reglab/housing_qa huggingface dataset:
TN Code § 71-5-147 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-147. Personal Needs Allowance — Protecting Nursing Home Residents From Diversion of Allowance

  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, 2010, a deduction shall be made from the person's total income in the amount of fifty dollars ($50.00) per month to be treated as a personal needs allowance within the meaning of applicable federal regulations.    The department of health 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.   The recommendations shall be provided to the general welfare, health and human resources committee of the senate and to the health and human resources committee of the house of representatives not later than the second Tuesday in January, 2010.
TN Code § 71-5-148 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-148. Health Care Safety Net for Uninsured

  To the extent that funds are specifically appropriated by the general appropriations act, including, but not limited to, any such funds that may be available from the bureau of TennCare's reserve funds, the department of finance and administration, in coordination with the department of health and the department of mental health and substance abuse services, is authorized to facilitate the expansion and augmentation of a health care safety net in this state. The health care safety net provides medical assistance and dental assistance to individuals in need of medical care and dental care to adults in need of adult emergency dental services who are uninsured and who lack financial resources to secure medical and dental care. It is the legislative intent that priority should be given to efforts pursuant to this section that benefit the greatest number of such individuals. Such efforts may include, but not be limited to:  Improvement and expansion of the provision of medical assistance, both medical services and pharmacy, in the county health departments, with specific emphasis placed in providing assistance in those counties with the largest number of uninsured individuals; such support could include funding for additional staffing needs and facility expansion;   Support for community-based health care facilities and practices, including not-for-profit clinics, faith-based facilities, community mental health agencies, and federally qualified health centers, for the provision of health care services to the uninsured;   Incentive-based measures to encourage and promote physician involvement and treatment of the uninsured population, including specific steps taken to assist in providing for continuity of care, including specialty care, for such individuals, as well as targeted efforts at comprehensive disease management;   Creation and implementation of a twenty-four-hour, seven-day a week health care safety net hotline designed to assist and direct individuals in need of medical care and services to available resources in their areas;   Creation of a donated care referral system that can be easily accessed by individuals in need of medical care;   Collaborative work with agencies and entities across the state to encourage citizens to volunteer their time, effort, and resources in creative efforts to assist in the overall care and well-being of uninsured individuals in this state; and   Support for community-based providers of behavioral health services to seriously and persistently mentally ill adults who are uninsured and who lack financial resources to secure behavioral health care.     Nothing established or supported pursuant to this section shall in any way be construed or determined to be an entitlement by any individual or entity to any medical assistance, medical services, or any pharmacy services, or, if such assistance or services are provided, to any continuing assistance or services by the state or by any other entity or person.
TN Code § 71-5-149 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-149. Disease Management Program

 The bureau of TennCare shall adopt a state disease management program, which may include contracting with a vendor that specializes in the provision of disease management services. The disease management program shall be designed to improve care to and reduce overall expenditures for TennCare beneficiaries with chronic illnesses. The disease management program may include the development of evidence-based medical practice guidelines, support services to assist physicians in monitoring their patients, more closely managed patient care, including management of the proper use of prescription drugs by patients, and the development of individual patient treatment plans that may include recommendations for improved medication compliance and improved lifestyle and behavioral compliance. The adoption of a disease management program is not an agency action and does not require rulemaking.
TN Code § 71-5-150 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-150. Reimbursement for Tenncare Crossover Payments

 The bureau of TennCare shall reimburse pharmacies for covered products and services provided for full benefit dual eligibles as TennCare crossover claims at one hundred percent (100%) of the federal medicare program's allowable charge for participating providers.
TN Code § 71-5-152 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-152. Procedure to Obtain Data Sets Derived From All Payer Claims Database — Use of Data — Annual Report

  Pursuant to § 56-2-125(d)(2)(B), and no later than October 1, 2016, the deputy commissioner of finance and administration responsible for the TennCare program shall establish a procedure permitting the following to obtain data sets derived from the all payer claims database through the department authorized to access the database for the purposes authorized in § 56-2-125(b)(1) within available resources of the bureau of TennCare:  The department of finance and administration;   The department of health;   The department of mental health and substance abuse services;   The department of intellectual and developmental disabilities; and   Other departments of this state.     Any data retrieved from the database or the managing vendor may only be used for internal purposes of the department. The data shall be confidential and shall not be a public record for the purposes of title 10, chapter 7. If any department seeks to produce reports based upon the data as public documents, then the department shall submit a request for approval of that use of the data to the Tennessee health information committee.   The bureau of TennCare shall submit an annual report to the chairs of the health and welfare committee of the senate, health committee of the house of representatives, and committee of the house of representatives having oversight over TennCare that shall describe the nature and purpose of any requests to utilize data from the all payer claims database submitted to the bureau or the health information committee. Any request for data from departments that cannot be provided within existing resources of the bureau shall be identified in this report. The report shall also describe the disposition made by the Tennessee health information committee of each request to utilize the data and shall detail how each member of the committee voted on each request. The bureau shall submit the report by January 15 each year.
TN Code § 71-5-153 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-153. Verification of Information

