HB 1213 – Tennessee

Status: Enacted
Year Introduced: 2024
Link: https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=HB1213&ga=113

This bill seeks to amend sections of the Tennessee Code Annotated, specifically titles pertaining to insurance. The revisions are relating to the Tennessee Right to Shop Act, which allows patients to compare prices for healthcare services. The bill provides a clear definition for “emergency medical service” and “healthcare service.” It allows enrollees to choose to pay for healthcare services out-of-pocket from an out-of-network provider and if they successfully negotiate a lower cost, they can send documentation to their carrier for consideration. Once verified, the amount paid out-of-pocket will count towards the enrollee’s deductible, coinsurance, copayment, or other cost-sharing amount. However, the amount counted must not exceed the total amount the covered person is required to pay out-of-pocket during a contractually agreed upon period. The incentive limits described does not apply to this provision. Carriers may offer incentives under the guidance of this section. 

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