Healthcare (Medicaid)

in committee · Tennessee · House Apr 15, 2026

HB 1887: Disability and Aging, Dept. Of - As introduced, creates a licensure process for prescribed pediatric extended care programs; requires TennCare to submit a waiver to the federal centers for medicare and medicaid services seeking approval to provide coverage and benefits for those who receive services from a prescribed pediatric extended care program. - Amends TCA Title 52; Title 56 and Title 71.

HB 1887 creates a state licensure process for "prescribed pediatric extended care programs" (PPECs) in Tennessee, which provide nonresidential care to medically dependent or technologically dependent minors (under age 20) requiring ongoing, technology-based medical services (like ventilator support). The bill requires facilities operating these programs to obtain a license, limits care to 12 hours per day (not 24-hour care), and mandates that TennCare submit a federal Medicaid waiver request to cover services provided by licensed PPECs. It directly affects vulnerable minors with complex medical needs, their families, and PPEC operators seeking to provide these specialized services. The law amends Tennessee health, insurance, and social services codes to establish licensing standards, facility requirements, and oversight for these programs.

Topics ✓ HealthcareSupports HealthcareCreates licensure for pediatric care programs and requires TennCare to seek federal Medicaid waiver for coverage, expanding access to medically dependent minors.95% confidence

Sub-Topics Children's Health Medicaid Medical Licensing Tags Licensing People with Disabilities

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in committee · Tennessee · Senate Mar 3, 2026

SB 1722: Insurance, Health, Accident - As introduced, prohibits a health insurance issuer or managed health insurance issuer from reimbursing for testing services a medical laboratory that is eligible to participate as an in-network participating provider at a rate less than the CMS clinical laboratory fee schedule for medical labs in this state; permits a managed health insurance issuer to require such lab to meet the performance metrics required of in-network labs. - Amends TCA Title 56, Chapter 7, Part 23.

SB 1722 requires Tennessee health insurance companies to pay non-network medical laboratories (that are eligible to join an insurance network) at least the federal Centers for Medicare & Medicaid Services (CMS) clinical laboratory fee schedule rate for covered lab tests. It also allows insurers to set the same performance standards for these non-network labs as they do for in-network providers. The law will take effect on July 1, 2026, and applies to health insurance and managed health insurance issuers in Tennessee.

Topics ✓ HealthcareSupports HealthcareMandates insurers pay non-network labs at CMS clinical lab fee schedule rate, ensuring fair reimbursement and supporting lab access to healthcare services.95% confidence

Sub-Topics Insurance Medicaid Medicare

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signed · Tennessee · Senate Apr 29, 2025

SB 1097: DUI Offenses - As enacted, requires the state treasurer to deem a person ordered by a court to use a functioning ignition interlock device to be indigent and unable to pay the costs of the device if the person receives funds from the supplemental nutrition assistance, temporary assistance for needy families, or state medicaid program; removes the requirement that a court determine whether a person asserting inability to pay for a functioning ignition interlock device is indigent; revises other provisions relative to the electronic monitoring indigency fund. - Amends TCA Section 55-10-419.

SB 1097 changes Tennessee law for DUI offenders required to use ignition interlock devices (IIDs) by automatically deeming individuals receiving SNAP, TANF, or state Medicaid benefits as unable to pay for the device, eliminating the need for a court hearing to determine indigency. Under this bill, eligible individuals must pay $30 monthly toward device costs, with the state covering the remainder up to $170 per month from the electronic monitoring indigency fund. The law updates reimbursement procedures for device providers, requiring them to submit claims with court orders and proof of the person's benefit eligibility. This applies specifically to those ordered to use a functioning IID for DUI offenses.

Topics ✓ Criminal JusticeSupports Criminal JusticeAutomatically deems SNAP/TANF/Medicaid recipients indigent for IID costs, removing court hearings and reducing financial barriers - aligns with criminal justice reform by protecting low-income defendants' rights and promoting fair compliance.85% confidence ✓ HealthcareSupports HealthcareUses Medicaid eligibility to waive IID costs, preventing financial barriers to healthcare access for beneficiaries.85% confidence

Sub-Topics Courts Medicaid

in committee · Tennessee · Senate Apr 20, 2026

SB 1053: TennCare - As introduced, requires the director to take such actions as the director deems necessary to enable the bureau to make available to an enrollee in Part A of the Katie Beckett program the option to use the wraparound home- and community-based services funds allotted to the enrollee by means of a health reimbursement arrangement, including seeking a waiver amendment or new amendment. - Amends TCA Title 71, Chapter 5.

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.

Topics ✓ HealthcareSupports HealthcareExpands access to community-based care funds for disabled children via flexible reimbursement arrangements, improving healthcare options under TennCare without restricting funds or services.95% confidence

Sub-Topics Long-Term Care Medicaid

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in committee · Tennessee · Senate Mar 11, 2025

SB 1256: Drugs, Prescription - As introduced, requires the department of finance and administration, in collaboration with the department of health and the bureau of TennCare, to apply for federal approval to import prescription drugs from Canada. - Amends TCA Title 8; Title 33; Title 53; Title 56; Title 63; Title 68 and Title 71.

SB 1256 requires Tennessee's Department of Finance and Administration, working with the Department of Health and TennCare, to apply for federal approval by January 1, 2026, to import prescription drugs from Canada. The bill mandates that the application must prove imported drugs meet federal/state safety standards, comply with supply chain laws, list cost-saving drugs, and estimate annual savings versus importation costs. If approved, the state would implement a program focused on the most cost-effective drugs for TennCare (state Medicaid) and residents. This bill does not directly change drug prices or guarantee savings but sets a process for potential future cost reductions through federal approval. It affects state Medicaid programs and residents relying on prescription medications.

