AN ACT to amend Tennessee Code Annotated, Title 56, Chapter 7 and Title 63, relative to payment for services rendered by chiropractors.
Summary
HB0029 revises Tennessee insurance reimbursement rules for chiropractic care. It changes statutory references from “chiropractor” to “chiropractic physician” in Tennessee Code Annotated § 56-7-2404 and adds a new requirement that, when a health insurance entity uses a nationally recognized coding system such as CPT to determine reimbursement for a covered service or procedure, it may not discriminate between a chiropractic physician and a physician licensed under Title 63 in the methodology used to calculate payment or in the amount paid. The bill also bars insurers from avoiding this rule by creating a chiropractic-specific code or payment method outside the standard coding book.
The bill preserves insurer flexibility to use national uniform relative value units (RVUs) that reflect the resources used to furnish a service. It defines “health insurance entity” by reference to existing law and clarifies that the coding rule applies to nationally recognized services and procedures code books, including CPT. The new reimbursement parity rule does not apply to TennCare or CoverKids, or their successor programs.
In practical terms, the bill affects private health insurance reimbursement practices in Tennessee by requiring parity in payment methodology and amounts for comparable services performed by chiropractic physicians and medical physicians, while leaving Medicaid-related programs untouched. It amends insurance law and related health-professions terminology, but does not create a new benefit mandate or expand coverage beyond existing services.
The bill appears to have broad support in the legislative process. It advanced through subcommittee and committee stages with unanimous or near-unanimous votes, and it passed floor votes overwhelmingly, including 81-7 on third consideration in the House and 86-0 on concurrence in a Senate amendment. The voting history suggests general agreement on the goal of reimbursement fairness for chiropractic providers.
The main point of contention is the scope of reimbursement parity: the bill requires insurers to treat chiropractic physicians the same as physicians for coded services, but it still allows use of RVUs and excludes TennCare and CoverKids. That balance suggests the debate centered on preventing discriminatory payment practices without fully eliminating insurer discretion or extending the rule into state-administered public health programs.
Impact
HB0029 amends Tennessee Code Annotated § 56-7-2404 in Title 56 and makes a related terminology change in the statute from “chiropractor” to “chiropractic physician.” It imposes a new nondiscrimination rule on health insurance entities using nationally recognized procedure codes, requiring equal reimbursement methodology and amounts for comparable services provided by chiropractic physicians and physicians licensed under Title 63, chapters 6 or 9, while expressly preserving the use of national RVUs. The bill excludes TennCare and CoverKids from its reach, so it primarily affects private health insurers and chiropractic providers rather than state public insurance programs.
Sentiment
The overall sentiment around HB0029 was strongly favorable. The bill moved through committee and floor votes with little opposition, including several unanimous committee recommendations and decisive floor passage. The vote pattern indicates broad bipartisan support for the concept of reimbursement parity for chiropractic physicians.
Contention
The principal issue is whether insurers should be barred from paying chiropractic physicians differently from medical physicians for the same coded services. Supporters appear to have favored equal treatment and prevention of insurer workarounds, while the bill’s structure shows an effort to address concerns about overreach by preserving RVU-based reimbursement and excluding TennCare and CoverKids. The absence of recorded committee transcript debate suggests any disagreement was limited or resolved before final votes.