Bill > SB1382

This bill amends Tennessee's health insurance regulations to provide special protections for patients with stage 4 advanced metastatic cancer and metastatic blood cancer by preventing health benefit plans from requiring step therapy (a process where patients must try less expensive medications before receiving prescribed treatments) for approved prescription drugs. The bill defines "stage 4 advanced metastatic cancer" as cancer that has spread to other body parts and "associated conditions" as symptoms or side effects related to these cancers. Health benefit plans must now cover approved prescription drugs for these patients without requiring step therapy, provided the drugs are FDA-approved, consistent with best medical practices, supported by peer-reviewed literature, and on the plan's drug formulary. Healthcare providers must submit annual reports to the health department detailing the number of cases treated, drugs used, and six-month survival rates. The bill does not apply to group insurance plans under Title 8, Chapter 27, and still allows insurers to require patients to try generic equivalents before covering branded drugs. The law will take effect on January 1, 2026, and apply to insurance policies entered into, renewed, or amended on or after that date, with both the commissioners of commerce and insurance and health empowered to create rules to implement the act.

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https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=SB1382&ga=114