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TN SB0650
TN SB0650AN ACT to amend Tennessee Code Annotated, Title 4 and Title 71, relative to TennCare.
summary
Introduced
01/31/2025
01/31/2025
In Committee
Crossed Over
Passed
Dead
Introduced Session
114th General Assembly
Bill Summary
As introduced, enacts "Emma's Bill," which requires that when making a determination of medical necessity, the bureau shall take into consideration the patient's overall condition and use such overall condition as a factor to determine the level of funding and what medical items and services the patient receives, even if such determination does not result in the least costly course of diagnosis or treatment. - Amends TCA Title 4 and Title 71.
AI Summary
This bill, known as "Emma's Bill," amends Tennessee's TennCare (the state's Medicaid program) regulations to modify how medical necessity is determined for patients. Specifically, the bill requires the state's healthcare bureau to consider a patient's overall medical condition when deciding funding and medical services, even if that approach is not the least expensive option. The bill provides a comprehensive definition of "overall condition" that includes factors such as the patient's mobility, cognitive awareness, communication ability, need for nursing supervision, and requirement for life-sustaining equipment like ventilators. By adding a new subsection to the existing law, the bill shifts the focus from purely cost-driven decision-making to a more holistic assessment of a patient's medical needs. The changes will take effect on July 1, 2025, and aim to ensure that patients with complex medical conditions receive more personalized and comprehensive healthcare support through the state's Medicaid program.
Committee Categories
Budget and Finance, Health and Social Services
Sponsors (1)
Last Action
Placed on Senate Finance, Ways, and Means Committee calendar for 4/21/2025 (on 04/17/2025)
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://wapp.capitol.tn.gov/apps/Billinfo/default.aspx?BillNumber=SB0650&ga=114 |
| Fiscal Note - HB0364 | https://www.capitol.tn.gov/Bills/114/Fiscal/HB0364.pdf |
| BillText | https://www.capitol.tn.gov/Bills/114/Bill/SB0650.pdf |
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