Posted on 03/25/2005 3:34:13 PM PST by SmithL
ASHVILLE - The federal government Thursday approved the first phase of the state's plan to restructure TennCare, agency officials said.
TennCare spokesmen said the approval by the U.S. Centers for Medicare and Medicaid Services allows the state to move ahead with efforts to cut TennCare enrollment.
However, the reductions remain under court challenge.
Dave Goetz, commissioner of the Tennessee Department of Finance, said the approval "is an important step in our efforts to gain financial control of TennCare." His department oversees TennCare, an expanded Medicaid program for 1.3 million enrollees.
Gov. Phil Bredesen has proposed cutting 323,000 people from TennCare and reducing benefits for others in order to cut costs in the $8 billion program.
TennCare officials said Thursday's approval authorized the state's procedures for reducing enrollment, including federally mandated requirements on notifying enrollees.
A second phase, still awaiting approval from the federal government, limits benefits.
A delegation of Tennessee officials traveled to Washington, D.C., three weeks ago to begin negotiations about the plan.
TennCare provides health care to poor, uninsured and disabled Tennesseans - or 23 percent of the state's population.
Tennessee must receive a waiver from the federal government to continue receiving federal money for TennCare. The federal government funds about two-thirds of the program's budget.
Critics of Bredesen's proposed cuts have said they believed the federal government would quickly approve the changes.
Other changes that Bredesen wants include capping benefits to 396,000 adults, including limits of four prescriptions a month, 12 doctor visits a year and 20 days of hospital stays per year. Enrollees who exceed the limits would be forced to pay for care.
Children would be unaffected by the proposed cuts.
Bredesen's plans would save Tennessee taxpayers $575 million but would cost the state $1.3 billion in federal aid, officials have said.
A report released in 2004 stated that TennCare, if left unchecked, could consume 91 percent of all new state revenue. Bredesen's budget for the fiscal year that begins in July largely is based on winning approval of his TennCare changes.
Shouldn't that be more than sufficient for all but the seriously ill (a small number) or the seriously cheating?
I have private insurance that would not cover even that much unless I had a diagnosis of a serious illness.
If this is going to save them money, they have a real problem with fraud.
IIRC, wasn't TennCare supposed to be the model upon which HitleryCare was supposed to have run?
bonneyman will have a lawsuit ready just after Easter to prevent this from happening.
I'm trying to understand what is going on.
Does Tennessee also have medicaid?
What is Tenncare paying for that isn't under Medicaid?
Where is the money coming from to pay for Tenncare?
Why do you want Tenncare?
I appreciate any clarification. Thanks.
States have the right to offer their own version of Medicaid. California has Medi-Cal, while Tennnessee has TennCare. TennCare is basically HillaryCare, much too ambitious and too expensive to work. Everytime the State tries to cut costs, Bonnyman sues.
Thanks..I'm moving there this summer. Please have this mess sorted out before I come. lol
I moved from Tennessee to California. I'll be back once I get this mess straightened out.
; )
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