(a) If a part of a quarterly assessment fee imposed by § 71-5-1003 is not paid on or before the due date, then a penalty of five percent (5%) of the unpaid fee balance accrues immediately and is added to the quarterly assessment fee. Thereafter, on the first day of each month during which a part of a quarterly assessment fee remains unpaid, an additional penalty of five percent (5%) of the original quarterly assessment fee balance is imposed. Payment is deemed to have been made upon date of deposit in the United States mail.
lawyer at desk

Ask a legal question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

Terms Used In Tennessee Code 71-5-1006

  • Bureau: means the bureau of TennCare. See Tennessee Code 71-5-1001
  • Fiscal year: The fiscal year is the accounting period for the government. For the federal government, this begins on October 1 and ends on September 30. The fiscal year is designated by the calendar year in which it ends; for example, fiscal year 2006 begins on October 1, 2005 and ends on September 30, 2006.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Litigation: A case, controversy, or lawsuit. Participants (plaintiffs and defendants) in lawsuits are called litigants.
  • Month: means a calendar month. See Tennessee Code 1-3-105
  • Nursing facility: means any entity defined as a nursing home under §. See Tennessee Code 71-5-1001
  • Person: includes a corporation, firm, company or association. See Tennessee Code 1-3-105
  • State: when applied to the different parts of the United States, includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
  • United States: includes the District of Columbia and the several territories of the United States. See Tennessee Code 1-3-105
  • Venue: The geographical location in which a case is tried.
  • Year: means a calendar year, unless otherwise expressed. See Tennessee Code 1-3-105
(b) The bureau of TennCare may for good cause approve an alternative payment plan, as long as full payment of the assessment fee plus any penalties are made. So long as the facility is current with payment of the current assessment and any authorized payment plan approved by the bureau of TennCare, no further penalties will be applied. Any payments after a penalty is assessed under this section shall be credited first to unpaid assessment amounts rather than to penalty amounts, beginning with the most delinquent installment. The bureau of TennCare may, as part of an approved payment plan, waive, in whole or in part, any penalty or interest imposed under this section. A waiver shall excuse the payment of that penalty or interest amount but shall not excuse payment of any assessments. Nothing in this section shall require the bureau of TennCare to agree to or approve any waiver under this section, and the waivers shall only be approved after the bureau’s determination that there is good cause for the waiver.
(c)

(1) If a nursing facility fails to pay a quarterly installment of the nursing home assessment fee within thirty (30) days of its due date or becomes or is in arrears for payment of its nursing home assessment fee on the first day of the state fiscal year, and does not have an approved payment plan for which payments are current, the bureau of TennCare shall direct its contracted managed care organizations (MCOs) to recover the full amount of the then-outstanding nursing home assessment fee and any applicable penalties and interest, which shall be accomplished through recoupment from payments made by the MCOs to nursing facilities to recover the full amount of the then-outstanding nursing home assessment fee and any related penalties and interest. TennCare MCOs shall remit promptly any of these recouped payments to the bureau of TennCare. The bureau of TennCare may recoup such amounts in as few or as many installment payments as it deems appropriate.
(2) If a nursing facility is more than ninety (90) days delinquent in paying any installment of its annual nursing home assessment fee; or becomes delinquent in any approved payment plan by more than ninety (90) days or fails to provide timely payment of any and all subsequent quarterly installments of its annual nursing home assessment fee while past due amounts are being recouped pursuant to subdivision (c)(1), the bureau of TennCare shall:

