| 4 | 3 | | |
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| 5 | 4 | | SENATE BILL 676 |
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| 6 | 5 | | By Taylor |
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| 7 | 6 | | |
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| 8 | 7 | | |
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| 9 | 8 | | SB0676 |
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| 10 | 9 | | 001799 |
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| 11 | 10 | | - 1 - |
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| 12 | 11 | | |
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| 13 | 12 | | AN ACT to amend Tennessee Code Annotated, Title 1; |
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| 14 | 13 | | Title 4; Title 33; Title 56; Title 63; Title 68 and Title |
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| 15 | 14 | | 71, relative to health care. |
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| 16 | 15 | | |
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| 17 | 16 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE: |
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| 18 | 17 | | SECTION 1. Tennessee Code Annotated, Title 68, Chapter 1, is amended by adding |
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| 19 | 18 | | the following as a new part: |
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| 20 | 19 | | 68-1-2501. Part definitions. |
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| 21 | 20 | | As used in this part: |
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| 22 | 21 | | (1) ''Department'' means the department of health; |
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| 23 | 22 | | (2) ''Detransition procedure'' means treatment, including mental health |
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| 24 | 23 | | treatment, medical interventions, and surgeries that stop, reverse, or help an |
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| 25 | 24 | | individual cope with the effects of a gender transition procedure due to the |
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| 26 | 25 | | resolution of any inconsistency between the individual's sex and the individual's |
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| 27 | 26 | | perceived sex or perceived gender; |
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| 28 | 27 | | (3) ''Gender'' means the psychological, behavioral, social, and cultural |
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| 29 | 28 | | aspects of being male or female; |
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| 30 | 29 | | (4) ''Gender clinic'' means a healthcare entity licensed under this title that |
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| 31 | 30 | | provides or prescribes gender transition procedures or refers individuals for |
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| 32 | 31 | | gender transition procedures; |
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| 33 | 32 | | (5) ''Gender transition procedure'' means any pharmaceutical or surgical |
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| 34 | 33 | | intervention to alter an individual's body to address an inconsistency between a |
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| 35 | 34 | | minor's sex and minor's perceived gender or perceived sex; |
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| 36 | 35 | | |
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| 37 | 36 | | |
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| 38 | 37 | | - 2 - 001799 |
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| 39 | 38 | | |
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| 40 | 39 | | (6) ''Healthcare professional'' means a healthcare provider, |
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| 41 | 40 | | establishment, or facility licensed, registered, certified, or permitted pursuant to |
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| 42 | 41 | | this title or title 63 and regulated under the authority of: |
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| 43 | 42 | | (A) The department of health; |
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| 44 | 43 | | (B) An agency, board, council, or committee attached to the |
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| 45 | 44 | | department of health; or |
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| 46 | 45 | | (C) The health facilities commission; |
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| 47 | 46 | | (7) ''Minor'' means an individual under eighteen (18) years of age; |
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| 48 | 47 | | (8) ''Perceived gender'' means an individual's internal sense of the |
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| 49 | 48 | | individual's gender; |
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| 50 | 49 | | (9) ''Perceived sex'' means an individual's internal sense of the |
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| 51 | 50 | | individual's sex; and |
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| 52 | 51 | | (10) ''Sex'' means a person's immutable characteristics of the |
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| 53 | 52 | | reproductive system that define the individual as male or female, as determined |
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| 54 | 53 | | by anatomy and genetics existing at the time of birth. |
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| 55 | 54 | | 68-1-2502. Right to effective care. |
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| 56 | 55 | | (a) A county or municipality shall not prohibit the provision of mental health |
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| 57 | 56 | | therapy to help a minor address an inconsistency between the minor's sex and the |
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| 58 | 57 | | minor's perceived gender or perceived sex. |
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| 59 | 58 | | (b) A county or municipality shall not prohibit a parent or legal guardian from |
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| 60 | 59 | | consenting to, or withholding consent from, the provision of mental health therapy to help |
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| 61 | 60 | | a minor address an inconsistency between the minor's sex and the minor's perceived |
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| 62 | 61 | | gender or perceived sex. |
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| 63 | 62 | | |
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| 64 | 63 | | |
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| 65 | 64 | | - 3 - 001799 |
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| 66 | 65 | | |
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| 67 | 66 | | (c) A gender clinic that uses funds provided by this state to directly or indirectly |
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| 68 | 67 | | provide or pay for gender transition procedures must, as a condition of receiving such |
