Tenn. Code Ann. § 71-5-2002 — TN Code / Title 71 / Chapter 5 / Section 71-5-2002
[Expires 7/1/2025] Part definitions
Status: in_force

As used in this part: (1) "Annual coverage assessment" means the annual assessment imposed on covered hospitals as set forth in this part; (2) "Annual coverage assessment base" means the total net patient revenue minus the medicare net revenue, for all hospitals as shown in the hospital's medicare cost report for the fiscal year that ended during calendar year 2021, on file with CMS as of September 30, 2023, subject to the following qualifications: (A) If a hospital does not have a full twelve-month medicare cost report for 2021 on file with CMS but has a full twelve-month cost report for a subsequent year, then the first full twelve-month medicare cost report for a year following 2021 on file with CMS is the hospital's portion of the annual coverage assessment base; (B) If a hospital does not have a full twelve-month medicare cost report for 2021 on file with CMS and does not have a full twelve-month cost report for a subsequent year, but has a cost report for 2021 that covers at least nine (9) months of 2021, then the hospital's portion of the assessment base is calculated by annualizing the 2021 cost report data; (C) If a hospital was first licensed in 2021 or later and did not replace an existing hospital, and if the hospital has a medicare cost report on file with CMS, then the hospital's initial cost report on file with CMS is the hospital's portion of the annual coverage assessment base for the hospital assessment. If the hospital does not have an initial cost report on file with CMS but does have a complete twelve-month joint annual report (JAR) filed with the department of health, then the net patient revenue from the first twelve-month JAR is the hospital's portion of the annual coverage assessment base. If the hospital does not have a medicare cost report or a full twelve-month JAR filed with the department of health, then the hospital's portion of the annual coverage assessment base is the hospital's projected net patient revenue for its first full year of operation as shown in its certificate of need application filed with the health facilities commission; (D) If a hospital was first licensed in 2021 or later and replaced an existing hospital, then the hospital's portion of the annual coverage assessment base is the replacement hospital's initial medicare cost report on file with CMS. If the hospital does not have a medicare cost report on file with CMS, then the hospital's portion of the annual coverage assessment base is either the predecessor hospital's net patient revenue as shown in its medicare cost report for its fiscal year that ended during calendar year 2021, or, if the predecessor hospital does not have a 2021 medicare cost report, then the cost report for the first fiscal year following 2021 on file with CMS; (E) If a hospital is not required to file an annual medicare cost report with CMS, then the hospital's portion of the annual coverage assessment base is its net patient revenue for the fiscal year ending during calendar year 2021 or the first fiscal year that the hospital was in operation after 2021 as shown in the covered hospital's JAR filed with the department of health; and (F) If a hospital's fiscal year 2021 medicare cost report is not contained in a CMS healthcare cost report information system file, and if the hospital does not meet another qualification listed in subdivisions (2)(A)-(E), then the hospital must submit a copy of the hospital's 2021 medicare cost report to the division in order to allow for the determination of the hospital's net patient revenue as its portion of the annual coverage assessment base; (3) "CMS" means the federal centers for medicare and medicaid services; (4) "Controlling person" means a person who, by ownership, contract, or otherwise, has the authority to control the business operations of a covered hospital. As used in this subdivision (4), "control" means indirect or direct ownership of ten percent (10%) or more of a covered hospital; (5) "Covered hospital" means a hospital licensed under title 33 or title 68, as of July 1, 2024, but does not include an excluded hospital; (6) "Division" means the division of TennCare; (7) "Excluded hospital" means: (A) A hospital that has been designated by CMS as a critical access hospital as of July 1, 2024; (B) A mental health hospital owned by this state; (C) A hospital providing primarily rehabilitative or long-term acute care services; (D) A children's research hospital that does not charge patients for services beyond that reimbursed by third-party payers; (E) A hospital that is determined by the division as eligible to certify public expenditures for the purpose of securing federal medical assistance percentage payments; and (F) A hospital that has been designated by CMS as a rural emergency hospital as of July 1, 2024; (8) "Hospital" means a facility licensed under title 33 or title 68 to provide inpatient hospital care; (9) "Medicare cost report" means CMS-2552-10 or a subsequent form adopted by CMS for medicare cost reporting, the cost report for electronic filing of hospitals, for the period applicable as set forth in this section; and (10) "Net patient revenue minus medicare net revenue" means the amount calculated in accordance with generally accepted accounting principles for hospitals that is reported on Worksheet G-3, Column 1, Line 3, of the 2021 medicare cost report, excluding net medicare revenue, long-term care inpatient ancillary and other nonhospital revenues, or, in the case of a hospital that did not file a 2021 medicare cost report, comparable data from the first complete cost report filed after 2021 by the hospital. Amended by 2024 Tenn. Acts, ch. 953,s 1, eff. 6/30/2024. Added by 2023 Tenn. Acts, ch. 232, s 1, eff. 6/30/2023.
As used in this part:
(1) "Annual coverage assessment" means the annual assessment imposed on covered hospitals as set forth in this part;
(2) "Annual coverage assessment base" means the total net patient revenue minus the medicare net revenue, for all hospitals as shown in the hospital's medicare cost report for the fiscal year that ended during calendar year 2021, on file with CMS as of September 30, 2023, subject to the following qualifications: (A) If a hospital does not have a full twelve-month medicare cost report for 2021 on file with CMS but has a full twelve-month cost report for a subsequent year, then the first full twelve-month medicare cost report for a year following 2021 on file with CMS is the hospital's portion of the annual coverage assessment base; (B) If a hospital does not have a full twelve-month medicare cost report for 2021 on file with CMS and does not have a full twelve-month cost report for a subsequent year, but has a cost report for 2021 that covers at least nine (9) months of 2021, then the hospital's portion of the assessment base is calculated by annualizing the 2021 cost report data; (C) If a hospital was first licensed in 2021 or later and did not replace an existing hospital, and if the hospital has a medicare cost report on file with CMS, then the hospital's initial cost report on file with CMS is the hospital's portion of the annual coverage assessment base for the hospital assessment. If the hospital does not have an initial cost report on file with CMS but does have a complete twelve-month joint annual report (JAR) filed with the department of health, then the net patient revenue from the first twelve-month JAR is the hospital's portion of the annual coverage assessment base. If the hospital does not have a medicare cost report or a full twelve-month JAR filed with the department of health, then the hospital's portion of the annual coverage assessment base is the hospital's projected net patient revenue for its first full year of operation as shown in its certificate of need application filed with the health facilities commission; (D) If a hospital was first licensed in 2021 or later and replaced an existing hospital, then the hospital's portion of the annual coverage assessment base is the replacement hospital's initial medicare cost report on file with CMS. If the hospital does not have a medicare cost report on file with CMS, then the hospital's portion of the annual coverage assessment base is either the predecessor hospital's net patient revenue as shown in its medicare cost report for its fiscal year that ended during calendar year 2021, or, if the predecessor hospital does not have a 2021 medicare cost report, then the cost report for the first fiscal year following 2021 on file with CMS; (E) If a hospital is not required to file an annual medicare cost report with CMS, then the hospital's portion of the annual coverage assessment base is its net patient revenue for the fiscal year ending during calendar year 2021 or the first fiscal year that the hospital was in operation after 2021 as shown in the covered hospital's JAR filed with the department of health; and (F) If a hospital's fiscal year 2021 medicare cost report is not contained in a CMS healthcare cost report information system file, and if the hospital does not meet another qualification listed in subdivisions (2)(A)-(E), then the hospital must submit a copy of the hospital's 2021 medicare cost report to the division in order to allow for the determination of the hospital's net patient revenue as its portion of the annual coverage assessment base;
(A) If a hospital does not have a full twelve-month medicare cost report for 2021 on file with CMS but has a full twelve-month cost report for a subsequent year, then the first full twelve-month medicare cost report for a year following 2021 on file with CMS is the hospital's portion of the annual coverage assessment base;
(B) If a hospital does not have a full twelve-month medicare cost report for 2021 on file with CMS and does not have a full twelve-month cost report for a subsequent year, but has a cost report for 2021 that covers at least nine (9) months of 2021, then the hospital's portion of the assessment base is calculated by annualizing the 2021 cost report data;
(C) If a hospital was first licensed in 2021 or later and did not replace an existing hospital, and if the hospital has a medicare cost report on file with CMS, then the hospital's initial cost report on file with CMS is the hospital's portion of the annual coverage assessment base for the hospital assessment. If the hospital does not have an initial cost report on file with CMS but does have a complete twelve-month joint annual report (JAR) filed with the department of health, then the net patient revenue from the first twelve-month JAR is the hospital's portion of the annual coverage assessment base. If the hospital does not have a medicare cost report or a full twelve-month JAR filed with the department of health, then the hospital's portion of the annual coverage assessment base is the hospital's projected net patient revenue for its first full year of operation as shown in its certificate of need application filed with the health facilities commission;
(D) If a hospital was first licensed in 2021 or later and replaced an existing hospital, then the hospital's portion of the annual coverage assessment base is the replacement hospital's initial medicare cost report on file with CMS. If the hospital does not have a medicare cost report on file with CMS, then the hospital's portion of the annual coverage assessment base is either the predecessor hospital's net patient revenue as shown in its medicare cost report for its fiscal year that ended during calendar year 2021, or, if the predecessor hospital does not have a 2021 medicare cost report, then the cost report for the first fiscal year following 2021 on file with CMS;
(E) If a hospital is not required to file an annual medicare cost report with CMS, then the hospital's portion of the annual coverage assessment base is its net patient revenue for the fiscal year ending during calendar year 2021 or the first fiscal year that the hospital was in operation after 2021 as shown in the covered hospital's JAR filed with the department of health; and
(F) If a hospital's fiscal year 2021 medicare cost report is not contained in a CMS healthcare cost report information system file, and if the hospital does not meet another qualification listed in subdivisions (2)(A)-(E), then the hospital must submit a copy of the hospital's 2021 medicare cost report to the division in order to allow for the determination of the hospital's net patient revenue as its portion of the annual coverage assessment base;
(3) "CMS" means the federal centers for medicare and medicaid services;
(4) "Controlling person" means a person who, by ownership, contract, or otherwise, has the authority to control the business operations of a covered hospital. As used in this subdivision (4), "control" means indirect or direct ownership of ten percent (10%) or more of a covered hospital;
(5) "Covered hospital" means a hospital licensed under title 33 or title 68, as of July 1, 2024, but does not include an excluded hospital;
(6) "Division" means the division of TennCare;
(7) "Excluded hospital" means: (A) A hospital that has been designated by CMS as a critical access hospital as of July 1, 2024; (B) A mental health hospital owned by this state; (C) A hospital providing primarily rehabilitative or long-term acute care services; (D) A children's research hospital that does not charge patients for services beyond that reimbursed by third-party payers; (E) A hospital that is determined by the division as eligible to certify public expenditures for the purpose of securing federal medical assistance percentage payments; and (F) A hospital that has been designated by CMS as a rural emergency hospital as of July 1, 2024;
(A) A hospital that has been designated by CMS as a critical access hospital as of July 1, 2024;
(B) A mental health hospital owned by this state;
(C) A hospital providing primarily rehabilitative or long-term acute care services;
(D) A children's research hospital that does not charge patients for services beyond that reimbursed by third-party payers;
(E) A hospital that is determined by the division as eligible to certify public expenditures for the purpose of securing federal medical assistance percentage payments; and
(F) A hospital that has been designated by CMS as a rural emergency hospital as of July 1, 2024;
(8) "Hospital" means a facility licensed under title 33 or title 68 to provide inpatient hospital care;
(9) "Medicare cost report" means CMS-2552-10 or a subsequent form adopted by CMS for medicare cost reporting, the cost report for electronic filing of hospitals, for the period applicable as set forth in this section; and
(10) "Net patient revenue minus medicare net revenue" means the amount calculated in accordance with generally accepted accounting principles for hospitals that is reported on Worksheet G-3, Column 1, Line 3, of the 2021 medicare cost report, excluding net medicare revenue, long-term care inpatient ancillary and other nonhospital revenues, or, in the case of a hospital that did not file a 2021 medicare cost report, comparable data from the first complete cost report filed after 2021 by the hospital.
Amended by 2024 Tenn. Acts, ch. 953,s 1, eff. 6/30/2024.
Added by 2023 Tenn. Acts, ch. 232, s 1, eff. 6/30/2023.
Tenn. Code Ann. § 71-5-1404 — TN Code / Title 71 / Chapter 5 / Section 71-5-1404
Development and implementation of a statewide fully integrated risk-based long-term care system
Status: in_force

(a) The commissioner shall develop and implement a statewide fully integrated risk-based long-term care system that integrates medicaid-reimbursed primary, acute and long-term care services, building in strong consumer protections and aligning incentives to ensure that the right care is delivered in the right place at the right time. The long-term care system shall rebalance the overall allocation of funding for medicaid-reimbursed long-term care services by expanding access to and utilization of cost-effective home and community-based alternatives to institutional care for medicaid-eligible individuals. The system may include, subject to the availability of funding in each year's appropriations bill, expansion of Programs of All Inclusive Care for the Elderly (PACE) sites in additional major metropolitan areas of the state. (b) The commissioner shall ensure that comprehensive, person-centered care coordination across all medicaid primary, acute and long-term care services is a central component of the integrated long-term care system and the contractor risk agreement. A qualified entity shall conduct a comprehensive individualized assessment of needs in accordance with protocols developed by the commissioner, and shall develop a care plan with active participation of the member and family or other caregivers that addresses the identified needs and builds on and does not supplant family and other caregiving supports. The entity responsible for care coordination shall cost-effectively implement the care plan, assure coordination and monitoring of all medicaid primary, acute and long-term care services to assist individuals and family or other caregivers in providing and securing necessary care and assure the availability of a qualified workforce, including backup workers when necessary, to timely provide necessary services. (c) Nothing in this part may be construed to create an entitlement to home and community-based services; provided, however, that the commissioner shall design and implement the integrated long-term care system in a manner that affords access to the appropriate level of cost-effective home and community-based services for the greatest number of medicaid-eligible elderly or physically disabled individuals, or both, possible, subject to the availability of funding in each year's appropriation bill. (d) The cost of home and community-based services provided to a medicaid-eligible individual, which includes the cost of home health services or private duty nursing, or both, to the extent covered under the medicaid program, shall not exceed the cost of institutional services for that individual in a nursing facility except as permitted under the current medicaid state plan or any federal waivers. (e) Notwithstanding another law to the contrary, an individual who enters an employment agreement with a provider agency participating in the TennCare program is not ineligible to receive payment under this part for providing TennCare medicaid-reimbursed home- and community-based long-term care services to an individual eligible to receive such TennCare medicaid-reimbursed home- and community-based long-term care services on the basis that the individual providing care and the individual receiving care reside in the same home. Acts 2008 , ch. 1190, § 5.
(a) The commissioner shall develop and implement a statewide fully integrated risk-based long-term care system that integrates medicaid-reimbursed primary, acute and long-term care services, building in strong consumer protections and aligning incentives to ensure that the right care is delivered in the right place at the right time. The long-term care system shall rebalance the overall allocation of funding for medicaid-reimbursed long-term care services by expanding access to and utilization of cost-effective home and community-based alternatives to institutional care for medicaid-eligible individuals. The system may include, subject to the availability of funding in each year's appropriations bill, expansion of Programs of All Inclusive Care for the Elderly (PACE) sites in additional major metropolitan areas of the state.
(b) The commissioner shall ensure that comprehensive, person-centered care coordination across all medicaid primary, acute and long-term care services is a central component of the integrated long-term care system and the contractor risk agreement. A qualified entity shall conduct a comprehensive individualized assessment of needs in accordance with protocols developed by the commissioner, and shall develop a care plan with active participation of the member and family or other caregivers that addresses the identified needs and builds on and does not supplant family and other caregiving supports. The entity responsible for care coordination shall cost-effectively implement the care plan, assure coordination and monitoring of all medicaid primary, acute and long-term care services to assist individuals and family or other caregivers in providing and securing necessary care and assure the availability of a qualified workforce, including backup workers when necessary, to timely provide necessary services.
(c) Nothing in this part may be construed to create an entitlement to home and community-based services; provided, however, that the commissioner shall design and implement the integrated long-term care system in a manner that affords access to the appropriate level of cost-effective home and community-based services for the greatest number of medicaid-eligible elderly or physically disabled individuals, or both, possible, subject to the availability of funding in each year's appropriation bill.
(d) The cost of home and community-based services provided to a medicaid-eligible individual, which includes the cost of home health services or private duty nursing, or both, to the extent covered under the medicaid program, shall not exceed the cost of institutional services for that individual in a nursing facility except as permitted under the current medicaid state plan or any federal waivers.
(e) Notwithstanding another law to the contrary, an individual who enters an employment agreement with a provider agency participating in the TennCare program is not ineligible to receive payment under this part for providing TennCare medicaid-reimbursed home- and community-based long-term care services to an individual eligible to receive such TennCare medicaid-reimbursed home- and community-based long-term care services on the basis that the individual providing care and the individual receiving care reside in the same home.
Acts 2008 , ch. 1190, § 5.
Tenn. Code Ann. § 71-5-2519 — TN Code / Title 71 / Chapter 5 / Section 71-5-2519
Written petition for objection to providing access to data - Enforcement of obligations
Status: in_force

