reglab/statecodes huggingface dataset:
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 12 - AID TO DISABLED PERSONS - PERSONAL CARE SERVICE SUBSIDIES (§§ 71-4-1201 — 71-4-1210) › Section 71-4-1205 - Eligibility evaluation teams

(a)
The director of the division shall designate one (1) or more evaluation teams, which shall consist of at least two (2) persons, one (1) of whom shall be a licensed medical professional and one (1) of whom shall be a licensed occupational therapist or physical therapist.
(b)
Each individual who applies to the division for a personal care assistance services subsidy shall be evaluated by an evaluation team, which shall determine the need of that individual for personal care assistance service and the extent of that need.
(c)
An individual receiving a personal care assistance services subsidy pursuant to this part shall be periodically reevaluated by an evaluation team to determine such individual's continuing need for personal care assistance services and the extent of that need.
Acts 1986, ch. 905, § 7; T.C.A., § 14-16-205.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 12 - AID TO DISABLED PERSONS - PERSONAL CARE SERVICE SUBSIDIES (§§ 71-4-1201 — 71-4-1210) › Section 71-4-1206 - Rules and regulations - Establishment of hourly rate

(a)
The commissioner of human services shall promulgate, in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, such rules as shall be necessary to ensure that this part is implemented in an efficient and effective manner.
(b)
The commissioner is authorized to establish the hourly rate for the subsidy for personal care assistance services. Funding for the subsidy provided by this part shall be from year to year as such funds are specifically appropriated in the general appropriations act pursuant to title 9, chapter 4, part 51.
Acts 1986, ch. 905, § 8; T.C.A., § 14-16-206.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 12 - AID TO DISABLED PERSONS - PERSONAL CARE SERVICE SUBSIDIES (§§ 71-4-1201 — 71-4-1210) › Section 71-4-1207 - Funds

(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.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 12 - AID TO DISABLED PERSONS - PERSONAL CARE SERVICE SUBSIDIES (§§ 71-4-1201 — 71-4-1210) › Section 71-4-1208 - Annual reports - Register of individuals

The department of human services shall annually report to the governor and the general assembly on the progress made in the personal care assistance program and shall maintain a register of individuals served and individuals eligible for the program but unserved.
Acts 1986, ch. 905, § 9; T.C.A., § 14-16-208.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 12 - AID TO DISABLED PERSONS - PERSONAL CARE SERVICE SUBSIDIES (§§ 71-4-1201 — 71-4-1210) › Section 71-4-1210 - Veterans education benefits

Notwithstanding any other provision of this chapter, to the extent permitted by federal law, the value of federal veterans education benefits received by an applicant shall not be included as any form of income when making eligibility determinations for assistance under this part.
Acts 2003, ch. 239, § 2.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 21 - DEAF AND HARD OF HEARING PERSONS (§§ 71-4-2101 — 71-4-2109) › Section 71-4-2101 - Part definitions

(1)
A "deaf-blind person" means the same as an "individual who is deaf-blind" and both mean any individual:
(A)
(i)
Who has a central visual acuity of 20/200 or less in the better eye with corrective lenses, or a field defect such that the peripheral diameter of visual field subtends an angular distance no greater than twenty degrees (20°), or a progressive visual loss having a prognosis leading to one (1) or both these conditions;
(ii)
Who has chronic hearing loss so severe that most speech cannot be understood with optimum amplification, or a progressive hearing loss having a prognosis leading to this condition; and
(iii)
For whom the combination of vision and hearing loss described in subdivisions (1)(A)(i) and (ii) cause extreme difficulty in attaining independence in daily life activities, achieving psychosocial adjustment, or obtaining a vocation;
(B)
Who despite the inability to be measured accurately for hearing and vision loss due to cognitive or behavioral constraints, or both, can be determined through functional and performance assessment to have severe hearing and visual disabilities that cause extreme difficulty in attaining independence in daily life activities, achieving psychosocial adjustment, or obtaining vocational objectives; or
(C)
Meets such other requirements as the secretary may prescribe by regulation;
(2)
A "deaf person" means a person whose hearing loss is total or whose hearing loss, with or without amplification, is so significant that the primary means of receiving spoken language is through visual input, including, but not limited to, speechreading, sign language, finger spelling, or writing; and
(3)
"Secretary" means the United States secretary of education.
Amended by 2019 Tenn. Acts, ch. 329,Secs.s3, s4, s5 eff. 5/8/2019.
Amended by 2013 Tenn. Acts, ch. 455,s 1, eff. 7/1/2013.
Acts 1978, ch. 889, § 1; T.C.A., § 14-2501; Acts 1983, ch. 48, § 1; T.C.A., § 14-18-101.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 21 - DEAF AND HARD OF HEARING PERSONS (§§ 71-4-2101 — 71-4-2109) › Section 71-4-2102 - Creation of the Tennessee council for the deaf, deaf-blind and hard of hearing

