AN ACT to amend Tennessee Code Annotated, Title 71, relative to TennCare.
SB1390 amends Tennessee’s TennCare statutes to create a new part authorizing the bureau of TennCare to establish an additional Program of All-Inclusive Care for the Elderly (PACE) as a pilot in one of the two grand divisions where no PACE program existed in 2024. The bill defines key terms, requires prospective applicants to file a letter of intent, and directs the director of TennCare to verify that applicants meet federal PACE eligibility and provider standards under 42 CFR Part 460.
The bill also requires applicants to submit a market analysis showing the number of eligible individuals, the expected membership and saturation rate, and evidence of unmet need in the proposed service area. TennCare must ensure managed care organizations and options counseling entities consider PACE when making long-term care referrals, and it must oversee quality and performance standards, monitor programs through reports submitted to CMS and the bureau, and provide annual reports to legislative leaders beginning January 1, 2026. The director is authorized to adopt rules to implement the new part.
In addition, the bill creates a narrow geographic expansion rule for existing PACE programs in counties meeting specific population ranges, allowing service areas to extend into certain contiguous counties with specified census populations. This makes the bill both a pilot-program authorization and a targeted service-area expansion measure within TennCare’s long-term care framework.
The overall sentiment appears strongly favorable and noncontroversial. The Senate Health and Welfare Committee recommended passage unanimously, and the Senate Finance, Ways and Means Committee also recommended passage unanimously, indicating broad support for expanding access to PACE services for frail elderly TennCare enrollees.
The main policy issue is how and where a new PACE program should be added, including whether there is sufficient unmet need and whether the proposed service area is appropriate. The bill’s use of population-specific thresholds and service-area rules could also draw attention because it effectively targets particular counties and regions, but the available record shows no recorded opposition in committee votes.
The bill adds a new part to Tennessee Code Annotated Title 71, Chapter 2, governing TennCare’s administration of PACE programs. It expands TennCare’s authority and duties by requiring a pilot PACE program in a previously unserved grand division, establishing application and market-analysis requirements, mandating oversight and reporting, and directing referral protocols for managed care organizations and counseling entities. It also creates a limited statutory basis for certain existing PACE programs to expand into specified contiguous counties based on census population ranges, affecting TennCare providers, applicants, managed care organizations, and eligible elderly individuals needing nursing-facility-level care.
The bill’s reception was uniformly positive in the available legislative history. Both committee votes were unanimous, with no recorded dissent, suggesting the measure was viewed as a practical expansion of long-term care options for elderly TennCare beneficiaries. The absence of committee transcript objections further indicates little visible controversy in the legislative process provided.
No direct opposition is reflected in the available votes or transcripts. The only likely points of policy discussion are the selection of the pilot region, the requirement that applicants demonstrate unmet need through market analysis, and the bill’s population-specific county expansion criteria, which may be seen as narrowly tailored or region-specific. Any concern would likely center on implementation, provider qualification, and whether TennCare should expand PACE capacity in the designated areas, but the record provided does not show active disagreement.