HB 44 allows students with prescribed rescue seizure medication (like emergency seizure drugs) to possess and self-administer it at school or school events. It requires three specific authorizations: a parent/guardian written statement, a healthcare provider's written details about the medication, and a liability waiver signed by parents. The medication must stay in its original sealed package with pharmacy label intact, and schools must keep these documents on file. The bill takes effect July 1, 2025, and clarifies that schools aren't liable for standard use (except in cases of willful misconduct).
SB 1261 requires Tennessee health insurance companies, including TennCare and pharmacy benefits managers, to follow strict rules when using artificial intelligence (AI) for healthcare decisions like approving treatments. It mandates that AI tools must base decisions on individual patient medical history and provider recommendations - not just group data - and cannot replace licensed doctors in determining medical necessity. Insurers must disclose AI use in their policies, regularly review AI performance, and ensure patient data is handled securely under HIPAA. The law prohibits AI from discriminating or causing harm and treats violations as unfair claims practices, allowing patients to sue for damages.
HB 1198 requires Tennessee health insurers and TennCare to allow patients to try biosimilar drugs (cost-effective copies of brand-name medications) before covering the original branded drug. It amends state law to permit health carriers to mandate a biosimilar trial for equivalent branded prescriptions, removing prior requirements for generic drug trials. The bill also directs TennCare’s pharmacy committee to consider biosimilar drugs when recommending medications for the state’s preferred drug list. These changes aim to reduce prescription drug costs by increasing biosimilar adoption, as stated in the bill’s legislative findings.
HB 693 eliminates a requirement that could force insured patients to pay administrative fees for pharmacist-provided hormonal contraceptives when their pharmacy benefit already covers the cost. The bill directly affects insured patients using pharmacy benefits for hormonal contraceptives and pharmacists who dispense these medications. Key provisions amend Tennessee law to change language from "shall prohibit" to "must not prohibit" fees, ensuring patients cannot be charged extra for covered contraceptives. This change applies to all pharmacists authorized under Tennessee law who provide hormonal contraceptives to insured patients. The law takes effect July 1, 2025.
SB 569 prevents pharmacies from charging administrative fees for hormonal contraceptives when a patient's insurance covers the cost and includes pharmacy benefits. It directly affects insured patients seeking hormonal contraceptives and pharmacists who previously might have charged such fees. The bill amends Tennessee law to remove language allowing pharmacies to require these fees, ensuring patients covered by insurance do not face additional costs. The law takes effect July 1, 2025, and applies to all pharmacies in Tennessee.
HB 1244 requires pharmacy benefits managers (PBMs) in Tennessee to pay pharmacies for prescription claims within 30 days for paper submissions and 14 days for electronic submissions if the claim is "clean" (complete, error-free, and without missing documentation). The bill removes previous caps on aggregate penalties for PBMs that fail to meet these payment deadlines, imposing tiered fines up to $200,000 for failing to process 60% of clean claims annually. It also mandates 1% monthly interest on overdue payments and defines key terms like "clean claim" to standardize processing requirements. This directly affects PBMs and pharmacists, ensuring faster reimbursement for prescription services under Tennessee’s insurance laws.
HB 1260 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 safety standards, comply with U.S. supply chain laws, list cost-saving drugs, and identify Canadian suppliers. If approved, the state would implement a program to import the most cost-effective drugs, aiming to reduce prescription drug costs for Tennessee residents, particularly those covered by TennCare. The bill does not guarantee savings or implementation but sets a timeline for seeking federal permission.
SB 424 would allow pharmacists in Tennessee to provide weight management services under existing collaborative agreements with doctors. This bill amends Tennessee laws (Title 63, Chapter 10 and Title 71, Chapter 5) to explicitly include weight management as an authorized service in these agreements. It directly affects pharmacists, enabling them to offer this support without needing separate physician authorization for each patient. The change takes effect upon becoming law, expanding patient access to weight management resources through pharmacy settings.
HB 870 prohibits insurers, pharmacy benefits managers, and third-party administrators from altering health plan coverage terms based on whether a patient qualifies for financial or product assistance for prescription drugs. The bill requires insurers to calculate enrollees' out-of-pocket costs using standard methods, including amounts paid by others on the enrollee's behalf, and explicitly bans conditioning coverage on drug assistance availability. It directly affects health plan enrollees and the entities managing prescription drug benefits in Tennessee. The law applies to health plans entered into, amended, or renewed on or after January 1, 2026, and amends multiple sections of Tennessee's health insurance code.
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.
