# Tennessee HB 1867: AN ACT to amend Tennessee Code Annotated, Title 71, Chapter 5, relative to the annual coverage assessment. Tennessee HB 1867, AN ACT to amend Tennessee Code Annotated, Title 71, Chapter 5, relative to the annual coverage assessment., is a 114th General Assembly (2025-2026) House bill sponsored by no sponsor on record; status signed, last action 2026-05-26 (Effective date(s) 07/01/2026) (as of 2026-11-01). - Canonical: https://policyrisk.com/state-bill/TN-HB1867-2025-2026 - As of: 2026-11-01 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: Tennessee HB 1867 - State: Tennessee - Session: 114th General Assembly (2025-2026) - Title: AN ACT to amend Tennessee Code Annotated, Title 71, Chapter 5, relative to the annual coverage assessment. - Status: signed - Chamber: House - Introduced: 2026-01-21 - Last action: 2026-05-26, Effective date(s) 07/01/2026 - Sponsors: no sponsor on record - Cosponsors: 3 - Subjects: Hospitals and Health Care Facilities - Touches household money: no - Roll calls: 7 (183 yes, 0 no in all) - Economic provisions PRIA read: 11 ## Summary No summary available. ## Bill overview: provisions PRIA read - Funding preserves TennCare services and training: benefit, high. Beginning July 1, 2026, trust-fund money and federal matching funds support TennCare benefits and services. The law prevents listed annual limits on hospital, outpatient, physician, laboratory, and imaging services and maintains occupational, physical, and speech therapy coverage. It keeps at least… - TennCare money stays protected after expiration: benefit, medium. Assessment receipts go into the coverage trust fund and cannot replace existing appropriations or be diverted to the general fund. The fund also holds remaining June 30, 2026 balances, investment earnings, penalties, interest, and eligible hospital transfers. Quarterly legislative reports begin Sep… - Patients protected from assessment surcharges: benefit, low. Covered hospitals cannot raise charges or add a surcharge because of the annual coverage assessment. This protects patients from charges tied to the assessment, but does not set limits on unrelated hospital charges. - Targeted funding helps hospitals and providers: benefit, low. Beginning July 1, 2026, the trust fund provides $21.391431 million to offset removal of the requirement that providers pass 340B drug-pricing benefits to TennCare health plans. It provides $175,000 toward hospital admission, discharge, and transfer messages supporting TennCare’s medical home progra… - Eligible hospitals must transfer coverage funds: cost, medium. For FY 2026–2027, hospitals eligible to certify public spending for federal Medicaid matching funds must make transfers to the coverage trust fund. Combined transfers cannot exceed $300 million. TennCare sets each hospital’s share using Medicaid days and total outpatient payments in its 2021 joint… - Covered hospitals pay a yearly assessment: cost, medium. Beginning July 1, 2026, covered hospitals owe an assessment for FY 2026–2027 totaling 6% of the recognized assessment base. The base generally uses 2021 net patient revenue minus Medicare revenue, with substitute calculations for missing reports and newer hospitals. Exemptions cover critical access… - TennCare fund pays staffing and audits: cost, low. Beginning July 1, 2026, the trust fund provides $382,400 for six full-time state employees managing hospital payment programs. It also provides $1.6 million for a program manager contract. The state comptroller can audit trust-fund spending using an accountant or the Department of Audit, but an aud… - Hospital funding comes with federal limits: