Healthcare (Insurance)

in committee · Tennessee · House Mar 19, 2025

HB 651: Insurance, Health, Accident - As introduced, prohibits a health insurance entity or TennCare MCO from including an all-products clause in a network participation agreement with a healthcare provider, and makes certain other changes related to MCO network adequacy. - Amends TCA Title 56 and Title 71.

HB 651 prohibits health insurance companies and TennCare managed care organizations (MCOs) from including "all-products clauses" in contracts with healthcare providers. These clauses would force providers (like doctors, nurses, and physician assistants) to join multiple networks or offer services under other plans from the same insurer as a condition of participation. The bill makes such clauses void and imposes a $10,000 civil penalty per violation on insurers. It requires the insurance commissioner to create rules by July 2026 to enforce this prohibition, directly affecting provider contracts and network access.

Topics ✓ HealthcareSupports HealthcareBans restrictive 'all-products clauses' forcing providers into multiple insurer networks, improving provider choice and access to care.95% confidence

Sub-Topics Insurance

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in committee · Tennessee · House Jan 28, 2025

HB 70: 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.

HB 70 requires TennCare health benefit plans (renewed or issued on or after July 1, 2025) to cover and reimburse biomarker testing for preeclampsia in pregnant women. This directly affects pregnant women enrolled in Tennessee's Medicaid program (TennCare) and the health insurance carriers providing their coverage. The bill mandates that testing must be ordered by a physician, conducted by the prenatal care provider using FDA-approved methods, and follow clinical guidelines. It also allows TennCare to create rules and seek federal approval to ensure Medicaid coverage for this testing.

Topics ✓ HealthcareSupports HealthcareMandates TennCare coverage for preeclampsia biomarker testing, expanding access to critical prenatal care for pregnant women.95% confidence

Sub-Topics Insurance Medicaid Women's Health

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introduced · Tennessee · House Feb 5, 2025

HB 508: Insurance, Health, Accident - As introduced, extends from 30 to 60 days the period of time following delivery of a medicare supplement policy or certificate during which an applicant may have the premium refunded, and about which each medicare supplement policy or certificate must have notice prominently printed on the first page of the policy or certificate. - Amends TCA Title 4, Chapter 3, Part 13; Title 8; Title 55, Chapter 12; Title 56 and Title 71.

HB 508 extends the refund period for Medicare supplement policies (Medigap) in Tennessee from 30 to 60 days after policy delivery. This change directly affects consumers who purchase these policies, giving them more time to review coverage and request a premium refund if unsatisfied. The bill requires all policies to include a clear notice about the 60-day refund window prominently on the first page. It will take effect January 1, 2026, for policies delivered on or after that date.

Topics ✓ HealthcareSupports HealthcareExtends Medigap refund window to 60 days, enhancing consumer protection and decision-making rights in healthcare insurance policies.85% confidence

Sub-Topics Insurance Medicare

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passed · Tennessee · House Mar 11, 2025

HB 27: Abortion - As introduced, enacts the "Reproductive Freedom Act." - Amends TCA Title 4; Title 5; Title 6; Title 7; Title 20; Title 29; Title 37; Title 39; Title 49; Title 53; Title 56; Title 63; Title 68 and Title 71.

HB 27, titled the "Reproductive Freedom Act," establishes a new legal framework protecting reproductive healthcare access in Tennessee. It defines "reproductive health care" to include abortion, contraception, prenatal care, and related services, and affirms individuals' fundamental rights to make decisions about their reproductive health without state interference. The bill requires health insurance plans to cover reproductive health care (Section 15) and repeals multiple existing state laws that restricted abortion access or imposed criminal penalties for reproductive care (Sections 2-22). This legislation directly affects all Tennesseans seeking reproductive healthcare by removing legal barriers and mandating coverage under state-regulated insurance plans.

Topics ✓ HealthcareSupports HealthcareRequires insurance coverage for reproductive health care (including abortion, contraception) and protects access without state interference, expanding coverage and protecting patient rights per bill summary.95% confidence

Sub-Topics Insurance Women's Health

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in committee · Tennessee · Senate Mar 25, 2025

SB 1372: Insurance, Health, Accident - As introduced, prohibits a health insurance entity or TennCare MCO from including an all-products clause in a network participation agreement with a healthcare provider, and makes certain other changes related to MCO network adequacy. - Amends TCA Title 56 and Title 71.

SB 1372 prohibits health insurers and TennCare managed care organizations (MCOs) from requiring healthcare providers (such as doctors, nurses, and physician assistants) to join multiple networks or offer services under different plans as a condition for participating in their provider networks. This "all-products clause" ban directly affects providers who previously faced pressure to accept bundled contracts. Violations carry a $10,000 civil penalty per occurrence, and the commissioner must create implementing rules by July 2026. The bill aims to improve provider network access, particularly in rural areas, by reducing restrictive contracting practices.

