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Friday, October 30, 2026Oct 30

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Tennessee Supreme Court strikes TennCare cap on emergency room payments

Health care workers are seen at Vanderbilt University Medical Center. Tennessee taxpayers could, under a new court ruling, be liable for years of back payments to emergency room doctors. / Tennessee Lookout photo by John Partipilo
Health care workers are seen at Vanderbilt University Medical Center. Tennessee taxpayers could, under a new court ruling, be liable for years of back payments to emergency room doctors. / Tennessee Lookout photo by John Partipilo Health care workers are seen at Vanderbilt University Medical Center. Tennessee taxpayers could, under a new court ruling, be liable for years of back payments to emergency room doctors. / Tennessee Lookout photo by John Partipilo

For more than a decade, Tennessee’s Medicaid program set a $50 cap on its payments to emergency room doctors treating low-income patients who show up at hospitals without experiencing a genuine medical emergency.

The Tennessee Supreme Court has now ruled that TennCare failed to follow the rules in setting the cap, a decision that potentially opens up taxpayers to years of back claims from the state’s hospitals and doctors over being underpaid for patient care since 2011.

(READ MORE: TennCare: Nearly 300,000 Tennesseans likely to lose coverage)

The cap is now void. It was originally included in a set of cost-cutting measures amid a $100 million shortfall for TennCare, the state’s publicly funded health insurer for low-income Tennesseans — mostly covering women, children and people with disabilities.

At the time, the agency promised to go through a standard rule-making process to put the cap in place, but that never occurred.