Chapter 5 - Programs and Services for Poor Persons
- Part 1 - Medical Assistance Act
- 71-5-101 - Short title.
- 71-5-102 - Purpose.
- 71-5-103 - Part definitions.
- 71-5-104 - Administration by department.
- 71-5-105 - Powers and duties of department Total number of ICF/MR beds Certificate of need exemption for DIDS public ICF/MR non-facility beds established pursuant to federal litigation.
- 71-5-106 - Determination of eligibility for medical assistance.
- 71-5-107 - Kinds of medical services.
- 71-5-108 - Payment methodology for medicaid enrollees not enrolled in medicare.
- 71-5-109 - Expenditures not to exceed appropriation.
- 71-5-110 - Application for medical assistance Application for TennCare enrollment Notice of change in application information.
- 71-5-111 - Investigation Determination of eligibility.
- 71-5-112 - Hearing concerning eligibility.
- 71-5-113 - Hearing concerning matters other than eligibility.
- 71-5-114 - Subpoena and examination of witnesses.
- 71-5-115 - Financial responsibility of relative When may be considered Reimbursement from responsible parties.
- 71-5-116 - Lien on real estate Claim against estate Restrictions.
- 71-5-117 - Recovery of benefits State's right of subrogation Assignment of insurance benefit rights Commissioner authorized to require certain information identifying persons covered by third parti
- 71-5-118 - Sanctions against vendors Fraudulently obtaining benefits or payment for medical assistance Penalties Investigations Recovery of benefits Medicaid fraud control unit Collection activi
- 71-5-119 - Discrimination prohibited.
- 71-5-120 - Residency requirement Determination Appeal.
- 71-5-121 - Transfer of income or resources.
- 71-5-122 - Statement of interest of vendors or suppliers holding equity interest in hospitals, apothecaries or nursing homes.
- 71-5-123 - Statement of public officials as to interest in vendors or providers.
- 71-5-124 - Duties of department of finance and administration.
- 71-5-125 - Duties of fiscal review committee.
- 71-5-126 - [Obsolete.]
- 71-5-127 - Conflict with federal law Single state agency.
- 71-5-128 - Contracts with health maintenance organizations Requirements.
- 71-5-129 - Charges for services of physician assistants.
- 71-5-130 - Determination of payments to vendors Audits.
- 71-5-131 - Contributed funds.
- 71-5-132 - Medicaid providers Responsibilities Changes in ownership or controlling interest.
- 71-5-133 - Provision of information concerning Norplant and other contraceptives.
- 71-5-134 - Rules and regulations Funding medical assistance.
- 71-5-135 - State unemployment health care benefits Scope Conditions.
- 71-5-136 - Hold harmless requirements prohibited.
- 71-5-137 - Disclosures required of persons associated with managed care organizations.
- 71-5-138 - Compliance with provisions regarding authorizations for pharmacy services.
- 71-5-139 - Protection of TennCare patients' federal and court ordered rights by health care providers receiving TennCare funds.
- 71-5-140 - Deductions for dental services paid by eligible individuals in long-term care facilities.
- 71-5-141 - Eligibility of aliens for medical assistance.
- 71-5-142 - Confidentiality and disclosure of proprietary information.
- 71-5-143 - TennCare advisory commission Composition Purpose Expert assistance Confidentiality Conflict Compensation.
- 71-5-144 - Medically necessary items and services.
- 71-5-145 - Cost effectiveness of providers.
- 71-5-146 - Pharmacy lock-in program.
- 71-5-147 - Personal needs allowance Protecting nursing home residents from diversion of allowance.
- 71-5-148 - Health care safety net for uninsured.
- 71-5-149 - Disease management program.
- 71-5-150 - Reimbursement for TennCare crossover payments.
- 71-5-151 - 71-5-159. [Repealed.]
- 71-5-160 - 71-5-170. [Reserved.]
- 71-5-171 - 71-5-176. [Repealed.]
- 71-5-177 - 71-5-180. [Reserved.]
- 71-5-181 - Tennessee Medicaid False Claims Act Short title.
- 71-5-182 - Violations Damages Definitions.
- 71-5-183 - Civil actions Employee remedies.
- 71-5-184 - Service Limitations.
- 71-5-185 - Venue.
- 71-5-186 - [Repealed.]
- 71-5-187 - [Expired.]
- 71-5-188 - Actuarial study of TennCare.
- 71-5-189 - Accounting of TennCare funds.
- 71-5-190 - TennCare prescription drug utilization review committee.
