TennCare

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

TennCare

This bill prohibits a healthcare provider who participates in a medical assistance health benefit plan, including a provider participating in the provider network of a managed care organization that contracts with the bureau of TennCare to provide servic es under a medical assistance health benefit plan, from refusing to provide healthcare services to an enrollee based solely on the enrollee's refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease.

What This Bill Does

• This bill prohibits a healthcare provider who participates in a medical assistance health benefit plan, including a provider participating in the provider network of a managed care organization that contracts with the bureau of TennCare to provide servic es under a medical assistance health benefit plan, from refusing to provide healthcare services to an enrollee based solely on the enrollee's refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease.
• This bill prohibits the bureau from providing reimbursement for a medical assistance health benefit plan to a provider who violates this bill unless and until the bureau finds that the provider is in compliance with this bill.
• However, this prohibition o nly applies with respect to an individual healthcare provider.
• The bureau must not refuse to provide reimbursement to a provider who did not violate this bill based on that provider's membership in a provider group or medical organization with an individ u al physician who violated this bill.

Limits and Unknowns

• This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Official Summary Text

This bill prohibits a healthcare provider who participates in a medical assistance health benefit plan, including a provider participating in the provider network of a managed care organization that contracts with the bureau of TennCare to provide servic
es under a medical assistance health benefit plan, from refusing to provide healthcare services to an enrollee based solely on the enrollee's refusal or failure to obtain a vaccine or immunization for a particular infectious or communicable disease.

This bill prohibits the bureau from providing reimbursement for a medical assistance health benefit plan to a provider who violates this bill unless and until the bureau finds that the provider is in compliance with this bill. However, this prohibition o
nly applies with respect to an individual healthcare provider. The bureau must not refuse to provide reimbursement to a provider who did not violate this bill based on that provider's membership in a provider group or medical organization with an individ
u
al physician who violated this bill.

EXEMPTIONS

This bill does not apply to a provider who is a specialist in oncology or organ transplant services.

RULEMAKING

This bill requires the director of TennCare to adopt rules necessary to implement this bill, including rules establishing the right of a provider who is alleged to have violated this bill to seek administrative and judicial review of the alleged violation.

FEDERAL WAIVER

This bill authorizes the director to seek such federal waiver that the director deems necessary to effectuate this bill.

ON APRIL 16, 2025, THE SENATE ADOPTED AMENDMENTS #1 AND #2 AND PASSED SENATE BILL 1389, AS AMENDED.

AMENDMENT #1 changes this bill's prohibition against refusing services for an enrollee based solely on the enrollee's refusal to obtain a vaccine or immunization. This amendment instead prohibits a healthcare provider who participates in a medical assist
ance health benefit plan, including a provider participating in the provider network of a managed care organization that contracts with the bureau of TennCare to provide services under a medical assistance health benefit plan, from refusing to provide hea
l
thcare services to an enrollee based on the enrollee's refusal or failure to obtain a vaccine or immunization if the enrollee, or if the enrollee is a minor, the enrollee's parent or legal guardian, has a religious or moral objection to the vaccine or imm
unization.

This amendment adds the following to the subjects for which this bill requires the director of TennCare to promulgate rules:

(1) A process by which an enrollee, the parent or legal guardian of an enrollee who is a minor, or another person may report an alleged violation of this bill to the bureau;

(2) An
opportunity for the individual who reported the alleged violation to attend and provide testimony at a hearing, if any, conducted as part of the administrative and judicial review process established pursuant to the introduced bill; and

(3) A process by which the individual who reported the alleged violation may appeal a final decision rendered as part of the administrative and judicial review process.

AMENDMENT #2 deletes the provisions of this bill that exempt oncologists and organ transplant specialists and authorize the director of TennCare to seek a federal waiver to effectuate this bill.

ON APRIL 21, 2025, THE HOUSE SUBSTITUTED SENATE BILL 1389 FOR HOUSE BILL 638, ADOPTED AMENDMENT #1, AND PASSED SENATE BILL 1389, AS AMENDED.

AMENDMENT #1 replaces this bill's rulemaking provisions, restores the exemptions for oncologists and specialists in organ transplant services, and adds an exemption for specialists who treating patients who are immunocompromised, including patients who a
re immunocompromised because of a disease or as a result of treatment for a disease. This amendment purports to amend provisions of this bill that were deleted by Senate Amendment #2.

ON APRIL 20, 2026, THE SENATE NON-CONCURRED IN HOUSE AMENDMENT #1.

ON APRIL 23, 2026, THE HOUSE REFUSED TO RECEDE IN ITS ACTION IN ADOPTING HOUSE AMENDMENT #1.

ON APRIL 23, 2026, THE SENATE REFUSED TO RECEDE AND APPOINTED A CONFERENCE COMMITTEE.

ON APRIL 23, 2026, THE HOUSE APPOINTED A CONFERENCE COMMITTEE.

ON APRIL 23, 2026, THE
SENATE ADOPTED THE CONFERENCE COMMITTEE REPORT AND MADE IT THE ACTION OF THE SENATE.

Current Bill Text

HOUSE BILL 638
By Carringer

SENATE BILL 1389
By Watson

SB1389
002021
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 33;
Title 56; Title 63; Title 68 and Title 71, relative to
healthcare providers.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 63, Chapter 1, Part 1, is amended by
adding the following as a new section:
(a) As used in this section:
(1) "Bureau" means the bureau of TennCare;
(2) "Director" means the director of TennCare;
(3) "Enrollee" means a person who is enrolled in a medical assistance
health benefit plan;
(4) "Healthcare provider" or "provider" means a person who is licensed,
certified, or otherwise authorized or permitted by the laws of this state to
administer health care in the ordinary course of business or practice of a
profession; and
(5) "Medical assistance health benefit plan" means a policy or contract
for health insurance coverage provided under:
(A) The TennCare program administered under the Medical
Assistance Act of 1968, compiled in title 71, chapter 5, part 1, or a
successor medicaid program; or
(B) The CoverKids Act of 2006, compiled in title 71, chapter 3,
part 11, or a successor program.

- 2 - 002021

(b) A healthcare provider who participates in a medical assistance health benefit
plan, including a provider participating in the provider network of a managed care
organization that contracts with the bureau of TennCare to provide services under a
medical assistance health benefit plan, shall not refuse to provide healthcare services to
an enrollee based solely on the enrollee's refusal or failure to obtain a vaccine or
immunization for a particular infectious or communicable disease.
(c) The bureau shall not provide reimbursement for a medical assistance health
benefit plan to a provider who violates this section unless and until the bureau finds that
the provider is in compliance with this section.
(d) Subsection (c) applies only with respect to an individual healthcare provider.
The bureau shall not refuse to provide reimbursement to a provider who did not violate
this section based on that provider's membership in a provider group or medical
organization with an individual physician who violated this section.
(e) This section does not apply to a provider who is a specialist in:
(1) Oncology; or
(2) Organ transplant services.
(f) The director shall adopt rules necessary to implement this section, including
rules establishing the right of a provider who is alleged to have violated this section to
seek administrative and judicial review of the alleged violation. The rules must be
promulgated in accordance with the Uniform Administrative Procedures Act, compiled in
title 4, chapter 5.
(g) The director may seek such federal waiver that the director deems necessary
to effectuate this section.
SECTION 2. This act takes effect July 1, 2025, the public welfare requiring it.