reglab/housing_qa huggingface dataset:
TN Code § 56-7-2363 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 23 - Mandated Insurer or Plan Coverage|§ 56-7-2363. Colorectal Cancer Early Detection

  All individual and group health insurance policies providing coverage on an expense incurred basis, individual and group service contracts issued by a health maintenance organization, all self-insured group arrangements to the extent not preempted by federal law and all managed health care delivery entities of any type or description, that are delivered or issued on or after January 1, 2004, in this state shall include, or shall offer to prospective policyholders and existing policyholders on renewal, as an optional benefit, coverage for colorectal cancer examinations and laboratory tests specified in current American Cancer Society guidelines or federal Preventive Services Task Force guidelines for colorectal cancer screening of asymptomatic individuals.   The benefits required by this section shall be subject to the annual deductible and co-insurance established for all other similar benefits within the policy or contract; provided, that the annual deductible and co-insurance for the benefits required by this section are no greater than the annual deductible and co-insurance established for all other similar benefits within that policy or contract of insurance.   Nothing in this section shall apply to the TennCare program administered pursuant to the waivers approved by the federal department of health and human services, to accident-only, specified disease, hospital indemnity, medicare supplement, long-term care or other limited benefit health insurance policies, or to any health benefit that is individually underwritten.
TN Code § 56-7-2364 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 23 - Mandated Insurer or Plan Coverage|§ 56-7-2364. Medication Counseling

  Notwithstanding any other law to the contrary, any insurer providing individual, franchise, blanket or group policy of insurance issued pursuant to this title, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society, health maintenance organization, preferred provider organization or managed care organization, that provides hospital expense and surgical or medical expense insurance or that is entered into, delivered, issued for delivery or renewed in this state after January 1, 2004, may offer to provide reimbursement coverage for medication counseling the insured receives from a pharmacist pursuant to this section.    An insured who is prescribed and uses six (6) or more types of medication may be entitled to receive two (2) medication counseling sessions during the first year the patient begins the sessions, with a doctor of pharmacy licensed in accordance with title 63, chapter 10, part 4, who has received additional clinical training in the areas of medication management and counseling. The goal of the counseling shall be to reduce the number of unnecessary medications for patients, and to reduce the incidence of negative interactions among various medications a patient may be taking. The first medication counseling session shall consist of the following:  An examination of the patient's medical history;   An evaluation of the number and types of medications the patient uses, including over-the-counter medications;   A determination of the types of interactions among the medications;   A recommended medication therapy and thorough analysis of the benefit of the medication therapy;   An evaluation of the cost savings gained as a result of any changes made to the prescribed course of medication; and   A summary of expected outcomes and proposed follow-up examination dates.     A report and recommendation from the first counseling session shall be forwarded to the prescribing physician or physicians for review. The physician may implement the recommendations or may disapprove the recommendations.   The second medication counseling session shall be a follow-up session during which the patient's response to the medication therapy will be monitored.     Both the first and second counseling sessions during the first year may be reimbursable through the patient's insurance coverage. The patient or the pharmacist may request an additional counseling session upon providing verification to the insurer that the patient has developed a change in the patient's medical condition.
TN Code § 56-7-2366 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 23 - Mandated Insurer or Plan Coverage|§ 56-7-2366. Notice of Termination of Coverage for Spouses and Former Spouses

