Tennessee § 71-4-2302 Coverage and reimbursement for medically necessary repairs and annual preventative maintenance

Tennessee Statutes

§ 71-4-2302 — Coverage and reimbursement for medically necessary repairs and annual preventative maintenance

(a)A policy, certificate, or agreement for health insurance coverage issued under the TennCare program must provide coverage and reimbursement for:

(1)Medically necessary repairs provided by authorized complex rehabilitation technology equipment suppliers; and (2) At least one (1) preventative maintenance visit per year provided by authorized complex rehabilitation technology equipment suppliers, including appropriate reimbursement for services rendered during the preventative maintenance, parts, labor, diagnostic and evaluation time, and other related costs.

(b)A TennCare program enrollee must be informed of the coverage required under this part at the time of initial enrollment and when a current enrollee renews a policy, certificate, or agreement for health insurance coverage under t

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(a) A policy, certificate, or agreement for health insurance coverage issued under the TennCare program must provide coverage and reimbursement for: (1) Medically necessary repairs provided by authorized complex rehabilitation technology equipment suppliers; and (2) At least one (1) preventative maintenance visit per year provided by authorized complex rehabilitation technology equipment suppliers, including appropriate reimbursement for services rendered during the preventative maintenance, parts, labor, diagnostic and evaluation time, and other related costs. (b) A TennCare program enrollee must be informed of the coverage required under this part at the time of initial enrollment and when a current enrollee renews a policy, certificate, or agreement for health insurance coverage under the TennCare program. (c) A policy, certificate, or agreement for health insurance coverage issued in this state under the TennCare program must: (1) Not require medical documentation or proof of continued need for a repair or preventative maintenance of a complex rehabilitation technology; and (2) Consistent with federal law and regulations, provide coverage for telehealth visits for complex rehabilitation technology. (d) Subdivision (c)(1) does not prohibit a policy issued under the TennCare program from requiring documentation needed for a medical necessity determination to be made in accordance with § 71-5-144 .

Tennessee § 71-4-2302 (Coverage and reimbursement for medically necessary repairs and annual preventative maintenance) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.