Back to Tennessee

HB1242 • 2026

Insurance, Health, Accident

AN ACT to amend Tennessee Code Annotated, Title 47, Chapter 18 and Title 56, relative to 340B entities.

Healthcare
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Helton-Haynes, Briggs
Last action
2025-05-13
Official status
Comp. became Pub. Ch. 404
Effective date
Not listed

Plain English Breakdown

The enforcement mechanism is not detailed in the provided official source material.

Health Insurance and Drug Discount Program Rules

This law changes rules for health insurance companies and drug manufacturers to protect certain hospitals that get discounts on drugs.

What This Bill Does

  • Prevents health insurers from paying less for drugs bought by special hospitals than they pay other pharmacies.
  • Stops health insurers from charging extra fees or making exclusions based on whether a pharmacy is part of the special discount program.
  • Forbids drug makers and their partners from limiting how these hospitals can buy discounted drugs unless it's required by federal or state law, starting July 1, 2025.
  • Requires anyone who helps these hospitals with their drug discounts to not interfere with their business relationships or choices.

Who It Names or Affects

  • Health insurance companies
  • Drug manufacturers
  • Special hospitals that get drug discounts
  • Pharmacies that work with these special hospitals

Terms To Know

340B entity
A hospital or clinic that participates in a federal program to buy drugs at discounted prices.
340B drug
Drugs purchased by special hospitals under the 340B discount program.

Limits and Unknowns

  • The law does not specify who will enforce it or how penalties will be applied.
  • Some parts of the law only apply after July 1, 2025.
  • It is unclear what happens if federal laws conflict with this Tennessee law.

Amendments

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

Amendment 1-0 to HB1242

Plain English: The amendment removes certain language from subsection (e) and replaces subdivision (g)(2) with new content that specifies which state laws are compatible with federal law, particularly those concerning a patient's citizenship status.

  • Removes the phrase ', or otherwise to consult for the purposes of facilitating,' from subsection (e).
  • Replaces subdivision (g)(2) with new language specifying compatibility with certain Tennessee state laws and federal law.
  • The exact impact of removing the specified phrase in subsection (e) is not fully explained.
  • It's unclear how this amendment will affect existing regulations or practices related to patient citizenship status.
Amendment 2-0 to HB1242

Plain English: The amendment adds new restrictions on drug manufacturers regarding their interactions with 340B entities and sets penalties for violations.

  • Drug manufacturers cannot impose additional requirements or limitations on 340B entities, such as data submission, unless required by federal or state law.
  • Manufacturers are prohibited from interfering with the business relationships of 340B entities or limiting their choice of drugs.
  • Violations of these restrictions will be considered unfair practices and can result in civil penalties up to $50,000 per violation.
  • The amendment does not specify how the new section will interact with existing federal laws and regulations.
Amendment 1-0 to SB1414

Plain English: The amendment removes certain language from subsection (e) and replaces subdivision (g)(2) with new content.

  • Removes the phrase ', or otherwise to consult for the purposes of facilitating,' from subsection (e).
  • Replaces subdivision (g)(2) with a new provision that allows another state law if it is compatible with federal law, specifically mentioning several titles and parts of Tennessee Code Annotated.
  • The exact impact of removing the phrase in subsection (e) is not fully explained.
  • It's unclear how the specific laws mentioned will interact with federal law without further context.
Amendment 2-0 to SB1414

Plain English: The amendment adds new restrictions on drug manufacturers regarding their interactions with 340B entities and sets penalties for violations.

  • Drug manufacturers cannot impose additional requirements or limitations on 340B entities, such as data submission, unless required by federal or state law.
  • Manufacturers are prohibited from interfering with the business relationships of 340B entities or limiting their choice of drugs.
  • Violations of these restrictions will be considered unfair practices and can result in civil penalties up to $50,000 per violation.
  • The amendment does not specify all the details about how violations will be enforced or reported.
Amendment 3-0 to SB1414

Plain English: The amendment changes a part of the bill to remove language that would prevent certain actions, replacing it with wording that allows for more flexibility.

  • Removes 'restrictions, prohibitions' and replaces them with 'restrictions or prohibitions on' in Section 47-18-136(c).
  • The amendment text is brief and technical, making it hard to fully explain the broader impact without additional context.

