ON MARCH 30, 2023, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 460, AS AMENDED.
AMENDMENT #1 rewrites this bill to make changes relative to the coverage of complex rehabilitation technology (CRT) by health insurance entities and managed care organizations.
COVERAGE FOR COMPLEX REHABILITATION TECHNOLOGY (CRT) BY HEALTH INSURANCE ENTITIES
This amendment prohibits a health insurance entity that offers health insurance coverage of CRT or manual wheelchairs from requiring a prior authorization for repairs of such technology or equipment unless:
(1) The repairs are covered under a manufacturer's warranty;
(2) The cost of the repairs exceeds the cost to replace the CRT or manual wheelchair; or
(3) The CRT or manual wheelchair in need of repair is subject to replacement because the age of the CRT or manual wheelchair exceeds, or is within one year of the expiration of, the recommended lifespan of the CRT or manual wheelchair.
COVERAGE FOR COMPLEX REHABILITATION TECHNOLOGY (CRT) BY MANAGED CARE ORGANIZATIONS
This amendment prohibits a health maintenance organization, behavioral health organization, or managed health insurance issuer that participates in the TennCare program ("managed care organization") from requiring a participant in the TennCare program to obtain and submit a prior authorization for repairing CRT or manual wheelchairs unless the conditions in (1)-(3) exist.
APPLICABILITY
This bill applies to contracts entered into, amended, or renewed on or after July 1, 2023.

Statutes affected:
Introduced: 56-6-705(a)(4), 56-6-705
Amended with SA0301 -- 03/30/2023: 56-6-705(a)(4), 56-6-705