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HB1244 • 2026

Insurance, Health, Accident

AN ACT to amend Tennessee Code Annotated, Title 56, relative to pharmacy benefits managers.

Healthcare
Enacted

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

Sponsor
Martin B, Reeves
Last action
2025-05-15
Official status
Comp. became Pub. Ch. 446
Effective date
Not listed

Plain English Breakdown

The bill's full financial impact is uncertain without more information about pharmacy reimbursements under the State Group Insurance Program.

Tennessee Act on Pharmacy Benefits Managers

This act amends Tennessee laws to remove penalty limits for violations by pharmacy benefits managers (PBMs), sets prompt payment standards for claims, and grants regulatory oversight powers to the commissioner of commerce and insurance.

What This Bill Does

  • Removes the aggregate penalty limits for PBMs who violate the law.
  • Establishes a 30-day timeframe for paying clean paper claims in full or notifying providers why they are not paid.
  • Sets a 14-day timeframe for paying clean electronic claims and imposes interest penalties if payments are late.
  • Requires PBMs to provide necessary information to healthcare providers for proper claim submission.

Who It Names or Affects

  • Pharmacy benefits managers (PBMs)
  • Healthcare providers

Terms To Know

Clean claim
A claim that requires no further information or adjustments and has no defects preventing timely payment.
Prompt payment standards
Rules requiring PBMs to pay clean claims within specific timeframes.

Limits and Unknowns

  • The bill does not specify an effective date.
  • The exact financial impact of the changes is uncertain without additional information about pharmacy reimbursements under the State Group Insurance Program.

Amendments

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

Amendment 1-0 to HB1244

Plain English: The amendment modifies Tennessee's insurance laws by adding new penalties for pharmacy benefits managers and setting standards for timely reimbursements.

  • Adds a new subdivision (7) to § 56-2-305(c), which includes violations by pharmacy benefits managers in the list of sanctions under that section.
  • Inserts a new section, 56-7-3124, requiring pharmacy benefits managers to follow prompt payment standards for health insurance claims as outlined in § 56-7-109.
  • The amendment text does not specify the exact penalties or requirements under § 56-7-109, which may require additional research to fully understand the implications.
  • It is unclear how this amendment will be enforced and what specific actions pharmacy benefits managers must take to comply with these new regulations.
Amendment 1-0 to SB0881

Plain English: The amendment changes Tennessee's insurance laws by adding new rules for pharmacy benefits managers and how they handle payments.

  • Adds a new section in Title 56, Chapter 7, Part 31 to require timely reimbursements of health insurance claims from pharmacy benefits managers.
  • Modifies the sanctions clause in Section 56-7-3110 to include specific provisions for violations by pharmacy benefits managers.
  • Includes a new subdivision (c)(7) in Section 56-2-305 that defines violations by pharmacy benefits managers.
  • The exact penalties and requirements are not fully detailed, only referenced to other sections of the code.

Bill History

  1. 2025-05-15 Tennessee General Assembly

    Comp. became Pub. Ch. 446

  2. 2025-05-15 Tennessee General Assembly

    Effective date(s) 05/09/2025

  3. 2025-05-15 Tennessee General Assembly

    Pub. Ch. 446

  4. 2025-05-09 Tennessee General Assembly

    Signed by Governor.

  5. 2025-05-01 Tennessee General Assembly

    Transmitted to Governor for action.

  6. 2025-04-30 Tennessee General Assembly

    Signed by H. Speaker

  7. 2025-04-29 Tennessee General Assembly

    Signed by Senate Speaker

  8. 2025-04-28 Tennessee General Assembly

    Enrolled and ready for signatures

  9. 2025-04-21 Tennessee General Assembly

    Comp. SB subst.

  10. 2025-04-21 Tennessee General Assembly

    Sponsor(s) Added.

  11. 2025-04-21 Tennessee General Assembly

    Passed H., Ayes 93, Nays 0, PNV 0

  12. 2025-04-21 Tennessee General Assembly

    Am. withdrawn. (Amendment 1 - HA0285)

  13. 2025-04-21 Tennessee General Assembly

    Subst. for comp. HB.

  14. 2025-04-17 Tennessee General Assembly

    H. Placed on Regular Calendar for 4/21/2025

  15. 2025-04-16 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 4/17/2025

  16. 2025-04-16 Tennessee General Assembly

    Rec. for pass; ref to Calendar & Rules Committee

  17. 2025-04-09 Tennessee General Assembly

    Placed on cal. Government Operations Committee for 4/14/2025

  18. 2025-04-08 Tennessee General Assembly

    Sponsor(s) Added.

