SB 2431

ON APRIL 21, 2026, THE SENATE ADOPTED AMENDMENT #1 AND PASSED SENATE BILL 2431, AS AMENDED. AMENDMENT #1 rewrites the bill to, instead, require the commissioner of health ("commissioner"") to prescribe conditions under which processed and verified claims data found on the UB-92 form are made available to the public, and to establish policies for the release of HIPAA-compliant limited use data sets. Present law requires a licensed hospital to report all claims data found on the UB-92 form or a successor form on every inpatient and outpatient discharge to the commissioner. The policies prescribe d by the commissioner must include policies for providing data for certificate of need applicant to the health facilities commission. Present law requires licensed ambulatory surgical treatment centers (ASTCs), licensed birthing centers, and licensed outpatient diagnostic centers (ODC) to report all claims data found on the appropriate form on every discharge to the commissioner. ASTC s, birthing centers, and ODCs must file joint annual reports as required by the department of health through third party entities approved by the department of health for the purpose of editing the data according to rules and regulations established by th e commissioner. This amendment requires the commissioner to prescribe conditions under which the processed and verified data are available to the public, and to establish policies for the release of HIPAA-compliant limited use data sets, including providin g data for certificate of need applicants to the health facilities commission. HEALTH FACILITIES COMMISSION Critical Access Hospitals This amendment authorizes the health facilities commission (""commission"") to determine eligibility for a licensed hospital for designation as a critical access hospital under the medicare rural hospital flexibility program to the fullest extent permitted by the medicare rural hospital flexibility program. The entity proposing to establish a critical access hospital is required to publish notice of its intent to do so in a newspaper of general circulation in the county where the hospital will be located an d in contiguous counties. Such notice must be published at least twice within a 15-day period. However, another licensed hospital located within the same county or a contiguous county may file a written objection to the proposal with the commission with in 30 days of the last publication date. The executive director of the commission must make a determination of eligibility or non-eligibility, and to notify the commission of such determination at the next regularly scheduled commission meeting. Such a de termination is subject to commission review. Other Facilities Present law authorizes the commission to license and regulate hospitals, recuperation centers, nursing homes, homes for the aged, residential HIV supportive living facilities, assisted-care living facilities, home care organizations, residential hospices, birthing centers, prescribed child care centers, renal dialys is clinics, ambulatory surgical treatment centers, outpatient diagnostic centers, adult care homes, and traumatic brain injury residential home s. This amendment also authorizes the commission t o license and regulate burn units, neonatal intensive care units, magnetic resonance imaging services, and positron emission tomography services. However, magnetic resonance imaging and positron emission tomography that are not used for diagnostic purpos es do not require a license. Commission Members Present law requires all commission members to annually review and sign a statement acknowledging the statute, rules, and policies concerning conflicts of interest. A member or employee must generally be recused from any deliberation of a matter schedul ed for consideration by the commission that results in a direct conflict of interest. This amendment authorizes a member or employee of the commission to participate in the commission's action on a matter if the member or employee of the commission publi cl y acknowledges such interest, when the member or employee of the commission, or a relative of the commission member or employee (i) is employed by or owns or controls an interest of less than 5% in the persons involved in a matter before the commission; ( ii) did not participate in the matter for persons involved in a matter before the commission; and (iii) is not an officer, director, trustee, partner, or similar position of the persons involved in a matter before the commission. Site Visits and Inspections If the commission conducts a site visit required for initial or renewal licensure, then this amendment authorizes the commission to require an applicant or licensee to pay the actual and reasonable costs of the site visit. The commission must send the applicant or licensee a final costs assessment for site review costs within 60 days from completion of the site visit. Any costs paid to the commission pursuant to this provision must remain with the commission. This amendment requires the commission to ensure the date of the most recent inspection for each licensed nursing home is no more than 15 months prior to December 30, 2028. Disciplinary Actions This amendment authorizes the commission to suspend or revoke the license of a facility for the failure to obtain accreditation within the time prescribed by an applicable certificate of need exemption. The commission may use forms of non-public discipl ine. This amendment authorizes the commission