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HB0782 • 2026

TennCare

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

Healthcare
Active

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

Sponsor
Martin G, Watson
Last action
2025-05-27
Official status
Effective date(s) 05/21/2025
Effective date
Not listed

Plain English Breakdown

The bill summary text does not provide specific details on the funding mechanism for the additional PACE program beyond mentioning federal support.

TennCare PACE Program Expansion

This bill requires TennCare to establish an additional PACE program as a pilot in one of two regions where no such program existed before 2024 and allows existing programs meeting specific population criteria to expand into nearby counties.

What This Bill Does

  • Requires the bureau of TennCare to authorize an additional PACE program as a pilot in one region that did not have a PACE program by 2024.
  • Asks prospective applicants for this pilot program to submit a letter of intent with details about their proposed service area and location.
  • Directs TennCare to ensure PACE applicants meet federal eligibility criteria and are qualified to provide services in the proposed geographic area.
  • Requires PACE applicants to submit a market analysis showing an unmet need for the program in the proposed service area.
  • Ensures managed care organizations consider referring individuals to the PACE program instead of nursing facilities when appropriate.
  • Directs TennCare to ensure all PACE programs meet federal quality and performance standards and oversees these programs through regular reports.

Who It Names or Affects

  • People who are elderly and need long-term care services in Tennessee.
  • Healthcare providers interested in starting or expanding a PACE program.
  • TennCare, the bureau responsible for overseeing healthcare programs in Tennessee.

Terms To Know

PACE Program
A program that provides comprehensive care to elderly individuals who need nursing home-level care but prefer to live at home.
Managed Care Organizations (MCOs)
Healthcare organizations that manage and coordinate healthcare services for a specific group of people, often through insurance plans.

Limits and Unknowns

  • The bill does not specify how the additional PACE program will be funded beyond mentioning federal support.
  • It is unclear what criteria TennCare uses to select which region gets the new pilot program.
  • The expansion of existing programs into nearby counties depends on specific population thresholds.

Bill History

  1. 2025-05-27 Tennessee General Assembly

    Effective date(s) 05/21/2025

  2. 2025-05-27 Tennessee General Assembly

    Pub. Ch. 502

  3. 2025-05-27 Tennessee General Assembly

    Comp. became Pub. Ch. 502

  4. 2025-05-21 Tennessee General Assembly

    Signed by Governor.

  5. 2025-05-09 Tennessee General Assembly

    Transmitted to Governor for his action.

  6. 2025-05-08 Tennessee General Assembly

    Signed by Senate Speaker

  7. 2025-04-30 Tennessee General Assembly

    Signed by H. Speaker

  8. 2025-04-28 Tennessee General Assembly

    Enrolled; ready for sig. of H. Speaker.

  9. 2025-04-22 Tennessee General Assembly

    Passed Senate, Ayes 33, Nays 0

  10. 2025-04-22 Tennessee General Assembly

    Senate substituted House Bill for companion Senate Bill.

  11. 2025-04-22 Tennessee General Assembly

    Received from House, Passed on First Consideration

  12. 2025-04-22 Tennessee General Assembly

    Companion House Bill substituted

  13. 2025-04-21 Tennessee General Assembly

    Engrossed; ready for transmission to Sen.

  14. 2025-04-21 Tennessee General Assembly

    Passed H., Ayes 86, Nays 0, PNV 1

  15. 2025-04-21 Tennessee General Assembly

    Placed on Senate Consent Calendar 2 for 4/22/2025

  16. 2025-04-21 Tennessee General Assembly

    Recommended for passage, refer to Senate Calendar Committee

  17. 2025-04-17 Tennessee General Assembly

    H. Placed on Consent Calendar for 4/21/2025

  18. 2025-04-17 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 4/17/2025

  19. 2025-04-17 Tennessee General Assembly

    Sponsor(s) Added.

