Amends TCA Title 4; Title 56 and Title 71.

This bill requires the department of finance and administration to establish a medicaid buy-in plan and offer the buy-in plan for purchase by a resident of this state: (1) Who is ineligible for TennCare, medicare, and advance premium tax credits under the federal Patient Protection and Affordable Care Act; and (2) Whose employer has not disenrolled or denied the resident enrollment in employer-sponsored health insurance coverage on the basis that the resident would otherwise qualify for enrollment in medicaid buy-in coverage. The buy-in plan must be established by July 1, 2022. The full text of this bill specifies 10 types of medical services that must be covered under the buy-in plan, although other services could be covered under the plan. Healthcare provider reimbursement rates under the buy-in plan must be based on the medicaid fee schedule. Subject to available funds, this bill authorizes the department to increase reimbursement rates for healthcare providers, as long as the increase does not negatively impact the sustainability of the buy-in plan or TennCare. In addition to establish the buy-in plan, this bill requires the department to: (1) Pursue available federal funding for the services and benefits provided; (2) Coordinate medicaid buy-in plan enrollment and eligibility to maximize continuity of coverage between medicaid buy-in plans, traditional medicaid, and private health insurance; and (3) Coordinate with other agencies to establish an application system for the buy-in plan and publicize the plan's availability. This bill authorizes the commissioner of finance and administration to seek a federal waiver to establish and operate the buy-in program. This bill authorizes the governor approve any such waiver.