All Roll Calls
Yes: 243 • No: 0
TennesseeHB 0858114th General Assembly (2025-2026)HouseWALLET
AN ACT to amend Tennessee Code Annotated, Title 8; Title 56; Title 63; Title 68 and Title 71, relative to step therapy.
Sponsored By: Sponsor information unavailable
Signed by Governor
Commerce and Insurance, Dept. of
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Bill Overview
Analyzed Economic Effects
1 provisions identified: 0 benefits, 0 costs, 1 mixed.
Cancer drug access protections and reporting
Beginning January 1, 2026, these rules apply to policies or agreements entered into, renewed, or amended on or after that date. Tennessee plans covering stage 4 advanced metastatic cancer or metastatic blood cancer cannot require other treatments before covering qualifying drugs. Stage 4 advanced metastatic cancer means cancer that has spread beyond its original site, including nearby tissues or lymph nodes. Qualifying drugs must be FDA-approved, follow best treatment practices, and appear on the plan’s covered drug list. They must also have peer-reviewed evidence consistent with the National Comprehensive Cancer Network Drugs and Biologics Compendium. Related symptoms or treatment side effects qualify when the treating provider judges that leaving them untreated further threatens the patient’s health. Providers must identify that link when requesting approval. Plans can still require an AB-rated generic equivalent, interchangeable biological product, or biosimilar before covering the brand-name drug. The new protection excludes group insurance plans under Tennessee Code Title 8, Chapter 27. State and local insurance programs remain included in the broader step-therapy rules, subject to that exception. Prescribers must report annually to the Department of Health, listing cancer case counts, drugs prescribed, and overall six-month survival rates. The department sets reporting dates and methods by rule. State health and insurance commissioners can issue rules to carry out the law.
Sponsors & Cosponsors
Sponsors
There is no primary sponsor on record.
Cosponsors
T.J. Hardaway
Democrat • House
Esther Helton-Haynes
Republican • House
Renea Jones
Republican • House
Mary Littleton
Republican • House
Susan M. Lynn
Republican • House
Bryan Terry
Republican • House
Roll Call Votes
House vote • 4/21/2025
FLOOR VOTE: MESSAGE CALENDAR CONCUR IN SENATE AMENDMENT # 1 4/21/2025
Yes: 92 • No: 0
Senate vote • 4/16/2025
FLOOR VOTE: as Amended Third Consideration 4/16/2025
Yes: 33 • No: 0
House vote • 3/31/2025
HOUSE CALENDAR & RULES COMMITTEE
Yes: 0 • No: 0
House vote • 3/31/2025
FLOOR VOTE: REGULAR CALENDAR AS AMENDED PASSAGE ON THIRD CONSIDERATION 3/31/2025
Yes: 94 • No: 0
House vote • 3/25/2025
HOUSE INSURANCE COMMITTEE
Yes: 18 • No: 0
House vote • 3/19/2025
INSURANCE SUBCOMMITTEE
Yes: 6 • No: 0
Actions Timeline
Effective date(s) 01/01/2026
5/27/2025Pub. Ch. 505
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.
4/23/2025HouseH. concurred in S. am. no. 1 Ayes 92, Nays 0 PNV 1 HB0858
4/21/2025HouseH. Placed on Message Calendar 4/17/2025
4/16/2025HousePassed Senate as amended, Ayes 33, Nays 0
4/16/2025SenateSenate adopted Amendment (Amendment 1 - SA0243)
4/16/2025SenateSenate substituted House Bill for companion Senate Bill.
4/16/2025SenateReceived from House, Passed on First Consideration
4/3/2025SenateEngrossed; ready for transmission to Sen.
4/1/2025HousePassed H., as am., Ayes 94, Nays 0, PNV 0
3/31/2025HouseSponsor(s) Added.
3/31/2025HouseH. adopted am. (Amendment 1 - HA0149)
3/31/2025HouseH. Placed on Regular Calendar for 3/31/2025
3/27/2025HousePlaced on cal. Calendar & Rules Committee for 3/27/2025
3/26/2025HouseRec. for pass. if am., ref. to Calendar & Rules Committee
3/25/2025HousePlaced on cal. Insurance Committee for 3/25/2025
3/19/2025HouseRec for pass if am by s/c ref. to Insurance Committee
3/19/2025HousePlaced on s/c cal Insurance Subcommittee for 3/19/2025
3/12/2025HouseAssigned to s/c Insurance Subcommittee
3/11/2025HouseRef. to Insurance Committee
3/11/2025House
Bill Text
HA0149 (Substitute)
3/31/2025
Enrolled / Public Chapter
Fiscal Note
Introduced
SA0243
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