Topics ✓ HealthcareSupports HealthcareBill mandates state application to import Canadian prescription drugs to reduce costs, directly improving patient access and affordability of medications per healthcare topic indicators.95% confidence

Sub-Topics Medicaid

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in committee · Tennessee · Senate Apr 20, 2026

SB 650: TennCare - As introduced, enacts "Emma's Bill," which requires that when making a determination of medical necessity, the bureau shall take into consideration the patient's overall condition and use such overall condition as a factor to determine the level of funding and what medical items and services the patient receives, even if such determination does not result in the least costly course of diagnosis or treatment. - Amends TCA Title 4 and Title 71.

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.

Topics ✓ HealthcareSupports HealthcareRequires TennCare to consider patient's overall health condition - not just cost - for coverage decisions, improving access for complex cases like mobility or ventilator needs.90% confidence

Sub-Topics Medicaid

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in committee · Tennessee · Senate Feb 10, 2025

SB 205: TennCare - As introduced, requires a TennCare health benefit plan renewed or issued on or after July 1, 2025, by a health insurance carrier to provide coverage and reimbursement for biomarker testing for preeclampsia in pregnant women. - Amends TCA Title 56; Title 63; Title 68 and Title 71.

SB 205 requires TennCare health benefit plans (for Tennessee's Medicaid program) renewed or issued after July 1, 2025, to cover and reimburse FDA-approved biomarker testing for preeclampsia in pregnant women. This directly affects pregnant TennCare enrollees, health insurance carriers providing TennCare plans, and healthcare providers who order the tests. The bill mandates coverage only when ordered by a physician following clinical guidelines, using tests that meet FDA standards for detecting preeclampsia biomarkers in blood or tissue. The law takes effect July 1, 2025, with TennCare able to seek federal approval for coverage through CMS waivers.

Topics ✓ HealthcareSupports HealthcareMandates TennCare coverage for FDA-approved preeclampsia biomarker testing, expanding maternal health access and requiring reimbursement for physician-ordered tests.95% confidence

Sub-Topics Insurance Medicaid

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in committee · Tennessee · House Apr 30, 2025

HB 712: Disability and Aging, Dept. Of - As enacted, directs the commissioner and the director of TennCare to develop guidelines for service providers for hiring qualified family members as a family caregiver; specifies that the department and the bureau of TennCare shall not prohibit qualified individuals from employment as a family caregiver at a service provider agency based on certain listed criteria. - Amends TCA Title 52 and Title 71.

HB 712 requires Tennessee's Department of Disability and Aging and TennCare to create and publish guidelines for hiring family members as caregivers for individuals with disabilities receiving Medicaid services. It prohibits service providers from denying employment to qualified family caregivers based on factors like family relationships, residence, age, guardianship status, or specific Medicaid waiver programs (including Katie Beckett and self-determination waivers). The bill also prevents providers from reducing benefits for individuals with disabilities solely because care is provided by a family member, unless through the person-centered planning process. This directly affects family caregivers seeking employment, disability service providers, and individuals receiving long-term care services under Tennessee's Medicaid programs.

Topics ✓ HealthcareSupports HealthcareHB 712 improves patient access to disability care by mandating guidelines allowing family caregivers, preventing denials based on family ties/residence, directly supporting healthcare access indicators.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentProhibits discrimination in hiring for family caregivers based on family relationships, residence, or other factors, protecting workers' rights and advancing employment standards.95% confidence

Sub-Topics Long-Term Care Medicaid

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signed · Tennessee · Senate Apr 30, 2025

SB 1178: Disability and Aging, Dept. Of - As enacted, directs the commissioner and the director of TennCare to develop guidelines for service providers for hiring qualified family members as a family caregiver; specifies that the department and the bureau of TennCare shall not prohibit qualified individuals from employment as a family caregiver at a service provider agency based on certain listed criteria. - Amends TCA Title 52 and Title 71.

SB 1178 requires Tennessee's Department of Disability and Aging and TennCare to create guidelines enabling family members to work as caregivers for people with disabilities. It prohibits Medicaid service providers from denying employment to qualified family caregivers based on factors like family relationship, residence, age, or guardianship status. The bill also prevents providers from reducing benefits for individuals with disabilities solely because their caregiver is a family member. These changes ensure family caregivers can work without discrimination under Tennessee's Medicaid programs.

Topics ✓ HealthcareSupports HealthcareRequires TennCare to enable family caregivers as service providers, prevents benefit reductions for disabled individuals with family caregivers, and expands access to disability healthcare services.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentPrevents employment discrimination against family caregivers by prohibiting denial based on family relationship, residence, or guardianship, strengthening workers' rights in caregiving roles.90% confidence

Sub-Topics Medicaid

signed · Tennessee · House Mar 31, 2025

HB 236: Sunset Laws - As enacted, extends the Bureau of TennCare within the department of finance and administration to June 30, 2029. - Amends TCA Title 4, Chapter 29 and Title 71.

HB 236 extends the Bureau of TennCare (Tennessee's Medicaid program) within the Department of Finance and Administration until June 30, 2029, by amending Tennessee Code Sections 4-29-246 and 4-29-250. It removes a sunset provision and formally incorporates the Bureau's structure under Executive Order No. 23 (1999), ensuring its continued operation without future expiration. This bill directly affects the TennCare program's administrative structure and the Department of Finance and Administration's management of Medicaid services. The law became effective March 26, 2025, after Governor approval.

Topics ✓ HealthcareSupports HealthcareExtends TennCare Medicaid program until 2029, preventing termination and maintaining healthcare access for beneficiaries through continued administrative structure.95% confidence

Sub-Topics Medicaid