TennCare - As introduced, requires a managed care organization or pharmacy benefits manager that is contracted with the bureau to reimburse a claim for a long-acting injectable drug intended for treatment and prevention of human immunodeficiency virus and administered in a pharmacy, physician's office, clinic, ambulatory surgical treatment center, or hospital. - Amends TCA Title 4; Title 56 and Title 71.

Summary

The bill requires any managed‑care organization or pharmacy‑benefits manager that contracts with TennCare to pay claims for long‑acting injectable HIV treatment or prevention drugs administered in a pharmacy, doctor's office, clinic, ambulatory surgical center, or hospital. If the drug is covered as a medical service, the insurer must also cover it as a pharmacy benefit, but only one payment is allowed per claim. The requirement becomes effective on July 1 2026.

AI-generated summary — may be incomplete or inaccurate. Verify against the official bill text.

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