Public Funds and Financing

Plain English Breakdown

The bill does not specify how much money will be available for grants each year beyond the initial appropriation.

Medical Expense Relief Fund for TennCare Enrollees

This bill creates a fund to help pay medical expenses and debts of people who were enrolled in TennCare at the time of death.

What This Bill Does

• Creates the Medical Expense Relief Fund within the state's general fund to assist with paying medical debts for decedents who were enrolled in TennCare at death.
• Requires the Department of Human Services to manage the fund and set up procedures for applying for grants from it.
• Specifies that grant recipients must provide proof of unpaid medical expenses before receiving funds.
• Sets a goal for the initial funding of $250 million, which will be used to pay TennCare-related costs.
• Requires an annual report on how the fund is being spent.

Who It Names or Affects

• People who were enrolled in TennCare at the time of death and their next of kin or legal representatives.
• The Department of Human Services, which will manage the Medical Expense Relief Fund.

Terms To Know

TennCare

A state health insurance program for low-income individuals in Tennessee.

Medical Expense Relief Fund

A special fund created to help pay medical expenses and debts of people who were enrolled in TennCare at the time of death.

Limits and Unknowns

• The bill does not specify how much money will be available for grants each year.
• It is unclear if there are limits on how many times a person can apply for funds from this program.
• The effectiveness and impact of the fund depend on proper administration by the Department of Human Services.

Official Summary Text

TENNCARE CLAIMS AGAINST ESTATES OF DECEDENTS

Before any probate estate may be closed, with respect to a decedent who, at the time of death, was enrol
led in the TennCare program,
present law requires
the personal representative of the estate
to
file with the clerk of the court exercising probate jurisdiction a release from the bureau of TennCare evidencing either
(i) p
ayment of all medical assistance be
nefits, premiums, or other costs due from the estate under law;

(
ii
)
w
aiver of the bureau's claims; or
(iii
)
a
statement from the bureau that no amount is due.

MEDICAL EXPENSE RELIEF FUND

This bill creates
within the state general fund a special account
to be known as the medical expense relief fund
, the purpose of which
is to assist the next of kin and the estate of a decedent who was enrolled in TennCare at the time of death with paying the decedent's medical debt and expenses, including the payment of
medical assistance benefits, premiums, or other costs due from
an
estate
described above
and federal law.

PROCEDURES

This bill requires t
he department of human services
to
administer the fund and establish procedures for the next of kin or the estate o
f a decedent who was enrolled in TennCare at the time of death to apply for grants awarded pursuant to this
bill
. The procedures must
include, at a minimum, all of the following:



A
pplication requirements and deadlines to apply for grants
.



Criteria for awarding grants, which allow the department to consider factors such as the amount of the decedent's medical debt and expenses and demonstrated need of the decedent's next of kin and estate
.



Criteria for determining whether to award a grant to the next of kin, the legal representative of the decedent's estate, or directly to the creditor or creditors to whom the obligation is owed
.



Reporting requirements for recipients who receive grants to ensure accountability and measure program effectiveness.

NEXT OF
KIN OR LEGAL REPRESENTATIVE OF DECEDENT

This bill authorizes

t
he next of kin or the legal representative of the estate of a decedent who was enrolled in TennCare at the time of death
to
apply for grant funds under this
bill
. The department
must
make ava
ilable to such persons a method of submitting an application for a grant and provide assistance, if requested, to the eligible recipient in completing the application and submitting supporting documentation. The department
must
require an applicant to pro
vide documentation of the decedent's unpaid medical debt and expenses, including the payment of medical assistance benefits, premiums, or other costs due from
an
estate
described above
and federal law.

Subject to available funds,
this bill requires
the d
epartment
to
allocate and disperse grants from the fund to eligible recipients identified by the department. Grant funds must be expended only for the decedent's medical debt and expenses, including the payment of medical assistance benefits, premiums, or
other costs due from
an
estate
described above
and federal law.

It is the general assembly's intent that the fund consists of an initial appropriation of
$250
million from the general fund.

