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HB0411 • 2026

TennCare

AN ACT to amend Tennessee Code Annotated, Title 8; Title 56 and Title 71, relative to pediatric medical disorders.

Children Healthcare
Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor
Lynn, Watson
Last action
2025-05-27
Official status
Effective date(s) 05/21/2025
Effective date
Not listed

Plain English Breakdown

The bill authorizes rather than requires the division of TennCare to mandate coverage for PANDAS and PANS.

Lucca's Law: TennCare Coverage for PANDAS and PANS

This bill authorizes MCOs to provide coverage for medically necessary treatments of PANDAS and PANS, including specific therapies.

What This Bill Does

  • Authorizes MCOs (health maintenance organizations that participate in TennCare) to provide coverage for physician-prescribed treatment deemed medically necessary for children with PANDAS and PANS starting January 1, 2026.
  • Specifies that treatments must include antibiotics, medication, behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.
  • Prohibits insurance companies from charging higher co-payments or deductibles for these treatments compared to other similar benefits.
  • Prevents denial or delay of coverage based on previous treatment history or diagnosis under a different name.

Who It Names or Affects

  • Children with PANDAS and PANS
  • Health insurance companies in Tennessee

Terms To Know

MCO
Managed Care Organization, which includes health maintenance organizations that participate in the TennCare program.
PANDAS
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections
PANS
Pediatric Acute-Onset Neuropsychiatric Syndrome

Limits and Unknowns

  • The bill does not require adherence to specific treatment recommendations but allows for consideration of medical professional consortium guidelines.
  • Coverage limits over the lifetime of a recipient are removed, except that MCOs can request information about treatment duration and outcomes.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Amendment 1-0 to HB0411

Plain English: This amendment requires health insurance plans in Tennessee to cover treatment for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset neuropsychiatric syndrome (PANS), starting January 1, 2026.

  • Health insurance plans must provide coverage for medically necessary treatments of PANDAS and PANS, including antibiotics, medication, behavioral therapies, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.
  • Insurance companies cannot deny or delay coverage based on previous treatment history or diagnosis under a different name.
  • For billing purposes, PANDAS and PANS will be coded as autoimmune encephalitis until specific codes are created by the American Medical Association and Centers for Medicare and Medicaid Services.
  • The amendment does not specify how insurance companies must determine what treatments are medically necessary.
  • It is unclear if there are any limitations on the duration or extent of coverage provided under this section.
Amendment 1-0 to SB1426

Plain English: This amendment requires health insurance companies participating in TennCare to cover treatment for PANDAS and PANS starting January 1, 2026.

  • Health insurance contracts and policies issued by managed care organizations (MCOs) must provide coverage for medically necessary treatments of PANDAS and PANS as prescribed by a physician.
  • Insurance companies cannot deny or delay coverage based on previous treatment history or diagnosis under different names.
  • For billing purposes, PANDAS and PANS will be coded as autoimmune encephalitis until specific codes are created.
  • The exact details of how the new requirements will be implemented by insurance companies are not fully explained in this amendment text.
Amendment 2-0 to SB1426

Plain English: The amendment adds a new section to the bill, renaming it 'Lucca's Law'.

  • Adds a new section at the beginning of the bill, which renames the entire act as 'Lucca's Law.'
  • The amendment text does not provide details about what 'Lucca's Law' entails or how it affects existing provisions in TennCare.

Bill History

  1. 2025-05-27 Tennessee General Assembly

    Effective date(s) 05/21/2025

  2. 2025-05-27 Tennessee General Assembly

    Pub. Ch. 482

  3. 2025-05-27 Tennessee General Assembly

    Comp. became Pub. Ch. 482

  4. 2025-05-21 Tennessee General Assembly

    Signed by Governor.

  5. 2025-05-09 Tennessee General Assembly

    Transmitted to Governor for his action.

  6. 2025-05-08 Tennessee General Assembly

    Signed by Senate Speaker

  7. 2025-04-30 Tennessee General Assembly

    Signed by H. Speaker

  8. 2025-04-25 Tennessee General Assembly

    Enrolled; ready for sig. of H. Speaker.

  9. 2025-04-22 Tennessee General Assembly

    H. concurred in S. am. no. 2 Ayes 97, Nays 0 PNV 0 HB0411

  10. 2025-04-22 Tennessee General Assembly

    H. Placed on Message Calendar 2 for 4/22/2025

  11. 2025-04-21 Tennessee General Assembly

    Passed Senate as amended, Ayes 33, Nays 0

  12. 2025-04-21 Tennessee General Assembly

    Senate adopted Amendment (Amendment 2 - SA0415)

  13. 2025-04-21 Tennessee General Assembly

    Amendment withdrawn. (Amendment 1 - SA0234)

  14. 2025-04-21 Tennessee General Assembly

    Senate substituted House Bill for companion Senate Bill.

  15. 2025-04-21 Tennessee General Assembly

    Sponsor(s) Added.