Effective July 1, 2013, there is hereby created the Tennessee council for the deaf, deaf-blind, and hard of hearing, which has the duty to:
(1)
Advocate services affecting people who are deaf, deaf-blind, and hard of hearing in the areas of public services, health care, education, vocational training, employment opportunity, emergency services, resource sharing and communication;
(2)
Act as a bureau of information for people who are deaf, deaf-blind, and hard of hearing to state agencies and public institutions providing health care, employment, vocational, educational services, resource sharing, and emergency services to the deaf, deaf-blind, and hard of hearing, and to local agencies and programs;
(3)
Collect facts and statistics and other special studies of conditions affecting the health and welfare of people who are deaf, deaf-blind, and hard of hearing in this state;
(4)
Provide for a mutual exchange of ideas and information on the national, state, and local levels;
(5)
Encourage and assist local governments and agencies in the development of programs for people who are deaf, deaf-blind, and hard of hearing;
(6)
Cooperate with public and private agencies and units of local, state, and federal governments in promoting coordination in programs for the deaf, deaf-blind, and hard of hearing;
(7)
Authorize the executive director to prepare an annual report and needs assessment to the council that reviews the status of state services for the deaf, deaf-blind, and hard of hearing. The council shall submit the approved report and needs assessment to the governor, lieutenant governor, and speaker of the house of representatives and make this report available to organizations serving the deaf, deaf-blind, and hard of hearing; and
(8)
Make recommendations for needed improvements and to serve as an advisory body in regard to new legislation affecting the deaf, deaf-blind, and hard of hearing.
Amended by 2013 Tenn. Acts, ch. 455, s 1, eff. 7/1/2013.
Acts 1978, ch. 889, § 2; T.C.A., §§ 14-2502, 14-18-102; Acts 2001, ch. 174, § 14.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 21 - DEAF AND HARD OF HEARING PERSONS (§§ 71-4-2101 — 71-4-2109) › Section 71-4-2104 - Executive director - Duties - Qualifications

(a)
The council for the deaf, deaf-blind, and hard of hearing shall recommend to the governor an executive director and shall fix the executive director's duties and responsibilities. The executive director shall serve as executive officer and secretary to the council and shall be a full-time employee of the council. Compensation for the executive director shall be established by the council with the approval of the commissioner of human resources. All reimbursement for travel expenses shall be in accordance with the comprehensive travel regulations as promulgated by the department of finance and administration and approved by the attorney general and reporter.
(b)
The executive director, with the advice and consent of the council, may, to the extent of available funds, plan and oversee the establishment of service centers for the deaf, deaf-blind, and hard of hearing, as well as, or in addition to, support and coordinate the activities of the existing centers in cooperation with the local board of directors.
(c)
The executive director, with the advice and consent of the council, shall:
(1)
Promote accessibility of all governmental services to deaf, deaf-blind, and hard of hearing citizens in Tennessee;
(2)
Identify agencies, both public and private that provide community services, evaluate the extent to which they make services available to deaf, deaf-blind, and hard of hearing people, and cooperate with the agencies in coordinating and extending these services;
(3)
Encourage the mutual exchange of ideas and information on services for deaf, deaf-blind, and hard of hearing people between federal, state and local governmental agencies, and private organizations and individuals;
(4)
Survey the needs of people who are deaf, deaf-blind, and hard of hearing in Tennessee, and assist the council in the preparation of its report to the governor, lieutenant governor, and speaker of the house of representatives;
(5)
Develop a strategy to create minimum standards for all sign language interpreters in Tennessee and make recommendations on how to implement these strategies to appropriate state departments, the governor, lieutenant governor, speaker of the house of representatives and general assembly;
(6)
Promote the training of interpreters for the deaf, deaf-blind, and hard of hearing; and
(7)
Perform such other duties as may be required by law.
(d)
In selecting an executive director, the council shall select an individual who is fluent in the American sign language of the deaf and otherwise qualified.
(e)
The executive director is authorized to arrange for such clerical or other assistance as may be required and as approved by the council.
Amended by 2013 Tenn. Acts, ch. 455,s 1, eff. 7/1/2013.
Acts 1978, ch. 889, § 4; T.C.A., §§ 14-2504, 14-18-104; Acts 1987, ch. 6, § 3; 2001, ch. 174, § 16.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 21 - DEAF AND HARD OF HEARING PERSONS (§§ 71-4-2101 — 71-4-2109) › Section 71-4-2105 - Data supplied by state agencies and political subdivisions

