After nearly 5 ½ hours spent on the final calendar, the Senate Commerce and Labor Committee adjourned on Tuesday. Senator Bo Watson had five bills on the calendar that expanded patient and physician protection from unfair insurance company policies. He likened the fight to David vs. Goliath as Blue Cross Blue Shield (BCBS) testified against every bill.

SB1376: This bill would have prohibited an out of network ambulance service provider from balance billing an enrollee in a health benefit plan for covered ambulance services under the enrollee’s health benefit plan. Despite passing on the House floor 94-0, it failed in the Senate Commerce Committee by a vote of 5-4. The only no votes received on this legislation were in this committee making the bill dead for this session.

SB2067: This bill builds upon the existing health care network adequacy laws by clarifying that all insurance plans must meet minimum network standards, protects patients by increasing transparency about the deficiencies of their physician network and strengthens the existing regulatory compliance process by the Tennessee Department of Commerce and Insurance (DCI) by clarifying key milestones, requiring published findings, and introducing penalties. TMA supports this legislation as it would improve network adequacy requirements for our physician members and improve accountability of the DCI for investigating network adequacy complaints. After BCBS and DCI testified against the bill, Senator Watson grilled representatives from DCI saying that “DCI has failed to carry out their responsibilities.” The bill narrowly passed out of the committee by a 5-4 vote.

To view the video of Senator Watson questioning DCI, click HERE. 

SB2081: Current law states that a health benefit plan that provides coverage for stage 4 advanced metastatic cancer, metastatic blood cancer, and associated conditions shall not require use of a step therapy protocol before the health benefit plan provides coverage of an approved prescription drug to an enrollee who has received a diagnosis of stage 4 advanced metastatic cancer or metastatic blood cancer. The bill would expand such prohibition on a health benefit plan requiring the use of a step therapy protocol before providing coverage of a federally approved prescription drug to any enrollee diagnosed with cancer, regardless of stage.

TMA supports this legislation while BCBS testified against it. The Senate Commerce and Labor Committee passed the bill out in a 5-4 vote.

SB2155: This bill brought by TMA would have made comprehensive changes to various health insurance statutes to ensure companies fairly and transparently adjudicate claims. It would have prohibited a health insurance entity from automatically downcoding a claim submitted by a provider unless there was first a review of the patient’s medical record and expanded prior authorization approval for treatment of a chronic condition from 6 months to 12 months. Two TMA physicians testified in favor of the legislation along with Julie Griffin, TMA’s Vice President of Government Affairs. BCBS testified against. TMA thanks Dr. Eric Bowman, an orthopedic surgeon from Vanderbilt, and Dr. Krish Patel, Director of Lymphoma Research at Sarah Cannon Research Institute, for their impactful testimony.

Unfortunately, despite passionate speeches from Senator Bo Watson (R-Hixson) and Senator Shane Reeves (R-Murfreesboro), the bill failed in Committee by a vote of 5-4. TMA thanks Senator Watson for carrying the bill and Senator Reeves, Senator Jack Johnson (R-Franklin), and Senator Brent Taylor (R-Memphis) for their YES votes. Senator Ken Yager (R-Kingston), Senator Paul Bailey (R-Sparta), Senator John Stevens (R-Huntingdon), Senator Steve Southerland (R-Morristown), and Senator Raumesh Akbari (D-Memphis) voted NO. If your Senator voted YES, TMA encourages you to complete the Call to Action below to send your thanks as well. The bill discussion is worth the watch. Take a look at the recording HERE. (Click on bill number SB2155 which begins at 4:03:07). 

SB2080: TMA’s bill for TennCare Provider Rate Increases passed out of the Senate Commerce Committee by a vote of 8-1. The bill would increase reimbursement rates to Medicare levels in three service areas: primary care and behavioral health, maternal care, and anesthesia. TennCare’s reimbursement rates for physicians, physician assistants, and advance practice registered nurses are still significantly below those of Medicare and commercial payers, creating a persistent payment gap that threatens access to care across Tennessee. The bill is in the Finance Committee of both houses.

If your legislator is Senator Watson, Johnson, Reeves, or Taylor, please send a thank you for their vote on the downcoding bill. You can thank them by completing the call to action below. 

Not sure who your elected officials are? Find out here.