(a) A person or entity requested to provide access to data pursuant to §§ 71-5-2513 - 71-5-2521 may object to providing all or part of such access by filing a written petition with the inspector general within thirty (30) days of receipt of notice of the request to which objection is made. The petition shall be treated as a contested case pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. (b) (1) In the event a person or entity requested to provide data pursuant to §§ 71-5-2513 - 71-5-2521 fails to do so or to file a timely petition objecting to provision of the data, the office of inspector general has the authority to petition the chancery court of Davidson County through the attorney general and reporter, or by special appointment or delegation from the attorney general and reporter as provided by law, for enforcement of the obligations imposed by this chapter, and for recovery of costs, attorney's fees, and any applicable civil penalties. (2) Upon filing of a petition for enforcement by the inspector general, the court shall order the person or entity named in the petition to show cause why they should not be held in contempt for failure to comply with the request. (3) In ruling on the petition, the court shall be authorized to: (A) Order the person or entity, on pain of contempt, to comply with the request, and to punish each day of failure to comply with the order as a separate contempt of court; and (B) Award to the attorney general and reporter and, if applicable, the office of inspector general, reasonable costs and attorney's fees incurred in enforcing the requirement, if the state prevails. (c) (1) Willful failure to provide data, or access to data, as required by this chapter, shall be subject to the same civil penalty established by law for willful failure to report recipient fraud to the inspector general. (2) A person or entity that has been assessed a civil penalty by the office of inspector general may object to the penalty by filing a written petition with the inspector general within thirty (30) days of receipt of notice of the assessment. The petition shall be treated as a contested case pursuant to the Uniform Administrative Procedures Act. (3) In the event that a person or entity that has been assessed a civil penalty by the office of inspector general has failed to pay the penalty or file a timely objection, the office of inspector general has the authority to file a petition in the chancery court of Davidson County through the attorney general and reporter, or by delegation from the attorney general and reporter as provided by law, for the collection of the penalty, and for enforcement of the request to provide access to data. Acts 2006, ch. 1010, § 1.
(a) A person or entity requested to provide access to data pursuant to §§ 71-5-2513 - 71-5-2521 may object to providing all or part of such access by filing a written petition with the inspector general within thirty (30) days of receipt of notice of the request to which objection is made. The petition shall be treated as a contested case pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
(b) (1) In the event a person or entity requested to provide data pursuant to §§ 71-5-2513 - 71-5-2521 fails to do so or to file a timely petition objecting to provision of the data, the office of inspector general has the authority to petition the chancery court of Davidson County through the attorney general and reporter, or by special appointment or delegation from the attorney general and reporter as provided by law, for enforcement of the obligations imposed by this chapter, and for recovery of costs, attorney's fees, and any applicable civil penalties. (2) Upon filing of a petition for enforcement by the inspector general, the court shall order the person or entity named in the petition to show cause why they should not be held in contempt for failure to comply with the request. (3) In ruling on the petition, the court shall be authorized to: (A) Order the person or entity, on pain of contempt, to comply with the request, and to punish each day of failure to comply with the order as a separate contempt of court; and (B) Award to the attorney general and reporter and, if applicable, the office of inspector general, reasonable costs and attorney's fees incurred in enforcing the requirement, if the state prevails.
(1) In the event a person or entity requested to provide data pursuant to §§ 71-5-2513 - 71-5-2521 fails to do so or to file a timely petition objecting to provision of the data, the office of inspector general has the authority to petition the chancery court of Davidson County through the attorney general and reporter, or by special appointment or delegation from the attorney general and reporter as provided by law, for enforcement of the obligations imposed by this chapter, and for recovery of costs, attorney's fees, and any applicable civil penalties.
(2) Upon filing of a petition for enforcement by the inspector general, the court shall order the person or entity named in the petition to show cause why they should not be held in contempt for failure to comply with the request.
(3) In ruling on the petition, the court shall be authorized to: (A) Order the person or entity, on pain of contempt, to comply with the request, and to punish each day of failure to comply with the order as a separate contempt of court; and (B) Award to the attorney general and reporter and, if applicable, the office of inspector general, reasonable costs and attorney's fees incurred in enforcing the requirement, if the state prevails.
(A) Order the person or entity, on pain of contempt, to comply with the request, and to punish each day of failure to comply with the order as a separate contempt of court; and
(B) Award to the attorney general and reporter and, if applicable, the office of inspector general, reasonable costs and attorney's fees incurred in enforcing the requirement, if the state prevails.
(c) (1) Willful failure to provide data, or access to data, as required by this chapter, shall be subject to the same civil penalty established by law for willful failure to report recipient fraud to the inspector general. (2) A person or entity that has been assessed a civil penalty by the office of inspector general may object to the penalty by filing a written petition with the inspector general within thirty (30) days of receipt of notice of the assessment. The petition shall be treated as a contested case pursuant to the Uniform Administrative Procedures Act. (3) In the event that a person or entity that has been assessed a civil penalty by the office of inspector general has failed to pay the penalty or file a timely objection, the office of inspector general has the authority to file a petition in the chancery court of Davidson County through the attorney general and reporter, or by delegation from the attorney general and reporter as provided by law, for the collection of the penalty, and for enforcement of the request to provide access to data.
(1) Willful failure to provide data, or access to data, as required by this chapter, shall be subject to the same civil penalty established by law for willful failure to report recipient fraud to the inspector general.
(2) A person or entity that has been assessed a civil penalty by the office of inspector general may object to the penalty by filing a written petition with the inspector general within thirty (30) days of receipt of notice of the assessment. The petition shall be treated as a contested case pursuant to the Uniform Administrative Procedures Act.
(3) In the event that a person or entity that has been assessed a civil penalty by the office of inspector general has failed to pay the penalty or file a timely objection, the office of inspector general has the authority to file a petition in the chancery court of Davidson County through the attorney general and reporter, or by delegation from the attorney general and reporter as provided by law, for the collection of the penalty, and for enforcement of the request to provide access to data.
Acts 2006, ch. 1010, § 1.
Tenn. Code Ann. § 71-5-501 — TN Code / Title 71 / Chapter 5 / Section 71-5-501
Part definitions
Status: in_force

As used in this part, unless the context otherwise requires: (1) "Department" means the department of finance and administration; and (2) "Manufacturer-sponsored prescription drug assistance program" means a program offered by a pharmaceutical manufacturer, through which the manufacturer provides a drug or drugs to eligible persons at no charge or at a discounted cost. Acts 2005, ch. 474, § 5.
As used in this part, unless the context otherwise requires:
(1) "Department" means the department of finance and administration; and
(2) "Manufacturer-sponsored prescription drug assistance program" means a program offered by a pharmaceutical manufacturer, through which the manufacturer provides a drug or drugs to eligible persons at no charge or at a discounted cost.
Acts 2005, ch. 474, § 5.
Tenn. Code Ann. § 71-5-312 — TN Code / Title 71 / Chapter 5 / Section 71-5-312
Administration costs
Status: in_force

Cost of the administration of the food stamp program shall consist of a contribution from the federal government in an amount as provided by congress, and a contribution from the state amounting to one hundred percent (100%) of the administrative expenditures not provided through federal funds. Acts 1971, ch. 136, § 13; 1973, ch. 303, § 1; T.C.A., §§ 14-2213, 14-27-112.
Cost of the administration of the food stamp program shall consist of a contribution from the federal government in an amount as provided by congress, and a contribution from the state amounting to one hundred percent (100%) of the administrative expenditures not provided through federal funds.
Acts 1971, ch. 136, § 13; 1973, ch. 303, § 1; T.C.A., §§ 14-2213, 14-27-112.
Tenn. Code Ann. § 71-6-101 — TN Code / Title 71 / Chapter 6 / Section 71-6-101
Short title - Legislative intent
Status: in_force

(a) This part may be cited as the "Tennessee Adult Protection Act." (b) (1) The purpose of this part is to protect adults coming within this part from abuse, neglect or exploitation by requiring reporting of suspected cases by any person having cause to believe that such cases exist. It is intended that, as a result of such reports, the protective services of the state shall prevent further abuse, neglect or exploitation within the limitations set out in this part. (2) It is recognized that adequate protection of adults will require the cooperation of many agencies and service providers in conjunction with the department of human services due to the often complex nature of the risks to this adult group, and that services to meet the needs of this group will not always be available in each community. However, it is desirable that the following services, as well as other services needed to meet the intent of this part, be available: medical care, mental health and developmental disabilities services, including in-home assessments and evaluations; in-home services including homemaker, home-health, chore, meals; emergency services including shelter; financial assistance; legal services; transportation; counseling; foster care; day care; respite care; and other services as needed to carry out the intent of this part. Acts 1978, ch. 899, § 1; T.C.A., § 14-2601; Acts 1986, ch. 630, § 1; T.C.A., § 14-25-101.
(a) This part may be cited as the "Tennessee Adult Protection Act."
(b) (1) The purpose of this part is to protect adults coming within this part from abuse, neglect or exploitation by requiring reporting of suspected cases by any person having cause to believe that such cases exist. It is intended that, as a result of such reports, the protective services of the state shall prevent further abuse, neglect or exploitation within the limitations set out in this part. (2) It is recognized that adequate protection of adults will require the cooperation of many agencies and service providers in conjunction with the department of human services due to the often complex nature of the risks to this adult group, and that services to meet the needs of this group will not always be available in each community. However, it is desirable that the following services, as well as other services needed to meet the intent of this part, be available: medical care, mental health and developmental disabilities services, including in-home assessments and evaluations; in-home services including homemaker, home-health, chore, meals; emergency services including shelter; financial assistance; legal services; transportation; counseling; foster care; day care; respite care; and other services as needed to carry out the intent of this part.
(1) The purpose of this part is to protect adults coming within this part from abuse, neglect or exploitation by requiring reporting of suspected cases by any person having cause to believe that such cases exist. It is intended that, as a result of such reports, the protective services of the state shall prevent further abuse, neglect or exploitation within the limitations set out in this part.
(2) It is recognized that adequate protection of adults will require the cooperation of many agencies and service providers in conjunction with the department of human services due to the often complex nature of the risks to this adult group, and that services to meet the needs of this group will not always be available in each community. However, it is desirable that the following services, as well as other services needed to meet the intent of this part, be available: medical care, mental health and developmental disabilities services, including in-home assessments and evaluations; in-home services including homemaker, home-health, chore, meals; emergency services including shelter; financial assistance; legal services; transportation; counseling; foster care; day care; respite care; and other services as needed to carry out the intent of this part.
Acts 1978, ch. 899, § 1; T.C.A., § 14-2601; Acts 1986, ch. 630, § 1; T.C.A., § 14-25-101.
Tenn. Code Ann. § 71-4-611 — TN Code / Title 71 / Chapter 4 / Section 71-4-611
Illegal use of lists - Penalty
Status: in_force

(a) It is unlawful, except for purposes directly connected with the administration of the vocational rehabilitation program, and in accordance with regulations, for any person or persons to solicit, disclose, receive, or make use of, or authorize, knowingly permit, participate in, or acquiesce in the use of any list of, or names of, or any information concerning persons applying for or receiving vocational rehabilitation, directly or indirectly derived from the records, papers, files, or communications of the state or subdivisions or agencies of the state, or acquired in the course of the performance of official duties. (b) A violation of this section is a Class C misdemeanor. Acts 1955, ch. 243, § 11; T.C.A., §§ 14-635, 14-14-411; Acts 1989, ch. 591, § 113.
(a) It is unlawful, except for purposes directly connected with the administration of the vocational rehabilitation program, and in accordance with regulations, for any person or persons to solicit, disclose, receive, or make use of, or authorize, knowingly permit, participate in, or acquiesce in the use of any list of, or names of, or any information concerning persons applying for or receiving vocational rehabilitation, directly or indirectly derived from the records, papers, files, or communications of the state or subdivisions or agencies of the state, or acquired in the course of the performance of official duties.
(b) A violation of this section is a Class C misdemeanor.
Acts 1955, ch. 243, § 11; T.C.A., §§ 14-635, 14-14-411; Acts 1989, ch. 591, § 113.
Tenn. Code Ann. § 71-5-133 — TN Code / Title 71 / Chapter 5 / Section 71-5-133
Provision of information concerning Norplant and other contraceptives
Status: in_force

(a) The department of human services shall provide written information concerning the availability through the medicaid program of the Norplant contraceptive implant, and other functionally equivalent contraceptives that provide similar long-lasting pregnancy prevention, to all temporary assistance for needy families (TANF) recipients or to recipients of any successor program when such persons apply for benefits or are recertified. The department shall provide information concerning the availability of birth control and contraceptive implants to all males whose incomes are below the federal poverty level and who are receiving any other state or federal government subsidies, including, but not limited to, food assistance pursuant to part 3 of this chapter, if such males also qualify for medicaid and are able to impregnate females. Such information shall also be supplied to other women of child-bearing age whose income is below the federal poverty level and are receiving any other state or federal government subsidies, including, but not limited to, food assistance pursuant to chapter 5, part 3 of this title, if such persons also qualify for medicaid. The information provided shall clearly state that qualified health care providers are available to discuss the contraceptive in more detail upon request. (b) Together with the information concerning availability required to be provided pursuant to subsection (a), the department shall also provide to each eligible recipient information regarding any risks involved in having such contraceptive implanted, as well as information on the use of all types of contraceptives, including abstinence, and the moral benefits of abstinence until marriage, and the health and other benefits of abstinence, which shall be disseminated in a manner that is reasonably calculated to make the information easily accessible to all recipients under the TANF program or to recipients of any successor program, as well as to other women of child-bearing age whose incomes are below the federal poverty level and who are receiving any other state or federal government subsidies, including, but not limited to, food assistance pursuant to chapter 5, part 3 of this title, if such persons also qualify for medicaid. The department's case workers will assist in making the appointment with the appropriate county health department. Acts 1993, ch. 255, § 1; 1996, ch. 950, § 17.
(a) The department of human services shall provide written information concerning the availability through the medicaid program of the Norplant contraceptive implant, and other functionally equivalent contraceptives that provide similar long-lasting pregnancy prevention, to all temporary assistance for needy families (TANF) recipients or to recipients of any successor program when such persons apply for benefits or are recertified. The department shall provide information concerning the availability of birth control and contraceptive implants to all males whose incomes are below the federal poverty level and who are receiving any other state or federal government subsidies, including, but not limited to, food assistance pursuant to part 3 of this chapter, if such males also qualify for medicaid and are able to impregnate females. Such information shall also be supplied to other women of child-bearing age whose income is below the federal poverty level and are receiving any other state or federal government subsidies, including, but not limited to, food assistance pursuant to chapter 5, part 3 of this title, if such persons also qualify for medicaid. The information provided shall clearly state that qualified health care providers are available to discuss the contraceptive in more detail upon request.
(b) Together with the information concerning availability required to be provided pursuant to subsection (a), the department shall also provide to each eligible recipient information regarding any risks involved in having such contraceptive implanted, as well as information on the use of all types of contraceptives, including abstinence, and the moral benefits of abstinence until marriage, and the health and other benefits of abstinence, which shall be disseminated in a manner that is reasonably calculated to make the information easily accessible to all recipients under the TANF program or to recipients of any successor program, as well as to other women of child-bearing age whose incomes are below the federal poverty level and who are receiving any other state or federal government subsidies, including, but not limited to, food assistance pursuant to chapter 5, part 3 of this title, if such persons also qualify for medicaid. The department's case workers will assist in making the appointment with the appropriate county health department.
Acts 1993, ch. 255, § 1; 1996, ch. 950, § 17.
Tenn. Code Ann. § 71-5-601 — TN Code / Title 71 / Chapter 5 / Section 71-5-601
Legislative intent
Status: in_force

It is the intent of the general assembly that, in order to maximize the medical care available to Tennesseans who are uninsurable but for the availability of Access Tennessee, federal matching funds should be identified and any applicable federal waiver should be negotiated that would enable the state to provide additional benefits or to provide subsidies to assist with payment of premiums or copayments to persons who are eligible for the Access Tennessee program or to any subset of persons who are eligible for the Access Tennessee program, including individuals with incomes below two hundred percent (200%) of the federal poverty level. It is the intent of the general assembly that any funds expended pursuant to this part in the future shall be administered in conformity with the federal determination of budget neutrality that was made in 2002 with respect to coverage of uninsurable adults under the TennCare waiver and in conformity with any federal waiver that shall be obtained in the future. Acts 2006, ch. 961, § 2.
It is the intent of the general assembly that, in order to maximize the medical care available to Tennesseans who are uninsurable but for the availability of Access Tennessee, federal matching funds should be identified and any applicable federal waiver should be negotiated that would enable the state to provide additional benefits or to provide subsidies to assist with payment of premiums or copayments to persons who are eligible for the Access Tennessee program or to any subset of persons who are eligible for the Access Tennessee program, including individuals with incomes below two hundred percent (200%) of the federal poverty level. It is the intent of the general assembly that any funds expended pursuant to this part in the future shall be administered in conformity with the federal determination of budget neutrality that was made in 2002 with respect to coverage of uninsurable adults under the TennCare waiver and in conformity with any federal waiver that shall be obtained in the future.
Acts 2006, ch. 961, § 2.
Tenn. Code Ann. § 71-5-1305 — TN Code / Title 71 / Chapter 5 / Section 71-5-1305
Grant payments
Status: in_force

Grant payments under this part shall be made to the individual monthly and forwarded to such person at the place of such individual's residence. Grant payments are non-assignable and payable only to the individual or such individual's legally authorized representative, which shall not be the nursing home. Acts 1992, ch. 954, § 1; 1993, ch. 425, § 2.
Grant payments under this part shall be made to the individual monthly and forwarded to such person at the place of such individual's residence. Grant payments are non-assignable and payable only to the individual or such individual's legally authorized representative, which shall not be the nursing home.
Acts 1992, ch. 954, § 1; 1993, ch. 425, § 2.
Tenn. Code Ann. § 71-2-115 — TN Code / Title 71 / Chapter 2 / Section 71-2-115
[Repealed]
Status: repealed

Repealed by 2024 Tenn. Acts, ch. 688,s 98, eff. 7/1/2024. Added by 2018 Tenn. Acts, ch. 548, s 1, eff. 3/9/2018.
Repealed by 2024 Tenn. Acts, ch. 688,s 98, eff. 7/1/2024.
Added by 2018 Tenn. Acts, ch. 548, s 1, eff. 3/9/2018.
Tenn. Code Ann. § 71-2-415 — TN Code / Title 71 / Chapter 2 / Section 71-2-415
Construction
Status: in_force

This part is declared to be remedial in nature and this part shall be liberally construed to effectuate its purposes. Acts 1996, ch. 1058, § 19; T.C.A. § 71-2-417; Acts 2000, ch. 981, § 72.
This part is declared to be remedial in nature and this part shall be liberally construed to effectuate its purposes.
Acts 1996, ch. 1058, § 19; T.C.A. § 71-2-417; Acts 2000, ch. 981, § 72.
Tenn. Code Ann. § 71-4-1105 — TN Code / Title 71 / Chapter 4 / Section 71-4-1105
Duties of department
Status: in_force

The department shall: (1) Supervise the administration of assistance to the permanently and totally disabled under this part; (2) Make such rules and regulations and take such action as may be necessary or desirable for carrying out this part to the end that equitable treatment shall be afforded to individuals in similar circumstances. All rules and regulations made by the department shall be binding on the counties and shall be complied with by the respective regional directors; (3) Establish criteria for determining who is permanently and totally disabled within the meaning of § 71-4-1102 ; (4) Establish standards for the determination of need of the individual including: (A) Statewide requirements essential to maintaining a minimum standard of economic security based on studies of current living costs; (B) Methods and procedures for measuring income and resources against such statewide requirements; (C) Property reserves that will not preclude eligibility for assistance under this part; (5) Employ personnel for the administration of this part in conformity with title 8, chapter 30, and the rules and regulations of the department of human resources; (6) Prescribe the form of and supply to the regional directors such forms as it may deem necessary and desirable; (7) Cooperate with the commissioner of social security, or any federal officer or agency made successor to the commissioner of social security, in any reasonable manner as may be necessary to qualify for federal aid for assistance to the permanently and totally disabled and in conformity with this part, including the making of such reports in such form and containing such information as the commissioner of social security may from time to time require, and comply with such provisions as such commissioner may from time to time find necessary to assure the correctness and verification of such reports; and (8) Publish an annual report and such interim reports as may be necessary. Acts 1953, ch. 16, § 4 (Williams, § 4765.156); modified; Acts 1973, ch. 303, § 19; 1974, ch. 628, § 10; T.C.A. (orig. ed.), § 14-405; Acts 1986, ch. 905, § 2; T.C.A., § 14-16-105; Acts 2012, ch. 800, § 49.
The department shall:
(1) Supervise the administration of assistance to the permanently and totally disabled under this part;
(2) Make such rules and regulations and take such action as may be necessary or desirable for carrying out this part to the end that equitable treatment shall be afforded to individuals in similar circumstances. All rules and regulations made by the department shall be binding on the counties and shall be complied with by the respective regional directors;
(3) Establish criteria for determining who is permanently and totally disabled within the meaning of § 71-4-1102 ;
(4) Establish standards for the determination of need of the individual including: (A) Statewide requirements essential to maintaining a minimum standard of economic security based on studies of current living costs; (B) Methods and procedures for measuring income and resources against such statewide requirements; (C) Property reserves that will not preclude eligibility for assistance under this part;
(A) Statewide requirements essential to maintaining a minimum standard of economic security based on studies of current living costs;
(B) Methods and procedures for measuring income and resources against such statewide requirements;
(C) Property reserves that will not preclude eligibility for assistance under this part;
(5) Employ personnel for the administration of this part in conformity with title 8, chapter 30, and the rules and regulations of the department of human resources;
(6) Prescribe the form of and supply to the regional directors such forms as it may deem necessary and desirable;
(7) Cooperate with the commissioner of social security, or any federal officer or agency made successor to the commissioner of social security, in any reasonable manner as may be necessary to qualify for federal aid for assistance to the permanently and totally disabled and in conformity with this part, including the making of such reports in such form and containing such information as the commissioner of social security may from time to time require, and comply with such provisions as such commissioner may from time to time find necessary to assure the correctness and verification of such reports; and
(8) Publish an annual report and such interim reports as may be necessary.
Acts 1953, ch. 16, § 4 (Williams, § 4765.156); modified; Acts 1973, ch. 303, § 19; 1974, ch. 628, § 10; T.C.A. (orig. ed.), § 14-405; Acts 1986, ch. 905, § 2; T.C.A., § 14-16-105; Acts 2012, ch. 800, § 49.
Tenn. Code Ann. § 71-5-1005 — TN Code / Title 71 / Chapter 5 / Section 71-5-1005
Bureau to seek federal approvals if necessary - Bureau authorized to adopt rules and regulations to implement part
Status: in_force

