The Tennessee Hospital Association (THA) is working to bring three pieces of legislation to the Tennessee General Assembly in addition to focused advocacy on a number of other issues during the current session.

The 111th Tennessee General Assembly convened its initial session last month. With more than 30 new legislators, a new governor and new members of leadership in each chamber, the session is attracting considerable attention from the healthcare community as well as the media.

The session promises to be a busy time with several major priorities for hospitals on THA's legislative agenda. According to the THA, this year the organization will bring three pieces of legislation in addition to focused advocacy on a number of other issues.
An item on the THA website reports that the three priorities are:

Hospital Assessment

• THA will bring legislation to continue to fund a shortfall in the TennCare budget through the voluntary hospital assessment
• This maintains coverage for physical, speech and occupational therapies, physician office visits and other services, as well as avoidance of a significant provider rate reduction

Modify Nurse Practice Act

• An update to the Nurse Practice Act is needed to address issues identified by the Centers for Medicare & Medicaid Services (CMS) related to EMTALA requirements for OB and psychiatric patients
• THA will bring legislation to clarify in statute that patient assessments performed by a registered nurse to determine if an emergency medical condition exists do not constitute a diagnosis
• Such clarification is consistent with longstanding practice in hospitals between nurses and physicians

Billing Clean-up

• THA members have identified the need to clarify several elements of 2018's out-of-network notice legislation, which often has been referred to as Public Chapter 840
• This year's legislation does not seek to change the intent of the law, but rather clarify elements of the law to ease implementation and ensure patients receive relevant and useful information about healthcare services as it relates to insurance benefits and cost-sharing

Certificate of Need

• Americans for Prosperity (AFP) Tennessee, the state level arm of the national conservative political organization of the same name, has identified elimination of certificate of need (CON) as one of its 2019 priorities
• Arguments that introducing free market principles to the healthcare system in Tennessee by eliminating CON would help reduce cost and improve access to care fail to understand the unique financial model of hospitals and other providers or the precarious financial situation experienced my many rural hospitals in the state
• Hospitals support continuation of the CON program and worked closely with legislators in 2016 to significantly overhaul and modernize the law, with an agreement to no additional changes for three years
• Given this action and 2018's extension of the Health Services and Development Agency (HSDA) for three years, THA believes it is premature to reexamine the CON law and elimination would run counter to last year's action by the General Assembly

Patient Transport

• Legislation is expected in 2019 to remove sheriffs from state law that requires law enforcement to transport mental health patients
• THA is working with the Tennessee Department of Mental Health and Substance Abuse Services and other stakeholders to identify alternative means and processes for transporting affected patients, as well as funding for such a solution, to present to the legislature for consideration