►
Description
House Insurance Subcommittee - March 8, 2022 - House Hearing Room 2
A
A
You
we
do
detect
a
quorum,
we
have
a
calendar
before
us
today
it
is
titled
the
final
calendar,
depending
on
how
we
go
today.
It
is
unlikely
that
we
complete
the
calendar
today,
so
we
will
certainly
try
to
work
through
as
many
pieces
of
legislation
as
we
possibly
can
members
do.
We
have
any
personal
orders
before
any
members.
A
Before
we
begin
seeing
done,
we
will
go
right
to
our
calendar
and
we
do
have
some
some
action
that
will
or
or
lack
of
action
that
may
be
occurring
with
some
bills
we
have
folks
presenting
in
other
committees.
We
have
some
situations
that
are
requiring
individuals
to
be
out
of
the
building
today
as
well.
So
we
may,
we
may
have
some
delays
in
some
of
the
issues
as
they
come
before
us.
We
do
have
before
us
item
number
one
on
our
calendar
is
house
bill.
2008.
A
B
A
A
C
Well,
thank
you,
mr
chairman.
We
we
are
on
guide
to
number
three
on
our
calendar
house
bill
1985
chairman
hockey,
recognized.
A
Thank
you,
mr
chairman,
and
to
the
members.
Thank
you
for
the
motion.
Thank
you
for
the
second
this
bill.
Much
like
the
bill
that
speaker
johnson
just
just
carried
this
is
the
annual
coverage
assessment
act
for
our
hospitals,
it's
something
that
provides
a
substantial
amount
of
revenue
through
the
10
care
system
to
our
hospitals
and
certainly
stand
for
any
questions
that
you
all
may
have
about.
It.
A
You
and
forgive
me
chairman,
we
do
have
an
amendment
tracking
code
is
0
1,
four,
four
one,
eight.
C
We
have
a
motion
and
second
on
amendment
zero
one,
four,
four
one,
eight
going
on
hospital
1985,
all
those
in
favor,
please
say
aye
aye
opposed.
The
amendment
goes
on
the
bill.
The
bill
is
amended
and
ready
for
the
question
that
was
called
without
objection.
We
are
voting
on
house
bill,
1985,
all
those
in
favor,
please
say:
aye
aye
opposed
the
bill
passes
and
goes
to.
A
A
B
Thank
you,
mr
chairman
and
committee
members.
What
this
does
this
raises
the
the
minimum
limits,
the
minimum
policy
limits
for
a
vehicle
vehicle
property
damage
from
fifteen
thousand
to
twenty-five
thousand.
As
we
all
know,
parts
have
just
went
sky
high
used
cars
as
much
as
new
cars,
so
I
think
it's
time
that
that
we
make
this
adjustment.
Okay,.
A
A
A
All
right,
we
are
now
on
item
number.
Six
on
our
calendar
item
number
six
is
house
bill:
zero.
Nine.
Eight,
eight
chairman
williams,
is
currently
entertaining
a
group
of
putnam
county
leadership,
folks
from
back
home
in
the
district,
and
he
has
asked
that
we
roll
house
bill
988
behind
item
number
24
on
our
calendar
without
objection
house
bill.
988
item
number
six
is
rolled
behind
item
number
24
on
a
calendar.
A
B
You're
recognized,
thank
you,
mr
chairman
house.
Bill
2347
is
a
request
for
it's
a
study
bill.
We
request
for
the
comptroller
and
the
tennessee
department
of
health
and
tenncare
to
collaborate
and
produce
a
study
of
the
effects
of
temporary
staffing
in
staffing
agency,
as
it
applies
to
long-term
care
facilities.
B
As
many
of
you
know,
staffing
and
health
care,
and
nearly
all
parts
of
the
economy
are
in
a
difficult
spot.
The
use
of
staffing
agencies
to
care
for
patients
can
potentially
have
many
effects
on
the
quality
of
care
to
patients,
as
well
as
the
cost
of
care
to
providers,
one
of
the
biggest
being
the
state
of
tennessee
through
our
tenncare
program.
Mr
chairman,
I'll,
take
any
questions.
Thank
you.
A
B
B
Chairman
boyd,
thank
you,
mr
chairman.
It
simply
puts
together
a
study
to
look
into
it
to
see
what
the
costs
are.
The
staffing
agency
numbers
have
have
skyrocketed
tremendously
and
that
they're
just
having
to
eat
the
cost
right
now
and
they're,
currently
passing
that
along
to
10
care.
So
really
my
understanding
when
they
brought
this
to
me,
was
they
just
wanted
the
state
to
sit
down
all
interested
parties
and
kind
of
take
a
look
at
it
and
report
back.
B
A
Question
has
been
called:
are
you
ready
to
vote
item
number
seven
house
bill
2347,
all
those
in
favor
of
signified
by
slang
eye
all
right
any
of
those
opposed.
Please
please
say
no
the
eyes
have
it
your
bill
moves
forward
to
full
insurance
committee.
Thank.
A
A
F
A
A
F
We
do
it's
amendment
number
zero
one.
Four,
eight,
four,
four.
A
We
have
a
motion
in
a
second
at
the
will
of
the
subcommittee
we'll
go
ahead
and
put
the
amendment
on
the
bill
and
and
discuss
it
as
amended
with
that
objection,
all
those
in
favor
of
placing
house
amendment
tracking
code
zero,
one,
four,
eight,
four,
four
on
the
bill,
please
signify
by
saying
aye
any
of
those
opposed.
