Tenn. Comp. R. & Regs. 0600-08-.03 - CRITERIA FOR EXEMPTION OF MEDICAL CLINICS

(1) As used in this rule "clinic" means a facility other than a hospital or other licensed health care facility that provides primary medical care.

(2) As used in this rule "primary medical care" means health care services that cover a range of disease prevention and general wellness services, including diagnosis and treatment of common conditions, patient counseling, and the management of a patient's overall care.

(3) A clinic owned by a charitable institution will be approved for exemption if it meets the following criteria:

(a) The clinic is located in a medically underserved area or serves a medically underserved population as designated by the U.S. Department of Health and Human Services or the State of Tennessee;

(b) The clinic provides services without regard to ability to pay and, if it submits claims to any third party payer, it does not decline TennCare, Medicare, or the uninsured;

(c) The clinic either does not charge for services to any patient, or if it charges for services, charges are based on a sliding-fee scale that is based on patients' family size and income, and

(d) No physician or other employee of the clinic is compensated in amounts in excess of what is reasonable for services performed for the clinic and comparable to other qualified and experienced providers.

Notes

Tenn. Comp. R. & Regs. 0600-08-.03

Original rule filed April 30, 2004; effective July 14, 2004. Amendment filed June 25, 2008; effective September 8, 2008. Amendments filed May 12, 2020; effective 8/10/2020.

Authority: T.C.A. §§ 67-1-305, 67-5-212, and 67-5-212(b).