2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 5 - PROGRAMS AND SERVICES FOR POOR PERSONS (§§ 71-5-NEW — 71-5-2604) › Part 20 - ANNUAL COVERAGE ASSESSMENT ACT OF 2023 [For expiration, see Section 71-5-2006] (§§ 71-5-2001 — 71-5-2007) › Section 71-5-2002 - [Expires 7/1/2025] Part definitions

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.