Healthcare (Medicare)

passed · Tennessee · House Apr 6, 2026

HB 1061: Insurance, Health, Accident - As introduced, prohibits an out-of-network ambulance service provider from balance billing an enrollee in a health benefit plan for emergency ambulance services; establishes allowable billable costs for such services. - Amends TCA Title 56, Chapter 7 and Title 68, Chapter 140.

HB 1061 prohibits out-of-network ambulance providers from charging patients extra fees (balance billing) for emergency ambulance services covered under their health insurance plan. It directly affects patients using emergency ambulance services who are enrolled in health benefit plans, ensuring they pay no more than the lesser of their in-network copay, the ambulance bill, or 325% of the Medicare rate for similar services in their area. The bill requires health insurers to count patient payments toward their deductibles and out-of-pocket limits, and bans providers from asking patients to waive these protections. The law takes effect July 1, 2025, for health plans issued or renewed on or after that date.

Topics ✓ HealthcareSupports HealthcareProhibits out-of-network ambulance balance billing, limits patient costs to in-network copays or 325% Medicare rate, directly protects patient rights and improves access to emergency care.95% confidence

Sub-Topics Insurance Medicare

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in committee · Tennessee · Senate Mar 26, 2025

SB 501: 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.

This bill would allow Tennessee's governor to expand Medicaid eligibility solely for sickle cell disease treatment, as permitted under federal law. It directly affects patients diagnosed with sickle cell disease in Tennessee who would gain access to Medicaid coverage for their treatment. The key mechanism requires the governor to negotiate terms with federal Medicare and Medicaid Services (CMS) to implement this targeted expansion under the Affordable Care Act. The bill amends specific Tennessee laws (TCA Title 4 and 71, Chapter 5) to authorize this limited Medicaid expansion.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid eligibility for sickle cell disease treatment, improving patient access to coverage under ACA framework.95% confidence

Sub-Topics Medicaid Medicare

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introduced · Tennessee · House Feb 5, 2025

HB 508: Insurance, Health, Accident - As introduced, extends from 30 to 60 days the period of time following delivery of a medicare supplement policy or certificate during which an applicant may have the premium refunded, and about which each medicare supplement policy or certificate must have notice prominently printed on the first page of the policy or certificate. - Amends TCA Title 4, Chapter 3, Part 13; Title 8; Title 55, Chapter 12; Title 56 and Title 71.

HB 508 extends the refund period for Medicare supplement policies (Medigap) in Tennessee from 30 to 60 days after policy delivery. This change directly affects consumers who purchase these policies, giving them more time to review coverage and request a premium refund if unsatisfied. The bill requires all policies to include a clear notice about the 60-day refund window prominently on the first page. It will take effect January 1, 2026, for policies delivered on or after that date.

Topics ✓ HealthcareSupports HealthcareExtends Medigap refund window to 60 days, enhancing consumer protection and decision-making rights in healthcare insurance policies.85% confidence

Sub-Topics Insurance Medicare

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in committee · Tennessee · Senate Mar 18, 2025

SB 552: Insurance, Health, Accident - As introduced, extends from 30 to 60 days the period of time following delivery of a medicare supplement policy or certificate during which an applicant may have the premium refunded, and about which each medicare supplement policy or certificate must have notice prominently printed on the first page of the policy or certificate. - Amends TCA Title 4, Chapter 3, Part 13; Title 8; Title 55, Chapter 12; Title 56 and Title 71.

SB 552 extends the refund period for Medicare supplement insurance policies in Tennessee from 30 to 60 days after policy delivery. It directly affects consumers purchasing these policies by giving them more time to cancel and receive a refund if they change their mind. The bill requires insurers to prominently display this 60-day window on the first page of every policy or certificate. This change applies to all new, renewed, or amended policies issued on or after January 1, 2026.

Topics ✓ HealthcareSupports HealthcareExtends Medicare supplement refund window from 30 to 60 days, enhancing consumer protection and choice in health insurance purchasing per bill's intent.85% confidence

Sub-Topics Insurance Medicare

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in committee · Tennessee · House Apr 9, 2025

HB 195: TennCare - As introduced, establishes separate reimbursement rates for ground-based rural ambulance services and urban ambulance services provided to TennCare recipients; allows for certain rural ambulance service providers to receive emergency medical services equipment grants. - Amends TCA Title 71.

HB 195 establishes separate reimbursement rates for ambulance services under Tennessee's TennCare program. Urban ambulance providers will be reimbursed at 67.5% of Medicare rates, while rural ambulance providers will receive 100% of Medicare rates for services to TennCare recipients. The bill also authorizes emergency medical equipment grants for for-profit rural ambulance service providers. These changes directly affect ambulance companies operating in rural or urban areas that bill TennCare. The policy aims to address cost disparities between service areas while maintaining existing billing frameworks.

Topics ✓ HealthcareSupports HealthcareIncreases rural ambulance reimbursement to 100% Medicare rates (vs urban 67.5%) and provides equipment grants, enhancing access to emergency medical services for rural TennCare patients.92% confidence

Sub-Topics Medicare

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in committee · Tennessee · Senate Jan 27, 2025

SB 164: TennCare - As introduced, directs the bureau to establish a temporary TennCare benefits program to provide medical assistance on a temporary basis to certain individuals who do not qualify for enrollment in TennCare, CoverKids, or a successor program; requires the bureau to submit a waiver to the federal centers for medicare and medicaid services by December 31, 2025. - Amends TCA Title 71, Chapter 5.

