Bill > HB1646

This bill mandates that health benefit plans in Tennessee, starting January 1, 2027, must cover medically necessary treatments for acquired brain injury (ABI), which is defined as any injury to the brain occurring after birth from various causes like infections, strokes, or traumatic events. This coverage includes a wide range of therapies such as cognitive rehabilitation therapy (CRT) for relearning essential daily living skills, cognitive communication therapy, neurobehavioral therapy, and community reintegration services designed to help individuals re-enter society. Importantly, these plans cannot impose lifetime or unreasonable annual limits on the number of treatment days or sessions, and any limitations must be clearly stated and separate from other rehabilitation services. Furthermore, the bill requires that only qualified healthcare professionals specializing in ABI care, known as clinical peer reviewers, can conduct reviews for coverage preauthorization or utilization review, and it establishes a process for expedited appeals of any adverse determinations, which are decisions by a health insurer that a service is not medically necessary. The Commissioner of Commerce and Insurance is tasked with creating rules for this expedited appeal process.

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https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=HB1646&ga=114