TennCare

AN ACT to amend Tennessee Code Annotated, Title 71, relative to ambulance services.

Healthcare Taxes

Active

The official status still shows this bill as active or still awaiting another formal step.

Sponsor: Martin B, Jackson
Last action: 2025-04-09
Official status: Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/14/2025
Effective date: Not listed

Plain English Breakdown

Checked against official source text during the last sync.

TennCare Ambulance Reimbursement Act

This bill changes how TennCare reimburses ambulance service providers for urban and rural services provided to TennCare recipients.

What This Bill Does

Sets new minimum reimbursement rates for urban and rural ambulance services provided to TennCare recipients.
Requires the bureau of TennCare to seek additional funding from other sources to increase these reimbursement rates if needed.
Establishes a program similar to the federal ET3 model to improve emergency medical care in Tennessee.
Allows for-profit ambulance service providers providing rural services to receive equipment grants.

Who It Names or Affects

Ambulance service providers who bill TennCare for urban and rural transports.
TennCare recipients receiving ambulance services.
The bureau of TennCare responsible for managing these reimbursements.

Terms To Know

ambulance service provider: A public or private ground-based rural or urban ambulance service that bills for transports and has a base in Tennessee.
ET3 model: Emergency Triage, Treat, and Transport model established by the federal Centers for Medicare and Medicaid Services to improve emergency medical care.

Limits and Unknowns

The bill does not specify how additional funding will be secured or if it will be approved.
There is uncertainty about whether the federal government will approve any proposed rate increases or changes to existing programs.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

HA0141

Amendment 1-0 to HB0195

Plain English: The amendment adds new rules about how TennCare must pay rural ambulance services.

Defines 'rural ambulance service' and 'rural area' based on federal standards.
Requires TennCare to reimburse rural ambulance services at least 78.5% of Medicare's allowable charge.

The exact impact on current reimbursement rates is not specified in the amendment text.

SA0182

Amendment 1-0 to SB0210

Plain English: The amendment adds new rules about how TennCare must pay rural ambulance services.

Defines 'rural ambulance service' and 'rural area' based on federal standards.
Requires TennCare to reimburse rural ambulance services at least 78.5% of Medicare's allowable charge.

The exact impact on current reimbursement rates is not specified in the amendment text.

Bill History

2025-11-03 Tennessee General Assembly
Sponsor(s) Added.
2025-04-17 Tennessee General Assembly
Placed on Senate Finance, Ways, and Means Committee calendar for 4/21/2025
2025-04-14 Tennessee General Assembly
Placed on Senate Finance, Ways, and Means Committee calendar for 4/15/2025
2025-04-14 Tennessee General Assembly
Rule #83(8) Suspended, to be heard in Senate Finance, Ways & Means Committee on 4/15/2025
2025-04-09 Tennessee General Assembly
Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/14/2025
2025-04-02 Tennessee General Assembly
Placed behind the budget
2025-03-26 Tennessee General Assembly
Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/2/2025
2025-03-26 Tennessee General Assembly
Assigned to s/c Finance, Ways, and Means Subcommittee
2025-03-25 Tennessee General Assembly
Sponsor(s) Added.
2025-03-20 Tennessee General Assembly
Sponsor(s) Added.
2025-03-19 Tennessee General Assembly
Rec. for pass. if am., ref. to Finance, Ways, and Means Committee
2025-03-18 Tennessee General Assembly
Recommended for passage with amendment/s, refer to Senate Finance, Ways, and Means Committee Ayes 8, Nays 0 PNV 0
2025-03-14 Tennessee General Assembly
Sponsor(s) Added.
2025-03-13 Tennessee General Assembly
Placed on Senate Commerce and Labor Committee calendar for 3/18/2025
2025-03-12 Tennessee General Assembly
Placed on cal. Insurance Committee for 3/19/2025
2025-03-12 Tennessee General Assembly
Action def. in Insurance Committee to 3/19/2025
2025-03-11 Tennessee General Assembly
Placed on Senate Commerce and Labor Committee calendar for 3/18/2025
2025-03-11 Tennessee General Assembly
Action deferred in Senate Commerce and Labor Committee to 3/18/2025
2025-03-05 Tennessee General Assembly
Placed on cal. Insurance Committee for 3/12/2025
2025-03-05 Tennessee General Assembly
Placed on Senate Commerce and Labor Committee calendar for 3/11/2025
2025-03-04 Tennessee General Assembly
Rec. for pass by s/c ref. to Insurance Committee
2025-02-26 Tennessee General Assembly
Placed on s/c cal Tenncare Subcommittee for 3/4/2025
2025-02-26 Tennessee General Assembly
Recommended for passage, refer to Senate Commerce and Labor Committee
2025-02-20 Tennessee General Assembly
Sponsor(s) Added.
2025-02-19 Tennessee General Assembly
Placed on Senate Health and Welfare Committee calendar for 2/26/2025
2025-02-10 Tennessee General Assembly
Sponsor(s) Added.
2025-02-10 Tennessee General Assembly
Passed on Second Consideration, refer to Senate Health and Welfare Committee
2025-02-03 Tennessee General Assembly
Assigned to s/c Tenncare Subcommittee
2025-02-03 Tennessee General Assembly
P2C, ref. to Insurance Committee
2025-01-27 Tennessee General Assembly
Intro., P1C.
2025-01-27 Tennessee General Assembly
Introduced, Passed on First Consideration
2025-01-16 Tennessee General Assembly
Filed for introduction
2025-01-16 Tennessee General Assembly
Filed for introduction

