Healthcare (Insurance)

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

Track

in committee · Tennessee · House May 15, 2025

HB 869: Health Care - As enacted, revises present law relative to a patient's electronic health record and requires a health insurance entity to establish and maintain a provider access API and a prior authorization API; makes related changes. - Amends TCA Title 8; Title 47; Title 56; Title 63 and Title 68.

HB 869 requires Tennessee health insurance companies to create two new digital systems: a "provider access API" to let doctors quickly retrieve patient records electronically, and a "prior authorization API" to speed up insurance approvals for treatments. It directly affects health insurance entities by mandating these technical standards under revised state laws in Titles 8, 47, 56, 63, and 68. The bill also shortens a deadline for insurers from 10 working days to 10 calendar days for certain patient record requests. This law aims to improve efficiency in healthcare coordination by standardizing electronic access to records and prior authorization processes.

Topics ✓ HealthcareSupports HealthcareMandates insurers to implement APIs for faster patient record access and prior authorization, improving healthcare efficiency and patient access per bill summary.95% confidence ✓ TechnologySupports TechnologyMandates health insurers to implement provider access and prior authorization APIs, directly advancing digital infrastructure for healthcare data interoperability and efficiency.95% confidence

Sub-Topics Insurance

Track

in committee · Tennessee · House Feb 10, 2025

HB 827: Employees, Employers - As introduced, requires an employer that terminates the employment of an employee who the employer knows to be pregnant and who is covered under an employer-sponsored health benefit plan to continue to provide coverage under the plan until the employee’s pregnancy ends. - Amends TCA Title 8, Chapter 27; Title 50; Title 56 and Title 71.

HB 827 requires employers to continue health insurance coverage for employees who are terminated while pregnant and covered under an employer-sponsored health plan. Employers must keep paying their share of premiums until the pregnancy ends, and employees must provide written confirmation of the pregnancy's end within 30 days. This applies to employers with health benefit plans starting July 1, 2025, directly affecting pregnant employees terminated during pregnancy. The law prevents employers from stopping coverage or insurers from dropping it without the employee's written confirmation.

Topics ✓ HealthcareSupports HealthcareRequires employers to maintain health coverage for terminated pregnant employees, preventing coverage gaps and protecting access to healthcare during pregnancy.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentRequires employers to maintain health coverage for terminated pregnant employees, protecting their benefits during pregnancy and preventing denial of coverage.95% confidence

Sub-Topics Insurance

Track

signed · Tennessee · Senate Apr 30, 2025

SB 1304: Insurance, Health, Accident - As enacted, extends the Access Tennessee health insurance program from June 30, 2025, to June 30, 2030. - Amends TCA Section 56-7-2916.

SB 1304 extends Tennessee's Access Tennessee health insurance program, which provides coverage for low-income residents, from ending on June 30, 2025, to June 30, 2030. The bill amends Tennessee Code Annotated Section 56-7-2916 to update the program's expiration date. This change ensures continued eligibility for current participants and future enrollees who qualify under the program's existing income and coverage criteria. The extension applies to all individuals currently enrolled or who meet the program's requirements before 2030.

Topics ✓ HealthcareSupports HealthcareExtends Access Tennessee health insurance program for low-income residents, ensuring continued coverage access without restrictions or funding cuts.95% confidence

Sub-Topics Insurance

failed · Tennessee · Senate Mar 11, 2025

SB 1010: Birth Control - As introduced, enacts the "Tennessee Contraceptive Freedom Act." - Amends TCA Title 4; Title 8; Title 53; Title 56; Title 63; Title 68 and Title 71.

SB 1010, the "Tennessee Contraceptive Freedom Act," establishes a fundamental right for all Tennesseans to access contraception without discrimination. It requires healthcare providers to either provide contraceptive services or refer patients to providers who do, while prohibiting restrictions that single out contraceptive care or impede access. The bill explicitly defines contraception as distinct from abortion and emphasizes equal access regardless of race, gender, income, or other factors, particularly protecting historically marginalized groups. It applies to all healthcare providers, health insurance carriers, and public health agencies across Tennessee.

Topics ✓ HealthcareSupports HealthcareEstablishes right to contraception access, mandates provider referrals, prohibits discriminatory restrictions - directly improves patient access to healthcare services95% confidence

Sub-Topics Insurance Public Health Women's Health

Track

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

Track

in committee · Tennessee · Senate May 27, 2025

SB 530: Military - As enacted, enacts the "Tennessee National Guard Servicemember's Medical Readiness Act." - Amends TCA Title 58, Chapter 1, Part 2.