ANNUAL REPORT

This bill provides that

a
ll expenditures from t
he fund are subject to review in the form of an annual report submitted by the commissioner of human services to the chair of the finance, ways and means committee of the senate and the chair of the committee of the house of representatives having jurisdi
c
tion over budget-related matters.

RULEMAKING

This bill requires

the
department
to
promulgate rules necessary to effectuate this
bill
.

Current Bill Text

SENATE BILL 647
By Crowe

HOUSE BILL 1280
By Hill

HB1280
001412
- 1 -

AN ACT to amend Tennessee Code Annotated, Title 4,
Chapter 3; Title 9 and Title 71, relative to medical
expenses.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:
SECTION 1. Tennessee Code Annotated, Title 71, Chapter 5, Part 1, is amended by
adding the following as a new section:
(a) There is created within the state general fund a special account to be known
as the medical expense relief fund. The purpose of this fund is to assist the next of kin
and the estate of a decedent who was enrolled in TennCare at the time of death with
paying the decedent's medical debt and expenses, including the payment of medical
assistance benefits, premiums, or other costs due from the estate under § 71-5-116 and
federal law.
(b) The department of human services shall administer the fund and establish
procedures for the next of kin or the estate of a decedent who was enrolled in TennCare
at the time of death to apply for grants awarded pursuant to this section. The
procedures must include, but are not limited to:
(1) Application requirements and deadlines to apply for grants;
(2) Criteria for awarding grants, which allow the department to consider
factors such as the amount of the decedent's medical debt and expenses and
demonstrated need of the decedent's next of kin and estate;
(3) Criteria for determining whether to award a grant to the next of kin,
the legal representative of the decedent's estate, or directly to the creditor or
creditors to whom the obligation is owed; and

- 2 - 001412

(4) Reporting requirements for recipients who receive grants to ensure
accountability and measure program effectiveness.
(c) The next of kin or the legal representative of the estate of a decedent who
was enrolled in TennCare at the time of death may apply for grant funds under this
section. The department shall make available to such persons a method of submitting
an application for a grant and provide assistance, if requested, to the eligible recipient in
completing the application and submitting supporting documentation. The department
shall require an applicant to provide documentation of the decedent's unpaid medical
debt and expenses, including the payment of medical assistance benefits, premiums, or
other costs due from the estate under § 71-5-116 and federal law.
(d) Subject to available funds, the department shall allocate and disperse grants
from the fund to eligible recipients identified by the department from those described in
subdivision (b)(3). Grant funds must be expended only for the decedent's medical debt
and expenses, including the payment of medical assistance benefits, premiums, or other
costs due from the estate under § 71-5-116 and federal law.
(e) It is the general assembly's intent that the fund consists of an initial
appropriation of two hundred fifty million dollars ($250,000,000) from the general fund.
(f) Unless otherwise specified in this section, moneys deposited in the fund must
be used only to implement and administer the purposes set forth in this section. In
addition to appropriations made to the fund, the department may accept other funds,
public or private, by way of gift or grant to the fund. A gift or grant must be deposited
into the fund to be expended in accordance with this section.
(g) The state treasurer shall invest moneys in the fund for the benefit of the fund
in accordance with § 9-4-603. Interest accruing on investments and deposits of the fund
must be credited to and remain part of the fund.

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(h) Any balance remaining unexpended at the end of a fiscal year in the fund
must be carried forward into the subsequent fiscal year.
(i) The department shall promulgate rules necessary to effectuate this section.
The rules must be promulgated in accordance with the Uniform Administrative
Procedures Act, compiled in title 4,chapter 5.
(j) All expenditures from the fund are subject to review in the form of an annual
report submitted by the commissioner of human services to the chair of the finance,
ways and means committee of the senate and the chair of the committee of the house of
representatives having jurisdiction over budget-related matters.
SECTION 2. This act is not an appropriation of funds, and funds must not be obligated
or expended pursuant to this act unless the funds are specifically appropriated by the general
appropriations act.
SECTION 3. This act takes effect July 1, 2025, the public welfare requiring it.