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| 69 | 68 | | funds, agree to provide or pay for the performance of detransition procedures. |
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| 70 | 69 | | 68-1-2503. Right to public transparency. |
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| 71 | 70 | | (a) A gender clinic operating in this state shall report statistics regarding all |
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| 72 | 71 | | gender transition procedures to the department on a form provided by the department. |
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| 73 | 72 | | (b) The department shall develop a form for reporting under subsection (a) and |
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| 74 | 73 | | determine the statistics to be reported, which must include: |
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| 75 | 74 | | (1) The date on which the gender transition procedure was prescribed or |
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| 76 | 75 | | the referral was made for the gender transition procedure; |
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| 77 | 76 | | (2) The age and sex of the person for whom the gender transition |
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| 78 | 77 | | procedure was prescribed or the gender transition procedure referral was made; |
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| 79 | 78 | | (3) For a drug prescribed as part of a gender transition procedure: |
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| 80 | 79 | | (A) The name of the drug; |
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| 81 | 80 | | (B) The dosage of the drug; |
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| 82 | 81 | | (C) The dosage frequency and duration; and |
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| 83 | 82 | | (D) The method by which the drug will be administered; |
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| 84 | 83 | | (4) For a surgical intervention provided or a referral made for a surgical |
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| 85 | 84 | | intervention as part of a gender transition procedure, the type of surgical |
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| 86 | 85 | | procedure identified by the current procedural terminology (CPT) code; |
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| 87 | 86 | | (5) The state and county of residence of the person receiving the gender |
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| 88 | 87 | | transition procedure; |
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| 89 | 88 | | (6) The name, contact information, and medical specialty of the |
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| 90 | 89 | | healthcare professional who prescribed the gender transition procedure or made |
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| 91 | 90 | | the referral for the gender transition procedure; and |
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| 92 | 91 | | |
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| 93 | 92 | | |
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| 94 | 93 | | - 4 - 001799 |
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| 95 | 94 | | |
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| 96 | 95 | | (7) A list of any diagnoses that the person receiving or referred for a |
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| 97 | 96 | | gender transition procedure has received of neurological, behavioral, or mental |
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| 98 | 97 | | health conditions. |
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| 99 | 98 | | (c) The form developed by the department must be: |
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| 100 | 99 | | (1) Completed by each gender clinic at which a gender transition |
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| 101 | 100 | | procedure is prescribed or a referral is made for a gender transition procedure; |
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| 102 | 101 | | (2) Signed by the healthcare professional who prescribes the gender |
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| 103 | 102 | | transition procedure or makes a referral for a gender transition procedure; and |
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| 104 | 103 | | (3) Transmitted by the gender clinic to the department no later than |
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| 105 | 104 | | fifteen (15) days after the end of the calendar month during which the gender |
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| 106 | 105 | | transition procedure was prescribed or the referral was made. |
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| 107 | 106 | | (d) Forms required under this section must not contain individually identifiable |
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| 108 | 107 | | health information as defined in 45 CFR § 160.103. |
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| 109 | 108 | | (e) The department shall submit a comprehensive annual statistical report by |
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| 110 | 109 | | December 31, 2025, and by December 31 of each year thereafter, to the speaker of the |
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| 111 | 110 | | senate, the speaker of the house of representatives, and the legislative librarian based |
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| 112 | 111 | | on all data obtained from forms required by this section. The department shall make the |
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| 113 | 112 | | statistical report available to the public on the department's public website in a |
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| 114 | 113 | | downloadable format. |
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| 115 | 114 | | (f) If a healthcare professional fails to comply with this section, then: |
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| 116 | 115 | | (1) The healthcare professional has engaged in unprofessional conduct |
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| 117 | 116 | | and is subject to discipline by the appropriate licensing entity or disciplinary |
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| 118 | 117 | | review board with competent jurisdiction in this state. Disciplinary action must |
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| 119 | 118 | | include suspension of the ability to administer health care or practice medicine |
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| 120 | 119 | | for at least six (6) months; and |
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| 121 | 120 | | |
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| 122 | 121 | | |
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| 123 | 122 | | - 5 - 001799 |
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| 124 | 123 | | |
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| 125 | 124 | | (2) The gender clinic where the healthcare professional is employed shall |
