SB 139 - HB 144
FISCAL NOTE
Fiscal Review Committee
Tennessee General Assembly
January 31, 2025
Fiscal Analyst: Chris Higgins | Email: chris.higgins@capitol.tn.gov | Phone: 615-741-2564
SB 139 - HB 144
SUMMARY OF BILL: Requires each hospital that accepts Medicaid to include on a
patient's admission or registration forms a provision for the patient or the patient's representative to
indicate whether the patient is: (1) a citizen of the United States; (2) lawfully present in the United
States; or (3) not lawfully present in the United States.
Requires each hospital to submit a report to the Department of Health (DOH) within 30 calendar
days after the end of each quarter with the number of hospital admissions and emergency
department visits within the previous quarter that were made by a patient based on their reported
legal status in the United States.
Requires DOH to submit an annual report, beginning July 1, 2026, to the Governor, the Speaker of
the Senate, and the Speaker of the House of Representatives detailing the total number of such
hospital admissions and emergency department visits for the previous year. Requires the report to
describe information relating to the costs of uncompensated care for a person not lawfully present
in the United States, and the impact of uncompensated care on the cost or ability of hospitals to
provide services to the public, hospital funding needs, and other related information.
FISCAL IMPACT:
NOT SIGNIFICANT
Assumptions:
• According to the Department of Mental Health and Substance Abuse Services (DMHSAS),
the regional mental health hospitals operated by the DMHSAS currently have a non-
mandatory citizenship field in their electronic admission forms.
• It is estimated that the existing form can be modified to conform with the proposed
legislation utilizing existing resources.
• Tennessee Code Annotated § 68-1-108(a) requires each hospital licensed by the Health
Facilities Commission or by DMHSAS to report all claims data on every inpatient and
outpatient discharge to the Commissioner of DOH at least quarterly.
• Pursuant to Tenn. Code Ann. §§ 68-1-109 and 68-11-310(a), all licensed hospitals must
submit to DOH a joint annual report of the statistical particulars relative to their patients
for the fiscal year, including information on reductions in charges made by the provider of
services because of the indigence or medical indigence of the patient.
• It is assumed that DOH can compile and submit the required reports utilizing existing
personnel and resources, without an increase in expenditures.
SB 139 - HB 144 2
CERTIFICATION:
The information contained herein is true and correct to the best of my knowledge.
Bojan Savic, Executive Director