  Every insured or policy holder of a group policy of accident and sickness insurance offered for sale in this state, that provides coverage for hospital or medical expenses that also provides coverage to the spouse of the insured, shall provide at least thirty (30) days' prior notice of the termination of coverage to the covered spouse as a result of a divorce, a legal separation, or other separation. The notice shall be written, filed with the court that is hearing the divorce or legal separation prior to or at the final hearing, and served upon the spouse as provided by Tennessee Rules of Civil Procedure. If no divorce, legal separation or similar legal proceeding is pending, then the notice shall be transmitted by certified mail, return receipt requested, to the last known address of the spouse.    The notice shall advise the spouse who is to be terminated that, when the divorce is final, the spouse shall not be eligible for continued coverage under the policy. The notice shall also advise the spouse of the availability of the COBRA continuation provision and of the procedures for applying for COBRA coverage, including identifying who should be contacted to obtain coverage. The notice shall indicate that the spouse who is to be terminated will be without health insurance coverage from the insured's policy and that the spouse must obtain coverage under COBRA continuation, or a separate source of insurance, if the spouse wishes to retain health insurance coverage.   For the purposes of this subsection (b), “COBRA continuation provision” means any of the following:  Section 4980B of the Internal Revenue Code of 1986 (26 U.S.C. § 4980B), other than subdivision (f)(1), insofar as it relates to pediatric vaccines;   The Employee Retirement Income Security Act (ERISA), Part 6 of Subtitle B of Title I (29 U.S.C. § 1161 et seq.), other than § 609 (29 U.S.C. § 1169); or   Title XXII of the Public Health Service Act (42 U.S.C. § 300bb-1 et seq.).       As an employer updates the plan summary, in the course of business, for any group policy of accident and sickness insurance that it may offer to its employees, the employer shall include a notice of the provisions of this section in the summary.   The attorney for the insured in any action for divorce shall advise the insured or policy holder of the obligation imposed by this section.   The administrative office of the courts shall develop a model notice to reflect this section.
TN Code § 56-7-2367 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 23 - Mandated Insurer or Plan Coverage|§ 56-7-2367. Autism Spectrum Disorders

  As used in this section, “autism spectrum disorders” means neurological disorders, usually appearing in the first three (3) years of a person's life, that affect normal brain functions and are typically manifested by impairments in communication and social interaction, as well as restrictive, repetitive, and stereotyped behaviors.   A contract or policy of an insurer that provides benefits for neurological disorders, whether under an individual or group health insurance policy providing coverage on an expense-incurred basis, an individual or group service contract issued by a health maintenance organization, a self-insured group arrangement to the extent not preempted by federal law or a managed health care delivery entity of any type or description shall provide benefits and coverage for treatment of autism spectrum disorders that are at least as comprehensive as those provided for other neurological disorders. These benefits and coverage for treatment shall be provided to any person less than twelve (12) years of age.   Benefits provided for treatment of autism spectrum disorders shall be subject to deductible and copayment requirements and benefit limits that are no more stringent than those established for the treatment of other neurological disorders.   An insurer that provides benefits for neurological disorders shall not refuse to renew policies, reissue policies, or otherwise terminate or restrict services to a person solely because the person is diagnosed with an autism spectrum disorder.   This section shall not expand the type or scope of treatment beyond that authorized for any other diagnosed neurological disorder and shall be effective upon any contract, policy, or plan that is delivered, issued for delivery, amended or renewed on or after January 1, 2007.   Nothing in this section shall apply to accident-only, specified disease, hospital indemnity, medicare supplement, long-term care, or other limited benefit hospital insurance policies.
TN Code § 56-7-2368 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 23 - Mandated Insurer or Plan Coverage|§ 56-7-2368. Health Insurance Coverage for Hearing Aids for Children

  As used in this section, unless the context otherwise requires:  “Child” or “children” means any person under eighteen (18) years of age; and   “Hearing aid” means any wearable, nonexperimental, nondisposable instrument or device designed for the ear and used to aid or compensate for impaired human hearing, including earmolds and services necessary to select, fit, and adjust the hearing aid, but excluding batteries, cords, and other assistive listening devices such as FM systems.     Every individual or group health insurance policy providing coverage on an expense-incurred basis, every policy or contract issued by a hospital or medical service corporation, every individual or group service contract issued by a health maintenance organization, and every self-insured group arrangement to the extent not preempted by federal law, which is delivered, issued for delivery, or renewed in this state on or after January 1, 2012, shall provide coverage of up to one thousand dollars ($1,000) per individual hearing aid per ear, every three (3) years, for every child covered by such policy whether as a dependent of the policy holder or otherwise.   The insured may choose a hearing aid exceeding one thousand dollars ($1,000) and pay the difference in cost above the amount of coverage required by this section. Reimbursement shall be provided according to the respective principles and policies of the insurer.   The insurer may require the policyholder to provide a prescription by a licensed audiologist or physician or show proof through other suitable documentation of the need for a hearing aid, and this section shall not preclude the insurer from conducting managed care, medical necessity, or utilization review or prevent the operation of such policy provisions as deductibles, coinsurance, allowable charge limitations, coordination of benefits or provisions restricting coverage to services by licensed, certified or carrier-approved providers or facilities.   This section shall not apply to insurance coverage providing benefits for the following:  Hospital confinement indemnity;   Disability income;   Accident only;   Long-term care;   Medicare supplement;   Limited benefit health;   Specified disease indemnity;   Sickness or bodily injury or death by accident, or both; and   Other limited benefit policies.     This section shall not apply to TennCare or any successor program provided for in title 71, chapter 5.
TN Code § 56-7-2401 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2401. Reimbursement for Services of Certain Health Care Providers

