Healthcare (Medicaid)

in committee · Tennessee · Senate Feb 12, 2025

SB 316: TennCare - As introduced, removes the requirement that the governor receive authorization by the general assembly prior to making any decision or obligating the state with regard to the expansion of optional enrollment in the medical assistance program. - Amends TCA Title 71.

SB 316 removes a requirement that the Tennessee governor must get approval from the state legislature before making decisions about expanding optional enrollment in TennCare (the state's Medicaid program). This change directly affects the governor's authority to manage Medicaid expansion without needing legislative authorization. The bill amends Tennessee Code Annotated Title 71 by deleting Section 71-5-126, which previously mandated this approval process. The key provision simplifies the decision-making process for Medicaid program expansion by eliminating the need for the General Assembly's prior consent.

Topics ✓ HealthcareSupports HealthcareRemoves legislative approval barrier for Medicaid expansion, enabling faster enrollment growth and broader coverage access under TennCare.90% confidence

Sub-Topics Medicaid

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in committee · Tennessee · House Apr 9, 2025

HB 173: TennCare - As introduced, establishes TennCare minimum and maximum reimbursement rate levels for rural hospitals and requires that the reimbursement rate is based on the rural hospital's current federal fiscal year. - Amends TCA Title 63; Title 68 and Title 71, Chapter 5.

HB 173 sets new minimum (100%) and maximum (120%) reimbursement rates for rural hospitals providing services to TennCare patients, directly affecting rural hospitals with 49 or fewer beds located outside urbanized areas. The bill requires these rates to be calculated based on each hospital's current federal Medicare reimbursement rates. It amends Tennessee Code to define "rural hospital" and mandates that TennCare's reimbursement levels align with Medicare rates for routine inpatient care. The director may seek federal waivers to implement this without expanding Medicaid eligibility.

Topics ✓ Budget & TaxesSupports Budget & TaxesMandates minimum (100%) reimbursement rates for rural hospitals in TennCare, ensuring stable state funding for essential healthcare services and directly managing government healthcare expenditure.92% confidence ✓ HealthcareSupports HealthcareSets minimum (100%) and maximum (120%) TennCare reimbursement rates for rural hospitals based on Medicare, ensuring adequate funding for rural healthcare access and services.95% confidence

Sub-Topics Hospitals Medicaid Medicare

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in committee · Tennessee · Senate Mar 26, 2025

SB 501: TennCare - As introduced, authorizes the governor to expand medicaid eligibility solely for the purpose of providing treatment for a patient with a diagnosis of sickle cell disease in accordance with the federal Patient Protection and Affordable Care Act and to negotiate with the centers for medicare and medicaid services with respect to the terms of such expansion. - Amends TCA Title 4 and Title 71, Chapter 5.

This bill would allow Tennessee's governor to expand Medicaid eligibility solely for sickle cell disease treatment, as permitted under federal law. It directly affects patients diagnosed with sickle cell disease in Tennessee who would gain access to Medicaid coverage for their treatment. The key mechanism requires the governor to negotiate terms with federal Medicare and Medicaid Services (CMS) to implement this targeted expansion under the Affordable Care Act. The bill amends specific Tennessee laws (TCA Title 4 and 71, Chapter 5) to authorize this limited Medicaid expansion.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid eligibility for sickle cell disease treatment, improving patient access to coverage under ACA framework.95% confidence

Sub-Topics Medicaid Medicare

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in committee · Tennessee · House Jan 28, 2025

HB 70: TennCare - As introduced, requires a TennCare health benefit plan renewed or issued on or after July 1, 2025, by a health insurance carrier to provide coverage and reimbursement for biomarker testing for preeclampsia in pregnant women. - Amends TCA Title 56; Title 63; Title 68 and Title 71.

HB 70 requires TennCare health benefit plans (renewed or issued on or after July 1, 2025) to cover and reimburse biomarker testing for preeclampsia in pregnant women. This directly affects pregnant women enrolled in Tennessee's Medicaid program (TennCare) and the health insurance carriers providing their coverage. The bill mandates that testing must be ordered by a physician, conducted by the prenatal care provider using FDA-approved methods, and follow clinical guidelines. It also allows TennCare to create rules and seek federal approval to ensure Medicaid coverage for this testing.

Topics ✓ HealthcareSupports HealthcareMandates TennCare coverage for preeclampsia biomarker testing, expanding access to critical prenatal care for pregnant women.95% confidence

Sub-Topics Insurance Medicaid Women's Health

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in committee · Tennessee · House Feb 12, 2025

HB 1387: TennCare - As introduced, requires, on and after July 1, 2026, a minor who is enrolled in TennCare medicaid or the CoverKids program to remain eligible for such program until the minor reaches 18; prohibits the division of TennCare from subjecting the minor to a redetermination of eligibility or disenrollment, except under certain circumstances; requires the director of TennCare to submit any necessary federal waiver request by December 31, 2025. - Amends TCA Title 71.

HB 1387 requires Tennessee's TennCare Medicaid and CoverKids programs to automatically renew coverage for enrolled minors until they turn 18, starting July 1, 2026. It prohibits the TennCare division from redetermining eligibility or disenrolling minors for routine reasons (like age) unless specific exceptions apply, such as income exceeding limits, fraud, or a parent/guardian requesting withdrawal. The bill also mandates that the TennCare director submit a federal waiver request by December 31, 2025, to implement this change under federal guidelines. This directly affects minors currently enrolled in these programs, ensuring continuous health coverage without automatic termination at age 18.

