Tennessee Medicaid Block Grant Waiver Amendment Agreement — Senate Joint Resolution 25 approves federal government waiver amendment to improve the quality and access to health care in the state in a first in the nation block grant agreement. The negotiated flexibilities will allow the state to add new TennCare recipients, structure benefit packages, better control fraud, and more effectively manage pharmacy programs. Priorities for program innovation include maternal health coverage enhancements, serving additional needy populations, clearing the wait list for individuals with intellectual and developmental disabilities, and addressing state-specific health crises.
Health Care Facilities / CON Process –Public Chapter 557 eliminates bureaucratic red tape by making the Certificate of Need (CON) process quicker, easier and less expensive. The law also reduces CON regulation of certain facilities and services, eliminates protectionist aspects of the CON process, and creates greater regulatory flexibility. It reduces or eliminates antiquated CON regulations for certain facilities and services to increase access to care and reduce cost. For example, economically distressed counties which do not currently have a hospital would be completely exempt from CON regulations, making it easier for health care companies to offer new health services to patients in those counties.
Graduate Medical Education –Public Chapter 587 increases the number of primary care physicians in Tennessee’s rural communities. The new law establishes residency opportunities focusing on family practice, general pediatrics, internal medicine and psychiatry to provide medical and behavioral health services in Tennessee’s underserved and distressed rural counties. Data shows that 60% to 70% of doctors stay in the communities where they train.
PBMs / Prescription Drugs – Public Chapter 569 helps ensure patients can use the pharmacies they choose and trust rather than being forced by their insurance companies to use specialty pharmacies that often don’t meet patients’ needs. The law also ensures transparency and that price reductions negotiated by the PBMs pass through the pharmacy directly to the consumer and that pharmacies are not paid below their acquisition cost. In addition, it seeks to prohibit PBMs from discriminating against 340B facilities, which are health care safety net providers that serve the state’s most vulnerable populations.
As always, I am truly humbled and honored to be your voice on Capitol Hill. If there is ever any issue I can assist with, please reach out to my office by calling 615-741-2190 or emailing me at firstname.lastname@example.org.