- 71-5-191 - Uniform TennCare claims process.
- 71-5-192 - Information management system.
- 71-5-193 - Children's mental health care Development of interagency projects and programs.
- 71-5-194 - Spend down eligibility for medical assistance.
- 71-5-195 - Study on use of prescription drugs in nursing homes.
- 71-5-196 - Veterans education benefits.
- 71-5-197 - Authority over TennCare pharmacy purchases Confidential information Exemption from open meeting laws.
- 71-5-198 - Prescription drug program waiver.
- 71-5-199 - State preferred drug list.
- Part 2 - Community Clinics
- Part 3 - Food Stamps
- 71-5-301 - Short title.
- 71-5-302 - Purpose.
- 71-5-303 - Part definitions.
- 71-5-304 - Duties of department.
- 71-5-305 - Eligibility requirements for assistance.
- 71-5-306 - Determination of amount of assistance.
- 71-5-307 - Method of applying for assistance.
- 71-5-308 - Investigation of applications Determination of eligibility.
- 71-5-309 - Appeal of determination of area manager.
- 71-5-310 - Review of determinations of area managers.
- 71-5-311 - Election of county to participate.
- 71-5-312 - Administration costs.
- 71-5-313 - Receipt or transfer of property by recipient Notice required Recovery of excess payments.
- 71-5-314 - Fraudulent receipt of food assistance Penalties Statute of limitations.
- 71-5-315 - Veterans education benefits.
- Part 4 - Energy Assistance
- Part 5 - Pharmaceutical Connection Program
- 71-5-501 - Part definitions.
- 71-5-502 - Establishment of pharmaceutical connection program.
- 71-5-503 - Assistance by department of finance and administration Volunteer assistance Assistance in development of program.
- 71-5-504 - Notification about program to pharmaceutical companies Opportunity for companies to submit information about assistance programs offered by companies.
- 71-5-505 - Strategies to improve access to prescription drugs.
- 71-5-506 - Annual report.
- 71-5-507 - Entitlement not created by program.
- Part 6 - Federal Matching Funds
- Parts 7-10 - . [Reserved.]
- Part 11 - Economic Opportunity Programs [Obsolete.]
- Part 12 - Families First Councils
- Part 13 - Grant Assistance Program for Nursing Home Care
- 71-5-1301 - Creation of grant assistance program.
- 71-5-1302 - Eligibility.
- 71-5-1303 - Application for payment Nursing home certification to department.
- 71-5-1304 - Processing of applications Funding Determination of grant.
- 71-5-1305 - Grant payments.
- 71-5-1306 - Rules and regulations.
- 71-5-1307 - Report of expenditures for grant assistance.
- 71-5-1308 - Administration of part.
- 71-5-1309 - Funding.
- 71-5-1310 - Total annual income Certification of income.
- 71-5-1311 - Veterans education benefits.
- Part 14 - Long-Term Care Community Choices Act of 2008
- 71-5-1401 - Short title.
- 71-5-1402 - Objectives of long-term care system.
- 71-5-1403 - Part definitions.
- 71-5-1404 - Development and implementation of a statewide fully integrated risk-based long-term care system.
- 71-5-1405 - Single entry point into the long-term care system.
- 71-5-1406 - Implementation of policies and processes by commissioner.
- 71-5-1407 - Level of care and continued stay criteria Pre-admission evaluation (PAE) assessment tool.
- 71-5-1408 - Strategies to encourage utilization of cost-effective home and community-based services Requirements related to nursing facility diversion.
- 71-5-1409 - Nursing facility transition initiative.
- 71-5-1410 - Strategies to assist nursing facilities in diversifying their lines of business.
- 71-5-1411 - Plan to expand cost-effective community-based residential alternatives to institutional care.
- 71-5-1412 - Transition period following implementation of managed long-term care service delivery system.
- 71-5-1413 - Acuity-based reimbursement methodology for nursing facility services.
- 71-5-1414 - Self-directed health care.
- 71-5-1415 - Quality assurance and quality improvement strategies.
- 71-5-1416 - Funding to increase access to home and community-based services in the state-funded options program.
- 71-5-1417 - Funding for medicaid long-term care services.
- 71-5-1418 - Long-term care client information, referral and assistance agency.
- 71-5-1419 - Operational plan and budget for home-based and community-based services to elderly and disabled individuals.
- 71-5-1420 - Veterans education benefits.
- 71-5-1421 - Prompt payment of claims and liability for bad faith failure to pay claims promptly.