  19. 2025-04-07 Tennessee General Assembly

    Action def. in Government Operations Committee to 4/14/2025

  20. 2025-04-03 Tennessee General Assembly

    Rcvd. from S., held on H. desk.

  21. 2025-04-02 Tennessee General Assembly

    Placed on cal. Government Operations Committee for 4/7/2025

  22. 2025-04-02 Tennessee General Assembly

    Rec. for pass. if am., ref. to Government Operations Committee

  23. 2025-03-31 Tennessee General Assembly

    Sponsor(s) Added.

  24. 2025-03-31 Tennessee General Assembly

    Engrossed; ready for transmission to House

  25. 2025-03-31 Tennessee General Assembly

    Passed Senate as amended, Ayes 30, Nays 0

  26. 2025-03-31 Tennessee General Assembly

    Senate adopted Amendment (Amendment 1 - SA0237)

  27. 2025-03-28 Tennessee General Assembly

    Placed on Senate Regular Calendar for 3/31/2025

  28. 2025-03-26 Tennessee General Assembly

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

  29. 2025-03-25 Tennessee General Assembly

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

  30. 2025-03-25 Tennessee General Assembly

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

  31. 2025-03-19 Tennessee General Assembly

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

  32. 2025-03-19 Tennessee General Assembly

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

  33. 2025-03-19 Tennessee General Assembly

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

  34. 2025-03-18 Tennessee General Assembly

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

  35. 2025-03-13 Tennessee General Assembly

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

  36. 2025-03-12 Tennessee General Assembly

    Placed on s/c cal Insurance Subcommittee for 3/19/2025

  37. 2025-03-11 Tennessee General Assembly

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

  38. 2025-02-27 Tennessee General Assembly

    Sponsor(s) Added.

  39. 2025-02-12 Tennessee General Assembly

    Assigned to s/c Insurance Subcommittee

  40. 2025-02-12 Tennessee General Assembly

    P2C, ref. to Insurance Committee - Government Operations for Review

  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

    Intro., P1C.

  43. 2025-02-10 Tennessee General Assembly

    Introduced, Passed on First Consideration

  44. 2025-02-06 Tennessee General Assembly

    Filed for introduction

  45. 2025-02-05 Tennessee General Assembly

    Filed for introduction

Official Summary Text

A violation of present law concerning pharmacy benefits managers ("PBMs") may subject the individual or entity that provides health coverage to covered individuals (a "covered entity") or the person who administe
rs the medication or device portion of pharmacy benefits coverage provided by the covered entity (a "pharmacy benefits manager") to sanctions applicable to violations of the laws applicable to insurance companies, which include a monetary penalty of up to

$1,000 per violation, not to exceed $100,000 in the aggregate, or, for knowing violations, $25,000 per violation, not to exceed $250,000 in the aggregate.

This bill removes the aggregate penalty limits for violations of law concerning PBMs.

This bill e
stablishes the following prompt payment standards for PBMs:

(1) Pay a clean claim, or portion of a claim that is a clean claim, within 30 days of receipt of a claim submitted on paper from a provider. This bill defines "clean claim" to mean a claim rec
eived by a PBM for adjudication that:

(A) Requires no further information, adjustment, or alteration by the provider of the services in order to be processed and paid by the PBM, and has no defect or impropriety, including a lack of any required substant
iating documentation or particular circumstance requiring special treatment that prevents timely payment from being made on the claim;

(B) Includes resubmitted paper claims with previously identified deficiencies corrected; and

(C) Does not include a d
uplicate claim or a claim submitted more than 90 days after the date of service;

(2) Notify a provider within 30 days of receipt of a claim as described in (1) of reasons why a claim or portion of a claim is not a clean claim and will not be paid;

(3)
Pay a clean claim, or portion of a claim that is a clean claim, within 14 days of receipt of a claim submitted electronically by a provider. A PBM that does not comply with this requirement will be required to pay 1 percent interest per month, accruing f
r
om the day after the payment was due, on that amount of the claim that remains unpaid;

(4) Notify a provider within 14 days of receipt of an electronically-submitted claim as described in (3) of reasons why a claim or portion of a claim is not a clean cl
aim and will not be paid;

(5) A paper claim must not be denied upon resubmission for lack of substantiating documentation or information that has been previously provided by the healthcare provider; and

(6) A PBM shall timely provide contracted provide
rs with all necessary information to properly submit a claim.