mixed, medium. For FY 2026–2027, TennCare makes federally approved hospital payments using claims and patient-use data, available funding, and a jointly designed quality program. If federal officials approve supplemental pools instead, payments first offset covered hospitals’ losses from treating TennCare members… - Provider rates protected; funding can stop: mixed, medium. TennCare must bar health plans from across-the-board cuts to negotiated hospital and physician rates in effect July 1, 2026. The protection covers eligible ancillary services and care settings, but allows case-by-case negotiations, specified ancillary changes announced in advance, legally required… - Hospital type determines assessment shares: mixed, medium. Hospitals’ assessment shares depend on classifications using the 2023 joint annual report. Primary inpatient/outpatient weights are: children’s, 0.8/0.3; tier 1, 1.0/0.5; tier 2, 0.75/0.3; tier 3, 0.151/0.175; psychiatric, 0.11/0.5; safety net, 0.133/0.157; and high out-of-state Medicaid, 0.151/0.1… - Hospitals face penalties but get refunds: mixed, medium. Hospital assessment installments are spread as evenly as possible across FY 2026–2027 and are due 15 days after corresponding federally approved hospital payments. Late payments carry a $500 daily penalty until paid; TennCare can waive it for a proven timely payment attempt. After 30 days past due,… ## Sponsors and cosponsors - Cosponsor: Rebecca K. Alexander (Republican), House - Cosponsor: Michael Hale (Republican), House - Cosponsor: William Lamberth (Republican), House ## Roll call votes | Date | Chamber | Motion | Result | Yes | No | Other | | --- | --- | --- | --- | --- | --- | --- | | 2026-04-15 | Senate | FLOOR VOTE: Third Consideration 4/15/2026 | pass | 33 | 0 | | | 2026-04-06 | House | HOUSE CALENDAR & RULES COMMITTEE | fail | 0 | 0 | | | 2026-04-06 | House | FLOOR VOTE: REGULAR CALENDAR AS AMENDED PASSAGE ON THIRD CONSIDERATION 4/6/2026 | pass | 92 | 0 | | | 2026-03-31 | House | HOUSE FINANCE, WAYS, AND MEANS COMMITTEE | pass | 25 | 0 | | | 2026-03-25 | House | HOUSE FINANCE, WAYS, AND MEANS SUBCOMMITTEE | pass | 12 | 0 | | | 2026-03-17 | House | HOUSE INSURANCE COMMITTEE | pass | 16 | 0 | | | 2026-03-03 | House | HOUSE TENNCARE SUBCOMMITTEE | pass | 5 | 0 | | ## Actions (34) - 2026-05-26: Effective date(s) 07/01/2026 - 2026-05-26: Pub. Ch. 991 - 2026-05-19: Signed by Governor. - 2026-05-07: Transmitted to Governor for his action. (House) - 2026-05-05: Signed by Senate Speaker (Senate) - 2026-04-30: Signed by H. Speaker (House) - 2026-04-20: Enrolled; ready for sig. of H. Speaker. (House) - 2026-04-15: Passed Senate, Ayes 33, Nays 0 (Senate) - 2026-04-15: Amendment withdrawn. (Amendment 1 - SA0536) (Senate) - 2026-04-15: Senate substituted House Bill for companion Senate Bill. (Senate) - 2026-04-09: Received from House, Passed on First Consideration (Senate) - 2026-04-06: Engrossed; ready for transmission to Sen. (House) - 2026-04-06: Passed H., as am., Ayes 92, Nays 0, PNV 0 (House) - 2026-04-06: Sponsor(s) Added. (House) - 2026-04-06: H. adopted am. (Amendment 1 - HA0698) (House) - 2026-04-02: Sponsor(s) Added. (House) - 2026-04-02: H. Placed on Regular Calendar for 4/6/2026 (House) - 2026-04-01: Placed on cal. Calendar & Rules Committee for 4/2/2026 (House) - 2026-03-31: Rec. for pass; ref to Calendar & Rules Committee (House) - 2026-03-25: Placed on cal. Finance, Ways, and Means Committee for 3/31/2026 (House) - 2026-03-25: Rec. for pass by s/c ref. to Finance, Ways, and Means Committee (House) - 2026-03-18: Placed on s/c cal Finance, Ways, and Means Subcommittee for 3/25/2026 (House) - 2026-03-17: Assigned to s/c