reglab/housing_qa huggingface dataset:
TN Code § 56-7-2409 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2409. Employer-Based Plans to Offer at Least One Plan Option Providing Copayment Amounts for Office Visits With Chiropractic Physicians, Physical or Occupational Therapists No Greater Than Those for Primary Care Physician Visits

  As used in this section:  “Coinsurance” means a percentage of the contractual fee schedule applicable to a particular health care provider that a covered person must pay for covered services rendered by that provider under the terms of a particular health insurance policy or plan;   “Copayment” means the specified dollar amount that a covered person must pay for covered services during a visit to a health care provider under the terms of a particular health insurance policy or plan;   “Covered person” has the same meaning as set forth in § 56-7-110(a); and   “Health insurance entity” has the same meaning as set forth in § 56-7-109, but does not include government insurance plans created by title 8, chapter 27.     A health insurance entity offering employer-based plans must offer to employers no less than one (1) plan option in which the copayment and coinsurance amounts for services rendered during an office visit to a chiropractic physician licensed under title 63, chapter 4, or to a physical therapist or occupational therapist licensed under title 63, chapter 13, are no greater than the copayment and coinsurance amounts for the services rendered during an office visit to a primary care physician licensed under title 63, chapter 6 or title 63, chapter 9.   Compliance with this section shall not be required with respect to a particular insurance plan if it is determined that compliance would cause that plan to lose its status as a grandfathered health plan within the meaning of § 1251 of the federal Patient Protection and Affordable Care Act, P.L. 111-148, as amended, and § 2301 of the federal Health Care and Education Reconciliation Act of 2010, P.L. 111-152, as amended, both compiled in 42 U.S.C. § 18011.   Nothing in this section shall apply to accident-only, specified disease, hospital indemnity, Medicare supplement, disability income, long-term care, or other limited benefit hospital insurance policies, and any employer plan exempt from regulation under this title due to § 514 of the federal Employee Retirement Income Security Act of 1974 (ERISA) (29 U.S.C. § 1144).
TN Code § 56-7-2410 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 24 - Mandated Scope of Practice|§ 56-7-2410. Limitation on Copayments or Coinsurance Amount Imposed for Primary Care Services Rendered During Visit to Physician Assistant

  As used in this section:  “Coinsurance” means a percentage of the contractual fee schedule applicable to a particular healthcare provider that a covered person must pay for covered services rendered by that provider under the terms of a particular health insurance policy or plan;   “Copayment” means the specified dollar amount that a covered person must pay for covered services during a visit to a healthcare provider under the terms of a particular health insurance policy or plan;   “Covered person” has the same meaning as set forth in § 56-7-110(a); and   “Health insurance entity” has the same meaning as set forth in § 56-7-109(a), but does not include the government insurance plans created pursuant to title 8, chapter 27, and title 71, chapter 5.     No health insurance entity shall impose on a covered person any copayment or coinsurance amount for services rendered during an office visit to a physician assistant licensed under title 63, chapter 19, and contracted or authorized as a primary care practitioner by that health insurance entity, that is greater than the copayment or coinsurance amount imposed on a covered person by that health insurance entity for the services rendered during an office visit to a physician licensed under title 63, chapter 6 or 9, and contracted or authorized by that health insurance entity as a primary care practitioner.   Nothing in this section shall prevent a health insurance entity from instituting measures designed to maintain quality and to control costs, including, but not limited to, imposing lower copayment or coinsurance amounts for services rendered by providers with proven clinical outcomes.   Nothing in this section shall apply to plans described in Section 1251 of the federal Patient Protection and Affordable Care Act (42 U.S.C. § 18011) and Section 2301 of the federal Health Care and Education Reconciliation Act.
TN Code § 56-7-2501 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 25 - Mandated Insurer or Plan Options|§ 56-7-2501. Sterilization Operations — Policy Provisions

  Any law to the contrary notwithstanding, no contract of insurance that provides coverage for sterilization operations or procedures may be entered into or renewed on or after July 1, 1971, if the contract imposes any disclaimer, restriction on, or limitation of coverage with respect to the insured's reason for sterilization. All such contracts entered into or renewed on or after July 1, 1971, shall be construed to be in compliance with this section and any provisions in any contract that are in conflict with this section shall be of no force or effect.   Any contract for a sterilization operation or procedure shall not be cancelled by the insurer unless the cancellation coincides with cancellation of the entire policy.
TN Code § 56-7-2502 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 25 - Mandated Insurer or Plan Options|§ 56-7-2502. Mammography Screening