(a) The bureau shall seek necessary federal approval in the form of state plan amendments in order to implement this part, if it determined such approvals are necessary. (b) The bureau is authorized to adopt rules and regulations necessary to implement this part or obtain approval of the state plan amendments. However, § 71-5-1413 shall be the exclusive authority for rulemaking by the bureau of TennCare regarding the initial rules regarding the acuity-based nursing home reimbursement system and any subsequent modifications to the nursing home reimbursement system. Amended by 2018 Tenn. Acts, ch. 836,s 7, eff. 7/1/2018. Amended by 2017 Tenn. Acts, ch. 377,s 4, eff. 7/1/2017. Acts 2014, ch. 859, § 1.
(a) The bureau shall seek necessary federal approval in the form of state plan amendments in order to implement this part, if it determined such approvals are necessary.
(b) The bureau is authorized to adopt rules and regulations necessary to implement this part or obtain approval of the state plan amendments. However, § 71-5-1413 shall be the exclusive authority for rulemaking by the bureau of TennCare regarding the initial rules regarding the acuity-based nursing home reimbursement system and any subsequent modifications to the nursing home reimbursement system.
Amended by 2018 Tenn. Acts, ch. 836,s 7, eff. 7/1/2018.
Amended by 2017 Tenn. Acts, ch. 377,s 4, eff. 7/1/2017.
Acts 2014, ch. 859, § 1.
Tenn. Code Ann. § 71-3-111 — TN Code / Title 71 / Chapter 3 / Section 71-3-111
Training and supervision
Status: in_force

(a) The department shall appropriately train and supervise all employees and other persons who are responsible for developing, evaluating and managing personal responsibility plans for recipients of temporary assistance. Such training and supervision shall include, but not be limited to, a competency based case management program to measure the effectiveness of each plan and to provide appropriate oversight and implementation. (b) Any necessary part-time or temporary job counseling and job placement personnel shall be employed as provided by law. (c) Any additional full-time positions required by the various departments involved in the implementation of this part and of chapter 5, part 12 of this title shall be employed as provided by law. Acts 1996, ch. 950, § 29; T.C.A., § 71-3-161.
(a) The department shall appropriately train and supervise all employees and other persons who are responsible for developing, evaluating and managing personal responsibility plans for recipients of temporary assistance. Such training and supervision shall include, but not be limited to, a competency based case management program to measure the effectiveness of each plan and to provide appropriate oversight and implementation.
(b) Any necessary part-time or temporary job counseling and job placement personnel shall be employed as provided by law.
(c) Any additional full-time positions required by the various departments involved in the implementation of this part and of chapter 5, part 12 of this title shall be employed as provided by law.
Acts 1996, ch. 950, § 29; T.C.A., § 71-3-161.
Tenn. Code Ann. § 71-5-2209 — TN Code / Title 71 / Chapter 5 / Section 71-5-2209
Liability for expenditures
Status: in_force

The commissioners shall be jointly and severally liable for the application of any money drawn on their order from the county treasury for the use of the asylum. Code 1858, § 1604; Shan., § 2688; Code 1932, § 4805; T.C.A. (orig. ed.), §§ 14-909, 14-20-209.
The commissioners shall be jointly and severally liable for the application of any money drawn on their order from the county treasury for the use of the asylum.
Code 1858, § 1604; Shan., § 2688; Code 1932, § 4805; T.C.A. (orig. ed.), §§ 14-909, 14-20-209.
Tenn. Code Ann. § 71-5-128 — TN Code / Title 71 / Chapter 5 / Section 71-5-128
Contracts with health maintenance organizations - Requirements
Status: in_force

Notwithstanding any other law to the contrary, the department of health shall follow, as nearly as is practicable, the requirements of 42 U.S.C. § 1395mm , as amended, together with any federal rules and regulations promulgated pursuant to such law, with respect to a health maintenance organization with which the state has entered into a contract for the provision of services under this part. Acts 1981, ch. 286, § 2; T.C.A., § 14-23-128.
Notwithstanding any other law to the contrary, the department of health shall follow, as nearly as is practicable, the requirements of 42 U.S.C. § 1395mm , as amended, together with any federal rules and regulations promulgated pursuant to such law, with respect to a health maintenance organization with which the state has entered into a contract for the provision of services under this part.
Acts 1981, ch. 286, § 2; T.C.A., § 14-23-128.
Tenn. Code Ann. § 71-5-2006 — TN Code / Title 71 / Chapter 5 / Section 71-5-2006
[Expires 7/1/2025] Expiration of part - Survival of certain rights and obligations
Status: in_force

This part expires on July 1, 2025. However, the following rights and obligations survive the expiration: (1) The authority of the division to impose late payment penalties and to collect unpaid annual coverage assessments and required refunds; (2) The rights of a covered hospital or an association of covered hospitals to file a petition for a declaratory order to determine compliance with this part; (3) The existence of the maintenance of coverage trust fund and the obligation of the division to use and apply the assets of the maintenance of coverage trust fund; and (4) The obligation of the division to implement and maintain the requirements of § 71-5-161 . Amended by 2024 Tenn. Acts, ch. 953,s 1, eff. 6/30/2024. Added by 2023 Tenn. Acts, ch. 232, s 1, eff. 6/30/2023.
This part expires on July 1, 2025. However, the following rights and obligations survive the expiration:
(1) The authority of the division to impose late payment penalties and to collect unpaid annual coverage assessments and required refunds;
(2) The rights of a covered hospital or an association of covered hospitals to file a petition for a declaratory order to determine compliance with this part;
(3) The existence of the maintenance of coverage trust fund and the obligation of the division to use and apply the assets of the maintenance of coverage trust fund; and
(4) The obligation of the division to implement and maintain the requirements of § 71-5-161 .
Amended by 2024 Tenn. Acts, ch. 953,s 1, eff. 6/30/2024.
Added by 2023 Tenn. Acts, ch. 232, s 1, eff. 6/30/2023.
Tenn. Code Ann. § 71-4-106 — TN Code / Title 71 / Chapter 4 / Section 71-4-106
Duties of department
Status: in_force

The department shall: (1) Supervise the administration of assistance to the needy blind under this part by the regional directors; (2) Make such rules and regulations and take such action as may be necessary or desirable for carrying out this part. All rules and regulations made by the department shall be binding on the counties and shall be complied with by the respective regional directors; (3) Establish standards for personnel employed by the department in the administration of this part and make necessary rules and regulations to maintain such standards; (4) Compile and supply to the regional director such forms as it may deem necessary and advisable; (5) Cooperate with the commissioner of social security, or any federal officer or agency made successor to the commissioner of social security, in any reasonable manner as may be necessary to qualify for federal aid for assistance to the needy blind and in conformity with this part, including the making of such reports in such forms and containing such information as the commissioner of social security may from time to time require, and comply with such provisions as such commissioner may from time to time find necessary to assure the correctness and verification of such reports; (6) Publish an annual report and such interim reports as may be necessary; (7) Designate a suitable number of ophthalmologists, duly licensed to practice medicine in Tennessee and actively engaged in the treatment of diseases of the human eye, or who are licensed, registered optometrists actively engaged in the practice of optometry in Tennessee, to examine recipients of assistance to the blind; (8) Fix the fees to be paid to ophthalmologists and optometrists for such examinations, such fees to be paid out of funds allocated to the department; and (9) Designate a suitable number of optometrists duly licensed to practice optometry in this state and holding a current certificate of registration to examine recipients of assistance to the blind; provided, that nothing in this part shall at any time be construed by any state or local agency as conferring upon the optometrist any rights or privileges with regard to the practice of optometry not specifically authorized under title 63, chapter 8. Acts 1937, ch. 51, § 5; 1943, ch. 152, § 1; C. Supp. 1950, § 4765.62 (Williams, § 4765.61); Acts 1951, ch. 194, §§ 2-6; modified; Acts 1973, ch. 303, § 25; 1974, ch. 628, § 17; T.C.A. (orig. ed.), §§ 14-507, 14-13-106.
The department shall:
(1) Supervise the administration of assistance to the needy blind under this part by the regional directors;
(2) Make such rules and regulations and take such action as may be necessary or desirable for carrying out this part. All rules and regulations made by the department shall be binding on the counties and shall be complied with by the respective regional directors;
(3) Establish standards for personnel employed by the department in the administration of this part and make necessary rules and regulations to maintain such standards;
(4) Compile and supply to the regional director such forms as it may deem necessary and advisable;
(5) Cooperate with the commissioner of social security, or any federal officer or agency made successor to the commissioner of social security, in any reasonable manner as may be necessary to qualify for federal aid for assistance to the needy blind and in conformity with this part, including the making of such reports in such forms and containing such information as the commissioner of social security may from time to time require, and comply with such provisions as such commissioner may from time to time find necessary to assure the correctness and verification of such reports;
(6) Publish an annual report and such interim reports as may be necessary;
(7) Designate a suitable number of ophthalmologists, duly licensed to practice medicine in Tennessee and actively engaged in the treatment of diseases of the human eye, or who are licensed, registered optometrists actively engaged in the practice of optometry in Tennessee, to examine recipients of assistance to the blind;
(8) Fix the fees to be paid to ophthalmologists and optometrists for such examinations, such fees to be paid out of funds allocated to the department; and
(9) Designate a suitable number of optometrists duly licensed to practice optometry in this state and holding a current certificate of registration to examine recipients of assistance to the blind; provided, that nothing in this part shall at any time be construed by any state or local agency as conferring upon the optometrist any rights or privileges with regard to the practice of optometry not specifically authorized under title 63, chapter 8.
Acts 1937, ch. 51, § 5; 1943, ch. 152, § 1; C. Supp. 1950, § 4765.62 (Williams, § 4765.61); Acts 1951, ch. 194, §§ 2-6; modified; Acts 1973, ch. 303, § 25; 1974, ch. 628, § 17; T.C.A. (orig. ed.), §§ 14-507, 14-13-106.
Tenn. Code Ann. § 71-5-2501 — TN Code / Title 71 / Chapter 5 / Section 71-5-2501
Short title
Status: in_force

This part shall be known and may be cited as "The TennCare Fraud and Abuse Reform Act of 2004". Acts 2004, ch. 673, § 20.
This part shall be known and may be cited as "The TennCare Fraud and Abuse Reform Act of 2004".
Acts 2004, ch. 673, § 20.
Tenn. Code Ann. § 71-5-147 — TN Code / Title 71 / Chapter 5 / Section 71-5-147
Personal needs allowance - Protecting nursing home residents from diversion of allowance
Status: in_force

(a) In determining the amount of an eligible individual's income available for the cost of long-term nursing home care authorized under this part on or after January 1, 2025, a deduction shall be made from the person's total income in the amount of seventy dollars ($70.00) per month to be treated as a personal needs allowance within the meaning of applicable federal regulations. (b) (1) The health facilities commission is directed to review, and revise as necessary, recommendations previously developed to protect nursing home residents from vendors and others who would seek to provide inappropriate or unneeded goods and services, or otherwise divert personal needs allowance funds for uses other than those meeting residents' personal needs. (2) The recommendations shall be provided to the chair of the health and welfare committee of the senate and the chair of the health committee of the house of representatives not later than January 15, 2025. Amended by 2024 Tenn. Acts, ch. 986,s 1, eff. 5/21/2024. Acts 2004, ch. 851, §§ 1, 2; 2009 , ch. 592, § 1.
(a) In determining the amount of an eligible individual's income available for the cost of long-term nursing home care authorized under this part on or after January 1, 2025, a deduction shall be made from the person's total income in the amount of seventy dollars ($70.00) per month to be treated as a personal needs allowance within the meaning of applicable federal regulations.
(b) (1) The health facilities commission is directed to review, and revise as necessary, recommendations previously developed to protect nursing home residents from vendors and others who would seek to provide inappropriate or unneeded goods and services, or otherwise divert personal needs allowance funds for uses other than those meeting residents' personal needs. (2) The recommendations shall be provided to the chair of the health and welfare committee of the senate and the chair of the health committee of the house of representatives not later than January 15, 2025.
(1) The health facilities commission is directed to review, and revise as necessary, recommendations previously developed to protect nursing home residents from vendors and others who would seek to provide inappropriate or unneeded goods and services, or otherwise divert personal needs allowance funds for uses other than those meeting residents' personal needs.
(2) The recommendations shall be provided to the chair of the health and welfare committee of the senate and the chair of the health committee of the house of representatives not later than January 15, 2025.
Amended by 2024 Tenn. Acts, ch. 986,s 1, eff. 5/21/2024.
Acts 2004, ch. 851, §§ 1, 2; 2009 , ch. 592, § 1.
Tenn. Code Ann. § 71-5-1203 — TN Code / Title 71 / Chapter 5 / Section 71-5-1203
Tennessee opportunity pilot program grants
Status: in_force

