SB 334, the "Tennessee Medicaid Modernization and Access Act of 2025," requires TennCare to update reimbursement rates for key healthcare services - including obstetrics/gynecology, primary care, outpatient mental health, and substance use disorder treatment - to match either the Medicare fee schedule or average commercial rates (whichever is higher) starting in 2025. This directly affects Medicaid beneficiaries (by improving access to these services) and healthcare providers (by ensuring fairer payments). The bill mandates annual rate reviews to maintain alignment with federal guidelines and allows providers to request administrative hearings for payment disputes. It also includes provisions for quality-based incentive payments in underserved areas and requires annual reports on fiscal impacts and service access improvements.
SB 647 creates a $250 million medical expense relief fund to help the next of kin or estate of a person who died while enrolled in TennCare pay outstanding medical bills and related costs, including unpaid premiums and benefits. The Tennessee Department of Human Services will administer the fund, requiring applicants to submit documentation of the deceased person's medical debt and financial need. Grants may be awarded directly to families, estates, or medical providers, but must be used exclusively for the deceased's medical expenses. The fund, initially funded by a state appropriation, will carry forward any unspent balance to the next fiscal year.
SB 210 establishes separate reimbursement rates for rural and urban ambulance services under Tennessee's TennCare program. Rural ambulance providers will receive 100% of Medicare's allowable charge for services to TennCare recipients, while urban providers receive 67.5%. The bill also authorizes emergency medical services equipment grants for for-profit rural ambulance providers. It defines "rural" and "urban" areas using federal standards (per 42 CFR 414.605) to determine service locations. This directly affects ambulance service providers operating in rural versus urban areas and ensures TennCare covers their services at these adjusted rates.
SB 474 prohibits Tennessee healthcare providers from asking patients about firearm ammunition ownership, possession, or access during medical visits. It also bans denying treatment or recording such information unless medically relevant, and requires written notice if an inquiry occurs. Violations carry a $1,000 fine per incident and potential disciplinary action from licensing authorities. The law directly affects most healthcare providers (excluding psychiatrists/psychologists) and protects patients' rights regarding firearm ownership during medical care.
SB 402 prohibits healthcare providers from reporting a patient's medical debt to credit bureaus and bans credit bureaus from including medical debt in consumer credit reports. It directly affects patients (preventing medical debt from damaging credit scores), healthcare providers (who can no longer report such debt to bureaus), and credit bureaus (which must remove existing medical debt records). The law takes effect July 1, 2025, covering all medical debt from healthcare services, though providers may still report to debt collectors. Violations are enforced under Tennessee's Consumer Protection Act, with remedies available through the Attorney General's office.
SB 165 updates Tennessee's funding formula for human resource agencies by increasing the state's maximum annual contribution to match local government funding. It sets new thresholds: for local assessments of 1-20 cents per capita, the state will match up to $295,000; for 21-30 cents, up to $340,000; and for 31+ cents, up to $370,000 annually. This directly affects local governments that fund human services through per capita assessments, allowing them to secure higher state funding based on their contribution levels. The bill modifies Tennessee Code Annotated, Title 13, Chapter 26, without changing eligibility requirements. The change aims to strengthen state-local partnerships in delivering human services to residents.
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.
SB 1390 expands Tennessee's TennCare Program of All-Inclusive Care for the Elderly (PACE) by creating a new pilot program in a grand division without an existing PACE service area as of 2024. It also allows an existing PACE program in a specific county (population 366,200-366,300) to expand into contiguous counties meeting defined population thresholds (12,700-12,800; 32,800-32,875; or 108,600-108,700). The bill requires applicants to submit service area plans, market analyses, and proof of unmet need, while directing TennCare to coordinate referrals and monitor program quality. This law directly affects elderly Tennesseans eligible for nursing facility-level care who require comprehensive, integrated services through PACE programs.
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.
SB 289 creates a legal presumption that post-traumatic stress disorder (PTSD) diagnosed in law enforcement officers and emergency medical responders (EMTs) is work-related if it results from responding to specific incidents, making it automatically eligible for workers' compensation coverage. This directly affects those first responders by streamlining their claims process without requiring separate proof of work connection. The bill amends Tennessee Code Sections 7-51-206 and 50-6-101 to replace "firefighter" with "law enforcement officer or emergency medical responder" throughout the relevant workers' compensation provisions. The change takes effect July 1, 2025, applying to claims for PTSD incurred while performing official duties.
