TennCare’s $50 emergency services reimbursement cap is void because it wasn’t promulgated through notice-and-comment rulemaking, Tennessee’s highest court said.
The provision implemented by the state’s Medicaid agency as a cost-saving measure met the Uniform Administrative Procedures Act’s definition of a “rule” and affected matters beyond the state’s internal management, the Tennessee Supreme Court said Thursday.
Tennessee’s UAPA is modeled on the federal Administrative Procedure Act. It requires agencies proposing a new rule to publish the proposal and accept comments from the public before finalizing it.
The procedure applies only to a rule, which the law defines as a “statement of ...