Senate Bill 1797, also known as House Bill 2093, amends Tennessee Code Annotated, specifically Section 71-5-1412, to establish clearer regulations regarding managed care organizations (MCOs) and their contracts with qualified nursing facilities participating in the TennCare program. The bill defines key terms such as "Bureau," "Managed care organization," and "Qualified nursing facility," and outlines the conditions under which MCOs can terminate contracts with these facilities. Notably, the bill prohibits MCOs from including provisions in their contracts that allow for termination without cause or without specifying grounds for termination. Additionally, it mandates that the Bureau of TennCare has exclusive authority over the eligibility and termination of qualified nursing facilities from the TennCare program.

The bill also emphasizes that MCOs must contract with any qualified nursing facility certified to provide Medicaid services, ensuring that these facilities are treated equitably in terms of participation requirements. It establishes that MCOs cannot independently determine a facility's eligibility and must adhere to the Bureau's standards. Furthermore, the Bureau is tasked with reviewing and approving all standard contract templates used by MCOs to ensure compliance with the new regulations. The act is set to take effect on July 1, 2026, and applies to all relevant policies, plans, and contracts entered into or renewed after that date.

Statutes affected:
Introduced: 71-5-1412
Amended with HA0948 -- 04/16/2026: 71-5-1412