Finance, Ways, and Means Subcommittee (House) - 2026-03-17: Rec. for pass. if am., ref. to Finance, Ways, and Means Committee (House) - 2026-03-11: Placed on cal. Insurance Committee for 3/17/2026 (House) - 2026-03-10: Action def. in Insurance Committee to 3/17/2026 (House) - 2026-03-04: Placed on cal. Insurance Committee for 3/10/2026 (House) - 2026-03-03: Rec for pass if am by s/c ref. to Insurance Committee (House) - 2026-02-25: Placed on s/c cal Tenncare Subcommittee for 3/3/2026 (House) - 2026-02-24: Assigned to s/c Tenncare Subcommittee (House) - 2026-02-24: Ref. to Insurance Committee (House) - 2026-02-02: P2C, caption bill, held on desk - pending amdt. (House) - 2026-01-22: Intro., P1C. (House) - 2026-01-21: Filed for introduction (House) ## Bill text - HA0698 (Substitute), 2026-04-06: [PDF](https://capitol.tn.gov/Bills/114/Amend/HA0698.pdf) - Enrolled / Public Chapter: [PDF](https://publications.tnsosfiles.com/acts/114/pub/pc0991.pdf) - Fiscal Note: [PDF](https://capitol.tn.gov/Bills/114/Fiscal/SB1939.pdf) - Introduced: [PDF](https://capitol.tn.gov/Bills/114/Bill/HB1867.pdf) - SA0536: [PDF](https://capitol.tn.gov/Bills/114/Amend/SA0536.pdf) ## Related bills - HB 1720: AN ACT to amend Tennessee Code Annotated, Title 5; Title 6; Title 7 and Title 13, relative to zoning outside of municipal boundaries. (failed) - HB 1710: AN ACT to amend Tennessee Code Annotated, Title 4, Chapter 1 and Title 4, Chapter 58, relative to public benefits. (failed) - HB 1667: AN ACT to amend Tennessee Code Annotated, Title 6 and Title 7, relative to penalties for violations of ordinances. (failed) - HB 1690: AN ACT to amend Tennessee Code Annotated, Title 29; Title 55 and Title 56, relative to motor vehicle financial responsibility. (failed) - HB 1681: AN ACT to amend Tennessee Code Annotated, Title 7; Title 9; Title 12; Title 13; Title 66; Title 67 and Title 68, relative to infrastructure development distric… (failed) - HB 1380: AN ACT to amend Tennessee Code Annotated, Title 67, Chapter 5, Part 7, relative to property tax relief for elderly persons. (failed) ## Sources - [HA0698 (Substitute) (PDF)](https://capitol.tn.gov/Bills/114/Amend/HA0698.pdf) - [Enrolled / Public Chapter (PDF)](https://publications.tnsosfiles.com/acts/114/pub/pc0991.pdf) - [Fiscal Note (PDF)](https://capitol.tn.gov/Bills/114/Fiscal/SB1939.pdf) - [Introduced (PDF)](https://capitol.tn.gov/Bills/114/Bill/HB1867.pdf) - [SA0536 (PDF)](https://capitol.tn.gov/Bills/114/Amend/SA0536.pdf) ## Related - [HB 1720: AN ACT to amend Tennessee Code Annotated, Title 5; Title 6; Title 7 and Title 1…](https://policyrisk.com/state-bill/TN-HB1720-2025-2026) - [HB 1710: AN ACT to amend Tennessee Code Annotated, Title 4, Chapter 1 and Title 4, Chapt…](https://policyrisk.com/state-bill/TN-HB1710-2025-2026) - [HB 1667: AN ACT to amend Tennessee Code Annotated, Title 6 and Title 7, relative to pena…](https://policyrisk.com/state-bill/TN-HB1667-2025-2026) - [HB 1690: AN ACT to amend Tennessee Code Annotated, Title 29; Title 55 and Title 56, rela…](https://policyrisk.com/state-bill/TN-HB1690-2025-2026) - [HB 1681: AN ACT to amend Tennessee Code Annotated, Title 7; Title 9; Title 12; Title 13;…](https://policyrisk.com/state-bill/TN-HB1681-2025-2026) - [HB 1380: AN ACT to amend Tennessee Code Annotated, Title 67, Chapter 5, Part 7, relative…](https://policyrisk.com/state-bill/TN-HB1380-2025-2026) - [Tennessee bills](https://policyrisk.com/states/tennessee/bills) - [Tennessee state hub](https://policyrisk.com/states/tennessee) - [All state legislation](https://policyrisk.com/state-bills) Source: PRIA, https://policyrisk.com/state-bill/TN-HB1867-2025-2026 (as of 2026-11-01).