Insurance, Health, Accident

Plain English Breakdown

Checked against official source text during the last sync.

Health Insurance Provider Credentialing

This bill requires health insurance companies in Tennessee to approve healthcare provider credentialing applications within two weeks if the provider is moving to a new practice group or facility already recognized by the same insurer.

What This Bill Does

• Changes Tennessee's laws about how long it takes for health insurers to review and accept healthcare providers' credentialing applications when they move to a new location.
• Requires health insurance companies to approve these applications within two weeks if certain conditions are met, such as the provider being previously credentialed by the same insurer and moving to another facility recognized by that insurer.

Who It Names or Affects

• Health insurance companies
• Healthcare providers who are relocating

Terms To Know

Credentialing

The process of verifying a healthcare provider's qualifications and licensing before they can be accepted by an insurer.

Practice group or facility

A specific location where medical services are provided, such as a hospital or clinic.

Limits and Unknowns

• The bill only applies to healthcare providers moving within the same insurance network.
• It does not specify what happens if an application is incomplete or missing information.
• The new rules start on July 1, 2026, and apply to applications submitted after that date.

Official Summary Text

Abstract summarizes the bill.

Current Bill Text

<BillNo> <Sponsor>

SENATE BILL 2436
By Crowe
SB2436
012447
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 56,
Chapter 7, relative to health insurer credentialing
of healthcare providers.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 56-7-1001(b), is amended by
deleting "Unless otherwise required by a national accrediting body," and substituting "Except as
provided in subsection (j), and unless otherwise required by a national accrediting body,".
SECTION 2. Tennessee Code Annotated, Section 56-7-1001(f)(2)(C), is amended by
deleting "A health insurance entity shall" and substituting "Except as provided in subsection (j),
a health insurance entity shall".
SECTION 3. Tennessee Code Annotated, Section 56-7-1001, is amended by adding
the following as a new subsection:
(j) Notwithstanding this section to the contrary, a health insurance entity shall
complete an application for credentialing within two (2) weeks of receipt of a complete
application from a healthcare provider, if:
(1) The healthcare provider relocates to a new healthcare practice group
or healthcare facility;
(2) The healthcare provider was credentialed at the healthcare provider's
immediately previous practice group or facility; and
(3) The new practice group or facility is credentialed by the health
insurance entity.
SECTION 4. This act takes effect July 1, 2026, the public welfare requiring it, and
applies to applications for credentialing initiated on or after that date.