The council for the deaf, deaf-blind, and hard of hearing may request and shall receive from any department, division, board, bureau, commission, or agency of the state or of any political subdivision of the state such data as might be needed to enable it to properly carry out its activities under this part.
Amended by 2013 Tenn. Acts, ch. 455,s 1, eff. 7/1/2013.
Acts 1978, ch. 889, § 5; T.C.A., §§ 14-2505, 14-18-105; Acts 2001, ch. 174, § 17.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 21 - DEAF AND HARD OF HEARING PERSONS (§§ 71-4-2101 — 71-4-2109) › Section 71-4-2106 - Plans for implementing community services for the deaf or hard of hearing

The council shall ensure that long range planning is conducted, which shall include a description of the locations and geographic service areas for community service centers, as well as a determination of personnel needs and strategies for coordinating service providers at state and local levels.
Amended by 2013 Tenn. Acts, ch. 455,s 1, eff. 7/1/2013.
Acts 1978, ch. 889, § 6; T.C.A., §§ 14-2506, 14-18-106.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 21 - DEAF AND HARD OF HEARING PERSONS (§§ 71-4-2101 — 71-4-2109) › Section 71-4-2107 - Purposes of community service centers

The purposes of community service centers for the deaf, deaf-blind and hard of hearing shall be to:
(1)
Inform deaf, deaf-blind, and hard of hearing persons and their families of their rights to services offered locally and to coordinate their referral to the appropriate organization;
(2)
Coordinate communication between deaf, deaf-blind, and hard of hearing persons and the desired agency or organization, and promote the accessibility of community services to deaf, deaf-blind, and hard of hearing persons;
(3)
Coordinate the provision of instruction in sign language to persons in community agencies;
(4)
Inform interested staff of community and professional organizations about the nature of deafness, deaf-blindness and hearing loss and the capabilities of people experiencing it;
(5)
Provide services as outlined by this part to employers of deaf, deaf-blind, and hard of hearing persons and related members of the family that may be involved;
(6)
Provide the specified services to the deaf, deaf-blind, and hard of hearing persons qualified under this part without cost;
(7)
Serve as an advocate for the rights and needs of people who are deaf, deaf-blind, and hard of hearing; and
(8)
Help deaf, deaf-blind, and hard of hearing citizens to become self-sufficient in meeting their needs in the community.
Amended by 2013 Tenn. Acts, ch. 455,s 1, eff. 7/1/2013.
Acts 1978, ch. 889, § 7; T.C.A., §§ 14-2507, 14-18-107; Acts 2001, ch. 174, § 18.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 21 - DEAF AND HARD OF HEARING PERSONS (§§ 71-4-2101 — 71-4-2109) › Section 71-4-2108 - Source of funds

The council for the deaf, deaf-blind, and hard of hearing is authorized to pursue and receive moneys from any source, including appropriate federal funds, gifts, grants, and bequests, which shall be expended for the purposes designated in this part.
Amended by 2013 Tenn. Acts, ch. 455,s 1, eff. 7/1/2013.
Acts 1978, ch. 889, § 8; T.C.A., §§ 14-2508, 14-18-108; Acts 2001, ch. 174, § 19.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 21 - DEAF AND HARD OF HEARING PERSONS (§§ 71-4-2101 — 71-4-2109) › Section 71-4-2109 - Authorization for other agencies to supply services

