Tennessee Consumer Protection
In 2021, the Tennessee General Assembly passed Public Chapter 569, a comprehensive Insurance Company (PBM) reform bill. This legislation prohibited PBMs from patient steering (i.e., requiring patients to use a specified pharmacy)
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TN Public Chapter 1070
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Patient Access to Pharmacy of Choice & Anti-Steerage Provisions
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Insurance companies (PBMs) cannot interfere with the right of a patient to choose a contracted pharmacy, nor offer financial or other incentives to utilize a pharmacy owned by or financially beneficial to the PBM .
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PBMs must allow pharmacies the opportunity to be in-network if they are licensed in the state AND are willing to accept the same terms and conditions for at least one of their networks in the state.
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PBMs cannot prevent a pharmacy from participating in a preferred or non-preferred network of pharmacies.
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PBMs cannot charge patients different co-payments or provide any inducement or financial incentives for using any pharmacy within a given network.
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2010 Tennessee Code Title 56 - Insurance
Chapter 7 - Policies and Policyholders
Part 1 - General Provisions
56-7-117 - Required use of mail-order pharmacy prohibited.
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56-7-117. Required use of mail-order pharmacy prohibited.
(a) No group medical benefit contract issued by an insurance company, a hospital service corporation, a hospital and medical service corporation, a medical service corporation, a health maintenance organization or a health care center, that provides coverage for prescription drugs, may require any person covered under the contract to obtain prescription drugs from a mail-order pharmacy in order to obtain benefits for the drugs, or to pay an additional fee or be subjected to any other penalty for failing to utilize any mail-order pharmacy designated by the insurance company or other issuing organization.
(b) The commissioner is authorized to promulgate regulations to implement and enforce this section.
[Acts 1990, ch. 836, §§ 1, 2.]