Legislation Signed Into Law
|Primary Focus||Mandated Benefit: Provider|
|Title/Description||Coverage for mental health, alcoholism, or drug dependency services|
|Citation||110th General Assembly, Public Chapter 1012|
Aligns definitions in state’s parity law with the Federal Parity Act; defines conditions covered by state’s parity law as any mental health of substance use disorder that falls under the diagnostic categories in the current edition of the International Classification of Disease or the Diagnostic and Statistical Manual of Mental Disorders; for substance use disorders, requires that insurers use American Society of Addiction Medicine clinical review criteria or other evidence-based clinical guidelines; requires the Department of Commerce and Insurance to implement and enforce provisions of the Federal Parity Act, and to issue a report on its parity enforcement activities to the General Assembly; requires the Department of Commerce and Insurance to request detailed analyses of plans’ parity compliance, particularly with respect to non-quantitative treatment limitations whenever the Department is conducting market conduct examinations; and notes that the mandate to provide coverage for mental health services shall not apply with respect to a group health plan if the application of the mandate to the plan results in an increase in the cost under the plan of more than one percent (1%).
Amended by Tenn. SB 2165.
|Senate Bill||SB 837|
|Sponsor||Rep. Clemmons and Sen. Briggs|
|Status||Signed into law 4/2017|
This bill requires all Medicaid managed care organizations providing coverage through TennCare to submit annual reports that demonstrate their compliance with the Federal Parity Law, including information that shows that NQTLs for behavioral health services are applied no more restrictively than those used for other medical services.
|Senate Bill||SB 2538|
|Sponsor||Rep. McManus & Sen. Tracy|
|Status||Signed into law 5/2014|
This bill created an autism spectrum disorder task force to study and make recommendations on ways to improve access to programs and services for screening, diagnosis, and treatment. Among other things, the bill required the task force to assess and develop recommendations on the availability of health insurance coverage for autism spectrum disorders.
|Primary Focus||Mandated Benefit: SUD|
|Title/Description||Alcoholism and drug dependence – Coverage for treatment|
|Citation||Tenn. Code Ann. § 56-7-2602|
Insurers, nonprofit hospitals and medical service plan corporations and health maintenance organizations transacting health insurance in this state shall offer and make available under group policies, contracts and plans providing hospital and medical coverage on an expense-incurred, service or prepaid basis, benefits for the necessary care and treatment of alcohol and other drug dependency that are not less favorable than for physical illness generally, subject to the same durational limits, dollar limits, deductibles and coinsurance factors, and that offer of benefits shall be subject to the right of the group policy or contract holder to reject the coverage or to select any alternative level of benefits if the right is offered by or negotiated with the insurer, service plan corporation or health maintenance organization.
|Effective Date||July 1, 2012|
Amended by Tenn. SB 2229.
|Primary Focus||Mandated Benefit: Provider|
|Title/Description||Health insurance — Coverage of mental illness|
|Citation||Tenn. Code Ann. § 56-7-2601|
This law was amended to delete the language “mental retardation” and substitute it with “intellectual disability” Additionally, The Department of Mental Health was substituted for the Department of Mental Health and Developmental Disabilities.
|Effective Date||May 5, 2011 and June 23, 2010, respectively.|
|Sponsor||Rep. Turner and Sen. Stewart|
|Status||Signed into law 5/2011|
This bill changed the section of the state insurance law about utilization review agents. It made clear that this section, relating to the percentage of reviews an agent is allowed to perform, applies to reviews of outpatient services for behavioral health conditions. It also changed the law so that agents that have Utilization Review Accreditation Commission (URAC) accreditation are no longer exempt from this section of the law if they are performing outpatient behavioral health reviews.
|Sponsor||Rep. C. Cobb and Sen. Kyle|
|Status||Signed into Law 7/2009|
This bill changed the section of the state insurance law about utilization review agents. It added that utilization review methods have to comply with the national standards set by either the Utilization Review Accreditation Commission (URAC) or the National Committee for Quality Assurance (NCQA) for reviews of behavioral health services.