- 71-5-1422 - Pilot project for disabled individuals and family members to self-direct supports and services.
- Part 15 - Community-Based Services for the Elderly [Repealed]
- Part 16 - Select Oversight Committee on Long-Term Care
- 71-5-1601 - Creation of committee Composition of committee.
- 71-5-1602 - Election of officers Powers of committee.
- 71-5-1603 - Meetings Reimbursement of expenses.
- 71-5-1604 - Report on committee activities.
- 71-5-1605 - Legislative intent for effective and efficient plan to deliver a long-term care services system with a home and community-based services component.
- 71-5-1606 - Assistance from other agencies.
- 71-5-1607 - Review of bills introduced in the general assemble.
- 71-5-1608 - Definition of
- 71-5-1609 - Termination.
- 71-5-1610 - Authority of the committee.
- Parts 17-20 - [Reserved.]
- Part 21 - Poor Asylums
- 71-5-2101 - Provision by county legislative body.
- 71-5-2102 - Site and construction.
- 71-5-2103 - Appointment of commissioners.
- 71-5-2104 - Appropriation of county funds.
- 71-5-2105 - Powers of commissioners.
- 71-5-2106 - Duty of superintendent.
- 71-5-2107 - Replacement of superintendent.
- 71-5-2108 - Residence of inmates.
- 71-5-2109 - Application for admission.
- 71-5-2110 - Superintendent's annual report.
- 71-5-2111 - Joint institutions.
- 71-5-2112 - Government of joint institutions.
- 71-5-2113 - Funds for joint institutions.
- Part 22 - Commissioners of the Poor
- 71-5-2201 - Permanent body Name Appointment Term of office.
- 71-5-2202 - Oath of office.
- 71-5-2203 - Chair Minutes.
- 71-5-2204 - Compensation.
- 71-5-2205 - Removal Vacancies.
- 71-5-2206 - Order for expenditures Warrants.
- 71-5-2207 - Book of accounts Items entered.
- 71-5-2208 - Examination and preservation of accounts.
- 71-5-2209 - Liability for expenditures.
- 71-5-2210 - Annual report.
- Part 23 - Miscellaneous Provisions
- 71-5-2301 - Allowances by county legislative body.
- 71-5-2302 - Exemption from road service.
- 71-5-2303 - Contract for support with use of farm.
- 71-5-2304 - Contracts for support of poor.
- 71-5-2305 - Employment of poor by contracts.
- 71-5-2306 - Supervision of contractors.
- 71-5-2307 - Setting aside contract.
- 71-5-2308 - Contracts for hospital care.
- 71-5-2309 - Order to receive county patient.
- 71-5-2310 - Hospitalization attained by county mayor.
- 71-5-2311 - Payment for hospitalization.
- 71-5-2312 - Attendance of patients by county physicians.
- 71-5-2313 - Welfare recipients may choose optometrist or physician Exception Fee schedule.
- 71-5-2314 - Payment of claims under TennCare partners program.
- Part 24 - Tennessee TennCare Pharmacy Advisory Committee
- Part 25 - TennCare Fraud and Abuse
- 71-5-2501 - Short title.
- 71-5-2502 - Office of inspector general.
- 71-5-2503 - Part definitions.
- 71-5-2504 - Rules and regulations.
- 71-5-2505 - Authority. [Amended effective June 30, 2010. See the Compiler's Notes.]
- 71-5-2506 - Fraud and abuse cases.
- 71-5-2507 - Enforcement by law enforcement officers.
- 71-5-2508 - Medicaid fraud control unit.
- 71-5-2509 - Powers when investigating fraud or abuse Judicial enforcement.
- 71-5-2510 - Investigations of fraud or abuse involving managed care organizations.
- 71-5-2511 - Annual reports.
- 71-5-2512 - Cash reward program for reporting criminal fraud by recipients of the TennCare program.
- 71-5-2513 - Legislative intent.
- 71-5-2514 - Definitions.
- 71-5-2515 - Data provided to the inspector general.
- 71-5-2516 - Confidentiality Liability for providing data Creation of new records or data Destruction of data.
- 71-5-2517 - Authority to require periodic provision of specific data Compliance Format of data Charge for supplying data Sufficient dedicated storage space and access to software Construction.
- 71-5-2518 - Rules and regulations.
- 71-5-2519 - Written petition for objection to providing access to data Enforcement of obligations.
- 71-5-2520 - Collections of penalties, fees and costs.
- 71-5-2521 - Report.
- Part 26 - Prevention of Fraud and Abuse in TennCare