2026 Legislative Activities

This was one of the most stressful sessions in recent memory as several bills that directly impact how we talk with and treat patients were introduced. There were big wins, but big losses as well (see priority bills below marked with asterisks). We want to give a tremendous Thank You to our Legislative Committee, our Legislative Committee Chair, Dr. Hunter Butler, and all of our TNAAP members who met with and called their legislators, lobbied these issues at our Day on the Hill, and took time out of their work schedules to testify before committee hearings. And of course, special thanks to our lobbyists Jim Schmidt and Amelia Mitchell, who worked tirelessly on these bills throughout the session. 

PATIENT- PHYSICIAN RELATIONSHIP LEGISLATION

*HB 387/ SB 474 (FAILED) would have restricted the ability of healthcare providers to discuss firearm ownership with patients, including in regards to patient safety and mental health. The bill was killed in the Senate Health committee after multiple amendments and strong lobbying efforts in opposition.

*HB 853/ SB 259 (PASSED) provides parental access to all treatment, rehabilitation, and prescription records of minors. Despite strong opposition, the amended legislation passed and has been sent to Governor Lee for signature. The amended bill does provide a few very specific exemptions for physician therapy notes and reportable abuse situations. However in most cases, it grants parents full access to a patient’s record, including discussions previously protected for 15-17 year old adolescents in regards to sensitive issues like mental health and STI’s. It is a gross infringement on adolescent patients’ rights and our ability to care for them while granting them confidentiality. It awaits Governor Lee’s signature.

*HB 1665/ SB 1664 (PASSED) restricts healthcare providers and facilities from asking minors questions about gender identity without written parental permission. This includes banning questions on intake forms. The legislation also restricts insurance companies from requiring such questions be asked. Despite strong lobbying efforts to include exceptions for primary care providers, the only included exceptions are psychologists, psychiatrists, licensed professional counselors marriage and family therapists, licensed clinical pastoral therapists, or a licensed clinical social workers.  The bill includes exemptions in cases of reportable abuse situations and for situations when the minor raises questions in the course of treatment. Public Chapter 748

HB 1872/ SB 2031 (PASSED) allows for a civil cause of action against healthcare providers who coerce a patient into gender transition services. The amended bill includes a definition of “coerce” as a current criminal definition that includes threat or assault and includes the current statutory exceptions for providing non-gender dysphoria-related treatments. The bill has been signed by Governor Lee but has not been assigned a public chapter number as of yet.

HB 1160/ SB 1064 (FAILED) would have required federal reporting of any adverse reaction to a psychotropic medication and mandated detailed informed consent discussions with patients. The bill failed in the House Health Subcommittee after numerous hearings.

IMMUNIZATION RELATED LEGISLATION

*HB 683/ SB 1389 (FAILED) would have disallowed TennCare providers from refusing services to families based upon vaccination status. The bill which passed to the House and Senate message calendars last year was the subject of a last day of session push by the Senate sponsor to force passage. He succeeded in having adoption in the Senate of a conference committee report but the House did not act on the conference committee report so it cannot become law.

HB 1852/ SB 1767 (FAILED) would have prohibited all mRNA treatments from being provided in the state. It failed for lack of a motion in the House subcommittee.

HB 2243/ SB 2070 (PASSED) known as the “SHIELD Act” requires managed care organizations and insurance companies to remove vaccine refusing families/ patients from the financial incentive considerations of quality metrics programs. While TNAAP was hesitant about the advocacy groups pushing the legislation, the bill does remove a quality metric that is often out of the control of practices despite patient and family education efforts. Public Chapter 797

HJR 28 (FAILED) was a constitutional amendment restricting compelled medical treatments, including vaccinations. The resolution was taken off notice.

HEALTH AND NUTRITION RELATED LEGISLATION

HB 2027/ SB 2080 (FAILED) would have allowed school districts to restrict physical education time periods as punishment. The bill was taken off notice.

HB 2396/ SB 162 (FAILED) would have forced local water systems to stop adding fluoride to their public water sources. The bill failed in the Senate Environment committee.

HB 1853/ SB 2423 (PASSED) removes certain food and beverages containing a number of dyes from school nutrition programs. The bill passed and is now Public Chapter 619.

HB 1550/ SB 1716 (PASSED) expands access to epinephrine for use in schools. The bill passed and awaits Governor Lee’s signature.

HB 1649/ SB 1656 (PASSED) prohibits the sale of Kratom in the state. The bill passed and awaits Governor Lee’s signature.