This bill authorizes the commissioner of commerce and insurance to exercise the following regulatory oversight authority over PBMs:

(1) Ensure, as part of the department's ongoing regulator
y oversight of PBMs, that PBMs properly process and pay claims;

(2) Upon a finding that a PBM has failed during any calendar year to properly process and pay 95% of all clean claims received from all providers during that year, and giving reasonable noti
ce, levy an aggregate penalty up to $10,000;

(3) Upon a finding that a PBM has failed during any calendar year to properly process and pay 85% of all clean claims received from all providers during that year, and giving reasonable notice, levy an aggrega
te penalty of $10,000 to $100,000;

(4) Upon a finding that a PBM has failed during any calendar year to properly process and pay 60% of all clean claims received from all providers during that year, and giving reasonable notice, levy an aggregate penalty
of $100,000 to $200,000;

(5) Issue an order directing a PBM or a representative of a PBM to cease and desist from engaging in a prohibited act or practice; and

(6) Conduct compliance examinations. This bill authorizes the commissioner to contract wit
h impartial outside sources to assist in compliance examinations.

This bill specifies that a PMB against whom the commissioner levies a penalty or issues a cease and desist order may obtain review of such action in an administrative hearing.

This bill
adds that, if a pharmacy or agent acting on behalf of a pharmacy prevails in appealing a reimbursement for failing to pay at least the actual cost to the pharmacy for the prescription drug or device, then within seven business days after notice of the app
e
al is received by the PBM or covered entity, the PBM or covered entity is required to apply the findings from the appeal as to the rate of the reimbursement and actual cost for the particular drug or medical product or device to all remaining refills on t
h
e issued prescription drug or medical product or device, if the reimbursement aligns with the appeal.

ON MARCH 31, 2025, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 881, AS AMENDED.

AMENDMENT #1 rewrites the bill to, instead, make the following revisions to present law:



R
emoves the aggregate penalty limits for violations of law concerning pharmacy benefits manager
s.



Provides that a
pharmacy benefits manager regulated under
law relative to
pharmacy benefits manager
s
is subject to
the insurance laws relative to t
imely reimbursement of health insurance claims and its requirements for timing of payments to pharmacists.



Provides that
a violation of the prompt pay standards is governed by the penalties set out in
insurance laws relative to t
imely reimbursement of health insurance claims
.



Applies this amendment to
conduct occurring on or after the effective date of th
e bill.

Current Bill Text

Read the full stored bill text
SENATE BILL 881
By Reeves

HOUSE BILL 1244
By Martin B

HB1244
002620
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 56,
relative to pharmacy benefits managers.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 56-7-3110, is amended by adding
the following at the end of the section immediately preceding the period:
, subject to § 56-2-305(c)(7)
SECTION 2. Tennessee Code Annotated, Section 56-2-305(c), is amended by adding
the following new subdivision:
(7) Violations made by pharmacy benefits managers as defined in § 56-7-3102.
SECTION 3. Tennessee Code Annotated, Section 56-7-3102, is amended by adding
the following as new, appropriately designated subdivisions:
( ) "Clean claim":
(A) Means a claim received by a pharmacy benefits manager for
adjudication that:
(i) Requires no further information, adjustment, or alteration by
the provider of the services in order to be processed and paid by the
pharmacy benefits manager; and
(ii) Has no defect or impropriety, including a lack of any required
substantiating documentation or particular circumstance requiring special
treatment that prevents timely payment from being made on the claim
under § 56-7-3124;

- 2 - 002620

(B) Includes resubmitted paper claims with previously identified
deficiencies corrected; and
(C) Does not include:
(i) A duplicate claim; or
(ii) A claim submitted more than ninety (90) days after the date of
service;
( ) "Duplicate claim" means an original claim and its duplicate, when the
duplicate is filed within thirty (30) days of the original claim;
( ) "Pay" means that the pharmacy benefits manager must send the provider
cash or a cash equivalent in full satisfaction of the allowed portion of the claim, or give
the provider a credit against any outstanding balance owed by that provider to the
pharmacy benefits manager. A payment occurs on the date when the cash, cash
equivalent, or notice of credit is mailed or otherwise sent to the provider;
( ) "Submitted" means that the provider mails or otherwise sends a claim to the
pharmacy benefits manager. A submission occurs on the date the claim is mailed or
otherwise sent to the pharmacy benefits manager;
SECTION 4. Tennessee Code Annotated, Title 56, Chapter 7, Part 31, is amended by
adding the following as a new section:
56-7-3124. Prompt payment standards.
(a) Not later than thirty (30) calendar days after the date that a pharmacy
benefits manager receives a claim submitted on paper from a provider, a pharmacy
benefits manager shall:
(1) For a clean claim, pay the total covered amount of the claim;

