Chapter

Part 27 [Reserved]

Tenn. Code Ann. § 71-5-101— Short title
Tenn. Code Ann. § 71-5-102— Purpose
Tenn. Code Ann. § 71-5-103— Part definitions
Tenn. Code Ann. § 71-5-104— Administration by department
Tenn. Code Ann. § 71-5-105— Powers and duties of department — Total number of ICF/MR beds — Certificate of need exemption for DIDD public ICF/MR non-facility beds established pursuant to federal litigation
Tenn. Code Ann. § 71-5-106— Determination of eligibility for medical assistance
Tenn. Code Ann. § 71-5-107— Kinds of medical services
Tenn. Code Ann. § 71-5-108— Payment methodology for medicaid enrollees not enrolled in medicare
Tenn. Code Ann. § 71-5-109— Expenditures not to exceed appropriation
Tenn. Code Ann. § 71-5-110— Application for medical assistance — Application for TennCare enrollment — Notice of change in application information
Tenn. Code Ann. § 71-5-111— Investigation — Determination of eligibility
Tenn. Code Ann. § 71-5-112— Hearing concerning eligibility
Tenn. Code Ann. § 71-5-113— Hearing concerning matters other than eligibility
Tenn. Code Ann. § 71-5-114— Subpoena and examination of witnesses
Tenn. Code Ann. § 71-5-115— Financial responsibility of relative — When may be considered — Reimbursement from responsible parties
Tenn. Code Ann. § 71-5-116— Lien on real estate — Claim against estate — Restrictions
Tenn. Code Ann. § 71-5-117— Recovery of benefits — State's right of subrogation — Assignment of insurance benefit rights — Commissioner authorized to require certain information identifying persons covered by third parties — State's right of action — Determination of subrogation interest — Attorney's fees — Remittance of net subrogation interest — Subrogation interest hearing — Legislative intent
Tenn. Code Ann. § 71-5-118— Contracts with vendors — Sanctions against vendors — Grounds for actions against providers — Administrative remedy to recover benefits from applicant — Collection activity report — Applicant warning — Prompt process of hospital presumptive eligibility applications
Tenn. Code Ann. § 71-5-119— Discrimination prohibited
Tenn. Code Ann. § 71-5-120— Residency requirement — Determination — Appeal
Tenn. Code Ann. § 71-5-121— Transfer of income or resources
Tenn. Code Ann. § 71-5-122— Statement of interest of vendors or suppliers holding equity interest in hospitals, apothecaries or nursing homes
Tenn. Code Ann. § 71-5-123— Statement of public officials as to interest in vendors or providers
Tenn. Code Ann. § 71-5-124— Duties of department of finance and administration
Tenn. Code Ann. § 71-5-125— Duties of fiscal review committee
Tenn. Code Ann. § 71-5-126— Medicaid expansion under federal Patient Protection and Affordable Care Act prohibited without joint resolution of General Assembly
Tenn. Code Ann. § 71-5-127— Conflict with federal law — Single state agency
Tenn. Code Ann. § 71-5-128— Contracts with health maintenance organizations — Requirements
Tenn. Code Ann. § 71-5-129— Charges for services of physician assistants
Tenn. Code Ann. § 71-5-130— Determination of payments to vendors — Audits
Tenn. Code Ann. § 71-5-131— Contributed funds
Tenn. Code Ann. § 71-5-132— Medicaid providers — Responsibilities — Changes in ownership or controlling interest
Tenn. Code Ann. § 71-5-133— Provision of information concerning Norplant and other contraceptives
Tenn. Code Ann. § 71-5-134— Rules and regulations — Funding medical assistance
