§ 56-60-101 Short title
§ 56-60-102 Chapter definitions
§ 56-60-103 Exceptions
§ 56-60-104 Registration as a contracting entity
§ 56-60-105 Granting a third party access to a provider’s health care services and contractual discounts pursuant to a provider network contract
§ 56-60-106 Subsequent grants of access to another third party
§ 56-60-107 Requirements for granting a third party access to the contracting entity’s provider network – Refusal to accept contractual discount
§ 56-60-108 Enforcement – Rules
§ 56-60-109 Unfair insurance practice – Complaints for violations

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Terms Used In Tennessee Code > Title 56 > Chapter 60 - Preferred Provider Organization Transparency Act

  • abandonment: means that:
    (i)
    (a) If the child is four (4) years of age or more, for a period of four (4) consecutive months immediately preceding the filing of a proceeding, pleading, petition, or amended or supplemental petition to terminate the parental rights of the parent or parents or the guardian or guardians of the child who is the subject of the petition for termination of parental rights or adoption, the parent or parents or the guardian or guardians either have failed to visit or have failed to support or have failed to make reasonable payments toward the support of the child. See Tennessee Code 36-1-102
  • Adoption: means the social and legal process of establishing by court order, other than by paternity or legitimation proceedings or by voluntary acknowledgment of paternity, the legal relationship of parent and child. See Tennessee Code 36-1-102
  • Adoptive parent or parents: means the person or persons who have been made the legal parents of a child by the entry of an order of adoption under this part or under of the laws of any state, territory or foreign country. See Tennessee Code 36-1-102
  • Adult: means any person who is eighteen (18) years of age or older. See Tennessee Code 36-1-102
  • Affidavit: A written statement of facts confirmed by the oath of the party making it, before a notary or officer having authority to administer oaths.
  • Affiliate: means an individual or entity that directly or indirectly through one (1) or more intermediaries, controls or is controlled by or is under common control with a contracting entity. See Tennessee Code 56-60-102
  • Allegation: something that someone says happened.
  • Amendment: A proposal to alter the text of a pending bill or other measure by striking out some of it, by inserting new language, or both. Before an amendment becomes part of the measure, thelegislature must agree to it.
  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Attachment: A procedure by which a person's property is seized to pay judgments levied by the court.
  • Biological parents: means the woman and man who physically or genetically conceived the child who is the subject of the adoption or termination proceedings or who conceived the child who has made a request for information pursuant to this part. See Tennessee Code 36-1-102
  • Chambers: A judge's office.
  • Child-caring agency: means any agency authorized by law to care for children outside their own homes for twenty-four (24) hours per day. See Tennessee Code 36-1-102
  • children: means any person or persons under eighteen (18) years of age. See Tennessee Code 36-1-102
  • Clerk of court: An officer appointed by the court to work with the chief judge in overseeing the court's administration, especially to assist in managing the flow of cases through the court and to maintain court records.
  • Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
  • Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-1-102
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Consent: means :
    (A) The written authorization to relinquish a child for adoption, which is given by an agency such as the department or a public child care agency of another state or country or licensed child-placing agency of this or another state, which agency has the authority, by court order or by surrender or by operation of law or by any combination of these, to place a child for adoption and to give permission for the adoption of that child by other persons. See Tennessee Code 36-1-102
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Contract: A legal written agreement that becomes binding when signed.
  • Contracting entity: means any individual or entity that is engaged in the act of contracting with providers and that has entered into a provider network contract with a provider for the delivery of health care services. See Tennessee Code 56-60-102
  • Conviction: A judgement of guilt against a criminal defendant.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • court: includes the juvenile court for purposes of the authority to accept the surrender or revocation of surrenders of a child and to issue any orders of reference, orders of guardianship, or other orders resulting from a surrender or revocation that it accepts and for purposes of authorizing the termination of parental rights pursuant to §. See Tennessee Code 36-1-102
  • Court report: means the report to the adoption or surrender court in response to an order of reference that describes to the court the status of the child and the prospective adoptive parents or the persons to whom the child is surrendered. See Tennessee Code 36-1-102
  • Damages: Money paid by defendants to successful plaintiffs in civil cases to compensate the plaintiffs for their injuries.
  • Defendant: In a civil suit, the person complained against; in a criminal case, the person accused of the crime.