HB 1679/ SB 1740 (PASSED) allows juvenile court and general sessions judges to penalize youth violating the vapor and tobacco law by imposing community service and completion of a tobacco/ vaping health risk program. The bill passed and awaits Governor Lee’s signature.

HB 2393/ SB 2310 (PASSED) will require school districts to develop policies for age appropriate limitations on digital devices in classes. The bill passed and was signed by Governor Lee but awaits a public chapter number.

HB 1466/ SB 1979 (PASSED) reestablishes the Presidential Physical Fitness test in TN schools.

Public Chapter 598  

*Additional Win: Through the budget process, the General Assembly funded $7M total to apply for the federal Summer EBT program which would bring an estimated $90M to TN in nutritional support services.

REIMBURSEMENT AND COVERAGE OF SERVICES LEGISLATION

*HB 2046/ SB 2080 (FAILED) would have utilized $150M of the current MCO tax collected in the state to provide a rate increase to TennCare physicians. The bill moved to the Finance committees of the House and Senate but failed to get funded in the budget.

HB 1770/ SB 1753 (PASSED) requires that insurance company medical necessity determinations be done by a TN licensed physician. The bill was passed and is now Public Chapter 697.

HB 1959/ SB 2040 (PASSED) known as the “FAIR Rx Act” and the impetus of a multi-million dollar advertising campaign by CVS in opposition will require divestiture of pharmacies by vertically integrated insurance owners. The bill passed through the legislature by large margins and awaits Governor Lee’s signature.

HB 2619/ SB 2155 (FAILED) known as the “Patients First Act” and supported by the healthcare provider community as a whole was defeated on a 4-5 vote in the Senate Commerce committee. The bill would have restricted downcoding practices by insurers and eliminated some prior authorization processes.

HB 1944/ SB 1697 (PASSED) requires the Department of Health to provide mandatory newborn sickle cell screening. Public Chapter 773

HB 484/ SB 435 (PASSED) requires coverage by TennCare and State Employee insurance plans for biomarker testing services. The legislation was passed and awaits Governor Lee’s signature.

HB 406/ SB 422 (FAILED) would have required insurance coverage of secondary prosthetic devices for children for athletic and recreational activity. The bill advanced out of the Senate Commerce committee but did not get funding in the budget.

ARTIFICIAL INTELLIGENCE LEGISLATION

HB 1470/ SB 1580 (PASSED) prohibits developers of AI systems from promoting or representing AI as a qualified mental health professional. The bill passed and is now Public Chapter 647.

HB 1898/ SB 2171 (FAILED) originally would have created significant guardrails for child safety in AI systems. The bill was amended to merely a study by TACIR in the House, but the Senate bill was sent back to committee after some communication from federal authorities.

HB 849/ SB 837 (PASSED) specifies in TN law that AI is not defined as a “person”. Public Chapter 781

HB 1946/ SB 1700 (PASSED) requires a TACIR study of AI Chatbots safety regulation. The bill passed and awaits Governor Lee’s signature.

SCOPE OF PRACTICE EXPANSION

HB 2315/ SB 2570 (FAILED) would have allowed psychologists to prescribe psychotropic medications. The bill was strongly opposed and taken off notice by the sponsor.

HB 1952/ SB 2076 (PASSED) allows optometrists to perform certain surgical (laser) and pharmacological services. Despite opposition from the House of Medicine, the bill was passed and signed by Governor Lee. There is no public chapter at this time.

*Additional Win: Efforts by the Governor’s administration to pass scope expansion for nurses, physician assistants, dental hygienists, and pharmacists as part of the Rural Health Transformation grant application were stalled by the General Assembly.

SAFETY AND CHILD WELFARE

HB 2588/ SB 2369 (PASSED) allows school districts to offer an optional hunter safety education class. Public Chapter 630

A series of bills would have created various expanded firearms rights and loosened current restrictions on business postings, parks and schools. Those bills were held off in the Senate Judiciary committee this year.

CONCLUSION

We want you to know that we truly did everything we could to fight some of these bills that impact how we treat our patients. In some cases, we had some big wins. In some cases, we had some very disheartening losses, and many of these bills are likely to come up again in the future. That is why it is so important for you, our members, to continue to stay active and involved. Let your voice be heard. Talk with your patients, talk with your legislators, talk with your community leaders. Your voice matters. And it is through the hard work of members like you that we make a true difference in the lives of our patients, children all over the state, and the future of Tennessee.

* Indicates Priority Bills