2019 Legislative Agenda

The 111th Tennessee General Assembly convened its first session on Jan. 8, 2019. This session brings much excitement, with more than 30 new legislators, new members of leadership in each chamber and a new governor. The session also promises to be a busy time with several major priorities for hospitals on THA’s legislative agenda.

This year, THA will bring three pieces of legislation in addition to focused advocacy on a number of other issues. These priorities are summarized below.

Hospital Assessment
SB474 by Sen. Ferrell Haile / HB771 by Rep. Patsy Hazlewood

  • THA will bring legislation to continue to fund a shortfall in the TennCare budget through the voluntary hospital assessment.
  • This maintains coverage for physical, speech and occupational therapies, physician office visits and other services, as well as avoidance of a significant provider rate reduction.
  • Final language for the assessment is being finalized and will be introduced as an amendment in early March.

Modify Tennessee’s Nurse Practice Act
SB317 by Sen. Shave Reeves / HB199 by Rep. Kevin Vaughan

  • An update to the Nurse Practice Act is needed to address issues identified by the Centers for Medicare & Medicaid Services (CMS) related to EMTALA requirements for OB and psychiatric patients.
  • THA will bring legislation to clarify in statute that patient assessments performed by a registered nurse to determine if an emergency medical condition exists do not constitute a diagnosis.
  • Such clarification is consistent with longstanding practice in hospitals between nurses and physicians.
  • THA has worked with the Tennessee Medical Association (TMA) and Tennessee Nurses Association (TNA) to finalize this legislation.
  • An additional amendment clarifying the scope of the legislation to apply only to registered nurses was requested by the Tennessee Association of Nurse Anesthetists (TANA) and has been accepted by THA.

Balance Billing Clean-up
SB1120 by Sen. Jon Lundberg / HB1342 by Rep. Jason Zachary

  • THA members have identified the need to clarify several elements of 2018’s out-of-network notice legislation, which often has been referred to as Public Chapter 840.
  • This year’s legislation does not seek to change the intent of the law, but rather clarify elements of the law to ease implementation and ensure patients receive relevant and useful information about healthcare services as it relates to insurance benefits and cost-sharing .

Certificate of Need
Multiple Bills

  • Certificate of need (CON) has emerged as a main policy priority for legislators in 2019 on multiple fronts. Most proposals focus on specific services – freestanding emergency departments, home health and cardiac catheterization – while others seek further reform of the law or complete elimination.
  • Proponents of elimination of CON argue that free market principles are needed in healthcare to reduce costs. However, this position fails to understand the unique financial model of hospitals and other providers or the precarious financial situation experienced by many rural hospitals in the state
  • Simply put, healthcare is not a free market. With more half of hospital revenue coming from government sources through Medicare and Medicaid (TennCare), as well as significant government regulation on the delivery of healthcare, it is impossible for true free market principles to take hold.
  • Hospitals support continuation of the CON program and believe it is important to ensure the law is relevant to the current healthcare landscape.
  • THA worked closely with legislators in 2016 to significantly overhaul and modernize the law, with an agreement to no additional changes for three years.
  • Given this action and 2018’s extension of the Health Services and Development Agency (HSDA) for three years, THA believes it is premature to reexamine the CON law and elimination would run counter to last year’s action by the General Assembly.

If you have questions, contact Joe Burchfield at 615-401-7472.