  20. 2025-04-17 Tennessee General Assembly

    Rec. for pass; ref to Calendar & Rules Committee

  21. 2025-04-17 Tennessee General Assembly

    Rec. for pass by s/c ref. to Finance, Ways, and Means Committee

  22. 2025-04-17 Tennessee General Assembly

    Placed on Senate Finance, Ways, and Means Committee calendar for 4/21/2025

  23. 2025-04-16 Tennessee General Assembly

    Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/17/2025

  24. 2025-04-14 Tennessee General Assembly

    Placed on Senate Finance, Ways, and Means Committee calendar for 4/15/2025

  25. 2025-04-14 Tennessee General Assembly

    Rule #83(8) Suspended, to be heard in Senate Finance, Ways & Means Committee on 4/15/2025

  26. 2025-04-09 Tennessee General Assembly

    Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/14/2025

  27. 2025-04-09 Tennessee General Assembly

    Placed behind the budget

  28. 2025-04-02 Tennessee General Assembly

    Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/9/2025

  29. 2025-04-02 Tennessee General Assembly

    Assigned to s/c Finance, Ways, and Means Subcommittee

  30. 2025-03-31 Tennessee General Assembly

    Rec. for pass; ref to Finance, Ways, and Means Committee

  31. 2025-03-26 Tennessee General Assembly

    Placed on cal. Government Operations Committee for 3/31/2025

  32. 2025-03-25 Tennessee General Assembly

    Rec. for pass; ref to Government Operations Committee

  33. 2025-03-19 Tennessee General Assembly

    Placed on cal. Insurance Committee for 3/25/2025

  34. 2025-03-19 Tennessee General Assembly

    Recommended for passage, refer to Senate Finance, Ways, and Means Committee

  35. 2025-03-18 Tennessee General Assembly

    Rec. for pass by s/c ref. to Insurance Committee

  36. 2025-03-12 Tennessee General Assembly

    Placed on s/c cal Tenncare Subcommittee for 3/18/2025

  37. 2025-03-12 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/19/2025

  38. 2025-03-12 Tennessee General Assembly

    Action deferred in Senate Health and Welfare Committee to 3/19/2025

  39. 2025-03-05 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/12/2025

  40. 2025-02-12 Tennessee General Assembly

    Sponsor(s) Added.

  41. 2025-02-12 Tennessee General Assembly

    Passed on Second Consideration, refer to Senate Health and Welfare Committee

  42. 2025-02-10 Tennessee General Assembly

    Assigned to s/c Tenncare Subcommittee

  43. 2025-02-10 Tennessee General Assembly

    Introduced, Passed on First Consideration

  44. 2025-02-06 Tennessee General Assembly

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

  45. 2025-02-06 Tennessee General Assembly

    Filed for introduction

  46. 2025-02-05 Tennessee General Assembly

    Intro., P1C.

  47. 2025-02-04 Tennessee General Assembly

    Filed for introduction

Official Summary Text

This bill requires t
he bureau
of TennCare to
authorize an additional PACE program as a pilot in one of the two grand divisions where a PACE prog
ram did not exist in 2024.
A PACE program is
a program of all-inclusive care for elderly persons that provides comprehensive, integrated acute and long-term care services for frail, elderly individuals who require the level of care provided in a nursing f
acility and who meet eligibility criteria established by the federal centers for medicare and medicaid services.
The
director
of TennCare must
ensure PACE applicants meet the program eligibility criteria under
federal law and regulations
and certify that
applicants are qualified to be PACE providers in the proposed geographic service area.

Letter of Intent Required

This bill requires a
prospective PACE applicant for the pilot program
to
submit a letter of intent to the bureau indicating the prospective
applicant's intent to submit a PACE application. The letter of intent must identify
(i) t
he prospective applicant
,
(
ii
)
t
he proposed service area, including the proposed zip codes and a service area map
,
and

(
iii
)
t
he proposed site location for the appli
cant's PACE center.

Market Analysis Required

This bill requires
PACE applicants
to
submit a market analysis of the proposed service area, which must include
(i) a
n estimate of the number of PACE eligible individuals
, (ii) a
description of the methodolo
gy and assumptions used to determine the potential membership
, (iii) the
projected market capture and saturation rat
e
and (
iv
)
a
demonstration that there is an unmet need for a PACE program in the proposed service area.

Referrals

This bill requires

t
h
e director
to
ensure that managed care organizations and all appropriate options counseling entities consider the availability of the PACE program when considering whether to refer a recipient to a nursing facility or other long-term care facility and esta
blish protocols for the referral of eligible persons to the PACE program.

