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HB 2093

Managed Care Organizations - As introduced, prohibits a managed care organization from suspending, denying, refusing to review, terminating, or otherwise taking action resulting in the actual or constructive termination of a qualified nursing facility contract except under certain listed circumstances; specifies that the bureau of TennCare has the exclusive authority to determine whether a qualified nursing facility may be terminated from participating in the TennCare program and makes other related changes. - Amends TCA Title 56; Title 68, Chapter 11 and Title 71, Chapter 5.

114th Regular Session (2025-2026) Introduced by Ryan Williams

Shifts nursing facility contract termination authority from managed care organizations to Tennessee's Medicaid bureau, restricting MCO terminations to state-approved circumstances.

H. adopted am. (Amendment 1 - HA0948)
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Bill Summary · HB 2093

Legislative bill overview

HB 2093 restricts managed care organizations (MCOs) from terminating or suspending nursing facility contracts except under specific circumstances, while granting the Tennessee Bureau of TennCare exclusive authority over nursing facility participation decisions in the state's Medicaid program. The bill modifies existing healthcare regulations across three sections of Tennessee code.

Why is this important

Nursing facility participation in TennCare directly affects elderly and disabled residents' access to care and facility financial viability. This bill shifts contract termination power from individual MCOs to state government, potentially increasing regulatory consistency but also affecting how quickly problematic facilities can be removed from the network.

Potential points of contention

  • MCO operational flexibility vs. state control: MCOs may argue they need swift termination authority to protect quality of care and financial interests, while the state consolidation could slow necessary contract actions
  • Definition ambiguity: The bill references "certain listed circumstances" for allowed terminations, but the specific circumstances aren't detailed in this summary, leaving uncertainty about what actually triggers permissible termination
  • Nursing facility protection debate: Supporters may see this as preventing arbitrary terminations that destabilize facilities; critics may view it as insulating underperforming facilities from market accountability and MCO oversight

Compiled from official sources — confirm details with the bill’s official record.

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