68-11-262 - Limit on amount of charges for services to an uninsured patient. - Tennessee Statutes

68-11-262. Limit on amount of charges for services to an uninsured patient.

(a)  Each healthcare facility licensed under this chapter shall be prohibited from requiring an uninsured patient to pay for services in an amount that exceeds one hundred seventy-five percent (175%) of the cost for the services provided, calculated using the cost to charge ratio in the most recent joint annual report.

(b)  As used in this section, the following terms shall have the meaning indicated:

     (1)  “Cost to charge ratio” means the ratio of a specific healthcare facility's total expenses to its grand total gross patient charges as reported in its joint annual report submitted annually to the department of health;

     (2)  “Healthcare facility” means a hospital, ambulatory surgery center, or outpatient diagnostic center; and

     (3)  “Uninsured patient” means a person with no public or private source of payment for medical services, including, but not limited to, medicare, TennCare, a contract of insurance, an employer-sponsored health plan, or other enforceable obligation under which a person is responsible for payment for healthcare services provided to the patient.

(c)  Information obtained by the department of health as to the amounts billed for services by a healthcare facility, pursuant to this section, shall be maintained on a confidential basis.

[Acts 2005, ch. 474, § 27; 2007, ch. 419, §§ 1, 2.]