Tennessee House Bill HB1691

Tennessee 2023-2024 Regular Session

• Introduced: 1/8/24
• Refer: 1/10/24
• Refer: 2/6/24
• Refer: 2/13/24
• Engrossed: 2/22/24
• Enrolled: 2/27/24
• Passed: 3/7/24
• Chaptered: 3/19/24

Caption

AN ACT to amend Tennessee Code Annotated, Section 71-05-117, relative to third parties for medical services.

Impact

If enacted, HB 1691 would significantly affect the handling of medical claims within Tennessee. By codifying the responsibilities of third parties, the bill is anticipated to streamline the claims process, reducing bureaucratic delays and enhancing access to necessary medical services for individuals eligible for state assistance. Additionally, the adjustment in the timeline for claim submissions from ninety days to sixty days indicates a push for quicker resolutions to payment issues, aligning the regulatory framework with a more expedited approach to healthcare reimbursement.

Summary

House Bill 1691 aims to amend Tennessee Code Annotated, Section 71-05-117, focusing on the obligations of third parties for medical services. The proposed legislation specifies that third parties accepting payment for medical services must adhere to state requirements surrounding claim submissions and authorizations. Among the provisions, the bill mandates the acceptance of the state's right to recover payments made under the state plan, along with establishing certain timelines related to claim submissions to ensure efficiency in processing and reimbursement.

Sentiment

General sentiment surrounding HB 1691 appears positive among healthcare administrators and legislators focused on improving the efficiency of the state's healthcare payment system. Supporters argue that by clarifying the roles and expectations of third parties, the bill can enhance financial stability for state-funded healthcare programs. However, some skepticism persists regarding the practical implementation of these changes and whether all third-party entities will comply effectively with the new regulations.

Contention

Notable points of contention associated with the bill center around the impacts it may have on compliance and the administrative burden placed on third parties. Critics have raised concerns about whether the requirements will be met consistently across various entities, potentially leading to discrepancies in claim processing. Additionally, there are discussions about how these amendments might affect smaller providers and their operational protocols regarding state programs, weighing the benefits of efficiency against the challenges of adherence to stricter regulations.