SB 955 - HB 1044
FISCAL NOTE
Fiscal Review Committee
Tennessee General Assembly
February 21, 2025
Fiscal Analyst: Chris Higgins | Email: chris.higgins@capitol.tn.gov | Phone: 615-741-2564
SB 955 - HB 1044
SUMMARY OF BILL: Enacts the Medical Ethics Defense Act (Act). Establishes that a
healthcare provider, including a healthcare professional, healthcare institution, or healthcare payer,
has the right to not participate in or pay for a healthcare procedure, treatment, or service that
violates the conscience of the healthcare provider.
Does not apply to procedures, treatments, or services governed by federal law, including the
Emergency Medical Treatment and Active Labor Act. Establishes that a healthcare payer may not decline
payment for a healthcare procedure, treatment, or service it is contractually obligated to pay for
under the terms of a contract with an insured party.
Establishes that the exercise of the right of conscience in declining to participate in or pay for a
healthcare service may not be used as the basis for a civil, criminal, or discriminatory action against a
healthcare provider. Grants whistleblower protections to a healthcare provider who reports on
violations of the Act.
Prohibits any political subdivision of the state from taking action against a healthcare provider for
engaging in speech, expression, or association that is protected from government interference by the
First Amendment to the United States Constitution, unless the political subdivision demonstrates by
clear and convincing evidence that the healthcare provider's speech, expression, or association was
the direct cause of physical harm to a person with whom the healthcare provider had a practitioner-
patient relationship within the three years immediately preceding the incident of physical harm.
Requires a department, agency, or other entity of the state to provide a healthcare provider with any
complaint it receives based on the provider's speech, expression, or association which may result in
the revocation of the provider's license, certification, or registration, within 21 days after receipt of
the complaint, and to pay the healthcare provider $500 per day for each day the complaint is not
provided after 21 days.
Creates a cause of action for violations of the Act for which an aggrieved party is entitled to an
award of injunctive and declaratory relief, and to recover damages sustained, along with the costs of
the action and reasonable attorney fees, upon the finding of a violation.
FISCAL IMPACT:
NOT SIGNIFICANT
SB 955 - HB 1044 2
Assumptions:
• The proposed legislation authorizes healthcare professionals and healthcare institutions to
refuse to participate in a healthcare procedure, treatment, or service that violates their
conscience.
• Pursuant to Tenn. Code Ann. § 68-11-1808(c), a healthcare provider may decline to comply
with an individual instruction or healthcare decision for reasons of conscience.
• Pursuant to Tenn. Code Ann. § 68-11-1808(d)(1), a healthcare institution may decline to
comply with an individual instruction or healthcare decision if it is contrary to the policy of
the institution that is based on reasons of conscience.
• Therefore, the proposed legislation is not expected to significantly impact healthcare
professionals or institutions’ operations.
• The proposed legislation further prohibits a healthcare payer from being forced to pay for a
medical procedure that violates their conscience, unless obligated to pay for such procedure
under the terms of a contract with an insured party.
• It is assumed that any non-emergency procedures which a healthcare payer deems to violate
their conscience will be stated as such prior to the procedure, and therefore, will not occur.
• The proposed legislation will primarily govern the actions of healthcare professionals
employed by private healthcare institutions.
• Any resulting impacts will be realized by the private parties involved in such actions.
• The changes are not estimated to significantly impact the caseloads of state or local courts.
• It is assumed that the proposed legislation will not significantly impact state departments or
agencies that employ healthcare professionals as most will not be faced with situations in
which they will need to participate in a procedure that violates their conscience.
• A state department, agency, or other entity can provide a healthcare provider with any
complaints it has received which may result in the revocation of the healthcare provider's
license, certification, or registration within 21 days utilizing existing resources and
personnel.
• The proposed legislation will not significantly impact state or local government
expenditures or operations.
CERTIFICATION:
The information contained herein is true and correct to the best of my knowledge.
Bojan Savic, Executive Director