Tenn. Code Ann. § 71-5-135— State unemployment health care benefits — Scope — Conditions
Tenn. Code Ann. § 71-5-136— Hold harmless requirements prohibited
Tenn. Code Ann. § 71-5-137— Disclosures required of persons associated with managed care organizations
Tenn. Code Ann. § 71-5-138— Compliance with provisions regarding authorizations for pharmacy services
Tenn. Code Ann. § 71-5-139— Protection of TennCare patients' federal and court ordered rights by health care providers receiving TennCare funds
Tenn. Code Ann. § 71-5-140— Deductions for dental services paid by eligible individuals in long-term care facilities
Tenn. Code Ann. § 71-5-141— Eligibility of aliens for medical assistance
Tenn. Code Ann. § 71-5-142— Confidentiality and disclosure of proprietary information
Tenn. Code Ann. § 71-5-143— TennCare advisory commission — Composition — Purpose — Expert assistance — Confidentiality — Conflict — Compensation
Tenn. Code Ann. § 71-5-144— Medically necessary items and services
Tenn. Code Ann. § 71-5-145— Cost effectiveness of providers
Tenn. Code Ann. § 71-5-146— Pharmacy lock-in program
Tenn. Code Ann. § 71-5-147— Personal needs allowance — Protecting nursing home residents from diversion of allowance
Tenn. Code Ann. § 71-5-148— Health care safety net for uninsured
Tenn. Code Ann. § 71-5-149— Disease management program
Tenn. Code Ann. § 71-5-150— Reimbursement for TennCare crossover payments
Tenn. Code Ann. § 71-5-151— Report on use of technical assistance groups of healthcare providers in developing episode of care
Tenn. Code Ann. § 71-5-152— Procedure to obtain data sets derived from all payer claims database — Use of data — Annual report
Tenn. Code Ann. § 71-5-153— Verification of information
Tenn. Code Ann. § 71-5-154— Annual report relating to coverage of mental health treatment
Tenn. Code Ann. § 71-5-155— Medication therapy management pilot program. [Effective until June 30, 2020.]
Tenn. Code Ann. § 71-5-156— Development of policy regarding births involving neonatal abstinence syndrome and opiod use by women of childbearing age
Tenn. Code Ann. § 71-5-157— Establishment of state policy to avoid use of state funds for elective abortions
Tenn. Code Ann. § 71-5-158— Amendment to TennCare ll waiver relating to work and community engagement requirements for certain adult enrollees
Tenn. Code Ann. § 71-5-159— Complex rehabilitation technology
Tenn. Code Ann. § 71-5-160— Maintenance of coverage trust fund
Tenn. Code Ann. § 71-5-161— Hospital payment rate corridors
Tenn. Code Ann. § 71-5-162— Identification of child enrollees eligible for federal supplemental security income upon reaching 18 years of age — Counseling — Enrollment assistance
Tenn. Code Ann. § 71-5-163— Submission of waiver in order to provide medical assistance to TennCare ll waiver population by means of block grant
Tenn. Code Ann. § 71-5-164— Waiver for purpose of establishing Katie Beckett program
Tenn. Code Ann. § 71-5-165— Reimbursement of ambulance service provider that provides covered service to TennCare recipient
Tenn. Code Ann. § 71-5-166— — 71-5-180. [Reserved.]
Tenn. Code Ann. § 71-5-181— Tennessee Medicaid False Claims Act — Short title
Tenn. Code Ann. § 71-5-182— Violations — Damages — Definitions
Tenn. Code Ann. § 71-5-183— Civil actions — Employee remedies
Tenn. Code Ann. § 71-5-184— Service — Limitations
Tenn. Code Ann. § 71-5-185— Venue
Tenn. Code Ann. § 71-5-186— , 71-5-187. [Reserved.]
