Senate Bill 185 amends Tennessee Code Annotated to establish new reimbursement guidelines for rural hospitals serving TennCare enrollees. It designates existing language in Section 71-5-161(d) as subdivision (d)(1) and introduces a new subdivision (d)(2) that defines "rural area" and "rural hospital." Specifically, a rural hospital is defined as one with no more than 49 licensed beds located in a rural area. The bill sets the minimum reimbursement level for routine, nonspecialized inpatient services at rural hospitals at 100% of the current FFY Medicare reimbursement, with a maximum level of 120%. Additionally, the director of TennCare is authorized to seek federal waivers necessary for implementing these reimbursement levels without expanding Medicaid.

The bill also modifies Section 71-5-161 by deleting subsection (e) and replacing it with a requirement for the bureau to publish and annually update a list of MS-DRGs (Medicare Severity Diagnosis Related Groups) included in each service category on its website. This updated list will also be directly provided to participating rural hospitals each year. The act is set to take effect upon becoming law, emphasizing the importance of supporting rural healthcare facilities in Tennessee.

Statutes affected:
Introduced: 71-5-161(d), 71-5-161