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| 126 | 125 | | pay a civil fine not to exceed one hundred fifty thousand dollars ($150,000). |
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| 127 | 126 | | (g) The attorney general and reporter may investigate a potential violation of this |
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| 128 | 127 | | part, seek production of documents or testimony through a civil investigative demand, |
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| 129 | 128 | | and bring an action to enforce compliance with this section. |
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| 130 | 129 | | SECTION 2. Tennessee Code Annotated, Title 56, Chapter 7, Part 23, is amended by |
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| 131 | 130 | | adding the following as a new section: |
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| 132 | 131 | | (a) As used in this section: |
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| 133 | 132 | | (1) ''Department'' means the department of health; and |
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| 134 | 133 | | (2) ''Detransition procedure'', "gender", "gender clinic", "gender transition |
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| 135 | 134 | | procedure", "health professional", "minor", "perceived gender", "perceived sex", |
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| 136 | 135 | | and "sex" have the same meanings as defined in § 68-1-2501. |
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| 137 | 136 | | (b) If an insurance policy issued, renewed, or amended in this state on or after |
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| 138 | 137 | | the effective date of this act, includes coverage for gender transition procedures, then |
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| 139 | 138 | | the policy must also include coverage for detransition procedures. |
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| 140 | 139 | | (c) An entity providing insurance coverage for detransition procedures must |
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| 141 | 140 | | provide statistics regarding insurance claims for detransition procedures in this state to |
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| 142 | 141 | | the department on a form provided by the department. |
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| 143 | 142 | | (d) The department shall develop a form for the reporting required by subsection |
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| 144 | 143 | | (c) and determine the statistics to be reported, which must include: |
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| 145 | 144 | | (1) The number of insurance claims made for detransition procedures; |
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| 146 | 145 | | (2) The age and sex of an individual receiving a detransition procedure; |
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| 147 | 146 | | (3) If known, the date that the individual initially began a gender transition |
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| 148 | 147 | | procedure; and |
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| 149 | 148 | | |
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| 150 | 149 | | |
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| 151 | 150 | | - 6 - 001799 |
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| 152 | 151 | | |
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| 153 | 152 | | (4) The state and county of residence of the person receiving the gender |
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| 154 | 153 | | transition procedure. |
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| 155 | 154 | | (e) The entity providing insurance coverage shall transmit the form to the |
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| 156 | 155 | | department no later than fifteen (15) days after the end of the calendar month during |
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| 157 | 156 | | which a claim for the gender transition procedure was approved. |
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| 158 | 157 | | (f) Reporting forms required under this section must not contain individually |
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| 159 | 158 | | identifiable health information as defined in 45 CFR § 160.103. |
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| 160 | 159 | | (g) The department shall submit a comprehensive annual statistical report by |
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| 161 | 160 | | December 31, 2025, and by December 31 of each year thereafter, to the speaker of the |
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| 162 | 161 | | senate, the speaker of the house of representatives, and the legislative librarian based |
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| 163 | 162 | | on all data obtained from forms required by this section. The department shall make the |
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| 164 | 163 | | statistical report available to the public on the department's public website in a |
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| 165 | 164 | | downloadable format. |
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| 166 | 165 | | (h) The attorney general and reporter may investigate a potential violation of this |
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| 167 | 166 | | section, seek production of documents or testimony through a civil investigative demand, |
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| 168 | 167 | | and bring an action to enforce compliance with this section. |
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| 169 | 168 | | SECTION 3. If any provision of this act or its application to any person or circumstance |
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| 170 | 169 | | is held invalid, then the invalidity does not affect other provisions or applications of the act that |
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| 171 | 170 | | can be given effect without the invalid provision or application, and to that end, the provisions of |
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| 172 | 171 | | this act are severable. |
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| 173 | 172 | | SECTION 4. The headings in this act are for reference purposes only and do not |
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| 174 | 173 | | constitute a part of the law enacted by this act. However, the Tennessee Code Commission is |
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| 175 | 174 | | requested to include the headings in any compilation or publication containing this act. |
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| 176 | 175 | | SECTION 5. This act takes effect upon becoming a law, the public welfare requiring it, |
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| 177 | 176 | | and applies to contracts for insurance entered into, amended, or renewed on or after that date. |
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