Tenn. Code Ann. § 71-5-188— Actuarial study of TennCare
Tenn. Code Ann. § 71-5-189— Accounting of TennCare funds
Tenn. Code Ann. § 71-5-190— TennCare prescription drug utilization review committee
Tenn. Code Ann. § 71-5-191— Uniform TennCare claims process
Tenn. Code Ann. § 71-5-192— Information management system
Tenn. Code Ann. § 71-5-193— Children's mental health care — Development of interagency projects and programs
Tenn. Code Ann. § 71-5-194— Spend down eligibility for medical assistance
Tenn. Code Ann. § 71-5-195— Study on use of prescription drugs in nursing homes
Tenn. Code Ann. § 71-5-196— Veterans education benefits
Tenn. Code Ann. § 71-5-197— Authority over TennCare pharmacy purchases — Confidential information — Exemption from open meeting laws
Tenn. Code Ann. § 71-5-198— Prescription drug program waiver
Tenn. Code Ann. § 71-5-199— State preferred drug list
Tenn. Code Ann. § 71-5-201— Reimbursement for services — Authorization
Tenn. Code Ann. § 71-5-202— Restrictions on services
Tenn. Code Ann. § 71-5-301— Short title
Tenn. Code Ann. § 71-5-302— Purpose
Tenn. Code Ann. § 71-5-303— Part definitions
Tenn. Code Ann. § 71-5-304— Duties of department
Tenn. Code Ann. § 71-5-305— Eligibility requirements for assistance
Tenn. Code Ann. § 71-5-306— Determination of amount of assistance
Tenn. Code Ann. § 71-5-307— Method of applying for assistance
Tenn. Code Ann. § 71-5-308— Investigation of applications — Determination of eligibility
Tenn. Code Ann. § 71-5-309— Appeal of determination of area manager
Tenn. Code Ann. § 71-5-310— Review of determinations of area managers
Tenn. Code Ann. § 71-5-311— Election of county to participate
Tenn. Code Ann. § 71-5-312— Administration costs
Tenn. Code Ann. § 71-5-313— Receipt or transfer of property by recipient — Notice required — Recovery of excess payments
Tenn. Code Ann. § 71-5-314— Fraudulent receipt of food assistance — Penalties — Statute of limitations
Tenn. Code Ann. § 71-5-315— Veterans education benefits
Tenn. Code Ann. § 71-5-316— Data matches
Tenn. Code Ann. § 71-5-401— Administration by department of human services
Tenn. Code Ann. § 71-5-402— Veterans education benefits
Tenn. Code Ann. § 71-5-501— Part definitions
Tenn. Code Ann. § 71-5-502— Establishment of pharmaceutical connection program
Tenn. Code Ann. § 71-5-503— Assistance by department of finance and administration — Volunteer assistance — Assistance in development of program
Tenn. Code Ann. § 71-5-504— Notification about program to pharmaceutical companies — Opportunity for companies to submit information about assistance programs offered by companies
Tenn. Code Ann. § 71-5-505— Strategies to improve access to prescription drugs
Tenn. Code Ann. § 71-5-506— Annual report
Tenn. Code Ann. § 71-5-507— Entitlement not created by program
Tenn. Code Ann. § 71-5-601— Legislative intent
Tenn. Code Ann. § 71-5-602— Federal waiver authority for matching funds
Tenn. Code Ann. § 71-5-603— Rules and regulations
Tenn. Code Ann. § 71-5-701— [Expired.]
Tenn. Code Ann. § 71-5-702— [Expired.]
Tenn. Code Ann. § 71-5-703— [Expired.]
Tenn. Code Ann. § 71-5-704— [Expired.]
Tenn. Code Ann. § 71-5-705— [Expired.]
Tenn. Code Ann. § 71-5-706— [Expired.]
Tenn. Code Ann. § 71-5-801— [Repealed.]
Tenn. Code Ann. § 71-5-802— [Repealed.]
Tenn. Code Ann. § 71-5-803— [Repealed.]
Tenn. Code Ann. § 71-5-804— [Repealed.]
Tenn. Code Ann. § 71-5-805— [Repealed.]
Tenn. Code Ann. § 71-5-806— [Repealed.]
