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)
TN Public Chapter 1070
Patient Access to Pharmacy of Choice & Anti-Steerage Provisions
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 .
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.
PBMs cannot prevent a pharmacy from participating in a preferred or non-preferred network of pharmacies.
PBMs cannot charge patients different co-payments or provide any inducement or financial incentives for using any pharmacy within a given network.
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.
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.]