Topics ✓ HealthcareSupports HealthcareProhibits restrictive 'all-products clauses' forcing providers into multiple networks, improving provider access and network adequacy per bill summary.92% confidence

Sub-Topics Insurance

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in committee · Tennessee · Senate Mar 18, 2025

SB 552: Insurance, Health, Accident - As introduced, extends from 30 to 60 days the period of time following delivery of a medicare supplement policy or certificate during which an applicant may have the premium refunded, and about which each medicare supplement policy or certificate must have notice prominently printed on the first page of the policy or certificate. - Amends TCA Title 4, Chapter 3, Part 13; Title 8; Title 55, Chapter 12; Title 56 and Title 71.

SB 552 extends the refund period for Medicare supplement insurance policies in Tennessee from 30 to 60 days after policy delivery. It directly affects consumers purchasing these policies by giving them more time to cancel and receive a refund if they change their mind. The bill requires insurers to prominently display this 60-day window on the first page of every policy or certificate. This change applies to all new, renewed, or amended policies issued on or after January 1, 2026.

Topics ✓ HealthcareSupports HealthcareExtends Medicare supplement refund window from 30 to 60 days, enhancing consumer protection and choice in health insurance purchasing per bill's intent.85% confidence

Sub-Topics Insurance Medicare

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in committee · Tennessee · House Mar 10, 2026

HB 870: 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.

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.

Topics ✓ HealthcareSupports HealthcareProhibits insurers from altering coverage terms based on drug assistance availability, protecting patient access to medications and preventing coverage restrictions.95% confidence

Sub-Topics Insurance Prescription Drugs

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signed · Tennessee · House Mar 23, 2026

HB 169: 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.

HB 169 requires health benefit plans in Tennessee that cover prescription contraceptives to provide a 12-month refill option for insured individuals, starting January 1, 2026. This applies to all health insurance plans (including TennCare and CoverKids programs) that renew or issue coverage after that date, directly affecting people with such plans who use contraceptives. The bill amends Tennessee law to define "health benefit plan" broadly and specifies that contraceptive coverage must include this extended refill option. It does not change existing contraceptive coverage requirements but adds a specific provision for 12-month supplies. The effective date was updated from 2024 to 2026 in the bill.

Topics ✓ HealthcareSupports HealthcareMandates 12-month contraceptive refill coverage in health plans, expanding access to reproductive healthcare without requiring additional visits or prescriptions.95% confidence

Sub-Topics Insurance

signed · Tennessee · Senate Apr 8, 2025

SB 1305: Health Care - As enacted, extends the CoverKids program from June 30, 2025, to June 30, 2030. - Amends TCA Section 71-3-1113.

SB 1305 extends Tennessee's CoverKids health insurance program for children by changing its expiration date from June 30, 2025, to June 30, 2030. This bill directly affects low-income children in Tennessee who qualify for the CoverKids program, ensuring continued access to health coverage. The key mechanism is amending Tennessee Code Annotated Section 71-3-1113 to update the program's termination date. The bill was signed into law on April 3, 2025, and became effective April 8, 2025.

Topics ✓ HealthcareSupports HealthcareExtends CoverKids health insurance program for low-income children, ensuring continued coverage access without restrictions.95% confidence

Sub-Topics Insurance

in committee · Tennessee · House Feb 12, 2025

HB 1382: Insurance Companies, Agents, Brokers, Policies - As introduced, imposes requirements for health insurance issuers using artificial intelligence, algorithms, or other software for utilization review or utilization management functions. - Amends TCA Title 8, Chapter 27; Title 56 and Title 71.

HB 1382 requires health insurance companies, HMOs, and programs like TennCare to follow specific rules when using artificial intelligence or algorithms to review treatment requests (utilization management). It mandates that AI tools must base decisions on individual patient medical history and provider recommendations - not group data - and cannot override licensed doctors' evaluations of medical necessity. Insurers must disclose AI use in their policies, regularly review AI performance for accuracy, and ensure tools don’t discriminate or harm patients. This bill directly affects all Tennessee health insurance issuers using AI for treatment reviews, including major programs like TennCare and pharmacy benefits managers.

Topics ✓ HealthcareSupports HealthcareMandates AI transparency and prevents override of physician decisions in insurance utilization review, protecting patient rights and ensuring individualized care.95% confidence ✓ TechnologySupports TechnologyRegulates AI use in health insurance to prevent bias, mandate transparency, and protect patient decisions from algorithmic override - aligns with consumer tech regulation.90% confidence

Sub-Topics Insurance Prescription Drugs Artificial Intelligence

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