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LEGISLATIVE

HB1175/SB1469 (Medicaid Reimbursement) PASSES IN THE LEGISLATURE!!!!

Last night the House and Senate passed this amended bill for TennCare to reimburse EMS providers at a minimum of 67.5% of the Medicare allowed charges ($7 million state funds/$20.4 million federal funds).

In addition to the 67.5% fee schedule, the amendment also directs TennCare to seek intergovernmental transfer of $10 million for the purpose of further increasing reimbursement rates. This was something that TennCare added in what we believe was an attempt to accomplish the 100% Medicare fee schedule. Our lobbyist is reporting that they believe this is in the form of a Medicaid waiver that has already been applied for and seems to be directed towards public EMS systems. We are working to get a meeting with TennCare to get more details and evaluate this process. We will share as soon as we get more information.

During the week and especially throughout the day yesterday, the TASA Board, our lobbyist and many EMS leaders across the state were making phone calls, sending emails and texts to their legislators encouraging passage of this important legislation. Due to the inability to attend the legislative meetings by the public, the TASA legislative committee was communicating remotely with legislators, lobbyist, and the Director of Fiscal Review to ensure proper language within the amendment. At one point, the amendment referenced “40% of Medicare charges” which was quickly caught by TASA members and corrected by the Director of Fiscal Review.

During the first part of the week it appeared this legislation was not going to make the final budget due to the current pandemic, resulting cuts to the Governor’s proposed budget and the cost associated with implementing this increase. However, due to the efforts of many in EMS and the legislature, a compromise was made to accept the amendment.

To put this in perspective, there were cuts to teacher and state employee raises, major cuts to other department requests and Governor priorities. In the end only 2 items outside the Governor’s original budget received funding – tele-health (to help address the pandemic) and AMBULANCE REIMBURSEMENT!

The legislators would have had a very good reason for not funding our request, but they understood the seriousness of our reimbursement issue and worked to make it happen.

Please take the opportunity to send a “thank you” to your representative(s) and senator(s) for their support – especially these legislative champions:

  • Representative Terry Lynn Weaver – original sponsor HB1175 (Reimbursement)
  • Senator Ken Yager – original sponsors SB1469 (Reimbursement) and SB2078 (Ground Assessment)
  • House Speaker Cameron Sexton – huge supporter of this legislation and lead the efforts of the last-minute negotiations
  • Lt. Governor Randy McNally – big EMS supported and helped champion the negotiations in the Senate
  • Representative Jay Reedy – original sponsor HB2184 (Ground Assessment)
  • Representative Kelly Keisling
  • Senator Paul Bailey
  • TN County Mayor’s Association – they have been with us throughout this whole process

SUMMARY OF AMENDMENT (017392): Deletes all language after the enacting clause. Requires the Division of TennCare (Division) to reimburse ambulance service providers for covered services provided to TennCare recipients at a rate not less than 67.5 percent of the federal Medicare program’s allowable charge for participating providers. Declares nothing in this section affects the Ground Ambulance Assessment Act. Requires the Division to seek an intergovernmental transfer of funds, in consultation with, and subject to approval of, the Commissioner of Finance and Administration (F&A) for the sole purpose of increasing the rate of reimbursement to ambulance service providers that provide covered services to TennCare recipients at a rate greater than a rate not less than 67.5 percent of the federal Medicare program’s allowable charge for participating providers. Assessment Act. Requires the Division to seek an intergovernmental transfer of funds, in consultation with, and subject to approval of, the Commissioner of Finance and Administration (F&A) for the sole purpose of increasing the rate of reimbursement to ambulance service providers that provide covered services to TennCare recipients at a rate greater than a rate not less than 67.5 percent of the federal Medicare program’s allowable charge for participating providers.

Legislation

County Resolution Template – Supporting Increased Medicaid Funding (download in PDF format) (download in MSWord format)

Please contact your State Representatives and Senators and ask them to support *HR1175 / *SB1469 which directs TennCare to READ MORE

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