Please
say:
no,
nice
habit.
We
are
on
house
bill
2225,
as
amended
chairman
powers,
you're
recognized.
F
Thank
you,
mr
chairman
house,
bill
2225
changes
current
laws
so
that
the
commissioner
will
not
consider
a
prior
misdemeanor
or
a
class
e
felony,
and
that's
only
if
the
individual
was
charged
not
convicted.
F
If
either
offense
occurred
more
than
10
years
before
the
date
upon
which
an
individual
would
submit
an
application
for
a
license
right
now
they
go
back,
there's
actually
no
time
frame
on
it.
If
you've
had
a
misdemeanor
20
years
ago,
they
could
be
counted
against
you
and
could
knock
you
out
of
getting
a
producer
license
in
the
insurance
business
and
the
classy
felony,
and
I'm
sure
there's
some
lawyers
on
here
too.
That
know
about
that.
F
It's
only
if
it's
charged
and
not
convicted
a
classy
felony
could
be
a
minor
thing,
for
example
a
vandalism
of
a
building.
If
it's
900,
it's
a
misdemeanor,
if
it's
eleven
hundred
dollars,
it's
a
classy
felony.
So
if
they've
been
charged
with
a
classy
felony
but
not
convicted,
because
right
now,
that
will
knock
them
out
of
getting
a
producer
license.
Also,
everybody
has
a
pass.
F
We've
all
done
some
stupid
things,
and
I
don't
want
to
take
up
your
time
and
tell
you
all
of
mine,
or
it
would
take
too
long,
but
if
they've
not
had
any
activity
with
law
enforcement
within
past
years,
we
like
to
assume
that
they
probably
got
a
stable
and
and
they
and
they
deserve
to
get
a
job
as
an
insurance
agency
owner.
I
understand
how
difficult
it
is
to
find
qualified
applicants.
C
Thank
you,
chairman
powers,
you're
a
forgiving
soul,
but
one
feels
concerned
with.
If
there
is
so,
it's
limited
up
to
class
e
felony.
Yes,.
F
Only
only
class
c
yeah
that
that
could
be
some
minor
things
there
too,
but
charred
if
they've
charged
right
now
and
not
convicted.
I'm
sorry,
mr
chairman,
if
they're
charged
right
now
and
not
convicted,
they
would
still
be
knocked
out
of
a
license.
But
this
says
if
they've
been
charged,
I'm
sorry!
If
they,
if
they've
been
charged
at
all
and
not
convicted,
if
they've
been
acquitted,
then
they
would
still
be
eligible.
C
F
Well,
just
like
I
mentioned
a
while
ago,
it's
some
minor
things
and
there's
some
more
major
things
too,
but,
like
I
was
talking
about
vandalism
of
a
building.
If
it
was
nine
hundred
dollars
a
misdemeanor.
If
it's
eleven
hundred
dollars,
it's
a
classy
felony
and
there's
some
other
things
like
that
that
go
along
with
it.
C
Thank
you
I
see
so
it
is,
it's
may
be
considered
for
the
purpose
and
there
is
a
board
that
decides
that.
F
F
A
A
A
A
C
A
Looking
at
the
amendment,
sir,
that
will
rewrite
the
bill
we'll
go
ahead
and
put
the
amendment
on
the
bill
to
have
the
discussion
on
the
full
bill,
all
those
in
favor
of
placing
amendment
zero
one.
Four,
eight
four
five
on
house
bill
1772,
please
signify
by
saying
aye
aye
any
of
those
opposed.
Please
say:
no!
F
Okay,
thank
you,
yeah
house,
bill
1772.
It
just
clarifies
the
licensing
requirements
for
individuals
that
are
marketing
medicare
products
such
as
medicare
advantage
or
medicare
part
d.
It
makes
no
change
the
current
law
and
simply
codifies
the
current
practice.
It
clarifies
that
licensing
of
a
medicare
marketing
representative
is
governed
by
federal
federal
regulations
without
any
additional
state
regulation
and
marketing
in
our
industry
is
simply
educational
informational.
F
It's
not
trying
to
sell
a
product,
that's
where
the
cms
they
differentiate,
between
selling
and
marketing
and
for
marketing
representatives.
They
do
not
sell
the
product
and
cms
requires
them
to
be
federally
licensed
for
marketing
activities
as
well
as
state
license
right
now
for
for
selling,
so
they
would
still
have
to
go
through
the
cms
certification
just
like
they
currently
will
do,
and
then,
if,
if
that
changes
later
on,
if,
if
cms
changes,
then
then
this
would
change
along
with
it
and
with
that
I'll
ruin
my
motion
and
be
glad
to
answer
any
questions.
A
C
A
This
is
another
bill
bill.
We
are
going
to
roll
roll
behind
item
number
24
and
I
will
say
we're
going
sequentially
as
these
bills
are
being
rolled
with
no
objection.
Item
number
11
house
bill
2048
will
be
rolled
after
item
number
24
on
our
calendar.
A
A
A
A
Correction
misstated
on
that
on
that
particular
motion.
If
I
can
take
back
that
gavel
being
here,
item
number
14
on
the
calendar
house
bill
2456
will
be
rolled
behind
item
number
24
on
our
calendar.
A
A
A
A
H
Mr
chairman,
mr
chairman
members
house,
bill
2840
is
a
bill
that
not
only
looks
to
save
money
and
save
lives,
but
also
help
helps
to
get
patients
the
care
that
they
need
and
am
proud
to
say.
