Tennessee Bill Changes...

(PYA Alert dated July 17, 2007)


Tennessee Bill Changes Limits on Uninsured Charges

On June 11, 2007, Governor Phil Bredesen signed Senate Bill 2292 which places limits on what healthcare facilities in Tennessee may charge uninsured patients.

According to the bill, each licensed healthcare facility (hospitals, treatment centers, nursing homes, and other facilities licensed to provide care) “shall be prohibited from requiring an uninsured patient to pay for services in an amount that exceeds one hundred seventy-five percent (175%) of the cost of the services provided.” The most recent joint annual report cost to charge ratio will be utilized for the calculation.

Previous Tennessee law limited the charges for services provided to uninsured patients at one hundred fifty percent (150%) of the average commercial health insurance reimbursement rate for services.

In addition to the above requirement, each healthcare facility will be required to “develop a concise statement of its charity care policies for use by members of the public” allowing “individuals to more accurately assess the potential cost for services provided.”1 All healthcare facilities are required to post the charity care policy in a publicly accessible place.

Senate Bill 2292 took effect on July 1, 2007.

Tennessee Bill Changes Provider Ranking Requirements

On June 11, 2007, Governor Phil Bredesen signed Senate Bill 732 which changes the notification requirements covering managed health insurance organizations (“the issuer”) that publish healthcare provider ratings.

The law will require the issuer to regularly inform healthcare providers regarding information and methods utilized to evaluate the performance or practice of the healthcare provider. The law also allows for healthcare providers to submit additional data to the issuer. The issuer is also required to publicly display the sources of the rating information and to include an explanation of the methodology used for their rankings.2

Senate Bill 732 will take effect immediately for new programs and on October 1, 2007 for existing programs.

If you would like additional information or to discuss further, please contact David McMillan at (800) 270-9629.

1 Senate General Welfare Committee Amendment 1. Amendment No. 1 to SB2292

2 Amendment No. 1 to SB0732

The information provided via PYA Alert, Tax Planning Alert, or Audit and Accounting Alert should not be construed as accounting, auditing, consulting, or legal advice on any specific facts or circumstances. The contents are intended for general information purposes only.  Please contact us at (800) 270-9629 to discuss your specific situation or to discuss any specific questions you may have.

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