Quality and Performance Standards

This bill requires

t
he bureau
to
ensure all PACE programs and organizations meet the quality and performance standards established by CMS and the bureau. The bureau
must
oversee and monitor the PACE programs and organizations based upon data and reports that must be periodically submitt
ed by PACE organizations to CMS and the bureau.

Existing PACE Program

If a PACE program exists in Hamilton
C
ounty, this bill authorizes the service area of the program to expand into contiguous Meigs, Rhea, and Bradley counties.

Annual Report

On or before January 1 each year,
this bill requires
the bureau
to
provide a PACE program report to the speaker of the house of representatives, speaker of the senate,
and
chair
s
of
legislative
committee
s
having jurisdiction over finance-related matters.

Rulemaking

This bill authorizes t
he director to promulgate rules to effectuate this
bill.

Current Bill Text

Read the full stored bill text 
SENATE BILL 1390
By Watson

HOUSE BILL 782
By Martin G

HB0782
002643
- 1 -

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

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 71, Chapter 2, is amended by adding
the following as a new part:
71-2-601.
As used in this part:
(1) "Bureau" means the bureau of TennCare;
(2) "Director" means the director of TennCare; and
(3) "PACE program" means a program of all-inclusive care for elderly
persons that provides comprehensive, integrated acute and long-term care
services for frail, elderly individuals who require the level of care provided in a
nursing facility and who meet eligibility criteria established by the federal centers
for medicare and medicaid services (CMS).
71-2-602.
(a) The bureau shall authorize an additional PACE program as a pilot in one (1)
of the two (2) grand divisions where a PACE program did not exist in 2024.
(b) A prospective PACE applicant for the pilot program shall submit a letter of
intent to the bureau indicating the prospective applicant's intent to submit a PACE
application. The letter of intent must identify:
(1) The prospective applicant;

- 2 - 002643

(2) The proposed service area, including the proposed zip codes and a
service area map; and
(3) The proposed site location for the applicant's PACE center.
(c) The director shall ensure PACE applicants meet the program eligibility
criteria under 42 CFR Part 460 and certify that applicants are qualified to be PACE
providers in the proposed geographic service area.
(d) PACE applicants shall submit a market analysis of the proposed service
area, which must include:
(1) An estimate of the number of PACE eligible individuals;
(2) A description of the methodology and assumptions used to determine
the potential membership;
(3) The projected market capture and saturation rate; and
(4) A demonstration that there is an unmet need for a PACE program in
the proposed service area.
(e) The director shall ensure that managed care organizations and all
appropriate options counseling entities consider the availability of the PACE program
when considering whether to refer a recipient to a nursing facility or other long-term care
facility and establish protocols for the referral of eligible persons to the PACE program.
(f) The bureau shall ensure all PACE programs and organizations meet the
quality and performance standards established by CMS and the bureau. The bureau
shall oversee and monitor the PACE programs and organizations based upon data and
reports that must be periodically submitted by PACE organizations to CMS and the
bureau.
(g) On or before January 1, 2026, and on or before January 1 each year
thereafter, the bureau shall provide a PACE program report to the speaker of the house

- 3 - 002643

of representatives, speaker of the senate, chair of the finance, ways, and means
committee of the senate, and chair of the committee of the house of representatives
having jurisdiction over finance-related matters.
(h) The director is authorized to promulgate rules to effectuate this part. The
rules must be promulgated in accordance with the Uniform Administrative Procedures
Act, compiled in title 4, chapter 5.
71-2-603.
If a PACE program exists in a county having a population of not less than three
hundred sixty-six thousand two hundred (366,200) nor more than three hundred sixty-six
thousand three hundred (366,300), according to the 2020 federal census or a
subsequent federal census, then the service area of the program may expand into
contiguous counties having:
(1) A population of not less than twelve thousand seven hundred
(12,700) nor more than twelve thousand eight hundred (12,800), according to the
2020 federal census or a subsequent federal census;
(2) A population of not less than thirty-two thousand eight hundred
(32,800) nor more than thirty-two thousand eight hundred seventy-five (32,875),
according to the 2020 federal census or a subsequent federal census; or
(3) A population of not less than one hundred eight thousand six hundred
(108,600) nor more than one hundred eight thousand seven hundred (108,700),
according to the 2020 federal census or a subsequent federal census.
SECTION 2. This act takes effect upon becoming a law, the public welfare requiring it.