Topics ✓ HealthcareSupports HealthcareExtends TennCare/CoverKids coverage to minors until age 18 without routine disenrollment, ensuring continuous healthcare access and preventing coverage gaps for vulnerable youth.95% confidence

Sub-Topics Medicaid

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in committee · Tennessee · Senate Jan 27, 2025

SB 164: TennCare - As introduced, directs the bureau to establish a temporary TennCare benefits program to provide medical assistance on a temporary basis to certain individuals who do not qualify for enrollment in TennCare, CoverKids, or a successor program; requires the bureau to submit a waiver to the federal centers for medicare and medicaid services by December 31, 2025. - Amends TCA Title 71, Chapter 5.

SB 164 creates a temporary healthcare program for low-income Tennesseans who don’t qualify for existing TennCare or CoverKids. It would provide medical assistance for up to 60 months total (with different limits for under-21 and 21+ individuals) to those with income at or below 138% of the federal poverty level. The program requires a federal waiver by December 2025, uses 90% federal and 10% state funding, and does not replace eligibility for existing programs. Enrollment would begin six months after federal approval, with benefits pausing if someone later qualifies for TennCare or CoverKids.

Topics ✓ HealthcareSupports HealthcareCreates temporary healthcare program expanding coverage for low-income Tennesseans excluded from existing TennCare/CoverKids, using federal funding to improve access without replacing current programs.95% confidence

Sub-Topics Medicaid Medicare

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failed · Tennessee · House Feb 17, 2026

HB 1101: TennCare - As introduced, authorizes the governor to expand medicaid pursuant to the federal Patient Protection and Affordable Care Act; authorizes the governor to negotiate with the federal centers for medicare and medicaid services to determine the terms of the expansion. - Amends TCA Title 71, Chapter 5.

HB 1101 authorizes Tennessee's governor to expand Medicaid eligibility under the federal Affordable Care Act, directly affecting low-income residents who currently lack coverage. The bill updates state law to allow the governor to negotiate terms with federal Medicare and Medicaid officials (CMS) for this expansion. Key provisions include removing existing barriers to Medicaid expansion and establishing the governor's authority to implement the program. This change would enable Tennessee to extend coverage to approximately 200,000 additional low-income adults, aligning with federal ACA requirements. The bill is pending in the Insurance Committee for further review.

Topics ✓ HealthcareSupports HealthcareBill explicitly authorizes Medicaid expansion under ACA, directly increasing health coverage for low-income residents by removing barriers and enabling governor negotiations with CMS.95% confidence

Sub-Topics Medicaid Medicare

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died · Tennessee · House Feb 11, 2026

HB 295: Health Care - As introduced, adds doula services performed by a person with a verification of certification to the list of services that may be provided as medical assistance under the TennCare program; directs the department of health to establish by rule a process for the verification of certification to a person who demonstrates that the person has completed a doula training program that meets certain requirements. - Amends TCA Title 63 and Title 71.

HB 295 would add doula services to Tennessee's TennCare Medicaid program, allowing certified doulas to provide covered support for pregnant individuals. The bill requires the Tennessee Department of Health to create a verification process for doulas who complete approved training programs covering pregnancy, childbirth, and postpartum care. This includes verifying knowledge of anatomy, emotional support strategies, comfort techniques, and community resources. The policy change would directly affect TennCare beneficiaries seeking doula support and certified doulas aiming to provide covered services. The bill does not change eligibility but expands covered services under TennCare.

Topics ✓ HealthcareSupports HealthcareAdds doula services to TennCare Medicaid coverage, expanding access to prenatal/postpartum support through certified providers.95% confidence

Sub-Topics Medicaid

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failed · Tennessee · House Mar 5, 2025

HB 18: TennCare - As introduced, directs the bureau to establish a temporary TennCare benefits program to provide medical assistance on a temporary basis to certain individuals who do not qualify for enrollment in TennCare, CoverKids, or a successor program; requires the bureau to submit a waiver to the federal centers for medicare and medicaid services by December 31, 2025. - Amends TCA Title 71, Chapter 5.

HB 18 proposes a temporary health coverage program for Tennesseans who don't qualify for existing TennCare or CoverKids. It would provide up to 60 months of medical assistance (resetting at age 21) to individuals under 21 with income ≤138% of the federal poverty level, or adults ≥21 with similar income, subject to strict 12-month/24-month usage limits. The program requires a federal waiver by December 2025, uses 90% federal/10% state funding, and explicitly states it does not replace eligibility for regular programs (benefits pause if enrollment becomes possible). The bill failed in the Insurance Committee on March 5, 2025, and remains inactive.

Topics ✓ HealthcareSupports HealthcareCreates temporary coverage for ineligible low-income youth/adults, expands access via federal waiver, uses 90% federal funds to fill coverage gap for those excluded from TennCare/CoverKids.95% confidence

Sub-Topics Medicaid Medicare

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in committee · Tennessee · Senate Apr 4, 2025

SB 321: Health Care - As enacted, creates the advisory task force on state reimbursement rates to make recommendations on annual adjustments to the reimbursement rates paid to agencies that perform healthcare functions and services, the purpose of which is to ensure such reimbursement rates are adequate. - Amends TCA Title 4; Title 62 and Title 63.

SB 321 creates an advisory task force to review and recommend annual adjustments to state reimbursement rates paid to healthcare providers under state contracts. The task force, composed of 6 appointed members (3 by each legislative chamber, representing health professions) plus agency representatives, will assess whether reimbursement rates cover agencies' costs, staff salaries, and administrative expenses for frontline healthcare workers. It must submit annual recommendations by August 1, starting in 2026, focusing on ensuring rates are adequate to support quality care for vulnerable populations. This bill directly affects state-contracted healthcare agencies and providers who serve Medicaid and other state-funded programs.

Topics ✓ HealthcareSupports HealthcareBill creates task force to ensure state reimbursement rates cover healthcare agencies' costs, staff salaries, and expenses, directly advancing provider funding adequacy.95% confidence

Sub-Topics Medicaid

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