All Roll Calls
Yes: 244 • No: 0
TennesseeHB 0411114th General Assembly (2025-2026)HouseWALLET
AN ACT to amend Tennessee Code Annotated, Title 8; Title 56 and Title 71, relative to pediatric medical disorders.
Sponsored By: Sponsor information unavailable
Signed by Governor
TennCare
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 2 benefits, 0 costs, 0 mixed.
Treatment coverage protections for children
Since May 21, 2025, health insurance policies and managed care plans cannot deny or delay medically necessary PANDAS or PANS treatment solely because a patient had the same or similar treatment before. They also cannot do so solely because the condition had another diagnostic name, such as autoimmune encephalopathy; treatment must meet Tennessee's TennCare medical-necessity standards. Providers and billing groups must code these disorders as autoimmune encephalitis until the American Medical Association and Centers for Medicare and Medicaid Services assign specific codes. After that, they may use autoimmune encephalitis, PANDAS, or PANS codes. The law's protections also follow these conditions if they receive a new common name or code.
New treatment coverage authority for children
Beginning January 1, 2026, TennCare can require TennCare-participating managed care organizations to cover medically necessary, doctor-prescribed PANDAS and PANS treatment. This authority covers group health contracts and group hospital or medical expense policies delivered, issued for delivery, amended, or renewed in Tennessee from that date; coverage is not automatic. Treatments include antibiotics, other medicines, behavioral therapy, medicines that change immune activity, plasma exchange, and intravenous immunoglobulin (IVIG). When TennCare requires coverage, copays, deductibles, and coinsurance cannot exceed those for comparable benefits, and approvals must follow state urgent-treatment timelines. Medical necessity follows Tennessee's TennCare standards; plans may consider published, evidence-based recommendations from a medical professional consortium and request treatment notes, expected treatment length, and expected results.
Sponsors & Cosponsors
Sponsors
There is no primary sponsor on record.
Cosponsors
Michele Carringer
Republican • House
Scott Cepicky
Republican • House
Elaine Davis
Republican • House
Jeremy Faison
Republican • House
Kirk Haston
Republican • House
Esther Helton-Haynes
Republican • House
Justin Lafferty
Republican • House
Mary Littleton
Republican • House
Bryan Terry
Republican • House
Roll Call Votes
House vote • 4/22/2025
FLOOR VOTE: MESSAGE CALENDAR 2 CONCUR IN SENATE AMENDMENT # 2 4/22/2025
Yes: 97 • No: 0
Senate vote • 4/21/2025
FLOOR VOTE: as Amended Third Consideration 4/21/2025
Yes: 33 • No: 0
House vote • 4/14/2025
FLOOR VOTE: REGULAR CALENDAR AS AMENDED PASSAGE ON THIRD CONSIDERATION 4/14/2025
Yes: 95 • No: 0
House vote • 4/14/2025
HOUSE CALENDAR & RULES COMMITTEE
Yes: 0 • No: 0
House vote • 4/2/2025
HOUSE INSURANCE COMMITTEE
Yes: 12 • No: 0
House vote • 3/18/2025
HOUSE TENNCARE SUBCOMMITTEE
Yes: 7 • No: 0
Actions Timeline
Effective date(s) 05/21/2025
5/27/2025Pub. Ch. 482
5/27/2025Signed by Governor.
5/21/2025Transmitted to Governor for his action.
5/9/2025HouseSigned by Senate Speaker
5/8/2025SenateSigned by H. Speaker
4/30/2025HouseEnrolled; ready for sig. of H. Speaker.
4/25/2025HouseH. concurred in S. am. no. 2 Ayes 97, Nays 0 PNV 0 HB0411
4/22/2025HouseH. Placed on Message Calendar 2 for 4/22/2025
4/22/2025HousePassed Senate as amended, Ayes 33, Nays 0
4/21/2025SenateSenate adopted Amendment (Amendment 2 - SA0415)
4/21/2025SenateAmendment withdrawn. (Amendment 1 - SA0234)
4/21/2025SenateSenate substituted House Bill for companion Senate Bill.
4/21/2025SenateReceived from House, Passed on First Consideration
4/15/2025SenateEngrossed; ready for transmission to Sen.
4/14/2025HousePassed H., as am., Ayes 95, Nays 0, PNV 0
4/14/2025HouseSponsor(s) Added.
4/14/2025HouseH. adopted am. (Amendment 1 - HA0284)
4/14/2025HouseH. Placed on Regular Calendar for 4/14/2025
4/10/2025HousePlaced on cal. Calendar & Rules Committee for 4/10/2025
4/9/2025HouseAction def. in Calendar & Rules Committee to 4/10/2025
4/3/2025HousePlaced on cal. Calendar & Rules Committee for 4/3/2025
4/2/2025HouseRec. for pass. if am., ref. to Calendar & Rules Committee
4/2/2025HousePlaced on cal. Insurance Committee for 4/1/2025
3/26/2025HouseAction def. in Insurance Committee to 4/1/2025
3/25/2025House
Bill Text
HA0284 (Substitute)
4/14/2025
Enrolled / Public Chapter
Fiscal Note
Introduced
SA0234
SA0415
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