(a) As used in this section:

Terms Used In Tennessee Code 56-7-2607

  • Person: means any association, aggregate of individuals, business, company, corporation, individual, joint-stock company, Lloyds-type organization, organization, partnership, receiver, reciprocal or interinsurance exchange, trustee or society. See Tennessee Code 56-16-102
  • State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
(1) “Covered person” means a person on whose behalf a health insurance entity is obligated to pay benefits or provide services, and who has a disability;
(2) “Disability” has the same meaning as defined in 42 U.S.C. § 12102;
(3) “Health insurance entity” has the same meaning as defined in § 56-7-109; and
(4) “Transplantation” means the transplantation or transfusion of a human body part into the body of another individual for the purpose of treating or curing a medical condition.
(b) A health insurance entity that offers plans in this state that provide coverage for transplantation to individuals or groups on an expense-incurred basis shall not deny coverage for transplantation solely on the basis of the covered person’s disability.
(c) This section does not require a health insurance entity to provide coverage for transplantation if the transplantation is not medically necessary.
(d) This section applies to a state or local insurance program, under title 8, chapter 27, and a managed care organization contracting with the state to provide insurance through the TennCare program.