Staff file photo by Troy Stolt / Karen Crowder gives Marcus Duckworth the Johnson and Johnson COVID-19 vaccine during a block party put on by Get Vaccinated Chattanooga at the Emma Wheeler Homes on Saturday, Aug. 21, 2021, in Chattanooga, Tenn.

There was good news and bad news on the health front this week. And thankfully more good news than bad — at least in the short term.

Tennessee finally came off the No. 1 list for new COVID-19 cases per capita.

According to the list the Chattanooga Times Free Press runs daily in our print and online editions, the Volunteer State gave up its top spot to North Dakota on Thursday.

Additionally, the rate of new COVID cases is declining in Tennessee, Georgia and Alabama, according to a separate state-by-state data analysis from The New York Times.

That doesn't, however, mean we're out of the woods. We're still No. 2 per capita for new cases based on seven-day averages. And even this week, those numbers were going up: 18,323 cases on Wednesday, 18,339 on Thursday and 18,367 on Friday. Additionally, our COVID test positivity rate still is 14.5%. A good rate would be 5% or lower.

That's why we were glad to read some even better news: Millions more of us — and across America — can now get vaccine booster shots from Moderna and from Johnson & Johnson. Pfizer boosters already were approved and recommended a few months ago. But with only 47.1% of Tennesseans fully vaccinated (51% in Hamilton County), we still have far more work to do other than just lining up for boosters.

More good news: Even as Tennessee's supermajority Republican legislature plans to meet in special session next week to contemplate banning vaccine and mask mandates (and pretty much any other common-sense protections against COVID), Tennessee labor officials told lawmakers they cannot reject a federal rule designed to protect health care workers from COVID-19 — this despite the labor department receiving stern instructions earlier this week from Republican lawmakers to do so.

In a letter sent to lawmakers Tuesday, Labor and Workforce Development Commissioner Jeff McCord told GOP lawmakers that Tennessee can't drop a federal COVID-19 rule for health care workers. There is no state statute or process allowing the withdrawal of a rule once it becomes effective, McCord argued.

According to McCord, the federal government could revoke Tennessee's authority to oversee its own workplace safety enforcement if the state refuses to comply with the U.S. Occupational Safety and Health Administration's COVID-19 rules. The Biden administration already issued such threats to three Republican-led states this week.

"At this time, TN-OSHA intends to maintain the (rules) for health care employees while it remains in effect," McCord wrote.

The federal rule, adopted by Tennessee in late August, outlines requirements for personal protective equipment, social distancing and other safety measures — like vaccines — for workers at medical facilities that care for people with COVID-19. It also requires paid sick time for employees who contract COVID-19, need to get vaccinated or are dealing with vaccine side effects.

Can someone explain to us why our lawmakers want to fight personal protective equipment, social distancing, vaccines and sick time for front-line health care employees or time off to get vaccinated? There clearly must be something bad in the water at the state Capitol.

But just wait and see: If our GOP leaders operate true to form, they will threaten to defund the state Department of Labor or push for the firing of McCord — just as they threatened to defund the Department of Health and pushed the firing of Michelle Fiscus, a former top state vaccination official, after state lawmakers decried health department posters and policies advocating vaccines for teens.

As for the bad news: Tennessee may have to repay more than $767 million in Medicaid funds.

That's a lot of money. So much for the state's $1.4 billion rainy-day fund.

According to a U.S. Health and Human Services inspector general report released Thursday, Tennessee did not comply with federal requirements and incorrectly claimed about three quarters of a billion dollars between 2009 and 2014.

Under a Medicaid waiver, Tennessee was allowed to claim uncompensated care costs that public hospitals — like Erlanger — bore for taking care of low-income patients as certified public expenditures. Tennessee uses those matching dollars to help fund its Medicaid program, TennCare, which provides health care coverage to about 1.5 million low-income residents, including children.

But certain of those expenses are supposed to be certified for eligibility for matching federal funds from Medicaid.

Between May 2019 and April 2021, auditors analyzed $2 billion in certified public expenditures that Tennessee claimed from 2009 to 2014 and found no problem with $909.4 million of the claims. But the remaining $1.1 billion — for which the federal share was $767.5 million — was excessive, according to auditors.

The auditors' report also noted the reason for the deep dives: The state claimed the same amount of $373.8 million for fiscal years 2010 through 2013. It does seem strange.

TennCare Director Stephen Smith told reporters Wednesdays that the agency "strongly disputes" the audit findings and will fight them before the U.S. Centers for Medicare and Medicaid Services, and even into court if needed.

"The findings date back to actions that took place more than a decade ago, so this goes all the way back to the [Gov. Phil] Bredesen administration. It has absolutely nothing to do with this administration or even recent years," he said in a virtual news briefing.