§ 71-5-188. Actuarial study of TennCare.

TN Code § 71-5-188 (2019) (N/A)
Copy with citation
Copy as parenthetical citation

(a) The comptroller of the treasury may conduct an annual actuarial study of the medical assistance program and any participating managed care organizations. The final study, and the oral and written comments, shall be reported to the finance, ways and means committees of the senate and the house of representatives, the committee of the house of representatives having oversight over TennCare, the office of legislative budget analysis and the fiscal review committee of the general assembly on or before April 15 of each year.

(b) The study will include the state's assessment of the rates paid to its contracted managed care organizations and behavioral health organizations each year. Included in the analysis will be a review of payments for hospital providers for similar services for comparable populations in other state medicaid programs. The review will be considered in determining reasonable payment rates for hospital providers, including safety net hospitals providing essential and unduplicated services and sole community provider hospitals.

(c) In addition, the study shall include an analysis of actual provider costs. This analysis will be used to determine reasonable costs for comparison with the provider assumptions used in the study. Information used to compile this study shall be public information.

(d) Before reporting the final study to the committees of the general assembly, the comptroller of the treasury shall release a copy of the draft study to interested parties and hold a public hearing within thirty (30) days of release, in order to afford all interested persons or their representatives an opportunity to present facts, views or arguments relative to the draft study under consideration. The agency shall afford each interested person an opportunity to present facts, views or arguments in writing, whether or not the person had an opportunity to present them orally.