Healthcare (Insurance)

died · Tennessee · Senate Feb 2, 2026

SB 2020: Insurance, Health, Accident - As introduced, prohibits health insurance entities from downcoding reimbursement claims from healthcare professionals except in limited circumstances; makes certain other changes related to health insurance claim adjudication. - Amends TCA Title 56, Chapter 7.

SB 2020 would prevent Tennessee health insurance companies from reducing payments for healthcare services (downcoding) except in specific, limited situations, requiring them to provide the treating provider's identification and credentials when doing so. It extends the validity of prior authorizations for essential treatments like mental health care, cancer therapies, opioid medications, and preventive services, reducing the need for repeated approvals for patients. The bill also prohibits insurers from using artificial intelligence tools alone to deny care, mandating that licensed physicians must review and approve such decisions based on individual patient history. This legislation would directly affect healthcare providers, insurers, and patients in Tennessee by streamlining payment processes and ensuring medical decisions are made by qualified professionals.

Topics ✓ HealthcareSupports HealthcareProhibits insurer downcoding without provider ID transparency, extends prior authorizations for mental health/cancer care, and protects healthcare professionals' reimbursement - directly improving access and provider rights.95% confidence

Sub-Topics Insurance Mental Health Substance Abuse

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in committee · Tennessee · House Apr 8, 2025

HB 1319: Health Care - As enacted, extends the CoverKids program from June 30, 2025, to June 30, 2030. - Amends TCA Section 71-3-1113.

HB 1319 extends Tennessee's CoverKids program, which provides health insurance for children, by changing its expiration date from June 30, 2025, to June 30, 2030. It amends Tennessee Code Annotated Section 71-3-1113 to update this deadline. The bill directly affects low-income children and families enrolled in CoverKids, ensuring continued eligibility for coverage through 2030. This is a straightforward extension of an existing program, with no changes to eligibility criteria or funding structure. The bill became law on April 8, 2025.

Topics ✓ HealthcareSupports HealthcareExtends CoverKids program, ensuring continued health insurance coverage for low-income children through 2030 without eligibility or funding changes.92% confidence

Sub-Topics Insurance

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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 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

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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

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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

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died · Tennessee · House Apr 29, 2025

HB 927: Insurance, Health, Accident - As enacted, clarifies that excepted benefits are not part of a requirement to provide coverage for a specific person, provider, treatment, service, condition, or disease, unless coverage of such excepted benefits is expressly required by law. - Amends TCA Title 56.

HB 927 clarifies that certain health insurance benefits (like dental or vision coverage, called "excepted benefits") do not need to be included in standard health insurance plans unless state law explicitly requires them. This affects health insurance providers and policyholders in Tennessee by removing an obligation to cover these specific benefits as part of standard coverage. The bill specifies that excepted benefits are exempt from requirements to cover specific people, providers, treatments, or conditions unless mandated by law. It applies to new or renewed insurance policies on or after July 1, 2025.

Topics ✗ HealthcareOpposes HealthcareRemoves obligation for insurers to cover dental/vision (excepted benefits) in standard plans unless explicitly required by law, restricting mandatory coverage scope.95% confidence

Sub-Topics Insurance

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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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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

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