  Any individual, franchise, blanket or group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society, or health maintenance organization that provides coverage for surgical services for a mastectomy, and that is delivered, issued for delivery, amended or renewed on or after July 1, 1989, shall also provide coverage for mammography screening performed on dedicated equipment for diagnostic purposes on referral by a patient's physician according to the following guidelines:  A baseline mammogram for women thirty-five (35) to forty (40) years of age;   A mammogram every two (2) years, or more frequently based on the recommendation of the woman's physician, for women forty (40) to fifty (50) years of age; and   A mammogram every year for women fifty (50) years of age and over.     Any increase in expenditure requirements on a municipality or a county resulting from this section shall be appropriated from funds that the municipality or county receives from the state-shared taxes that are not earmarked by statute for a particular purpose.    This section shall not apply to medicare supplemental policies unless mammography is covered under medicare. This section shall not apply to policies that provide only hospital indemnity benefits or to policies that provide only benefits for specified accidents. Insurance policies that provide benefits only for specified diseases and that cover mastectomies shall be subject to the requirements of this section, unless the owner of the policy has other insurance that provides mammography coverage as guaranteed by this section.   The issuer of the specified disease policy has the burden of proving that the insured has other insurance that covers mammography to the extent guaranteed by this section.
TN Code § 56-7-2503 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 25 - Mandated Insurer or Plan Options|§ 56-7-2503. Accident and Sickness — Denial of Coverage for Persons With Mental Illness or Intellectual Disabilities for Lack of Surgical Facilities Prohibited

 Any law to the contrary notwithstanding, no policy of accident and sickness insurance may be entered into or renewed on or after July 1, 1974, if the policy by way of exclusion, definition, or otherwise denies coverage to an insured undergoing care and treatment in a facility for the care and treatment of persons with mental illness or intellectual disability, based upon the fact that the facility does not have organized facilities for operative surgery, if, in fact, the facility in question has, at the time a claim arises, a bona fide arrangement, by contract or otherwise, with an accredited hospital to perform the surgical procedures as may be required by the facility for persons with mental illness or intellectual disability.
TN Code § 56-7-2504 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 25 - Mandated Insurer or Plan Options|§ 56-7-2504. Cancer Treatment

  In the event that coverage for the treatment of cancer by dose-intensive chemotherapy/autologous bone marrow transplants or stem cell transplants is provided for patients or enrollees included in the TennCare program, then each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis, each corporation providing individual or group accident and sickness subscription contracts, and each health maintenance organization providing a health care plan for health care services shall offer and make available the coverage, in the manner provided in subsection (b), under the policy, contract or plan delivered, issued for delivery or renewed in this state on and after January 1, 1996.   The coverage may be offered at an additional cost but the health care service shall not be subject to any greater deductible than any other health care service under the policy, contract or plan. Any required copayment shall not exceed the standard copayment required by the insured's policy, contract or plan for health care services.   This section shall not apply to short-term travel, long-term care, credit insurance, dental insurance, disability income, medical surgical supplemental insurance, vision insurance, hospital indemnity, accident-only limited or specified disease policies, or to short-term nonrenewable policies of not more than six (6) months' duration.
TN Code § 56-7-2505 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 25 - Mandated Insurer or Plan Options|§ 56-7-2505. Phenylketonuria (Pku) Treatment

  Any individual, franchise, blanket or group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society, or health maintenance organization that provides hospital expense and surgical expense insurance and that is delivered, issued for delivery, amended or renewed on or after July 1, 1995, shall provide coverage for the treatment of phenylketonuria.   As used in this section, “treatment” means licensed professional medical services under the supervision of a physician and those special dietary formulas that are medically necessary for the therapeutic treatment of phenylketonuria.
TN Code § 56-7-2507 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 25 - Mandated Insurer or Plan Options|§ 56-7-2507. Reconstructive Breast Surgery

   Any individual, franchise, blanket or group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society, health maintenance organization, or managed care organization that provides coverage for mastectomy surgery shall provide coverage for all stages of reconstructive breast surgery on the diseased breast as a result of a mastectomy, but not including a lumpectomy, as well as any surgical procedure on the nondiseased breast deemed necessary to establish symmetry between the two (2) breasts in the manner chosen by the patient and physician. The surgical procedure performed on a nondiseased breast to establish symmetry with the diseased breast must occur within five (5) years of the date the reconstructive breast surgery was performed on a diseased breast.   Coverage for reconstructive breast surgery shall be subject to applicable copayments, coinsurance and deductibles.     This section applies to any policy, plan, or contract entered into or renewed on or after July 1, 1997.
TN Code § 56-7-2508 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 25 - Mandated Insurer or Plan Options|§ 56-7-2508. Coverage for Infant Hearing Screening Test

