TN HB0372

TennCare reimbursement rates for OB/GYN, primary care, outpatient mental health, and substance use disorder services must be increased to match the Medicare fee schedule or average commercial rate, whichever is higher, beginning January 1, 2025

Department of Health and Bureau of TennCare must conduct annual reviews to ensure reimbursement rates remain aligned with Medicare and commercial benchmarks per CMS 2024 final rule requirements

Healthcare providers may receive additional incentive payments based on quality of care and patient access metrics, with emphasis on rural and underserved areas

Providers experiencing payment delays or reimbursement errors may request administrative hearings through the Commissioner of Health

Annual joint reports due to legislative committees by February 1, 2026 and each year thereafter, detailing fiscal impacts, provider participation, and access improvements