Tennessee § 56-32-129 - Prohibited discrimination.

§ 56-32-129. Prohibited discrimination.

The managed health insurance issuer shall not discriminate with respect to participation, referral, reimbursement of covered services or indemnification as to any provider within a class of providers who is acting within the scope of the provider's license or certification under state law, solely on the basis of the license or certification. In selecting among providers of health services for membership in a provider network, the managed health insurance issuer or other network shall not discriminate against a class of providers who provide services that are covered by the plan by prohibiting the class of providers from membership in the provider network. This section shall not be construed as prohibiting managed health insurance issuers from including providers or classes of providers only to the extent necessary to meet the needs of the managed health insurance issuer's plan and its enrollees, or from limiting referrals or establishing any other measure designed to maintain quality and control costs consistent with the responsibilities of the plan. This chapter shall not be construed as creating coverage for any service that is not otherwise covered under the terms of the managed health insurance issuer's plan. As used in this section, “class of providers” means optometrists, ophthalmologists, podiatrists, pharmacists, and chiropractors. Acts 1998, ch. 1033, § 6; 2002, ch. 641, § 1; T.C.A. § 56-32-229 ; Acts 2017, ch. 82, § 1. Code Commission Notes. Former part 2, §§ 56-32-201 — 56-32-238 , was redesignated as part 1, §§ 56-32-101 — 56-32-138 , by the code commission in 2008. Compiler's Notes. Acts 1998, ch. 1033, § 11 provided that the effects of this section shall be reviewed and studied by the department of commerce and insurance, the department of health and the comptroller of the treasury, and their joint report relative to the social, fiscal and economic impact of the act shall be submitted to the general assembly on or before February 1, 2001. Former part 1, §§ 56-32-101 — 56-32-109 (Acts 1971, ch. 419, §§ 1 — 5; 1978, ch. 818, § 1; T.C.A., §§ 56-4101 — 56-4105; Acts 1981, ch. 202, § 1; 1981, ch. 262, § 1; 1983, ch. 374, § 1; 1985, ch. 354, §§ 4, 5), concerning health maintenance organizations, was repealed by Acts 1986, ch. 713, § 27. For provisions relating to health maintenance organizations, see this part. Amendments. The 2017 amendment inserted “, pharmacists,” near the end of (b). Effective Dates. Acts 2017, ch. 82, § 2. July 1, 2017. Cross-References. Reporting requirements satisfied by notice to general assembly members of publication of report, § 3-1-114 . Law Reviews. The Brief Life of the Gag Clause: Why Anti-Gag Clause Legislation Isn't Enough, 67 Tenn. L. Rev. 1 (1999).