  “Hearing screening” or “hearing screening test” means a screening or test provided in accordance with current hearing screening standards established by a nationally recognized organization such as the Joint Committee on Infant Hearing Screening of the American Academy of Pediatrics.   Any individual, franchise, blanket or group health insurance policy, medical service plan contract, hospital service corporation contract, hospital and medical service corporation contract, managed health insurance issuer contract, fraternal benefits society plan, or health maintenance organization plan that provides coverage for hospital and surgical expense insurance and that is delivered, issued for delivery, amended or renewed in this state on or after July 1, 2008, shall provide coverage for infant hearing screening tests as provided in § 68-5-904.   The coverage required by this section may be subject to annual deductible, co-pays, co-insurance and contractual requirements established for other similar benefits within the policy or contract; provided, that the annual deductible, co-pays, co-insurance and contractual requirements for the coverage required by this section are no greater or more restrictive than those established for other similar benefits within the policy or contract of insurance.   Nothing in this section shall apply to accident only, specified disease, hospital indemnity, medicare supplemental, long-term care, disability or other limited benefit insurance policies or to any employer plan exempt from regulation under this title due to § 514 of the Employee Retirement Income Security Act of 1974 (ERISA) (29 U.S.C. § 1144).
TN Code § 56-7-2602 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 26 - Mandated Offerings of Coverage|§ 56-7-2602. Alcoholism and Drug Dependence — Coverage for Treatment

  Purpose.  The purpose of this section is to encourage consumers to avail themselves of basic levels of benefits under group health insurance policies and contracts for the care and treatment of alcohol and other drug dependency, and to preserve the rights of the consumer to select the coverage according to the consumer's medical-economic needs.   Availability of Coverage for Alcohol and Other Drug Dependency.  Insurers, nonprofit hospitals and medical service plan corporations and health maintenance organizations transacting health insurance in this state shall offer and make available under group policies, contracts and plans providing hospital and medical coverage on an expense-incurred, service or prepaid basis, benefits for the necessary care and treatment of alcohol and other drug dependency that are not less favorable than for physical illness generally, subject to the same durational limits, dollar limits, deductibles and coinsurance factors, and that offer of benefits shall be subject to the right of the group policy or contract holder to reject the coverage or to select any alternative level of benefits if the right is offered by or negotiated with the insurer, service plan corporation or health maintenance organization.   Any benefits so provided shall be determined as if necessary care and treatment in an alcohol or other drug dependency treatment center were care and treatment in a hospital. For purposes of this section, “alcohol or other drug dependency treatment center” means a facility that provides a program for the treatment of alcohol or other drug dependency pursuant to a written treatment plan approved and monitored by a physician, and which facility is also:  Affiliated with a hospital under a contractual agreement with an established system for patient referral;   Licensed, certified or approved as an alcohol or other drug dependency treatment center by the department of mental health and substance abuse services; or   Accredited as such a facility by the joint commission on accreditation of hospitals.       Applicability.  This section shall apply to group policies or contracts delivered or issued for delivery in this state more than one hundred twenty (120) days after October 1, 1982; but shall not apply to blanket, short term travel, accident only, limited or specified disease, individual conversion policies or contracts, or to policies or contracts designed for issuance to persons eligible for coverage under Title XVIII of the Social Security Act, known as medicare (42 U.S.C. § 1395 et seq.), or any other similar coverage under state or federal governmental plans.
TN Code § 56-7-2603 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 26 - Mandated Offerings of Coverage|§ 56-7-2603. Treatment by Licensed Audiologists or Speech Pathologists

