Featured Legal News: Professional Privilege Tax

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4/9/2024

 

Professional Privilege Tax  
In 2022, the Tennessee General Assembly passed a bill to remove physicians from the requirement to pay the professional privilege tax and it was effective in 2023.  

ERISA toolkit
For many providers, the prospect of dealing with health plans subject to the Employee Retirement Income Security Act, or ERISA, is a bleak one. ERISA requirements apply to most employment-sponsored and self-funded group health plans, which means that any patients who receive their health insurance through some type of employer contribution fall under ERISA. The regulations are complex, and many health plan administrators actively try to work around the requirements. However, providers can actually use ERISA requirements to their advantage when trying to get claims paid. To that end, the TMA Legal Department has developed a series of resources, including forms and sample letters, for providers to use when seeking to get ERISA claims paid. Go to tnmed.org/legal to access. Member login required.

No Surprises Act  
Congress passed the No Surprises Act (NSA) in December 2020 as part of the Consolidated Appropriations Act. It applies to all insurance plans (including ERISA plans) except for Medicare, Medicaid, and TRICARE and prohibits balance billing of patients by a healthcare provider in certain situations. TMA’s Law Guide topic, No Surprises Act, is a summary of this law and details requirements that physicians must meet. Member login required to access.

Step Therapy
The Tennessee General Assembly addressed step therapy in code for the first time in 2022. The law sets out a process by which health care providers can obtain exceptions to health insurance step therapy requirements for drugs. TMA has a new Law Guide topic, Step Therapy, explaining this new law.  

 

For more information, email legal@tnmed.org.