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TN HB1382
Bill
Status
2/6/2025
Primary Sponsor
Torrey Harris
Click for details
AI Summary
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Health insurance issuers using AI, algorithms, or software tools for utilization review must base determinations on individual enrollee medical history and clinical circumstances, not solely on group datasets
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AI tools are prohibited from denying, delaying, or modifying healthcare services based on medical necessity; only licensed physicians or qualified healthcare professionals may make medical necessity determinations
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Applies to private insurers, HMOs, pharmacy benefit managers, TennCare, CoverKids, and state employee group insurance plans
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Violations constitute unfair claims practices; aggrieved individuals may bring private lawsuits and recover actual damages, punitive damages, court costs, and attorneys' fees
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Effective July 1, 2025, for conduct occurring on or after that date
Legislative Description
AN ACT to amend Tennessee Code Annotated, Title 8, Chapter 27; Title 56 and Title 71, relative to health insurance.
Insurance Companies, Agents, Brokers, Policies
Last Action
Assigned to s/c Insurance Subcommittee
2/12/2025