  Whenever any policy of insurance issued in this state provides for reimbursement for any service that is within the lawful scope of practice of a duly licensed optometrist, as defined in § 63-8-102; a licensed psychologist designated as a health service provider, as provided by title 63, chapter 11; licensed psychological examiner; certified psychological assistant supervised, as provided by title 63, chapter 11; licensed senior psychological examiner; a duly licensed podiatrist, as defined in § 63-3-101; a person duly licensed to engage in independent practice as a licensed clinical social worker in accordance with § 63-23-105; a duly licensed marital and family therapist, as defined in § 63-22-115; or a duly licensed professional counselor, as defined in § 63-22-122, the insured or other person entitled to benefits under the policy shall be entitled to reimbursement for the services, whether the services are performed by a duly licensed physician; by a duly licensed optometrist; by a duly licensed podiatrist; by a duly licensed psychologist designated as a health service provider; by a duly licensed psychological examiner supervised, as provided by title 63, chapter 11; by a certified psychological assistant supervised, as provided by title 63, chapter 11; by a duly licensed senior psychological examiner; by a duly licensed independent practitioner of social work; by a duly licensed marital and family therapist; or by a duly licensed professional counselor, not to exceed the percentage of reimbursement provided for psychiatrists in the policy, notwithstanding any other provision in the policy.   Reimbursements shall be made in a timely manner.   The provisions of this section relating to podiatric services shall apply to all contracts, plans or policies issued or renewed on or after July 1, 1981.   As used in this section, “licensed psychologist designated as a health service provider” includes all psychologists previously licensed as clinical, school and counseling psychologists pursuant to title 63, chapter 11, prior to June 30, 1993, and who have been designated as health service providers.
TN Code § 56-7-2402 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2402. Participation by Optometrists, Podiatrists and Social Workers in Medical, Hospital, and Hospital and Medical Service Plans

  Whenever any subscribers under any medical service plan or hospital service contract or hospital and medical service contract, as provided under Chapters 27 29 of this title or any similar statutes, or any other persons covered by the plan or contract, are entitled to reimbursement for any services that are within the lawful scope of practice of a duly licensed optometrist as defined in § 63-8-102; a duly licensed podiatrist as defined in § 63-3-101; a person duly licensed to engage in independent practice as a licensed clinical social worker in accordance with § 63-23-105; the subscriber or other person shall be entitled to reimbursement for the services, whether the services are performed by a duly licensed physician; a duly licensed optometrist; a duly licensed podiatrist; or a person duly licensed to engage in independent  practice as a licensed clinical social worker, notwithstanding any provision to the contrary in any other statute or in the plan or contract; and duly licensed optometrists and podiatrists shall be entitled to participate in the plans or contracts providing for the services to the same extent and subject to the same limitations as duly licensed physicians.   The provisions of this section relating to podiatric services apply to all contracts, plans or policies issued or renewed on or after July 1, 1981.
TN Code § 56-7-2403 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2403. Applicability and Scope of §§ 56-7-2401 and 56-7-2402

  Sections 56-7-2401 and 56-7-2402 are not applicable to any policy or policies of insurance issued in this state prior to June 1, 1965, nor shall any part of §§ 56-7-2401 and 56-7-2402 be construed as enlarging the scope of practice of optometry or podiatry or the requiring of any insurance policy, medical service plan, hospital service contract or hospital and medical service contract to provide for visual care services or foot care services.   The provisions of this section relating to podiatric services apply to all contracts, plans or policies issued or renewed on or after July 1, 1981.
TN Code § 56-7-2404 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2404. Reimbursable Services Within Scope of Practice of Chiropractor — Discrimination Prohibited