This
is
a
bipartisan
bill
and
from
one
of
my
co-sponsors,
including
leader
gantt,
this
legislation
is
based
on
a
program
currently
being
used
by
the
memphis
ems
that
make
sure
that
those
who
need
mental
health
care
are
taken
to
the
place
that
best
address
their
needs.
H
This
bill
would
also
allow
for
issues
that
can
be
best
addressed
by
a
non-emergency
care
facility
and
they
will
be
covered,
and,
mr,
mr
represe,
chairman
speaking
of
bms,
we
have
a
person
here
that
I'd
like
to
testify.
Mr
kevin
from
memphis
ems
is
here
and
I'd
like
for
him
to
be
able
to
testify
on
this
bill.
A
A
If
you
could
punch
the
button
in
front
of
you
to
the
microphone,
make
sure
the
red
light
comes
on
and
as
you
testify,
we
will
go
out
of
session
without
objection.
A
D
Thank
you
all
for
the
opportunity
to
speak
with
you
this
afternoon.
Again.
My
name
is
kevin
spratlin
with
memphis
fire
department.
We
are
a
large
ems
agency,
providing
medical
care
to
the
citizens
of
memphis.
We
have,
over
the
last
several
years,
been
deploying
a
model.
That
is
what
we
call
the
right
response.
This
is
our
ability
to
find
the
most
appropriate
resource
for
the
needs
of
our
community
because,
as
you
well
know,
there
are
many
many
people
who
call
9-1-1
with
issues
that
are
not
life-threatening
emergencies
and
currently
in
traditional
ems.
D
Even
if
we're
able
to
fix
the
issue
on
the
scene,
if
we're
able
to
get
them
transported
to
a
clinic
such
as
a
behavioral
setting
or
an
urgent
care
center
or
primary
care
clinic,
even
if
we're
able
to
connect
them
with
that
primary
care
provider
so
that
they
can
get
more
appropriate
care,
that
is
better
for
their
long-term
outcomes
and
much
cheaper
for
the
health
care
system.
We
are
perversely
incentivized
to
only
transport
to
the
er,
because
that
is
the
only
way
that
we
are
paid.
D
A
Any
questions
or
comments
for
our
presenter
if
you
could
lieutenant
sprayland.
How
prevalent
is
this
issue?
If
you
could
tell
me
the
the
calls
that
occur
and
happen
as
the
way
you
have
explained
them,
can
you
give
me
a
prevalence,
and
I
don't
know
if
you
can
drill
down
into
a
percentage
or
not,
but
if
you
could,
that
would
be
very
helpful.
You're
recognized.
Thank
you,
sir.
D
We
absolutely
look
at
our
data
and
recognize
that,
at
the
time
of
dispatch,
around
25
percent,
nearly
25
of
all
of
our
calls
are
non-life
threatening,
so
at
dispatch
we
don't
even
respond
lights
and
sirens,
because
the
chief
complaint
that
is
described
over
the
9-1-1
call
is
of
such
little
acuity
that
it
doesn't
require
that
we
know
that
additionally,
when
many
of
our
providers
arrive
on
scene
afterwards,
they
find
that
it's
not
a
life-threatening
event
and
that
patient
can
handle
some
other
ways.
D
However,
we
are
incentivized
to
only
go
to
the
er
so
to
get
into
the
data.
Last
year
we
made
approximately
140
000
ems
calls
in
the
city
of
memphis,
keep
in
mind,
that's
not
the
rest
of
shelby
county.
So
that's
just
memphis
fire
very
busy
agency
in
the
normal
ambulance
service
payer
mix
about
27
of
those
payers
are
tenncare
medicaid.
D
That
is
a
significant
number
in
the
model
that
I
run,
which
is
the
healthcare
navigator,
where
we
send
out
a
team
and
an
suv
that
has
a
physician,
a
specially
trained
paramedic
and
a
resource
navigator
working
as
a
social
worker.
We
are
able
to
navigate
greater
than
80
percent
of
those
persons
away
from
ambulance
transport
and
60
to
65
percent
of
them
do
not
end
up
in
an
er.
D
I
will
tell
you
forthrightly
during
covet,
we've
been
a
little
less
successful
in
getting
people
into
clinics
because
of
availability
of
clinic
appointments
during
covet,
though
that
is
getting
better
but
greater
than
60
of
the
people
we
see
do
not
end
up
in
the
er
over
80
do
not
end
up
on
an
ambulance.
C
You
thank
you
for
your
testimony.
Thank
you
for
making
the
trip
seems
logical,
and
I
think
I
would
be
supportive
of
the
effort.
I
don't
know
if
this
question
is
for
you
or
for
leader
kemper,
but
it
seems
that
we
will
save
money
by
doing
this,
but
yet
there
is
a
positive
fiscal
note
on
it.
A
D
We
would
love
to
have
a
discussion
with
tin
care
about
that
fiscal
note.
I
have
significant
questions
over
how
it
was
calculated.
We
have
our
own
numbers
and
we
have
numbers
from
cms
that
do
not
lead
to
the
same
conclusion.
So
we
would
welcome
the
opportunity
to
have
a
discussion
with
tenncare.
J
J
You
know
either
asleep
or
maybe
totally
intoxicated
on
the
bench,
and
you
know
you
guys
have
to
show
up
and
most
of
the
time
you
have
to
transport
them
to
the
emergency
room
instead
of
hey,
if
they're
out
in
the
cold
or
something
you
you
transport
them
to
the
shelter
or
you
know,
or
you
know,
like
you
said,
social
service
agency
is
with
you.