Tenn. Code Ann. § 71-5-901— Commissioner of human services to conduct study of poverty
Tenn. Code Ann. § 71-5-902— Poverty reduction plan
Tenn. Code Ann. § 71-5-903— Deadline for submission of findings and recommendations
Tenn. Code Ann. § 71-5-1001— Part definitions
Tenn. Code Ann. § 71-5-1002— Legislative intent — Creation of nursing home assessment trust fund
Tenn. Code Ann. § 71-5-1003— Payment of assessments — Determination of rate — Time for payment
Tenn. Code Ann. § 71-5-1004— Quality-based component of reimbursement methodology for nursing facility services
Tenn. Code Ann. § 71-5-1005— Bureau to seek federal approvals if necessary — Bureau authorized to adopt rules and regulations to implement part
Tenn. Code Ann. § 71-5-1006— Penalties for late payment — Payment plan — Proceedings before board — Waiver of penalties — Fees in abeyance
Tenn. Code Ann. § 71-5-1007— Requirements for nursing homes participating in medicaid program — Penalties for noncompliance — Waiver of penalties
Tenn. Code Ann. § 71-5-1008— Oversight authority of fiscal review committee
Tenn. Code Ann. § 71-5-1009— Enactment of part does not excuse payment of assessment fee
Tenn. Code Ann. § 71-5-1010— Termination of fee — Suspension of assessment
Tenn. Code Ann. § 71-5-1011— [Repealed.]
Tenn. Code Ann. § 71-5-1101— [Expired.]
Tenn. Code Ann. § 71-5-1102— [Expired.]
Tenn. Code Ann. § 71-5-1103— [Expired.]
Tenn. Code Ann. § 71-5-1104— [Expired.]
Tenn. Code Ann. § 71-5-1105— [Expired.]
Tenn. Code Ann. § 71-5-1106— [Expired.]
Tenn. Code Ann. § 71-5-1201— Establishment
Tenn. Code Ann. § 71-5-1202— Membership — Compensation — Meetings — Rules and regulations
Tenn. Code Ann. § 71-5-1203— Inventory and coordination of services and opportunities
Tenn. Code Ann. § 71-5-1204— Cooperation by state entities
Tenn. Code Ann. § 71-5-1301— Creation of grant assistance program
Tenn. Code Ann. § 71-5-1302— Eligibility
Tenn. Code Ann. § 71-5-1303— Application for payment — Nursing home certification to department
Tenn. Code Ann. § 71-5-1304— Processing of applications — Funding — Determination of grant
Tenn. Code Ann. § 71-5-1305— Grant payments
Tenn. Code Ann. § 71-5-1306— Rules and regulations
Tenn. Code Ann. § 71-5-1307— [Reserved.]
Tenn. Code Ann. § 71-5-1308— Administration of part
Tenn. Code Ann. § 71-5-1309— Funding
Tenn. Code Ann. § 71-5-1310— Total annual income — Certification of income
Tenn. Code Ann. § 71-5-1311— Veterans education benefits
Tenn. Code Ann. § 71-5-1401— Short title
Tenn. Code Ann. § 71-5-1402— Objectives of long-term care system
Tenn. Code Ann. § 71-5-1403— Part definitions
Tenn. Code Ann. § 71-5-1404— Development and implementation of a statewide fully integrated risk-based long-term care system
Tenn. Code Ann. § 71-5-1405— Single entry point into the long-term care system
Tenn. Code Ann. § 71-5-1406— Implementation of policies and processes by commissioner
Tenn. Code Ann. § 71-5-1407— Level of care and continued stay criteria — Preadmission evaluation (PAE) assessment tool
Tenn. Code Ann. § 71-5-1408— Strategies to encourage utilization of cost-effective home and community-based services — Requirements related to nursing facility diversion
Tenn. Code Ann. § 71-5-1409— Nursing facility transition initiative
Tenn. Code Ann. § 71-5-1410— Strategies to assist nursing facilities in diversifying their lines of business
Tenn. Code Ann. § 71-5-1411— Plan to expand cost-effective community-based residential alternatives to institutional care
Tenn. Code Ann. § 71-5-1412— Transition period following implementation of managed long-term care service delivery system
Tenn. Code Ann. § 71-5-1413— Acuity-based reimbursement methodology for nursing facility services