  • Department: means the department of commerce and insurance. See Tennessee Code 56-60-102
  • Department: means the department of children's services or any of its divisions or units. See Tennessee Code 36-1-102
  • Dependent: A person dependent for support upon another.
  • disability: means that the individual is a minor pursuant to any state, territorial, or federal law, or the law of any foreign country, or that the individual has been determined by any such laws to be in need of a person or entity to care for the individual due to that individual's physical or mental incapacity or infirmity. See Tennessee Code 36-1-102
  • Discount medical plan organization: means an entity that, in exchange for fees, dues, charges or other consideration, provides access for plan members to providers of medical services and the right to receive medical services from those providers at a discount. See Tennessee Code 56-60-102
  • Dismissal: The dropping of a case by the judge without further consideration or hearing. Source:
  • Docket: A log containing brief entries of court proceedings.
  • Entity: means a corporation, business trust, trust, partnership, limited liability company, association, joint venture, public corporation, government or governmental subdivision, agency or instrumentality, or any other legal or commercial entity. See Tennessee Code 56-60-102
  • Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
  • failed to visit: means the failure, for the applicable time period, to visit or engage in more than token visitation. See Tennessee Code 36-1-102
  • Foster care: has the meaning given to that term in §. See Tennessee Code 36-1-102
  • Fraud: Intentional deception resulting in injury to another.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Guardian: means a person or entity appointed by a court to provide care, custody, control, supervision, and protection for a child, and authorized by the court to adopt or consent to the adoption of the child as a result of a surrender, parental consent, or termination of parental rights. See Tennessee Code 36-1-102
  • Guardianship: means the status created by a court order appointing a person or entity guardian of the child. See Tennessee Code 36-1-102
  • Health care services: means services for the diagnosis, prevention, treatment or cure of a health condition, illness, injury or disease. See Tennessee Code 56-60-102
  • Health insurance plan: means any hospital and medical expense incurred policy, nonprofit health care service plan contract, health maintenance organization subscriber contract or any other health care plan or arrangement that pays for or furnishes medical or health care services, whether by insurance or otherwise. See Tennessee Code 56-60-102
  • Home study: means the product of a preparation process in which individuals or families are assessed by themselves and the department or licensed child-placing agency, or a licensed clinical social worker as to their suitability for adoption and their desires with regard to the child they wish to adopt. See Tennessee Code 36-1-102
  • Injunction: An order of the court prohibiting (or compelling) the performance of a specific act to prevent irreparable damage or injury.
  • Interrogatories: Written questions asked by one party of an opposing party, who must answer them in writing under oath; a discovery device in a lawsuit.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Lease: A contract transferring the use of property or occupancy of land, space, structures, or equipment in consideration of a payment (e.g., rent). Source: OCC
  • Legal parent: means :
    (i) The biological mother of a child. See Tennessee Code 36-1-102
  • Licensed child-placing agency: means any agency operating under a license to place children for adoption issued by the department, or operating under a license from any governmental authority from any other state or territory or the District of Columbia, or any agency that operates under the authority of another country with the right to make placement of children for adoption and that has, in the department's sole determination, been authorized to place children for adoption in this state. See Tennessee Code 36-1-102
  • Licensed clinical social worker: means an individual who holds a license as an independent practitioner from the board of social worker certification and licensure pursuant to title 63, chapter 23, and, in addition, is licensed by the department to provide adoption placement services. See Tennessee Code 36-1-102
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • Minor: means any person who has not attained eighteen (18) years of age. See Tennessee Code 1-3-105
  • Oath: A promise to tell the truth.
  • Oath: includes affirmation. See Tennessee Code 1-3-105
  • Order of reference: means the order from the court where the surrender is executed or filed or where the adoption petition is filed that directs the department or a licensed child-placing agency or licensed clinical social worker to conduct a home study or preliminary home study or to complete a report of the status of the child who is or may be the subject of an adoption proceeding, and that seeks information as to the suitability of the prospective adoptive parents to adopt a child. See Tennessee Code 36-1-102
  • Oversight: Committee review of the activities of a Federal agency or program.
