Within 30 calendar days after receiving a paper claim (and 21 calendar days after receiving a claim by electronic submission), a health insurance entity shall pay or deny the claim, or request additional information. No paper claim may be denied upon resubmission for lack of substantiating documentation or information that has been previously provided by the health care provider. Any health insurance entity that does not comply with these timeframes shall pay 1% interest per month, accruing from the day after the payment was due, on that amount of the claim that remains unpaid.

Link to Existing Law: Tenn. Code Ann. Title 56, Chapter 7 Part 1 §56-7-109

This law would be improved by explicitly including PBMs (or other agents/intermediaries) within the definition of health insurance entity to ensure that the law is applied to them. In addition, the only means for enforcement of the law are through the insurance commissioner, thus, it would benefit from a private right of action.