Tennessee House Bill HB2463

Tennessee 2023-2024 Regular Session

• Introduced: 1/30/24
• Refer: 2/1/24

Caption

AN ACT to amend Tennessee Code Annotated, Title 8; Title 56 and Title 71, relative to pediatric medical disorders.

Impact

The bill will have significant implications for healthcare coverage related to pediatric mental health disorders in Tennessee. By ensuring coverage for PANDAS and PANS, the bill will support families seeking medical treatments for children suffering from these conditions. Additionally, the bill prohibits MCOs from denying or delaying coverage based on prior treatments for these disorders or alternative diagnoses, aiming to facilitate seamless access to necessary care. This amendment is expected to improve the quality of life for affected children by promoting timely and appropriate medical intervention.

Summary

House Bill 2463 aims to amend the Tennessee Code Annotated by introducing provisions that mandate managed care organizations (MCOs) to provide coverage for specific pediatric medical disorders, specifically Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) and Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Starting from January 1, 2025, MCOs will be required to cover medically necessary treatments related to these disorders, including various medications and therapies, without imposing stricter co-payment, deductibles, or coinsurance than for other similar benefits provided.

Contention

Notable points of contention around HB2463 may involve the adequacy of resources available for the implementation of these provisions and potential concerns from insurance providers regarding increased costs. There may be debates on how effectively MCOs can comply with the new coverage requirements and the implications this could have on premium rates for policyholders. Moreover, while the bill aims to standardize treatment access, advocates for other pediatric conditions may argue for similar legislative measures, raising questions about equity in healthcare coverage across various disorders.