Amends TCA Title 56; Title 63 and Title 68.
This bill requires notification to a patient regarding communications between the patient's health insurance entity, the patient's healthcare provider, and the patient's healthcare facility, if the communication concerns healthcare services covered by the patient's health insurance coverage. <br /> <br /> Such notice must be given to the patient by each party (the insurer, the healthcare provider, and healthcare facility, as applicable) to the communication within two business days after the communication has occurred. The notification must include a brief summary of the communication or a copy of the communication and must be via electronic means, such as by email or through an online patient portal offered by the health insurance entity, unless the patient requests, in writing, an alternative notification method. If the patient is a minor, then the health insurance entity must notify the policyholder whose health insurance coverage covers the minor.<br /> <br /> For the purpose of rule promulgation, this bill will take effect upon becoming a law. For all other purposes, this bill will take effect January 1, 2022.<br /> <br /> ON APRIL 21, 2021, THE HOUSE ADOPTED AMENDMENT #2 AND PASSED HOUSE BILL 1195, AS AMENDED.<br /> <br /> AMENDMENT #2 removes the definition of "patient" from this bill (which the bill had defined as "an individual who has health insurance coverage and is being treated by a provider for a healthcare service").<br /> <br /> ON FEBRUARY 24, 2022, THE SENATE SUBSTITUTED HOUSE BILL 1195 FOR SENATE BILL 1248, ADOPTED AMENDMENT #2, AND PASSED HOUSE BILL 1195, AS AMENDED.<br /> <br /> AMENDMENT #2 incorporates the provisions of House Amendment #2, substitutes the term "healthcare facility" for health facility, adds a requirement that the utilization review agent notify the provider or healthcare facility (as well as the enrollee) when additional information is needed for a prior authorization request, and changes this bill's effective date for all purposes other than rulemaking to January 1, 2023.<br />
This bill requires notification to a patient regarding communications between the patient's health insurance entity, the patient's healthcare provider, and the patient's healthcare facility, if the communication concerns healthcare services covered by the patient's health insurance coverage. <br /> <br /> Such notice must be given to the patient by each party (the insurer, the healthcare provider, and healthcare facility, as applicable) to the communication within two business days after the communication has occurred. The notification must include a brief summary of the communication or a copy of the communication and must be via electronic means, such as by email or through an online patient portal offered by the health insurance entity, unless the patient requests, in writing, an alternative notification method. If the patient is a minor, then the health insurance entity must notify the policyholder whose health insurance coverage covers the minor.<br /> <br /> For the purpose of rule promulgation, this bill will take effect upon becoming a law. For all other purposes, this bill will take effect January 1, 2022.<br /> <br /> ON APRIL 21, 2021, THE HOUSE ADOPTED AMENDMENT #2 AND PASSED HOUSE BILL 1195, AS AMENDED.<br /> <br /> AMENDMENT #2 removes the definition of "patient" from this bill (which the bill had defined as "an individual who has health insurance coverage and is being treated by a provider for a healthcare service").<br /> <br /> ON FEBRUARY 24, 2022, THE SENATE SUBSTITUTED HOUSE BILL 1195 FOR SENATE BILL 1248, ADOPTED AMENDMENT #2, AND PASSED HOUSE BILL 1195, AS AMENDED.<br /> <br /> AMENDMENT #2 incorporates the provisions of House Amendment #2, substitutes the term "healthcare facility" for health facility, adds a requirement that the utilization review agent notify the provider or healthcare facility (as well as the enrollee) when additional information is needed for a prior authorization request, and changes this bill's effective date for all purposes other than rulemaking to January 1, 2023.<br />
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