Senate Bill 437 amends Tennessee Code Annotated to establish new requirements for health benefit plans regarding the coverage of mental health and substance abuse services. The bill introduces a definition for "Psychiatric collaborative care model" (PCCM), which is an integrated behavioral healthcare model involving collaboration between primary care providers, care managers, and psychiatric consultants. Starting July 1, 2025, health benefit plans that offer mental health and substance abuse services must provide coverage and reimbursement for these services through a PCCM, with specific conditions under which coverage may be denied based on medical necessity.
Additionally, the bill stipulates that managed care organizations contracted with the state, such as those providing insurance through the TennCare or CoverKids programs, must comply with these coverage requirements if the services are deemed medically necessary. The legislation emphasizes adherence to existing state laws and the federal Mental Health Parity and Addiction Equity Act of 2008, ensuring that mental health and substance abuse services are treated equitably in health benefit plans. The act is set to take effect on July 1, 2025.