Tenn. Code Ann. § 71-5-1414— Self-directed health care
Tenn. Code Ann. § 71-5-1415— Quality assurance and quality improvement strategies
Tenn. Code Ann. § 71-5-1416— Funding to increase access to home and community-based services in the state-funded options program
Tenn. Code Ann. § 71-5-1417— Funding for medicaid long-term care services
Tenn. Code Ann. § 71-5-1418— Long-term care client information, referral and assistance agency
Tenn. Code Ann. § 71-5-1419— Operational plan and budget for home-based and community-based services to elderly and disabled individuals
Tenn. Code Ann. § 71-5-1420— Veterans education benefits
Tenn. Code Ann. § 71-5-1421— Prompt payment of claims and liability for bad faith failure to pay claims promptly
Tenn. Code Ann. § 71-5-1422— Pilot project for disabled individuals and family members to self-direct supports and services
Tenn. Code Ann. § 71-5-1423— Hearing on resident’s appeal of involuntary discharge from facility — Timeframe for hearing and final order
Tenn. Code Ann. § 71-5-1424— Hearing on appeal of TennCare’s initial determination of ineligibility for nursing facility services — Motion to intervene by facility
Tenn. Code Ann. § 71-5-1425— Guidance regarding whether temporary family healthcare structures are covered — Federal approval of waiver amendment to offer benefit — Applicability of waiver
Tenn. Code Ann. § 71-5-1501— Short title
Tenn. Code Ann. § 71-5-1502— Part definitions
Tenn. Code Ann. § 71-5-1503— Annual coverage assessment on covered hospitals
Tenn. Code Ann. § 71-5-1504— Calculation of uniform assessment per ground transport — Quarterly transport data
Tenn. Code Ann. § 71-5-1505— Maintenance of coverage trust fund
Tenn. Code Ann. § 71-5-1506— Policy measures to ensure enforcement and compliance — Penalties — Quarterly transport count data
Tenn. Code Ann. § 71-5-1507— Annual cost and utilization report
Tenn. Code Ann. § 71-5-1508— Audit
Tenn. Code Ann. § 71-5-1509— Implementation of part — Termination of ground ambulance provider assessment
Tenn. Code Ann. § 71-5-1510— Promulgation of rules
Tenn. Code Ann. § 71-5-2001— Short title. [Effective until July 1, 2021.]
Tenn. Code Ann. § 71-5-2002— Part definitions. [Effective until July 1, 2021.]
Tenn. Code Ann. § 71-5-2003— Annual coverage assessment on covered hospitals. [Effective until July 1, 2021.]
Tenn. Code Ann. § 71-5-2004— Amount of annual coverage assessment — Payment — Penalty — Suspension of payments — Civil action. [Effective until July 1, 2021.]
Tenn. Code Ann. § 71-5-2005— Deposits in Maintenance of Coverage Trust Fund — Expenditures — Quarterly Reports. [Effective until July 1, 2021.]
Tenn. Code Ann. § 71-5-2006— Expiration of part — Survival of certain rights and obligations. [Effective until July 1, 2021.]
Tenn. Code Ann. § 71-5-2007— Audit of expenditure of funds from maintenance of coverage trust fund. [Effective until July 1, 2021.]
Tenn. Code Ann. § 71-5-2101— Provision by county legislative body
Tenn. Code Ann. § 71-5-2102— Site and construction
Tenn. Code Ann. § 71-5-2103— Appointment of commissioners
Tenn. Code Ann. § 71-5-2104— Appropriation of county funds
Tenn. Code Ann. § 71-5-2105— Powers of commissioners
Tenn. Code Ann. § 71-5-2106— Duty of superintendent
Tenn. Code Ann. § 71-5-2107— Replacement of superintendent
Tenn. Code Ann. § 71-5-2108— Residence of inmates
Tenn. Code Ann. § 71-5-2109— Application for admission
Tenn. Code Ann. § 71-5-2110— Superintendent's annual report
Tenn. Code Ann. § 71-5-2111— Joint institutions
Tenn. Code Ann. § 71-5-2112— Government of joint institutions
Tenn. Code Ann. § 71-5-2113— Funds for joint institutions
