SENATE BILL 898
By Massey
HOUSE BILL 867
By Hicks T
HB0867
002756
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AN ACT to amend Tennessee Code Annotated, Title 56;
Title 63; Title 68 and Title 71, relative to maternal
health.
WHEREAS, remote patient monitoring services are already covered services by
TennCare; and
WHEREAS, pregnancies impacted by maternal hypertension and maternal diabetes are
more likely to have pregnancy complications; and
WHEREAS, maternal health outcomes remain poor in Tennessee; and
WHEREAS, there is a need to establish in Tennessee a targeted maternal health
program that impacts pregnant recipients of medical assistance who have higher risks of
pregnancy complications because of their maternal hypertension or maternal diabetes; now,
therefore,
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 71, Chapter 5, is amended by adding
the following as a new part:
71-5-801. Definitions.
As used in this part:
(1) "Bureau" means the bureau of TennCare;
(2) "Director" means the director of TennCare;
(3) "Eligible participant" means a patient who:
(A) Is a recipient of medical assistance under this chapter;
(B) Is a member of a participating managed care organization; and
(C) Is pregnant;
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(4) "Healthcare provider" means an obstetrician or maternal fetal medicine
physician who:
(A) Is licensed in this state under title 63, chapter 6 or 9; and
(B) Is caring for an eligible participant during pregnancy;
(5) "Nursing team" means a team of two (2) or more nurses licensed under title
63, chapter 7, and at least one (1) dietitian or diabetes care and education specialist who
is licensed, certified, or authorized or permitted by the laws of this state to administer
health care in the ordinary course of practice of such professions;
(6) "Participating managed care organization" means the managed care
organization selected by the bureau to administer the pilot program;
(7) "Pilot program" means the maternal health monitoring pilot program;
(8) "Remote patient monitoring for maternal hypertension and maternal
diabetes" or "remote patient monitoring devices" means technology provided by a
technology vendor that:
(A) Collects health data from an eligible participant and electronically
transmits that information securely for interpretation and recommendation;
(B) Monitors health data, including blood pressure, weight, blood glucose
levels, or other physiological health data as determined by the eligible
participant's healthcare provider;
(C) Is capable of transmitting health data through cellular networks so
eligible participants who lack broadband or a wireless telecommunications device
can benefit; and
(D) Is preprogrammed equipment provided specifically for an eligible
participant that works directly out of the box for that specific eligible participant;
and
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(9) "Technology vendor" means a technology company that is authorized by the
United States food and drug administration to provide technology services, and that is
selected by the bureau to contract with the participating managed care organization in
administering the pilot program.
71-5-802. Establishment of pilot program.
The maternal health monitoring pilot program is to be administered by the bureau
to offer eligible participants improved maternal health care through remote patient
monitoring for maternal hypertension and maternal diabetes.
71-5-803. Administration of pilot program.
The bureau shall select a managed care organization and technology vendor to
administer the pilot program in a manner determined by the bureau. For the purpose of
administering the pilot program, the participating managed care organization shall
contract directly with a technology vendor to offer remote patient monitoring for maternal
hypertension and maternal diabetes.
71-5-804. Remote patient monitoring for maternal hypertension and maternal
diabetes requirements.
(a) When offering remote patient monitoring for maternal hypertension and
maternal diabetes to an eligible participant under the pilot program, the technology
vendor shall ensure that:
(1) Remote patient monitoring for maternal hypertension and maternal
diabetes is possible during the second and third trimesters and for up to three (3)
months postpartum;
(2) Remote patient monitoring devices are delivered to the eligible
participant; and
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(3) The eligible participant has a process to be trained in how to use the
remote patient monitoring devices.
(b) The technology vendor shall:
(1) Employ a healthcare provider or a nursing team; and
(2) Assign a program manager to support implementation and
administration of this pilot program and to coordinate efforts with participating
managed care organizations and the bureau.
(c) The technology vendor's healthcare provider or nursing team must be
capable of supporting the eligible participant by:
(1) Monitoring and reviewing health data of the eligible participant;
(2) Creating an agreed-upon escalation pathway with the managed care
organization if the eligible participant's remote patient monitoring readings, in
conjunction with the eligible participant's symptoms, require immediate attention
from the eligible participant's healthcare provider; and
(3) Providing health coaching to the eligible participant in matters
including nutrition, condition management, and healthy behavior modification.
71-5-805. Pilot participation goals.
The bureau shall implement the pilot program in as many counties as necessary
to ensure participation of no less than three hundred (300) eligible participants. The
participating managed care organization shall ensure that eligible participants in the
counties selected by the bureau have access to the pilot program. The pilot program
must be operational no later than one hundred eighty (180) calendar days after the date
on which the contract is entered between the participating managed care organization
and the technology vendor.
71-5-806. Fee payment for administration of pilot program.
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Subject to appropriations or the availability of funds, the bureau shall pay a fee to
the participating managed care organization to administer the pilot program. The
participating managed care organization shall contract with the technology vendor.
Payment for contracting with the technology vendor must be bundled to include costs of
providing remote patient monitoring for maternal hypertension and maternal diabetes as
provided in this part. It is the legislative intent that an initial appropriation of six hundred
thousand dollars ($600,000) be appropriated in fiscal year 2025-2026 and each
subsequent fiscal year to offset the costs of the pilot program.
71-5-807. Operation of pilot program.
The bureau shall implement the pilot program as necessary to ensure
participation of a statistically relevant number of eligible participants.
71-5-808. Report.
On or before January 1, 2026, and on or before January 1 each year thereafter,
the bureau shall submit a report, in consultation with the participating managed care
organization and technology vendor, on the evaluation of the pilot program, including
recommendations regarding whether the pilot program should be expanded throughout
this state, to the speaker of the house of representatives, speaker of the senate, chair of
the health and welfare committee of the senate, and the chair of the committee of the
house of representatives having jurisdiction over health-related matters.
71-5-809. Rulemaking.
The director is authorized to promulgate rules to effectuate this part. The rules
must be promulgated in accordance with the Uniform Administrative Procedures Act,
compiled in title 4, chapter 5.
SECTION 2. The headings in this act are for reference purposes only and do not
constitute a part of the law enacted by this act. However, the Tennessee Code Commission is
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requested to include the headings in any compilation or publication containing this act.
SECTION 3. This act takes effect upon becoming a law, the public welfare requiring it.