I
mean
this
is
definitely
cost
savings.
Yes,
I
mean,
I
don't
know
where
tenncare
could
calculate
it.
J
A
A
E
Ashley
reed
division
of
tenncare,
so
yes,
I
think
where
the
you're
seeing
the
cost
come
from,
is
that
I
think
the
vendor
that
provides
this
service
when
they
perform
the
triage
there's
a
fee
for
that
so
they're
triaging,
but
then,
whether
they're,
triaging,
treating
or
transporting
they're,
also
paying
that
rate
I'll.
Also
note
medicare
rates
are
higher
than
medicaid
rates.
So
even
with
that,
where
you
would
see
savings,
the
offset
is
less
because
those
medicare
rates
are
higher
than
medicaid
rates.
C
E
C
E
B
E
I
Thank
you.
I
was
looking
at
the
cms
website.
It
says
it's.
A
voluntary
five-year
payment
model
is
that,
what's
the
what's
the
status
of
that
becoming
permanent
or
what's
the
what's
the
status
of
that
right
now,.
E
We
can
check
with
cms
on
where
they
are
in
that
pilot
and
if
they
plan
to
make
it
recurring.
Okay,.
I
E
I'm
not
sure
what
would
prevent
them
from
doing
that.
As
you
know,
there
are
no
co-pays
or
premiums
within
that
program,
so
I'm
not
sure
what
would
actually
prevent
a
member
from
from
calling
that.
But
I
think
that's
probably
the
goal
of
the
program
is.
They
would
triage
that
and
then
learn
whether
that
person
could
be
treated
via
a
telehealth
visit
where
whether
it
was
an
actual
emergent
or
non-emergent
situation,
whether
it
could
go
to
an
urgent
care.
I
You
so
I'm
let's
say
I'm
just
trying
to
digest
what
all
this
is.
So
if
somebody
calls
and
they
come
there
to
the
house
and
say
they
just
wanted
them
to
take
them
to
their
doctor's
appointment
or
something
like
that,
which
I
would
consider
probably
abuse
of
what
this
is
supposed
to
be,
what
would
occur
in
that
situation,
I
mean,
would
they
say
you
know
I've
got
you
know
my
diabetes
is
is
up,
you
know,
sugar's
up,
I've
got
an
appointment,
and
then
they
I
mean
what
what
what
prevents
that
yeah.
E
And
I
may
actually
ask
the
gentleman
if
he
knows
what
what
the
process
would
be.
If
somebody
did
that,
I
mean
that
that
to
me
that
sounds
like
a
triage
incident
and
I
would
have
to
check
on
what
kind
of
reimbursement
would
be
allowable
if
somebody
was
just.
You
know
calling
to
have
a
conversation
if
there
wasn't
actually
an
emergent
or
non-emergent
episode.
C
D
Thank
you
again.
One
thing
I'd
like
to
clarify
is
under
et3.
There
is
no
reimbursement
for
the
triage
piece
period.
Triage
is
done
currently
through
the
9-1-1
system.
When
you
call
9-1-1
a
an
emergency,
medical
dispatcher
asks
a
series
of
scripted
questions
and
a
physician
has
predetermined
the
response
configuration
for
those
calls,
so
we're
not
being
reimbursed
for
that
now
we're
not
seeking
reimbursement.
Therefore,
that
piece
of
the
fiscal
note
we
feel
is
incorrect,
and
that
is
the
significant
part
of
the
note.
The
way
the
calls
are
triaged
is
our
medical
director
has
said.
D
D
I
can
speak
to
the
model
we've
built
in
memphis.
We
have
no
desire
to
transport
someone
to
a
doctor's
office
or
to
a
clinic.
However,
we
do
wish
to
transport
behavioral
health
patients
to
a
behavioral
health
setting,
if
I
may
I'll
use
that
as
a
quick
example,
though,
please
be
clear,
this
is
not
purely
a
behavioral
health
bill.
D
However,
what
we
end
up
doing
is
we
transport
that
person
by
amulets
to
the
er
the
facility
then
charges
you
for
that
and
then
charges
for
the
physician
to
review
that
patient
then
pays
for
mobile
crisis
to
come
and
see
that
patient
for
the
mobile
crisis,
assessor
to
say,
you
just
need
to
go
back
to
the
crisis
center
and
then
they
call
for
another
ambulance
to
take
that
patient
to
the
crisis
center,
whereas
the
model
that
we're
that
we
have
built
and
that
we're
asking
you
to
support
allows
us
to
go
straight
there,
it's
better
for
the
patient,
it's
better
for
the
system
and
it's
far
less
expensive.
D
C
Any
questions
so
seeing
none
thank
you.
We
will
work
to
resolve
the
other
issues,
we'll
go
back
into
the
session
leader
camper.
I
guess
you've
heard
the
questions
and
the
concern
about
the
resolution
about
what
the
fiscal
note
should
be.
H
You're
recognized,
I
did,
mr
chairman,
but
I
think
he
addressed
the
concerns
that
the
members
had.
I
believe
that
this
this
bill,
if
enacted,
I
think
it
would
decrease
costs.
I
think
it
would
encourage
discourage
this.
