Amends TCA Title 71, Chapter 5.

Generally under present law, an annual assessment is imposed on licensed, covered hospitals. A covered hospital is one licensed by the state for the provision of providing services for health care, mental health care, substance abuse, and intellectual and developmental disabilities, but does not include:<br /> <br /> (1) A hospital that has been designated by CMS as a critical access hospital;<br /> <br /> (2) A mental health hospital owned by the state of Tennessee;<br /> <br /> (3) A hospital providing primarily rehabilitative or long-term acute care services;<br /> <br /> (4) A children's research hospital that does not charge patients for services beyond that reimbursed by third-party payors; and<br /> <br /> (5) A hospital that is determined by the bureau of TennCare as eligible to certify public expenditures for the purpose of securing federal medical assistance percentage payments.<br /> <br /> This bill imposes on each covered licensed hospital in this state, an annual coverage assessment for fiscal year 2021-2022. The annual assessment will be 4.87 percent of a covered hospital's annual coverage assessment base.<br /> <br /> ON MAY 3, 2021, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 123, AS AMENDED.<br /> <br /> AMENDMENT #1 rewrites this bill to enact the Annual Coverage Assessment Act of 2021. Generally, under present law, an annual assessment is imposed on licensed, covered hospitals. A covered hospital is one licensed by the state for the provision of providing services for health care, mental health care, substance abuse, and intellectual and developmental disabilities, but does not include:<br /> <br /> (1) A hospital that has been designated by CMS as a critical access hospital;<br /> <br /> (2) A mental health hospital owned by the state of Tennessee;<br /> <br /> (3) A hospital providing primarily rehabilitative or long-term acute care services;<br /> <br /> (4) A children's research hospital that does not charge patients for services beyond that reimbursed by third-party payors; and<br /> <br /> (5) A hospital that is determined by the bureau of TennCare as eligible to certify public expenditures for the purpose of securing federal medical assistance percentage payments.<br /> <br /> This amendment imposes on each covered licensed hospital in this state, an annual coverage assessment for fiscal year 2021-2022. The annual assessment will be 4.87 percent of a covered hospital's annual coverage assessment base, which is the same rate as fiscal year 2020-2021.<br /> <br /> EXPENDITURE OF FUNDS<br /> <br /> This amendment reduces the minimum amount of the payments that must be made from the maintenance of coverage trust fund to reduce unreimbursed costs of providing services to TennCare patients from 43.8 percent of unreimbursed TennCare cost for all hospitals licensed by the state that reported unreimbursed TennCare cost on the 2018 joint annual report (JAR), excluding state-owned hospitals, to 40.2 percent of such costs as reported on the 2019 JAR.<br /> <br /> The full text of this amendment specifies various authorized expenditures from maintenance of coverage trust fund revenues for benefits and services under the TennCare program, including those that would have been subject to reduction or elimination from TennCare funding for fiscal year 2021-2022, except for the availability of one-time funding for that year only. The amounts and purposes for which such expenditures are authorized differ from some of the amounts and purposes authorized for the 2020-2021 fiscal year. Two such authorized expenditures that were not authorized expenditures for fiscal year 2020-2021 are:<br /> <br /> (1) Programs and initiatives developed by the bureau, in consultation with the Tennessee Hospital Association, to offset the unreimbursed costs of providing services to TennCare enrollees and the financial consequences of the public health emergency caused by the COVID-19 pandemic. This amendment also adds to the Annual Coverage Assessment Act of 2020 by authorizing such expenditures for fiscal year 2020-2021; and<br /> <br /> (2) Refunds, in proportion to the amount paid in, to covered hospitals based on circumstances where the bureau, in consultation with the Tennessee Hospital Association, has determined a lower coverage assessment would have been required to carry out the purposes for which expenditures are authorized.<br />