BSB/4/13
Sponsored by Ryan Marina, Krishna Deepak of Franklin High School
This legislation was filed in the Commerce and Insurance category
Presented as part of the YIG Volunteer 2024 conference
| 1 | BE IT ENACTED BY THE TENNESSEE YMCA YOUTH IN GOVERNMENT |
| 2 | |
| 3 | Section 1: Definitions. |
| 4 | a) Hospital: A facility licensed as a hospital by the Tennessee Department of Health pursuant to |
| 5 | T.C.A. Title 33, Chapter 1. |
| 6 | b) Municipality: For the purposes of this Act, a County of the State of Tennessee. |
| 7 | c) Targeted Municipality: A Municipality in which there is not a Hospital present within. |
| 8 | d) Original Reimbursement Rate: The rate of reimbursement for a certain procedure pursuant to |
| 9 | the TennCare Rules and Regulations. |
| 10 | e) Provider: An individual or entity that is involved in the process of providing healthcare services |
| 11 | to an individual. |
| 12 | f) Procedure: An action, course of action, or set of steps carried out by a Healthcare Professional |
| 13 | on behalf of a Hospital to diagnose, remediate, or otherwise resolve, a problem of medical nature. |
| 14 | g) Covered Procedure: For a given Provider, the condition of a Procedure’s billed cost being paid |
| 15 | pursuant to the documented Reimbursement Rate for a given Procedure by TennCare. |
| 16 | h) Hospital Population Coefficient: A number, for any given Municipality, that is: |
| 17 | i) No less than 1; and |
| 18 | ii) Calculated to be inversely proportional to the hospital capacity in the given Municipality. |
| 19 | |
| 20 | Section 2: Duty of Municipality Report. |
| 21 | a) At or before the beginning of each session of this Assembly, the various Municipalities of |
| 22 | Tennessee are obligated to report to the Director of TennCare: |
| 23 | i) The results of a census of Hospitals and their respective capacities and other healthcare |
| 24 | facilities within their borders, and |
| 25 | ii) Their status as a Targeted Municipality. |
| 26 | |
| 27 | Section 3: Direction to the Governor. |
| 28 | a) The governor, through the office of the Director of TennCare, is directed to: |
| 29 | i) amend the TennCare Rules and Regulations such that Providers operating in Targeted |
| 30 | Municipalities are to be reimbursed the Original Reimbursement Rate for a given Covered |
| 31 | Procedure times the Hospital Population Coefficient for a given Municipality; |
| 32 | ii) perform an annual analysis of Hospital Population Coefficients for the various Targeted |
| 33 | Municipalities, and if necessary, adjust them; and |
| 34 | iii) from time to time, solicit the opinion of the General Assembly, expressed via special session |
| 35 | or other similar means, on the configuration of the Hospital Population Coefficients for the various |
| 36 | Targeted Municipalities. |
| 37 | |
| 38 | Section 4: Conflicting Bills Repealed. |
| 39 | |
| 40 | Section 5: Line Item. |
| 41 | a) Pursuant to the Hospital Population Coefficient determined in conjunction with the General |
| 42 | Assembly, the Governor, and the Director of TennCare, any increase in state expenditure shall be |
| 43 | provided for by the TennCare General Fund. |
| 44 | |
| 45 | Section 6: Date of Effect. |
| 46 | a) This bill will take effect on the first day of the next Federal Fiscal Year, the public welfare |
| 47 | requiring it. |
| 48 |