Terms Used In Tennessee Code 56-48-103

  • Balanced budget: A budget in which receipts equal outlays.
  • Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-48-102
  • HHS: means the United States department of health and human services. See Tennessee Code 56-48-102
  • PSO: means a public or private entity that:
    (A) Is established or organized, and operated, by a health care provider, or group of affiliated health care providers. See Tennessee Code 56-48-102
  • Public law: A public bill or joint resolution that has passed both chambers and been enacted into law. Public laws have general applicability nationwide.
  • 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

Before an entity may operate under the Medicare+Choice program, the entity must obtain a license from the commissioner or be a PSO that obtains a waiver of the requirement for state licensure from HHS in accordance with United States Public Law 105-33, the Balanced Budget Act of 1997. Any entity that obtains such a waiver is not required to obtain a license from the commissioner to operate as a PSO offering a Medicare+Choice plan in this state.