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HB 201

TennCare - As introduced, requires the bureau of TennCare to reimburse certain public or private ground-based ambulance services that bill for transports at a rate not less than 67.5 percent of the federal medicare program's allowable charge for participating providers for emergency services and 100 percent of the federal medicare program's allowable charge for participating providers for nonemergency services. - Amends TCA Title 71.

114th Regular Session (2025-2026) Introduced by Gary Hicks

Requires TennCare to reimburse ground ambulances at 67.5% of Medicare rates for emergencies and 100% for nonemergency transports, increasing state healthcare costs.

Placed on s/c cal Finance, Ways, and Means Subcommittee for 4/14/2025
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Bill Summary · HB 201

Legislative bill overview

HB 201 mandates that Tennessee's TennCare program reimburse ground ambulance services at specified rates: a minimum of 67.5% of Medicare's allowable charges for emergency transports and 100% of Medicare's allowable charges for nonemergency transports. This applies to both public and private ambulance providers who participate in the program.

Why is this important

Ambulance services operate on thin margins, and reimbursement rates directly affect service availability, particularly in rural areas. This bill addresses potential gaps between what TennCare currently pays and what Medicare allows, which could impact whether ambulance providers can sustain operations and continue serving TennCare beneficiaries. The financial obligation represents a meaningful increase in state healthcare expenditures.

Potential points of contention

  • Fiscal impact: The bill requires increased state spending without specified funding source; the subcommittee placement "behind the budget" suggests budget concerns exist
  • Rate justification: The 67.5% emergency/100% nonemergency split differs from Medicare's own structure, raising questions about why emergency services receive lower reimbursement than nonemergency ones
  • Provider scope: Unclear whether this applies only to TennCare-enrolled providers or creates new enrollment incentives, potentially expanding program costs beyond current baseline

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

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