Senate Bill 1797, also known as House Bill 2093, amends Tennessee Code Annotated to establish new regulations for managed care organizations (MCOs) in relation to qualified nursing facilities participating in the TennCare program. The bill defines key terms such as "managed care organization," "qualified nursing facility," and "termination," and outlines the responsibilities of MCOs regarding contracts with these facilities. Notably, MCOs are prohibited from adopting participation requirements or termination standards beyond those set by the bureau of TennCare, and they cannot independently determine a facility's eligibility for participation in the TennCare program. The bureau retains exclusive authority to determine the termination of a qualified nursing facility's contract with an MCO.

Additionally, the bill stipulates that MCOs must continue to honor contracts with nursing facilities while the bureau reviews any performance or compliance concerns. It also mandates that any contractual provisions allowing MCOs to terminate contracts without cause are void and unenforceable. The bureau is tasked with reviewing and approving standard contract templates used by MCOs to ensure compliance with these 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