Amends TCA Title 4 and Title 71.
Tennessee HB0364 amends the criteria for determining medical necessity under the TennCare program by allowing the bureau of TennCare to consider a patient's overall condition, rather than strictly adhering to the least costly treatment alternative. This change affects enrollees in the TennCare program by potentially broadening the scope of medical items and services they may receive. Key provisions include a comprehensive review of factors such as mobility, cognitive awareness, and the need for life-sustaining equipment in the assessment of medical necessity.
Tennessee HB0364 amends the criteria for determining medical necessity under the TennCare program by allowing the bureau of TennCare to consider a patient's overall condition, rather than strictly adhering to the least costly treatment alternative. This change affects enrollees in the TennCare program by potentially broadening the scope of medical items and services they may receive. Key provisions include a comprehensive review of factors such as mobility, cognitive awareness, and the need for life-sustaining equipment in the assessment of medical necessity.
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