Prohibition Against Denial of Reimbursement to or Discrimination Against Physician Based on Maintenance of Certification or Licensure

1. Law
2. Tennessee Code
3. Insurance
4. Policies and Policyholders
5. Health and Accident Insurance
6. Prohibition Against Denial of Reimbursement to or Discrimination Against Physician Based on Maintenance of Certification or Licensure

1. As used in this section:
   1. “Continuing medical education” means board of medical examiners or board of osteopathic examination required continued postgraduate medical education intended to provide medical professionals with knowledge of new developments in the professional's field;
   2. “Maintenance of certification” means any process requiring periodic recertification examinations or other activities to maintain specialty medical board certification;
   3. “Maintenance of licensure” means the proprietary framework for physician license renewal established through the Federation of State Medical Boards or its successor organization, which includes additional periodic testing or requirements other than continuing medical education; and
   4. “Specialty medical board certification” means certification by a board that specializes in one (1) particular area of medicine and typically requires additional examinations other than the requirements of the board of medical examiners or board of osteopathic examination to practice medicine.
2. A health insurance entity, as defined in § 56-7-109, shall not deny reimbursement to or prevent a physician licensed pursuant to title 63, chapter 6 or 9 from participating in any of the insurance entity's provider networks based solely on a physician's decision not to participate in any form of maintenance of licensure or maintenance of certification, including basing a physician's network participation on any form of maintenance of licensure tied to maintenance of certification.
3. A health insurance entity, as defined in § 56-7-109, shall not discriminate with respect to reimbursement levels based solely on a physician's decision not to participate in any form of maintenance of licensure or maintenance of certification, including basing a physician's reimbursement level on any form of maintenance of licensure tied to maintenance of certification.

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