Tennessee House Bill HB1000

Tennessee 2025-2026 Regular Session

• Introduced: 2/5/25
• Refer: 2/25/25
• Refer: 3/4/25
• Refer: 3/12/25
• Chaptered: 4/8/25
• Passed: 4/8/25

Caption

AN ACT to amend Tennessee Code Annotated, Title 71, Chapter 5, relative to the annual coverage assessment.

Summary

HB1000 amends Tennessee’s Medicaid-related annual coverage assessment provisions in Title 71, Chapter 5. The bill creates a new rule for situations where most federal CMS determinations, approvals, and confirmations have been obtained, but one specified approval remains outstanding. In that circumstance, the assessment may still be implemented and imposed under the existing statutory framework rather than waiting for every federal approval to be complete. The bill also limits how much of the assessment revenue may be used for directed payments to hospitals while that interim status exists. Those expenditures must be capped at either the FY 2024 amount authorized in 2023 Public Chapter 232 or a higher amount set by the division in consultation with the Tennessee Hospital Association, but only up to the amount approved by CMS. Once all CMS approvals and confirmations are obtained and written notice is provided to the Tennessee Hospital Association, the normal process resumes.

Impact

The bill affects Tennessee Code Annotated § 71-5-2003 and § 71-5-2005 by allowing the annual coverage assessment to proceed before one remaining CMS approval is finalized and by temporarily constraining hospital directed-payment expenditures during that period. Its practical effect is to preserve the financing mechanism supporting TennCare-related hospital payments while aligning the program more closely with federal approval timing and limits. The measure primarily affects the state Medicaid/TennCare financing structure, the Tennessee Division of TennCare, and hospitals receiving directed payments.

Sentiment

The available voting history shows strong support for the bill in committee, with unanimous favorable votes in both the House TennCare Subcommittee and the House Insurance Committee. The committee actions indicate broad agreement on the need for the measure, likely because it preserves funding continuity while addressing federal approval issues. No committee transcript was provided, so there is no recorded floor or committee debate reflecting opposition in the supplied materials.

Contention

The main point of potential contention is the timing of implementation before all CMS approvals are complete. Supporters appear to favor allowing the assessment and related hospital payments to continue without interruption, while any concern would likely center on operating under partial federal approval and ensuring the directed-payment amounts stay within CMS-approved limits. Another possible issue is the role of the Tennessee Hospital Association in consultation over payment levels during the interim period, though the vote record provided shows no recorded opposition in committee.