Senate Bill 1722, also known as House Bill 1993, amends Tennessee Code Annotated, Title 56, Chapter 7, Part 23, concerning the participation of medical laboratories in health insurance plans. The bill prohibits health insurance issuers and managed health insurance issuers from denying licensed medical laboratories the right to participate as providers under the same terms as other laboratories. It also allows individuals covered by a policy to select their preferred licensed medical laboratory, provided that the laboratory is a participating provider. Additionally, the bill mandates that non-network medical laboratories eligible to participate must be reimbursed at a rate no less than the federal Medicare and Medicaid services' clinical laboratory fee schedule.

Furthermore, the bill introduces a new provision allowing managed health insurance issuers to require non-network medical laboratories to meet the same performance metrics as in-network laboratories to qualify for the specified reimbursement rates. This amendment aims to ensure that all participating laboratories maintain a standard of quality while also addressing network adequacy and patient care needs. The act is set to take effect on July 1, 2026.

Statutes affected:
Introduced: 56-7-2357(b), 56-7-2357