(a) In fiscal year 2022, the department shall dedicate one hundred eighty-two million dollars ($182,000,000), subject to appropriations in the general appropriations act, from the department's existing surplus reserve of TANF funds to support the planning, implementation, and evaluation of four-year Tennessee opportunity pilot programs in six (6) communities and one (1) pilot program to be administered by the department with the goal of demonstrating the efficacy of well-implemented two-generation approaches to improving education, health, and economic outcomes for children and the adults in those children's lives. (b) (1) By July 1, 2021, the department shall dedicate up to five million dollars ($5,000,000), subject to appropriations in the general appropriations act, from the funds dedicated in subsection (a) for Tennessee opportunity pilot planning grants. The department shall award no more than fifty (50) planning grants. The following entities may apply for a planning grant: (A) A political subdivision of this state; (B) A nonprofit corporation, created pursuant to title 48; (C) A development district, created pursuant to the Development District Act of 1965, compiled in title 13, chapter 14; and (D) A human resource agency, created pursuant to the Human Resource Agency Act of 1973, compiled in title 13, chapter 26. (2) The department shall award the planning grants no earlier than October 1, 2021, in amounts up to five hundred thousand dollars ($500,000), subject to appropriations in the general appropriations act, to applicants that demonstrate commitment and capacity to create a compelling two-generation plan for increasing economic advancement and family well-being in the community. An application must include a detailed description of how the applicant intends to utilize evidence-based practices and evidence-informed practices, including, but not limited to: (A) Home visiting services; (B) High-quality child care programs and child care provider networks; (C) Wrap-around services; (D) After school and summer learning programs with curricula approved by the department of education; (E) Workforce training and apprenticeship programs; (F) Economic advancement supports, including transportation and housing; (G) High-quality data systems for accountability and continuous improvement; and (H) Other evidence-based and evidence-informed solutions identified by the community. (3) The department shall define and determine the grant application guidelines, award levels, and selection criteria. (4) The department shall select the planning grant recipient communities and ensure that the recipient communities represent a mix of urban, rural, and suburban populations in this state. (c) By May 1, 2022, and subject to subsection (d), the department shall award a four-year implementation grant up to twenty-five million dollars ($25,000,000), subject to appropriations in the general appropriations act, to each of six (6) implementation grantees selected from the planning grant recipients that submitted the most compelling and qualified Tennessee opportunity pilot program plans pursuant to subdivision (b)(1). The department shall distribute an implementation grant to each selected implementation grantee in an amount of twenty-five million dollars ($25,000,000), subject to appropriations in the general appropriations act, over four (4) years with no single recipient receiving more than twenty-five million dollars ($25,000,000) over the course of the pilot. (d) The department shall select the implementation grantees and ensure that there are two (2) implementation grantees from each grand division and that there is a mix of urban, rural, and suburban populations in this state. (e) No earlier than October 1, 2021, the department shall select and fund a research partner or partners that will support the research and evaluation of the Tennessee opportunity pilot programs. Selected partners shall utilize scientific approaches to research and evaluation, such as randomized controlled trials. (f) In the event the federal government deems planning grants to be administrative costs, the department must utilize its remaining fiscal capacity for administrative costs to provide the grants. The remainder of funds dedicated for planning grants must be reallocated across the six (6) pilot program grantees with approval of the advisory board. (g) The department is authorized to enter into, or amend an existing, grant contract or other contract as necessary to ensure successful implementation and completion of the Tennessee opportunity pilot program created by this section, except that the department shall not enter into or amend a contract in a manner that causes the contract to extend beyond December 31, 2026. Amended by 2024 Tenn. Acts, ch. 769,s 1, eff. 4/23/2024. Amended by 2023 Tenn. Acts, ch. 51, Secs.s 3, s 4 eff. 3/21/2023. Amended by 2021 Tenn. Acts, ch. 515, s 4, eff. 7/1/2021. Acts 1996, ch. 950, § 27; 1999, ch. 520, § 47.
(a) In fiscal year 2022, the department shall dedicate one hundred eighty-two million dollars ($182,000,000), subject to appropriations in the general appropriations act, from the department's existing surplus reserve of TANF funds to support the planning, implementation, and evaluation of four-year Tennessee opportunity pilot programs in six (6) communities and one (1) pilot program to be administered by the department with the goal of demonstrating the efficacy of well-implemented two-generation approaches to improving education, health, and economic outcomes for children and the adults in those children's lives.
(b) (1) By July 1, 2021, the department shall dedicate up to five million dollars ($5,000,000), subject to appropriations in the general appropriations act, from the funds dedicated in subsection (a) for Tennessee opportunity pilot planning grants. The department shall award no more than fifty (50) planning grants. The following entities may apply for a planning grant: (A) A political subdivision of this state; (B) A nonprofit corporation, created pursuant to title 48; (C) A development district, created pursuant to the Development District Act of 1965, compiled in title 13, chapter 14; and (D) A human resource agency, created pursuant to the Human Resource Agency Act of 1973, compiled in title 13, chapter 26. (2) The department shall award the planning grants no earlier than October 1, 2021, in amounts up to five hundred thousand dollars ($500,000), subject to appropriations in the general appropriations act, to applicants that demonstrate commitment and capacity to create a compelling two-generation plan for increasing economic advancement and family well-being in the community. An application must include a detailed description of how the applicant intends to utilize evidence-based practices and evidence-informed practices, including, but not limited to: (A) Home visiting services; (B) High-quality child care programs and child care provider networks; (C) Wrap-around services; (D) After school and summer learning programs with curricula approved by the department of education; (E) Workforce training and apprenticeship programs; (F) Economic advancement supports, including transportation and housing; (G) High-quality data systems for accountability and continuous improvement; and (H) Other evidence-based and evidence-informed solutions identified by the community. (3) The department shall define and determine the grant application guidelines, award levels, and selection criteria. (4) The department shall select the planning grant recipient communities and ensure that the recipient communities represent a mix of urban, rural, and suburban populations in this state.
(1) By July 1, 2021, the department shall dedicate up to five million dollars ($5,000,000), subject to appropriations in the general appropriations act, from the funds dedicated in subsection (a) for Tennessee opportunity pilot planning grants. The department shall award no more than fifty (50) planning grants. The following entities may apply for a planning grant: (A) A political subdivision of this state; (B) A nonprofit corporation, created pursuant to title 48; (C) A development district, created pursuant to the Development District Act of 1965, compiled in title 13, chapter 14; and (D) A human resource agency, created pursuant to the Human Resource Agency Act of 1973, compiled in title 13, chapter 26.
(A) A political subdivision of this state;
(B) A nonprofit corporation, created pursuant to title 48;
(C) A development district, created pursuant to the Development District Act of 1965, compiled in title 13, chapter 14; and
(D) A human resource agency, created pursuant to the Human Resource Agency Act of 1973, compiled in title 13, chapter 26.
(2) The department shall award the planning grants no earlier than October 1, 2021, in amounts up to five hundred thousand dollars ($500,000), subject to appropriations in the general appropriations act, to applicants that demonstrate commitment and capacity to create a compelling two-generation plan for increasing economic advancement and family well-being in the community. An application must include a detailed description of how the applicant intends to utilize evidence-based practices and evidence-informed practices, including, but not limited to: (A) Home visiting services; (B) High-quality child care programs and child care provider networks; (C) Wrap-around services; (D) After school and summer learning programs with curricula approved by the department of education; (E) Workforce training and apprenticeship programs; (F) Economic advancement supports, including transportation and housing; (G) High-quality data systems for accountability and continuous improvement; and (H) Other evidence-based and evidence-informed solutions identified by the community.
(A) Home visiting services;
(B) High-quality child care programs and child care provider networks;
(C) Wrap-around services;
(D) After school and summer learning programs with curricula approved by the department of education;
(E) Workforce training and apprenticeship programs;
(F) Economic advancement supports, including transportation and housing;
(G) High-quality data systems for accountability and continuous improvement; and
(H) Other evidence-based and evidence-informed solutions identified by the community.
(3) The department shall define and determine the grant application guidelines, award levels, and selection criteria.
(4) The department shall select the planning grant recipient communities and ensure that the recipient communities represent a mix of urban, rural, and suburban populations in this state.
(c) By May 1, 2022, and subject to subsection (d), the department shall award a four-year implementation grant up to twenty-five million dollars ($25,000,000), subject to appropriations in the general appropriations act, to each of six (6) implementation grantees selected from the planning grant recipients that submitted the most compelling and qualified Tennessee opportunity pilot program plans pursuant to subdivision (b)(1). The department shall distribute an implementation grant to each selected implementation grantee in an amount of twenty-five million dollars ($25,000,000), subject to appropriations in the general appropriations act, over four (4) years with no single recipient receiving more than twenty-five million dollars ($25,000,000) over the course of the pilot.
(d) The department shall select the implementation grantees and ensure that there are two (2) implementation grantees from each grand division and that there is a mix of urban, rural, and suburban populations in this state.
(e) No earlier than October 1, 2021, the department shall select and fund a research partner or partners that will support the research and evaluation of the Tennessee opportunity pilot programs. Selected partners shall utilize scientific approaches to research and evaluation, such as randomized controlled trials.
(f) In the event the federal government deems planning grants to be administrative costs, the department must utilize its remaining fiscal capacity for administrative costs to provide the grants. The remainder of funds dedicated for planning grants must be reallocated across the six (6) pilot program grantees with approval of the advisory board.
(g) The department is authorized to enter into, or amend an existing, grant contract or other contract as necessary to ensure successful implementation and completion of the Tennessee opportunity pilot program created by this section, except that the department shall not enter into or amend a contract in a manner that causes the contract to extend beyond December 31, 2026.
Amended by 2024 Tenn. Acts, ch. 769,s 1, eff. 4/23/2024.
Amended by 2023 Tenn. Acts, ch. 51, Secs.s 3, s 4 eff. 3/21/2023.
Amended by 2021 Tenn. Acts, ch. 515, s 4, eff. 7/1/2021.
Acts 1996, ch. 950, § 27; 1999, ch. 520, § 47.
Tenn. Code Ann. § 71-4-301 — TN Code / Title 71 / Chapter 4 / Section 71-4-301
Use of appropriation for home industries
Status: in_force

(a) The appropriation heretofore made by chapter 119 of the Public Acts of 1945 for the use and benefit of the department of human services shall be expended by the department for the purchase of raw materials and supplies to be used by blind persons in this state in home industries. (b) The director of services for the blind of the department has jurisdiction, under the supervision of the commissioner of human services, of the expenditure and repayment of such funds. (c) Despite any law to the contrary, purchases of such material by the director of services for the blind may be made without the necessity of taking bids for the purchases, advertisement for such bids or other restrictions now governing the purchases of materials generally on behalf of the state. Acts 1945, ch. 119, § 1; mod. C. Supp. 1950, § 4765.79 (Williams, § 4765.78); impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A. (orig. ed.), §§ 14-614, 14-14-201.
(a) The appropriation heretofore made by chapter 119 of the Public Acts of 1945 for the use and benefit of the department of human services shall be expended by the department for the purchase of raw materials and supplies to be used by blind persons in this state in home industries.
(b) The director of services for the blind of the department has jurisdiction, under the supervision of the commissioner of human services, of the expenditure and repayment of such funds.
(c) Despite any law to the contrary, purchases of such material by the director of services for the blind may be made without the necessity of taking bids for the purchases, advertisement for such bids or other restrictions now governing the purchases of materials generally on behalf of the state.
Acts 1945, ch. 119, § 1; mod. C. Supp. 1950, § 4765.79 (Williams, § 4765.78); impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A. (orig. ed.), §§ 14-614, 14-14-201.
Tenn. Code Ann. § 71-5-145 — TN Code / Title 71 / Chapter 5 / Section 71-5-145
Cost effectiveness of providers
Status: in_force

(a) Notwithstanding any law to the contrary, any initiative, program or measure operated by the bureau of TennCare, including, but not limited to, disease management programs, may require enrollees to obtain prescription drugs, durable medical equipment, or medical supplies in such manner as the bureau of TennCare determines to be the most cost-effective. (b) The bureau of TennCare shall consult with Tennessee pharmacists who are providers actively participating in the TennCare pharmacy program in making a determination of cost effectiveness of any proposed pharmacy program. Acts 2004, ch. 673, § 23.
(a) Notwithstanding any law to the contrary, any initiative, program or measure operated by the bureau of TennCare, including, but not limited to, disease management programs, may require enrollees to obtain prescription drugs, durable medical equipment, or medical supplies in such manner as the bureau of TennCare determines to be the most cost-effective.
(b) The bureau of TennCare shall consult with Tennessee pharmacists who are providers actively participating in the TennCare pharmacy program in making a determination of cost effectiveness of any proposed pharmacy program.
Acts 2004, ch. 673, § 23.
Tenn. Code Ann. § 71-5-1415 — TN Code / Title 71 / Chapter 5 / Section 71-5-1415
Quality assurance and quality improvement strategies
Status: in_force

The commissioner shall develop and implement quality assurance and quality improvement strategies to ensure the quality of long-term care services provided pursuant to this part and shall specify in contractor risk agreements with contractors responsible for coordination of medicaid primary, acute and long-term care services requirements related to the quality of long-term care services provided. The strategies may include the use of electronic visit verification for data collection and reporting, HEDIS measures pertaining to long-term care services, and shall include mechanisms to ensure direct feedback from members and family or other caregivers regarding the quality of services received. The commissioner shall ensure that recipients of long-term care services are notified how to contact the bureau of TennCare if they have concerns about the long-term care services they are or are not receiving and the process for resolving such issues. Acts 2008, ch. 1190, § 16.
The commissioner shall develop and implement quality assurance and quality improvement strategies to ensure the quality of long-term care services provided pursuant to this part and shall specify in contractor risk agreements with contractors responsible for coordination of medicaid primary, acute and long-term care services requirements related to the quality of long-term care services provided. The strategies may include the use of electronic visit verification for data collection and reporting, HEDIS measures pertaining to long-term care services, and shall include mechanisms to ensure direct feedback from members and family or other caregivers regarding the quality of services received. The commissioner shall ensure that recipients of long-term care services are notified how to contact the bureau of TennCare if they have concerns about the long-term care services they are or are not receiving and the process for resolving such issues.
Acts 2008, ch. 1190, § 16.
Tenn. Code Ann. § 71-5-110 — TN Code / Title 71 / Chapter 5 / Section 71-5-110
Application for medical assistance - Application for TennCare enrollment - Notice of change in application information
Status: in_force

(a) An applicant for medical assistance under this part, or a person acting in the applicant's behalf, shall file the application in a place and manner as may be designated by the department of health or the department of human services as may be designated by the governor. (b) Any application for TennCare enrollment shall include the applicant's legal place of residence in addition to the applicant's address, if the address is different from the applicant's legal place of residence or is or contains a post office box number, and a telephone number. The inability to provide a legal place of residence or telephone number due to homelessness shall not, in itself, preclude eligibility. To the extent permitted by federal law, the application of a self-employed individual for medical assistance as a part of the TennCare program shall include a copy of the individual's most recent federal income tax return or, if the individual's business is newly established, documentation deemed sufficient by the bureau of TennCare or the department of human services to project self-employment earnings pending completion of the upcoming year's income tax return. (c) (1) Unless expressly exempted by rule of the department from reporting under this section, each enrollee in and applicant for TennCare uninsured or uninsurable coverage, including a person who applies on behalf of a family member, shall notify the bureau of any material change affecting any information given to the bureau or the bureau's designee on or with the person's TennCare application. The enrollee or applicant shall be responsible for mailing documentation of any such change within thirty (30) days of any change. The bureau shall update the person's file to reflect such changes. An enrollee or applicant, including a person who applies on behalf of a family member, commits the offense of theft of services under title 39, chapter 14, who intentionally fails to so notify the bureau of any material change that would, if properly reported, result in ineligibility or an increase in the amount of any premium or cost sharing. (2) The department shall ensure that application forms for TennCare uninsured or uninsurable coverage under this part used after July 1, 2000, apprise applicants of the requirements of this chapter. Acts 1968, ch. 551, § 10; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., § 14-1910; Acts 1982, ch. 730, § 10; T.C.A., § 14-23-110; Acts 1999, ch. 139, § 1; 2000, ch. 853, § 3; 2002, ch. 880, §§ 6, 15; 2004, ch. 673, § 9.
(a) An applicant for medical assistance under this part, or a person acting in the applicant's behalf, shall file the application in a place and manner as may be designated by the department of health or the department of human services as may be designated by the governor.
(b) Any application for TennCare enrollment shall include the applicant's legal place of residence in addition to the applicant's address, if the address is different from the applicant's legal place of residence or is or contains a post office box number, and a telephone number. The inability to provide a legal place of residence or telephone number due to homelessness shall not, in itself, preclude eligibility. To the extent permitted by federal law, the application of a self-employed individual for medical assistance as a part of the TennCare program shall include a copy of the individual's most recent federal income tax return or, if the individual's business is newly established, documentation deemed sufficient by the bureau of TennCare or the department of human services to project self-employment earnings pending completion of the upcoming year's income tax return.
(c) (1) Unless expressly exempted by rule of the department from reporting under this section, each enrollee in and applicant for TennCare uninsured or uninsurable coverage, including a person who applies on behalf of a family member, shall notify the bureau of any material change affecting any information given to the bureau or the bureau's designee on or with the person's TennCare application. The enrollee or applicant shall be responsible for mailing documentation of any such change within thirty (30) days of any change. The bureau shall update the person's file to reflect such changes. An enrollee or applicant, including a person who applies on behalf of a family member, commits the offense of theft of services under title 39, chapter 14, who intentionally fails to so notify the bureau of any material change that would, if properly reported, result in ineligibility or an increase in the amount of any premium or cost sharing. (2) The department shall ensure that application forms for TennCare uninsured or uninsurable coverage under this part used after July 1, 2000, apprise applicants of the requirements of this chapter.
(1) Unless expressly exempted by rule of the department from reporting under this section, each enrollee in and applicant for TennCare uninsured or uninsurable coverage, including a person who applies on behalf of a family member, shall notify the bureau of any material change affecting any information given to the bureau or the bureau's designee on or with the person's TennCare application. The enrollee or applicant shall be responsible for mailing documentation of any such change within thirty (30) days of any change. The bureau shall update the person's file to reflect such changes. An enrollee or applicant, including a person who applies on behalf of a family member, commits the offense of theft of services under title 39, chapter 14, who intentionally fails to so notify the bureau of any material change that would, if properly reported, result in ineligibility or an increase in the amount of any premium or cost sharing.
(2) The department shall ensure that application forms for TennCare uninsured or uninsurable coverage under this part used after July 1, 2000, apprise applicants of the requirements of this chapter.
Acts 1968, ch. 551, § 10; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., § 14-1910; Acts 1982, ch. 730, § 10; T.C.A., § 14-23-110; Acts 1999, ch. 139, § 1; 2000, ch. 853, § 3; 2002, ch. 880, §§ 6, 15; 2004, ch. 673, § 9.
Tenn. Code Ann. § 71-1-122 — TN Code / Title 71 / Chapter 1 / Section 71-1-122
Review of human services advisory committees
Status: in_force

The human services advisory committees appointed by the commissioner shall periodically be subject to review pursuant to the governmental entity review law, compiled in title 4, chapter 29, simultaneously with, and as an adjunct to, the department. Acts 1985, ch. 127, § 3; T.C.A., § 14-1-122.
The human services advisory committees appointed by the commissioner shall periodically be subject to review pursuant to the governmental entity review law, compiled in title 4, chapter 29, simultaneously with, and as an adjunct to, the department.
Acts 1985, ch. 127, § 3; T.C.A., § 14-1-122.
Tenn. Code Ann. § 71-5-185 — TN Code / Title 71 / Chapter 5 / Section 71-5-185
Venue
Status: in_force

Any action under § 71-5-183 may be brought in any judicial district in which the defendant or, in the case of multiple defendants, any one (1) defendant can be found, resides, transacts business, or in which any act proscribed by § 71-5-182 occurred. A summons as required by the Rules of Civil Procedure shall be issued by the appropriate district court and served at any place within or outside the United States. Acts 1993, ch. 364, § 5.
Any action under § 71-5-183 may be brought in any judicial district in which the defendant or, in the case of multiple defendants, any one (1) defendant can be found, resides, transacts business, or in which any act proscribed by § 71-5-182 occurred. A summons as required by the Rules of Civil Procedure shall be issued by the appropriate district court and served at any place within or outside the United States.
Acts 1993, ch. 364, § 5.
Tenn. Code Ann. § 71-5-1502 — TN Code / Title 71 / Chapter 5 / Section 71-5-1502
Part definitions
Status: in_force

As used in this part: (1) "Ambulance provider" means a public or private ground-based ambulance service, other than an ambulance service based on federal property, that bills for transports and has a base of operations within this state; (2) "Assessment" means the medicaid ambulance provider assessment established by this part; (3) "Bureau" means the bureau of TennCare; (4) "Medicaid transport" means qualifying ground ambulance services approved by CMS, and consistent with services identified in 42 CFR 433.56 , and paid by medicaid, as recorded by the managed care organization under contract to the bureau; (5) "Net operating revenue" means all revenues, regardless of payer source, collected by ambulance providers for patient services excluding charity care or any other uncompensated patient services, in accordance with 42 CFR 433.68 ; (6) "Office of emergency medical services" means the office of emergency medical services within the department of health; and (7) "Taxable transports" means the total ground ambulance transports reported during the base period by a provider to the office of emergency medical services that qualify as a permissible service to impose a healthcare-related provider assessment pursuant to 42 CFR 433.56 . Amended by 2022 Tenn. Acts, ch. 1052, s 1, eff. 5/25/2022. Amended by 2018 Tenn. Acts, ch. 874, s 1, eff. 7/1/2018. Added by 2017 Tenn. Acts, ch. 258, s 1, eff. 7/1/2017.
As used in this part:
(1) "Ambulance provider" means a public or private ground-based ambulance service, other than an ambulance service based on federal property, that bills for transports and has a base of operations within this state;
(2) "Assessment" means the medicaid ambulance provider assessment established by this part;
(3) "Bureau" means the bureau of TennCare;
(4) "Medicaid transport" means qualifying ground ambulance services approved by CMS, and consistent with services identified in 42 CFR 433.56 , and paid by medicaid, as recorded by the managed care organization under contract to the bureau;
(5) "Net operating revenue" means all revenues, regardless of payer source, collected by ambulance providers for patient services excluding charity care or any other uncompensated patient services, in accordance with 42 CFR 433.68 ;
(6) "Office of emergency medical services" means the office of emergency medical services within the department of health; and
(7) "Taxable transports" means the total ground ambulance transports reported during the base period by a provider to the office of emergency medical services that qualify as a permissible service to impose a healthcare-related provider assessment pursuant to 42 CFR 433.56 .
Amended by 2022 Tenn. Acts, ch. 1052, s 1, eff. 5/25/2022.
Amended by 2018 Tenn. Acts, ch. 874, s 1, eff. 7/1/2018.
Added by 2017 Tenn. Acts, ch. 258, s 1, eff. 7/1/2017.
Tenn. Code Ann. § 71-5-151 — TN Code / Title 71 / Chapter 5 / Section 71-5-151
Report on use of technical assistance groups of healthcare providers in developing episode of care
Status: in_force