The governor is authorized to designate existing departments of state government, or divisions of state government, to provide statewide services to the deaf, deaf-blind, and hard of hearing as specified in this part.
Amended by 2013 Tenn. Acts, ch. 455,s 1, eff. 7/1/2013.
Acts 1978, ch. 889, § 9; T.C.A., §§ 14-2509, 14-18-109; Acts 2001, ch. 174, § 20.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 22 - SERVICES TO FAMILIES OF PRESCHOOL CHILDREN WITH DISABILITIES (§ 71-4-2201) › Section 71-4-2201 - Development of incentives

To the extent that federal funds are not jeopardized and in accordance with responsibilities required to be performed by the interagency coordinating council created pursuant to
20 U.S.C. § 1482
, the council shall advise and assist the lead agency appointed pursuant to
20 U.S.C. § 1476
[repealed] in developing incentives that will encourage programs serving young children with disabilities to provide or improve services to families of preschool children with disabilities. The development of the incentives may include, but is not limited to:
(1)
Identifying and publicizing model programs with parent involvement components or model practices for services to parents;
(2)
Assuring that training opportunities are provided to educate program staff in current best practices for serving families; and
(3)
Identifying and coordinating all available resources within the state from federal, state, local and private sources for existing programs and for future programs to hire staff to provide training and support services to parents.
Acts 1988, ch. 625, § 1; 2011 , ch. 47, § 105.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 23 - PREVENTATIVE MAINTENANCE VISITS (§§ 71-4-2301 — 71-4-2303) › Section 71-4-2301

As used in this part:
(1)
"Authorized complex rehabilitation technology supplier" means a seller of complex rehabilitation technology that supplies products and services for complex rehabilitation technology equipment;
(2)
"Complex rehabilitation technology":
(A)
Has the same meaning as defined in § 71-5-159; and
(B)
Includes a manual wheelchair;
(3)
"Manual wheelchair":
(A)
Has the same meaning as described in § 71-5-159(a)(1); and
(B)
Includes a nonpower, specialized, and medically necessary wheelchair;
(4)
"Preventative maintenance" means an assessment of a complex rehabilitation technology and its use by an authorized technician working on behalf of an: authorized complex rehabilitation technology supplier, including an assessment of:
(A)
The physical condition of the complex rehabilitation technology; and
(B)
Any needed repairs that the authorized technician is able to complete;
(5)
"Repair" means the repair or replacement of a deficient, broken, or otherwise malfunctioning part, component, hardware, or software, wh~n the deficient, broken, or otherwise malfunctioning state of such part, component, hardware, or software results in the incapacity of or otherwise diminished capacity for use of a complex rehabilitation technology; and
(6)
"TennCare program":
(A)
Means the medical assistance program provided for in title 71, chapter 5, or a successor program; and
(B)
Includes the CoverKids program provided for in title 71, chapter 3, part 11.
Added by 2024 Tenn. Acts, ch. 1050,s 2, eff. 7/1/2024.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 23 - PREVENTATIVE MAINTENANCE VISITS (§§ 71-4-2301 — 71-4-2303) › Section 71-4-2302

(a)
A policy, certificate, or agreement for health insurance coverage issued under the TennCare program must provide coverage and reimbursement for:
(1)
Medically necessary repairs provided by authorized complex rehabilitation technology equipment suppliers; and
(2)
At least one (1) preventative maintenance visit per year provided by authorized complex rehabilitation technology equipment suppliers, including appropriate reimbursement for services rendered during the preventative maintenance, parts, labor, diagnostic and evaluation time, and oth,er related costs.
(b)
A TennCare program enrollee must be informed of the coverage required under this part at the time of initial enrollment and when a current enrollee renews a policy, certificate, or agreement for health insurance coverage under the TennCare program.
(c)
A policy, certificate, or agreement for health insurance coverage issued in this state under the TennCare program must:
(1)
Not require medical documentation or proof of continued need for a repair or preventative maintenance of a complex rehabilitation technology; and
(2)
Consistent with federal law and regulations, provide coverage for telehealth visits for complex rehabilitation technology.
(d)
Subdivision (c)(1) does not prohibit a policy issued under the TennCare program from requiring documentation needed for a medical necessity determination to be made in accordance with § 71-5-144.
Added by 2024 Tenn. Acts, ch. 1050,s 2, eff. 7/1/2024.
2023 Tennessee Code › Title 71 - WELFARE (§§ 71-1-101 — 71-7-103) › Chapter 4 - PROGRAMS AND SERVICES FOR PERSONS WITH DISABILITIES (§§ 71-4-101 — 71-4-2303) › Part 23 - PREVENTATIVE MAINTENANCE VISITS (§§ 71-4-2301 — 71-4-2303) › Section 71-4-2303

