§ 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.
§ 71-5-1411. Plan to Expand Cost-Effective Community-Based Residential Alternatives to Institutional Care
The commissioner shall develop and implement a plan to expand cost-effective community-based residential alternatives to institutional care for persons who are elderly or adults with physical disabilities, or both, which may include, but not limited to, the development of multiple levels of assisted-care living facility services, adult family care homes, adult foster care homes, companion […]
§ 71-5-1412. Transition Period Following Implementation of Managed Long-Term Care Service Delivery System
A managed care organization (MCO) shall contract with any nursing facility licensed under title 68, chapter 11, part 2, and certified by the centers for medicare and medicaid services, that provides medicaid nursing facility services pursuant to an approved preadmission evaluation (PAE) and is willing to contract with the MCO to provide that service under […]
§ 71-5-1413. Acuity-Based Reimbursement Methodology for Nursing Facility Services
The commissioner shall develop and implement an acuity-based reimbursement methodology for nursing facility services, based on an individualized assessment of need, as an alternative to the current cost-based nursing facility reimbursement system. The methodology may include, but is not limited to, the development of enhanced rates for specified chronic care services that may encourage the […]
§ 71-5-1414. Self-Directed Health Care
The commissioner shall, upon approval of a waiver amendment granting authority from the federal government, develop and make available consumer-directed options for persons receiving home and community-based long-term care services under the long-term care program, which may include, but are not limited to, the ability to select, direct or employ persons delivering unskilled hands-on or […]
§ 71-5-1415. Quality Assurance and Quality Improvement Strategies
The commissioner shall develop and implement quality assurance and quality improvement strategies to ensure the quality of long-term care services provided pursuant to this part and shall specify in contractor risk agreements with contractors responsible for coordination of medicaid primary, acute and long-term care services requirements related to the quality of long-term care services provided. […]
§ 71-5-1416. Funding to Increase Access to Home and Community-Based Services in the State-Funded Options Program
Subject to the availability of funding, the commissioner shall designate in each year’s appropriations bill an amount of money that can be used to increase access to home and community-based services in the state-funded options program for persons who do not qualify for medicaid long-term care services. This funding may be used to provide services […]
§ 71-5-1417. Funding for Medicaid Long-Term Care Services
The commissioner shall provide medicaid long-term care services subject to the availability of funding in each year’s appropriations bill.