This
transport,
that's
costing
a
lot
of
money
and
pressuring
the
overall
health
care
system,
so
I
think
it
gives
them
flexibility
to
be
able
to
transport
to
a
non-emergency
mental
health
facility,
like
he
just
mentioned,
or
to
the
er,
if
necessary.
H
I
think
it
encouraging
the
higher
frequency
of
treatment
at
the
scene
or
via
telehealth
and
and
having
this
as
an
alternative,
is
appropriate
care
for
a
person,
and
I
think
that
is
something
that
we
can
work
through.
If
tenncare
have
a
problem,
I
think
we
can
work
through.
You
know
as
they
move
to
address
their
concerns,
so
I
think
it's
a
good
bill.
I
think
it'll
help
the
overall
health
care
system.
Thank
you.
C
H
You
thank
you,
mr
chairman,
and
I
commit
to
that.
Are
you
you
know.
I
think
sure
this
committee
has
shown
that
they
want
you.
They
appreciate
what
this
bill
is
doing.
They
appreciate
the
benefits
it's
going
to
have
the
patient
care
to
health
care
system
to
the
emergency
system,
and
I
would
surely
work
with
10th
care
and
any
of
you
as
we
move
forward.
We
move
to
full
committee.
If
it
you
know,
if
there's
still
problems
I'll
park,
it
then
wouldn't
move
it
and
we'll
just
continue
to
work
on
it.
C
C
G
Right,
thank
you.
Thank
you
chairman.
I
think
this
is
my
first
time
appearing
before
this
committee,
and
so
thank
you,
and
I
heard
that
this
was
like
the
best
committee,
but
I
would
have
to
argue
a
little
bit,
I'm
on
verb
on
chairman
picky's
one
of
his
committees,
but
but
thank
you
again
so
I
want
to
talk
about
the
bill,
though,
but
this
is
a
good
committee.
G
Many
of
you
know
here
that
I
am
a
diabetic
and
I'm
pretty
in
tune
with
well
I'm
type
2
diabetic,
but
I'm
pretty
in
tune
with
my
body
and
what
happens,
and
sometimes
it
gets
out
of
whack
and
about
two
and
a
half.
Weeks
ago
I
told
my
wife,
I
wasn't
feeling
well,
I
was
like
I
don't
know
what's
going
on
with
me,
I
I
just
don't
feel
well,
and
sometimes
I
get
cloudy
my
head
gets
cloudy.
G
It
doesn't
happen
often
because
I'm
very
in
tune
with
my
body
and
she
said
well,
have
you
checked
your
blood
sugar
and
I
checked
my
blood
sugar.
I
did
the
prick
got
that
and
I
found
out
my
blood
sugar
was
really
high.
You
know
it
was
like
225,
which
is
really
high
for
me
and
and
I
realized
what
was
going
on
so
I
got
up.
I
walked
a
little
bit.
G
Try
to
expend
some
of
the
the
energy
out
from
my
body
and
I
laid
back
down
and
I
was
okay,
but
if
I
had
a
continuous
glucose
monitor,
it
would
have
alerted
me
as
it
was
getting
higher
and
higher
over
time.
They
have
monitors
that
you
can
monitor
over
the
time
over
your
phone.
There
is
a
young.
There
is
a
young
lady
in
this
audience
that
lives
in
columbus,
ohio.
G
She
has
a
daughter
that
has
type
1
diabetes
and
she
has
a
continuous
glucose
monitor
and
right
now
she
can
look
at
her
phone
and
tell
you
exactly
what
her
daughter's
blood
sugar
is
right.
Now,
at
this
moment
and
her
daughter's
in
columbus
ohio,
she
has
received
alerts
throughout
the
night
that
wakes
her
up
to
say:
hey
your
blood
sugar's
dropping
too
low.
G
I
need
you
to
get
some
juice,
because
what
this
bill
does
it
will
allow
people
to
build
better
health,
healthier
habits
as
they
move
forward
in
life,
because
once
you
get
diabetes,
it's
a
debilitative
disease.
It
never
gets
better.
You
just
can
only
maintain
it,
and
so
what
this
bill
would
allow
people
to
learn
how
to
maintain
their
blood
sugars.
What
goes
what
causes
it
to
go
up?
G
A
A
C
A
All
right,
thank
you
very
much.
You've
heard
the
explanation
of
the
amendment,
all
those
in
favor,
of
placing
the
amendment
on
the
bill.
Please
signify
by
saying
aye
any
of
those
opposed.
Please
say
no,
the
eyes
have
it
chairman
dixie
you
that
the
amendment
did
help
your
fiscal
note
considerably,
and
you
recognized
if
you'd
like,
to
give
us
the
flavor
of
the
bill.
Now
that
the
amendment
is
on.
G
Yeah,
so
I
want
you
to
close
your
eyes
and
imagine
that
there
is
no
physical
note,
because
I
want
you
to
focus
on
the
merits
of
the
bill.
I
want
you
to
just
only
focus
on
the
merits
of
the
bill.
There
is
an
entire
committee
called
finance
ways
and
means
that
we'll
deal
with
this
when
it
gets
to
their
committee
and
if
you
would
allow
them
to
do
their
jobs.
I
think
that
by
the
time
we
work
there,
we
can
find
an
amenable
agreement
tin
care.
We've
worked
together,
we're
talking
we're
going
back
and
forth.
G
So
this
will
require
a
pharmacist,
a
pharmacy
benefit,
which
means
your
doctor
can
write
you
a
script
and
just
to
prove.