(a)
A preventative maintenance visit may be performed at any location agreed upon by the enrollee and the authorized complex rehabilitation technology supplier and is not required to be performed at the enrollee's location.
(b)
(1)
Preventative maintenance must be performed by a qualified technician who is an employee of the authorized complex rehabilitation technology supplier, and must be performed according to the manufacturer's guidelines. The preventative maintenance may be performed during a complex rehabilitation technology appointment for an unrelated issue, and is not required to be a standalone appointment or event.
(2)
The authorized complex rehabilitation technology supplier shall document and maintain all records of preventative maintenance services performed pursuant to this part.
Added by 2024 Tenn. Acts, ch. 1050,s 2, eff. 7/1/2024.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-NEW - [Newly enacted section not yet numbered] (§ 71-5-NEW) › 1

(a)
As used in this section, "CPT code" means the unique numerical designations established by the American Medical Association for various medical, surgical, and diagnostic services used in billing healthcare services.
(b)
No later than December 31, 2024, the bureau of TennCare shall amend existing rules, or promulgate new rules, on fee-for-service and medicaid managed care plans regarding reimbursement to allow for the reimbursement of remote ultrasound procedures and remote fetal nonstress tests utilizing established CPT codes for such procedures when the patient is in a residence or other off-site location that is separate from the patient's provider and the same standard of care is met.
(c)
When amending or promulgating rules pursuant to subsection (b), the bureau shall ensure that:
(1)
A remote ultrasound procedure or remote fetal nonstress test is only reimbursable when the provider uses digital technology:
(A)
To collect medical and other forms of health data from a patient and electronically transmit that information securely to a healthcare provider who is in a separate location for the purpose of interpretation and making recommendations;
(B)
That is compliant with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA)(
42 U.S.C. § 1320d
et seq.); and
(C)
That is approved by the federal food and drug administration; and
(2)
A fetal nonstress test is only reimbursable with a place of service modifier for at-home monitoring with remote monitoring solutions that are cleared by the federal food and drug administration for on-label use for monitoring fetal heart rate, maternal heart rate, and uterine activity.
Added by 2024 Tenn. Acts, ch. 674,s 1, eff. 4/11/2024.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-NEW - [Newly enacted section not yet numbered] (§ 71-5-NEW) › 2

(a)
As used in this section:
(1)
"Division" means the division of TennCare; and
(2)
"Non-opioid treatment" means a drug or biological product that is indicated to produce analgesia without acting on the body's opioid receptors.
(b)
The division shall ensure that reimbursement is provided to a healthcare provider who provides a non-opioid treatment to a recipient under the medical assistance program.
(c)
The division shall ensure that, to the extent permitted by law, a hospital that provides either inpatient or outpatient services to a recipient is reimbursed under the medical assistance program for any medically necessary non-opioid treatment provided as a part of those services.
Added by 2024 Tenn. Acts, ch. 762,s 2, eff. 7/1/2024.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-NEW - [Newly enacted section not yet numbered] (§ 71-5-NEW) › 3

Notwithstanding another law, when a healthcare prescriber prescribes a non-opioid medication for the treatment of acute or chronic pain, a managed care organization or other health insurance issuer shall not deny coverage of the non-opioid prescription drug in favor of an opioid prescription drug. As used in this section, "healthcare prescriber" means a prescriber as defined in § 53-10-203.
Added by 2024 Tenn. Acts, ch. 762,s 3, eff. 7/1/2024.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-NEW - [Newly enacted section not yet numbered] (§ 71-5-NEW) › 4

