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SB 2221

TennCare - As introduced, extends the ground ambulance service annual assessment to June 30, 2027; changes the penalty imposed by the bureau on an ambulance provider for each day an assessment remains unpaid from $50 per calendar day to 5 percent of the principal amount owed per month for each month. - Amends TCA Title 71, Chapter 5, Part 15.

114th Regular Session (2025-2026) Introduced by Ken Yager

Tennessee extends ambulance assessment fees to 2027 and increases late payment penalties from $50/day to 5% monthly, raising compliance costs for providers.

Signed by Senate Speaker
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Bill Summary · SB 2221

Legislative bill overview

SB 2221 extends Tennessee's ground ambulance service annual assessment fee requirement until June 30, 2027, and modifies the penalty structure for unpaid assessments. Rather than charging ambulance providers $50 per calendar day for unpaid amounts, the bill changes the penalty to 5 percent of the principal owed per month, compounding monthly for each month the debt remains unpaid.

Why is this important

This bill affects ambulance service providers' operational costs and cash flow management in Tennessee. The penalty structure change could significantly increase financial consequences for late payments—a 5 percent monthly penalty (60 percent annually) is substantially higher than the previous $50 daily rate ($18,250 annually on a $100,000 assessment), creating stronger incentives for timely payment but also greater financial burdens for struggling providers.

Potential points of contention

  • Impact on rural ambulance services: Rural and volunteer ambulance services operating on thin margins may face disproportionate hardship from the increased penalty structure
  • Assessment necessity justification: No clear explanation for why the assessment extension through 2027 is needed or what it funds
  • Penalty rate proportionality: The 5 percent monthly rate (60 percent annually) may be considered excessive compared to typical commercial lending rates and could force service closures

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

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