Amends TCA Title 56, Chapter 7.

This bill requires a health benefit plan that amends, renews, or delivers a policy of coverage on or after July 1, 2024, and that provides coverage for prescription contraceptives, to provide coverage for a 12-month refill of contraceptives obtained at one time by an insured person, unless the insured requests a smaller supply or the prescribing healthcare provider instructs that the insured must receive a smaller supply. A health benefit plan that provides coverage must allow the insured to receive the contraceptives on-site at the provider's office, if available, and prescribing, dispensing, and administration practices must follow all clinical guidelines to ensure the health of the patient while maximizing access to effective contraceptives. <br /> <br /> This bill prohibits a health benefit plan that provides coverage for hormonal contraceptives, in the absence of clinical contraindications, from imposing utilization controls or other forms of medical management limiting the supply of contraceptives that may be dispensed or furnished by a provider or pharmacy, or at a location licensed or otherwise authorized to dispense drugs or supplies, to an amount that is less than a 12-month supply.<br /> <br /> However, this bill does not require a health benefit plan to cover contraceptives provided by a provider, pharmacy, or at a location authorized to dispense drugs or supplies, that does not participate in the health benefit plan's provider or pharmacy network, as applicable, except as may be otherwise authorized or required by federal or state law or by the plan's policies governing out-of-network coverage.<br /> <br /> ON MARCH 4, 2024, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 1919, AS AMENDED.<br /> <br /> AMENDMENT #1 makes the following changes to the bill:<br /> <br /> (1) Revises the definition of a "health benefit plan" as used in the bill to, instead, mean a policy or contract for health insurance coverage provided under (i) the TennCare program administered under the Medical Assistance Act of 1968 or (ii) the CoverKids Act of 2006 or a successor program;<br /> <br /> (2) Revises the definition of a "health insurance entity" as used in the bill to, instead, mean a managed care organization contracting with the state to provide insurance through (i) the TennCare program administered under the Medical Assistance Act of 1968 or (ii) the CoverKids program administered under the CoverKids Act of 2006 or a successor program; and<br /> <br /> (3) Provides that the bill takes effect January 1, 2025.<br />