(a)
As used in this section:
(1)
"Health benefit plan" means a plan of health insurance coverage under the medical assistance program;
(2)
"Health insurance carrier":
(A)
Means an entity subject to title 56, or subject to the jurisdiction of the commissioner of commerce and insurance, that contracts with healthcare providers in connection with a plan of health insurance, health benefits, or health services; and
(B)
Includes a vendor or an entity that provides a health benefit plan of coverage under TennCare or a successor program provided for pursuant to this chapter; and
(3)
"TennCare health benefit plan" means a health benefit plan issued by a health insurance carrier pursuant to an agreement with the bureau of TennCare to provide health insurance coverage for an enrollee in the medical assistance program.
(b)
Notwithstanding another law to the contrary, a TennCare health benefit plan issued by a health insurance carrier must provide coverage and reimbursement for mental health services and treatment to the same extent that the TennCare health benefit plan provides coverage and reimbursement for the treatment of alcoholism and drug dependence.
Added by 2024 Tenn. Acts, ch. 949,s 1, eff. 7/1/2024.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-101 - Short title

This part may be cited as and shall be known as the "Medical Assistance Act of 1968."
Acts 1968, ch. 551, § 1; T.C.A., §§ 14-1901, 14-23-101.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-104 - Administration by department

(a)
The department of health is hereby designated as the department to administer this part as provided in Title XIX or as provided by any federal waiver received by the state that waives any or all of the provisions of Title XIX or pursuant to any other federal law as adopted by amendment to the required Title XIX state plan.
(b)
The bureau of TennCare shall notify each member of the general assembly via electronic mail or other type of electronic communication when it:
(1)
Proposes a change in services or reimbursement that affects more than two thousand five hundred (2,500) beneficiaries; or
(2)
Proposes a change that will affect current or future appropriations made by the general assembly in any amount that is greater than ten million dollars ($10,000,000).
(c)
The bureau of TennCare shall report at least quarterly to members of the Tennessee general assembly via electronic mail or other type of electronic communication on the following:
(1)
Status of TennCare reform and improvements;
(2)
Number of recipients on TennCare and costs to the state;
(3)
Viability of MCOs and providers in the TennCare program; and
(4)
Success of fraud detection and prevention.
(d)
The bureau of TennCare shall concurrently transmit to members of the general assembly via electronic mail or other type of electronic communication TennCare's annual budget proposal when presented in a public forum.
Acts 1968, ch. 551, § 4; 1973, ch. 276, § 3; impl. am. Acts 1975, ch. 219, § 1 (a), (b); T.C.A., § 14-1904; Acts 1982, ch. 730, § 4; T.C.A., § 14-23-104; Acts 1993, ch. 358, § 3; 2010, ch. 1079, § 3.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-108 - Payment methodology for medicaid enrollees not enrolled in medicare

The TennCare bureau is directed to submit a state plan amendment to the centers for medicare and medicaid services that sets out a payment methodology for medicaid enrollees who are not also enrolled in medicare, consistent with provisions in § 6085 of the federal Deficit Reduction Act of 2005, regarding emergency services furnished by noncontract providers for managed care enrollees. The payment amount shall be the average contract rate that would apply under the state plan for general acute care hospitals. A tiered grouping of hospitals by size or services may be utilized to administer these payments. The payment methodology developed pursuant to this section shall be budget neutral for the state fiscal year 2007-2008 when compared to the actual experience for emergency services furnished by non-contract providers for medicaid managed care enrollees prior to January 1, 2007. It is the intent that this section only applies to the emergency services furnished by noncontract providers for medicaid managed care enrollees.
Acts 2007, ch. 409, § 1.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-109 - Expenditures not to exceed appropriation

(a)
In no event shall the services paid for by the state including assistance from the United States government require expenditure of state funds in excess of the amount appropriated for such purpose.
(b)
The commissioner may by rule and regulation fix the maximum level of services as are deemed necessary to ensure that an expenditure of state funds shall not exceed the amount provided for those purposes, as approved by the commissioner of finance and administration.
Acts 1968, ch. 551, § 9; T.C.A., §§ 14-1909, 14-23-109.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-110 - Application for medical assistance - Application for TennCare enrollment - Notice of change in application information

