Tennessee House Bill HB7104

Tennessee 2023-2024 Regular Session

• Introduced: 8/21/23
• Refer: 8/24/23

Caption

AN ACT to amend Tennessee Code Annotated, Title 8; Title 56 and Title 71, relative to coverage of behavioral health services.

Impact

The bill stipulates that any group health insurance contracts effective after the enactment of this bill must not impose quantitative limitations on behavioral health services. Moreover, it mandates that MCOs reimburse in-network providers for covered services at a rate of at least 180% of the allowable CMS charges, and out-of-network providers at 100% of the CMS charges. This approach aims to incentivize providers to offer more behavioral health services and improve access to care for patients who may need these critical services.

Summary

House Bill 7104 seeks to amend the Tennessee Code Annotated by implementing changes related to the coverage of behavioral health services. Specifically, this bill focuses on requiring managed care organizations (MCOs) that participate in the TennCare program to remove quantitative treatment limitations for behavioral health services. The intention is to enhance the access and quality of behavioral health care for enrollees by ensuring that they receive appropriate services without arbitrary limits on treatment scope or duration.

Contention

Discussions surrounding HB7104 may include concerns from various stakeholders about the implications of these changes. Supporters of the bill argue that removing quantitative treatment limitations is essential for improving mental health outcomes and ensuring fair treatment practices. However, some may express worries about the financial impact on MCOs and the potential for increased insurance premiums as a result of these new reimbursement structures. The balance between enhancing care access and managing costs for both insurers and patients will likely feature prominently in legislative discussions.