Category Archives: Health Care

Former GOP leader/lobbyist leads new Insure TN promotional campaign

The Tennessee Hospital Association earlier this year formed a spinoff group – named Tennesseans for a Responsible Future — to promote Gov. Bill Haslam’s Insure Tennessee proposal, a Medicaid expansion move that failed in the 2015 legislative session. Now, the group has chosen Adam Nickas, a former political operative for the state Republican party and more recently a lobbyist, as executive director.

Here’s the press release from Tennesseans for a Responsible Future:
NASHVILLE, Tenn. – Today, Tennesseans for a Responsible Future (TRF) announced Adam Nickas as Executive Director. A Nashville resident and Memphis-area native, Nickas served as Executive Director of the Tennessee Republican Party during the 2012 election cycle and Political Director during the 2010 cycle. TRF was launched in January 2016 with the goal of promoting healthcare policies that benefit Tennesseans.
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Harwellcare task force meets in Memphis; ‘It’s for real’

As the third meeting of House Speaker Beth Harwell’s the task force charged with finding alternatives to Insure Tennessee began breaking up Monday in Memphis, reports the Commercial Appeal, Rep. Steve McManus took hold of the microphone to rebut citizens’ criticism that the panel is a farce.

“We’re for real, and we’re going to work for you,” said McManus, a Cordova Republican who sits on the task force.

Rep. Cameron Sexton, chairman of the “3-Star Healthy Project” task force and a Crossville Republican, said after the meeting — agreeing with McManus — that the goal wasn’t to completely scrap Gov. Bill Haslam’s Insure Tennessee plan, which failed to win legislative approval. Instead, the task force will re-evaluate it to see what parts, if any, the General Assembly can support.

“Insure didn’t have the votes,” he said. “We’re going to look to see if there’s a different approach.”

Summing up his takeaways from the meeting, Sexton said the task force — which includes Rep. Karen Camper, D-Memphis — could try to ease restrictions on faith-based health care organizations like the Church Health Center, which connects patients with volunteer doctors for a flat $35 fee.

Dr. Scott Morris, CEO of Church Health Center, told the task force that state law should be changed to allow citizens to claim health care coverage to satisfy the requirements of the Affordable Care Act and avoid costly fines for being uninsured.

Harwellcare task force talks ‘circuit breakers’

Members of a health care task force assigned with proposing alternatives to Republican Gov. Bill Haslam’s Insure Tennessee plan on Tuesday stressed their desire to include “circuit breakers” to prevent out-of-control costs, reports the Times-Free Press.

The panel was appointed by Republican House Speaker Beth Harwell of Nashville earlier this month to design the plan expanding access to health coverage to present to the federal government this summer.

State Democratic Party Chairwoman Mary Mancini criticized the panel as a “political show” to give Republicans cover for voting last year to reject Haslam’s plan to extend coverage to 280,000 low-income people in the state.

…The panel was joined Tuesday by Republican Sen. Richard Briggs of Knoxville, who voted in favor of Insure Tennessee last year, and Democratic Rep. Karen Camper of Memphis.

Rep. Matthew Hill, R-Jonesborough, said he was concerned that the governor’s proposal wouldn’t have allowed for the program to pause and take stock of growing enrollment.

Hill said his preference would be to “roll it out in phases, keep in measurable and most important keep it measureable, with circuit-breakers and stuff, so that we can keep control.”

“Instead of, ‘Plop, here’s the 280,000 to 300,000 people, and good luck,'” he said.

Further, from The Tennessean:
Outgoing TennCare Director Darin Gordon and his successor, Dr. Wendy Long, provided lawmakers with a crash course on the state’s health care system. Continue reading

Sunday column: Harwellcare task force providing political insurance?

House Speaker Beth Harwell left Democrats howling and some fellow Republicans scratching their heads with the announcement last week that she has set up a task force to contemplate how to deal with health care coverage for poor Tennesseans.

Of course, Republican Gov. Bill Haslam proposed in late 2014 his idea on how to deal with those folks after more than a year of contemplation and compromising. It was called Insure Tennessee and was summarily shot down last year by the Republican supermajority, with Harwell waffling, refusing to either support or oppose a plan denounced as part of GOP-despised Obamacare by critics and defended by Haslam as an innovative way to expand Medicaid.

