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HB0435 • 2026

Consumer Protection

AN ACT to amend Tennessee Code Annotated, Title 9, Chapter 8; Title 16; Title 18; Title 20; Title 21; Title 27; Title 28; Title 29; Title 33; Title 45; Title 47; Title 63; Title 68 and Title 71, relative to healthcare costs.

Healthcare
Active

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

Sponsor
Jones J, Lamar
Last action
2025-02-05
Official status
Assigned to s/c Health Subcommittee
Effective date
Not listed

Plain English Breakdown

The official summary does not provide specific details on enforcement mechanisms beyond sanctions by the health facilities commission, which were included in the candidate explanation but are not explicitly detailed in the provided source material.

Healthcare Debt Relief Act

This bill requires healthcare facilities receiving public funds to forgive patient debts equal to those funds and notify patients about this forgiveness.

What This Bill Does

  • Requires healthcare facilities that receive public funds for uncompensated care to forgive an amount of outstanding patient debt equal to the received funds.
  • Prohibits these facilities from taking legal action against patients for forgiven portions of their debt.
  • Mandates that facilities inform patients about the forgiven portion of their debt and provide instructions on how to pay any remaining balance, if applicable.
  • Directs the health facilities commission to create rules ensuring maximum patient debt forgiveness under this bill.
  • Requires an annual report from the Department of Health and TennCare detailing expenditures for uncompensated care payments.

Who It Names or Affects

  • Healthcare facilities that receive public funds for providing uncompensated care.
  • Patients with outstanding medical debts who have received services at healthcare facilities covered by this bill.
  • The health facilities commission, which must create rules to implement the bill's requirements.
  • The Department of Health and TennCare, responsible for submitting annual reports.

Terms To Know

Uncompensated care
Healthcare services provided without payment from the patient or on behalf of the patient.
Disproportionate share hospital (DSH) payments
Payments made to hospitals that serve a large number of low-income patients who cannot afford care.

Limits and Unknowns

  • The bill does not specify the exact amount or source of public funds for uncompensated care.
  • It is unclear how facilities will implement the debt forgiveness and notification process.
  • The effectiveness of the annual report in addressing healthcare costs remains to be seen.

Amendments

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

Amendment 1-0 to SB0403

Plain English: The amendment requires the Tennessee Department of Health to submit an annual report on uncompensated care costs and funding received from state sources.

  • Adds a new subsection (d) to Tennessee Code Annotated, Section 68-1-109, which mandates an annual report on uncompensated care by August 1st each year starting in 2025.
  • The report must include the amount of public funds distributed for uncompensated care and the total cost of healthcare services classified as uncompensated care provided by facilities that accept such funding.
  • The amendment text does not specify how the data will be collected or what happens if complete data is unavailable.
  • It's unclear which specific committees in the Senate and House are responsible for receiving the report presentations.

Bill History

  1. 2025-03-18 Tennessee General Assembly

    Failed in Senate Commerce and Labor Committee

  2. 2025-03-13 Tennessee General Assembly

    Placed on Senate Commerce and Labor Committee calendar for 3/18/2025

  3. 2025-03-11 Tennessee General Assembly

    Placed on Senate Commerce and Labor Committee calendar for 3/18/2025

  4. 2025-03-04 Tennessee General Assembly

    Action deferred in Senate Commerce and Labor Committee to 3/18/2025

  5. 2025-02-25 Tennessee General Assembly

    Placed on Senate Commerce and Labor Committee calendar for 3/4/2025

  6. 2025-02-25 Tennessee General Assembly

    Placed on Senate Commerce and Labor Committee calendar for 3/4/2025

  7. 2025-02-12 Tennessee General Assembly

    Passed on Second Consideration, refer to Senate Commerce and Labor Committee

  8. 2025-02-10 Tennessee General Assembly

    Introduced, Passed on First Consideration

  9. 2025-02-05 Tennessee General Assembly

    Assigned to s/c Health Subcommittee

  10. 2025-02-05 Tennessee General Assembly

    P2C, ref. to Health Committee- Government Operations for Review

  11. 2025-02-03 Tennessee General Assembly

    Intro., P1C.

