HB 1291 requires Tennessee health insurance carriers to cover mental health services at the same level as coverage for alcoholism and drug dependence. This means insurance plans must provide equal benefits, coverage, and reimbursement rates for mental health treatment compared to substance use disorder treatment. The bill also mandates that insurers include clear explanations of this equal coverage in plan materials. It applies to all health insurance plans issued or renewed on or after July 1, 2025.
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.
SB 1369 removes the requirement for acute care hospitals in Tennessee to obtain state approval (a "certificate of need") to establish or operate, effective July 1, 2028. It defines "acute care hospital" as one primarily treating patients with an average stay of 25 days or less. This change directly affects new and existing acute care hospitals by eliminating a regulatory hurdle for expansion or operation. The bill amends specific Tennessee Code sections to implement this change, while maintaining certificate of need requirements for other hospital types.
SB 225 requires Tennessee health insurers to reimburse chiropractic physicians at the same rate as medical doctors for identical services, amending Tennessee Code Annotated Titles 56 and 63. It prohibits insurers from using separate payment codes or methodologies for chiropractic services compared to physician services, ensuring equal reimbursement based on nationally recognized coding systems like the CPT book. This applies to private health insurance plans but excludes TennCare, CoverKids, and government-provided insurance. The bill aims to eliminate reimbursement disparities for chiropractors offering equivalent services to medical doctors. It was scheduled to take effect July 1, 2025, but failed in committee on March 25, 2025.
SB 428 requires insurers offering health insurance plans to Tennessee state employees to treat non-opioid pain medications (FDA-approved for pain treatment) equally with opioids on their preferred drug list, ensuring they are not disadvantaged in coverage or discouraged. It also mandates separate reimbursement for healthcare providers and hospitals when non-opioid pain treatments are provided to covered employees. The law applies immediately upon FDA approval of a non-opioid drug and takes effect July 1, 2025. This directly affects insurers and state employee health plans under Tennessee Code.
SB 577 amends Tennessee's TennCare program by shortening the time frame for implementing the annual coverage assessment from seven days to five days. It also establishes limits on hospital payments under specific circumstances, directly affecting TennCare administrators and participating hospitals. The bill changes the timing requirement in Tennessee Code Annotated Section 71-5-2005(d)(2)(D) and became effective April 3, 2025, after being signed by the Governor.
SB 1395 changes how state-funded nursing home care grants are paid. It requires payments to be made either monthly or quarterly directly to the nursing home resident or their legally authorized representative, not to the nursing home facility itself. This applies to all recipients of these specific grants under Tennessee law, ensuring funds go directly to individuals who need care. The bill amends multiple sections of the Tennessee Code to implement this payment method change, effective July 1, 2025.
SB 692 requires Tennessee's Attorney General to annually report to legislative leaders (starting March 1, 2026) on violations of existing restrictions on medical procedures for minors related to gender identity. The report must include: (1) the number of violations reported to the Attorney General, (2) actions taken against healthcare providers who violated these rules, and (3) civil penalties collected. This bill directly affects the Attorney General's office (as the reporting entity) and healthcare providers who may perform restricted procedures. It does not change the underlying medical restrictions but adds transparency requirements for tracking enforcement.
HB 502 expands TennCare coverage to include diagnosis (including genetic testing) and treatment for Kleefstra syndrome, a rare genetic disorder affecting development and multiple body systems. It requires TennCare to provide this coverage in the same manner and extent as for autism spectrum disorder, Down syndrome (Trisomy 21), and other similar genetic disorders, when medically necessary. This applies to all enrolled individuals with Kleefstra syndrome and covers therapies, medications, assistive devices, and interventions aimed at improving quality of life. The law takes effect July 1, 2025, after being signed by the Governor in April 2025.
SB 1063 removes two notification requirements related to prior authorization for healthcare services in Tennessee. It eliminates the requirement for healthcare providers to notify patients when communicating with insurance companies about missing information for prior authorization, and it removes the requirement for insurance companies to notify patients when additional information is needed from the patient or provider. The bill directly affects healthcare providers, insurance companies, and patients by reducing administrative steps in the prior authorization process. These changes amend Tennessee Code sections 63-1-171 and 56-6-705, effective April 3, 2025.
