§ 71-5-1509. Implementation of Part — Termination of Ground Ambulance Provider Assessment
The assessment in this part shall not be implemented until after the bureau receives notice from the centers for medicare and medicaid services that approval for the assessment is granted. The bureau shall implement this part to the extent that it is not inconsistent with the TennCare II federal waiver or any successor federal waiver. […]
§ 71-5-1510. Promulgation of Rules
The bureau is authorized to promulgate rules to effectuate the purposes of this part. The rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
§ 71-5-2001. Short Title. [Effective Until July 1, 2021.]
This part shall be known and may be cited as the “Annual Coverage Assessment Act of 2020.”
§ 71-5-1421. Prompt Payment of Claims and Liability for Bad Faith Failure to Pay Claims Promptly
Any managed care organization shall comply with § 56-32-126 and any prompt pay provisions within the MCO contractor risk agreements with TennCare. In addition, the MCO shall ensure that ninety percent (90%) of clean claims for nursing facility services shall be processed and paid within fourteen (14) calendar days and ninety-nine and one half percent […]
§ 71-5-1422. Pilot Project for Disabled Individuals and Family Members to Self-Direct Supports and Services
The commission on aging and disability shall develop a pilot project proposal in accordance with this section. The long-term care services planning council shall be responsible for evaluating the implementation of the project. If funded in the general appropriations act, the pilot project shall be implemented and shall continue for three (3) years. The commission […]
§ 71-5-1423. Hearing on Resident’s Appeal of Involuntary Discharge From Facility — Timeframe for Hearing and Final Order
If a resident appeals the facility’s notice of involuntary discharge to that resident and a hearing is requested pursuant to 42 C.F.R. § 431.220(a)(3) before the bureau of TennCare: The hearing shall be conducted and a final order rendered within ninety (90) days from the date of the resident’s appeal of the facility’s involuntary discharge […]
§ 71-5-1424. Hearing on Appeal of Tenncare’s Initial Determination of Ineligibility for Nursing Facility Services — Motion to Intervene by Facility
If an individual appeals TennCare’s initial determination that they are not eligible for TennCare nursing facility services: The hearing on any appeal of an initial determination that the individual is not financially eligible shall be conducted and a final order rendered within ninety (90) days from the date of the individual’s appeal; provided, however, that […]
§ 71-5-1425. Guidance Regarding Whether Temporary Family Healthcare Structures Are Covered — Federal Approval of Waiver Amendment to Offer Benefit — Applicability of Waiver
As part of the plan to expand cost-effective community-based residential alternatives to institutional care as required pursuant to § 71-5-1411(a), the bureau of TennCare shall seek written guidance from the centers for medicare and medicaid services regarding whether a temporary family healthcare structure, as defined in § 13-7-501, may be covered in whole or in […]
§ 71-5-1501. Short Title
This part shall be known and may be cited as the “Ground Ambulance Service Provider Assessment Act.” The intent of this part is to enhance EMS services and improve access to emergency medical pre-hospital care in this state.
§ 71-5-1502. Part Definitions
As used in this part: “Ambulance provider” means a public or private ground-based ambulatory service, other than an ambulance service based on federal property, that bills for transports and has a base of operations within the state; “Assessment” means the medicaid ambulance provider assessment established by this part; “Bureau” means the bureau of TennCare; “Medicaid […]