Title 71, Welfare

For the purposes of this part, any nursing home participating in the medicaid program shall file cost reports in accordance with the rules adopted by the bureau. Any nursing home participating in the medicaid program that does not adopt the uniform classification of accounts, or …

The fiscal review committee shall review and have oversight of the implementation of this part and the nursing home assessment trust fund.

Enactment of this part and any amendments to this part shall not operate to excuse the monthly installment payment of any nursing home assessment fee due during any current or prior fiscal year.

This part is known and may be cited as the “Medical Assistance Act of 1968.”

(a) The nursing home annual assessment fee established by this part shall terminate on June 30, 2027. (b) The assessment imposed by this part shall be suspended if the bureau attempts to utilize the money in the account for any use other than permitted by this part. (c) Any asses…

(a) The purpose of this part is to make possible medical assistance to those recipients determined to be eligible under this chapter to receive medical assistance that conforms to the requirements of Title XIX of the Social Security Act (42 U.S.C. § 1396 et seq.), and the regulat…

(1) As used in this part, unless the context otherwise requires:(1) “Adult behavioral health services for the seriously and persistently mentally ill” means behavioral health services for individuals nineteen (19) years of age and older, including, but not limited to, assessment,…

(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 Title XIX or pursuant to any other federal law as adopted by amendment to the …

(a) The department shall:(1) Supervise the administration of medical assistance for eligible recipients;(2) Make uniform rules and regulations, not inconsistent with the law, for implementing, administering and enforcing this part in an efficient, economical and impartial manner;…

(a) (1) The departments of health and human services, as may be designated by the governor, shall make the determination of eligibility under this part, subject to approval of the finance, ways and means and health and welfare committees of the senate and the finance, ways and me…

(a) Medical assistance, including demonstration projects and programs designed to enhance the efficient and economic operation of the medicaid program, shall be provided to those classes of individuals determined to be eligible under § 71-5-106. This medical assistance, in the am…

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 Reducti…

(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 servi…

(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) A…

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 as…

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…

(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 Unifo…

(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 …

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.

(a) No applicant shall be required to execute an agreement for a lien on real property occupied as the applicant's residence on account of medical assistance paid or to be paid on the applicant's behalf pursuant to this part. (b) No lien may be imposed against the real property o…

(a) Medical assistance paid to, or on behalf of, any recipient cannot be recovered from a beneficiary unless such assistance has been incorrectly paid, or, unless the recipient or beneficiary recovers or is entitled to recover from a third party reimbursement for all or part of t…

(a) The commissioner of finance and administration has the authority to enter into contracts with qualified vendors to provide to eligible recipients medical assistance allowed under § 71-5-107. The commissioner has the authority to terminate or suspend existing contracts with pr…

(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 as…

(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 …

(a) (1) There is created a families first community advisory board to:(A) Approve the department's retention of a research partner or partners to assist in the research and evaluation of the Tennessee opportunity pilot program created by this part;(B) Review and approve the selec…

(a) The department shall begin accepting grant applications from eligible nonprofit organizations and other qualified entities, distributed proportionally across the three (3) grand divisions of the state to the extent possible, for programs to provide services to families and in…

(a) In fiscal year 2022, the department shall dedicate one hundred eighty-two million dollars ($182,000,000), subject to appropriations in the general appropriations act, from the department's existing surplus reserve of TANF funds to support the planning, implementation, and eva…

(a) The department shall, at the beginning of federal fiscal year 2022, ensure that a rainy-day fund in an amount not to exceed the TANF annual federal award of the existing reserve of federal TANF funds remain unobligated in order to address unforeseen future economic needs, inc…

(a) As used in this section:(1) “Child care and development fund” or “CCDF” means the federal child care and development fund established pursuant to 45 CFR 98;(2) “Department” means the department of human services;(3) “Smart steps program” means the state child care assistance …

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 proper…

(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…

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, apothe…

(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 as…

(1) 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 cha…

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 (Pub. L. No…

If it is found that any of this part is in conflict with the single state agency requirements of the federal Medicaid Law, Title XIX, then, and in that event, the department of finance and administration shall become the single state agency.

Notwithstanding any other law to the contrary, the department of health shall follow, as nearly as is practicable, the requirements of 42 U.S.C. § 1395mm, as amended, together with any federal rules and regulations promulgated pursuant to such law, with respect to a health mainte…

Charges to be reimbursed for physician assistants from medicaid funds shall not exceed sixty percent (60%) of the charges provided for licensed physicians under the medicaid program or fees charged by licensed physicians that are reasonable in the locality where the services are …

(a) With regard to the payments to vendors pursuant to this part:(1) The payment for all vendors providing health care that receive payment pursuant to this part shall be determined by the comptroller of the treasury, in accordance with rules and regulations established by the de…

There is hereby created a grant assistance program to provide financial support for eligible individuals residing in nursing homes licensed by the state, which individuals do not have their nursing home care paid for, in whole or in part, by a federal, state or combined federal-s…

(1) To be eligible to apply for a grant assistance payment under this part, an individual must meet the following qualifications:(1) The individual must have resided or be residing, after June 30, 1992, in a facility licensed by the state as a nursing home. Residents in facilitie…

(a) An application for grant assistance program payments must be made by the individual or such individual's legally authorized representative on forms prescribed by regulations of the department of health. Such forms shall include a certification of the individual's annual incom…

(1) Applications shall be processed by the department on a first come, first served basis and are subject to the amount annually appropriated for this program in the general appropriations act. Based on the application, the department shall calculate a projected annual nursing ho…

Grant payments under this part shall be made to the individual monthly and forwarded to such person at the place of such individual's residence. Grant payments are non-assignable and payable only to the individual or such individual's legally authorized representative, which shal…

The department of health is authorized to promulgate regulations pursuant to the Uniform Administrative Procedures Act, compiled in title 4, chapter 5, as necessary to implement this part. Notwithstanding any other law, the commissioner of health is authorized to promulgate such …

The department of health is authorized to administer this part, including, but not limited to, the ability to contract with other state agencies or entities to make payments or verify income as required by this part.