   Notwithstanding any other law to the contrary, any insurer providing individual, franchise, blanket or group policy of insurance issued pursuant to this title that provides hospital expense and surgical or medical expense insurance and/or that is entered into, delivered, issued for delivery or renewed in this state after January 1, 1989, shall offer to provide benefits for expense of residents of this state covered under the policy or plan arising from conditions or disorders of hearing or conditions or disorders of speech, voice, or language, so long as such conditions or disorders receive treatment from duly licensed audiologists or speech pathologists, as defined in § 63-17-103.   This section is applicable to all health benefit policies, programs, or contracts offered by commercial insurance companies, nonprofit insurance companies, prepaid plans, i.e., health maintenance organizations, and to all health benefit programs provided state government employees.     Nothing in this section shall apply to any insurance policy that only provides coverage for specified diseases, hospital indemnity, medicare supplement or other limited benefit coverages.   Notwithstanding any provision of this section to the contrary, this section shall be construed to apply to the state and its political subdivisions.
TN Code § 56-7-2604 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 26 - Mandated Offerings of Coverage|§ 56-7-2604. Health Insurance — Newly Born Children — Coverage — Notification

  After January 1, 1983, every insurer that proposes to issue a group policy or contract in this state and every nonprofit hospital and medical service plan corporation that proposes to issue a group service plan contract in this state that provides maternity benefits shall make available benefits for pediatric nursery care of newly born children. The additional benefit shall be for a specified number of nursery care days and maximum dollar limits as elected by the group policyholder or group contract holder.   With respect to policies and contracts, as described in subsection (a), that were delivered or issued for delivery in this state on or before January 1, 1983, each insurer and nonprofit hospital and medical service plan corporation shall notify the group policyholder or group contract holder of the availability of coverage described in subsection (a).
TN Code § 56-7-2701 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 27 - Genetic Information Nondiscrimination in Health Insurance Act|§ 56-7-2701. Short Title

 This part shall be known and may be cited as the “Genetic Information Nondiscrimination in Health Insurance Act of 1997.”
TN Code § 56-7-2702 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 27 - Genetic Information Nondiscrimination in Health Insurance Act|§ 56-7-2702. Part Definitions

 As used in this part, unless the context otherwise requires:   “Family member” means with respect to an individual, another individual related by blood to that individual;   “Genetic information” means information derived from genetic testing to determine the presence or absence of variations or mutations, including carrier status, in an individual's genetic material or genes that are scientifically or medically believed to cause a disease, disorder or syndrome, or are associated with a statistically increased risk of developing a disease, disorder or syndrome, that is asymptomatic at the time of testing. The testing does not include either routine physical examinations or chemical, blood or urine analysis unless conducted purposefully to obtain genetic information or questions regarding family history;   “Genetic services” means health services to obtain, assess, and interpret genetic information for diagnostic and therapeutic purposes, and for genetic education and counseling;   “Health insurance coverage” means a contractual arrangement for the provision of a payment for health care, including:  A group health plan; and   Any other health insurance arrangement, including any arrangement consisting of a hospital or medical expense incurred policy or certificate, hospital or medical service plan contract, or health maintenance organization subscriber contract;     “Insurance provider” means an insurer or other entity providing health insurance coverage; and   “Person” includes a corporation, company, association, firm, partnership, society, and joint stock company, as well as an individual.
TN Code § 56-7-2703 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 27 - Genetic Information Nondiscrimination in Health Insurance Act|§ 56-7-2703. Discrimination on Grounds of Genetic Services Prohibited

 An insurance provider may not deny or cancel health insurance coverage, or vary the premiums, terms, or conditions for health insurance coverage, for an individual or a family member of an individual on the basis that the individual or family member of an individual has requested or received genetic services.
TN Code § 56-7-2704 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 27 - Genetic Information Nondiscrimination in Health Insurance Act|§ 56-7-2704. Genetic Information — Privacy — Prohibited Disclosures

  An insurance provider may not request or require an individual to whom the provider provides health insurance coverage, or an individual who desires the provider to provide health insurance coverage, to disclose to the provider genetic information about the individual or family member of the individual.   An insurance provider may not disclose genetic information about an individual without the prior written authorization of the individual or legal representative of the individual. The authorization is required for each disclosure and shall include an identification of the person to whom the disclosure would be made.
TN Code § 56-7-2705 (2021)
2021 Tennessee Code|Title 56 - Insurance|Chapter 7 - Policies and Policyholders|Part 27 - Genetic Information Nondiscrimination in Health Insurance Act|§ 56-7-2705. Applicability

 This part does not apply to the underwriting, denial of claims or issuance of a life insurance policy, disability income policy, long-term care policy, accident only policy, hospital indemnity or fixed indemnity policy, dental policy or vision policy or any other actions of an insurer directly related to a life insurance policy, disability income policy, long-term care policy, accident only policy, hospital indemnity or fixed indemnity policy, dental policy or vision policy.