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TN SB1063

TN SB1063
AN ACT to amend Tennessee Code Annotated, Title 56 and Title 63, Chapter 1, relative to prior authorization for healthcare services.


summary

Introduced
02/05/2025
In Committee
Crossed Over
03/13/2025
Passed
03/25/2025
Dead
Signed/Enacted/Adopted
04/08/2025

Introduced Session

114th General Assembly

Bill Summary

As enacted, removes the requirement that a provider notify a patient of communication between the provider and a health insurance entity or healthcare facility concerning additional information needed to process a prior authorization request for the patient; removes the requirement that an utilization review agent notify the enrollee and the provider or healthcare facility when additional information is needed from the enrollee, provider, or healthcare facility to make a determination on the request for prior authorization. - Amends TCA Title 56 and Title 63, Chapter 1.

AI Summary

This bill removes existing requirements related to prior authorization communications in Tennessee healthcare settings. Specifically, the bill eliminates two legal provisions: first, it removes Tennessee Code Section 63-1-171 in its entirety, which previously mandated that healthcare providers notify patients about communications with health insurance entities or healthcare facilities regarding additional information needed for processing a prior authorization request. Second, the bill deletes subdivision (a)(4) from Tennessee Code Section 56-6-705, which previously required utilization review agents to notify both the enrollee and the provider or healthcare facility when additional information was needed to make a determination on a prior authorization request. Prior authorization is a process where healthcare providers must obtain advance approval from insurance companies before performing certain medical services or treatments. By removing these notification requirements, the bill reduces administrative obligations for healthcare providers and insurance entities, potentially streamlining the prior authorization process. The bill will take effect immediately upon becoming law, as stated in Section 3 of the document.

Committee Categories

Business and Industry

Sponsors (1)

Last Action

Effective date(s) 04/03/2025 (on 04/08/2025)

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