111th General Assembly – 2020 Session: Health related Legislation
The 2020-2021 budget increased funding for health care, with highlights including:
•An additional $9.2 million in non-recurring funds for the adult health care safety net and $3 million in recurring funds;
•A combined $26.5 million to strengthen the safety network for both mental health and health care services;
•Approximately $19 million to support the health care network, $7.5 million to support the children’s behavioral and mental health services, and $3 million to expand the School Based Behavioral Liaisons across the state;
•Fully funds inflationary growth in TennCare; and
•An additional $1 million invested in the Rural Hospital Transformation program so rural health facilities can continue to evaluate their business models in efforts to ensure they effectively operate and address health needs that arise under these extraordinary circumstances.
New law helps rural health clinics recruit doctors — The General Assembly enacted legislation allowing rural health clinics to employ a physician, a move that will help many Tennessee counties. Previously, state law prevented corporations from employing doctors due to a ban on the corporate practice of medicine with certain exceptions for hospitals, nursing homes, and federally qualified health centers. The measure was passed to aid efforts to recruit doctors to work in Tennessee’s rural health clinics and in economically distressed communities.
New law encourages alternative pain treatments to opioids — Legislation encouraging the use of more alternative pain treatments rather than opioids was approved during the 2020 session. The new law amends the state’s opioid reform legislation to include medical devices like pain pumps, spinal cord stimulators, occupational therapy and non-opioid medicinal drugs as non-opioid based alternative therapies for chronic pain. A 2019 law called for alternative pain treatment for chiropractic care, physical therapy, acupuncture, and other treatments to be encouraged for pain relief before opioids are dispensed. Both measures are part of an ongoing effort in Tennessee to provide alternative pathways to treat pain in order to curb opioid addiction, which has claimed the lives of thousands of Tennesseans.
New law ensures 911 operators are trained for CPR – Legislation passed the General Assembly this year to ensure 911 operators across the state are prepared to provide CPR instructions to a caller in an emergency situation. Previously, not all counties allowed 911 operators to run callers through CPR instructions. The new law, SB 1958, ensures all 911 operators in the state will provide telecommunicator cardiopulmonary resuscitation (T-CPR), as well as receive proper training to administer it. The legislation also includes liability protection for those providing this service.
General Assembly votes to continue funds to support hospitals, nursing homes, ambulance services – State lawmakers approved three bills before the March recess critical to the operations of Tennessee’s hospitals, nursing homes and ambulance services by extending assessments used to draw down federal matching funds. This includes the Tennessee Hospital Assessment Act, which raises $600 million in state funds. The action allows Tennessee to receive $1.1 billion in federal matching funds, for a total of $1.7 billion for the state’s TennCare program. The assessment, which has been in effect since 2010, provides hospitals a portion of their unreimbursed TennCare costs. In addition to the reduction in payments to hospitals and health professionals, a few examples of programs that would be affected without the assessment are: critical access hospital; the Graduate Medical Education program, x-rays, physician office procedures, various therapies, and the enrollment cap for the medically needy.
Similarly, legislation that provides funds essential for operating nursing homes in Tennessee was adopted. The measure raises funds allocated to the Nursing Home Assessment Trust Fund by $134.6 million, allowing Tennessee to draw down $259.8 million in needed federal matching funds. The state’s ground ambulance providers will be aided by federal matching funds made available through Tennessee’s Ground Service Provider Assessment Act renewed this year. Many cash-strapped rural ambulance services have a difficult time staying in the black on current operating revenue due to the Medicaid reimbursement rate. This new law helps ambulance services transport patients by matching $22.5 million in federal funds with the $11.7 million assessed by the state. All three assessments are placed in separate trust funds, ensuring they will only be used to support hospitals, nursing homes and ambulance services.
General Assembly approves increase in ambulance reimbursement rates – In addition, legislation passed this year, which I co-sponsored, increases the percentage that public and private ambulance services are reimbursed by the Centers for Medicare and Medicaid (CMS) for performing Medicaid transports. On average, ambulance services are reimbursed at 50 percent of the Medicare rate. The new law increases that percentage to 67.5 percent. The state will provide $7 million to cover the increased reimbursement from federal dollars. Ambulance providers will then draw down approximately $21 million, for a total of $28 million going to public and private providers across the state so that lifesaving care can be more adequately compensated.