Healthcare (Medicaid)

signed · Tennessee · House May 14, 2026

HB 29: Chiropractors - As enacted, requires certain insurers to reimburse chiropractic physicians at the same rate as physicians for the same services. - Amends TCA Title 56, Chapter 7 and Title 63.

HB 29 requires health insurance companies to reimburse chiropractic physicians at the same rate as medical doctors for identical services, using the same payment methodology. It prohibits insurers from creating separate chiropractic codes or rates to avoid this requirement, applying to standard medical coding systems like CPT. The law directly affects chiropractors and insurers, but excludes state Medicaid (TennCare), CoverKids, and government-provided insurance. Key provisions mandate equal reimbursement calculations based on nationally recognized codes, with no impact on existing payment structures for exempt programs. The bill takes effect July 1, 2025.

Topics ✓ HealthcareSupports HealthcareRequires insurers to reimburse chiropractors equally to physicians for identical services, expanding access to chiropractic care under private insurance by mandating equal payment rates and prohibiting rate discrimination.95% confidence

Sub-Topics Insurance Medicaid

in committee · Tennessee · Senate Mar 26, 2025

SB 851: 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.

SB 851 would authorize Tennessee's governor to expand Medicaid coverage for low-income residents under the federal Affordable Care Act (ACA), directly affecting thousands of Tennesseans currently ineligible for Medicaid. The bill specifically allows the governor to negotiate the terms of this expansion with federal officials at the Centers for Medicare and Medicaid Services (CMS). It amends state law to remove barriers to implementing the ACA's Medicaid expansion, which would extend health coverage to more adults with low incomes. The bill does not create new funding but provides the legal framework for the state to join the federal Medicaid expansion program.

Topics ✓ HealthcareSupports HealthcareBill explicitly authorizes Medicaid expansion under ACA, removing barriers to extend coverage for low-income Tennesseans, directly advancing healthcare access and funding.95% confidence

Sub-Topics Medicaid Medicare

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in committee · Tennessee · Senate Feb 12, 2025

SB 1356: TennCare - As introduced, directs the governor to seek a new TennCare waiver within 180 days of the effective date of this act to provide medical assistance coverage for individuals whose gross annual income is equal to or less than 138 percent of the federal poverty level; clarifies that the amendment takes effect upon federal approval. - Amends TCA Title 71, Chapter 5.

SB 1356 directs Tennessee's governor to apply for a new federal waiver within 180 days of the bill's effective date. This waiver would expand TennCare coverage to cover individuals with gross annual incomes at or below 138% of the federal poverty level. The coverage would begin only after federal approval, as specified in the bill. The bill amends Tennessee Code Annotated, Title 71, Chapter 5, to implement this change.

Topics ✓ HealthcareSupports HealthcareExpands TennCare coverage to individuals at or below 138% of federal poverty level, directly increasing healthcare access for low-income residents per bill's mandate.95% confidence

Sub-Topics Medicaid

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in committee · Tennessee · House Feb 17, 2026

HB 1104: TennCare - As introduced, removes the requirement that the governor receive authorization by the general assembly prior to making any decision or obligating the state with regard to the expansion of optional enrollment in the medical assistance program. - Amends TCA Title 71.

HB 1104 removes a requirement that the Tennessee governor must obtain approval from the state legislature before making decisions about expanding Medicaid enrollment (TennCare). This change directly affects the governor's authority regarding Medicaid program expansions, eliminating the need for legislative authorization. The bill amends Tennessee Code Annotated Title 71 by deleting Section 71-5-126, which previously mandated that legislative approval be secured for such decisions. The policy change allows the governor to act independently on Medicaid expansion without prior consent from the General Assembly.

Topics ✓ HealthcareSupports HealthcareRemoves legislative approval barrier for Medicaid expansion, enabling easier program growth and increased coverage access per bill's intent to streamline TennCare enrollment decisions.95% confidence

Sub-Topics Medicaid

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in committee · Tennessee · Senate Apr 28, 2025

SB 436: Drugs, Prescription - As enacted, adds mandating the use of biosimilar drugs as a cost-saving measure the bureau of TennCare may implement; adds that a health carrier, health benefit plan, or utilization review organization may require a patient to try a biosimilar product prior to providing coverage for the equivalent branded prescription drug; requires the TennCare pharmacy advisory committee to consider as a factor the use of biosimilar drugs in the committee's recommendation to the bureau of TennCare on any drugs to be added to the state preferred drug list. - Amends TCA Title 4; Title 53; Title 56; Title 68 and Title 71.

