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HB 869

Health Care - As enacted, revises present law relative to a patient's electronic health record and requires a health insurance entity to establish and maintain a provider access API and a prior authorization API; makes related changes. - Amends TCA Title 8; Title 47; Title 56; Title 63 and Title 68.

114th Regular Session (2025-2026) Introduced by Iris Rudder

Tennessee requires health insurers to build APIs enabling provider access to patient records and automating prior authorization to reduce administrative delays and improve care coordination.

Comp. became Pub. Ch. 447
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Bill Summary · HB 869

Legislative bill overview

HB 869 mandates that health insurance entities in Tennessee establish and maintain two specific application programming interfaces (APIs): one for provider access to patient electronic health records and another for streamlining prior authorization requests. The bill amends multiple sections of Tennessee code governing healthcare, insurance, and related regulatory matters.

Why is this important

APIs that connect providers to patient records and automate prior authorization can reduce administrative burden, speed up care decisions, and improve patient access to their own health information. However, implementation costs and technical complexity could affect smaller insurers and healthcare providers, potentially influencing insurance premiums and operational efficiency across the state's healthcare system.

Potential points of contention

  • Implementation burden and costs: Smaller health insurance entities may face significant expenses developing and maintaining these APIs, potentially passed to consumers through higher premiums
  • Data security and privacy concerns: Expanding API access to patient records requires robust cybersecurity measures; breaches could expose sensitive health information
  • Prior authorization delays: While APIs aim to streamline the process, unclear standards or technical failures could still create bottlenecks if not properly designed and monitored
  • Compliance timeline: The bill doesn't specify implementation deadlines, creating uncertainty about when requirements become enforceable

Compiled from official sources — confirm details with the bill’s official record.

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