Transition Period Following Implementation of Managed Long-Term Care Service Delivery System
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A managed care organization (MCO) shall contract with any nursing facility licensed under title 68, chapter 11, part 2, and certified by the centers for medicare and medicaid services, that provides medicaid nursing facility services pursuant to an approved preadmission evaluation (PAE) and is willing to contract with the MCO to provide that service under the same terms and conditions as are offered to any other participating facility contracted with that MCO to provide that service under any policy, contract, or plan that is part of the TennCare managed long-term care service delivery system. Terms and conditions shall not include the rate of reimbursement.
Nothing in this section shall be interpreted as preventing the bureau of TennCare or an MCO from enforcing a contract between an MCO and a nursing facility or as preventing the bureau of TennCare from adopting reasonable and necessary requirements for the participation of a nursing facility in the TennCare program. All requirements for participation adopted after July 1, 2016, shall be promulgated by the bureau of TennCare as a rule under title 4, chapter 5, part 2, and shall include a hearing under § 4-5-203, prior to the enforcement of such requirement as part of any provider contract, unless otherwise required by federal law.