Bill History

  1. 2025-05-13 Tennessee General Assembly

    Comp. became Pub. Ch. 404

  2. 2025-05-13 Tennessee General Assembly

    Effective date(s) 05/05/2025

  3. 2025-05-13 Tennessee General Assembly

    Pub. Ch. 404

  4. 2025-05-05 Tennessee General Assembly

    Signed by Governor.

  5. 2025-04-23 Tennessee General Assembly

    Transmitted to Governor for action.

  6. 2025-04-22 Tennessee General Assembly

    Signed by H. Speaker

  7. 2025-04-22 Tennessee General Assembly

    Signed by Senate Speaker

  8. 2025-04-22 Tennessee General Assembly

    Enrolled and ready for signatures

  9. 2025-04-16 Tennessee General Assembly

    Comp. SB subst.

  10. 2025-04-16 Tennessee General Assembly

    Sponsor(s) Added.

  11. 2025-04-16 Tennessee General Assembly

    Sponsor(s) Added.

  12. 2025-04-16 Tennessee General Assembly

    Passed H., Ayes 82, Nays 4, PNV 4

  13. 2025-04-16 Tennessee General Assembly

    Am. withdrawn. (Amendment 2 - HA0419)

  14. 2025-04-16 Tennessee General Assembly

    Am. withdrawn. (Amendment 1 - HA0055)

  15. 2025-04-16 Tennessee General Assembly

    Subst. for comp. HB.

  16. 2025-04-16 Tennessee General Assembly

    Engrossed; ready for transmission to House

  17. 2025-04-16 Tennessee General Assembly

    Passed Senate as amended, Ayes 27, Nays 5

  18. 2025-04-16 Tennessee General Assembly

    Amendment withdrawn. (Amendment 1 - SA0233)

  19. 2025-04-16 Tennessee General Assembly

    Senate adopted Amendment (Amendment 3 - SA0408)

  20. 2025-04-16 Tennessee General Assembly

    Senate adopted Amendment (Amendment 2 - SA0379)

  21. 2025-04-15 Tennessee General Assembly

    Sponsor(s) Added.

  22. 2025-04-15 Tennessee General Assembly

    H. Placed on Regular Calendar for 4/16/2025

  23. 2025-04-14 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 4/15/2025

  24. 2025-04-14 Tennessee General Assembly

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

  25. 2025-04-14 Tennessee General Assembly

    Placed on Senate Regular Calendar for 4/16/2025

  26. 2025-04-09 Tennessee General Assembly

    Placed on cal. Finance, Ways, and Means Committee for 4/14/2025

  27. 2025-04-09 Tennessee General Assembly

    Rec for pass if am by s/c ref. to Finance, Ways, and Means Committee

  28. 2025-04-08 Tennessee General Assembly

    Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 8, Nays 3 PNV 0

  29. 2025-04-02 Tennessee General Assembly

    Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/9/2025

  30. 2025-04-01 Tennessee General Assembly

    Placed on Senate Finance, Ways, and Means Committee calendar for 4/8/2025

  31. 2025-03-25 Tennessee General Assembly

    Recommended for passage with amendment/s, refer to Senate Finance, Ways, and Means Committee Ayes 5, Nays 4 PNV 0

  32. 2025-03-19 Tennessee General Assembly

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

  33. 2025-03-18 Tennessee General Assembly

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

  34. 2025-03-13 Tennessee General Assembly

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

  35. 2025-03-12 Tennessee General Assembly

    Assigned to s/c Finance, Ways, and Means Subcommittee

  36. 2025-03-11 Tennessee General Assembly

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

  37. 2025-03-11 Tennessee General Assembly

    Action deferred in Senate Commerce and Labor Committee to 3/18/2025

  38. 2025-03-05 Tennessee General Assembly

    Rec. for pass. if am., ref. to Finance, Ways, and Means Committee

  39. 2025-03-05 Tennessee General Assembly

    Placed on Senate Commerce and Labor Committee calendar for 3/11/2025

  40. 2025-02-26 Tennessee General Assembly

    Placed on cal. Insurance Committee for 3/5/2025

  41. 2025-02-26 Tennessee General Assembly

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

  42. 2025-02-26 Tennessee General Assembly

    Sponsor(s) Added.

  43. 2025-02-25 Tennessee General Assembly

    Sponsor(s) Added.

  44. 2025-02-20 Tennessee General Assembly

    Sponsor(s) Added.

