Environmental & Healthcare Legislative Watch50 States · D.C. · U.S. Congress
From official state and federal legislative records. Informational only, not legal advice.
Now law
This is now an official law, recorded in the state's law books.
The governor signed it. Nothing left to watch.
In plain words
AI summaryWritten by AI from the bill text. Check the official text before relying on it.
Fiscal Summary STATE GOVERNMENTEXPENDITURESGeneral FundFY26-27 & Subsequent Years$205,100Total Positions Required: 6 FEDERAL GOVERNMENTEXPENDITURES FY26-27 & Subsequent Years$357,500 Bill Summary Present law requires a managed care organization ("MCO") to contract with any nursing home that is licensed in this state and is certified by the bureau of TennCare ("bureau") to provide medicaid nursing facility services pursuant to an approved preadmission evaluation ("qualified nursing facility") to provide such services under the same terms and conditions as are offered by any other participating facility contracted with that MCO to provide the same service under any policy, contract, or plan that is part of the TennCare managed long-term care service delivery system. As used in present law, a "managed care organization" means a health maintenance organization, behavioral health organization, or managed health insurance issuer that has a contract with the bureau and participates in the TennCare program. This bill prohibits an MCO from adopting any participation requirements, network admission criteria, or termination standards for a qualified nursing facility beyond those established by the bureau. However, the MCO may enforce other contractual provisions that do not affect the facility's participation status. This bill gives the bureau the exclusive authority to determine whether a qualified nursing facility may be terminated from participation in the TennCare program, including the termination of a qualified nursing facility's contract with an MCO. An MCO is generally prohibited from suspending, denying, refusing to review, terminating, or otherwise taking any action resulting in the actual or constructive termination of a qualified nursing facility contract. However, this does not apply if (i) the bureau has taken a fi