(A) Initiate a proceeding before the board for licensing health care facilities, in accordance with the Uniform Administrative Procedures Act, for the purpose of having the board indefinitely suspend admissions to the facility until all outstanding nursing home assessment fees and applicable penalties and interest have been repaid. Failure of a nursing facility to pay a quarterly installment of the nursing home assessment fee, or any penalties or interest required to be paid by this part, shall be considered by the board to be a license deficiency; and
(B) Initiate proceedings to terminate the nursing facility’s TennCare identification number.
(3) Upon initiation of a proceeding before the board for licensing healthcare facilities by the bureau of TennCare pursuant to subdivision (c)(2), the board shall suspend admissions to the facility after the bureau of TennCare meets the burden of proof required by the Uniform Administrative Procedures Act. The board shall have no discretion to impose any sanction or take any action other than that set out in this subdivision (c)(3) in the proceeding. Immediately following the full payment by the facility, or its successor, of all then-outstanding assessment fees and any applicable penalties and interest, any suspension of admissions to the nursing facility imposed according to this section shall be automatically lifted without requiring further action by the board, so long as the full payment of then-outstanding amounts are made within the sixty (60) days immediately following the date of the suspension of admissions.
(4) On or after the sixtieth day following the date of suspension of admissions to the nursing facility if either the nursing facility fails to pay all then-outstanding nursing home assessment fees and any applicable penalties and interest accrued thereon or the nursing facility fails to be current on the terms of its payment plan if a plan is in place, then the bureau of TennCare shall initiate proceedings before the board for licensing healthcare facilities in accordance with the Uniform Administrative Procedures Act for the purpose of revoking the nursing facility’s license. Upon initiation of a proceeding before the board by the bureau of TennCare pursuant to this subdivision (c)(4), the board shall revoke the nursing facility’s license upon the bureau of TennCare meeting the burden of proof required by the Uniform Administrative Procedures Act. The board shall have no discretion to impose any sanction or take any action other than that set out in this subdivision (c)(4) in the proceeding.
(5) Revocation of either the nursing facility’s license or the nursing facility’s TennCare identification number shall not remedy, discharge, satisfy, or otherwise extinguish the nursing facility’s liability for the then-outstanding nursing home assessment fees and any related penalties and interest.
(6) Upon revocation of the nursing facility’s license or termination of the nursing facility’s TennCare identification number, the nursing facility shall be required to reapply for a license, TennCare identification number, or both the license and the identification number, in order to provide services to the TennCare population. As a condition of reapplication, the nursing facility, or its successor shall pay in full all then-outstanding nursing home assessment fees, penalties, and interest.
(7) Notwithstanding this part, the bureau of TennCare is authorized to file a civil action against a covered nursing facility and its controlling person or persons to collect any nursing home assessment fees, penalties, and interest when such fees, penalties, and interest have been delinquent for more than ninety (90) days. The bureau of TennCare shall have the right to pursue a civil action pursuant to this subdivision (c)(7) simultaneously while pursuing actions in subdivisions (c)(2) and (4). The bureau of TennCare shall be entitled to receive, in addition to the nursing home assessment fees, penalties, and interest, all reasonable costs of litigation, including attorneys’ fees and court costs, incurred by it in bringing a civil action under this subdivision (c)(7). Exclusive jurisdiction and venue for a civil action authorized in this subdivision (c)(7) shall be in the chancery court for Davidson County. For the purposes of this subdivision (c)(7), “controlling person or persons” means any and all natural persons or entities that own more than fifty percent (50%) of the nursing facility, or the natural person or persons, entity or entities that is or are the majority owner of the nursing facility if no owner owns more than fifty percent (50%) of the nursing facility.
(d) Unless otherwise agreed to by the bureau of TennCare and the nursing facility, full payment to the bureau of TennCare of any outstanding nursing home assessment fees, and any applicable penalties and interest, shall be required for the continuation of the nursing facility’s ongoing certification as a medicaid provider.
(e)

(1) Any facility that is delinquent on the payment of its nursing home annual assessment fee imposed by law for any current or prior fiscal year shall establish a payment plan as provided for in this section.
(2) If a facility has established a payment plan concerning the delinquency that has been approved by the bureau of TennCare, then all fees and penalties imposed by this section must not be imposed so long as the facility is current with its payment plan, and no interest must accrue on any balance unpaid as of the due date for that amount.
(3) If a facility has not established a payment plan approved by the bureau of TennCare, then the bureau has the authority to recoup the amount of any delinquent payments as provided for in this section, and such amounts must be applied to reduce the unpaid balance of any nursing home assessment fees owed by the facility.
(f) Any licensed facility that changes its licensure status to inactive status pursuant to § 68-11-206(b) shall be entitled to request that its nursing home annual assessment fee be held in abeyance until such time as the facility returns to active status, at which time the facility shall resume payment of the annual assessment fee that was held in abeyance. During the abeyance because of inactive status, the facility shall not be determined to be delinquent pursuant to this section. Nothing in this subsection (f) shall operate to excuse any licensee from the payment of its nursing home annual assessment fee.
  Previous section
Next section  
 Part 10 Contents