Amends TCA Section 33-2-404; Title 33, Chapter 5; Section 68-11-202 and Section 71-2-412.

Generally, present law authorizes that the department of mental health and substance abuse services, the department of intellectual and developmental disabilities, the board for licensing health care facilities, and the commissioner of human services to amend applicable rules for licensure of facilities or entities under their purview to be consistent with the federal home-based and community-based settings final rule, published in the Federal Register at 79 FR 2947 (January 16, 2014), including the authority to differentiate licensure requirements for any entity contracted to provide Medicaid-reimbursed home- and community-based services in order to allow the facility or entity to comply with the federal rule and continue to receive Medicaid reimbursement for home- and community-based services. <br /> <br /> This bill adds that the rules must be consistent with the express intent of the final rule referenced above that services are received in the most integrated setting appropriate to the individual's needs. <br /> <br /> This bill also authorizes the bureau of TennCare to make eligible for consumer direction and reimbursement qualifying home- and community-based services received from non-contracted providers when:<br /> <br /> (1) Services are provided by a state-licensed program or provider;<br /> (2) Services are provided in the most integrated setting appropriate to the individual's needs;<br /> (3) Services are comparable to those included in the home- and community-based CHOICES program;<br /> (4) Services align with the person-centered individualized support plan; and<br /> (5) Services do not exceed annual cost limits assigned to a CHOICES benefit group.<br /> <br /> This bill also authorizes the bureau of TennCare to enact or amend its rules to reflect additional services eligible for consumer direction.<br /> <br />