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SB 1063

Insurance Companies, Agents, Brokers, Policies - As enacted, removes the requirement that a provider notify a patient of communication between the provider and a health insurance entity or healthcare facility concerning additional information needed to process a prior authorization request for the patient; removes the requirement that an utilization review agent notify the enrollee and the provider or healthcare facility when additional information is needed from the enrollee, provider, or healthcare facility to make a determination on the request for prior authorization. - Amends TCA Title 56 and Title 63, Chapter 1.

114th Regular Session (2025-2026)

Tennessee law eliminates requirements for insurers to notify patients and providers when additional information is needed for prior authorization requests.

Pub. Ch. 125
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Bill Summary · SB 1063

Legislative bill overview

SB 1063 eliminates two notification requirements in Tennessee's health insurance regulations: providers no longer must notify patients when communicating with insurers about prior authorization information requests, and utilization review agents no longer must notify enrollees or providers when additional information is needed to process prior authorization requests. The bill amends Tennessee's insurance and healthcare regulations (TCA Titles 56 and 63).

Why is this important

Prior authorization is a common insurance process that can delay patient access to care, and notification requirements previously ensured transparency about these delays. Removing these requirements streamlines the authorization process administratively but reduces patient visibility into when their care is being held up and why, potentially affecting patients' ability to advocate for themselves or understand delays in treatment.

Potential points of contention

  • Patient transparency: Patients lose automatic notification that their care authorization is pending or requires additional information, potentially causing confusion about why treatment hasn't begun
  • Administrative burden vs. patient rights: While reducing insurer and provider notification costs, the change prioritizes efficiency over informed patient consent and participation in their own healthcare decisions
  • Information asymmetry: Providers and insurers communicate about authorization needs without patient knowledge, shifting responsibility to patients to proactively check authorization status rather than being informed of holds

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

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