Official Summary Text

This bill rewrites the present law provisions under the Medical Assistance Act regarding the reimbursement of a public or private gr
ound-based rural or urban ambulance service that bills for transports and has a base of operations in this state ("ambulance service providers"), and which provides covered service to TennCare recipients.

This bill requires the bureau of TennCare ("bur
eau") to (i) reimburse an ambulance service provider for providing a covered urban ambulance service to a TennCare recipient at a rate not less than 67.5
%
of the federal medicare program's allowable charge for participating providers; and (ii) reimburse an
ambulance service provider for providing a covered rural ambulance service to a TennCare recipient at a rate not less than 100
%
of the federal medicare program's allowable charge for participating providers.

FUNDING

–
GRANTS

This bill provides that fun
ds described under this bill and those under the Ground Ambulance Service Provider Assessment Act must not be used to fund the other.

This bill requires the bureau to seek an intergovernmental transfer of funds in consultation with, and subject to approva
l of, the commissioner of finance and administration for the sole purpose of increasing the rate of reimbursement to ambulance service providers that provide covered services to TennCare recipients at a rate greater than the rates described under this bil
l
. Additionally, this bill requires the bureau, in consultation with and subject to approval of the commissioner of finance and administration, to develop and implement a program substantially similar to the federal centers for medicare and medicaid servi
c
es' Emergency Triage, Treat, and Transport (ET3) model in a manner that complies with this bill.

This bill further provides that for-profit ambulance service providers providing an ambulance service in which the point of pick up occurs in a rural area are
eligible to receive emergency medical services equipment grants.

Current Bill Text

Read the full stored bill text

SENATE BILL 210
By Jackson

HOUSE BILL 195
By Martin B

HB0195
001618
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 71,
relative to ambulance services.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 71-5-165, is amended by deleting the
section and substituting:
(a) As used in this section:
(1) "Ambulance service provider" means a public or private ground-based
rural or urban ambulance service that bills for transports and has a base of
operations in this state;
(2) "Rural ambulance service" means an ambulance service in which the
point of pick up occurs in a rural area;
(3) "Rural area" has the same meaning as defined in 42 CFR 414.605
and means an area located outside an urban area, or a rural census tract within
a metropolitan statistical area as determined under the most recent version of the
Goldsmith modification as determined by the office of rural health policy of the
health resources and services administration within the United States department
of health and human services;
(4) "Urban ambulance service" means an ambulance service in which the
point of pick up occurs in an urban area; and
(5) "Urban area" has the same meaning as defined in 42 CFR 414.605
and means a metropolitan statistical area, as defined by the federal executive
office of management and budget.

- 2 - 001618

(b) The bureau of TennCare shall:
(1) Reimburse an ambulance service provider for providing a covered
urban ambulance service to a TennCare recipient at a rate not less than sixty-
seven and one-half percent (67.5%) of the federal medicare program's allowable
charge for participating providers; and
(2) Reimburse an ambulance service provider for providing a covered
rural ambulance service to a TennCare recipient at a rate not less than one
hundred percent (100%) of the federal medicare program's allowable charge for
participating providers.
(c) This section does not affect the Ground Ambulance Service Provider
Assessment Act, compiled under part 15 of this chapter. Funds described under this
section and part 15 of this chapter must not be used to fund the other.
(d) The bureau of TennCare shall seek an intergovernmental transfer of funds in
consultation with and subject to approval of the commissioner of finance and
administration for the sole purpose of increasing the rate of reimbursement to
ambulance service providers that provide covered services to TennCare recipients at a
rate greater than the rates described under subsection (b).
(e) The bureau of TennCare, in consultation with and subject to approval of the
commissioner of finance and administration, shall develop and implement a program
substantially similar to the federal centers for medicare and medicaid services'
Emergency Triage, Treat, and Transport (ET3) model, established pursuant to Section
1115A of the federal Social Security Act (42 U.S.C. § 1315a), in a manner that complies
with this section.
(f) For-profit ambulance service providers providing rural ambulance services
are eligible to receive emergency medical services equipment grants.

- 3 - 001618

SECTION 2. This act takes effect upon becoming a law, the public welfare requiring it.