   Whenever any policy of insurance issued in this state provides for reimbursement for any service that is within the lawful scope of practice of a duly licensed chiropractor, the insured or other person entitled to benefits under the policy shall be entitled to reimbursement for the services, whether the services are performed by a duly licensed medical physician or by a duly licensed chiropractor, notwithstanding any provision contained in the policy.   Whenever any insurance subscribers under any sickness and accident, medical service plan, hospital service contract or hospital and medical service contract, as provided under Chapters 26 29 of this title or any similar statutes, or any other persons covered by the plan or contract, are entitled to reimbursement for any services that are within the lawful scope of practice of a duly licensed chiropractor, the subscriber or other person shall be entitled to reimbursement for the services, whether the services are performed by a duly licensed medical physician or a duly licensed chiropractor, notwithstanding any provision to the contrary in any other statute or in the plan or contract; and duly licensed chiropractors shall be entitled to participate in the plans or contracts providing for the services to the same extent and subject to the same limitations as duly licensed medical physicians.     This section shall not be construed as enlarging the scope of practice of chiropractic or the requiring of any insurance policy, medical service plan, hospital service contract or hospital and medical service contract to provide for spinal, neurological or musculoskeletal care.   This section shall apply to all policies or plans issued or renewed on and after July 1, 1981.
TN Code § 56-7-2405 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2405. Health and Accident Policies — Surgical Procedures Within Scope of Dentistry and Podiatry

  “Physician” or “doctor,” whenever used in any group or individual health or accident insurance policy issued in this state or in a medical service plan or hospital service contract or hospital and medical service contract, as provided in Chapters 27 29 of this title or any similar statutes, providing for reimbursement or payment for surgical procedures or other medical or health care services that are specified in the policy, plan or contract, and are within the scope of practice of dentistry as defined in § 63-5-108 or within the scope of practice of a podiatrist as defined in § 63-3-101, shall be construed to include a duly licensed dentist or duly licensed podiatrist who performs the specified procedures or services, any  provision in any  policy, plan or contract to the contrary notwithstanding.   This section shall apply to all policies, plans and contracts issued, renewed or reinstated on and after July 1, 1974, and to all other policies, plans and contracts otherwise in existence on July 1, 1974, whenever there is a premium or rate change under the policies, plans and contracts.   The provisions of this section relating to podiatric services shall apply to all contracts, plans or policies issued or renewed on or after July 1, 1981.
TN Code § 56-7-2406 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2406. Health Care Services Provided by St. Jude Children's Research Hospital

  Each managed care organization (MCO), preferred provider organization (PPO), health maintenance organization (HMO), and other health organizations shall provide, through direct contract with St. Jude Children's Research Hospital or otherwise, all enrollees in the health care organization with access to the health care services at St. Jude Children's Research Hospital to the extent access is practical and feasible and the services are medically appropriate.   Reimbursement to St. Jude Children's Research Hospital for the services provided pursuant to this section shall be no greater than the reimbursement rate a managed care organization would pay other entities providing similar services to its enrollees.   Any dispute regarding the application of this section shall be resolved by a committee composed of the commissioner of health, the commissioner of commerce and insurance and the commissioner of finance and administration.
TN Code § 56-7-2407 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2407. Nurse Midwife Services

  Whenever any contract, plan, or policy of insurance issued in this state provides for reimbursement of any service that is within the lawful scope of practice of a nurse midwife, duly licensed by the state board of nursing as a registered nurse and also duly certified as a nurse midwife by the American College of Nurse-Midwives, the insured or other person entitled to benefits under the contract, plan, or policy shall be entitled to reimbursement for the services, whether the services are performed by a duly licensed physician or by a duly licensed and certified nurse midwife.   Reimbursements shall be made in a timely manner.   The provisions of this section relating to nurse midwife services shall apply to all contracts, plans, or policies issued or renewed on or after July 1, 1994.
TN Code § 56-7-2408 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2408. Reimbursement for Services by Nurse in Advanced Practice

  Whenever any contract, plan, or policy of insurance issued in this state provides for reimbursement of any service that is within the lawful scope of practice of a nurse in advanced practice, the insured or other person entitled to benefits under the contract, plan, or policy shall be entitled to reimbursement for the services, whether the services are performed by a duly licensed physician or a duly licensed nurse in advanced practice. As used in this section, “nurse in advanced practice” means a registered nurse who is duly licensed by the state board of nursing and who is also a nationally certified nurse practitioner, a nationally certified registered nurse anesthetist, or a nationally certified clinical specialist.   Reimbursements shall be made in a timely manner.   The provisions of this section relating to the services of a nurse in advanced practice apply to all contracts, plans, or policies issued or renewed on or after July 1, 1996.