State Law

Tennessee Code-Title 56-Chapter 7- Part 23. Mandated Insurer or Plan Coverage

08/24/2023 Tennessee Section 56-7-2358

Continuity of care

Continuity of Care Post-Contract

(a) If a provider who is a member of a managed health insurance issuer’s network terminates its agreement with the issuer, or the issuer terminates the provider without cause, then the provider and issuer shall allow a subscriber or enrollee who is:

(1) Under active treatment for a particular injury or sickness, to continue to receive covered benefits from the treating provider for the injury or sickness for a period of one hundred twenty (120) days from the date of notice of termination;

(2) In the second trimester of pregnancy to continue care with a treating provider until completion of postpartum care; and

(3) Being treated at an inpatient facility to remain at the facility until the patient is discharged.

(b) Subsection (a) shall apply only if the treating provider or inpatient facility agrees to continue to be bound by the terms, conditions and reimbursement rates of the provider’s agreement with the issuer.