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TN SB2499

TN SB2499
AN ACT to amend Tennessee Code Annotated, Title 4; Title 56 and Title 71, relative to the coverage of long-acting injectable drugs for the treatment or prevention of human immunodeficiency virus.


summary

Introduced
02/02/2026
In Committee
Crossed Over
Passed
Dead

Introduced Session

114th General Assembly

Bill Summary

As introduced, requires a managed care organization or pharmacy benefits manager that is contracted with the bureau to reimburse a claim for a long-acting injectable drug intended for treatment and prevention of human immunodeficiency virus and administered in a pharmacy, physician's office, clinic, ambulatory surgical treatment center, or hospital. - Amends TCA Title 4; Title 56 and Title 71.

AI Summary

This bill requires managed care organizations (MCOs) and pharmacy benefits managers (PBMs), which are entities that manage prescription drug benefits for health plans, to reimburse claims for long-acting injectable drugs used to treat or prevent human immunodeficiency virus (HIV) when these drugs are administered in various healthcare settings like pharmacies, doctor's offices, clinics, or hospitals. It also clarifies that if an MCO or PBM covers such a drug as a medical service, they must also cover it as a pharmacy benefit, with specific rules to prevent duplicate payments to providers for the same treatment. This legislation aims to ensure access to these important HIV medications for individuals covered by TennCare, the state's Medicaid program, by mandating coverage and reimbursement for these treatments.

Sponsors (1)

Last Action

Refer to Senate Delayed Bills Committee (on 02/02/2026)

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