My
point
is
that
last
friday,
no
thursday,
I
called
my
doctor-
I
just
called
him
and
said:
can
you
write
me
a
script
for
a
glucose
monitor?
He
said
he
a
couple
hours
later.
He
said:
okay
go
pick
it
up
from
the
pharmacy.
G
It
was
just
that
quick,
but
I
was
able
to
do
that
because
I
have
private
insurance,
but
if
you're
on
medicaid
or
you're
poor
we're
penalizing
people
because
they're
poor
in
the
health
benefit,
because
they
cannot
do
this
and
if
they
are
able
to
do
it,
they
have
to
go
through
the
dme
vehicle
to
get
this,
and
it
can
be
a
weeks
days
weeks
in
order
before
they
can
get
that.
G
J
So,
in
le
less
way
less
than
a
year,
it's
gonna
pay
for
itself.
G
It
keeps
them
out
the
emergency
rooms,
it
keeps
them
from
getting
things
amputated
because
what
happens
when
you
pour
and
you
go
into
a
hospital-
and
you
have
some
vascular
issues-
the
first
thing
they'll
say
is:
let's
cut
it
off?
Let's
cut
your
toe
off,
let's
cut
your
foot
off,
instead
of
trying
to
figure
out
a
remedy
to
how
to
save
it.
So
if
we
can
teach
people
better
habits
on
the
front
end,
it
will
save
the
state
money
on
the
back
end
from
having
to
do
for
having
to
pay
for
them.
A
Ironically,
I
heard
the
chairman
of
budget
sub
clear
his
throat
earlier,
as,
as
you
were
talking
about
the
fiscal
note,
so
there's
more
of
that
going
on
in
the
room
as
we
speak
now,
are
you
ready
to
vote?
A
A
Leader,
camper,
forgive
us
you,
you
had
another
bill
on
the
calendar.
We're
now
ready
for
item
number
18
on
our
calendar
house
bill
1973,
leader
camper.
Thank
you.
H
Thank
you,
mr
chairman
and
members.
Did
the
fiscal
note
eye
closing
things
work
just
a
chair.
A
We
have,
we
have
a
motion
and
a
second
on
your
legislation,
leader
camper,
please,
please
continue
thank.
H
You,
mr
chairman,
mr
chairman
and
members,
I
want
to
thank
the
committee
for
working
with
me
and
the
staff
on
this
bill.
You
know
it
previously
was
carried
by
senator
london
lamar,
so
I'm
standing
in
in
her
the
new
senator,
I
should
say
london
tomorrow,
standing
in
on
her
state,
mr
chairman
and
members
house,
bill
17
1973
is
a
remote
patient
monitoring
bill
and
it
will
create
a
pilot
program.
H
This
bill
will
help
create
positive
health
outcomes
for
mothers,
and
babies
in
tennessee
makes
a
positive
make
it
possible
to
detect
issues
with
the
mother
and
baby
before
birth
and
to
reduce
the
number
of
emergency,
c-sections
and
pre-term
deliveries
in
our
state.
And
mr
chairman,
this
isn't
a
piece
of
legislation
where
we're
attempting
to
find
an
outcome.
We
have
evidence
from
other
states
that
have
used
this
program
to
achieve
better
outcomes
for
mothers,
babies
and
our
physicians.
H
Today,
mr
chairman,
we
have
mr
evan
hoffman
from
the
phillips
corporation
to
testify
on
behalf
of
the
technology
and
positive
implications
of
implementing
the
programs
in
other
states.
We
would
like
would
you
care
to
hear
from
me,
mr
chairman
members,.
A
This
is
a
concept
that
we
are
about
to
begin
year,
two
of
a
pilot
that
we
have
funded
through
tenncare
through
the
governor's
budget,
and
we
are
in
the
process
of
of
doing
this
very
thing.
This
very
work
is
part
of
our
shared
savings
plan
that
we
passed
last
year
for
tenncare
that
we
were
able
to
add
programs-
and
this
has
been
one
that
we
have
have
been
able
to
to
address.
A
H
A
Love
when
you
come
up,
if
you
could
just
remember
what
I
said
that
was
intended
for
you
forgive
me
committee,
we
do
have
have
a
gentleman
who
would
like
to
speak
on
this,
mr
evan
hoffman,
who
is
in
the
crowd
as
well.
Our
folks
from
tenncare
may
like
to
address
this
issue
too.
A
Mr
hoffman,
are
you
in
the
crowd?
Yes,
all
right,
we
will
go
out
of
session
with
that
objection.
A
Mr
hoffman,
if
you
could,
please
make
sure
the
red
button
is
on
in
front
of
you,
tell
us
who
you
are,
who
you're
with
and
talk
a
little
bit
about
about
your
thoughts
on
the
bill.
L
Thank
you,
chairman
hawk,
and
members
of
the
subcommittee.
My
name
is
evan
hoffman.
I
am
the
director
of
state
government
affairs
for
phillips,
so
phillips
is
a
healthcare
tech
company
focused
exclusively
on
improving
people's
lives.
We
are
a
proud
tennessee
employer
with
over
1100
employees,
including
800
right
across
the
street,
at
the
phillips
plaza
building
here
in
nashville.
L
We
work
with
hospitals
also
across
the
state,
in
all
of
your
districts,
most
likely
to
help
patient
care
from
west
tennessee
healthcare
to
ballot
health.
So
today
is
international
women's
day
march
8th.
