Insurance subcommittee advances health-care transparency, amid provider objections

The Tennessee House Insurance Subcommittee voted 5–1 on March 25 to send House Bill 2170, the Health Care Transparency and Fraud Prevention Act, to the full insurance committee after extended testimony and questions from members.

Representative Travis, the bill sponsor, told the committee HB 2170 merges several measures — the Patient Financial Act, the Health Care Billing Integrity Act and the Pharmaceutical Pricing Transparency Act — and listed four core aims: clearer patient bills and more time to respond to disputes; ensuring patients are billed only for care actually received; increased disclosure of provider ownership; and greater clarity in prescription pricing.

The bill drew sustained opposition from the Tennessee Medical Association. John Carr, assistant director of government affairs for TMA, said the group opposes the bill as amended because it "imposes sweeping regulatory burdens on physicians and medical practices that will undermine patient care and increase health care costs in Tennessee." He argued several provisions could create civil penalties "without requiring proof of intent," interfere with independent medical judgment, and require disclosure and reporting mandates that would generate substantial new administrative costs for practices.

Julie Griffin of the Tennessee Medical Association reiterated those concerns, saying the bill "doubles the opportunity for people to go after providers" by layering state discipline on top of existing federal oversight and recent state laws addressing downcoding and pharmacy benefit manager practices.

Committee members pressed witnesses on enforcement mechanics and the bill's overlap with federal law. Several members asked who decides whether an insurer's allegation of upcoding is justified and what review occurs before a complaint reaches the board of medical examiners. Representative Travis and Blue Cross Blue Shield testified the amended bill includes checks: an amendment requires notification timelines (the sponsor cited a 60‑day notice provision before debt collection) and the sponsor said original civil penalties were removed in the amendment. Russell Martie, vice president of state government relations for Blue Cross Blue Shield of Tennessee, told the committee the bill is intended to target "bad actors" and that potential upcoding flags are reviewed by clinicians, not automatic systems.

Martie said the bill defines "systemic upcoding" as five or more violations in a 12‑month period and that penalties are discretionary and subject to human review by the department and the board of medical examiners, language that Blue Cross said is designed to avoid punitive treatment for isolated mistakes.

The subcommittee exchange highlighted a split in priorities: the sponsor and insurer witnesses emphasized transparency and consumer protections, while TMA witnesses emphasized the risks of duplicative enforcement and increased administrative burden for providers. Members suggested potential fixes such as a clarified notice-and-documentation requirement before a provider could face disciplinary scrutiny; the sponsor said a friendly amendment in the full committee could address that.

The clerk recorded 5 ayes and 1 nay on final passage in subcommittee; Representative Travis thanked the committee and said the bill will be taken to the full insurance committee next.

What happens next: HB 2170, as amended, advances to the full House insurance committee for further consideration.