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HB 1836

TennCare - As introduced, increases from 67.5 percent to 110 percent the rate of reimbursement of the federal medicare program's allowable charges for participating providers the bureau shall reimburse an ambulance service provider; deletes the Ground Ambulance Service Provider Assessment Act. - Amends TCA Title 68 and Title 71.

114th Regular Session (2025-2026) Introduced by Michael Hale

HB 1836 raises TennCare ground ambulance reimbursements to 110% of Medicare and ends the Ground Ambulance Service Provider Assessment Act by July 1, 2026.

Taken off notice for cal in s/c Finance, Ways, and Means Subcommittee of Finance, Ways, and Means Committee
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Bill Summary · HB 1836

Summary of HB 1836 (Session 114) – Tennessee

Proposed changes to TennCare regarding ambulance reimbursements and related provisions

Purpose and intent

  • Increase the reimbursement rate that TennCare must pay to ground-based ambulance service providers for covered services to TennCare enrollees.
  • Eliminate the Ground Ambulance Service Provider Assessment Act (and its funding mechanism) by terminating it on July 1, 2026.
  • Preserve any remaining funds in the Ambulance Service Assessment Revenue Fund (ASARF) consistent with existing law after June 30, 2026.

Key provisions

  1. Reimbursement rate for ambulance services (TennCare)

    • Section 71-5-165(a): Replaces the current minimum reimbursement rate for ground-based ambulance providers from 67.5% of the Medicare allowable rate to 110% of the Medicare allowable rate for participating providers.
    • Section 71-5-165(b): The subsection is repealed (terminates the current mechanism or rule set in that subsection).
    • Overall effect: At minimum, ambulance providers will be reimbursed at 110% of the Medicare rate, significantly higher than the prior 67.5% baseline.

  2. Ground Ambulance Service Provider Assessment Act (GASPA)

    • Section 71-5-165, Part 15 (Ground Ambulance Service Provider Assessment Act) is deleted in its entirety.
    • Section 4: Any funds remaining in the Ambulance Service Assessment Revenue Fund (ASARF) after June 30, 2026, must remain in the fund and be expended or disbursed under the Act as it existed on that date (i.e., continued governance of remaining funds under existing provisions).

  3. Fiscal and timing notes

    • Effective date: July 1, 2026.
    • Termination date for GASPA: July 1, 2026.
    • Remaining ASARF funds: Must stay in the fund and be disbursed according to the pre-termination Act provisions as of June 30, 2026.
    • Fiscal impact estimates (from the fiscal note):
      • State government expenditures: $14,045,300 (FY26-27 and subsequent years).
      • Federal government expenditures: $24,482,500 (FY26-27 and subsequent years).
      • Recurring increase in ambulance reimbursement costs (minimum rate increase) estimated at $38,527,800 starting FY26-27.
      • Medicaid matching: With a federal match rate of 63.545% and state share of 36.455%, approximately $24.48 million in federal funds and $14.05 million in state funds would be affected per year.
      • The GASPA termination is projected to have not significant net revenue changes beyond these amounts.

Affected parties

  • Ambulance service providers (ground-based): Receive a higher minimum reimbursement rate under TennCare (110% of Medicare allowable charges for participating providers). This represents a substantial increase in revenue for these providers.
  • TennCare division: Responsible for implementing the new reimbursement floor and terminating GASPA, including administrative transition and ensuring funds in ASARF are handled per existing law through June 30, 2026.
  • ASARF (Ambulance Service Assessment Revenue Fund): Any remaining funds after June 30, 2026, continue to be managed under current fund provisions until expended or disbursed.

Procedural and timeline aspects

  • Effective date: July 1, 2026.
  • Termination of GASPA: July 1, 2026.
  • Outstanding ASARF funds: Must be retained and disbursed under the Act as of June 30, 2026, with continued applicability through the existing provisions.
  • Legislative history notes: The bill has companion Senate Bill 1805 and has undergone several committee and subcommittee actions in 2026 before floor consideration.

Summary in plain terms

HB 1836 would raise the minimum TennCare reimbursement to ambulance providers from 67.5% to 110% of the Medicare rate and eliminate the Ground Ambulance Service Provider Assessment Act, terminating its funding mechanism on July 1, 2026. Funds remaining in ASARF after that date would stay in the fund and be disbursed under the Act as it existed on June 30, 2026. The fiscal note projects a significant increase in state and federal expenditures to support higher reimbursements, with most of the cost shared at the federal matching rate typical for TennCare/Medicaid programs.

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

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