That light you see, off yonder, peaking its rays above the horizon and rounding the bend of the tunnel? That’s the theoretical end of the session. Somehow. Already. Most of the legislative committees, save for both of the Finance, Ways and Means committees, have wrapped up their agendas for the year. It’s possible they encounter some urgent legislation that necessitates they meet again, but they are likely in the process of cleaning out their lockers. As the committees close shop, our priority bill list grows smaller and smaller. That said, we still have a number of important bills we’re watching and working on here at TDC, and we still need the support of our TDC family to get some of them across the finish line. Stay tuned for how our TDC family can make the difference. 

TDC Priority Bill Update (it’s a lot this week)

• ID Death Penalty Bill – this bill modernizes the state’s definition of ID and provides a pathway for individuals sentenced to death to be evaluated for ID with this modern definition.
  • It’s go-time for our top priority bill. If we’re climbing Everest (sometimes it feels that way), we’re at the Second Step. It’s been placed on respective calendars for both the House and Senate for Monday afternoon. 
    • We still feel pretty very mostly probably good about where this one stands. Big shout out to the team on this one. 
  • But let’s not leave anything to chance - GRASSROOTS:  let your Senator and Representative know that they need to vote “Aye” on Monday. 
    • Even if you’ve filled their inbox with emails over the last couple months, the more oxygen the bill has near the summit, the better. 
      • Seriously, please take 2 minutes and send one more email and help ensure that this bill succeeds. Love you TDC Family!
• Transplant Anti-Discrimination Bill – this bill prohibits health care and insurance providers from denying people with disabilities access to transplants, transplant lists and anatomical gifts based solely on that person’s disability. 
  • I haven’t talked about this one for a while, but it remains a Very Good Bill. It hasn’t had a ton of opposition throughout the committee process, so the story has been kind of quiet.
  • It has already passed the Senate, and is set for the House Consent Calendar on Monday, meaning that unless something crazy happens, it will be on Governor Lee’s desk in no time. 
    • Kudos to Representative Cochran and Senator Bell on a bill well done.
• IEP Services Reimbursement – this bill requires TennCare to reimburse school districts for money spent on necessary services specified in a student’s IEP. 
  • I almost totally missed this one, but this we like this one – it ensures that students who need services are getting them, and that school districts are able to afford to provide them.
    • One of the biggest things this bill does is eliminate the physicians note mandate – which used to require parents to get a physician’s not describing the medical necessity of the service – before receiving services at school. 
      • It was noted in committee that parents got such a note only 30% of the time.
  • It’s set to be heard in the House and Senate Finance, Ways and Means committees next Wednesday and Tuesday, respectively. 
    • It’s tough to predict which way this bill will go – on one hand, it hasn’t had any trouble in committee, whatsoever. On the other hand, the fiscal note is enormous (though it is paid by TennCare who is paid by federal CMS dollars)
• Medically Necessary Definition – this bill establishes a statewide definition of “medically necessary” for the purposes of patient care, and shifts the burden of proof for necessity to physicians, rather than insurance providers.
  • This is also a pretty good bill – we like that it makes a doctor’s opinion about the best course of care for their patient the determinant opinion in paying for it. 
  • I have bad news, however: while the Senate version got rolled to the 2022 calendar, the bill failed in the House Insurance committee. 
    • Concerns over the prescribing power of opioids, the cost of the fiscal note, cost-shifting to consumers and the phrase “healthy balance”, doomed this one in the house. 
• Pharmacy Benefit Manager Reform – this bill addresses a variety of practices used by Pharmacy Benefit Managers that have the effect of raising the costs of healthcare for consumers. 
  • This is comprehensive, albeit huge, bill addressing a real issue with artificially inflated healthcare costs (check out the summary on the bill page for more info).
    • It’s an expensive bill, and somewhat redundant with other legislation (see the next bill below), that has received quite a bit of pushback in committee. 
  • It was placed in “behind the budget”, which means that it won’t go anywhere unless there is a budget amendment approved that pays for it. 
    • I’m not optimistic this is gonna happen. 
• 340B Non-Discrimination – this bill forbids health insurance companies from reimbursing 340B entities (like pharmacies) at different rates than other healthcare entities. 
  • The bill essentially prohibits Pharmacy Benefit Managers from lowering the reimbursement rate for 340B entities because they know that the federal government will pick up the balance while they reap the difference for themselves. 
  • This bill passed the House in early April, but has been stalled in the Senate. It’s been referred to the Senate Calendar Committee, but hasn’t been assigned to the Senate floor yet.
    • GRASSROOTS: If you want to see this bill move forward, I’m sure members of the Senate Calendar Committee would LOVE to hear from you.
• Text-to-911 – this bill requires Tennessee to establish a statewide text-to-911 system
  • Up to this point, this bill has seen nothing but smooth sailing – it has already passed the Senate with zero dissent in committee.
    • For some reason, however, the bill has been placed behind the budget in the House. 
      • This is weird. There is no cost to the state, and a very small cost to localities, spread across every locality in the state. It is unclear why it would need to be in the Governor’s budget if it costs the state $0. 
      • We’ll keep an eye on this one, hope that it’s a weird glitch in the matrix, work to fix said glitch, and celebrate once we see this bill signed. 