  16. 2025-04-21 Tennessee General Assembly

    Companion House Bill substituted

  17. 2025-04-17 Tennessee General Assembly

    Placed on Senate Regular Calendar for 4/21/2025

  18. 2025-04-16 Tennessee General Assembly

    Sponsor(s) Added.

  19. 2025-04-16 Tennessee General Assembly

    Senate Reset on calendar for 4/21/2025

  20. 2025-04-15 Tennessee General Assembly

    Received from House, Passed on First Consideration

  21. 2025-04-14 Tennessee General Assembly

    Engrossed; ready for transmission to Sen.

  22. 2025-04-14 Tennessee General Assembly

    Passed H., as am., Ayes 95, Nays 0, PNV 0

  23. 2025-04-14 Tennessee General Assembly

    Sponsor(s) Added.

  24. 2025-04-14 Tennessee General Assembly

    H. adopted am. (Amendment 1 - HA0284)

  25. 2025-04-14 Tennessee General Assembly

    Placed on Senate Regular Calendar for 4/16/2025

  26. 2025-04-10 Tennessee General Assembly

    H. Placed on Regular Calendar for 4/14/2025

  27. 2025-04-09 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 4/10/2025

  28. 2025-04-03 Tennessee General Assembly

    Action def. in Calendar & Rules Committee to 4/10/2025

  29. 2025-04-02 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 4/3/2025

  30. 2025-04-02 Tennessee General Assembly

    Rec. for pass. if am., ref. to Calendar & Rules Committee

  31. 2025-03-26 Tennessee General Assembly

    Placed on cal. Insurance Committee for 4/1/2025

  32. 2025-03-25 Tennessee General Assembly

    Action def. in Insurance Committee to 4/1/2025

  33. 2025-03-25 Tennessee General Assembly

    Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 0

  34. 2025-03-19 Tennessee General Assembly

    Placed on cal. Insurance Committee for 3/25/2025

  35. 2025-03-19 Tennessee General Assembly

    Placed on Senate Commerce and Labor Committee calendar for 3/25/2025

  36. 2025-03-18 Tennessee General Assembly

    Rec for pass if am by s/c ref. to Insurance Committee

  37. 2025-03-18 Tennessee General Assembly

    Action deferred in Senate Commerce and Labor Committee to 3/25/2025

  38. 2025-03-13 Tennessee General Assembly

    Placed on Senate Commerce and Labor Committee calendar for 3/18/2025

  39. 2025-03-12 Tennessee General Assembly

    Placed on s/c cal Tenncare Subcommittee for 3/18/2025

  40. 2025-03-11 Tennessee General Assembly

    Placed on Senate Commerce and Labor Committee calendar for 3/18/2025

  41. 2025-02-12 Tennessee General Assembly

    Passed on Second Consideration, refer to Senate Commerce and Labor Committee

  42. 2025-02-10 Tennessee General Assembly

    Introduced, Passed on First Consideration

  43. 2025-02-06 Tennessee General Assembly

    Filed for introduction

  44. 2025-02-05 Tennessee General Assembly

    Assigned to s/c Tenncare Subcommittee

  45. 2025-02-05 Tennessee General Assembly

    P2C, ref. to Insurance Committee

  46. 2025-02-03 Tennessee General Assembly

    Intro., P1C.

  47. 2025-01-28 Tennessee General Assembly

    Filed for introduction

Official Summary Text

This bill requires the division of TennCare to require every group health insurance contract, and every group hospital or medical expense insurance policy, plan, and group policy delivered, issued for delivery, amended, or renewed in th
is state by an MCO on or after January 1, 2026, to provide coverage for physician prescribed treatment, deemed medically necessary, of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) and pediatric acute-on
s
et neuropsychiatric syndrome (PANS). Such treatment must include antibiotics, medication, behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy. As used in this bill,
an "MCO" means a health maintenance organization, behavioral health organization, or managed health insurance issuer that participates in the TennCare program.

PROHIBITIONS

This bill prohibits the following:



Benefits provided under this bill from being subject to a greater co-payment, deductible, or coinsurance than another similar benefit provided by the MCO. Coverage authorization must be provided in a timely manner consistent with department of commerce and insurance rules for urgent treatments.



A group or individual policy of accident and health insurance or managed care from denying or delaying coverage for medically necessary treatment under this bill solely because the recipient previously received treatment, including the same or similar treatment, for PANDAS or PANS, or because the recipient has been diagnosed with or received treatment for their condition under a different diagnostic name, such as autoimmune encephalopathy. For the purposes of this bill, coverage of PANDAS and PANS must adhere to the treatment recommendations developed by a medical professional consortium convened for the purposes of researching, identifying, and publishing best practice standards for diagnosis and treatment of such disorders that are accessible for medical professionals and are based on evidence of positive patient outcomes.



Coverage for a form of medically necessary treatment from being limited over the lifetime of a recipient or by the duration of a policy period. However, this bill does not prevent an MCO from requesting treatment notes and anticipated duration of treatment and outcomes.