SB 164 creates a temporary healthcare program for low-income Tennesseans who don’t qualify for existing TennCare or CoverKids. It would provide medical assistance for up to 60 months total (with different limits for under-21 and 21+ individuals) to those with income at or below 138% of the federal poverty level. The program requires a federal waiver by December 2025, uses 90% federal and 10% state funding, and does not replace eligibility for existing programs. Enrollment would begin six months after federal approval, with benefits pausing if someone later qualifies for TennCare or CoverKids.

Topics ✓ HealthcareSupports HealthcareCreates temporary healthcare program expanding coverage for low-income Tennesseans excluded from existing TennCare/CoverKids, using federal funding to improve access without replacing current programs.95% confidence

Sub-Topics Medicaid Medicare

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in committee · Tennessee · Senate Apr 20, 2026

SB 210: TennCare - As introduced, establishes separate reimbursement rates for ground-based rural ambulance services and urban ambulance services provided to TennCare recipients; allows for certain rural ambulance service providers to receive emergency medical services equipment grants. - Amends TCA Title 71.

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.

Topics ✓ HealthcareSupports HealthcareEstablishes higher reimbursement rates (100% vs 67.5%) and equipment grants for rural ambulance services under TennCare, directly increasing funding and access to emergency healthcare services in underserved areas.95% confidence

Sub-Topics Medicare

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failed · Tennessee · House Feb 17, 2026

HB 1101: TennCare - As introduced, authorizes the governor to expand medicaid pursuant to the federal Patient Protection and Affordable Care Act; authorizes the governor to negotiate with the federal centers for medicare and medicaid services to determine the terms of the expansion. - Amends TCA Title 71, Chapter 5.

HB 1101 authorizes Tennessee's governor to expand Medicaid eligibility under the federal Affordable Care Act, directly affecting low-income residents who currently lack coverage. The bill updates state law to allow the governor to negotiate terms with federal Medicare and Medicaid officials (CMS) for this expansion. Key provisions include removing existing barriers to Medicaid expansion and establishing the governor's authority to implement the program. This change would enable Tennessee to extend coverage to approximately 200,000 additional low-income adults, aligning with federal ACA requirements. The bill is pending in the Insurance Committee for further review.

Topics ✓ HealthcareSupports HealthcareBill explicitly authorizes Medicaid expansion under ACA, directly increasing health coverage for low-income residents by removing barriers and enabling governor negotiations with CMS.95% confidence

Sub-Topics Medicaid Medicare

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in committee · Tennessee · House Apr 15, 2026

HB 767: Taxes, Business - As introduced, exempts from business tax, receipts from the sale of a prescription drug or medicine with a cost for a 30-day equivalent supply that exceeds the medicare cost threshold for 2025 plan years and services necessary for proper preparation, storage, handling, administration, patient education, or post-sale monitoring of such exempted drugs or medicines. - Amends TCA Title 67, Chapter 4, Part 7.

HB 767 exempts from Tennessee business tax the sales of prescription drugs or medicines that exceed the Medicare Part D specialty tier cost threshold for 2025 plan years, as set by federal Medicare. It also exempts related services like preparation, storage, administration, patient education, and post-sale monitoring for these drugs. The bill directly affects pharmacies and healthcare providers selling high-cost prescription drugs that meet the Medicare threshold. This tax exemption takes effect July 1, 2025, and amends Tennessee tax code sections 67-4-708 and 67-4-712.

Topics ✓ Budget & TaxesSupports Budget & TaxesExempts high-cost prescription drug sales from business tax, providing tax relief to pharmacies and healthcare providers selling drugs exceeding Medicare thresholds.95% confidence ✓ HealthcareSupports HealthcareExempts high-cost prescription drug sales from business tax, reducing pharmacy costs and improving access to Medicare Part D specialty medications for patients.85% confidence

Sub-Topics Business Taxes Sales Tax Tax Incentives Medicare Prescription Drugs

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failed · Tennessee · House Mar 5, 2025

HB 18: TennCare - As introduced, directs the bureau to establish a temporary TennCare benefits program to provide medical assistance on a temporary basis to certain individuals who do not qualify for enrollment in TennCare, CoverKids, or a successor program; requires the bureau to submit a waiver to the federal centers for medicare and medicaid services by December 31, 2025. - Amends TCA Title 71, Chapter 5.

HB 18 proposes a temporary health coverage program for Tennesseans who don't qualify for existing TennCare or CoverKids. It would provide up to 60 months of medical assistance (resetting at age 21) to individuals under 21 with income ≤138% of the federal poverty level, or adults ≥21 with similar income, subject to strict 12-month/24-month usage limits. The program requires a federal waiver by December 2025, uses 90% federal/10% state funding, and explicitly states it does not replace eligibility for regular programs (benefits pause if enrollment becomes possible). The bill failed in the Insurance Committee on March 5, 2025, and remains inactive.

Topics ✓ HealthcareSupports HealthcareCreates temporary coverage for ineligible low-income youth/adults, expands access via federal waiver, uses 90% federal funds to fill coverage gap for those excluded from TennCare/CoverKids.95% confidence

Sub-Topics Medicaid Medicare

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