(a) Each managed care organization (MCO), preferred provider organization (PPO), health maintenance organization (HMO), and other health organizations shall provide, through direct contract with St. Jude Children’s Research Hospital or otherwise, all enrollees in the health care organization with access to the health care services at St. Jude Children’s Research Hospital to the extent access is practical and feasible and the services are medically appropriate.
Terms Used In Tennessee Code 56-7-2406
Contract: A legal written agreement that becomes binding when signed.
(b) Reimbursement to St. Jude Children’s Research Hospital for the services provided pursuant to this section shall be no greater than the reimbursement rate a managed care organization would pay other entities providing similar services to its enrollees.(c) Any dispute regarding the application of this section shall be resolved by a committee composed of the commissioner of health, the commissioner of commerce and insurance and the commissioner of finance and administration.
