Healthcare (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

in committee · Tennessee · Senate Mar 23, 2026

SB 589: Insurance, Health, Accident - As enacted, expands the definition of a health benefit plan; requires a health benefit plan that amends, renews, or delivers a policy of coverage on or after January 1, 2026, and that provides coverage for prescription contraceptives, to provide coverage for a 12-month refill of contraceptives obtained at one time by an insured person. - Amends TCA Title 56 and Title 71.

SB 589 requires health insurance plans in Tennessee that cover prescription contraceptives to provide a 12-month refill option at one time, instead of shorter-term refills. This applies to all health benefit plans (including Medicaid/TennCare and CoverKids programs) that renew, amend, or issue coverage on or after January 1, 2026. The bill directly affects insured individuals who use prescription contraceptives by simplifying access to longer-term supply. It amends Tennessee law to expand the definition of "health benefit plan" and updates the effective date for this requirement. The policy change focuses on coverage mechanics, not outcomes or advocacy.

Topics ✓ HealthcareSupports HealthcareRequires 12-month contraceptive refills, expanding coverage access for reproductive health services and aligning with healthcare support indicators.90% confidence

Sub-Topics Insurance Medicaid

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passed both · Tennessee · Senate Mar 24, 2025

SB 44: Health Care - As introduced, adds doula services performed by a person with a verification of certification to the list of services that may be provided as medical assistance under the TennCare program; directs the department of health to establish by rule a process for the verification of certification to a person who demonstrates that the person has completed a doula training program that meets certain requirements. - Amends TCA Title 63 and Title 71.

SB 44 adds doula services to TennCare, Tennessee's Medicaid program, making coverage available for certified doulas who provide continuous emotional and physical support during labor, birth, and postpartum care. It directly affects low-income pregnant people in Tennessee who may now access doula support through TennCare. The bill requires the Department of Health to establish a certification verification process for doulas who complete approved training programs meeting specific standards, including knowledge of anatomy, support strategies, and community resources. This process will verify doulas' qualifications before they can provide services covered under TennCare.

Topics ✓ HealthcareSupports HealthcareAdds doula services to TennCare Medicaid, expanding coverage for low-income pregnant people and requiring certification verification to improve access to maternal health support.95% confidence

Sub-Topics Medicaid

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in committee · Tennessee · Senate Apr 20, 2026

SB 706: TennCare - As introduced, enacts the "TennCare Network Reporting Reform Act." - Amends TCA Title 71.

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.

Topics ✓ HealthcareSupports HealthcareRequires public reporting of TennCare service access metrics (wait times, approval delays), improving transparency and accountability for beneficiaries in disability waiver programs.80% confidence

Sub-Topics Medicaid

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in committee · Tennessee · House Apr 9, 2025

HB 1158: 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.

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.

Topics ✓ HealthcareSupports HealthcareExpands access to home/community-based services for disabled children by enabling flexible fund usage via health reimbursement arrangements under TennCare, improving patient access options.95% confidence

Sub-Topics Long-Term Care Medicaid

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in committee · Tennessee · Senate Mar 31, 2025

SB 58: 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.

SB 58 extends the existence of the Bureau of TennCare within Tennessee's Department of Finance and Administration until June 30, 2029, preventing its automatic termination. The bill amends Tennessee Code Annotated sections 4-29-246 and 4-29-250 to formally establish the Bureau's continued operation under the Department of Finance and Administration. This change directly affects the administrative structure managing TennCare (the state's Medicaid program) by ensuring its ongoing oversight without requiring new legislation each year. The extension applies to the Bureau itself, not the TennCare program's eligibility or benefits for residents.

Topics ✓ HealthcareSupports HealthcareExtends TennCare (state Medicaid) operations until 2029, maintaining existing healthcare coverage structure without termination.95% confidence

Sub-Topics Medicaid

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in committee · Tennessee · House Apr 15, 2026

HB 372: TennCare - As introduced, enacts the "Tennessee Medicaid Modernization and Access Act of 2025," which aligns TennCare's current Medicaid reimbursement rates for obstetrics/gynecology, primary care, outpatient mental health, and substance use disorder treatment with the Medicare fee schedule or average commercial rates, whichever is higher. - Amends TCA Title 63; Title 68 and Title 71.

