Tennessee § 71-5-165 Reimbursement of ambulance service provider that provides covered service to TennCare recipient

Tennessee Statutes

§ 71-5-165 — Reimbursement of ambulance service provider that provides covered service to TennCare recipient

(a)The bureau of TennCare shall reimburse an ambulance service provider that provides a covered service to a TennCare recipient at a rate not less than sixty-seven and one-half percent (67.5%) of the federal medicare program's allowable charge for participating providers. For purposes of this section, "ambulance service provider" means a public or private ground-based ambulance service that bills for transports and has a base of operations in this state.

(b)This section does not affect the Ground Ambulance Service Provider Assessment Act, compiled under part 15 of this chapter. Funds described under this section and part 15 of this chapter may not be used to fund the other.

(c)The bureau of TennCare shall seek an intergovernmental transfer of funds, in consultation with, and subject to

Free access — add to your briefcase to read the full text and ask questions with AI

(a) The bureau of TennCare shall reimburse an ambulance service provider that provides a covered service to a TennCare recipient at a rate not less than sixty-seven and one-half percent (67.5%) of the federal medicare program's allowable charge for participating providers. For purposes of this section, "ambulance service provider" means a public or private ground-based ambulance service that bills for transports and has a base of operations in this state. (b) This section does not affect the Ground Ambulance Service Provider Assessment Act, compiled under part 15 of this chapter. Funds described under this section and part 15 of this chapter may not be used to fund the other. (c) The bureau of TennCare shall seek an intergovernmental transfer of funds, in consultation with, and subject to approval of, the commissioner of finance and administration for the sole purpose of increasing the rate of reimbursement to ambulance service providers that provide covered services to TennCare recipients at a rate greater than the rate described under subsection (a). (d) The bureau of TennCare, in consultation with and subject to approval of the commissioner of finance and administration, shall develop and implement a program substantially similar to the federal centers for medicare and medicaid services' Emergency Triage, Treat, and Transport (ET3) model, established pursuant to Section 1115A of the federal Social Security Act ( 42 U.S.C. § 1315a ), in a manner that complies with this section.

Tennessee § 71-5-165 (Reimbursement of ambulance service provider that provides covered service to TennCare recipient) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.