This bill requires the bureau of TennCare to do the following:
(1) Require that each group health insurance contract, or group hospital or medical expense insurance policy, plan, or group policy delivered, issued for delivery, amended, or renewed in this state by an MCO on or after the effective date of this bill to not include quantitative treatment limitations for mental health services;
(2) Reimburse an in-network or contract provider for covered mental health services provided to an enrollee at a rate not less than 180 percent of the federal centers for medicare and medicaid services medicare program's allowable charge for participating providers that is in effect at the time the service is provided; and
(3) Allow an enrollee to access an out-of-network or non-contract provider for covered mental health services and reimburse such provider at a rate not less than 100 percent of the CMS medicare program's allowable charge for participating providers that is in effect at the time the service is provided. However, a provider reimbursed pursuant to this (3) must not bill an enrollee for an amount above the allowed amount.
APPLICABILITY
This bill applies only to contracts or policies entered into, amended, or renewed on or after the effective date of this bill.