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Tenn. Code Ann. § 56-32-129

Prohibited discrimination

Known as the Health Maintenance Organization Act

The act spans §§ 56-32-101 to 56-32-138 (38 sections).

Applied in 1 court decision — leading case Spectera, Inc. v. Wilson (2012)

Most recently applied in Spectera, Inc. v. Wilson (July 2012)

Acts 1998, ch. 1033, § 6; 2002, ch. 641, § 1; T.C.A. § 56-32-229; Acts 2017, ch. 82, § 1.

(1) The managed health insurance issuer shall not discriminate with respect to participation, referral, reimbursement of covered services or indemnification as to any provider within a class of providers who is acting within the scope of the provider's license or certification under state law, solely on the basis of the license or certification. In selecting among providers of health services for membership in a provider network, the managed health insurance issuer or other network shall not discriminate against a class of providers who provide services that are covered by the plan by prohibiting the class of providers from membership in the provider network. This section shall not be construed as prohibiting managed health insurance issuers from including providers or classes of providers only to the extent necessary to meet the needs of the managed health insurance issuer's plan and its enrollees, or from limiting referrals or establishing any other measure designed to maintain quality and control costs consistent with the responsibilities of the plan. This chapter shall not be construed as creating coverage for any service that is not otherwise covered under the terms of the managed health insurance issuer's plan.

(2) As used in this section, “class of providers” means optometrists, ophthalmologists, podiatrists, pharmacists, and chiropractors.

Current official text: Tennessee Code (LexisNexis). Digitized from the UniCourt Code Improvement Commission public-domain capture. Reproduced from public-domain Tennessee statutes; confirm against the official source for the current text. Not legal advice.