Bill > SB2070

This bill, known as the "Stopping Health Insurers from Excluding Legal Decisions (SHIELD) Act," amends Tennessee law to prevent health insurance entities from penalizing healthcare providers based on patients who have chosen not to receive certain vaccinations. Specifically, it clarifies that if a healthcare provider documents a patient as having an exemption from a vaccination and submits a claim with a code indicating the immunization was not given, the health insurance entity must exclude that patient from calculations used to determine the provider's performance on vaccination-related quality measures. These "quality measures" are metrics used by insurers to set reimbursement rates, bonuses, and network participation. The bill also prohibits insurers from terminating providers from their networks, reducing reimbursement rates, or withholding incentive payments solely because a provider has exempt patients, and ensures that claims denied or reduced in violation of these provisions are treated as "clean claims" for timely reimbursement purposes, subject to interest penalties if not resolved promptly.