AN ACT to amend Tennessee Code Annotated, Title 71, relative to TennCare.
Summary
HB0201 amends Tennessee’s TennCare statute to require the bureau of TennCare to reimburse certain ground-based ambulance providers at specified minimum rates when they transport TennCare recipients. For covered emergency ambulance services, reimbursement must be at least 67.5% of the federal Medicare allowable charge for participating providers. For covered nonemergency ground ambulance services, reimbursement must be at least 100% of the Medicare allowable charge.
The bill applies to both public and private ambulance services that bill for transports and have a base of operations in Tennessee. It is framed as an amendment to Title 71 of the Tennessee Code Annotated and would take effect immediately upon becoming law, citing the public welfare as the reason for immediate effectiveness.
Impact
The bill would directly change TennCare reimbursement law by setting statutory minimum payment floors for ground ambulance transports, limiting the bureau’s discretion to pay below those percentages. It would affect public and private in-state ambulance providers that serve TennCare enrollees, and could increase state Medicaid spending if current reimbursement levels are below the new minimums. The measure also ties Tennessee reimbursement policy to Medicare’s allowable charge methodology, making federal Medicare rates the benchmark for TennCare payments.
Sentiment
The available voting history shows strong support in committee, with unanimous or near-unanimous favorable recommendations in both the House TennCare Subcommittee and the House Insurance Committee. No committee transcript is available, so there is no recorded debate to indicate opposition or detailed concerns. Overall, the bill appears to have been received positively at the committee stage.
Contention
No specific points of contention are documented in the provided materials, but the likely policy issue is the fiscal impact of mandating higher reimbursement rates for ambulance services. Potential stakeholders include TennCare administrators, ambulance providers, and budget-focused lawmakers, since the bill could raise program costs while improving provider payment adequacy. The absence of recorded dissent suggests any concerns were not strong enough to affect committee votes.