Tennessee Medicaid Modernization and Access Act of 2025
Amends TCA Title 63; Title 68 and Title 71.
Tennessee SB0334, titled the "Tennessee Medicaid Modernization and Access Act of 2025," aims to require TennCare reimbursements for key services to be updated to match either the Medicare fee schedule or the average commercial rate, whichever is higher, starting January 1, 2025. It affects healthcare providers offering obstetrics-gynecology, primary care, outpatient mental health, and substance use disorder services. Key provisions include annual reviews of reimbursement rates, the ability for providers to request administrative hearings for payment disputes, and the establishment of quality and access metrics for incentive payments.
Tennessee SB0334, titled the "Tennessee Medicaid Modernization and Access Act of 2025," aims to require TennCare reimbursements for key services to be updated to match either the Medicare fee schedule or the average commercial rate, whichever is higher, starting January 1, 2025. It affects healthcare providers offering obstetrics-gynecology, primary care, outpatient mental health, and substance use disorder services. Key provisions include annual reviews of reimbursement rates, the ability for providers to request administrative hearings for payment disputes, and the establishment of quality and access metrics for incentive payments.
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Crowe, Rusty
114th General Assembly
January 27, 2025
April 20, 2026
Action deferred in Senate Finance, Ways & Means Committee to 4/21/2026