Managed Care Organizations - As enacted, prohibits a managed care organization from including a provision in the managed care organization's contract with a qualified nursing facility to provide medicaid nursing facility, the official text

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~tate of ~ennessee

PUBLIC CHAPTER NO. 1004

                                                  HOUSE BILL NO. 2093

                                              By Representative Williams

                                       Substituted for: Senate Bill No. 1797

    By Senators Reeves, Mr. Speaker McNally, Bailey, Bowling, Massey, Rose, Stevens,
                                                        Walley, Yager

          AN ACT to amend Tennessee Code Annotated, Title 56; Title 68, Chapter 11 and Title
71, Chapter 5, relative to managed care organizations.

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:

          SECTION 1. Tennessee Code Annotated, Section 71-5-1412, is amended by inserting
the following immediately preceding the existing subsection (a) as new subsections (a) and (b),
and redesignating the existing subsections (a) and (b)accordingly:

                    (a) As used in this section:

                              (1) "Bureau" means the bureau of TennCare;

                              (2) "Managed care organization" or "MCO" means a health maintenance
                    organization, behavioral health organization, or managed health insurance issuer
                    that has a contract with the bureau and participates in the TennCare program;

                              (3) "Qualified nursing facility" means a nursing home that is licensed
                    under title 68, chapter 11, part 2, and is certified by. the bureau to provide
                    medicaid nursing facility services; and

                              (4) "Termination":

                                        (A) Means the involuntary removal, exclusion, or non-renewal of a
                              qualified medicaid provider from an MCO's provider network or the
                              medicaid program; and

                                        (B) Does not include the voluntary withdrawal by the qualified
                              medicaid provider.

                    (b) A managed care organization shall not include a provision in the MCO's
          contract with a qualified nursing facility to provide medicaid nursing facility services that
          permit actual or constructive termination by the MCO without cause, for convenience, or
          termination without specifying the grounds for termination. In conjunction with the
          department of commerce and insurance, the bureau shall review and approve all
          standard contract templates used by MCOs for facility contracting to ensure compliance
          with this subsection (b).

          SECTION 2. If any provision of this act or the application of any provision of this act to
any person or circumstance is held invalid, then the invalidity does not affect other provisions or
applications of the act that can be given effect without the invalid provision or application, and to
that end, the provisions of this act are severable.

          SECTION 3. This act takes effect July 1, 2026, the public welfare requiring it, and
applies to policies, plans, and contracts entered into, renewed, amended, or delivered on or
after that date.
         HOUSE BILL NO. 2093

PASSED:  April 16, 2026

                         C.~

                            CAMERONSEXTON,SPEAKER
                           HOUSE OF REPRESENTATIVES

                                      RANDY MCNALLY
                         SP~AKER OF THE SENATE

APPROVED this \<1tl. day of MctA D ,  2026
                         0

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BILL LEE, GOVERNOR