- 3 - 002620

(2) Pay the portion of the claim that constitutes a clean claim and that is
not in dispute and notify the provider in writing why the remaining portion of the
claim will not be paid; or
(3) Notify the provider in writing of all reasons why the claim does not
constitute a clean claim and will not be paid and what substantiating
documentation and information is required to adjudicate the claim as a clean
claim.
(b) Not later than fourteen (14) calendar days after receiving a claim by
electronic submission, a pharmacy benefits manager shall:
(1) For a clean claim, pay the total covered amount of the claim;
(2) Pay the portion of the claim that constitutes a clean claim and that is
not in dispute and notify the provider why the remaining portion of the claim will
not be paid; or
(3) Notify the provider of the reason why the claim does not constitute a
clean claim and will not be paid and what substantiating documentation or
information is required to adjudicate the claim.
(c) A paper claim must not be denied upon resubmission for lack of
substantiating documentation or information that has been previously provided by the
healthcare provider.
(d) A pharmacy benefits manager shall timely provide contracted providers with
all necessary information to properly submit a claim.
(e) A pharmacy benefits manager that does not comply with subdivision (b)(1)
shall pay one percent (1%) interest per month, accruing from the day after the payment
was due, on that amount of the claim that remains unpaid.
(f) Regulatory oversight.

- 4 - 002620

(1) The commissioner shall ensure, as part of the department's ongoing
regulatory oversight of pharmacy benefits managers, that pharmacy benefits
managers properly process and pay claims in accordance with this section.
(2)
(A) If the commissioner finds a pharmacy benefits manager has
failed during any calendar year to properly process and pay ninety-five
percent (95%) of all clean claims received from all providers during that
year in accordance with this section, then the commissioner may levy an
aggregate penalty up to ten thousand dollars ($10,000), if reasonable
notice in writing is given of the intent to levy the penalty.
(B) If the commissioner finds a pharmacy benefits manager has
failed during any calendar year to properly process and pay eighty-five
percent (85%) of all clean claims received from all providers during that
year in accordance with this section, then the commissioner may levy an
aggregate penalty in an amount of not less than ten thousand dollars
($10,000) nor more than one hundred thousand dollars ($100,000), if
reasonable notice in writing is given of the intent to levy the penalty.
(C) If the commissioner finds a pharmacy benefits manager has
failed during any calendar year to properly process and pay sixty percent
(60%) of all clean claims received from all providers during that year in
accordance with this section, then the commissioner may levy an
aggregate penalty in an amount of not less than one hundred thousand
dollars ($100,000) nor more than two hundred thousand dollars
($200,000), if reasonable notice in writing is given of the intent to levy the
penalty.

- 5 - 002620

(D) In determining the amount of any penalty, the commissioner
shall take into account whether the failure to achieve the standards in this
section is due to circumstances beyond the pharmacy benefits manager's
control and whether the pharmacy benefits manager has been in the
business of processing claims for two (2) years or less.
(E) The pharmacy benefits manager may request an
administrative hearing contesting the assessment of any administrative
penalty imposed by the commissioner within thirty (30) days after receipt
of the notice of the assessment.
(3) The commissioner may issue an order directing a pharmacy benefits
manager or a representative of a pharmacy benefits manager to cease and
desist from engaging in any act or practice in violation of this section. Within
fifteen (15) days after service of the cease and desist order, the respondent may
request a hearing on the question of whether acts or practices in violation of this
section have occurred.
(4) All hearings under this part must be conducted pursuant to the
Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
(5) In the case of any violations of this section, if the commissioner elects
not to issue a cease and desist order, or in the event of noncompliance with a
cease and desist order issued by the commissioner, the commissioner may
institute a proceeding to obtain injunctive or other appropriate relief in the
chancery court of Davidson County.
(6) Examinations to determine compliance with this section may be
conducted by the commissioner's staff. The commissioner may, if necessary,
contract with qualified, impartial outside sources to assist in examinations to

- 6 - 002620

determine compliance with this section. The expenses of the examinations must
be assessed against pharmacy benefits managers in accordance with § 56-32-
115(e). For other pharmacy benefits managers, the commissioner shall bill the
expenses of the examinations to those entities in accordance with § 56-1-413.
(g) Rules.
The commissioner shall adopt rules in accordance with the Uniform
Administrative Procedures Act, compiled in title 4, chapter 5, to effectuate
compliance with this section.
SECTION 5. Tennessee Code Annotated, Section 56-7-3206(c)(3)(A), is amended by
adding the following new subdivision:
(vii) Apply the findings from the appeal as to the rate of the reimbursement and
actual cost for the particular drug or medical product or device to all remaining refills on
the issued prescription drug or medical product or device, if the reimbursement aligns
with the appeal.
SECTION 6. The headings in this act are for reference purposes only and do not
constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
requested to include the headings in any compilation or publication containing this act.
SECTION 7. This act takes effect upon becoming a law, the public welfare requiring it.