“Since 1938, THA’s mission has been to lead its members in advocacy for, and support of, community-based hospitals and health systems and assist them in delivering accessible, cost-effective quality health services.”
Hospital Assessment (SB2026 by Sen. Ferrell Haile / HB2084 by Rep. Steve McDaniel)
Keeps TennCare budget whole in order to fund some enrollee benefits and provider reimbursement.
Provides roughly $452 million in state funding for the TennCare program. With federal matching funds, the amount totals more than $1.2 billion for the program.
This keeps in place several benefits for enrollees – including physical, speech and occupational therapies – and avoids steep reimbursement cuts to hospitals and physicians.
THA supports the hospital assessment for another year.
Maintenance of Certification (SB1824 by Sen. Richard Briggs / HB1927 by Rep. Ryan Williams)
THA believes the decision on whether to require maintenance of certification (MOC) for physician privileges belongs at the hospital level.
Hospital medical staffs – which include physicians who have privileges in a given facility – currently vote on whether to require MOC. This decision then is ratified or rejected by the governing body of the hospital, which is a process required by federal regulation and The Joint Commission.
Not all hospitals in Tennessee require MOC, but there is broad agreement among chief medical officers and many other physicians that state law should not dictate or alter the current process used by hospitals.
Physicians in favor of new regulations on hospitals argue the current MOC process – which is managed by national physician specialty boards – is costly, irrelevant and burdensome. However, the solution to these problems should be identified and addressed within the physician community.
THA supports an amendment that clarifies a process for hospital medical staffs and governing boards to require MOC.
HSDA Extension (SB1538 by Sen. Mike Bell / HB1646 by Rep. Jeremy Faison)
THA supports a three-year extension of the agency and continuation of the state’s certificate of need (CON) program.
In 2016, hospitals supported an overhaul of the state’s CON law and reached an agreement with bill sponsors to extend the Health Services and Development Agency (HSDA) for three years.
In the 2017 session, the agency was extended for a single year. In the summer, the Joint Government Operations Committee made a recommendation for a three-year extension of the HSDA as originally discussed in 2016.
THA supports the three-year extension of the HSDA.
Trauma Services Codes (SB1945 by Sen. Rusty Crowe / HB1762 by Rep. Gary Hicks)
Corrects a technical reference in current statute definitions to ensure proper trauma funding to hospitals.
Current statute specifies the International Classification of Diseases (ICD) system version 9 – also known as ICD-9 – which is no longer in use.
In order to ensure proper funding to hospitals, the statute needs to be updated to recognize the current system – ICD-10 – or any future version of the system in use.
THA supports updating this definition in state law.
Psychiatric Hospital Data Reporting (SB1776 by Sen. Rusty Crowe / HB1678 by Rep. Ron Gant)
Requires psychiatric hospitals in Tennessee to report claims data to the Tennessee Department of Health (TDH).
Acute care hospitals currently are required by state law to report all claims data to TDH. As part of the reporting process, hospitals also gain access to this dataset for planning and operations purposes.
Adds reporting requirement to psychiatric hospitals and will strengthen the quality of claims data received by TDH and provide a broader view of healthcare services provided in Tennessee’s hospitals.
THA supports discharge data reporting by psychiatric hospitals.
Balance Billing (Multiple Bills)
THA supports meaningful legislation to improve insurance network adequacy and minimize the impact on patients who may be treated by out-of-network physicians while being seen at in-network hospitals or healthcare facilities.
Balance billing occurs when a patient visits an in-network hospital and receives care from a physician who is not contracted with the patient’s insurance carrier.
While there are multiple drivers for such situations, ensuring adequacy of provider networks by insurers, as well as notice and education to patients about the network status of providers, is necessary to address the issue.
For instances where out-of-network physicians do treat a patient, there is a need for a clearly defined process between insurers and providers that allows for fair compensation for services without negatively affecting the patient.