(a) In developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare or the health care finance and administration (HCFA) of the department of finance and administration, the bureau and HCFA shall report on the use of technical assistance groups of healthcare providers in developing any episode of care. The reports shall include all recommendations made by technical assistance groups throughout the period of implementation of any episode of care. In addition to any other information required in the quarterly report to the general assembly pursuant to § 71-5-104(c) , the bureau of TennCare shall summarize in quarterly reports the recommendations of any technical assistance group concerning the payment reform initiative and identify any action taken by the bureau or HCFA to address those recommendations. The bureau and HCFA shall report to the health and welfare committee of the senate and the health committee of the house of representatives by July 1 each year, beginning in 2016, specifically concerning the use of technical assistance groups, on each recommendation made by those groups, and the response by the bureau or HCFA to each recommendation. This section shall apply to any payment reform initiative utilizing episodes of care, including any initiative receiving a state innovation model initiative grant from the federal centers for medicare and medicaid services. (b) In developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare or the HCFA of the department of finance and administration, the bureau and HCFA shall not impose a fine or penalty on any provider. The bureau and HCFA may impose withholds in order to recover some portion of costs that exceeds a cost threshold for an episode developed by the initiative. A withhold may not be called a fine or a penalty. (c) (1) The bureau of TennCare and the HCFA shall study the means of fair and just implementation of the episodes of care initiatives, especially with respect to costs associated with: (A) A healthcare facility located in an area that lacks an alternative healthcare facility within a thirty-minute drive; (B) Lack of more than a single provider of healthcare services for, including, but not limited to, radiology, anesthesia, pathology, or physical therapy; and (C) Contractual arrangements between the bureau of TennCare, managed care organizations, and other participating providers or healthcare facilities associated with the particular episode of care if such contracts are the cause of increased costs. (2) No later than January 31, 2019, the bureau of TennCare and HCFA shall report the results of the study conducted pursuant to this subsection (c) to the health and welfare committee of the senate and the health committee of the house of representatives. (d) (1) In developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare, a healthcare provider shall not be required to pay the portion of the risk sharing payment that is attributable to the increased cost of pain relief services if the following conditions are met: (A) The healthcare provider is required to make an episodes of care risk-sharing payment to a managed care organization; (B) Some portion of the episode costs were due to pain relief services; (C) The pain relief services provided to the patient were more expensive than an alternative pain relief service; and (D) The provider can demonstrate that the pain relief services provided to the patient had the effect of reducing opioid use by the patient relative to an alternative pain relief service routinely used by other providers in the episode. (2) The bureau of TennCare is authorized to promulgate rules, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as may be necessary to implement this section. (e) On and after July 1, 2018, in developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare or the HCFA of the department of finance and administration, the bureau and the HCFA shall exclude anxiety episodes and non-emergent depression episodes from the initiative. This subsection (e) shall apply to any initiative receiving a state innovation model initiative grant from the federal centers for medicare and medicaid services. Amended by 2021 Tenn. Acts, ch. 64, s 123, eff. 3/29/2021. Amended by 2019 Tenn. Acts, ch. 345, s 137, eff. 5/10/2019. Amended by 2018 Tenn. Acts, ch. 843, s 1, eff. 7/1/2018. Amended by 2018 Tenn. Acts, ch. 766, s 1, eff. 7/1/2018. Added by 2016 Tenn. Acts, ch. 1079, s 2, eff. 7/1/2016.
(a) In developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare or the health care finance and administration (HCFA) of the department of finance and administration, the bureau and HCFA shall report on the use of technical assistance groups of healthcare providers in developing any episode of care. The reports shall include all recommendations made by technical assistance groups throughout the period of implementation of any episode of care. In addition to any other information required in the quarterly report to the general assembly pursuant to § 71-5-104(c) , the bureau of TennCare shall summarize in quarterly reports the recommendations of any technical assistance group concerning the payment reform initiative and identify any action taken by the bureau or HCFA to address those recommendations. The bureau and HCFA shall report to the health and welfare committee of the senate and the health committee of the house of representatives by July 1 each year, beginning in 2016, specifically concerning the use of technical assistance groups, on each recommendation made by those groups, and the response by the bureau or HCFA to each recommendation. This section shall apply to any payment reform initiative utilizing episodes of care, including any initiative receiving a state innovation model initiative grant from the federal centers for medicare and medicaid services.
(b) In developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare or the HCFA of the department of finance and administration, the bureau and HCFA shall not impose a fine or penalty on any provider. The bureau and HCFA may impose withholds in order to recover some portion of costs that exceeds a cost threshold for an episode developed by the initiative. A withhold may not be called a fine or a penalty.
(c) (1) The bureau of TennCare and the HCFA shall study the means of fair and just implementation of the episodes of care initiatives, especially with respect to costs associated with: (A) A healthcare facility located in an area that lacks an alternative healthcare facility within a thirty-minute drive; (B) Lack of more than a single provider of healthcare services for, including, but not limited to, radiology, anesthesia, pathology, or physical therapy; and (C) Contractual arrangements between the bureau of TennCare, managed care organizations, and other participating providers or healthcare facilities associated with the particular episode of care if such contracts are the cause of increased costs. (2) No later than January 31, 2019, the bureau of TennCare and HCFA shall report the results of the study conducted pursuant to this subsection (c) to the health and welfare committee of the senate and the health committee of the house of representatives.
(1) The bureau of TennCare and the HCFA shall study the means of fair and just implementation of the episodes of care initiatives, especially with respect to costs associated with: (A) A healthcare facility located in an area that lacks an alternative healthcare facility within a thirty-minute drive; (B) Lack of more than a single provider of healthcare services for, including, but not limited to, radiology, anesthesia, pathology, or physical therapy; and (C) Contractual arrangements between the bureau of TennCare, managed care organizations, and other participating providers or healthcare facilities associated with the particular episode of care if such contracts are the cause of increased costs.
(A) A healthcare facility located in an area that lacks an alternative healthcare facility within a thirty-minute drive;
(B) Lack of more than a single provider of healthcare services for, including, but not limited to, radiology, anesthesia, pathology, or physical therapy; and
(C) Contractual arrangements between the bureau of TennCare, managed care organizations, and other participating providers or healthcare facilities associated with the particular episode of care if such contracts are the cause of increased costs.
(2) No later than January 31, 2019, the bureau of TennCare and HCFA shall report the results of the study conducted pursuant to this subsection (c) to the health and welfare committee of the senate and the health committee of the house of representatives.
(d) (1) In developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare, a healthcare provider shall not be required to pay the portion of the risk sharing payment that is attributable to the increased cost of pain relief services if the following conditions are met: (A) The healthcare provider is required to make an episodes of care risk-sharing payment to a managed care organization; (B) Some portion of the episode costs were due to pain relief services; (C) The pain relief services provided to the patient were more expensive than an alternative pain relief service; and (D) The provider can demonstrate that the pain relief services provided to the patient had the effect of reducing opioid use by the patient relative to an alternative pain relief service routinely used by other providers in the episode. (2) The bureau of TennCare is authorized to promulgate rules, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as may be necessary to implement this section.
(1) In developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare, a healthcare provider shall not be required to pay the portion of the risk sharing payment that is attributable to the increased cost of pain relief services if the following conditions are met: (A) The healthcare provider is required to make an episodes of care risk-sharing payment to a managed care organization; (B) Some portion of the episode costs were due to pain relief services; (C) The pain relief services provided to the patient were more expensive than an alternative pain relief service; and (D) The provider can demonstrate that the pain relief services provided to the patient had the effect of reducing opioid use by the patient relative to an alternative pain relief service routinely used by other providers in the episode.
(A) The healthcare provider is required to make an episodes of care risk-sharing payment to a managed care organization;
(B) Some portion of the episode costs were due to pain relief services;
(C) The pain relief services provided to the patient were more expensive than an alternative pain relief service; and
(D) The provider can demonstrate that the pain relief services provided to the patient had the effect of reducing opioid use by the patient relative to an alternative pain relief service routinely used by other providers in the episode.
(2) The bureau of TennCare is authorized to promulgate rules, pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as may be necessary to implement this section.
(e) On and after July 1, 2018, in developing or implementing any payment reform initiative involving the use of episodes of care with respect to medical assistance provided under this chapter by the bureau of TennCare or the HCFA of the department of finance and administration, the bureau and the HCFA shall exclude anxiety episodes and non-emergent depression episodes from the initiative. This subsection (e) shall apply to any initiative receiving a state innovation model initiative grant from the federal centers for medicare and medicaid services.
Amended by 2021 Tenn. Acts, ch. 64, s 123, eff. 3/29/2021.
Amended by 2019 Tenn. Acts, ch. 345, s 137, eff. 5/10/2019.
Amended by 2018 Tenn. Acts, ch. 843, s 1, eff. 7/1/2018.
Amended by 2018 Tenn. Acts, ch. 766, s 1, eff. 7/1/2018.
Added by 2016 Tenn. Acts, ch. 1079, s 2, eff. 7/1/2016.
Tenn. Code Ann. § 71-5-2301 — TN Code / Title 71 / Chapter 5 / Section 71-5-2301
Allowances by county legislative body
Status: in_force

The county legislative body may, in its discretion, allow and pay to poor persons who may become chargeable as paupers, and who will probably be benefited thereby, such sums or such annual allowance, to be paid according to the direction of the legislative body, as will not exceed the charge of their maintenance in the ordinary mode. Code 1858, § 1621; Shan., § 2705; Code 1932, § 4821; impl. am. Acts 1978, ch. 934, §§ 7, 36; T.C.A. (orig. ed.), §§ 14-1001, 14-20-301.
The county legislative body may, in its discretion, allow and pay to poor persons who may become chargeable as paupers, and who will probably be benefited thereby, such sums or such annual allowance, to be paid according to the direction of the legislative body, as will not exceed the charge of their maintenance in the ordinary mode.
Code 1858, § 1621; Shan., § 2705; Code 1932, § 4821; impl. am. Acts 1978, ch. 934, §§ 7, 36; T.C.A. (orig. ed.), §§ 14-1001, 14-20-301.
Tenn. Code Ann. § 71-3-1103 — TN Code / Title 71 / Chapter 3 / Section 71-3-1103
[Effective until 6/30/2025. See T.C.A. 71-3-1113] Purpose
Status: in_force

The purpose of this part is to create a program to provide health care coverage for uninsured children who are not eligible for health care services under any part of Tennessee's medicaid program, either pursuant to the medicaid state plan or pursuant to any medicaid waivers secured by the bureau of TennCare. It is the intent of the legislature to create and fund a program separate from the Tennessee medicaid program and Title XIX ( 42 U.S.C. § 1396 et seq.), and not subject to any consent decrees or judicial orders applicable to the Tennessee medicaid program. Acts 2006, ch. 867, § 7.
The purpose of this part is to create a program to provide health care coverage for uninsured children who are not eligible for health care services under any part of Tennessee's medicaid program, either pursuant to the medicaid state plan or pursuant to any medicaid waivers secured by the bureau of TennCare. It is the intent of the legislature to create and fund a program separate from the Tennessee medicaid program and Title XIX ( 42 U.S.C. § 1396 et seq.), and not subject to any consent decrees or judicial orders applicable to the Tennessee medicaid program.
Acts 2006, ch. 867, § 7.
Tenn. Code Ann. § 71-5-2505 — TN Code / Title 71 / Chapter 5 / Section 71-5-2505
Authority
Status: in_force

The office of inspector general shall have the authority to: (1) Investigate civil and criminal fraud and abuse of the TennCare program, or any other violations of state criminal law related to the operation of TennCare; (2) Cooperate with the MFCU, and where a preliminary investigation of fraud and abuse by a provider establishes a sufficient basis to warrant a full investigation, refer such matters to the MFCU; (3) Refer matters to the appropriate enforcement authority for criminal prosecution; (4) Refer matters to the appropriate enforcement authorities for civil proceedings, and assist in the recovery of funds which have been inappropriately paid by the TennCare program, including, but not limited to, referral to the attorney general and reporter for civil recovery; (5) Cooperate with the appropriate federal departments in any reasonable manner as may be necessary to qualify for federal aid in connection with TennCare; (6) Cooperate with the federal government and other state governments to investigate TennCare and medicaid fraud and abuse; (7) Cooperate with other state agencies to investigate TennCare and medicaid fraud and abuse; (8) Within sixty (60) days after the close of each fiscal year, prepare and print a summary report, which shall be submitted to the governor, members of the general assembly, the TennCare advisory commission, and the commissioner. This report shall include a summary of all activities of the office of inspector general during that fiscal year; (9) Furnish information to acquaint the public with the fraud and abuse laws pertaining to TennCare; (10) Contract with necessary entities to carry out the required duties of this part. All such contracts shall be procured in accordance with the requirements of title 12, chapter 4, part 1; and (11) Exercise any additional powers necessary to carry out the purposes and provisions of this part. Amended by 2021 Tenn. Acts, ch. 64, s 127, eff. 3/29/2021. Amended by 2019 Tenn. Acts, ch. 345, s 142, eff. 5/10/2019. Acts 2004, ch. 673, § 20; 2005, ch. 474, § 8; 2006, ch. 867, § 8; 2010 , ch. 872, § 7; 2011 , ch. 410, § 6 (g).
The office of inspector general shall have the authority to:
(1) Investigate civil and criminal fraud and abuse of the TennCare program, or any other violations of state criminal law related to the operation of TennCare;
(2) Cooperate with the MFCU, and where a preliminary investigation of fraud and abuse by a provider establishes a sufficient basis to warrant a full investigation, refer such matters to the MFCU;
(3) Refer matters to the appropriate enforcement authority for criminal prosecution;
(4) Refer matters to the appropriate enforcement authorities for civil proceedings, and assist in the recovery of funds which have been inappropriately paid by the TennCare program, including, but not limited to, referral to the attorney general and reporter for civil recovery;
(5) Cooperate with the appropriate federal departments in any reasonable manner as may be necessary to qualify for federal aid in connection with TennCare;
(6) Cooperate with the federal government and other state governments to investigate TennCare and medicaid fraud and abuse;
(7) Cooperate with other state agencies to investigate TennCare and medicaid fraud and abuse;
(8) Within sixty (60) days after the close of each fiscal year, prepare and print a summary report, which shall be submitted to the governor, members of the general assembly, the TennCare advisory commission, and the commissioner. This report shall include a summary of all activities of the office of inspector general during that fiscal year;
(9) Furnish information to acquaint the public with the fraud and abuse laws pertaining to TennCare;
(10) Contract with necessary entities to carry out the required duties of this part. All such contracts shall be procured in accordance with the requirements of title 12, chapter 4, part 1; and
(11) Exercise any additional powers necessary to carry out the purposes and provisions of this part.
Amended by 2021 Tenn. Acts, ch. 64, s 127, eff. 3/29/2021.
Amended by 2019 Tenn. Acts, ch. 345, s 142, eff. 5/10/2019.
Acts 2004, ch. 673, § 20; 2005, ch. 474, § 8; 2006, ch. 867, § 8; 2010 , ch. 872, § 7; 2011 , ch. 410, § 6 (g).
Tenn. Code Ann. § 71-4-802 — TN Code / Title 71 / Chapter 4 / Section 71-4-802
Purpose of part
Status: in_force

The purpose of this part is to authorize the establishment of a qualified ABLE program as an agency or instrumentality of the state to assist an eligible individual in saving money to meet the eligible individual's qualified disability expenses. The intent of the program is to encourage and assist individuals and families to save private funds for the purpose of supporting individuals with disabilities to maintain health, independence, and quality of life. Acts 2015, ch. 470, § 2.
The purpose of this part is to authorize the establishment of a qualified ABLE program as an agency or instrumentality of the state to assist an eligible individual in saving money to meet the eligible individual's qualified disability expenses. The intent of the program is to encourage and assist individuals and families to save private funds for the purpose of supporting individuals with disabilities to maintain health, independence, and quality of life.
Acts 2015, ch. 470, § 2.
Tenn. Code Ann. § 71-4-805 — TN Code / Title 71 / Chapter 4 / Section 71-4-805
Authority of state treasurer
Status: in_force

