AN ACT to amend Tennessee Code Annotated, Title 56; Title 63; Title 68 and Title 71, relative to TennCare.
Summary
SB2080 would direct a portion of Tennessee’s health maintenance organization tax revenue to support TennCare provider reimbursement beginning July 1, 2026. Specifically, the bill requires the first $150 million collected under the HMO tax to be used to draw down federal matching funds and reimburse eligible TennCare providers for certain CPT-coded services, including evaluation and management, obstetrics and gynecology, and anesthesia services.
The bill also creates a new section in Title 71 governing how those funds are to be used and sets the reimbursement ceiling at up to 110% of the current Medicare rate for the same CPT code. It defines key provider categories—physicians, advanced practice registered nurses, and physician assistants—and authorizes the Bureau of TennCare and the Department of Commerce and Insurance to adopt rules to implement the program. The act takes effect immediately for rulemaking purposes, but the reimbursement provisions apply only to services provided on or after July 1, 2026.
Impact
SB2080 would amend Tennessee law to earmark HMO tax revenue for TennCare-related provider payments and establish a new statutory reimbursement mechanism tied to Medicare rates. It affects Title 56 by redirecting tax revenue under the HMO tax statute and adds a new TennCare reimbursement provision in Title 71. The bill would directly affect TennCare, the Bureau of TennCare, the Department of Commerce and Insurance, and eligible physicians, advanced practice registered nurses, and physician assistants who bill for covered services.
Sentiment
The available voting history suggests generally favorable committee sentiment toward the bill. The Senate Commerce and Labor Committee recommended passage by an 8-1 vote, indicating broad support with limited opposition. No committee transcript was provided, so the discussion record does not show detailed arguments, but the vote suggests the bill was viewed positively by most members.
Contention
The main point of potential contention is the use of the first $150 million in HMO tax revenue for this specific reimbursement purpose, which may raise questions about budget priorities, revenue allocation, and the scope of TennCare spending. Another possible issue is the reimbursement level of up to 110% of Medicare, which could draw scrutiny from those concerned about provider payment policy or state costs. The lone dissenting vote in committee suggests at least one member had reservations, though the record provided does not identify the specific objection.