HB 372, the "Tennessee Medicaid Modernization and Access Act of 2025," aligns TennCare’s reimbursement rates for key healthcare services - obstetrics/gynecology, primary care, outpatient mental health, and substance use disorder treatment - with either the Medicare fee schedule or average commercial rates in Tennessee, whichever is higher. This change directly affects healthcare providers who serve Medicaid patients and Medicaid beneficiaries, particularly in rural and underserved areas, by ensuring providers receive fairer compensation. The bill requires annual reviews to update rates based on Medicare or commercial benchmarks and mandates new annual reports on fiscal impacts and access improvements. It does not automatically appropriate funds but requires future budget allocations to cover implementation costs.

Topics ✓ Budget & TaxesSupports Budget & TaxesIncreases state Medicaid spending by aligning provider reimbursement rates with higher Medicare/commercial benchmarks, funding essential healthcare access for underserved populations.95% confidence ✓ HealthcareSupports HealthcareAligns TennCare reimbursement rates with higher Medicare/commercial rates, improving provider access and patient care for key services including mental health and substance use treatment in underserved areas.95% confidence

Sub-Topics Fees & Licensing Medicaid Medicare Primary Care

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failed · Tennessee · House Feb 3, 2026

HB 1393: TennCare - As introduced, directs the governor to seek a new TennCare waiver within 180 days of the effective date of this act to provide medical assistance coverage for individuals whose gross annual income is equal to or less than 138 percent of the federal poverty level; clarifies that the amendment takes effect upon federal approval. - Amends TCA Title 71, Chapter 5.

HB 1393 requires Tennessee's governor to apply for a federal waiver within 180 days of the bill's effective date to expand TennCare coverage to low-income residents earning up to 138% of the federal poverty level. This would directly affect Tennesseans currently ineligible for Medicaid under existing income limits, potentially providing medical assistance to thousands. The bill amends state law to mandate this waiver application process, with coverage taking effect immediately upon federal approval. The legislation focuses on procedural changes to access federal Medicaid funding, not on altering current eligibility rules.

Topics ✓ HealthcareSupports HealthcareExpands TennCare coverage to 138% FPL, increasing Medicaid eligibility for low-income Tennesseans and directly advancing healthcare access under federal waiver approval.95% confidence

Sub-Topics Medicaid

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in committee · Tennessee · House Mar 19, 2025

HB 15: TennCare - As introduced, authorizes the governor to expand medicaid eligibility solely for the purpose of providing treatment for a patient with a diagnosis of sickle cell disease in accordance with the federal Patient Protection and Affordable Care Act and to negotiate with the centers for medicare and medicaid services with respect to the terms of such expansion. - Amends TCA Title 4 and Title 71, Chapter 5.

HB 15 would allow Tennessee's governor to expand Medicaid eligibility exclusively for sickle cell disease treatment, in alignment with federal law. The bill requires the governor to negotiate with federal health officials (Centers for Medicare and Medicaid Services) on the specific terms of this expansion. This change would directly affect Tennessee residents diagnosed with sickle cell disease by potentially providing Medicaid coverage for their treatment. The expansion is strictly limited to sickle cell disease and must comply with the federal Patient Protection and Affordable Care Act.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid eligibility for sickle cell disease treatment, improving access to healthcare coverage per federal law and requiring CMS negotiations.95% confidence

Sub-Topics Medicaid Medicare

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failed · Tennessee · Senate Feb 4, 2026

SB 401: TennCare - As introduced, requires, on and after July 1, 2026, a minor who is enrolled in TennCare medicaid or the CoverKids program to remain eligible for such program until the minor reaches 18; prohibits the division of TennCare from subjecting the minor to a redetermination of eligibility or disenrollment, except under certain circumstances; requires the director of TennCare to submit any necessary federal waiver request by December 31, 2025. - Amends TCA Title 71.

SB 401 ensures minors enrolled in Tennessee's TennCare Medicaid or CoverKids program remain eligible until age 18, starting July 1, 2026, without requiring rechecks of their eligibility. The bill prohibits the TennCare division from removing minors from coverage except in specific cases like parental request, death, moving out of state, income exceeding limits, or enrollment fraud. The TennCare director must submit a federal waiver request by December 31, 2025, to implement this change. This directly affects minors under 18 currently covered by these programs, guaranteeing continuous healthcare access through age 18.

Topics ✓ HealthcareSupports HealthcareEnsures minors retain TennCare coverage until 18 without unnecessary eligibility checks, expanding access to healthcare services for young people.95% confidence

Sub-Topics Medicaid

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