TennCare Cuts?

February 4th, 2011

Several of our Tennessee clients have expressed concerns over the TennCare cuts that may go into effect July 1.

For a summary of cuts, visit:  http://www.tn.gov/tenncare/forms/tenncarewaiveramed12.pdf.

What concerns most of our clients is the eight day limit for hospital inpatient service, physician and nurse practitioner office visits and laboratory services. 

Although we aren't fortune tellers, we think (and hope) the cut is unlikely.

The Affordable Care Act prohibits the reduction in eligibility for Medicaid between when the bill was passed in March 2010 and when the Act will be substantially implemented in 2014.  Reducing eligibility = no federal funding.  Although the amendments do not technically go to eligibility, the spirit of the Affordable Care Act was not just elibility but any reduction in benefits.

Per KHN:  Governors are bristling against rules in the stimulus program and the health overhaul law that generally require them to maintain current Medicaid levels for adults until 2014, when much of the law kicks in, or risk losing federal matching funds. They say they need to be able to trim their Medicaid rolls now because their state budgets are in such dire straits – partly because stimulus funding that helped many prop up their health programs ends in June.

In Tennessee, cuts similar to those proposed for July were averted in 2010 when the hospitals agreed to a 3.5 percent fee on revenues.  Hospitals will likely agree to continue the fee instead of facing the potential of no pay for Medicaid patients who exceed the eight days of inpatient visits.

Since Federal law requires Advance Notice of any change in Medicaid coverage, Tennessee put the public on notice about the proposed changes in case other funding options do not materialize.

Tags: TennCare, Affordable Care Act


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