The state treasurer has the following powers and authorities necessary and convenient to carry out the purposes and provisions of this part, the purposes and objectives of the program and the trustees' plan, and the powers delegated by any other law of this state and the code, including, but not limited to, the following express powers: (1) Provide investment options or investment products for eligible individuals who have established an ABLE account; (2) Purchase insurance from insurers licensed to do business in this state providing for coverage against any loss in connection with the program's property, assets, or activities; (3) Make, execute, and deliver contracts, conveyances, and other instruments necessary and proper for the implementation of the program; (4) Contract for the provision of all or any part of the services necessary for the administration, implementation, operation, or management of the program; (5) Enter into a contract with another state that has a qualified ABLE program as a contracting state in order to provide similar benefits to Tennessee residents, or allow residents of other states to participate in a Tennessee qualified ABLE program; (6) Contract with financial consultants, actuaries, auditors, investment managers, and other consultants and professionals as necessary to carry out the duties and responsibilities under this part and the plan established by the trustees. These services may be procured in a manner prescribed by the trustees without regard to the requirements of former § 12-4-109 , if the trustees determine that the services are necessary or desirable for the efficient administration of this part. All expenses and fees incidental to the procurement of services shall be charged to and paid from participant accounts; (7) Administer or operate the program at the direction of the trustees' plan; (8) Promote, advertise, market, and publicize the program; (9) Solicit and accept monetary gifts made by will, trust, or other disposition, grants, loans, and other monetary aids from any personal source or participate in any other way in any federal, state, or local governmental programs in carrying out the purpose of this part; (10) Establish and impose reasonable residency requirements for designated beneficiaries that must be met by the designated beneficiary prior to establishing an account; (11) Establish and impose reasonable limits on the number of accounts; (12) Establish and impose limits on contributions that may be made by or on behalf of a designated beneficiary; (13) Provide adequate safeguards to prevent aggregate contributions on behalf of a designated beneficiary in excess of the contribution limitations established by the trustees; (14) Establish and impose restrictions for a change in or substitution of designated beneficiaries; (15) Establish and impose limitations on distributions and rollovers from the account used for qualified disability expenses; (16) Establish and impose restrictions or conditions on the transfer of account ownership; (17) Establish and impose restrictions on the investment direction of deposits in an account and the interest earned thereon; (18) Determine the disposition of an account upon the designated beneficiary's death or the abandonment of an account; (19) Enter into memoranda of understanding with appropriate state agencies to develop, implement, and market educational programs and related informational materials to inform individuals with disabilities and their legal representatives about the ABLE program; (20) Impose and collect application fees and other administrative fees and charges in connection with any transaction under this part; (21) Promulgate reasonable rules as are necessary to carry out the purpose and intent of this part, and to ensure that the program is in compliance with the code and other applicable provisions of federal or state laws or rules. All such rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5; (22) Enter into participation agreements with eligible individuals or an eligible individual's legal representative; (23) Define the terms and conditions under which payments may be withdrawn from the program and impose reasonable charges for withdrawal; (24) Enter into agreements with any public or private employer under which an employee may agree to have a designated amount deducted in each payroll period from the wages or salary due the employee for the purpose of making contributions to an account pursuant to a participation agreement. The agreement shall be subject to the approval of the trustees and in conformity with such terms and conditions as determined by the trustees. In the event the agreement is approved by the trustees, the employer shall be responsible for submitting to the trustees such information and for performing the duties prescribed by the trustees to implement its employee contributions to an account by payroll deduction. All costs and expenses incidental to implementing and administering a payroll deduction program shall be borne by the respective employer; (25) Operate and provide for the operation of the program in a manner that qualifies the program under the code and takes any and all necessary action to maintain such qualification; provided, that the account owner's rights to fund the respective accounts shall not be limited or impaired; (26) Seek rulings from the secretary of the United States department of the treasury and the internal revenue service relating to the program; and (27) Make changes to the program that are required for eligible individuals to obtain federal income tax benefits or treatment provided by the code. Acts 2015, ch. 470, § 5.
The state treasurer has the following powers and authorities necessary and convenient to carry out the purposes and provisions of this part, the purposes and objectives of the program and the trustees' plan, and the powers delegated by any other law of this state and the code, including, but not limited to, the following express powers:
(1) Provide investment options or investment products for eligible individuals who have established an ABLE account;
(2) Purchase insurance from insurers licensed to do business in this state providing for coverage against any loss in connection with the program's property, assets, or activities;
(3) Make, execute, and deliver contracts, conveyances, and other instruments necessary and proper for the implementation of the program;
(4) Contract for the provision of all or any part of the services necessary for the administration, implementation, operation, or management of the program;
(5) Enter into a contract with another state that has a qualified ABLE program as a contracting state in order to provide similar benefits to Tennessee residents, or allow residents of other states to participate in a Tennessee qualified ABLE program;
(6) Contract with financial consultants, actuaries, auditors, investment managers, and other consultants and professionals as necessary to carry out the duties and responsibilities under this part and the plan established by the trustees. These services may be procured in a manner prescribed by the trustees without regard to the requirements of former § 12-4-109 , if the trustees determine that the services are necessary or desirable for the efficient administration of this part. All expenses and fees incidental to the procurement of services shall be charged to and paid from participant accounts;
(7) Administer or operate the program at the direction of the trustees' plan;
(8) Promote, advertise, market, and publicize the program;
(9) Solicit and accept monetary gifts made by will, trust, or other disposition, grants, loans, and other monetary aids from any personal source or participate in any other way in any federal, state, or local governmental programs in carrying out the purpose of this part;
(10) Establish and impose reasonable residency requirements for designated beneficiaries that must be met by the designated beneficiary prior to establishing an account;
(11) Establish and impose reasonable limits on the number of accounts;
(12) Establish and impose limits on contributions that may be made by or on behalf of a designated beneficiary;
(13) Provide adequate safeguards to prevent aggregate contributions on behalf of a designated beneficiary in excess of the contribution limitations established by the trustees;
(14) Establish and impose restrictions for a change in or substitution of designated beneficiaries;
(15) Establish and impose limitations on distributions and rollovers from the account used for qualified disability expenses;
(16) Establish and impose restrictions or conditions on the transfer of account ownership;
(17) Establish and impose restrictions on the investment direction of deposits in an account and the interest earned thereon;
(18) Determine the disposition of an account upon the designated beneficiary's death or the abandonment of an account;
(19) Enter into memoranda of understanding with appropriate state agencies to develop, implement, and market educational programs and related informational materials to inform individuals with disabilities and their legal representatives about the ABLE program;
(20) Impose and collect application fees and other administrative fees and charges in connection with any transaction under this part;
(21) Promulgate reasonable rules as are necessary to carry out the purpose and intent of this part, and to ensure that the program is in compliance with the code and other applicable provisions of federal or state laws or rules. All such rules shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5;
(22) Enter into participation agreements with eligible individuals or an eligible individual's legal representative;
(23) Define the terms and conditions under which payments may be withdrawn from the program and impose reasonable charges for withdrawal;
(24) Enter into agreements with any public or private employer under which an employee may agree to have a designated amount deducted in each payroll period from the wages or salary due the employee for the purpose of making contributions to an account pursuant to a participation agreement. The agreement shall be subject to the approval of the trustees and in conformity with such terms and conditions as determined by the trustees. In the event the agreement is approved by the trustees, the employer shall be responsible for submitting to the trustees such information and for performing the duties prescribed by the trustees to implement its employee contributions to an account by payroll deduction. All costs and expenses incidental to implementing and administering a payroll deduction program shall be borne by the respective employer;
(25) Operate and provide for the operation of the program in a manner that qualifies the program under the code and takes any and all necessary action to maintain such qualification; provided, that the account owner's rights to fund the respective accounts shall not be limited or impaired;
(26) Seek rulings from the secretary of the United States department of the treasury and the internal revenue service relating to the program; and
(27) Make changes to the program that are required for eligible individuals to obtain federal income tax benefits or treatment provided by the code.
Acts 2015, ch. 470, § 5.
Tenn. Code Ann. § 71-1-118 — TN Code / Title 71 / Chapter 1 / Section 71-1-118
Restrictions on use of welfare list
Status: in_force

(a) The welfare lists referred to in § 71-1-117 cannot be used for political or commercial purposes and no one will be permitted to copy such a list. (b) A violation of this section is a Class C misdemeanor. Acts 1953, ch. 29, § 2 (Williams, § 4765.13a); T.C.A. (orig. ed.), §§ 14-118, 14-1-118; Acts 1989, ch. 591, § 113.
(a) The welfare lists referred to in § 71-1-117 cannot be used for political or commercial purposes and no one will be permitted to copy such a list.
(b) A violation of this section is a Class C misdemeanor.
Acts 1953, ch. 29, § 2 (Williams, § 4765.13a); T.C.A. (orig. ed.), §§ 14-118, 14-1-118; Acts 1989, ch. 591, § 113.
Tenn. Code Ann. § 71-4-811 — TN Code / Title 71 / Chapter 4 / Section 71-4-811
Suspension or termination of program
Status: in_force

If the trustees determine that the program is financially infeasible or is not beneficial to the citizens of this state or the state itself, the trustees may suspend or terminate the program immediately. Acts 2015, ch. 470, § 11.
If the trustees determine that the program is financially infeasible or is not beneficial to the citizens of this state or the state itself, the trustees may suspend or terminate the program immediately.
Acts 2015, ch. 470, § 11.
Tenn. Code Ann. § 71-5-112 — TN Code / Title 71 / Chapter 5 / Section 71-5-112
Hearing concerning eligibility
Status: in_force

Whenever a hearing concerning eligibility determinations is required by state or federal law or constitutional provision, the agency designated to determine eligibility shall hear such hearings before a hearing officer or administrative judge designated by the agency. The hearing shall be held in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. Acts 1968, ch. 551, § 12; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., § 14-1912; Acts 1982, ch. 730, § 12; T.C.A., § 14-23-112.
Whenever a hearing concerning eligibility determinations is required by state or federal law or constitutional provision, the agency designated to determine eligibility shall hear such hearings before a hearing officer or administrative judge designated by the agency. The hearing shall be held in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5.
Acts 1968, ch. 551, § 12; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., § 14-1912; Acts 1982, ch. 730, § 12; T.C.A., § 14-23-112.
Tenn. Code Ann. § 71-2-308 — TN Code / Title 71 / Chapter 2 / Section 71-2-308
Improper use of names of recipients - Penalty
Status: in_force

(a) It is unlawful for any person, except for purposes directly connected with the administration of this chapter, to solicit, disclose, receive, make use of, authorize or knowingly permit, participate in, or acquiesce in the use of, any list or names of, or any information concerning, persons applying for or receiving medical assistance, directly or indirectly derived from the records, papers, files or communications of the department or divisions of the department, or acquired in the course of the performance of official duties. (b) A violation of this section is a Class C misdemeanor. Acts 1961, ch. 96, § 14; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., §§ 14-1614, 14-3-108; Acts 1989, ch. 591, § 113.
(a) It is unlawful for any person, except for purposes directly connected with the administration of this chapter, to solicit, disclose, receive, make use of, authorize or knowingly permit, participate in, or acquiesce in the use of, any list or names of, or any information concerning, persons applying for or receiving medical assistance, directly or indirectly derived from the records, papers, files or communications of the department or divisions of the department, or acquired in the course of the performance of official duties.
(b) A violation of this section is a Class C misdemeanor.
Acts 1961, ch. 96, § 14; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., §§ 14-1614, 14-3-108; Acts 1989, ch. 591, § 113.
Tenn. Code Ann. § 71-5-115 — TN Code / Title 71 / Chapter 5 / Section 71-5-115
Financial responsibility of relative - When may be considered - Reimbursement from responsible parties
Status: in_force

To the extent permitted by federal law, the department may require or permit that responsible parties of a recipient of medical assistance supplement or reimburse for any benefit or benefits rendered to the recipient pursuant to this part. Acts 1968, ch. 551, § 15; 1979, ch. 177, § 1; T.C.A., § 14-1915; Acts 1982, ch. 730, § 14; T.C.A., § 14-23-115.
To the extent permitted by federal law, the department may require or permit that responsible parties of a recipient of medical assistance supplement or reimburse for any benefit or benefits rendered to the recipient pursuant to this part.
Acts 1968, ch. 551, § 15; 1979, ch. 177, § 1; T.C.A., § 14-1915; Acts 1982, ch. 730, § 14; T.C.A., § 14-23-115.
Tenn. Code Ann. § 71-2-213 — TN Code / Title 71 / Chapter 2 / Section 71-2-213
Charging for assistance to applicants unlawful
Status: in_force

(a) It is unlawful for any person, firm, or corporation to directly or indirectly either charge or receive anything of value for assisting any person in making application to the proper authorities of this state, or any of them, for relief or assistance under any statutes of this state providing for financial assistance to persons over sixty-five (65) years of age. (b) A violation of this section is a Class C misdemeanor. Acts 1937, ch. 118, § 1; C. Supp. 1950, § 4765.37; T.C.A. (orig. ed.), §§ 14-219, 14-2-113; Acts 1989, ch. 591, § 113.
(a) It is unlawful for any person, firm, or corporation to directly or indirectly either charge or receive anything of value for assisting any person in making application to the proper authorities of this state, or any of them, for relief or assistance under any statutes of this state providing for financial assistance to persons over sixty-five (65) years of age.
(b) A violation of this section is a Class C misdemeanor.
Acts 1937, ch. 118, § 1; C. Supp. 1950, § 4765.37; T.C.A. (orig. ed.), §§ 14-219, 14-2-113; Acts 1989, ch. 591, § 113.
Tenn. Code Ann. § 71-3-1102 — TN Code / Title 71 / Chapter 3 / Section 71-3-1102
[Effective until 6/30/2025. See T.C.A. 71-3-1113] Part definitions
Status: in_force

As used in this part, unless the context otherwise requires: (1) "Department" means the department of finance and administration; (2) "Enrollee" means an individual who is eligible and enrolled in the program; (3) "Program" means any program established to provide health coverage to children pursuant to this part; (4) "Tennessee medicaid program" means the federal- and state-financed, state-run program of medical assistance established pursuant to Title XIX ( 42 U.S.C. § 1396 et seq.), including any waivers thereof; (5) "Title XIX" means Title XIX of the Social Security Act, Subchapter XIX, Chapter 7 of Title 42, United States Code ( 42 U.S.C. § 1396 et seq.), providing grants to states for medical assistance programs; and (6) "Title XXI" means Title XXI of the Social Security Act, Subchapter XXI, Chapter 7 of Title 42, United States Code ( 42 U.S.C. §§ 1397aa , et seq.), establishing the State Children's Health Insurance Program. Acts 2006, ch. 867, § 7.
As used in this part, unless the context otherwise requires:
(1) "Department" means the department of finance and administration;
(2) "Enrollee" means an individual who is eligible and enrolled in the program;
(3) "Program" means any program established to provide health coverage to children pursuant to this part;
(4) "Tennessee medicaid program" means the federal- and state-financed, state-run program of medical assistance established pursuant to Title XIX ( 42 U.S.C. § 1396 et seq.), including any waivers thereof;
(5) "Title XIX" means Title XIX of the Social Security Act, Subchapter XIX, Chapter 7 of Title 42, United States Code ( 42 U.S.C. § 1396 et seq.), providing grants to states for medical assistance programs; and
(6) "Title XXI" means Title XXI of the Social Security Act, Subchapter XXI, Chapter 7 of Title 42, United States Code ( 42 U.S.C. §§ 1397aa , et seq.), establishing the State Children's Health Insurance Program.
Acts 2006, ch. 867, § 7.
Tenn. Code Ann. § 71-2-301 — TN Code / Title 71 / Chapter 2 / Section 71-2-301
Part definitions
Status: in_force

As used in this part, unless the context otherwise requires: (1) "Applicant" means a person requesting medical assistance under this part; (2) "Department" means the department of human services; (3) "Medical assistance" means vendor payments or other payments for drugs in behalf of any person in need of this form of medical assistance as determined by department standards; and (4) "Recipient" means a person receiving medical assistance under the terms of this part. Acts 1961, ch. 96, § 1; 1971, ch. 43, § 1; impl. am. Acts 1975, ch. 219, § 1(a, b); T.C.A., §§ 14-1601, 14-3-101.
As used in this part, unless the context otherwise requires:
(1) "Applicant" means a person requesting medical assistance under this part;
(2) "Department" means the department of human services;
(3) "Medical assistance" means vendor payments or other payments for drugs in behalf of any person in need of this form of medical assistance as determined by department standards; and
(4) "Recipient" means a person receiving medical assistance under the terms of this part.
Acts 1961, ch. 96, § 1; 1971, ch. 43, § 1; impl. am. Acts 1975, ch. 219, § 1(a, b); T.C.A., §§ 14-1601, 14-3-101.
Tenn. Code Ann. § 71-4-1111 — TN Code / Title 71 / Chapter 4 / Section 71-4-1111
Amendment of law
Status: in_force

All assistance granted under this part shall be deemed to be granted to be held subject to any amending or repealing act that may hereafter be passed, and no recipient shall have any claim for compensation, or otherwise, by reason of such recipient's assistance being affected in any way by any amending or repealing act. Acts 1953, ch. 16, § 17 (Williams, § 4765.169); T.C.A. (orig. ed.), § 14-416; Acts 1986, ch. 905, § 2; T.C.A., § 14-16-111.
All assistance granted under this part shall be deemed to be granted to be held subject to any amending or repealing act that may hereafter be passed, and no recipient shall have any claim for compensation, or otherwise, by reason of such recipient's assistance being affected in any way by any amending or repealing act.
Acts 1953, ch. 16, § 17 (Williams, § 4765.169); T.C.A. (orig. ed.), § 14-416; Acts 1986, ch. 905, § 2; T.C.A., § 14-16-111.
Tenn. Code Ann. § 71-5-138 — TN Code / Title 71 / Chapter 5 / Section 71-5-138
Compliance with provisions regarding authorizations for pharmacy services
Status: in_force

Any managed care organization participating in the TennCare program shall comply with the provisions of § 56-32-138 concerning authorizations given to a pharmacy services provider for care to be delivered to an enrollee receiving TennCare benefits. Acts 2001, ch. 340, § 3.
Any managed care organization participating in the TennCare program shall comply with the provisions of § 56-32-138 concerning authorizations given to a pharmacy services provider for care to be delivered to an enrollee receiving TennCare benefits.
Acts 2001, ch. 340, § 3.
Tenn. Code Ann. § 71-5-309 — TN Code / Title 71 / Chapter 5 / Section 71-5-309
Appeal of determination of area manager
Status: in_force

If an application is not acted upon by the area manager or the area manager's designated agent within a reasonable time after the filing of the application, or is denied in whole or in part, or if an award of food stamp assistance is modified or cancelled under any provisions of this part, the applicant or recipient may appeal to the department in the manner and form prescribed by the department, and shall be afforded reasonable notice and opportunity for a fair hearing by the department. Written notice of a right to a fair hearing shall be given to each applicant and recipient at such time as any action concerning the amount of benefits awarded to the individual is taken or at the time a decision is made on an applicant's eligibility for such assistance. Acts 1971, ch. 136, § 9; 1973, ch. 337, § 5; T.C.A., §§ 14-2209, 14-27-109; Acts 1996, ch. 950, § 13.
If an application is not acted upon by the area manager or the area manager's designated agent within a reasonable time after the filing of the application, or is denied in whole or in part, or if an award of food stamp assistance is modified or cancelled under any provisions of this part, the applicant or recipient may appeal to the department in the manner and form prescribed by the department, and shall be afforded reasonable notice and opportunity for a fair hearing by the department. Written notice of a right to a fair hearing shall be given to each applicant and recipient at such time as any action concerning the amount of benefits awarded to the individual is taken or at the time a decision is made on an applicant's eligibility for such assistance.
Acts 1971, ch. 136, § 9; 1973, ch. 337, § 5; T.C.A., §§ 14-2209, 14-27-109; Acts 1996, ch. 950, § 13.
Tenn. Code Ann. § 71-4-506 — TN Code / Title 71 / Chapter 4 / Section 71-4-506
Effect of part
Status: in_force

Nothing in this part shall supersede any cooperative agreements that are in effect between the department and public property management on July 1, 1994, regarding the current operation of vending facilities on public properties, nor shall anything in this part preclude the department from entering into future agreements that may be less restrictive than this part, if, in the department's judgment, such agreements are in the best interest of the program. Acts 1994, ch. 723, § 2.
Nothing in this part shall supersede any cooperative agreements that are in effect between the department and public property management on July 1, 1994, regarding the current operation of vending facilities on public properties, nor shall anything in this part preclude the department from entering into future agreements that may be less restrictive than this part, if, in the department's judgment, such agreements are in the best interest of the program.
Acts 1994, ch. 723, § 2.
Tenn. Code Ann. § 71-4-113 — TN Code / Title 71 / Chapter 4 / Section 71-4-113
Amendment of law
Status: in_force

All assistance granted under this part shall be deemed to be granted and to be held subject to any amending or repealing statute that may hereafter be passed, and no recipient shall have any claim for compensation, or otherwise, by reason of the recipient's assistance being affected in any way by any amending or repealing statute. Acts 1937, ch. 51, § 20; C. Supp. 1950, § 4765.77 (Williams, § 4765.74); T.C.A. (orig. ed.), §§ 14-520, 14-13-113.
All assistance granted under this part shall be deemed to be granted and to be held subject to any amending or repealing statute that may hereafter be passed, and no recipient shall have any claim for compensation, or otherwise, by reason of the recipient's assistance being affected in any way by any amending or repealing statute.
Acts 1937, ch. 51, § 20; C. Supp. 1950, § 4765.77 (Williams, § 4765.74); T.C.A. (orig. ed.), §§ 14-520, 14-13-113.
Tenn. Code Ann. § 71-5-310 — TN Code / Title 71 / Chapter 5 / Section 71-5-310
Review of determinations of area managers
Status: in_force

The department may also, upon its own motion, review any decision of an area manager or an area manager's designated agent and may consider any application upon which a decision has not been made by the area manager or the area manager's designated agent within a reasonable time. The department may make such additional investigation as it may deem necessary, and shall make such decision on such application as in its opinion is justified and in conformity with this part. Applicants or recipients affected by such decisions of the department shall be notified of such decision in writing, and shall, upon request, be given reasonable notice and opportunity for a fair hearing by the department. All decisions of the department shall be binding upon the county involved and shall be complied with by the area manager or the area manager's designated agent. Acts 1971, ch. 136, § 10; 1973, ch. 337, § 5; T.C.A., §§ 14-2210, 14-27-110; Acts 1996, ch. 950, § 13.
The department may also, upon its own motion, review any decision of an area manager or an area manager's designated agent and may consider any application upon which a decision has not been made by the area manager or the area manager's designated agent within a reasonable time. The department may make such additional investigation as it may deem necessary, and shall make such decision on such application as in its opinion is justified and in conformity with this part. Applicants or recipients affected by such decisions of the department shall be notified of such decision in writing, and shall, upon request, be given reasonable notice and opportunity for a fair hearing by the department. All decisions of the department shall be binding upon the county involved and shall be complied with by the area manager or the area manager's designated agent.
Acts 1971, ch. 136, § 10; 1973, ch. 337, § 5; T.C.A., §§ 14-2210, 14-27-110; Acts 1996, ch. 950, § 13.
Tenn. Code Ann. § 71-5-805 — TN Code / Title 71 / Chapter 5 / Section 71-5-805
[Repealed]
Status: repealed