  • Parental consent: means the consent described in subdivision (16)(C). See Tennessee Code 36-1-102
  • Parental rights: means the legally recognized rights and responsibilities to act as a parent, to care for, to name, and to claim custodial rights with respect to a child. See Tennessee Code 36-1-102
  • parents: means any biological, legal, adoptive parent or parents or, for purposes of §. See Tennessee Code 36-1-102
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
  • Physical custody: means physical possession and care of a child. See Tennessee Code 36-1-102
  • Physician: means any individual licensed as a chiropractic physician under title 63, chapter 4. See Tennessee Code 56-60-102
  • Physician hospital organization: means an organization that includes, but is not limited to, hospitals and physicians and that contracts with and provides administrative services to hospitals and physicians that have entered into or intend to enter into managed care arrangements. See Tennessee Code 56-60-102
  • Physician organization: means an organization that contracts with and provides administrative services to physicians who have entered into managed care arrangements. See Tennessee Code 56-60-102
  • Pleadings: Written statements of the parties in a civil case of their positions. In the federal courts, the principal pleadings are the complaint and the answer.
  • Preliminary hearing: A hearing where the judge decides whether there is enough evidence to make the defendant have a trial.
  • Preliminary home study: means an initial home study conducted prior to or, in limited situations, immediately after, the placement of a child with prospective adoptive parents who have not previously been subject to a home study that was conducted or updated not less than six (6) months prior to the date a surrender is sought to be executed to the prospective adoptive parents or prior to the date of the filing of the adoption petition. See Tennessee Code 36-1-102
  • Probable cause: A reasonable ground for belief that the offender violated a specific law.
  • Property: includes both personal and real property. See Tennessee Code 1-3-105
  • Prospective adoptive parents: means a nonagency person or persons who are seeking to adopt a child and who have made application with a licensed child-placing agency or licensed clinical social worker or the department for approval, or who have been previously approved, to receive a child for adoption, or who have received or who expect to receive a surrender of a child, or who have filed a petition for termination or for adoption. See Tennessee Code 36-1-102
  • Provider: means a physician, a physician organization or a physician hospital organization. See Tennessee Code 56-60-102
  • Putative father: means a biological or alleged biological father of a child who, at the time of the filing of the petition to terminate the parental rights of such person, or if no such petition is filed, at the time of the filing of a petition to adopt a child, meets at least one (1) of the criteria set out in §. See Tennessee Code 36-1-102
  • Record: means information that is inscribed on a tangible medium or that is stored in an electronic or other medium and is retrievable in a perceivable form. See Tennessee Code 1-3-105
  • Related: means grandparents or any degree of great-grandparents, aunts or uncles, or any degree of great-aunts or great-uncles, or stepparent, or cousins of the first degree, or first cousins once removed, or any siblings of the whole or half degree or any spouse of the above listed relatives. See Tennessee Code 36-1-102
  • Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
  • Service of process: The service of writs or summonses to the appropriate party.
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.
  • sex: means a person's immutable biological sex as determined by anatomy and genetics existing at the time of birth and evidence of a person's biological sex. See Tennessee Code 1-3-105
  • signed: includes a mark, the name being written near the mark and witnessed, or any other symbol or methodology executed or adopted by a party with intention to authenticate a writing or record, regardless of being witnessed. See Tennessee Code 1-3-105
  • 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
  • Statute: A law passed by a legislature.
  • Subscriber: means a person obligated under a reciprocal insurance agreement. See Tennessee Code 56-16-102
  • Surrender: means a document executed under §. See Tennessee Code 36-1-102
  • Testimony: Evidence presented orally by witnesses during trials or before grand juries.
  • Third party: means an organization that enters into a contract with a contracting entity or with another third party to gain access to a provider network contract. See Tennessee Code 56-60-102
  • token visitation: means that the visitation, under the circumstances of the individual case, constitutes nothing more than perfunctory visitation or visitation of such an infrequent nature or of such short duration as to merely establish minimal or insubstantial contact with the child. See Tennessee Code 36-1-102
  • Trial: A hearing that takes place when the defendant pleads "not guilty" and witnesses are required to come to court to give evidence.
  • under common control with: means the possession, direct or indirect, of the power to direct or cause the direction of the management and policies of an individual or entity, whether through the ownership of voting securities, by contract other than a commercial contract for goods or nonmanagement services, or otherwise, unless the power is the result of an official position with or corporate office held by the individual or entity. See Tennessee Code 56-60-102
  • United States: includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
  • Venue: The geographical location in which a case is tried.
  • written: includes printing, typewriting, engraving, lithography, and any other mode of representing words and letters. See Tennessee Code 1-3-105
  • Year: means a calendar year, unless otherwise expressed. See Tennessee Code 1-3-105