  45. 2025-02-19 Tennessee General Assembly

    Placed on s/c cal Insurance Subcommittee for 2/26/2025

  46. 2025-02-18 Tennessee General Assembly

    Sponsor(s) Added.

  47. 2025-02-18 Tennessee General Assembly

    Sponsor(s) Added.

  48. 2025-02-12 Tennessee General Assembly

    Assigned to s/c Insurance Subcommittee

  49. 2025-02-12 Tennessee General Assembly

    P2C, ref. to Insurance Committee

  50. 2025-02-12 Tennessee General Assembly

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

  51. 2025-02-10 Tennessee General Assembly

    Intro., P1C.

  52. 2025-02-10 Tennessee General Assembly

    Introduced, Passed on First Consideration

  53. 2025-02-06 Tennessee General Assembly

    Filed for introduction

  54. 2025-02-06 Tennessee General Assembly

    Filed for introduction

Official Summary Text

Present law generally prohibits a health insurance issuer, managed health insurance issuer, pharmacy benefits manager, or other third-party payer from:

(1) Reimbursing a 3
40B entity for pharmacy-dispensed drugs at a rate lower than the rate paid for the same drug by national drug code number to pharmacies that are not 340B entities;

(2) Assessing a fee, chargeback, or adjustment upon a 340B entity that is not equally asse
ssed on non-340B entities;

(3) Excluding 340B entities from its network of participating pharmacies based on criteria that is not applied to non-340B entities; or

(4) Requiring a claim for a drug by national drug code number to include a modifier to id
entify that the drug is a 340B drug.

Present law defines "340B entity" to mean a covered entity participating in the federal 340B drug discount program, including the entity's pharmacy or pharmacies, or any pharmacy or pharmacies under contract with the
340B covered entity to dispense drugs on behalf of the 340B covered entity.

This bill prohibits a drug manufacturer or their agent or affiliate, from:

(1) Denying, restricting, prohibiting, discriminating against, or otherwise limiting the acquisitio
n of a 340B drug by, or delivery of a 340B drug to, a 340B entity or other location that is under contract with, or otherwise authorized by, a 340B entity to receive 340B drugs on behalf of the 340B entity unless such receipt is prohibited by the U.S. dep
a
rtment of health and human services or state law;

(2) Imposing additional requirements or limitations on a 340B entity, including requiring the submission of data as a condition for allowing the acquisition of a 340B drug by, or delivery of a 340B drug
to, a 340B entity or other location that is under contract with or otherwise authorized by a 340B entity to receive 340B drugs on behalf of the 340B entity unless such data submission is explicitly required by the U.S. department of health and human servi
c
es or state law;

(3) Requiring a 340B entity to reverse, resubmit, or clarify a claim after the initial adjudication unless these actions are in the normal course of business and not related to the 340B program;

(4) Imposing any requirements relating
to the number of 340B entities or their contract pharmacies or inventory management systems of 340B drugs, unless such requirement is required by the U.S. department of health and human services or state law;

(5) Imposing any requirement relating to the
frequency, duration, or scope of audits that are not imposed on pharmacies or providers that are not 340B entities;

(6) Imposing requirements relating to accreditation, recertification, credentialing, or recredentialing that are not imposed on pharmacie
s or providers that are not 340B entities; or

(7) Imposing any requirement determined by the commissioner to interfere with the ability of a 340B entity to access discounts provided under the 340B program.

A violation under (1)
–
(7) constitutes an un
fair trade practice in the business of insurance and an unfair or deceptive act under the Consumer Protection Act of 1977; provided, that a $50,000 civil penalty may be assessed per violation. Each package of 340B drugs applicable to a violation under (1
)

–
(7) constitutes a separate violation.

This bill requires a person or entity that contracts with a 340B entity to dispense 340B drugs or to administer, or otherwise to consult for the purposes of facilitating, a 340B entity's participation in the
340B program to do the following:

(1) Not interfere with, prohibit, restrict, or limit a 340B entity's contracts or prospective business relationships with another person or entity;

(2) Not deny, restrict, prohibit, or otherwise interfere with a 340B
entity's choice of 340B drugs acquired, delivered, or otherwise distributed under subsection (b); or

(3) Exclude claims from 340B entities which would result in a net loss to the covered entity.