Acts 2014 , ch. 877, § 1; repealed by terms of former § 71-5-806, effective June 30, 2015.
Tenn. Code Ann. § 71-2-117 — TN Code / Title 71 / Chapter 2 / Section 71-2-117
[Repealed]
Status: repealed

Repealed by 2024 Tenn. Acts, ch. 688,s 98, eff. 7/1/2024. Amended by 2023 Tenn. Acts, ch. 466, s 16, eff. 7/1/2023. Amended by 2020 Tenn. Acts, ch. 526, Secs.s 1, s 2, s 3, s 4 eff. 3/6/2020. Added by 2019 Tenn. Acts, ch. 364, s 2, eff. 5/10/2019.
Repealed by 2024 Tenn. Acts, ch. 688,s 98, eff. 7/1/2024.
Amended by 2023 Tenn. Acts, ch. 466, s 16, eff. 7/1/2023.
Amended by 2020 Tenn. Acts, ch. 526, Secs.s 1, s 2, s 3, s 4 eff. 3/6/2020.
Added by 2019 Tenn. Acts, ch. 364, s 2, eff. 5/10/2019.
Tenn. Code Ann. § 71-3-702 — TN Code / Title 71 / Chapter 3 / Section 71-3-702
Current operation - Expansion
Status: in_force

During fiscal year 1989-1990, the department shall continue to operate Project RAP in Memphis as a model program, as it has since 1986. Beginning July 1, 1990, if and only if funds are specifically allocated in the general appropriations act for the purpose of expanding Project RAP, then the department shall geographically expand Project RAP into additional areas of the state in which there are significant concentrations of first time teen mothers, foster care teens, and other teens at high risk of pregnancy. In implementing such expansion, priority shall be given to establishing Project RAP in each of the state's three (3) grand divisions within those areas in which the project can exercise maximum impact both upon the state's pregnancy rate, among females seventeen (17) years of age and under, and upon taxpayer expenditures for temporary assistance for needy families (TANF), other types of public assistance, and medicaid. Acts 1989, ch. 293, § 2.
During fiscal year 1989-1990, the department shall continue to operate Project RAP in Memphis as a model program, as it has since 1986. Beginning July 1, 1990, if and only if funds are specifically allocated in the general appropriations act for the purpose of expanding Project RAP, then the department shall geographically expand Project RAP into additional areas of the state in which there are significant concentrations of first time teen mothers, foster care teens, and other teens at high risk of pregnancy. In implementing such expansion, priority shall be given to establishing Project RAP in each of the state's three (3) grand divisions within those areas in which the project can exercise maximum impact both upon the state's pregnancy rate, among females seventeen (17) years of age and under, and upon taxpayer expenditures for temporary assistance for needy families (TANF), other types of public assistance, and medicaid.
Acts 1989, ch. 293, § 2.
Tenn. Code Ann. § 71-6-111 — TN Code / Title 71 / Chapter 6 / Section 71-6-111
Authority and responsibility of department
Status: in_force

It is the legislative intent that the protective services set out in this part be provided and that the department have present authority to provide or to arrange for the provision of the same. However, the provision of the services is subject to budgetary limitations and the availability of funds appropriated for the general provision of protective services to all persons entitled to services. Acts 1978, ch. 899, § 1; T.C.A., §§ 14-2611, 14-25-111.
It is the legislative intent that the protective services set out in this part be provided and that the department have present authority to provide or to arrange for the provision of the same. However, the provision of the services is subject to budgetary limitations and the availability of funds appropriated for the general provision of protective services to all persons entitled to services.
Acts 1978, ch. 899, § 1; T.C.A., §§ 14-2611, 14-25-111.
Tenn. Code Ann. § 71-5-1410 — TN Code / Title 71 / Chapter 5 / Section 71-5-1410
Strategies to assist nursing facilities in diversifying their lines of business
Status: in_force

(a) The commissioner shall develop and implement strategies to assist nursing facilities in diversifying their lines of business, including provision of home and community-based services and specialized nursing facility care to meet the targeted needs of chronic care populations. (b) The strategies may include, but are not limited to, provision of training and technical assistance, streamlined provider enrollment processes for home and community-based services and development of special acuity-based rates to meet the more intensive caregiving demands of certain chronic care populations, subject to the availability of funding in each year's appropriations bill. Acts 2008, ch. 1190, § 11.
(a) The commissioner shall develop and implement strategies to assist nursing facilities in diversifying their lines of business, including provision of home and community-based services and specialized nursing facility care to meet the targeted needs of chronic care populations.
(b) The strategies may include, but are not limited to, provision of training and technical assistance, streamlined provider enrollment processes for home and community-based services and development of special acuity-based rates to meet the more intensive caregiving demands of certain chronic care populations, subject to the availability of funding in each year's appropriations bill.
Acts 2008, ch. 1190, § 11.
Tenn. Code Ann. § 71-2-306 — TN Code / Title 71 / Chapter 2 / Section 71-2-306
Recipient receiving property or income - Notice required - Recovery - Fraudulently obtaining aid or disposing of property - Penalty
Status: in_force

(a) If, at any time during the certification for medical assistance, the recipient becomes possessed of any property, real or personal, or income in excess of the amount stated in such recipient's application for medical assistance or transfers any of such recipient's property, real or personal, it shall be the duty of the recipient to immediately notify the local county office of the department. Any medical assistance paid after the recipient has come into possession of property, real or personal, or income, or has transferred any of such recipient's property, real or personal, that renders the recipient ineligible to receive medical assistance under the rules and regulations of the department, shall be recoverable in a suit by the state as a debt due the state. (b) Whoever: (1) Knowingly obtains, or attempts to obtain, or aids, or abets any person to obtain by means of a willfully false statement or representation or by impersonation, or other fraudulent device, medical assistance to which such person is not entitled or medical assistance greater than that to which such person is justly entitled; or (2) With intent to defraud, aids or abets in buying or in any way disposing of the property, either personal or real, of a recipient of medical assistance, without the consent of the department; commits a Class E felony and is punishable accordingly, except such acts shall be punished as Class A misdemeanors where the amount involved is less than five hundred dollars ($500). Acts 1961, ch. 96, § 12; 1965, ch. 13, § 1; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., §§ 14-1612, 14-3-106; Acts 1989, ch. 591, §§ 1, 6, 103.
(a) If, at any time during the certification for medical assistance, the recipient becomes possessed of any property, real or personal, or income in excess of the amount stated in such recipient's application for medical assistance or transfers any of such recipient's property, real or personal, it shall be the duty of the recipient to immediately notify the local county office of the department. Any medical assistance paid after the recipient has come into possession of property, real or personal, or income, or has transferred any of such recipient's property, real or personal, that renders the recipient ineligible to receive medical assistance under the rules and regulations of the department, shall be recoverable in a suit by the state as a debt due the state.
(b) Whoever: (1) Knowingly obtains, or attempts to obtain, or aids, or abets any person to obtain by means of a willfully false statement or representation or by impersonation, or other fraudulent device, medical assistance to which such person is not entitled or medical assistance greater than that to which such person is justly entitled; or (2) With intent to defraud, aids or abets in buying or in any way disposing of the property, either personal or real, of a recipient of medical assistance, without the consent of the department; commits a Class E felony and is punishable accordingly, except such acts shall be punished as Class A misdemeanors where the amount involved is less than five hundred dollars ($500).
(1) Knowingly obtains, or attempts to obtain, or aids, or abets any person to obtain by means of a willfully false statement or representation or by impersonation, or other fraudulent device, medical assistance to which such person is not entitled or medical assistance greater than that to which such person is justly entitled; or
(2) With intent to defraud, aids or abets in buying or in any way disposing of the property, either personal or real, of a recipient of medical assistance, without the consent of the department; commits a Class E felony and is punishable accordingly, except such acts shall be punished as Class A misdemeanors where the amount involved is less than five hundred dollars ($500).
commits a Class E felony and is punishable accordingly, except such acts shall be punished as Class A misdemeanors where the amount involved is less than five hundred dollars ($500).
Acts 1961, ch. 96, § 12; 1965, ch. 13, § 1; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., §§ 14-1612, 14-3-106; Acts 1989, ch. 591, §§ 1, 6, 103.
Tenn. Code Ann. § 71-4-202 — TN Code / Title 71 / Chapter 4 / Section 71-4-202
Employment by public agencies
Status: in_force

It is the further policy of this state that totally blind or partially blind persons and persons otherwise disabled shall be employed in the state service, the service of the political subdivisions of the state, in the public schools and in all other employment supported in whole or part by public funds on the same terms and conditions as the able-bodied, unless it is shown that the particular disability prevents the performance of the work involved in such employment. Acts 1972, ch. 480, § 2; T.C.A., §§ 14-639, 14-14-102.
It is the further policy of this state that totally blind or partially blind persons and persons otherwise disabled shall be employed in the state service, the service of the political subdivisions of the state, in the public schools and in all other employment supported in whole or part by public funds on the same terms and conditions as the able-bodied, unless it is shown that the particular disability prevents the performance of the work involved in such employment.
Acts 1972, ch. 480, § 2; T.C.A., §§ 14-639, 14-14-102.
Tenn. Code Ann. § 71-5-2112 — TN Code / Title 71 / Chapter 5 / Section 71-5-2112
Government of joint institutions
Status: in_force

Any institution established jointly by counties, as provided in § 71-5-2111 , shall in all respects serve as a county institution of each of the counties participating, subject to the rules and regulations agreed upon by the legislative bodies of the participating counties. Such contract shall be executed by the governing body of each county by its proper officer. Acts 1929, ch. 135, § 2; mod. Code 1932, § 4796; impl. am. Acts 1978, ch. 934, §§ 7, 36; T.C.A. (orig. ed.), §§ 14-812, 14-20-112.
Any institution established jointly by counties, as provided in § 71-5-2111 , shall in all respects serve as a county institution of each of the counties participating, subject to the rules and regulations agreed upon by the legislative bodies of the participating counties. Such contract shall be executed by the governing body of each county by its proper officer.
Acts 1929, ch. 135, § 2; mod. Code 1932, § 4796; impl. am. Acts 1978, ch. 934, §§ 7, 36; T.C.A. (orig. ed.), §§ 14-812, 14-20-112.
Tenn. Code Ann. § 71-2-104 — TN Code / Title 71 / Chapter 2 / Section 71-2-104
[Repealed]
Status: repealed

Amended by 2024 Tenn. Acts, ch. 688,s 179, eff. 7/1/2024. Repealed by 2024 Tenn. Acts, ch. 688,s 98, eff. 7/1/2024. Acts 1981, ch. 428, § 5; 1982, ch. 834, § 5; 1984, ch. 943, § 2; T.C.A., § 14-6-104; Acts 2001, ch. 397, § 5; 2003 , ch. 311, § 1; 2010 , ch. 1100, §§ 133, 134; 2012 , ch. 575, § 2; 2012 , ch. 986, §§ 12 - 14.
Amended by 2024 Tenn. Acts, ch. 688,s 179, eff. 7/1/2024.
Repealed by 2024 Tenn. Acts, ch. 688,s 98, eff. 7/1/2024.
Acts 1981, ch. 428, § 5; 1982, ch. 834, § 5; 1984, ch. 943, § 2; T.C.A., § 14-6-104; Acts 2001, ch. 397, § 5; 2003 , ch. 311, § 1; 2010 , ch. 1100, §§ 133, 134; 2012 , ch. 575, § 2; 2012 , ch. 986, §§ 12 - 14.
Tenn. Code Ann. § 71-5-806 — TN Code / Title 71 / Chapter 5 / Section 71-5-806
[Repealed]
Status: repealed

Acts 2014 , ch. 877, § 1; repealed by terms of former § 71-5-806, effective June 30, 2015.
Tenn. Code Ann. § 71-2-302 — TN Code / Title 71 / Chapter 2 / Section 71-2-302
Determination of amount of medical assistance
Status: in_force

The amount of medical assistance that any person shall receive in the form of drugs under this part shall be determined by measuring the income and resources of such person against the statewide standards provided in § 71-2-303(3) and shall be approved by the regional director or a designated agent and the county mayor of the county in which such person resides. Acts 1961, ch. 96, § 3; 1971, ch. 43, § 3; impl. am. Acts 1978, ch. 934, §§ 16, 36; T.C.A., §§ 14-1603, 14-3-102; Acts 2003, ch. 90, § 2.
The amount of medical assistance that any person shall receive in the form of drugs under this part shall be determined by measuring the income and resources of such person against the statewide standards provided in § 71-2-303(3) and shall be approved by the regional director or a designated agent and the county mayor of the county in which such person resides.
Acts 1961, ch. 96, § 3; 1971, ch. 43, § 3; impl. am. Acts 1978, ch. 934, §§ 16, 36; T.C.A., §§ 14-1603, 14-3-102; Acts 2003, ch. 90, § 2.
Tenn. Code Ann. § 71-5-708 — TN Code / Title 71 / Chapter 5 / Section 71-5-708
Premium payments - Billing and payment of premiums
Status: in_force

(a) The director shall ensure, when determining the premium amount a person must pay for participation in the buy-in program, that: (1) The bureau counts only the income of the person approved for the program, and does not count the income of another household member; (2) For purposes of determining countable income to be used in the premium calculation, the bureau applies the following rules: (A) Income is considered available and owned when it is: (i) Received; and (ii) Can be used to meet the person's needs for food, clothing, and shelter; and (B) Certain receipts are not income as described in 20 C.F.R. § 416.1103 ; (3) The buy-in program premium amount equals, rounded down to the nearest whole dollar, five percent (5%) of countable income described in subdivision (a)(2), including both earned and unearned income; (4) When determining the premium amount, the bureau uses the verified income amount until a change in income is reported and processed, unless good cause for delay in verifying changes exists; and (5) A change in the premium amount is effective the month after the change in income is reported to and processed by the bureau. (b) The director shall ensure, when billing for and processing payments of buy-in program premiums, that: (1) For current and ongoing coverage, the bureau bills for program premiums during the month following the benefit month; (2) The first monthly premium begins the first full month of coverage; (3) Pursuant to § 71-5-706(3) , the bureau may terminate program coverage if premiums are not paid in full for four (4) consecutive months; (4) The person must pay the monthly premium in full to avoid losing program coverage and, if a person makes a partial payment, the payment does not count as a full payment toward the premium; (5) Payments received are applied to premiums owed in the following order: (A) Past due months, beginning with the most delinquent month; and (B) The current coverage month that has been invoiced; and (6) A person must pay a premium for any month that program coverage is provided, including months when a redetermination of coverage is made, months when continued coverage is requested, and during the period of an aid-pending eligibility appeal. Added by 2024 Tenn. Acts, ch. 1002,s 1, eff. 5/21/2024.
(a) The director shall ensure, when determining the premium amount a person must pay for participation in the buy-in program, that: (1) The bureau counts only the income of the person approved for the program, and does not count the income of another household member; (2) For purposes of determining countable income to be used in the premium calculation, the bureau applies the following rules: (A) Income is considered available and owned when it is: (i) Received; and (ii) Can be used to meet the person's needs for food, clothing, and shelter; and (B) Certain receipts are not income as described in 20 C.F.R. § 416.1103 ; (3) The buy-in program premium amount equals, rounded down to the nearest whole dollar, five percent (5%) of countable income described in subdivision (a)(2), including both earned and unearned income; (4) When determining the premium amount, the bureau uses the verified income amount until a change in income is reported and processed, unless good cause for delay in verifying changes exists; and (5) A change in the premium amount is effective the month after the change in income is reported to and processed by the bureau.
(1) The bureau counts only the income of the person approved for the program, and does not count the income of another household member;
(2) For purposes of determining countable income to be used in the premium calculation, the bureau applies the following rules: (A) Income is considered available and owned when it is: (i) Received; and (ii) Can be used to meet the person's needs for food, clothing, and shelter; and (B) Certain receipts are not income as described in 20 C.F.R. § 416.1103 ;
(A) Income is considered available and owned when it is: (i) Received; and (ii) Can be used to meet the person's needs for food, clothing, and shelter; and
(i) Received; and
(ii) Can be used to meet the person's needs for food, clothing, and shelter; and
(B) Certain receipts are not income as described in 20 C.F.R. § 416.1103 ;
(3) The buy-in program premium amount equals, rounded down to the nearest whole dollar, five percent (5%) of countable income described in subdivision (a)(2), including both earned and unearned income;
(4) When determining the premium amount, the bureau uses the verified income amount until a change in income is reported and processed, unless good cause for delay in verifying changes exists; and
(5) A change in the premium amount is effective the month after the change in income is reported to and processed by the bureau.
(b) The director shall ensure, when billing for and processing payments of buy-in program premiums, that: (1) For current and ongoing coverage, the bureau bills for program premiums during the month following the benefit month; (2) The first monthly premium begins the first full month of coverage; (3) Pursuant to § 71-5-706(3) , the bureau may terminate program coverage if premiums are not paid in full for four (4) consecutive months; (4) The person must pay the monthly premium in full to avoid losing program coverage and, if a person makes a partial payment, the payment does not count as a full payment toward the premium; (5) Payments received are applied to premiums owed in the following order: (A) Past due months, beginning with the most delinquent month; and (B) The current coverage month that has been invoiced; and (6) A person must pay a premium for any month that program coverage is provided, including months when a redetermination of coverage is made, months when continued coverage is requested, and during the period of an aid-pending eligibility appeal.
(1) For current and ongoing coverage, the bureau bills for program premiums during the month following the benefit month;
(2) The first monthly premium begins the first full month of coverage;
(3) Pursuant to § 71-5-706(3) , the bureau may terminate program coverage if premiums are not paid in full for four (4) consecutive months;
(4) The person must pay the monthly premium in full to avoid losing program coverage and, if a person makes a partial payment, the payment does not count as a full payment toward the premium;
(5) Payments received are applied to premiums owed in the following order: (A) Past due months, beginning with the most delinquent month; and (B) The current coverage month that has been invoiced; and
(A) Past due months, beginning with the most delinquent month; and
(B) The current coverage month that has been invoiced; and
(6) A person must pay a premium for any month that program coverage is provided, including months when a redetermination of coverage is made, months when continued coverage is requested, and during the period of an aid-pending eligibility appeal.
Added by 2024 Tenn. Acts, ch. 1002,s 1, eff. 5/21/2024.
Tenn. Code Ann. § 71-3-520 — TN Code / Title 71 / Chapter 3 / Section 71-3-520
Child care improvement pilot program - Funding - Funding subject to review
Status: in_force