(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.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-111 - Investigation - Determination of eligibility

When an application for medical assistance under this part is filed with the agency designated to determine eligibility under this part, the agency shall promptly make or cause to be made such investigation as it may deem necessary. The object of such investigation shall be to ascertain the fact supporting the application and such other information as may be required.
Acts 1968, ch. 551, § 11; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., § 14-1911; Acts 1982, ch. 730, § 11; T.C.A., § 14-23-111.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-112 - Hearing concerning eligibility

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.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-113 - Hearing concerning matters other than eligibility

(a)
Except as required in §
71-5-112
, whenever a hearing is required by state or federal law or constitutional provision, the department shall provide such hearings before the commissioner or the commissioner's designee.
(b)
Such hearing shall be held in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, except that the commissioner may adopt rules that establish procedures not necessarily in accordance with the Uniform Administrative Procedures Act for the review of appeals from denials of claims for payment for medical assistance under this part where the amount of the claim is less than five hundred dollars ($500).
(c)
The procedures shall include the opportunity for an informal hearing before the commissioner or the commissioner's designee, who shall not be a medicaid employee.
Acts 1968, ch. 551, § 13; T.C.A., § 14-1913; Acts 1982, ch. 730, § 13; 1984, ch. 607, § 1; T.C.A., § 14-23-113.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-114 - Subpoena and examination of witnesses

(a)
The appropriate departments have the power to subpoena witnesses, to compel their attendance and the production of papers and writings.
(b)
The officers and employees designated by the appropriate department may administer oaths and examine witnesses under oath in connection with any application or proceedings under this part.
Acts 1968, ch. 551, § 14; T.C.A., §§ 14-1914, 14-23-114.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-115 - Financial responsibility of relative - When may be considered - Reimbursement from responsible parties

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.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-119 - Discrimination prohibited

(a)
No discrimination shall be practiced or asserted against any applicant for or recipient of medical assistance under this chapter on the basis of race, color or national origin.
(b)
The furnishing of care and services under this part to any applicant or recipient of medical assistance shall not be delayed or denied on the basis of race, color or national origin.
Acts 1968, ch. 551, § 19; T.C.A., § 14-1919; Acts 1982, ch. 730, § 17; T.C.A., § 14-23-119.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-120 - Residency requirement - Determination - Appeal

(a)
No period of residence in this state shall be required as a condition for eligibility for medical assistance under this chapter, but an individual who does not reside in this state shall not be eligible.
(b)
The bureau of TennCare shall adopt rules for determining whether an applicant is a resident of this state subject to the requirements of federal law. The rules shall require that state residency is not established unless the applicant does both of the following:
(1)
The applicant produces one (1) of the following:
(A)
A current Tennessee rent or mortgage receipt or utility bill in the adult applicant's name;
(B)
A current Tennessee motor vehicle driver's license or identification card issued by the Tennessee department of safety in the adult applicant's name;
(C)
A current Tennessee motor vehicle registration in the adult applicant's name;
(D)
A document showing that the adult applicant is employed in this state;
(E)
A document showing that the adult applicant has registered with a public or private employment service in this state;
(F)
Evidence that the adult applicant has enrolled the applicant's children in a school in this state;
(G)
Evidence that the adult applicant is receiving public assistance in this state;
(H)
Evidence of registration to vote in this state; or
(I)
Other evidence deemed sufficient to the bureau or the department of human services, or both, as proof of residency in this state; and
(2)
The adult applicant declares, under penalty of perjury, that all of the following apply:
(A)
The adult applicant does not own or lease a principal residence outside of this state; and
(B)
The adult applicant is not receiving public assistance outside of this state. As used in this subdivision (b)(2)(B), "public assistance" does not include unemployment insurance benefits.
(c)
Residency for minors shall be determined as otherwise permitted under state and federal law. A minor for the purposes of this subsection (c) is a person younger than nineteen (19) years of age.
(d)
A denial of determination of residency may be appealed in the same manner as any other denial of eligibility. A determination of residency shall not be granted unless a preponderance of the credible evidence supports the adult applicant's intent to remain indefinitely in this state. In making determinations or verifications of residency, subject to the requirements of subsection (b), the department of human services shall apply the same policies and procedures as are applied in the determination of residency for other programs administered by the department to the extent permitted under or by federal law.
Acts 2002, ch. 880, § 14.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-121 - Transfer of income or resources