  Prior to awarding assistance, and on a quarterly basis thereafter, the bureau of TennCare shall verify identity information for each respective applicant and enrollee against the following:  Wage and income information maintained by state and federal sources;   Immigration status information maintained by federal citizenship and immigration services; and   Information maintained by the department of health, office of vital records.     Subsection (a) shall not take effect until the last day of the first full quarter following implementation of an automated, electronic eligibility system by the bureau of TennCare. The bureau of TennCare shall notify the executive secretary of the code commission upon implementation of an automated, electronic eligibility system.
TN Code § 71-5-157 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-157. Establishment of State Policy to Avoid Use of State Funds for Elective Abortions

  It is the policy of the state to favor childbirth as integral to the health and welfare of the citizens of the state and therefore to favor family planning services that do not include elective abortions or the promotion of elective abortions within the continuum of care or services offered by the provider and to avoid the direct or indirect use of state funds to promote or support elective abortions.   In furtherance of this state policy, a waiver amendment to the existing TennCare II waiver that requires elective abortion providers be excluded from participation as providers in the TennCare program shall be submitted to the federal centers for medicare and medicaid services for approval. The waiver amendment shall be implemented within ten (10) business days of approval.   For purposes of this section, an “elective abortion provider” means any entity that performed, or operated or maintained a facility that performed, more than fifty (50) abortions in the previous year, or any affiliate of such an entity.   This section does not affect compliance with § 9-4-5116.
TN Code § 71-5-158 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-158. Amendment to Tenncare Ll Waiver Relating to Work and Community Engagement Requirements for Certain Adult Enrollees

 An amendment to the existing TennCare II waiver shall be submitted to the federal centers for medicare and medicaid services (CMS) authorizing the bureau of TennCare to create reasonable work and community engagement requirements for able-bodied working age adult enrollees without dependent children under the age of six (6). The waiver shall be consistent with the most recent guidance to state medicaid directors provided by CMS concerning opportunities to promote work and community engagement in demonstration projects authorized under § 1115 of the federal social security act (42 U.S.C. § 1315). The state shall seek the necessary approval from the United States department of health and human services to utilize funds from the temporary assistance to needy families (TANF) program under the Families First Act of 1996, compiled in chapter 3, part 1 of this title, for eligible expenditures related to the waiver. Implementation of the waiver shall be contingent upon the available use of TANF funds or other federal appropriations to meet the requirements of the waiver.
TN Code § 71-5-159 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-159. Complex Rehabilitation Technology

  As used in this section, “complex rehabilitation technology”:  Means items classified within medicare as group 3, group 4, or group 5 power wheelchairs and manual wheelchairs with the HCPCS billing codes K0005 and E1161; and   Includes options and accessories related to any of such items.     The commissioner of finance and administration, or the commissioner's designee, shall recognize complex rehabilitation technology as a separate covered service from other items considered to be durable medical equipment within medicare, and must list complex rehabilitation technology benefits separately on any proposed budget document or other financial publication made available to the public if the budget document or other financial publication establishes a change in reimbursement for complex rehabilitation technology.
TN Code § 71-5-160 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-160. Maintenance of Coverage Trust Fund

  There is continued and revived, if necessary, a segregated account within the state treasury that shall be known as the maintenance of coverage trust fund created by Chapter 909 of the Public Acts of 2010. The fund shall not be used to replace any moneys otherwise appropriated to the TennCare program by the general assembly or to replace any moneys appropriated outside of the TennCare program.   The maintenance of coverage trust fund shall consist of:  All annual coverage assessments received by the bureau; and   Investment earnings credited to the assets of the maintenance of coverage trust fund.     Monies credited or deposited to the maintenance of coverage trust fund together with all federal matching funds shall be available to and used by the bureau only for expenditures in the TennCare program and shall include the purposes authorized in the annual coverage assessment act enacted by the general assembly and codified in this title.
TN Code § 71-5-162 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-162. Identification of Child Enrollees Eligible for Federal Supplemental Security Income Upon Reaching 18 Years of Age — Counseling — Enrollment Assistance

 The bureau of TennCare shall establish a program that:   Identifies child enrollees in TennCare who, by reason of a disability, are likely to be eligible for federal supplemental security income upon reaching eighteen (18) years of age;   In the year prior to each eligible child enrollee's eighteenth birthday, counsels the child and the child's parent or guardian on the benefits available from and enrollment requirements for the federal supplemental security income program; and   Provides enrollment assistance to the child prior to the child's eighteenth birthday in a manner that the bureau determines is most likely to ensure that there will be no gap in TennCare eligibility or coverage due to the child reaching eighteen (18) years of age.
TN Code § 71-5-163 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-163. Submission of Waiver in Order to Provide Medical Assistance to Tenncare Ll Waiver Population by Means of Block Grant