SB 436 requires Tennessee's Medicaid program (TennCare) to consider using biosimilar drugs - cost-saving, FDA-approved versions of biologic medications - as part of its drug coverage strategy. It also allows health insurers to require patients to try a biosimilar before covering a branded drug, and directs the state's pharmacy advisory committee to factor biosimilar use into recommendations for the state drug formulary. The bill amends multiple Tennessee Code sections governing drug coverage, pharmacy practices, and formulary decisions. These changes aim to reduce prescription drug costs by expanding the use of biosimilars while maintaining FDA safety and efficacy standards. The bill directly affects TennCare patients, health insurers, and the state's drug formulary decision-making process.

Topics ✗ HealthcareOpposes HealthcareBill requires patients to try biosimilar before branded drug coverage, restricting immediate access to branded drugs and limiting patient choice in treatment options.90% confidence

Sub-Topics Medicaid Prescription Drugs

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failed · Tennessee · Senate Mar 18, 2025

SB 403: Consumer Protection - As introduced, requires a healthcare facility that accepts public funds as compensation for losses due to providing uncompensated care to ensure that an amount of outstanding patient debt equal to the amount of public funds accepted is designated as satisfied and that patient is notified of such satisfied debt; prohibits the healthcare facility from seeking a judgment or taking other legal action to collect from the debtor any portion of such debt that is so designated; requires the department of health and division of TennCare to submit an annual report on uncompensated care payments to hospitals. - Amends TCA Title 9, Chapter 8; Title 16; Title 18; Title 20; Title 21; Title 27; Title 28; Title 29; Title 33; Title 45; Title 47; Title 63; Title 68 and Title 71.

SB 403 requires Tennessee healthcare facilities receiving public funds (like Medicaid reimbursements) to cover uncompensated care costs to cancel debt equal to that funding for eligible patients. Facilities must notify patients whose debt is canceled and cannot pursue legal action for the canceled amount. The bill also mandates annual reports from the Department of Health and TennCare on uncompensated care payments to the legislature. It directly affects hospitals receiving public funds for charity care and patients with outstanding medical debt.

Topics ✓ HealthcareSupports HealthcareCancels patient debt for uncompensated care covered by public funds, prevents legal action for canceled debt, and improves access to healthcare services.95% confidence

Sub-Topics Medicaid

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in committee · Tennessee · Senate Apr 20, 2026

SB 334: TennCare - As introduced, enacts the "Tennessee Medicaid Modernization and Access Act of 2025," which aligns TennCare's current Medicaid reimbursement rates for obstetrics/gynecology, primary care, outpatient mental health, and substance use disorder treatment with the Medicare fee schedule or average commercial rates, whichever is higher. - Amends TCA Title 63; Title 68 and Title 71.

SB 334, the "Tennessee Medicaid Modernization and Access Act of 2025," requires TennCare to update reimbursement rates for key healthcare services - including obstetrics/gynecology, primary care, outpatient mental health, and substance use disorder treatment - to match either the Medicare fee schedule or average commercial rates (whichever is higher) starting in 2025. This directly affects Medicaid beneficiaries (by improving access to these services) and healthcare providers (by ensuring fairer payments). The bill mandates annual rate reviews to maintain alignment with federal guidelines and allows providers to request administrative hearings for payment disputes. It also includes provisions for quality-based incentive payments in underserved areas and requires annual reports on fiscal impacts and service access improvements.

Topics ✓ Budget & TaxesSupports Budget & TaxesIncreases state Medicaid spending by requiring higher reimbursement rates for essential healthcare services, directly funding public health programs.90% confidence ✓ HealthcareSupports HealthcareUpdates TennCare reimbursement rates to Medicare/commercial levels for mental health, OB/GYN, primary care, and substance use services, improving provider access and patient coverage.95% confidence

Sub-Topics Fees & Licensing Medicaid Medicare Primary Care

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