The governor, who has created dozens of task forces to study stuff while avoiding a decision on various matters, was on hand at the announcement of Harwell’s “3-Star Healthy Project” to praise participants for taking a “political risk” in being willing to even talk about such things.

Actually, there doesn’t seem to be much political risk here. Harwell waited until after the qualifying deadline for legislative candidates had passed before setting up the task force. She and all four Republican representatives appointed to the panel now have no opposition in GOP primaries. It may be worth noting, though, that all four — and Harwell — do have Democratic opponents waiting in November. Ergo, any political risk they face is from underdog Democrats.
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Harwell to study health care via task force; Democrats howl

By Erik Schelzig, Associated Press
NASHVILLE, Tenn. — Republican House Speaker Beth Harwell on Tuesday touted a new initiative to improve health care access in the state, but Democrats quickly derided it as an election-year “charade” to deflect criticism of lawmakers who rejected the governor’s Insure Tennessee proposal.

Harwell said she began talking with health policy experts at Vanderbilt University’s medical school to come up with alternatives last year after lawmakers rejected Republican Gov. Bill Haslam’s proposal to extend health coverage to 280,000 low-income Tennesseans.

Harwell, R-Nashville, has dubbed her initiative the “3-Star Healthy Project,” and said it will tap conservative ideas like encouraging greater responsibility for enrollees; create health savings accounts funded by co-payments; and provide more support for people trying to rejoin the workforce.

She is a creating task force to propose ways to improve access to health care in Tennessee. Harwell said the four Republican House members she has appointed to the task force will work to come up with a specific proposal to make to the federal government as early as June, though the plan could require lawmaker approval next year.

Democrats called the announcement an attempt to give Republicans political cover for rejecting Insure Tennessee.

“This is simply designed to give the false impression that the House Republican leadership is willing to do anything about health care,” said House Democratic Caucus Chairman Mike Stewart of Nashville. “It’s clearly not. This is a charade, it’s an effort to delay, and to not simply pass Gov. Haslam’s Insure Tennessee plan.

“It’s pathetic,” Stewart said.
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State questions merger of Northeast TN hospital chains

The state Department of Health is questioning plans for the merger of Mountain States Health Alliance and Wellmont Health System in Northeast Tennessee, reports the Johnson City Press.

The department is asking the systems for more information about such issues as finances, public impact, competition and workforce consequences. In a letter dated March 28 and posted Thursday on the department’s website, Commissioner John J. Dreyzehner cited several deficiencies in the joint COPA (certificate of public advantage) application, including the lack of a separation plan in the event of failure.

“The department’s requirement for a plan of separation is to specifically ensure that if a COPA is issued and the New Health System (as defined in the application) fails to live up to the promised commitments and understanding reached by the department and the parties, the department may terminate the COPA and require a clear plan of action to return the parties to a pre-consolidation state,” Dreyzehner wrote. “The minimal framework presented in the application does not provide the level of detail necessary to meet the department’s requirement to outline a clear, actionable plan to separate a merged entity.”

On Feb. 16, the leaders of the nonprofit health organizations submitted thousands of pages of documents to state regulators asking for a COPA from Tennessee and a letter authorizing a cooperative agreement from Virginia. The applications kicked off a review process in both states — at least 120 days in Tennessee and 150 in Virginia — giving the health officials time to ponder the proposals before making final determinations, which the systems hope will be made in their favor this fall.

Asked for comment regarding the COPA letter, Mountain States and Wellmont issued a joint statement saying ongoing dialogue with both Virginia and Tennessee is an expected and welcome part of the application review process.

…Should regulatory approval be granted, the merged system would operate 19 hospitals, dominating the inpatient care system locally, and is expected to to reach $2 billion in annual revenues in two years, according to a budget included in the applications.

Wendy Long named new TennCare director

News release from the governor’s office

NASHVILLE – Tennessee Gov. Bill Haslam today announced Dr. Wendy Long will become the director of TennCare and deputy commissioner of Health Care Finance and Administration (HCFA).

Long will replace Darin Gordon, who is leaving at the end of June after 10 years as TennCare director. She has served as deputy director and chief of staff of the Health Care Finance and Administration division of the Tennessee Department of Finance and Administration since 2013.  Long served as chief medical officer for TennCare from 2004-2012.