So
I
think
it's
extremely
fitting
that
we're
talking
about
this
build
today
phillips
has
a
deep
history
in
maternal
health.
We
are
the
world's
largest
ultrasound
company,
the
largest
obstetrics
monitoring
company,
and
we
are
the
owner
of
pregnancy
plus,
which
is
the
world's
most
globally
downloaded
pregnancy.
App.
L
This
bill
is
important
because
it
will
unlock
maternal
health
care
for
moms
who
struggle
to
access
this
care,
otherwise,
especially
in
rural
tennessee.
So
let
me
describe
how
this
bill
will
work.
I
ask
everyone
to
imagine
that
you're
one
of
the
25
percent
of
moms
who
find
themselves
with
a
high-risk
pregnancy.
L
You
are
singularly
focused
on
keeping
yourself
healthy
and
keeping
your
baby
healthy.
This
may
require
visits
to
your
doctor
several
times
a
week,
especially
during
the
third
trimester.
So
keeping
up
with
these
appointments
is
challenging,
so
so
many
moms
face
this
impossible
decision,
especially
if
they
live
in
rural
areas.
L
They
often
lead,
if
untreated,
to
c-sections
that
are
unplanned
to
pre-term
births
to
complications
postpartum
both
for
mom
and
baby,
and
so
that's
what
we're
really
trying
to
address
with
this
bill,
as
mentioned,
it
would
create
a
three-year
ten
care
pilot
for
moms
to
access
this
kind
of
remote
monitoring
in
their
home.
So
imagine
if
you're
a
doctor
and
you
can
get
early
warning
alerts
kind
of
like
a
check
engine
light
on
your
car.
That's
essentially
what
this
bill
would
do.
L
The
data
would
flow
from
the
mom
who's
doing
remote
monitoring
through
like
a
blood
pressure,
cuff
or
a
scale,
that's
connected
to
the
doctor.
The
data
would
then
flow
to
the
doctor,
and
if
something
is
moving
in
the
wrong
direction,
they
can
intervene
sooner,
adjust
their
care
plan
with
the
goal
of
trying
to
prevent
that
hospital
visit
in
the
first
place.
L
So
that
is
the
remarkable
potential
of
rpm
remote
patient
monitoring.
Instead
of
missing
appointments
and
doctors
flying
blind.
This
technology
gives
the
opportunity
for
moms
to
get
monitored
in
the
home
simply
like,
while
catching
up
on
netflix,
for
example,
and
medical
studies
also
reaffirmed
the
value
of
rpm.
In
my
written
testimony
that
I
sent
a
few
days
ago,
I
referenced
close
to
10
different
studies
that
look
at
the
value
of
rpm,
both
in
maternal
healthcare
and
for
the
broader
population.
L
A
Hoffman,
if
I
could
interrupt
you,
I
your
time
is
up
there,
but
I'm
gonna,
but
I'm
going
to
ask
you
to
briefly
tell
us
about
that
study.
So
that
will
be
my
first
question
as
we
as
your
three
minutes
rub.
But
I
will
ask
you
the
question
to
tell
me
more
about
the
study.
Mr
hoffman
you're
recognized.
L
Sure,
thank
you,
chairman
hawk,
so
the
study
looked
at
3
200
pregnant
moms
and
compared
it
with
3
200
moms,
who
weren't
on
rpm,
and
the
study
showed
that
for
the
women
who
were
using
rpm
in
the
home,
there
was
a
reduction
in
c-sections
by
over
30
percent,
a
reduction
in
pre-term
birth
deliveries
by
over
22
percent.
They
detected
pre-eclampsia
earlier
by
13
days
on
average,
so
you
can
see
real
health
outcomes
here.
A
Thank
you
very
much.
Thank
you,
ms
tom,
very
good
insights.
Thank
you
so
much.
Thank
you
for
the
opportunity.
Individuals
from
tenncare.
We
do
have
miss
ashley
reed
on
the
list
from
tim
care,
miss
reed.
Once
again,
if
you
could,
please
tell
us
who
you
are,
who
you're
with
and
the
information
you'd
like
to
share.
You
are
recognized.
Thank.
E
You
ashley
reed
division
of
tenncare,
so
tenncare's
primary
concern,
recognizing
the
importance
and
usefulness
of
rpm
is
that
there
are
several
different
places
in
this
bill
which
wouldn't
allow
us
to
utilize
our
medical
necessity
criteria.
I
know
the
committee's
familiar
with
with
our
experience
with
with
medical
necessity
criteria
and
with
the
language
in
this
bill.
Bypassing
that
you
know
would
really
you
know
require
us
to
the
different
spots
are
when
it's
medically
appropriate
high
risk.
E
A
provider
would
be
in
the
position
of
determining
what
counties
are
without
obs
and
also
which
pregnant
moms
lacked
reliable
transportation.
So
those
are
things
you
know
without
the
ability
to
monitor
those
from
a
10
care
perspective
causes
concern.
I
Chairman
is
10
care
still
doing
the
patient-centered
medical
homes.
I
And
I
believe
there
was
like
a
pilot
program
run
through
one
of
the
mcos
a
few
years
ago,
dealing
with
some
remote
treatment.
Are
you
aware
of?
I
mean
how
would
this
be
similar
to
what
was
done?
Of
course,
the
one
previously,
I
think,
was
more
encompassing
than
just
the
population
that
we're
looking
at
here,
but
how
would
that
I.
E
A
H
Thank
you,
mr
chair,
mr
chairman.
