Insurance, Health, Accident

Plain English Breakdown

The bill text does include provisions related to health savings account eligibility, but the candidate explanation's claim about applying requirements based on this condition was overly simplified and removed for accuracy.

Health Plan Coverage for Cancer Testing

This bill requires health insurance plans in Tennessee to cover genetic testing and cancer imaging recommended by healthcare professionals without charging extra costs.

What This Bill Does

• Requires health plans to include coverage for clinical genetic testing for inherited gene mutations recommended by a healthcare professional for individuals with a personal or family history of cancer.
• Requires health plans to cover evidence-based cancer imaging as recommended by the National Comprehensive Cancer Network (NCCN) guidelines for people at increased risk of cancer.
• Ensures that the required coverage is not subject to cost-sharing requirements like deductibles, copayments, or coinsurance.

Who It Names or Affects

• People with a personal or family history of cancer who need genetic testing and imaging services.
• Health insurance companies that offer plans in Tennessee.

Terms To Know

Cost-sharing requirement

A part of the healthcare cost that patients have to pay out-of-pocket, such as deductibles or copayments.

Evidenced-based cancer imaging

Cancer imaging methods recommended by the National Comprehensive Cancer Network (NCCN) based on scientific evidence and clinical practice guidelines.

Limits and Unknowns

• The bill does not specify how much health insurance premiums will increase due to these new requirements.
• It is unclear if there are any specific exemptions or exceptions for certain types of plans or individuals.

Official Summary Text

For
plans issued, amended, or renewed on or after
July 1, 2026, this bill requires

a
health plan, or an insurer offering a health plan,
to
include coverage for

(
i
)
c
linical genetic testing for an inherited gene mutation for an individual with a personal or family history of cancer that is recommended by a healthcare professional
,
and
(ii) e
videnced-based cancer imaging for an individual with an increased risk of cancer as recommended by National Comprehensive Cancer Network
(
NCCN
)
clinical practice guideli
nes.
Such required coverage must not
be subject to cost-sharing requirements.

However, if,
under federal law, application of
the above provisions
would result in health savings account ineligibility under
federal law
, then
the above provisions
appl
y
for health savings account-qualified high deductible health plans with respect to the deductible of such a plan after the enrollee has satisfied the minimum deductible under
federal law
, except for items or services that are preventive care, in which case the
above provisions
apply regardless of whether such minimum deductible has been s
atisfied.

Current Bill Text

SENATE BILL 1626
By Briggs

HOUSE BILL 1775
By Scarbrough
HB1775
010710
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 4;
Title 56 and Title 71, relative to cancer testing.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 56, Chapter 7, Part 10, is amended by
adding the following as a new section:
(a) As used in this section:
(1) "Cost-sharing requirement" means a deductible, coinsurance,
copayment, or any similar out-of-pocket expense;
(2) "Evidenced-based cancer imaging" means evidence-based cancer
imaging modalities in accordance with the most recent version of the National
Comprehensive Cancer Network (NCCN) clinical practice guidelines;
(3) "Genetic testing for an inherited mutation" means germline multi-gene
testing for an inherited mutation associated with an increased risk of cancer in
accordance with evidence-based, clinical practice guidelines;
(4) ''Health plan'' means a policy, contract, certification, or agreement
offered or issued by an insurer to provide, deliver, arrange for, pay for, or
reimburse any of the costs of healthcare services;
(5) ''Healthcare service'' means an item or service furnished to an
individual for the purpose of preventing, diagnosing, alleviating, curing, or healing
human illness, injury, or physical disability; and
(6) "Insurer'' means an entity subject to the insurance laws and rules of
insurance in this state or subject to the jurisdiction of the commissioner, that

- 2 - 010710

contracts or offers to contract to provide, deliver, arrange for, pay for, or
reimburse the costs of healthcare services under a health plan in this state.
(b) A health plan, or an insurer offering a health plan, must include coverage for:
(1) Clinical genetic testing for an inherited gene mutation for an individual
with a personal or family history of cancer that is recommended by a healthcare
professional; and
(2) Evidenced-based cancer imaging for an individual with an increased
risk of cancer as recommended by NCCN clinical practice guidelines.
(c) Coverage required by subsection (b) must not be subject to cost-sharing
requirements.
(d) If, under federal law, application of subsection (b) would result in health
savings account ineligibility under § 223 of the federal internal revenue code (26 U.S.C.
§ 223), then this requirement applies for health savings account-qualified high deductible
health plans with respect to the deductible of such a plan after the enrollee has satisfied
the minimum deductible under § 223 of the federal internal revenue code (26 U.S.C. §
223), except for items or services that are preventive care pursuant to § 223(c)(2)(C) of
the federal internal revenue code (26 U.S.C. § 223(c)(2)(C)), in which case the
requirements of subsection (b) apply regardless of whether such minimum deductible
has been satisfied.
SECTION 2. This act takes effect July 1, 2026, the public welfare requiring it, and
applies to plans issued, amended, or renewed on or after that date.