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- Advocacy Win: Tennessee Pathologists, CAP- Amended Laboratory Choice Bill Enacted
On May 17, Gov. Bill Lee enacted Tennessee Society of Pathologists-CAP amended Senate Bill 1275, prohibiting health insurance issuers from denying clinical laboratories the right to participate in their network plans under the same terms as conditions as others participating laboratories furnishing covered laboratory services. The CAP did not take a position on the “any willing provider” bill but focused on removing a provision of concern.
Specifically, the Tennessee Society of Pathologists and the CAP, in collaboration with the Tennessee Medical Association successfully removed an anti-competitive provision permitting health plans to limit and restrict patient and health care provider referral access to a single clinical laboratory for non-emergency services under certain circumstances. The proposed provision would have conferred unprecedented statutory authority on health plans to limit clinical laboratory choice and access under vaguely defined conditions.
The CAP advocates for sufficient health plan network adequacy mandates to ensure that health plans are subject to regulatory incentives and state oversight to contract with clinical laboratories and pathologists. The amended legislation ensures Tennessee patients are not limited or restricted in clinical laboratory testing by optimizing patient and physician choice in the referral of the clinical laboratory services.
The law will take effect on July 1, 2023.