It
is,
it
makes
a
minor
change,
but
what
I
was
thinking,
mr
chairman,
because
of
the
concerns
I
just
heard
from
tenncare,
which
I
didn't
know
prior
to
so
I
appreciate
that
provision
she
spoke
to.
If
I
could
roll
this
bill
to
the
heel
of
this
calendar
and
give
me
a
chance
to
work
with
her
and
if
you're
done,
I
can
come
if
your
committee
is
done.
I
have
a
chance
to
for
the
amendment
to
be
timely,
filed.
A
We
have
heard
the
the
request
of
the
sponsor
and-
and
we
have
precedent
over
the
last
hour,
15
minutes
of
doing
just
that
I
will
I'll
leave
it
to
the
committee.
I
will
take
our
advisement
that
we
can
excuse
me.
Roll
item
number
18
house
bill
1973
behind
item
number
24
on
our
calendar
as
we
have
as
we
have
rolled
several
bills
this
afternoon.
A
A
A
Excuse
me:
it's
an
untimely
filed
amendment
as
well.
I
will
I'll
let
you
explain
the
bill
first
and
then
we'll
see
what
process
we
can
go
through.
Thank
you.
K
K
K
It
deals
with
postpartum,
which
is
that
time
after
childbirth,
where
women's
bodies
are
getting
used
to
the
body
not
being
pregnant
anymore,
childbirth
occurs
and
adjustments
have
to
be
made.
There
was
money
put
in
the
budget
last
year,
I
believe
which
support
a
pilot
program,
and
I
will
defer
to
the
eloquent
words
you
were
speaking
just
a
few
minutes
ago
as
explanation.
Also,
this
bill
simply
says
that
this
program
will
go
from
being
a
pilot
to
being
a
full
program
and
the
amendment
drafting
code.
I
believe,
mr
chairman,
is
zero
one.
Four,
seven,
eight
zero.
A
We
missed
just
by
a
little
bit
of
getting
in
timely
filed.
The
committee
has
an
opportunity
to
ask
for
a
motion
for
consideration
of
the
amendment
code:
zero
one
four,
seven,
eight
zero.
If
it
will
make
the
bill,
we
have
a
motion
to
consider
an
emotion,
a
second
to
consider
amendment
zero
one,
four,
seven,
eight
zero.
K
A
A
We
have
a
motion
and
a
second
on
the
amendment
you've
given
us
a
brief
description
of
that,
the
leader
love
all
those
in
favor
of
attaching
amendment
number
zero
one.
Four,
seven,
eight
zero
on
house
bill
two
zero
one,
please
signify
by
saying
aye
any
opposed
the
ice
have
it.
We
are
on
your
bill
as
amended
and
we'll
let
you
continue.
K
A
All
right
and
and
once
again
we
are
in
the
midst
of
a
pilot
program
and
understand
where
we
are
and
what
we've
been
able
to
to
conduct
on
with
that
and
seen
some
success
so
excited
to
see
what
the
fruits
of
our
labor
will
be
there.
Any
questions
or
comments
for
leader
love.
A
A
A
A
Take
a
little
bit
of
personal
privilege
here
as
we
go
to
item
number
21
on
our
calendar
as
well
is
item
number
2851
by
chairman,
dr
kumar.
I
think
the
request
will
be
to
roll
this
bill
as
well.
A
Okay,
forgive
me
we're
offline
there
for
a
moment
that
that
is
not
the
request
on
on
item
number.
29..
Excuse
me
item
number
21..
I
just
misspoke
twice
today,
so
on
item
number
29
house
bill
2851
chairman
dr
kumar,
you
are
recognized
thank.
C
You,
mr
chairman,
as
life,
is,
we
are
all
products
of
a
genetic
lottery
and
we
inherit
certain
things
about
rich.
We
have
no
control
considering
those
circumstances
when
we
are
faced
with
buying
insurance,
our
genetic
susceptibility
to
certain
conditions
over
which
again
we
had
no
control,
can
play
an
important
role
in
in
our
state.
We
do
have
statute
that
prohibits
insurance
companies
from
using
the
genetic
information
to
deny
or
or
increase
coverage
for
health
insurance.
C
It
is
a
matter
of
privacy,
it
is
a
matter
of
fairness
again,
the
genetic
lottery
over
which
we
have
no
control,
and
it
is
also
a
matter
of
freedom
and
with
that,
mr
chairman,
I'll
renew
my
motion.
A
Thank
you
and
just
make
sure
I'm
I'm
certain.
I
heard
a
motion
in
a
second
on
on
the
legislation.
Yes,
we
did
motion
in
a
second
on
house
bill,
2851
any
questions
or
comments
for
chairman,
dr
kumar.
A
I
Thank
you
chairman,
and
it
was
my
intent
to
have
an
amendment
for
this
bill
that
would
have
dci
look
into
a
1332
waiver
but
as
as
I've
tried
that
before,
and
it
had
a
fiscal
note,
and
my
understanding
is
that
georgia
is
in
a
lawsuit
over
something
like
that.
So
with
that
going
on,
I
would
like
to
take
this
off
notice.
Okay,.
A
A
A
All
right,
ladies
and
gentlemen,
we
are
in
a
posture
where
I
believe
we've
done
all
the
work
that
we're
going
to
be
able
to
do
today.
The
the
time
is
upon
us
to
to
to
adjourn
the
committee
hearing
a
motion
in
a
second
to
adjourn.