In all actions for the transfer of income or resources from an institutionalized spouse for the support of the community spouse, the court shall apply the standards utilized to determine medicaid eligibility in this state, regardless of any state laws relating to community property or the division of marital property.
Acts 2002, ch. 880, § 16.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-122 - Statement of interest of vendors or suppliers holding equity interest in hospitals, apothecaries or nursing homes

(a)
Any individual or corporate vendor or provider participating under this part who holds an equity interest in any hospital, apothecary, nursing home, or other vendor or provider participating under this part shall submit annually to the department of finance and administration information disclosing their interest in these vendors or providers.
(b)
Any such party who fails to file the information required by this section shall not be entitled to participate in the program.
Acts 1969, ch. 326, § 4; T.C.A., §§ 14-1923, 14-23-122.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-123 - Statement of public officials as to interest in vendors or providers

Any department head, deputy, assistant, or director of any state department, including, but not limited to, any person who certificates eligibles or who makes payments to vendors or providers participating under this part, and who holds any equity interest in any hospital, apothecary, nursing home, or other vendors or providers participating under this part, shall submit annually to the department of finance and administration information disclosing their interest in these vendors or providers.
Acts 1969, ch. 326, § 5; T.C.A., §§ 14-1924, 14-23-123.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-124 - Duties of department of finance and administration

(a)
The department of finance and administration shall supervise and assist the department of health, which shall be the single state agency as defined in the federal Medicaid Law, Title XIX with respect to all financial matters in the planning and establishment of the medical assistance program as set forth in §§
71-5-101
- 71-5-120, and after the program is established on July 1, 1969, the department of finance and administration shall perform those functions with respect to such medical assistance programs as are set forth in title 9, chapter 4, part 51.
(b)
In addition, the commissioner of finance and administration and the comptroller of the treasury have the duty and authority to review and audit such expenditure of funds as may be made under this part either directly or indirectly by any fiscal intermediary, and nothing in this section shall limit the authority of the commissioner of finance and administration to ensure that program expenditures are maintained within legislative appropriations.
Acts 1969, ch. 326, § 6; T.C.A., §§ 14-1925, 14-23-124.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-125 - Duties of fiscal review committee

The fiscal review committee is directed to obtain the following information from the single state agency in charge of medicaid and the department of human services and report quarterly to the membership of the general assembly, except that if an item on the report has not changed from one (1) quarter to the next, there shall be no necessity to repeat this information in the subsequent report:
(1)
All expenditures under the medicaid program in the preceding quarter;
(2)
The quarterly allotment for the next quarter;
(3)
Any requests for additional funds;
(4)
The classifications set up for the staffing of the medicaid personnel;
(5)
The names, salary, position and previous work experience of staff hired;
(6)
Caseloads, increases and decreases;
(7)
Dollar expenditures and utilization of the separate programs under medicaid; and
(8)
Copies of all regulations issued to implement the medicaid program.
Acts 1969, ch. 326, § 7; impl. am. Acts 1975, ch. 219, § 1 (a, b); T.C.A., §§ 14-1926, 14-23-125; Acts 2002, ch. 880, § 19; 2012, ch. 673, § 4.
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 1 - MEDICAL ASSISTANCE ACT (§§ 71-5-NEW — 71-5-199) › Section 71-5-126 - Medicaid expansion under federal Patient Protection and Affordable Care Act prohibited without joint resolution of General Assembly

The governor shall not make any decision or obligate the state of Tennessee in any way with regard to the expansion of optional enrollment in the medical assistance program, also known as the medicaid program, pursuant to the Patient Protection and Affordable Care Act, Public Law 111-148, as interpreted by the United States Supreme Court in National Federation of Independent Business v. Sebelius to be unconstitutional when applied to states as a mandatory expansion, unless authorized by joint resolution of the general assembly.