This bill defines "340B drug" to mean a drug that is a co
vered outpatient drug within the meaning of the federal 340B program; is eligible for any offer for reduced prices by a manufacturer under the federal 340B program; and is purchased by a 340B entity or would have been purchased by a 340B entity but for ce
r
tain restrictions or limitations imposed by a pharmacy benefits manager, or third party that makes payment for those drugs.

ON APRIL 16, 2025, THE SENATE ADOPTED AMENDMENTS #2 AND #3 AND PASSED SENATE BILL 1414, AS AMENDED.

AMENDMENT #2 makes the following revisions:



Removes the prohibition on a drug
manufacturer or their agent or affiliate, either directly or indirectly
,
denying, restricting, prohibiting, discriminating against, or otherwise limiting the acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B entity or other location that is under contract with, or otherwise authorized by, a 340B entity to receive 340B drugs on behalf of the 340B entity.



Prohibits, instead, on or after July 1, 2025,
a drug manufacturer, or its agent or affiliate, either directly or indirectly,
from
denying, imposing any restrictions,
prohibi
ting
, discriminat
ing
against
,
or
otherwise
limiting the acquisition of a
340B drug by, or delivery of a 340B drug to, a 340B entity or other location that is under contract with, or otherwise authorized by, a 340B entity to receive 340B drugs on behalf of the 340B entity unless such receipt is prohibited by the United States department of health and human services or applicable state law. However, this prohibition does not apply to any requirements, prohibitions, limitations, or restrictions in place on or before June 1, 2025.



Clarifies that the other prohibitions placed on a
drug manufacturer or their agent or affiliate
apply on or after July 1, 2025.



Removes the prohibition on
a drug manufacturer or their agent or affiliate, either directly or indirectly
, i
mpos
ing

as an
additional requirement or limitation on a 340B entity

the submission of any health information, claims or utilization data, purchasing data, payment data, or other data as a condition for allowing the acquisition of a 340B drug by, or delivery of a 340B drug to, a location
, other
than a 340B entity location, that is under
contract with or otherwise authorized by a 340B entity to receive 340B drugs on behalf of the 340B entity
.



Removes the prohibition on
a drug manufacturer or their agent or affiliate, either directly or indirectly
, i
mpos
ing
any requirements relating to the number of 340B entities or their contract pharmacies
.



Prohibits
a drug manufacturer or their agent or affiliate, either directly or indirectly
, from i
mpos
ing
any requirement determined by the attorney general
, instead of the commissioner,
to interfere with the ability of a 340B entity to access discounts provided under the 340B program.



Removes prohibitions placed on
a person or entity that contracts with a 340B entity

to consult for the purposes of facilitating

a 340B entity's participation in the 340B program
.



Removes as a result of a violation of the bill (i)
a civil penalty
authorized to be
assessed in the amount of $50,000 per violation
and (ii) the authority for the violation to be
jointly or separately enforced by the commissioner or attorney general
.



Exempts from the application of the bill (i) the TennCare Program, (ii) t
he CoverKids Act of 2006
, and (iii) t
he prescription drug discount plan
, Volunteer RX.



Removes from the definition of a "340B entity," for purposes of this bill,
any pharmacy or pharmacies under contract with the 340B entity to dispense drugs on behalf of the 340B entity
.

AMENDMENT #3 makes a technical correction.

Current Bill Text

Read the full stored bill text
SENATE BILL 1414
By Briggs

HOUSE BILL 1242
By Helton-Haynes

HB1242
002710
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 47,
Chapter 18 and Title 56, relative to 340B entities.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 56-7-3119, is amended by deleting
subsection (d) and substituting:
(d) A drug manufacturer or their agent or affiliate, shall not, either directly or
indirectly:
(1) Deny, restrict, prohibit, discriminate against, or otherwise limit the
acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B entity or
other location that is under contract with, or otherwise authorized by, a 340B
entity to receive 340B drugs on behalf of the 340B entity unless such receipt is
prohibited by the United States Department of health and human services or
applicable state law;
(2) Impose additional requirements or limitations on a 340B entity,
including requiring the submission of any health information, claims or utilization
data, purchasing data, payment data, or other data as a condition for allowing the
acquisition of a 340B drug by, or delivery of a 340B drug to, a 340B entity or
other location that is under contract with or otherwise authorized by a 340B entity
to receive 340B drugs on behalf of the 340B entity unless such data submission
is explicitly required by the United States department of health and human
services or applicable state law;

