Tennessee Legislature (healthcare bills) · April 8, 2025 · Primary source
TN HB 1074: Insurance Companies, Agents, Brokers, Policies - As enacted, removes the requirement that a provider notify a patient of communication between the provider and a health insurance entity or healthcare facility concerning additional information needed to process a prior authorization request for the patient; removes the requirement that an utilization review agent notify the enrollee and the provider or healthcare facility when additional information is needed from the enrollee, provid
Summary
Tennessee enacted HB 1074 (Public Chapter 125), which removes the requirement that providers notify patients when a health insurance entity or healthcare facility requests additional information needed to process a prior authorization request. The law also eliminates the obligation of utilization review agents to notify enrollees and providers when additional information is needed from the enrollee or provider during utilization review. The amendments reduce patient-facing transparency requirements in prior authorization workflows under Tennessee insurance law.
What this may mean
Health plans, utilization review organizations, and providers operating in Tennessee are no longer required under state law to notify patients of certain communications during the prior authorization process. This reduces a previously mandated patient-notification step in utilization review workflows for Tennessee-regulated health insurance products.
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