Other stuff this week:

• HB0130/SB0114 - $15 DSP Wages (Sen. Gardenhire and Rep. Hazlewood)
  • Senate Finance, Ways and Means Committee – 4/27 @ 2:30pm
• HB0636/SB0603 – Health Benefit Plan Network Access and Adequacy Act (Sen. Watson and Rep. Smith)
  • House Finance, Ways and Means Committee – 4/28 @ 1pm

Federal Update

• A group of federal lawmakers are urging President Biden to overhaul Social Security Insurance benefits. They have asked the President to consider:
  • Increasing SSI benefits to 100% of the federal poverty line from $794/mo to $1,073/mo for 1 individual.
  • Raising the asset limit above $2,000 for an individual and $3,000 for a couple.
  • Eliminating the marriage penalty, which can lower benefit amounts or eliminate them entirely.
  • The group of lawmakes hope that President Biden will include these priorities in Part 2 of his Infrastructure Plan (sometimes referred to as the American Families Plan)
• Speaking of the American Family Plan, the Biden Administration is expected to release details of the plan as early as Monday. 
  • The proposal is rumored to include: paid family leave, universal pre-K, tuition-free community college and a slew of tax credits for things like child care and the extension of the more generous Child Tax Credit (passed in the American Rescue Plan earlier this year). 
  • It is expected that the proposal would be financed by a hike in taxes for wealthy Americans and higher corporate and capital gains taxes. 
• GRASSROOTS: last week we talked about the concerning changes coming to TennCare and the Department of Intellectual and Developmental Disabilities related to Tennessee’s new “block grant” waiver.
  • Don’t forget to make a comment to CMS letting them know about these concerns – it could be your last and only chance until 2031!
  • Also, check out the recent lawsuit brought by 13 TennCare recipients, mostly children, aiming to undo the block grant altogether 

Media Highlights

• Hendersonville Standard – two of Governor Lee’s priority bills concerning criminal justice reform have gained bipartisan support. Bills for alternative sentencing and reentry support for formerly incarcerated individuals have passed the House. Another reform bill, which bans no-knock warrants and chokeholds and mandates a “duty to intervene” has made quick moves in the Senate. 
• WKRN – for those of you lamenting the dearth of movies shot in historic Jonesborough, scenic Townsend, lively Lower Broadway or in BBQ Central Memphis, a new set of tax breaks for movie, TV and digital production companies may just make you smile (or a star!). 
• Commercial Appeal – IF YOU HAVE PLANS ON SATURDAY AND LIVE IN MEMPHIS, CANCEL THEM. The world-famous Oscar Meyer Wienermobile will be passing through town this weekend, providing unbridled joy, breathless wonder and inspired awe for the blessed Memphians fortunate enough to be graced by its majestic elegance. DO NOT MISS IT.

That’s it, that’s all, folks. Thanks for reading this week. I really want to encourage you to get your GRASSROOTS on this week – there is only a small amount of time left in this session to make a difference, and I hope this is the week for you. Use the links above and let’s flex our TDC Family muscle right into session adjournment. Thanks for all you do!

- Jeff