- 2 - 002710

(3) Require a 340B entity to reverse, resubmit, or clarify a claim after the
initial adjudication unless these actions are in the normal course of business and
not related to the 340B program;
(4) Impose any requirements relating to the number of 340B entities or
their contract pharmacies or inventory management systems of 340B drugs,
unless such requirement is required by the United States department of health
and human services or applicable state law;
(5) Impose any requirement relating to the frequency, duration, or scope
of audits that are not imposed on pharmacies or providers that are not 340B
entities;
(6) Impose requirements relating to accreditation, recertification,
credentialing, or recredentialing that are not imposed on pharmacies or providers
that are not 340B entities; or
(7) Impose any requirement determined by the commissioner to interfere
with the ability of a 340B entity to access discounts provided under the 340B
program.
(e) A person or entity that contracts with a 340B entity to dispense 340B drugs
or to administer, or otherwise to consult for the purposes of facilitating, a 340B entity's
participation in the 340B program shall:
(1) Not interfere with, prohibit, restrict, or limit a 340B entity's contracts or
prospective business relationships with another person or entity;
(2) Not deny, restrict, prohibit, or otherwise interfere with a 340B entity's
choice of 340B drugs acquired, delivered, or otherwise distributed under
subsection (b); or

- 3 - 002710

(3) Exclude claims from 340B entities which would result in a net loss to
the covered entity.
(f)
(1) A violation of subsection (d) constitutes a violation of § 56-8-104;
provided, that a civil penalty may be assessed in the amount of fifty thousand
dollars ($50,000) per violation.
(2) A violation of subsection (d) constitutes a violation of § 47-18-104;
provided, that a civil penalty may be assessed in the amount of fifty thousand
dollars ($50,000) per violation.
(3) Each package of 340B drugs applicable to a violation of subsection
(d) constitutes a separate violation.
(4) A violation of subsection (d) may be jointly or separately enforced by
the commissioner or attorney general and reporter.
(g) This section must not be construed or applied to be in conflict with or less
restrictive than:
(1) Applicable federal law and regulations, including limited distribution of
a drug required under 21 U.S.C. § 355-1; or
(2) Another law of this state if the state law is compatible with applicable
federal law.
(h) As used in this section:
(1) "340B drug" means a drug that is a covered outpatient drug within the
meaning of 42 U.S.C. § 256b; is eligible for any offer for reduced prices by a
manufacturer under 42 U.S.C. § 256b(a)(1); and is purchased by a 340B entity or
would have been purchased by a 340B entity but for a restriction or limitation
described in subsection (b);

- 4 - 002710

(2) "340B entity" means a covered entity participating in the federal 340B
drug discount program, as defined in section 340B of the Public Health Service
Act, 42 U.S.C. § 256b, including the entity's pharmacy or pharmacies, or any
pharmacy or pharmacies under contract with the 340B entity to dispense drugs
on behalf of the 340B entity;
(3) "Claim" means a request from a 340B entity to be reimbursed for the
cost of filling, refilling, or administering a prescription drug or for providing a
medical supply or device;
(4) "Health information" means any information, including demographic
information collected from an individual or a group of individuals, that:
(A) Is created or received by a healthcare provider, pharmacy,
health plan, employer, or healthcare clearinghouse; and
(B) Relates to the past, present, or future physical or mental
health or condition of an individual, the provision of health care to an
individual, or the past, present, or future payment for the provision of
health care to an individual;
(5) "Health insurance issuer" has the same meaning as defined in § 56-
2-125;
(6) "Managed health insurance issuer" has the same meaning as defined
in § 56-32-128;
(7) "National drug code number" means the unique national drug code
number that identifies a specific approved drug, its manufacturer, and its
package presentation; and
(8) "Package" has the same meaning as defined in 21 U.S.C. §
360eee(11)(A).

- 5 - 002710

SECTION 2. Tennessee Code Annotated, Section 56-8-104, is amended by adding the
following new subdivision:
(24) A violation of § 56-7-3119(d).
SECTION 3. Tennessee Code Annotated, Section 47-18-104(b), is amended by adding
the following new subdivision:
(68) Violating § 56-7-3119(d).
SECTION 4. If any provision of this act or its application to any person or circumstance
is held invalid, then the invalidity does not affect other provisions or applications of the act that
can be given effect without the invalid provision or application, and to that end, the provisions of
this act are severable.
SECTION 5. This act takes effect July 1, 2025, the public welfare requiring it.