71-5-1412. Transition period following implementation of managed long-term care service delivery system.
(a) The bureau of TennCare shall require that any managed care organization (MCO) contract with all current nursing facility providers for a transition period of at least three (3) years following implementation of the managed long-term care service delivery system or four (4) years from July 1, 2008.
(b) For purposes of this section, current nursing facility providers are those nursing facility providers that meet the federal statutory definition of a nursing facility as defined at § 1919(h) of the Social Security Act, codified in 42 USCS § 1396r, and its implementing regulations, and that fully satisfy one (1) or more of the following three (3) conditions:
(1) The nursing facility has a signed TennCare medicaid provider agreement for the delivery of nursing facility services on July 1, 2008;
(2) The nursing facility had a signed TennCare medicaid provider agreement for the delivery of nursing facility services as of January 1, 2007, did not voluntarily withdraw from participation in the medicaid program, and has requested recertification as a medicaid or medicare provider, or both, by the centers for medicare and medicaid services (CMS) as of July 1, 2008; or
(3) The nursing facility has applied for or received an approved certificate of need for a new or replacement facility as of July 1, 2008.
(c) MCOs may, but shall not be required to, contract with nursing facility providers that meet the federal statutory definition of a nursing facility as defined at Section 1919(h) of the Social Security Act, codified in 42 USCS § 1396r, and its implementing regulations, but that do not fully satisfy one (1) or more of the conditions specified in (b)(1)-(3).
71-5-1412. Transition period following implementation of managed long-term care service delivery system.
(a) The bureau of TennCare shall require that any managed care organization (MCO) contract with all current nursing facility providers for a transition period of at least three (3) years following implementation of the managed long-term care service delivery system or four (4) years from July 1, 2008.
(b) For purposes of this section, current nursing facility providers are those nursing facility providers that meet the federal statutory definition of a nursing facility as defined at § 1919(h) of the Social Security Act, codified in 42 USCS § 1396r, and its implementing regulations, and that fully satisfy one (1) or more of the following three (3) conditions:
(1) The nursing facility has a signed TennCare medicaid provider agreement for the delivery of nursing facility services on July 1, 2008;
(2) The nursing facility had a signed TennCare medicaid provider agreement for the delivery of nursing facility services as of January 1, 2007, did not voluntarily withdraw from participation in the medicaid program, and has requested recertification as a medicaid or medicare provider, or both, by the centers for medicare and medicaid services (CMS) as of July 1, 2008; or
(3) The nursing facility has applied for or received an approved certificate of need for a new or replacement facility as of July 1, 2008.
(c) MCOs may, but shall not be required to, contract with nursing facility providers that meet the federal statutory definition of a nursing facility as defined at Section 1919(h) of the Social Security Act, codified in 42 USCS § 1396r, and its implementing regulations, but that do not fully satisfy one (1) or more of the conditions specified in (b)(1)-(3).
71-5-1412. Transition period following implementation of managed long-term care service delivery system.
(a) The bureau of TennCare shall require that any managed care organization (MCO) contract with all current nursing facility providers for a transition period of at least three (3) years following implementation of the managed long-term care service delivery system or four (4) years from July 1, 2008.
(b) For purposes of this section, current nursing facility providers are those nursing facility providers that meet the federal statutory definition of a nursing facility as defined at § 1919(h) of the Social Security Act, codified in 42 USCS § 1396r, and its implementing regulations, and that fully satisfy one (1) or more of the following three (3) conditions:
(1) The nursing facility has a signed TennCare medicaid provider agreement for the delivery of nursing facility services on July 1, 2008;
(2) The nursing facility had a signed TennCare medicaid provider agreement for the delivery of nursing facility services as of January 1, 2007, did not voluntarily withdraw from participation in the medicaid program, and has requested recertification as a medicaid or medicare provider, or both, by the centers for medicare and medicaid services (CMS) as of July 1, 2008; or
(3) The nursing facility has applied for or received an approved certificate of need for a new or replacement facility as of July 1, 2008.
(c) MCOs may, but shall not be required to, contract with nursing facility providers that meet the federal statutory definition of a nursing facility as defined at Section 1919(h) of the Social Security Act, codified in 42 USCS § 1396r, and its implementing regulations, but that do not fully satisfy one (1) or more of the conditions specified in (b)(1)-(3).
