TN HB0870

Insurers must count cost-sharing amounts paid by enrollees or on their behalf by third parties (such as copay assistance programs) toward deductibles and out-of-pocket maximums

For high-deductible health plans linked to health savings accounts, third-party payments count toward cost-sharing only after the enrollee meets the minimum IRS deductible, except for preventive care which counts immediately

Third-party payment credits do not apply to brand-name drugs when a generic alternative exists, unless the enrollee obtained the brand through prior authorization, step therapy, or the insurer's appeals process

Insurers, pharmacy benefits managers, and third-party administrators are prohibited from altering health plan coverage or benefit design based on the availability of prescription drug financial assistance programs

Applies to health plans entered into, amended, extended, or renewed on or after January 1, 2026