HB 111 – SB 1283
FISCAL NOTE
Fiscal Review Committee
Tennessee General Assembly
February 12, 2025
Fiscal Analyst: Chris Higgins | Email: chris.higgins@capitol.tn.gov | Phone: 615-741-2564
HB 111 – SB 1283
SUMMARY OF BILL: Adds hepatitis C antibody to the list of conditions for which a
pregnant woman's blood must be tested as part of a standard serological test. Requires a positive test
for hepatitis C to be reported to the local health department.
Requires a sample of blood from each pregnant woman to be taken between the 28
th
and 32
nd
week
of gestation, and the time of delivery, and tested for syphilis.
FISCAL IMPACT:
NOT SIGNIFICANT
Assumptions:
• Pursuant to Tenn. Code Ann. § 68-5-602(a), each pregnant woman during gestation shall
have a sample of her blood taken by the physician or other attending person during her first
examination and visit, or within 10 days after the first examination. The blood sample must
be sent to a laboratory approved by the Department of Health (DOH) to be tested for
syphilis, rubella immunity, and hepatitis B.
• A sample of blood shall also be taken during or after the 28
th
week of gestation for a
woman whom the attending physician determines to be at high risk of hepatitis B or
syphilis according to the current standards of care.
• The proposed legislation requires a pregnant woman's initial blood sample to be tested for
hepatitis C antibody, and requires additional testing for syphilis during gestation and after
delivery.
• The American College of Obstetricians and Gynecologists (ACOG) recommends routine,
universal hepatitis B and hepatitis C screening early in each pregnancy.
• The ACOG's guidelines also recommend that a pregnant individual be screened for syphilis
at the first prenatal care visit, followed by universal rescreening during the third trimester
and at birth.
• The DOH does not offer prenatal care, but conducts testing for sexually transmitted
infections in health departments, including testing for infectious diseases in early pregnancy.
• Pursuant to Tenn. Code Ann. § 68-5-603, the required pregnancy serological tests shall be
made without charge in the laboratories of the DOH, upon request.
• The Medical Laboratory Board (Board) licenses private laboratories where serological
testing is performed.
• Based on information provided by the DOH, any fiscal impact to the department or the
Board as a result of the proposed legislation is estimated to be not significant.
HB 111 – SB 1283 2
• Aligning pregnancy serological testing requirements with existing clinical guidelines will not
have a significant impact on the Division of TennCare or Benefits Administration.
CERTIFICATION:
The information contained herein is true and correct to the best of my knowledge.
Bojan Savic, Executive Director