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HB1000 • 2026

TennCare

AN ACT to amend Tennessee Code Annotated, Title 71, Chapter 5, relative to the annual coverage assessment.

Healthcare Taxes
Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor
Hicks G, Haile
Last action
2025-04-08
Official status
Comp. became Pub. Ch. 115
Effective date
Not listed

Plain English Breakdown

The official source material does not provide specific details on how much money can be spent on directed payments or what conditions are required for implementation beyond CMS approval and confirmation.

TennCare Annual Coverage Assessment Changes

This bill changes the time frame for implementing the annual coverage assessment and sets limits on hospital payments until all necessary approvals are received.

What This Bill Does

  • Changes the time frame for implementing the annual coverage assessment from seven days to five days if certain conditions are met.
  • Limits expenditures for directed payments to hospitals until all required approvals, including those from CMS, are obtained.

Who It Names or Affects

  • Tennessee residents who receive TennCare services
  • Hospitals in Tennessee that receive directed payments through TennCare

Terms To Know

annual coverage assessment
A yearly evaluation of the costs and benefits for TennCare, which can affect how much hospitals are paid.
CMS
The Centers for Medicare & Medicaid Services, a federal agency that oversees health care programs like TennCare.

Limits and Unknowns

  • It is not clear what specific changes will be made to the budget neutrality agreement with CMS.
  • The exact amount of hospital payments may vary based on consultations between the division and the Tennessee Hospital Association.

Amendments

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

Amendment 1-0 to HB1000

Plain English: The amendment changes how certain assessments and payments are handled under TennCare by allowing for specific conditions where these can proceed even if some approvals from CMS have not been fully obtained.

  • Adds a new subsection (e) to § 71-5-2003, which allows the assessment authorized by this section to be implemented and imposed if all required CMS determinations and approvals are obtained except for one specific approval.
  • Adds a new subsection (i) to § 71-5-2005, limiting expenditures for directed payments to hospitals based on either the amount authorized for FY 2024 or a greater amount determined by the division in consultation with the Tennessee Hospital Association until full CMS approvals are obtained.
  • The exact impact and implementation details of these changes may depend on further clarification from CMS and other relevant authorities.
Amendment 1-0 to SB0577

Plain English: The amendment allows for certain healthcare assessments and payments to hospitals even if some federal approvals are pending.

  • If all required CMS (Centers for Medicare & Medicaid Services) determinations and approvals have been obtained except for one specific approval, the annual coverage assessment can still be implemented.
  • Expenditures for directed hospital payments will be limited to either the amount authorized for fiscal year 2024 or a higher amount determined by the division in consultation with the Tennessee Hospital Association until all CMS requirements are met.
  • The exact impact of these changes on healthcare costs and hospital funding is not specified.
  • Details about how the division will consult with the Tennessee Hospital Association to determine a higher expenditure amount, if applicable, are not provided in the amendment text.

Bill History

  1. 2025-04-08 Tennessee General Assembly

    Comp. became Pub. Ch. 115

  2. 2025-04-08 Tennessee General Assembly

    Effective date(s) 04/03/2025

  3. 2025-04-08 Tennessee General Assembly

    Pub. Ch. 115

  4. 2025-04-03 Tennessee General Assembly

    Signed by Governor.

  5. 2025-03-26 Tennessee General Assembly

    Transmitted to Governor for action.

  6. 2025-03-26 Tennessee General Assembly

    Signed by H. Speaker

  7. 2025-03-25 Tennessee General Assembly

    Signed by Senate Speaker

  8. 2025-03-25 Tennessee General Assembly

    Enrolled and ready for signatures

  9. 2025-03-24 Tennessee General Assembly

    Comp. SB subst.

  10. 2025-03-24 Tennessee General Assembly

    Passed H., Ayes 94, Nays 0, PNV 0

  11. 2025-03-24 Tennessee General Assembly

    Am. withdrawn. (Amendment 1 - HA0078)

  12. 2025-03-24 Tennessee General Assembly

    Subst. for comp. HB.

  13. 2025-03-20 Tennessee General Assembly

    H. Placed on Regular Calendar for 3/24/2025

  14. 2025-03-19 Tennessee General Assembly

    Placed on cal. Calendar & Rules Committee for 3/20/2025

  15. 2025-03-17 Tennessee General Assembly

    Rcvd. from S., held on H. desk.

  16. 2025-03-13 Tennessee General Assembly

    Engrossed; ready for transmission to House

  17. 2025-03-13 Tennessee General Assembly

    Passed Senate as amended, Ayes 31, Nays 0

  18. 2025-03-13 Tennessee General Assembly

    Senate adopted Amendment (Amendment 1 - SA0076)

  19. 2025-03-12 Tennessee General Assembly

    Rec. for pass. if am., ref. to Calendar & Rules Committee

  20. 2025-03-11 Tennessee General Assembly

    Placed on Senate Regular Calendar for 3/13/2025

  21. 2025-03-05 Tennessee General Assembly

    Placed on cal. Insurance Committee for 3/12/2025

  22. 2025-03-05 Tennessee General Assembly

    Sponsor change.

  23. 2025-03-05 Tennessee General Assembly

    Sponsor(s) withdrawn.

  24. 2025-03-05 Tennessee General Assembly

    Recommended for passage with amendment/s, refer to Senate Calendar Committee Ayes 9, Nays 0 PNV 0

  25. 2025-03-04 Tennessee General Assembly

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

  26. 2025-02-26 Tennessee General Assembly

    Placed on s/c cal Tenncare Subcommittee for 3/4/2025

  27. 2025-02-26 Tennessee General Assembly

    Placed on Senate Health and Welfare Committee calendar for 3/5/2025

  28. 2025-02-25 Tennessee General Assembly

    Assigned to s/c Tenncare Subcommittee

  29. 2025-02-25 Tennessee General Assembly

    Ref. to Insurance Committee

  30. 2025-02-12 Tennessee General Assembly

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

  31. 2025-02-10 Tennessee General Assembly

    P2C, caption bill, held on desk - pending amdt.

  32. 2025-02-10 Tennessee General Assembly

    Introduced, Passed on First Consideration

  33. 2025-02-06 Tennessee General Assembly

    Intro., P1C.

  34. 2025-02-05 Tennessee General Assembly

    Filed for introduction

  35. 2025-01-30 Tennessee General Assembly

    Filed for introduction

Official Summary Text

ON MARCH 13, 2025, SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 577, AS AMENDED.

AMENDMENT #1 rewrites the bill to, instead, provide that if the CMS determination, approvals,
and confirmation relative to the annual coverage assessment have all been obtained, except for the approval from CMS of an adjustment to the budget neutrality agreement with CMS, then the annual coverage assessment is implemented and imposed. If the annu
a
l coverage assessment is so implemented, then the expenditures for directed payments to hospitals must be limited to either the same amount authorized for FY 2024 or a greater amount as determined by the division in consultation with the Tennessee Hospita
l
Association, up to the amount approved by CMS, until such time as the CMS determination, approvals, and confirmation relative to the annual coverage assessment have been obtained and the division provides written notice to the Tennessee Hospital Associat
i
on.

Current Bill Text

Read the full stored bill text 
SENATE BILL 577
By Haile

HOUSE BILL 1000
By Hicks G

HB1000
002477
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 71,
Chapter 5, relative to the annual coverage
assessment.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Section 71-5-2005(d)(2)(D), is amended by
deleting the language "seven (7) days" and substituting instead the language "five (5) days".
SECTION 2. This act takes effect upon becoming a law, the public welfare requiring it.