Department of Finance And Administration, Division Of TennCare v. The Chattanooga-Hamilton County Hospital Authority D/B/A Erlanger Health System

This appeal concerns an administrative judge’s decision to exclude several exhibits in a contested case between a hospital and the TennCare Division of the Tennessee Department of Finance and Administration. At issue in the contested case is the validity of two TennCare rules that regulate payment for emergency services provided to Medicaid beneficiaries when the hospital has no contract with the beneficiaries’ managed care provider. The exhibits contain out-of-court statements made by industry representatives and federal agency employees about the meaning and application of federal and state law. TennCare asserts that the exhibits are necessary to show the reasonableness of its decision-making process. The healthcare services provider argues that the exhibits contain irrelevant, inadmissible hearsay. Having determined that the exhibits are not admissible under the Uniform Administrative Procedures Act, we affirm the administrative judge’s ruling.