to utilize one or more screening panels in its investigative and disciplinary process to assure that complaints filed and investigations conducted are meritorious and appropriate. The activities of a screening pa nel and any mediation or arbitration sessions are not an open meeting of an agency, and must remain confidential. The members of a screening panel, mediators, and arbitrators have a deliberative privilege and immunity and are not subject to deposition or s ubpoena to testify regarding any matter or issue raised in a contested case, criminal prosecution, or civil lawsuit. Further, documents produced at the screening panel are exempt from disclosure as a public record, until there is a filing of a notice of charges. Screening panels must be instructed as to the statutes, rules, and philosophies of the relevant board as it pertains to disciplinary action and procedures that must be followed by the panel, and each panel must be provided with a copy of Tenness ee Supreme Court Rule 31 for review by members of the screening panel. If the commission imposes sanctions on a licensee following a disciplinary proceeding, this amendment authorizes the commission to require the licensee to pay the actual and reasonable costs of the investigation and prosecution of the disciplinary procee ding, including all of the following:  All costs absorbed by the commission in connection with the investigation and prosecution of the matter, including all investigator time, travel, and lodging incurred during the prosecution .  All costs absorbed by the commission for the use of facilities and personnel for prosecution of the matter .  All costs assessed against the commission for the appearance fees, transcripts, time, travel, and lodging of administrative law judges, court reporters, and witnesses required in the prosecution of the matter .  All costs attributed to and assessed against the commission in connection with the prosecution of the matter, including all attorney and paralegal time, travel, and lodging incurred during the prosecution of the matter. This amendment requires the commission to include in any order in which the payment of costs has been assessed in an amount that is the maximum owed by the licensee at the time the order is entered. Further, the commission must send to the licensee a fi nal costs assessment within 60 days that does not exceed the maximum amount in the order. Any fines, costs, and fees paid to the commission pursuant to this provision must remain with the commission. Present law authorizes the executive director of the health facilities commission to impose civil monetary penalties upon deficient nursing homes. Such civil penalties may be type A civil penalties, type B civil penalties, or type C civil penalties. A nursing home subject to a penalty to pay the penalty assessed or file an answer with the commission demanding a contested case hearing within 5 working days. This amendment extends the response deadline to 10 working days. CERTIFICATES OF NEED Present law requires a person to apply for and receive a certificate of need before establishing a healthcare institution, changing the bed complements, and initiations of certain healthcare services. However, the executive director of the commission may issue an exemption for the relocation of existing healthcare institutions and approved services if the executive director determines that (i) at least 95% of patients to be served are reasonably expected to reside in the same zip codes as the existing pa ti ent population; (ii) the relocation will not reduce access to consumers in underserved communities, those who are uninsured or underinsured, women and racial ethnic minorities, TennCare or medicaid recipients, and low-income groups; and (iii) the payor mi x will not include an increase in commercial insurance. This amendment prohibits an exemption from being issued for an approved but unimplemented certificate of need unless the new location is within a one-mile radius of the location specified in the cer ti ficate of need. Present law requires an ODC to become accredited by the American College of Radiology in the modalities provided by that facility within two years as a condition of receiving a certificate of need. An outpatient diagnostic center that fails to comply wi th this requirement is subject to licensure sanction. This amendment instead requires an ODC to become accredited by a nationally recognized and CMS-approved accrediting organization for each machine and diagnostic type, in the modalities provided by the f acility, within two years as a condition of receiving the certificate of need. Present law requires a provider of positron emission tomography established without a certificate of need to become accredited by the American College of Radiology and provide the commission with proof of accreditation within two years of the date of licensure. A provider that fails to comply with the accreditation requirements is subject to licensure sanction. This amendment instead requires a provider of positron emission topography established without a certificate of need to become accredited by a nationally recognized and CMS-approved accrediting organization in the modalities provided by that person and submit proof of the accreditation to the commission within two years of the date of licensure. RULEMAKING This amendment requires the commission to promulgate emergency rules to effectuate this bill as soon as practicable after this bill becomes a law."