Title 71, Welfare

There is created a division of state government which shall be known and designated as the office of inspector general. This division shall be located within the department of finance and administration and shall report directly to the commissioner of finance and administration. …

(1) As used in this part and part 26 unless the context otherwise requires:(1) “Abuse” shall be given the same meaning as currently exists in federal regulations located at 42 CFR 455.2, with the following exceptions:(A) It shall also apply to practices by vendors or other person…

The commissioner is authorized to promulgate rules and regulations, including emergency rules pursuant to § 4-5-208, to effectuate the purposes of this part. All such rules and regulations shall be promulgated in accordance with the Uniform Administrative Procedures Act, compiled…

(1) 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 inve…

(a) The office of inspector general shall have the authority to provide legal assistance to the attorney general and reporter and the state district attorneys general for the purpose of initiating and handling proceedings in appropriate TennCare fraud and abuse cases. Such assist…

(a) The staff of the office of inspector general may include law enforcement officers, as defined in § 39-11-106(a) and qualified as defined in § 38-8-106, who have successfully completed a training course approved by the Tennessee peace officer standards and training commission,…

There is established a medicaid fraud control unit, referred to as the medicaid fraud control division, which is separate and distinct from the state medicaid agency, and is within the Tennessee bureau of investigation or within another appropriate agency at the discretion of the…

(a) (1) The office of inspector general, when conducting any investigation relating to TennCare fraud or abuse, shall have the power to issue subpoenas, and compel the attendance of witnesses, the examination of such witnesses under oath, and the production of books, accounts, pa…

Notwithstanding any other provision of this chapter or of title 38, the Tennessee bureau of investigation and the office of inspector general are authorized to investigate allegations of fraud or abuse involving TennCare managed care organizations.

(a) The inspector general shall annually report by October 1 of each year for the prior fiscal year to the governor and the general assembly on the activities of the inspector general's office. The report shall include actual numbers of complaints, investigation, charges, prosecu…

(a) The office of inspector general shall establish an incentive program to provide a cash reward to citizens who notify the office of inspector general of criminal fraud by recipients of the TennCare program. The cash reward shall be paid if the information provided by the citiz…

(1) The general assembly recognizes that data mining is an important tool that should be used for the detection of fraud and abuse in the TennCare program; therefore, it is the intention of the general assembly that:(1) The office of inspector general shall engage in data mining …

(1) As used in §§ 71-5-2513 — 71-5-2521, unless the context otherwise requires:(1) “Access” means the ability to extract intelligible information through automated means, and to store, retrieve, use, and otherwise manipulate that information in a way that may lead to meaningful a…

(1) All persons and entities under contract with the TennCare bureau or its agent or designee, including, but not limited to, all managed care organizations, benefit managers, and other managed care contractors, shall promptly provide to the office of inspector general, on reques…

(a) All records obtained pursuant to this chapter shall be treated as confidential investigative records of the office of inspector general and shall not be open to public inspection; provided, however, that nothing in this part shall be construed to affect the obligation of the …

(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…

The inspector general shall have authority to promulgate rules and regulations pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as are necessary to implement §§ 71-5-2513 — 71-5-2521. The rules shall be promulgated as emergency rules. The ins…

(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 objectio…

(a) All funds collected as civil penalties, attorney's fees, costs, or costs of investigation by the inspector general, pursuant to this part or part 26, shall be deposited by the state treasurer in a separate account exclusively for the use of that office to defray the expenses …

The office of inspector general shall include in its annual report information on the progress of its data mining efforts, including any difficulties encountered in obtaining access to data from either private or government entities, and suggestions for legislative or other solut…

(a) (1) (A) A person, including an enrollee, recipient, or applicant, commits an offense who knowingly obtains, or attempts to obtain, or aids or abets any person to obtain, by means of a willfully false statement, representation, or impersonation, or by concealment of any materi…

(a) Upon submitting a claim for, or upon receiving payment for, goods, services, items, facilities or accommodations under the TennCare program, a managed care organization, provider, vendor, subcontractor, or any other person or entity, shall maintain adequate records for a mini…

(a) All managed care organizations, contractors, subcontractors, providers or any other person or entity shall advise the office of TennCare inspector general immediately when there is actual knowledge, not subject to a testimonial privilege, that an act of recipient, enrollee, o…

(a) Without regard to any other civil or criminal liability that might attach, by operation of this section or any other law, the office of inspector general shall have an administrative remedy against an enrollee, recipient, applicant, or person purporting to be an enrollee, rec…

This part is known and may be cited as the “Food Stamp Act of 1971.”

The purpose of this part is to provide for improved levels of nutrition among economically needy households through a cooperative federal-state program of food assistance to be operated in such counties of this state as may be certified by the department of human services and des…

(1) As used in this part, unless the context requires otherwise:(1) “Applicant” means any person who has applied for benefits under this part;(2) “Area manager” means the director or manager of the county or area office of the department of human services;(3) “Assistance” or “foo…

(1) The department shall:(1) Supervise the administration of the food stamp or food assistance program in this state for eligible recipients;(2) Make uniform rules and regulations, not inconsistent with law, for carrying out and enforcing this part in an efficient, economical and…

Assistance under this part shall be granted to any needy person, household or low-income family that meets the requirements set forth in federal statutes and such standards of need as may be established by the department or required by any subsequently enacted federal statute on …

The amount of assistance to which any person, household or family shall be entitled to receive in the form of food coupons, food stamps or food purchase benefits transferred electronically or by other means under this part shall be determined by measuring the income and resources…

An applicant for assistance under this part, or a person acting in an applicant's behalf, shall file the application in the county office in the county wherein the applicant resides and in which county a food stamp program is currently in operation, in such manner and form as sha…

(a) When an application for food stamp assistance is filed with the county office, the area manager, or a designated agent, shall promptly make or cause to be made such investigation as it may deem necessary. The object of such investigation shall be to ascertain facts supporting…

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 this part, the app…

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.…

(a) Any county may elect to participate in the food stamp program by the adoption of a resolution by the county legislative body of the county, requesting certification by the department to the United States department of agriculture, or a successor agency, as to the county's eli…

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…

If at any time during the certification for food stamp assistance, the recipient becomes possessed of any property, real or personal, or income in excess of the amount stated in the recipient's application for such assistance or transfers any of the recipient's property, real or …

(a) A person commits an offense who, knowingly, obtains, or attempts to obtain, or aids, or abets any person to obtain, by means of a willfully false statement, representation, or impersonation, or by any other fraudulent means or in any manner not authorized by this part, or by …

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…

(a) On at least a quarterly basis, the department of human services shall conduct data matches against information databases as required by federal law, including the following:(1) Earned and unearned income information maintained by the federal internal revenue service;(2) Emplo…

(a) (1) The department shall submit a report to the general assembly no later than October 31, 2022, and annually thereafter, to include the following:(A) Information from the preceding federal fiscal year related to all instances in which the department sought, applied for, acce…

(a) The department shall identify any federal regulations or state law or rules that it determines inhibit the department's ability to timely review and approve applications and deliver benefits for the food assistance program. (b) The department shall identify any federal waiver…

(a) As used in this section:(1) “Inmate” means an individual incarcerated in a state correctional institution; and(2) “State correctional institution” means a public or private facility that is operated by or under contract with the department of correction that has the power to …

(a) (1) The department of human services shall administer any funding received under the federal low-income energy assistance and weatherization programs, any other federal funds for energy assistance or energy conservation for residential units and any state funds appropriated t…

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…

(1) 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 ma…