  The governor, acting through the commissioner of finance and administration, is directed to submit to the federal centers for medicare and medicaid services a waiver amendment to the existing TennCare II waiver, or to submit a new waiver, in order to provide medical assistance to the TennCare II waiver population by means of a block grant in accordance with this section no later than one hundred eighty (180) days after May 24, 2019. The block grant authorized by this section may convert the federal share of all medical assistance funding for this state into an allotment that is tailored to meet the needs of this state and that:  When determining the base amount for the block grant, factors the current inaccurate reflection of the state's labor costs in the state's Medicare Wage Index and the index's negative impact on healthcare delivery in this state;   Is indexed for population growth;   Is indexed for inflation and other costs;   Excludes from the block grant financing amount any expenses that are not included in the state's existing 1115 demonstration waiver;   Excludes administrative costs from the block grant financing amount and permits the state to continue to draw federal matching funds for administrative costs;   Provides the state with maximum flexibility with regard to existing federal mandates and regulations and with implementing cost controls as determined appropriate by the state, and either exempts the state from the requirements of any new mandates, regulations, or federal court orders during the period of block grant financing or increases the amount of block grant financing to offset any cost increases to the state from such mandates, regulations, or federal court orders;   Provides the state with maximum flexibility regarding pharmacy benefits including fluctuation of prescription drug costs, diabetic testing supplies, and over-the-counter medications;   Provides the state with maximum flexibility to serve other needy populations with distinct financial or healthcare needs; and   Remains at the level set according to the block grant without any decrease in the federal share of all medical assistance funding for this state based on deflation or a reduction in population.     A waiver amendment to the existing TennCare II waiver requested pursuant to subsection (a), if approved by the federal government and the commissioner of finance and administration, does not take effect unless subsequently authorized by joint resolution of the general assembly.
TN Code § 71-5-165 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-165. Reimbursement of Ambulance Service Provider That Provides Covered Service to Tenncare Recipient

  The bureau of TennCare shall reimburse an ambulance service provider that provides a covered service to a TennCare recipient at a rate not less than sixty-seven and one-half percent (67.5%) of the federal medicare program's allowable charge for participating providers. For purposes of this section, “ambulance service provider” means a public or private ground-based ambulance service that bills for transports and has a base of operations in this state.   This section does not affect the Ground Ambulance Service Provider Assessment Act, compiled under part 15 of this chapter. Funds described under this section and part 15 of this chapter may not be used to fund the other.   The bureau of TennCare shall seek an intergovernmental transfer of funds, in consultation with, and subject to approval of, the commissioner of finance and administration for the sole purpose of increasing the rate of reimbursement to ambulance service providers that provide covered services to TennCare recipients at a rate greater than the rate described under subsection (a).
TN Code § 71-5-184 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-184. Service — Limitations

  A subpoena requiring the attendance of a witness at a trial or hearing conducted under § 71-5-183 may be served at any place in the United States.   A civil action under § 71-5-183 may not be brought:  More than six (6) years after the date on which the violation of § 71-5-182 is committed; or   More than three (3) years after the date when facts material to the right of action are known or reasonably should have been known by the official of the state charged with responsibility to act in the circumstances, but in no event more than ten (10) years after the date on which the violation is committed, whichever occurs last.     If the state elects to intervene and proceed with an action brought under § 71-5-183(b), the state may file its own complaint or amend the complaint of a person who has brought an action under § 71-5-183(b) to clarify or add detail to the claims in which the state is intervening and to add any additional claims with respect to which the state contends it is entitled to relief. For statute of limitations purposes, any such state pleading shall relate back to the filing date of the complaint of the person who originally brought the action, to the extent that the claim of the state arises out of the conduct, transactions, or occurrences set forth, or attempted to be set forth, in the prior complaint of that person.   In any action brought under § 71-5-183, the state shall be required to prove all essential elements of the cause of action, including damages, by a preponderance of the evidence.   Notwithstanding any other law, the Tennessee Rules of Criminal Procedure, or the Tennessee Rules of Evidence, a final judgment rendered in favor of the state in any criminal proceeding charging fraud or false statements, whether upon a verdict after trial or upon a plea of guilty or nolo contendere, shall stop the defendant from denying the essential elements of the offense in any action that involves the same transaction as in the criminal proceeding and that is brought under subsection (a) or (b) or § 71-5-183.
TN Code § 71-5-185 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-185. Venue

 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.
TN Code § 71-5-189 (2021)
2021 Tennessee Code|Title 71 - Welfare|Chapter 5 - Programs and Services for Poor Persons|Part 1 - Medical Assistance Act|§ 71-5-189. Accounting of Tenncare Funds

 The bureau of TennCare shall provide to the comptroller of the treasury on a quarterly basis an accounting of funds involved in the pharmacy rebate program, including a summary of bills and receipts.