Tennessee House Bill HB2093

Tennessee 2025-2026 Regular Session

• Introduced: 2/2/26
• Refer: 2/5/26
• Refer: 3/25/26
• Refer: 3/31/26
• Refer: 4/6/26
• Engrossed: 4/16/26
• Enrolled: 4/23/26

Caption

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

Impact

The bill gives exclusive authority to the bureau of TennCare to determine the eligibility of nursing facilities and restricts MCOs from applying termination standards or participation requirements beyond those set by the bureau. This move is positioned to enhance the stability of nursing facilities within the Medicaid framework by protecting them from arbitrary disqualifications or terminations by managed care organizations. It promotes an environment where qualified nursing facilities can operate without excessive barriers imposed by MCO policies that could obstruct access for Medicaid recipients.

Summary

House Bill 2093 aims to amend specific sections of the Tennessee Code regarding managed care organizations (MCOs) and their responsibilities related to qualified nursing facilities participating in the TennCare program. The bill establishes that MCOs must contract with any qualified nursing facility certified under the Medicaid program, ensuring these facilities are treated equally and fairly when it comes to participation terms and conditions, barring reimbursement rates. This provision seeks to standardize the requirements imposed by MCOs, potentially leading to better service availability for Medicaid beneficiaries.

Contention

While supporters of HB 2093 argue that the bill fosters fair treatment of nursing facilities, critics may point to concerns regarding potential administrative burdens on the bureau of TennCare in managing these regulations effectively. Additionally, the necessity for uniformity in participation terms may be seen as impediments to allowing nursing facilities to implement policies that address specific local needs. There might also be apprehensions about the implications for MCOs' operational flexibility in managing their networks, which could lead to debates on regulatory balance between facilitating access to care and maintaining the efficiency of the managed care system.