Tenn. Code Ann. § 56-7-128: Application programming interfaces - Establishment and maintenance - Interface requirements

(a) As used in this section, "health insurance entity" has the same meaning as defined in § 56-7-109 . (b) To facilitate patient and provider access to health information, a health insurance entity shall establish and maintain the following application programming interfaces (API) for the benefit of all insureds and contracted providers, as applicable: (1) Patient access API, as described in 42 CFR § 422.119(a)-(e) ; (2) Provider directory API, as described in 42 CFR § 422.120 ; and (3) Payer-to-payer exchange API, as described in 42 CFR § 422.119(f) . (c) In addition to the API described in subsection (b), the department may require a health insurance entity to establish and maintain the following APIs if and when final rules are published by the federal government: (1) Provider access API; and (2) Prior authorization support API. (d) An API described in subdivision (b)(3) must be established in accordance with standards published in a final rule issued by the federal centers for medicare and medicaid services and published in the Federal Register, and must align with federal effective dates, including enforcement delays and suspensions, issued by the federal centers for medicare and medicaid services. (e) This section does not limit existing requirements under this chapter. (f) The commissioner of commerce and insurance may promulgate rules to effectuate this section. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Added by 2024 Tenn. Acts, ch. 931,s 4, eff. 5/6/2024.

(a) As used in this section, "health insurance entity" has the same meaning as defined in § 56-7-109 .

(b) To facilitate patient and provider access to health information, a health insurance entity shall establish and maintain the following application programming interfaces (API) for the benefit of all insureds and contracted providers, as applicable: (1) Patient access API, as described in 42 CFR § 422.119(a)-(e) ; (2) Provider directory API, as described in 42 CFR § 422.120 ; and (3) Payer-to-payer exchange API, as described in 42 CFR § 422.119(f) .

(1) Patient access API, as described in 42 CFR § 422.119(a)-(e) ;

(2) Provider directory API, as described in 42 CFR § 422.120 ; and

(3) Payer-to-payer exchange API, as described in 42 CFR § 422.119(f) .

(c) In addition to the API described in subsection (b), the department may require a health insurance entity to establish and maintain the following APIs if and when final rules are published by the federal government: (1) Provider access API; and (2) Prior authorization support API.

(1) Provider access API; and

(2) Prior authorization support API.

(d) An API described in subdivision (b)(3) must be established in accordance with standards published in a final rule issued by the federal centers for medicare and medicaid services and published in the Federal Register, and must align with federal effective dates, including enforcement delays and suspensions, issued by the federal centers for medicare and medicaid services.

(e) This section does not limit existing requirements under this chapter.

(f) The commissioner of commerce and insurance may promulgate rules to effectuate this section. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.