Emergency Medical Care Facilities, a company that provides services in Tennessee emergency departments, said TennCare did not follow the correct procedure for making the $50 cap rule under the Uniform Administrative Procedures Act. The case required the appeals court to determine whether the rule falls under the UAPA.
The trial court had determined that the $50 cap rule is defined as a “rule” by the UAPA, is subject to the law’s requirements, and that TennCare did not comply with the law’s requirements for rule-making.
TennCare appealed the decision. The appeals court determined that the $50 cap rule is not subject to the UAPA because it falls under the internal management exception in the 2009 version of the law, reversing the trial court decision.