CODES FOR PANDAS AND PANS

For billing and diagnosis purposes, this bill requires PANDAS and PANS to be coded as autoimmune encephalitis until the American Medical Asso
ciation and the centers for medicare and medicaid services create and assign a specific code for PANDAS and PANS. Thereafter, PANDAS and PANS may be coded as autoimmune encephalitis, PANDAS, or PANS. If a new common name or code is utilized for PANDAS a
n
d PANS, then this bill applies to patients with conditions under that new common name or code.

ON APRIL 14, 2025, THE HOUSE ADOPTED AMENDMENT #1 AND PASSED HOUSE BILL 411, AS AMENDED.

AMENDMENT #1 makes the following revisions:



Authorizes, instead of requires, the division of TennCare to require every group health insurance contract, and every group hospital or medical expense insurance policy, plan, and group policy delivered, issued for delivery, amended, or renewed in this state by an MCO on or after January 1, 2026, to provide coverage for physician prescribed treatment, deemed medically necessary, of pediatric autoimmune neuropsychiatric disorders associated with PANDAS and PANS.



Authorizes, instead of requires, such treatment to include antibiotics, medication, behavioral therapies to manage neuropsychiatric symptoms, immunomodulating medicines, plasma exchange, and intravenous immunoglobulin therapy.



Authorizes coverage of PANDAS and PANS to take into consideration, instead of requiring adherence to, the treatment recommendations developed by a medical professional consortium convened for the purposes of researching, identifying, and publishing best practice standards for diagnosis and treatment of such disorders that are accessible for medical professionals and are based on evidence of positive patient outcomes.



Removes the provision prohibiting coverage for a form of medically necessary treatment from being limited over the lifetime of a recipient or by the duration of a policy period.

ON APR
IL 21, 2025, THE SENATE SUBSTITUTED HOUSE BILL 411 FOR SENATE BILL 1426, ADOPTED AMENDMENT #2, AND PASSED HOUSE BILL 411, AS AMENDED.

AMENDMENT #2 names the bill "Lucca's Law."

Current Bill Text

Read the full stored bill text
SENATE BILL 1426
By Watson

HOUSE BILL 411
By Lynn

HB0411
000450
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 8;
Title 56 and Title 71, relative to pediatric medical
disorders.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 71, Chapter 5, Part 1, is amended by
adding the following as a new section:
(a) For the purpose of this section, "managed care organization" or "MCO"
means a health maintenance organization, behavioral health organization, or managed
health insurance issuer that participates in the TennCare program.
(b) The division of TennCare shall require every group health insurance contract,
and every group hospital or medical expense insurance policy, plan, and group policy
delivered, issued for delivery, amended, or renewed in this state by an MCO on or after
January 1, 2026, to provide coverage for physician prescribed treatment, deemed
medically necessary pursuant to § 71-5-144, of pediatric autoimmune neuropsychiatric
disorders associated with streptococcal infections (PANDAS) and pediatric acute-onset
neuropsychiatric syndrome (PANS). Such treatment must include antibiotics,
medication, behavioral therapies to manage neuropsychiatric symptoms,
immunomodulating medicines, plasma exchange, and intravenous immunoglobulin
therapy. Benefits provided under this section are not subject to a greater co-payment,
deductible, or coinsurance than another similar benefit provided by the MCO. Coverage
authorization must be provided in a timely manner consistent with department of
commerce and insurance rules for urgent treatments adopted pursuant to the Uniform
Administrative Procedures Act, compiled in title 4, chapter 5.

- 2 - 000450

(c) A group or individual policy of accident and health insurance or managed
care must not deny or delay coverage for medically necessary treatment under this
section solely because the recipient previously received treatment, including the same or
similar treatment, for PANDAS or PANS, or because the recipient has been diagnosed
with or received treatment for their condition under a different diagnostic name, such as
autoimmune encephalopathy. For the purposes of this section, coverage of PANDAS
and PANS must adhere to the treatment recommendations developed by a medical
professional consortium convened for the purposes of researching, identifying, and
publishing best practice standards for diagnosis and treatment of such disorders that are
accessible for medical professionals and are based on evidence of positive patient
outcomes. Coverage for a form of medically necessary treatment must not be limited
over the lifetime of a recipient or by the duration of a policy period. This section does not
prevent an MCO from requesting treatment notes and anticipated duration of treatment
and outcomes.
(d) For billing and diagnosis purposes, PANDAS and PANS must be coded as
autoimmune encephalitis until the American Medical Association and the centers for
medicare and medicaid services create and assign a specific code for PANDAS and
PANS. Thereafter, PANDAS and PANS may be coded as autoimmune encephalitis,
PANDAS, or PANS. If a new common name or code is utilized for PANDAS and PANS,
then this section applies to patients with conditions under that new common name or
code.
SECTION 2. This act takes effect upon becoming a law, the public welfare requiring it.