ON APRIL 14, 2025, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 576, AS AMENDED. AMENDMENT #1 rewrites the bill to, instead, make the following revisions to present law relative to the annual coverage assessment:  Provide that, if a hospital was first licensed in 2021 or later and did not replace an existing hospital, and the hospital does not have a medicare cost report or a full 12-month joint annual report (JAR) filed with the department of health, the hospital's portion of the annual coverage assessment base is the hospital's projected net patient revenue for its first full year of operation as shown in its certificate of need application or equivalent financial report filed with the health facilities commission or other agency that has issued a license to the hospital to operate in this state.  Provides that the assessment is implemented if the federal centers for medicare and medicaid services (CMS) determination, approvals, and confirmation have all been obtained except for the approval from CMS of an adjustment to the budget neutrality agreement with CMS, pursuant to the process set forth in the special terms and conditions in the division's 1115 demonstration project.  Revises the provision requiring the division of TennCare ("division") to establish a schedule of four equal installment payments spread as evenly as possible throughout the fiscal year to, instead, establish a schedule of equal installment payments spread as evenly as possible throughout fiscal year.  Adds, if the status of an excluded hospital changes to meet the definition of a covered hospital, and if such hospital contributed an intergovernmental transfer, then the intergovernmental transfer and assessment obligations must be applied to such hospital proportionally based on the length of time the hospital met each of the respective definitions.  Adds that, for purposes of the maintenance of coverage trust fund, the intergovernmental transfer amount is determined on the proportion of a hospital's medicaid days and total outpatient payments as reported on the 2021 JAR. Increases the expenditure for benefits and services under the division's program from $590,770 to $598,945 to maintain reimbursement at the same emergency care rate as in FY 2024-2025 for nonemergent care to children from 12 to 24 months.  Increases the expenditure for benefits and services under the division's program from $2,111,400 to $2,140,620 to the division to offset the elimination of the provision in the division's managed care contractor risk agreements for hospitals.  Decreases the minimum percentage paid to covered hospitals from no less than 37% to no less than 36% of unreimbursed division costs for all hospitals licensed by the state that reported division charges, revenue, and total expenses on the 2023 JAR, excluding state-owned hospitals.  Adds funding for a program manager contract in the amount of $1,600,000.  Adds, if the assessment is implemented after CMS determination, approvals, and confirmation have all been obtained except for the approval from CMS of an adjustment to the budget neutrality agreement with CMS, then the expenditures for directed payments to hospitals must be limited to either the same amount authorized for FY 2024, or a greater amount as determined by the division in consultation with the Tennessee Hospital Association, up to the amount approved by CMS, until such time as the CMS determination, approvals, and confirmation have been obtained and the division provides written notice to the Tennessee Hospital Association.

Statutes affected:
Introduced: 71-5-2005(g), 71-5-2005