Tennessee putting the people back in TennCare as some in-person help is restored

Tennessee putting the people back in TennCare as some in-person help is restored

June 19th, 2014 by Kate Belz in Local Regional News


Most people applying for TennCare can now apply only through the federal health insurance marketplace, healthcare.gov, or by calling the toll-free number at 1-800-318-2596.

The state has a new toll-free number called the "Tennessee Health Connection" intended to help with TennCare application: 1-855-259-0701.

Long term care-related and Medicare Savings Program applications may still be filed directly with the state. Applications can be downloaded at www.tn.gov/tenncare/members.shtml. Area Agency on Aging & Disability or by calling Tennessee Health Connection and requesting an application.

Pregnant women and people with breast or cervical cancer can obtain presumptive eligibility directly through local health departments throughout the state.

Pregnant women who are on TennCare at the time they give birth can report the birth of their baby directly to the state, initiating eligibility for the infant.

Tennessee remains the only state that has handed its Medicaid application process over to the federal government, and for several months it has been the only state to shutter its in-person Medicaid application services.

But state leaders say they are taking steps to restore some face-to-face help for people struggling with the new application process.

This spring, members of the state's Department of Human Services staff went through training to become certified counselors who can help people with the process, which primarily steers Tennesseans through HealthCare.gov to apply for TennCare.

The state offices used to be where people could go to apply in person for TennCare. A branch of the office determined TennCare eligibility and worked with applicants to make sure they applied for the right kind of benefits.

But on Jan. 1, the state decided to remove the TennCare arm of human services and instead turned that process over to the federal government through the new marketplace, HealthCare.gov.

The move has sparked fierce criticism from health advocates, who say that hundreds of people seeking coverage through TennCare have struggled to navigate the web-based system, or have since become stuck in bureaucratic limbo as they're shuffled between state and federal hotlines.

"Those assisting with enrollment have known how important real in-person assistance is, especially for people trying to deal with the intricacies of TennCare," said Gordon Bonnyman, attorney with the Tennessee Justice Center.

TennCare officials did not address that criticism when explaining why they decided to restore some in-person help, but said the counseling training "would better position DHS workers as they provide in-person assistance to individuals applying for coverage," said TennCare spokeswoman Sarah Tanksley in an email.

All local human services offices are supposed to have at least one employee who has completed that training.

The return of some in-person assistance at the state offices sparked a "rush of relief" among those advocacy groups, Bonnyman said. But he said it has since become clear that "not much had really changed," since the counselors primarily just help with the federal website.

"The DHS offices still do not provide the public what they used to provide, what every other state provides their residents, and what the law requires," Bonnyman said. "DHS does not actually take applications and get them resolved. ... That just doesn't work for many people, as every other state recognizes."

Walter Davis, executive director of the Tennessee Healthcare Campaign, said the move to train human services staff to assist as counselors was "a step," but that it remained to be seen what kind of impact it would have.

"They ultimately just need to have people in their offices who are devoted to handling TennCare, like they used to. The people TennCare was designed to serve need to be their priority."

TennCare officials have said the current enrollment process is the best way to handle sign-ups while they try to finish a new computer system that has now been delayed for months.

The $35.7 million system, called the "Tennessee Eligibility Determination System" or "TEDS," was supposed to start making TennCare enrollment decisions as early as last fall.

But the system is still not ready, and there is no projected completion date, TennCare officials say. The first phase of testing for TEDS is scheduled to be completed in the next few weeks, officials said.

"The state is committed to thoroughly testing TEDS and all of its interfaces to ensure that eligibility determinations for Medicaid and CHIP are done accurately and efficiently," Tanksley said.

TennCare officials blame some of the delays in the project on last-minute directions from the federal government.

Other problems at the federal level, including the initial failure to accurately transfer eligible applicants to TennCare, "diverted resources away from the main project to implement work-arounds," said Tanksley.

Even though the open enrollment period for private insurance through HealthCare.gov is closed, TennCare enrollment through the site is ongoing.

As of mid-May, TennCare has enrolled more than 80,000 members, TennCare officials say.

The figure includes both regular, month-to-month growth in the program since January, but also an increase of people who were previously eligible for services, but did not know it until they sought insurance on Healthcare.gov.

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