(a) There is created a child care improvement pilot program to provide grants to nonprofit organizations to be used for establishing a new child care agency in this state or making improvements to, or assisting with staffing, recruitment, or salary gaps, at an existing child care agency in this state. The program must be operated from July 1, 2023, to June 30, 2026. (b) There is created within the state general fund a special account to be known as the child care improvement fund (the fund). (c) The department of human services shall administer the fund, and moneys in the fund must be expended and obligated only in accordance with this section and in accordance with appropriations made by the general assembly. (d) Unless otherwise specified in this section, moneys deposited in the fund must be used only to implement and administer the purposes set forth in this section. In addition to appropriations made to the fund, the department may accept other funds, public or private, by way of gift or grant to the fund. A gift or grant must be deposited into the fund to be expended in accordance with this section. (e) The state treasurer shall invest moneys in the fund for the benefit of the fund in accordance with § 9-4-603 . Interest accruing on investments and deposits of the fund must be credited to and remain part of the fund. (f) Any unencumbered moneys and any unexpended balance of the fund remaining at the end of a fiscal year do not revert to the general fund, but must be carried forward until expended in accordance with this section. No part of the fund shall be diverted to the general fund or any other public fund. (g) All expenditures from the fund are subject to review in the form of a written report submitted by the department to the commissioner of finance and administration no later than January 15, 2024, and by January 15 each year thereafter until the close of the pilot program period. Added by 2023 Tenn. Acts, ch. 452, s 1, eff. 5/17/2023.
(a) There is created a child care improvement pilot program to provide grants to nonprofit organizations to be used for establishing a new child care agency in this state or making improvements to, or assisting with staffing, recruitment, or salary gaps, at an existing child care agency in this state. The program must be operated from July 1, 2023, to June 30, 2026.
(b) There is created within the state general fund a special account to be known as the child care improvement fund (the fund).
(c) The department of human services shall administer the fund, and moneys in the fund must be expended and obligated only in accordance with this section and in accordance with appropriations made by the general assembly.
(d) Unless otherwise specified in this section, moneys deposited in the fund must be used only to implement and administer the purposes set forth in this section. In addition to appropriations made to the fund, the department may accept other funds, public or private, by way of gift or grant to the fund. A gift or grant must be deposited into the fund to be expended in accordance with this section.
(e) The state treasurer shall invest moneys in the fund for the benefit of the fund in accordance with § 9-4-603 . Interest accruing on investments and deposits of the fund must be credited to and remain part of the fund.
(f) Any unencumbered moneys and any unexpended balance of the fund remaining at the end of a fiscal year do not revert to the general fund, but must be carried forward until expended in accordance with this section. No part of the fund shall be diverted to the general fund or any other public fund.
(g) All expenditures from the fund are subject to review in the form of a written report submitted by the department to the commissioner of finance and administration no later than January 15, 2024, and by January 15 each year thereafter until the close of the pilot program period.
Added by 2023 Tenn. Acts, ch. 452, s 1, eff. 5/17/2023.
Tenn. Code Ann. § 71-5-190 — TN Code / Title 71 / Chapter 5 / Section 71-5-190
TennCare prescription drug utilization review committee
Status: in_force

(a) In order to provide oversight of prescription drug utilization under the TennCare program, there is hereby created a TennCare prescription drug utilization review committee. The committee shall consist of: one (1) member of the house of representatives appointed by the speaker of the house; one (1) member of the senate appointed by the speaker of the senate; and two (2) pharmacists, two (2) physicians, two (2) representatives of managed care organizations, two (2) representatives of pharmaceutical companies and two (2) consumers, all of whom shall be appointed by the comptroller of the treasury. The TennCare bureau shall provide to the committee such information as the committee deems appropriate concerning the prescriptions made to TennCare enrollees who receive more than seven (7) prescriptions. The committee shall review such information and make recommendations to the health and welfare committee of the senate, the health committee of the house of representatives, and the TennCare bureau concerning potential drug interactions, abuse of prescription drugs or other appropriate matters. (b) (1) Non-legislative members of the committee shall serve without compensation, but they shall be entitled to reimbursement for all necessary expenses incurred in the performance of their duties, in accordance with the comprehensive state travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter. (2) Legislative members of the committee shall not receive from the state an expense allowance or mileage allowance paid solely in consideration for serving on or attending meetings of the committee; provided, that this subdivision (b)(2) shall at no time preclude a legislative member from receiving an expense allowance or mileage allowance otherwise payable to such member in connection with attending the general assembly. Amended by 2021 Tenn. Acts, ch. 64, s 126, eff. 3/29/2021. Amended by 2019 Tenn. Acts, ch. 345, s 140, eff. 5/10/2019. Amended by 2013 Tenn. Acts, ch. 236, s 53, eff. 4/19/2013. Acts 1999, ch. 536, § 1; 2000, ch. 796, § 1; 2011 , ch. 410, § 6 (d).
(a) In order to provide oversight of prescription drug utilization under the TennCare program, there is hereby created a TennCare prescription drug utilization review committee. The committee shall consist of: one (1) member of the house of representatives appointed by the speaker of the house; one (1) member of the senate appointed by the speaker of the senate; and two (2) pharmacists, two (2) physicians, two (2) representatives of managed care organizations, two (2) representatives of pharmaceutical companies and two (2) consumers, all of whom shall be appointed by the comptroller of the treasury. The TennCare bureau shall provide to the committee such information as the committee deems appropriate concerning the prescriptions made to TennCare enrollees who receive more than seven (7) prescriptions. The committee shall review such information and make recommendations to the health and welfare committee of the senate, the health committee of the house of representatives, and the TennCare bureau concerning potential drug interactions, abuse of prescription drugs or other appropriate matters.
(b) (1) Non-legislative members of the committee shall serve without compensation, but they shall be entitled to reimbursement for all necessary expenses incurred in the performance of their duties, in accordance with the comprehensive state travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter. (2) Legislative members of the committee shall not receive from the state an expense allowance or mileage allowance paid solely in consideration for serving on or attending meetings of the committee; provided, that this subdivision (b)(2) shall at no time preclude a legislative member from receiving an expense allowance or mileage allowance otherwise payable to such member in connection with attending the general assembly.
(1) Non-legislative members of the committee shall serve without compensation, but they shall be entitled to reimbursement for all necessary expenses incurred in the performance of their duties, in accordance with the comprehensive state travel regulations promulgated by the commissioner of finance and administration and approved by the attorney general and reporter.
(2) Legislative members of the committee shall not receive from the state an expense allowance or mileage allowance paid solely in consideration for serving on or attending meetings of the committee; provided, that this subdivision (b)(2) shall at no time preclude a legislative member from receiving an expense allowance or mileage allowance otherwise payable to such member in connection with attending the general assembly.
Amended by 2021 Tenn. Acts, ch. 64, s 126, eff. 3/29/2021.
Amended by 2019 Tenn. Acts, ch. 345, s 140, eff. 5/10/2019.
Amended by 2013 Tenn. Acts, ch. 236, s 53, eff. 4/19/2013.
Acts 1999, ch. 536, § 1; 2000, ch. 796, § 1; 2011 , ch. 410, § 6 (d).
Tenn. Code Ann. § 71-6-119 — TN Code / Title 71 / Chapter 6 / Section 71-6-119
[Repealed]
Status: repealed

Repealed by 2019 Tenn. Acts, ch. 474, s 16, eff. 1/1/2020. Amended by 2018 Tenn. Acts, ch. 1050, s 14, eff. 1/1/2019. Acts 1995, ch. 486, § 6; 2007 , ch. 468, § 1.
Repealed by 2019 Tenn. Acts, ch. 474, s 16, eff. 1/1/2020.
Amended by 2018 Tenn. Acts, ch. 1050, s 14, eff. 1/1/2019.
Acts 1995, ch. 486, § 6; 2007 , ch. 468, § 1.
Tenn. Code Ann. § 71-3-701 — TN Code / Title 71 / Chapter 3 / Section 71-3-701
Project RAP - Creation - Services
Status: in_force

(a) There is created within the department of children's services the responsible adolescent parenting project (also known as "Project RAP"). (b) The project shall include information, programs, counseling, and services: (1) For teens who are pregnant with, or who have recently had, their first child; and (2) For foster care teens. (c) Project RAP may also include information, programs, counseling and services for other teens at high risk of pregnancy. In administering the project, the department shall strive to improve the parenting skills of those Project RAP clients who are pregnant or who are recent first time parents. The department shall also strive to prevent unintended future pregnancies among the total Project RAP client population and to encourage all project participants to pursue and complete educational and vocational opportunities. Acts 1989, ch. 293, § 1; 1996, ch. 1079, § 182.
(a) There is created within the department of children's services the responsible adolescent parenting project (also known as "Project RAP").
(b) The project shall include information, programs, counseling, and services: (1) For teens who are pregnant with, or who have recently had, their first child; and (2) For foster care teens.
(1) For teens who are pregnant with, or who have recently had, their first child; and
(2) For foster care teens.
(c) Project RAP may also include information, programs, counseling and services for other teens at high risk of pregnancy. In administering the project, the department shall strive to improve the parenting skills of those Project RAP clients who are pregnant or who are recent first time parents. The department shall also strive to prevent unintended future pregnancies among the total Project RAP client population and to encourage all project participants to pursue and complete educational and vocational opportunities.
Acts 1989, ch. 293, § 1; 1996, ch. 1079, § 182.
Tenn. Code Ann. § 71-5-198 — TN Code / Title 71 / Chapter 5 / Section 71-5-198
Prescription drug program waiver
Status: in_force

(a) If necessary, the bureau of TennCare is authorized to seek a research and demonstration waiver under Section 1115 of the federal Social Security Act from the United States department of health and human services to create a TennCare prescription program, subject to funding by the general assembly and the terms and conditions imposed by the waiver. (b) To the extent and only to the extent permitted by federal law or the terms of the waiver, the TennCare prescription program may provide a prescription benefit to individuals lacking prescription drug insurance coverage who meet criteria established by the bureau of TennCare and the general assembly in its annual appropriation bill. (c) To the extent permitted by federal law and the TennCare waiver, the bureau of TennCare may implement, either independently or in combination with a state preferred drug list (PDL), cost saving measures for pharmaceutical services including, but not limited to, tiered co-payments, reference pricing, prior authorization, step therapy requirements, exclusion from coverage of drugs or classes of drugs, mandating the use of generic drugs, and mandating the use of therapeutic equivalent drugs. (d) To the extent permitted by federal law or the terms of the waiver, the bureau of TennCare, through a state pharmacy benefit manager (PBM) or on its own, may negotiate manufacturer rebates for TennCare prescription drug purchases. The bureau of TennCare shall retain ultimate authority to negotiate or contract directly with a pharmaceutical manufacturer, in the interest of implementing rebates or other cost saving measures and for other purposes permitted by this section. Notwithstanding anything under Tennessee law to the contrary, the bureau's designation of a negotiating agent shall not infringe upon the state's ability to negotiate and contract directly with pharmaceutical manufacturers. (e) To the extent permitted by federal law or the terms of the waiver, the bureau of TennCare may establish an open enrollment period based on appropriations from the general assembly. (f) To the extent permitted by federal law or the terms of the waiver, the bureau of TennCare may contract with another department or a private entity to conduct an eligibility determination. The bureau or a contracted entity may implement an eligibility determination process to ensure participants comply with eligibility standards set by the bureau and the general assembly. (g) As permitted by the waiver or federal law, program participants may purchase prescription drugs through pharmacies participating in the state network. (h) To the extent permitted by federal law or the terms of the waiver, the bureau of TennCare may establish an enrollment fee to defray administrative expenses associated with the program. Acts 2003, ch. 350, § 4; 2004, ch. 673, § 14; 2005, ch. 442, § 1.
(a) If necessary, the bureau of TennCare is authorized to seek a research and demonstration waiver under Section 1115 of the federal Social Security Act from the United States department of health and human services to create a TennCare prescription program, subject to funding by the general assembly and the terms and conditions imposed by the waiver.
(b) To the extent and only to the extent permitted by federal law or the terms of the waiver, the TennCare prescription program may provide a prescription benefit to individuals lacking prescription drug insurance coverage who meet criteria established by the bureau of TennCare and the general assembly in its annual appropriation bill.
(c) To the extent permitted by federal law and the TennCare waiver, the bureau of TennCare may implement, either independently or in combination with a state preferred drug list (PDL), cost saving measures for pharmaceutical services including, but not limited to, tiered co-payments, reference pricing, prior authorization, step therapy requirements, exclusion from coverage of drugs or classes of drugs, mandating the use of generic drugs, and mandating the use of therapeutic equivalent drugs.
(d) To the extent permitted by federal law or the terms of the waiver, the bureau of TennCare, through a state pharmacy benefit manager (PBM) or on its own, may negotiate manufacturer rebates for TennCare prescription drug purchases. The bureau of TennCare shall retain ultimate authority to negotiate or contract directly with a pharmaceutical manufacturer, in the interest of implementing rebates or other cost saving measures and for other purposes permitted by this section. Notwithstanding anything under Tennessee law to the contrary, the bureau's designation of a negotiating agent shall not infringe upon the state's ability to negotiate and contract directly with pharmaceutical manufacturers.
(e) To the extent permitted by federal law or the terms of the waiver, the bureau of TennCare may establish an open enrollment period based on appropriations from the general assembly.
(f) To the extent permitted by federal law or the terms of the waiver, the bureau of TennCare may contract with another department or a private entity to conduct an eligibility determination. The bureau or a contracted entity may implement an eligibility determination process to ensure participants comply with eligibility standards set by the bureau and the general assembly.
(g) As permitted by the waiver or federal law, program participants may purchase prescription drugs through pharmacies participating in the state network.
(h) To the extent permitted by federal law or the terms of the waiver, the bureau of TennCare may establish an enrollment fee to defray administrative expenses associated with the program.
Acts 2003, ch. 350, § 4; 2004, ch. 673, § 14; 2005, ch. 442, § 1.
Tenn. Code Ann. § 71-5-2203 — TN Code / Title 71 / Chapter 5 / Section 71-5-2203
Chair - Minutes
Status: in_force

The commissioners shall appoint one (1) of their number chair, and they shall keep minutes of their proceedings in a well-bound book. Code 1858, § 1600; Shan., § 2684; Code 1932, § 4801; T.C.A. (orig. ed.), §§ 14-903, 14-20-203.
The commissioners shall appoint one (1) of their number chair, and they shall keep minutes of their proceedings in a well-bound book.
Code 1858, § 1600; Shan., § 2684; Code 1932, § 4801; T.C.A. (orig. ed.), §§ 14-903, 14-20-203.
Tenn. Code Ann. § 71-3-902 — TN Code / Title 71 / Chapter 3 / Section 71-3-902
"Low-income entrepreneur" defined
Status: in_force

For the purpose of this part, unless the context otherwise requires, a low-income entrepreneur is one who is starting or expanding a business and who meets the eligibility criteria for receipt of temporary assistance for needy families (TANF), or successor program. Acts 1996, ch. 886, § 2.
For the purpose of this part, unless the context otherwise requires, a low-income entrepreneur is one who is starting or expanding a business and who meets the eligibility criteria for receipt of temporary assistance for needy families (TANF), or successor program.
Acts 1996, ch. 886, § 2.
Tenn. Code Ann. § 71-4-1207 — TN Code / Title 71 / Chapter 4 / Section 71-4-1207
Funds
Status: in_force

(a) In addition to any state funds appropriated to provide services under this part, the department of human services may apply for and use any federal or private funds, grants, and other support that is available to carry out the personal care assistance program. (b) Expenditures under this part shall be subject to the approval of the commissioner of finance and administration. Acts 1986, ch. 905, §§ 11, 13; T.C.A., § 14-16-207.
(a) In addition to any state funds appropriated to provide services under this part, the department of human services may apply for and use any federal or private funds, grants, and other support that is available to carry out the personal care assistance program.
(b) Expenditures under this part shall be subject to the approval of the commissioner of finance and administration.
Acts 1986, ch. 905, §§ 11, 13; T.C.A., § 14-16-207.
Tenn. Code Ann. § 71-5-2517 — TN Code / Title 71 / Chapter 5 / Section 71-5-2517
Authority to require periodic provision of specific data - Compliance - Format of data - Charge for supplying data - Sufficient dedicated storage space and access to software - Construction
Status: in_force

(a) The office of inspector general is authorized to require periodic provision of specific categories, types, or collations of data without the necessity of issuing a new request at the commencement of each period. (b) Compliance with a request by the office of inspector general is not dependent on approval by the bureau of TennCare, and it shall not be a defense to an action for enforcement or sanctions under this part that the bureau of TennCare does not require copies of or access to the requested data. (c) Data kept in the regular course of business in electronic format shall on request be provided to the office of inspector general in the same electronic format. The data shall be provided in a manner that permits meaningful analysis with the aid of commonly available computer software and hardware. To this end, access to data shall be accompanied by access to any existing record layout, field definitions, or other guides or directions associated with the data. (d) Notwithstanding any law to the contrary, access to data required pursuant to §§ 71-5-2513 - 71-5-2521 shall be provided to the office of inspector general without charge. (e) The division of strategic technology solutions shall assist the office of inspector general by providing sufficient dedicated storage space and access to software on the state's computer network to permit the office of inspector general to accomplish the data mining contemplated by §§ 71-5-2513 - 71-5-2521. (f) Nothing in this part shall be construed to prevent the bureau of TennCare or any other subdivision of the single state agency from conducting data mining, identifying suspected fraud cases, and referring suspected provider fraud to the medicaid fraud control unit pursuant to 42 CFR, Part 455 . Nothing in this part shall be construed to affect the obligation of the single state medicaid agency or any of its subdivisions to refer to the medicaid fraud control unit, pursuant to 42 CFR 455, all cases in which the agency has reason to believe, after a preliminary investigation, that an incident of provider fraud or abuse has occurred in the TennCare program. Amended by 2020 Tenn. Acts, ch. 690, s 21, eff. 6/11/2020. Acts 2006, ch. 1010, § 1.
(a) The office of inspector general is authorized to require periodic provision of specific categories, types, or collations of data without the necessity of issuing a new request at the commencement of each period.
(b) Compliance with a request by the office of inspector general is not dependent on approval by the bureau of TennCare, and it shall not be a defense to an action for enforcement or sanctions under this part that the bureau of TennCare does not require copies of or access to the requested data.
(c) Data kept in the regular course of business in electronic format shall on request be provided to the office of inspector general in the same electronic format. The data shall be provided in a manner that permits meaningful analysis with the aid of commonly available computer software and hardware. To this end, access to data shall be accompanied by access to any existing record layout, field definitions, or other guides or directions associated with the data.
(d) Notwithstanding any law to the contrary, access to data required pursuant to §§ 71-5-2513 - 71-5-2521 shall be provided to the office of inspector general without charge.
(e) The division of strategic technology solutions shall assist the office of inspector general by providing sufficient dedicated storage space and access to software on the state's computer network to permit the office of inspector general to accomplish the data mining contemplated by §§ 71-5-2513 - 71-5-2521.
(f) Nothing in this part shall be construed to prevent the bureau of TennCare or any other subdivision of the single state agency from conducting data mining, identifying suspected fraud cases, and referring suspected provider fraud to the medicaid fraud control unit pursuant to 42 CFR, Part 455 . Nothing in this part shall be construed to affect the obligation of the single state medicaid agency or any of its subdivisions to refer to the medicaid fraud control unit, pursuant to 42 CFR 455, all cases in which the agency has reason to believe, after a preliminary investigation, that an incident of provider fraud or abuse has occurred in the TennCare program.
Amended by 2020 Tenn. Acts, ch. 690, s 21, eff. 6/11/2020.
Acts 2006, ch. 1010, § 1.