AN ACT to amend Tennessee Code Annotated, Title 33; Title 56; Title 63; Title 68 and Title 71, relative to healthcare providers.
Summary
HB0638 would prohibit healthcare providers who participate in TennCare or CoverKids, including providers in managed care networks, from refusing to provide healthcare services to an enrollee solely because the enrollee declined or failed to obtain a vaccine or immunization for a particular infectious or communicable disease. The bill defines key terms such as “enrollee,” “provider,” and “medical assistance health benefit plan,” and it applies to providers serving patients under Tennessee’s Medicaid-related programs.
The bill also directs the Bureau of TennCare to withhold reimbursement from a provider who violates this prohibition until the bureau determines the provider is back in compliance. It clarifies that the penalty applies only to the individual provider who committed the violation, not to other members of the provider’s group or organization. The bill exempts oncology specialists and organ transplant service providers, and it requires the TennCare director to adopt rules for implementation, including procedures for administrative and judicial review. The director is also authorized to seek any necessary federal waiver, and the act would take effect July 1, 2025.
Impact
The bill would add a new restriction in Tennessee law governing participation in TennCare and CoverKids by limiting when providers may deny care based on vaccination status. It would create an enforcement mechanism through TennCare reimbursement, potentially affecting provider participation, billing, and compliance procedures for Medicaid-related healthcare services. It also requires agency rulemaking and may require federal approval or waiver action to align the policy with federal program requirements.
Sentiment
The committee votes suggest generally favorable but not unanimous support. The bill advanced out of the House Health Subcommittee, House Health Committee, and House Government Operations Committee, each by majority vote, indicating broad interest in the measure’s patient-access protections. At the same time, the repeated “rec. for pass if am.” language and the nontrivial number of nays show that some members had reservations about the bill’s scope or implementation.
Contention
The main point of contention appears to be the balance between patient access and provider discretion. Supporters likely view the bill as preventing denial of care to TennCare and CoverKids enrollees based solely on vaccine refusal, while opponents may be concerned about interference with clinical judgment, provider autonomy, or operational burdens on practices. The exemptions for oncology and organ transplant specialists suggest lawmakers recognized that some specialties may have heightened infection-control concerns, and the need for federal waiver authority indicates possible uncertainty about how the policy fits within Medicaid program rules.
AN ACT to amend Tennessee Code Annotated, Title 4; Title 8; Title 33; Title 39; Title 49; Title 53; Title 56; Title 63; Title 68 and Title 71, relative to mental health.
AN ACT to amend Tennessee Code Annotated, Title 4; Title 8; Title 33; Title 39; Title 49; Title 53; Title 56; Title 63; Title 68 and Title 71, relative to mental health.