| 1 | 1 | | |
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| 2 | 2 | | HOUSE BILL 173 |
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| 3 | 3 | | By Martin B |
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| 4 | 4 | | |
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| 5 | 5 | | SENATE BILL 185 |
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| 6 | 6 | | By Jackson |
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| 7 | 7 | | |
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| 8 | 8 | | |
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| 9 | 9 | | SB0185 |
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| 10 | 10 | | 001616 |
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| 11 | 11 | | - 1 - |
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| 12 | 12 | | |
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| 13 | 13 | | AN ACT to amend Tennessee Code Annotated, Title 63; |
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| 14 | 14 | | Title 68 and Title 71, Chapter 5, relative to hospital |
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| 15 | 15 | | reimbursement. |
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| 16 | 16 | | |
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| 17 | 17 | | BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE: |
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| 18 | 18 | | SECTION 1. Tennessee Code Annotated, Section 71-5-161(d), is amended by |
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| 19 | 19 | | designating the existing language as subdivision (d)(1) and adding the following new subdivision |
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| 20 | 20 | | (d)(2): |
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| 21 | 21 | | (2) |
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| 22 | 22 | | (A) As used in this subdivision (d)(2): |
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| 23 | 23 | | (i) ''Rural area'' means an area that is not delineated as an |
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| 24 | 24 | | urbanized area by the federal census bureau; and |
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| 25 | 25 | | (ii) ''Rural hospital'' means a hospital with no more than forty-nine |
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| 26 | 26 | | (49) licensed beds, operating in a rural area. |
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| 27 | 27 | | (B) The minimum and maximum level for aggregate rates to rural |
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| 28 | 28 | | hospitals for services to TennCare enrollees must be based on the percentages |
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| 29 | 29 | | of each rural hospital's current FFY medicare reimbursement set forth in |
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| 30 | 30 | | subdivision (d)(2)(C). |
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| 31 | 31 | | (C) For routine, nonspecialized inpatient services at rural hospitals, the |
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| 32 | 32 | | minimum level of reimbursement is one hundred percent (100%) and the |
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| 33 | 33 | | maximum level is one hundred twenty percent (120%). |
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| 34 | 34 | | (D) The director of TennCare may seek a federal waiver or other |
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| 35 | 35 | | authorization the director deems necessary to implement subdivision (d)(2)(C), |
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| 36 | 36 | | without requiring the expansion of medicaid. |
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| 37 | 37 | | |
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| 38 | 38 | | |
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| 39 | 39 | | - 2 - 001616 |
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| 40 | 40 | | |
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| 41 | 41 | | SECTION 2. Tennessee Code Annotated, Section 71-5-161, is amended by deleting |
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| 42 | 42 | | subsection (e) and substituting: |
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| 43 | 43 | | (e) The bureau shall publish the list of MS-DRGs included in each service |
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| 44 | 44 | | category on its website, and the bureau shall update the list annually to reflect all |
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| 45 | 45 | | changes as necessary. The bureau shall annually furnish an updated list of MS-DRGs |
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| 46 | 46 | | directly to participating rural hospitals. |
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| 47 | 47 | | SECTION 3. This act takes effect upon becoming a law, the public welfare requiring it. |
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