access starting in 2026. It directly affects TennCare beneficiaries, particularly those using disability waiver programs like CHOICES and Employment and Community First CHOICES, by making system performance data accessible. The bill mandates annual publication of metrics including appointment wait times, time between service approval and receipt, service utilization rates, and network adequacy data, broken down by service type, county, and demographics. This data must be published on TennCare's website in a downloadable CSV format for public transparency.
SB 650 ("Emma's Bill") requires Tennessee's TennCare program to consider a patient's overall health condition - not just cost - when deciding if medical services are medically necessary. It directly affects TennCare patients (particularly those with complex needs like ventilator use or mobility issues) and the Tennessee Department of Health (the "bureau" making coverage decisions). The bill amends TennCare rules to mandate that reviewers assess factors like mobility, cognitive ability, need for supervision, and life-sustaining equipment, even if the chosen care isn't the least expensive option. This shifts the focus from cost-cutting to holistic patient needs in coverage determinations. The law takes effect July 1, 2025.
SB 1053 would allow TennCare enrollees in Part A of the Katie Beckett program (children with disabilities requiring long-term care) to access their allocated community-based care funds through health reimbursement arrangements instead of traditional service delivery. 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 by expanding how they can use their state-funded care resources. The change modifies Tennessee Code Annotated § 71-5-164 to implement this flexibility in fund utilization. This is a procedural policy change focused on administrative access to existing funds.
SB 185 establishes minimum (100%) and maximum (120%) reimbursement rates for rural hospitals providing routine inpatient services to TennCare enrollees. It directly affects rural hospitals defined as those with 49 or fewer beds located in non-urban census areas. The bill requires these rates to be based on each hospital's current Medicare reimbursement rates for the federal fiscal year, rather than a fixed formula. The legislation is pending review by the Senate Finance Committee and has not yet become law.
SB 748 changes how Tennessee's TennCare program reimburses ambulance services. It requires TennCare to pay public or private ambulance providers in Tennessee at least 67.5% of Medicare's rate for emergency transports and 100% of Medicare's rate for non-emergency transports. This applies specifically to ambulance services with a base of operations in Tennessee that bill for covered services provided to TennCare recipients. The bill amends Tennessee law to establish these specific reimbursement rates relative to Medicare's allowable charges.
