NASHVILLE - A sometimes-defiant Haslam administration fired off its response Monday to criticisms from the Obama administration over Tennessee's implementation of rules and programs intended to facilitate enrollment of low-income residents under the federal health care law.
In a letter to Cindy Mann, director of the federal Centers for Medicare and Medicaid Services, TennCare Director Darin Gordon took issue with CMS' assertions.
The agency said in a June 27 letter the state is not in compliance with six of its seven main "critical success factors" with regard to a streamlined eligibility and enrollment processes for Medicaid.
Similar letters were sent out to five other states and updated "mitigation plans" had to be submitted by Monday.
"We must respectfully disagree," Gordon wrote in his letter to Mann.
In addition to his alternately defiant and defensive tone, Gordon submitted the updated plan but sought permission to work with federal officials in resolving several issues.
Earlier, Gordon outlined what he called "five misstatements or mischaracterizations" in Mann's letter.
For example, he noted that Tennessee does indeed have counselors at Department of Human Services offices in all 95 counties to help would-be enrollees steer through paperwork and get enrolled on the federal government's Healthcare.gov website.
As he did in an interview with reporters on Saturday, Gordon blamed federal officials for Tennessee's main problem -- its failure to get a new $35 million computer system designed to process TennCare applications according to new federal rules.
Because of the delay, Tennessee has sent nearly all TennCare applicants to Healthcare.gov.
Federal officials had said Tennessee "repeatedly expressed reluctance" to enact fixes required by the law and demanded officials submit the plan for corrective action by Monday.
But Gordon told reporters over the weekend that the department would rather be late in getting its computer system to go live than to have a system that doesn't work, as other states have done.
And he noted the federal government's own troubled rollout of its Healthcare.gov website and what he complained were evolving standards for the state's website.
Similar complaints were made in the state's official response.
Nonetheless, Gordon said, Northrop Grumman -- which won the bid to build the system -- has missed deadlines and the agency will be conducting an outside assessment as to when the system can be finished.
He reiterated that in the letter.
"We will remain focused on the goal of a successful implementation without distraction, but we will not go live with a system that has not been adequately tested."
He also said despite federal criticisms, some 125,000 have successfully signed up for coverage, about a quarter steered successfully by the state.
And while providing federal officials a summary of the state's "updated mitigation plan" he emphasized it is only an "interim solution pending completion" of the state's new computer enrollment system.
Gordon asked for an "expedited consideration of our requests" as well as "our overall, updated mitigation plan."
In a more conciliatory noted, Gordon notes "we share your sense of urgency about these issues, and we have tried to develop creative yet operationally feasible solutions."
But he ends the letter saying "to be clear, though, our ability to operate" hospital-related issues "is fully contingent upon HHS's approval of the entire mitigation plan.
"Of course, we are willing and able to discuss these requests with you at your convenience," the letter said.
Kate Harrison contributed to this report.
Contact staff writer Andy Sher at email@example.com or 615-255-0550.