This bill creates the "Tennessee National Guard Servicemember's Medical Readiness Act," establishing a state program to reimburse Tennessee National Guard members for certain health insurance premiums. It specifically covers premiums paid for TRICARE Reserve Select or TRICARE Dental coverage by eligible members who are Tennessee National Guard members and qualify for those programs. The military department will administer the program, with the adjutant general setting application rules, and it will not reimburse premiums already covered by federal government payments. The program requires separate annual appropriations by the legislature and takes effect on July 1, 2025.

Topics ✓ HealthcareSupports HealthcareReimburses National Guard members' TRICARE premiums, directly supporting insurance coverage access for a specific group under healthcare topic.85% confidence ✓ VeteransSupports VeteransReimburses TN National Guard members for TRICARE premiums, directly funding healthcare access for military personnel eligible for veteran benefits.95% confidence

Sub-Topics Insurance National Guard & Reserve

Track

in committee · Tennessee · House May 15, 2025

HB 296: Insurance Companies, Agents, Brokers, Policies - As enacted, requires TACIR to conduct a study on the feasibility of implementing and potential effects of enacting the insurance coverage requirements proposed in Senate Bill 231 of the 114th General Assembly, as originally filed; requires TACIR to publish a report of its findings and recommendations. - Amends TCA Title 8; Title 56; Title 63; Title 68 and Title 71.

HB 296 requires Tennessee health insurance plans to cover speech therapy for stuttering without annual limits, prior authorization, or restrictions based on the type of stuttering. It applies to all health benefit plans that renew or issue policies on or after July 1, 2025, directly affecting insurance companies and policyholders seeking speech therapy services. The law mandates coverage for both habilitative and rehabilitative speech therapy services, including telehealth options, without visit limits or medical necessity requirements. This implementation follows requirements originally proposed in Senate Bill 231 of the 114th General Assembly.

Topics ✓ HealthcareSupports HealthcareMandates insurance coverage for speech therapy without limits/restrictions, expanding patient access to essential healthcare services for stuttering treatment.95% confidence

Sub-Topics Insurance Telehealth

Track

signed · Tennessee · House May 14, 2026

HB 484: Insurance, Health, Accident - As enacted, requires a health insurer that issues, amends, delivers, or renews a contract or agreement for a health benefit plan to take effect on or after January 1, 2027, to include coverage for biomarker testing; requires a TennCare health benefit plan that is issued, amended, or renewed on or after January 1, 2027, to provide coverage for biomarker testing when medically necessary. - Amends TCA Title 56 and Title 71.

HB 484 requires health insurers and TennCare to cover biomarker testing for diagnosis, treatment, or monitoring of diseases starting January 1, 2026. It applies to all health benefit plans (including private insurance) and TennCare plans, mandating coverage when tests are supported by FDA approvals, clinical guidelines, or evidence-based standards. The bill specifies that insurers must approve or deny prior authorization requests within 24-72 hours and provide clear appeal processes for patients. This policy directly affects patients needing biomarker tests (e.g., for cancer treatment) and insurers managing coverage for these tests.

Topics ✓ HealthcareSupports HealthcareMandates insurers and TennCare to cover biomarker testing for diagnosis/treatment, expanding patient access to essential medical services.95% confidence

Sub-Topics Insurance

in committee · Tennessee · Senate Apr 7, 2026

SB 420: Insurance, Health, Accident - As introduced, prohibits an insurer, pharmacy benefits manager, or third-party administrator from changing or conditioning the terms of health plan coverage based on availability of financial or other product assistance for a prescription drug; establishes certain procedures for calculating an enrollee's contribution to an applicable cost sharing requirement. - Amends TCA Title 4; Title 8; Title 10; Title 53; Title 56; Title 63; Title 68 and Title 71.

SB 420 prohibits insurers, pharmacy benefits managers, and third-party administrators in Tennessee from altering health plan coverage terms - such as cost-sharing or benefit design - based on whether a patient has access to prescription drug assistance programs (like manufacturer coupons or patient aid). This directly affects health plan enrollees who use such programs to lower drug costs. The bill requires insurers to calculate cost-sharing contributions based on actual patient payments, not external assistance, and applies to plans entered into or renewed on or after January 1, 2026. It aims to prevent insurers from penalizing patients for utilizing available drug cost-saving resources.

Topics ✓ HealthcareSupports HealthcarePrevents insurers from penalizing patients using drug assistance programs, ensuring cost-sharing reflects actual patient payments and improving access to affordable medications.95% confidence

Sub-Topics Insurance Prescription Drugs

Track