  12. 2025-01-28 Tennessee General Assembly

    Filed for introduction

  13. 2025-01-28 Tennessee General Assembly

    Filed for introduction

Official Summary Text

This bill generally requires a healthcare facility that accepts public funds as compensation for losses
due to providing uncompensated care, to (i) ensure that an amount
of outstanding patient debt equal to the amount of public funds accepted is designated as satisfied, and
to (ii)
not seek a judgment or take other legal action to collect from the debtor any
portion of such debt that is so designated.

NOTIFICATION

This bill requires a
facility that accepts public funds
in the manner previously mentioned to
notify the patient whose debt has been satisfied.
The
notification must include the amount of satisf
ied patient debt, and, if applicable, instructions on how to pay the remaining balance of the patient's debt.

RULEMAKING

This bill requires the health facilities commission to make rules to establish a process for facilities that accept public funds to
use to offset uncompensated care losses to ensure that the facility maximizes the number of patients with outstanding debt that is designated as satisfied pursuant to this bill.

VIOLATIONS

This bill provides that a facility found in violation of this b
ill is subject to sanctions by the health facilities commission.

ANNUAL REPORT

This bill requires the department of health, in collaboration with the division of TennCare, to submit an annual report to the general assembly no later than January 15, 2026
, and by each January 15 thereafter. The report must include, at a minimum, a report
on all expenditures in the previous calendar year for virtual disproportionate share hospital
(DSH)
payments and for payments to hospitals for uncompensated care to chari
ty patients
,
as those categories of payments are defined in, the TennCare 1115 demonstration waiver from the federal centers for medicare and medicaid services.

Current Bill Text

Read the full stored bill text
SENATE BILL 403
By Lamar

HOUSE BILL 435
By Jones J

HB0435
000075
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 9,
Chapter 8; Title 16; Title 18; Title 20; Title 21; Title
27; Title 28; Title 29; Title 33; Title 45; Title 47;
Title 63; Title 68 and Title 71, relative to healthcare
costs.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 68, Chapter 11, Part 2, is amended by
adding the following as a new section:
(a) As used in this section, "uncompensated care" means healthcare services
rendered by a facility for which no payment was received from the patient or on behalf of
the patient.
(b) A facility that accepts public funds as compensation for losses due to
providing uncompensated care shall ensure that an amount of outstanding patient debt
equal to the amount of public funds accepted is designated as satisfied, and the facility
shall not seek a judgment or take other legal action to collect from the debtor any portion
of such debt that is so designated.
(c) A facility that accepts public funds pursuant to subsection (b) shall notify the
patient whose debt has been satisfied. Such notification must include the amount of
satisfied patient debt, and, if applicable, instructions on how to pay the remaining
balance of the patient's debt.
(d) The health facilities commission shall promulgate rules to establish a process
for facilities that accept public funds to use to offset uncompensated care losses to
ensure that the facility maximizes the number of patients with outstanding debt that is
designated as satisfied pursuant to subsection (b). The rules must be promulgated in

- 2 - 000075

accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter
5.
(e) A facility that violates this section is subject to sanctions by the health
facilities commission.
SECTION 2. Tennessee Code Annotated, Section 68-1-109, is amended by adding the
following as a new subsection:
( ) The department of health, in collaboration with the division of TennCare,
shall submit an annual report to the general assembly no later than January 15, 2026,
and by each January 15 thereafter, that includes, but is not limited to, a report on all
expenditures in the previous calendar year for virtual disproportionate share hospital
(DSH) payments and for payments to hospitals for uncompensated care to charity
patients with all of those payments being made in accordance with, and as those
categories of payments are defined in, the TennCare 1115 demonstration waiver from
the federal centers for medicare and medicaid services.
SECTION 3. This act takes effect upon becoming a law, the public welfare requiring it.