Groups weighing TennCare response

Groups weighing TennCare response

July 11th, 2014 by Kate Harrison Belz in Local - Breaking News

Excerpts from HHS letter about TennCare compliance with federal law.

Document: Tennessee mitigation letter

Tennessee mitigation letter

Two national legal advocacy groups have joined a Tennessee organization to "closely monitor" how TennCare responds to federal demands that it repair a dysfunctional application process that has caused backlogs and long delays for people trying to get coverage.

The Southern Poverty Law Center, a civil rights advocacy group, and the National Health Law Program, a nonprofit that litigates at the state and federal level, have been working with the Nashville-based Tennessee Justice Center, a public policy and advocacy group, to assess ongoing TennCare problems.

Michele Johnson, director of the Tennessee Justice Center, said Thursday that a lawsuit would be a "last resort" if Tenn-Care does not work quickly to address longstanding problems cited by the federal Center for Medicare & Medicaid Services in a letter to TennCare Director Darin Gordon.

The letter stated that Tennessee has failed to meet all but one of seven federal requirements to get a new eligibility system up and running under the Affordable Care Act.

"We need the state to take seriously the management failures that are resulting in the suffering of hundreds of Tennesseeans," Johnson said. The Tennessee Justice Center has not brought a major lawsuit against the state since 1998.

Delays in implementing the new eligibility system, including the completion of a $35 million computer system, have meant people wanting to apply for TennCare programs can only apply through the federal HealthCare.gov website. In-person assistance was removed from the application process Jan. 1.

The backlog has meant many Tennesseans do not know the status of their applications, and that TennCare-eligible newborns have remained uncovered for as long as six months.

The June 27 letter from federal officials demanded Tennessee submit a plan of corrective action by Monday. The letter said Tennessee had "repeatedly expressed reluctance" to enact fixes required by the law.

But TennCare officials have said they disagree with "numerous aspects" of the federal ultimatum and plan to issue a more detailed response Monday.

In a joint statement Wednesday, the three law groups said the federal letter to TennCare was "an important step toward ending the systemic failures that are causing severe harm to the state's most vulnerable citizens."

The statement said state officials have refused their "urgent requests" to enact the federally required reforms.

"Tennessee is the only state with such severe transgressions," according to the statement.

"We will be watching closely to see how those responsible respond to this challenge."

Contact staff writer Kate Harrison at kharrison@timesfreepress.com or 423-757-6673.