Amends TCA Title 4; Title 6; Title 8; Title 56; Title 67; Title 68 and Title 71.

This bill authorizes the comptroller of the treasury to use all investigative powers granted under present law to do the following: (1) Investigate the operations of rural hospitals that are at risk of failure or abandonment due to financial, managerial, operational, or other difficulties; (2) Investigate individuals or entities operating such rural hospitals that have adversely affected or have the potential to adversely affect the financial stability and operational integrity of such rural hospitals; and (3) Implement protective measures to protect the rural hospital's assets and services from being compromised by illicit activities. During such an investigation, this bill provides that if the comptroller determines a government-owned rural hospital has failed or is abandoned, then the comptroller may transfer the government-owned rural hospital's operations or ownership to a healthcare operator or organization, including a for-profit hospital corporation. When determining the appropriate entity to transfer a government-owned rural hospital's operations or ownership to under this bill, the comptroller must consider and give priority to the following: (1) An entity conducting business in this state with demonstrated success and profitability managing or owning acute care rural hospitals, rural ambulance services, and clinics; (2) A transfer that would minimize tax burdens and liabilities; and (3) An entity that will be accountable to the local affected community and preserves continuity of care for the local affected community. This bill authorizes the comptroller to provide oversight and to take necessary legal action to ensure that the transfer protects the public interest and preserves continuity of care for the affected community. This bill also authorizes a fund to be established to support government-owned rural hospital transfers under this bill, subject to the approval of the general assembly. This bill requires the comptroller, in consultation with the attorney general, to report to the general assembly by December 31, 2024, and each December 31 thereafter, on actions taken under this bill.