Bill > HB0654

This bill introduces new requirements for health insurance plans in Tennessee regarding mental health and substance abuse services, mandating the use of a Psychiatric Collaborative Care Model (PCCM) starting January 1, 2026. Under this model, health benefit plans must provide coverage and reimbursement for mental health and substance abuse services through a collaborative approach involving a primary care provider, a care manager, and a psychiatric consultant (like a psychiatrist). The PCCM requires structured care management with regular patient assessments and treatment modifications, as well as ongoing consultations between the primary care provider, care manager, and psychiatric consultant. The bill allows health benefit plans to deny coverage on grounds of medical necessity and provides flexibility for TennCare and CoverKids programs to determine coverage based on medical necessity. The law defines mental health and substance abuse services as care for conditions listed in the Diagnostic and Statistical Manual of Mental Disorders and applies to health insurance plans offered, delivered, or issued on or after January 1, 2026.

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https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=HB0654&ga=114