Tenn. Code Ann. § 71-5-2201— Permanent body — Name — Appointment — Term of office
Tenn. Code Ann. § 71-5-2202— Oath of office
Tenn. Code Ann. § 71-5-2203— Chair — Minutes
Tenn. Code Ann. § 71-5-2204— Compensation
Tenn. Code Ann. § 71-5-2205— Removal — Vacancies
Tenn. Code Ann. § 71-5-2206— Order for expenditures — Warrants
Tenn. Code Ann. § 71-5-2207— Book of accounts — Items entered
Tenn. Code Ann. § 71-5-2208— Examination and preservation of accounts
Tenn. Code Ann. § 71-5-2209— Liability for expenditures
Tenn. Code Ann. § 71-5-2210— Annual report
Tenn. Code Ann. § 71-5-2301— Allowances by county legislative body
Tenn. Code Ann. § 71-5-2302— Exemption from road service
Tenn. Code Ann. § 71-5-2303— Contract for support with use of farm
Tenn. Code Ann. § 71-5-2304— Contracts for support of poor
Tenn. Code Ann. § 71-5-2305— Employment of poor by contracts
Tenn. Code Ann. § 71-5-2306— Supervision of contractors
Tenn. Code Ann. § 71-5-2307— Setting aside contract
Tenn. Code Ann. § 71-5-2308— Contracts for hospital care
Tenn. Code Ann. § 71-5-2309— Order to receive county patient
Tenn. Code Ann. § 71-5-2310— Hospitalization attained by county mayor
Tenn. Code Ann. § 71-5-2311— Payment for hospitalization
Tenn. Code Ann. § 71-5-2312— Attendance of patients by county physicians
Tenn. Code Ann. § 71-5-2313— Welfare recipients may choose optometrist or physician — Exception — Fee schedule
Tenn. Code Ann. § 71-5-2314— Payment of claims under TennCare partners program
Tenn. Code Ann. § 71-5-2401— Establishment — Members — Recommendations concerning drugs on auto-exemptions list
Tenn. Code Ann. § 71-5-2402— Removal of member
Tenn. Code Ann. § 71-5-2403— Conflicts of interest — Compensation
Tenn. Code Ann. § 71-5-2404— Recommendations for inclusion on preferred drug list
Tenn. Code Ann. § 71-5-2501— Short title
Tenn. Code Ann. § 71-5-2502— Office of inspector general
Tenn. Code Ann. § 71-5-2503— Part definitions
Tenn. Code Ann. § 71-5-2504— Rules and regulations
Tenn. Code Ann. § 71-5-2505— Authority
Tenn. Code Ann. § 71-5-2506— Fraud and abuse cases
Tenn. Code Ann. § 71-5-2507— Enforcement by law enforcement officers
Tenn. Code Ann. § 71-5-2508— Medicaid fraud control unit
Tenn. Code Ann. § 71-5-2509— Powers when investigating fraud or abuse — Judicial enforcement
Tenn. Code Ann. § 71-5-2510— Investigations of fraud or abuse involving managed care organizations
Tenn. Code Ann. § 71-5-2511— Annual reports
Tenn. Code Ann. § 71-5-2512— Cash reward program for reporting criminal fraud by recipients of the TennCare program
Tenn. Code Ann. § 71-5-2513— Legislative intent
Tenn. Code Ann. § 71-5-2514— Definitions
Tenn. Code Ann. § 71-5-2515— Data provided to the inspector general
Tenn. Code Ann. § 71-5-2516— Confidentiality — Liability for providing data — Creation of new records or data — Destruction of data
Tenn. Code Ann. § 71-5-2517— Authority to require periodic provision of specific data — Compliance — Format of data — Charge for supplying data — Sufficient dedicated storage space and access to software — Construction
Tenn. Code Ann. § 71-5-2518— Rules and regulations
Tenn. Code Ann. § 71-5-2519— Written petition for objection to providing access to data — Enforcement of obligations
Tenn. Code Ann. § 71-5-2520— Collections of penalties, fees and costs
Tenn. Code Ann. § 71-5-2521— Report
Tenn. Code Ann. § 71-5-2601— Offenses — Penalties — Remedies — Limitations
Tenn. Code Ann. § 71-5-2602— Record keeping
Tenn. Code Ann. § 71-5-2603— Fraud reporting requirements — Immunity from liability
Tenn. Code Ann. § 71-5-2604— Administrative remedies — Recovery of costs — Contested cases — Rules and regulations — Final orders