Tennessee House Bill HB0173

Tennessee 2025-2026 Regular Session

• Introduced: 1/15/25
• Refer: 1/27/25
• Refer: 3/18/25
• Refer: 4/2/25

Caption

AN ACT to amend Tennessee Code Annotated, Title 63; Title 68 and Title 71, Chapter 5, relative to hospital reimbursement.

Impact

The implementation of HB 0173 is expected to have a significant impact on the financial landscape of rural hospitals across Tennessee. By setting a minimum reimbursement rate at 100% and a maximum at 120% of the current Medicare reimbursement levels for routine inpatient services, the bill aims to bolster the viability of rural healthcare facilities. This is particularly crucial in rural areas where access to healthcare can be limited, and hospitals often struggle financially. The provision allowing the director of TennCare to seek federal waivers reinforces the bill's intent to provide necessary funding without necessitating an expansion of Medicaid.

Summary

House Bill 0173 aims to amend various sections of the Tennessee Code regarding the reimbursement rates for rural hospitals under the TennCare program. This bill introduces specific definitions for 'rural area' and 'rural hospital' and establishes a framework for the minimum and maximum reimbursement rates that rural hospitals can receive for services provided to TennCare enrollees. The bill seeks to ensure that these hospitals, defined as having no more than 49 licensed beds, receive adequate financial support, essential for their operational viability in serving rural communities.

Contention

While the bill is designed to enhance support for rural hospitals, there may be points of contention surrounding the funding sources and the overall implications for the state's Medicaid budget. Critics may argue that focusing on increasing reimbursements to rural hospitals could divert funds from urban healthcare facilities that also require financial support. Additionally, the mechanisms for determining reimbursement rates could be scrutinized, with stakeholders advocating for transparency and accountability in the reimbursement process.