| 1 | 1 | | |
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| 2 | 2 | | HOUSE BILL 37 |
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| 3 | 3 | | By Davis |
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| 4 | 4 | | |
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| 5 | 5 | | SENATE BILL 428 |
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| 6 | 6 | | By Reeves |
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| 7 | 7 | | |
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| 8 | 8 | | |
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| 9 | 9 | | SB0428 |
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| 10 | 10 | | 000599 |
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| 11 | 11 | | - 1 - |
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| 12 | 12 | | |
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| 13 | 13 | | AN ACT to amend Tennessee Code Annotated, Title 8; |
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| 14 | 14 | | Title 53; Title 56; Title 63; Title 68 and Title 71, |
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| 15 | 15 | | relative to the use of drugs for the treatment of |
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| 16 | 16 | | pain. |
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| 17 | 17 | | |
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| 18 | 18 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE: |
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| 19 | 19 | | SECTION 1. Tennessee Code Annotated, Title 56, Chapter 7, is amended by adding |
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| 20 | 20 | | the following new part: |
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| 21 | 21 | | 56-7-3801. |
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| 22 | 22 | | As used in this part: |
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| 23 | 23 | | (1) "Group insurance plan" means a group insurance plan that covers |
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| 24 | 24 | | state employees approved pursuant to title 8, chapter 27; |
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| 25 | 25 | | (2) "Healthcare prescriber" means a prescriber as defined in § 53-10- |
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| 26 | 26 | | 203; |
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| 27 | 27 | | (3) "Insurer" means an insurer that offers a group insurance plan; and |
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| 28 | 28 | | (4) "Non-opioid treatment" means a drug or biological product that is |
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| 29 | 29 | | indicated to produce analgesia without acting on the body's opioid receptors. |
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| 30 | 30 | | 56-7-3802. |
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| 31 | 31 | | (a) Except as otherwise provided in this section, an insurer, for purposes of |
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| 32 | 32 | | offering a group insurance plan, may adopt or amend a state preferred drug list (PDL). |
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| 33 | 33 | | (b) |
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| 34 | 34 | | (1) In establishing and maintaining the PDL, the insurer shall ensure that |
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| 35 | 35 | | a non-opioid drug approved by the United States food and drug administration for |
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| 36 | 36 | | the treatment or management of pain is not disadvantaged or discouraged with |
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| 37 | 37 | | |
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| 38 | 38 | | |
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| 39 | 39 | | - 2 - 000599 |
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| 40 | 40 | | |
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| 41 | 41 | | respect to coverage relative to an opioid or narcotic drug for the treatment or |
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| 42 | 42 | | management of pain on the PDL. |
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| 43 | 43 | | (2) Subdivision (b)(1) does not prohibit an opioid medication from being |
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| 44 | 44 | | preferred over other opioid medications, or a non-opioid medication from being |
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| 45 | 45 | | preferred over other non-opioid medications. |
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| 46 | 46 | | (c) This section applies to a non-opioid drug immediately upon its approval by |
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| 47 | 47 | | the United States food and drug administration for the treatment or management of pain, |
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| 48 | 48 | | regardless of whether the drug has been reviewed by the insurer for inclusion on the |
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| 49 | 49 | | PDL. This section also applies to drugs being provided under a contract between the |
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| 50 | 50 | | insurer and a pharmacy benefits manager for purposes of a group insurance plan. |
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| 51 | 51 | | 56-7-3803. |
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| 52 | 52 | | (a) An insurer, for purposes of offering a group insurance plan, shall ensure that |
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| 53 | 53 | | reimbursement is provided to a healthcare prescriber who provides a non-opioid |
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| 54 | 54 | | treatment to a covered employee under the group insurance plan. |
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| 55 | 55 | | (b) The insurer shall ensure that, to the extent permitted by law, a hospital that |
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| 56 | 56 | | provides either inpatient or outpatient services to a recipient is reimbursed separately |
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| 57 | 57 | | under the group insurance plan for any non-opioid treatment provided as a part of those |
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| 58 | 58 | | services. |
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| 59 | 59 | | SECTION 2. This act takes effect July 1, 2025, the public welfare requiring it. |
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