“We are fortunate to have someone with such a depth of experience working in TennCare to take on this assignment,” Haslam said. “TennCare is among the best managed Medicaid programs in the nation, and this move will help us maintain that performance. Tennesseans can have great confidence in Dr. Long in this important position.”

Started in 1994, TennCare is the state’s Medicaid program, a $10.5 billion health care enterprise that provides services to nearly 1.5 million Tennesseans. In her role as deputy director of HCFA, Long has provided leadership to all areas of its operation including oversight of contracts with TennCare’s network of managed care companies.

“I am honored that Gov. Haslam asked me to serve in this role,” Long said. “My tenure as TennCare’s deputy director has provided invaluable experience and I am grateful for this leadership opportunity. The dedicated staff at Health Care Finance and Administration are an exceptional group of public servants and I look forward to our continued efforts to promote the delivery of high-quality, cost-effective care for the citizens of Tennessee.”

Prior to becoming TennCare’s chief medical officer in 2004, Long held a variety of positions of increasing responsibility at the Tennessee Department of Health including assistant commissioner and medical director for the Bureau of Health Services.  Long also has previous TennCare experience having served as medical director from 1997-1999 and as interim director from March 1998-January 1999.

Long received her undergraduate and medical degrees from Ohio State University and completed a preventive medicine residency and master of public health program at the University of South Carolina.

Long and her husband, Rick, have two grown children, Brian and Lindsey.

Deal cut on revising CON process, but not not repealing it

A negotiated deal has been reached on changing the Tennessee’s “certificate of need” (CON) program, which requires health care facilities to get a state agency’s approval before major expansions, reports the Commercial Appeal. This comes with a growing movement to completely repeal the CON program and abolish the oversight agency, the Health Services and Development Agency.

The deal is laid out in an amendment to Senate Bill 1842/House Bill 1730, a “caption bill” sponsored by Sen. Todd Gardenhire, R-Chattanooga, and Rep. Cameron Sexton, R-Crossville, with a goal, they say, of modernizing the process to give providers more flexibility and to make the system more “free-market oriented.”

The script calls for approval in health committees of both the House and Senate on Wednesday.

Its major provisions include:

Retaining the CON program and the HSDA but reducing the kinds of services, facilities and expansions that are subject to its provisions. CON approval would continue to be required, for example, for entirely new hospitals and for outpatient diagnostic centers statewide.

Allowing hospitals to add up to 10 percent of the beds they are currently licensed for, by specific categories, every three years without CONs.

Repealing the current requirement for a CON for any hospital modification or expansion project costing at least $5 million. Abolishing the $5 million threshold would let hospitals modify or expand non-health care areas regardless of the cost without HSDA approval.

Repealing the current requirement for a CON for the acquisition of major medical equipment exceeding $2 million, so most high-priced major equipment purchases would no longer require state approval.

AP story on demise of TN ‘fetal assault’ law

By Sheila Burke, Associated Press

NASHVILLE, Tenn. — Brittany Hudson was pregnant, addicted to painkillers and afraid of a Tennessee law that calls for the arrest of mothers of drug-dependent babies. She eventually gave birth without medical help, on the side of a road in the foothills of the Great Smoky Mountains.

Hudson’s dilemma, doctors say, was one of many unintended consequences of the Tennessee Legislature’s decision in 2014 to become the first and only state with an explicit criminal offense for these addicted mothers.

The law was meant to deter drug abuse by threatening mothers with up to a year behind bars, while allowing them to avoid jail and have their assault convictions removed if they got drug treatment. It was also an experiment with a “sunset” clause, meaning it will expire this July because the law’s supporters lacked the votes to extend it.

The problem of drug use and pregnancy is worsening nationwide, with a drug-dependent baby born every 25 minutes in the U.S. at a cost of $1.5 billion in additional health care, according to a Vanderbilt study. And states can’t just arrest their way out of it, said Dr. Stephen Patrick, a neonatologist who co-authored the study.

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Darin Gordon stepping down as TennCare director

News release from the governor’s office
NASHVILLE – Tennessee Gov. Bill Haslam today announced TennCare Director and Deputy Commissioner of Health Care Finance and Administration Darin Gordon will enter the private sector at the end of June, leaving a nationally respected legacy of stability and innovation for a program serving some of Tennessee’s most vulnerable populations.

Started in 1994, TennCare is the state’s Medicaid program, a $10.5 billion health care enterprise that provides services to nearly 1.5 million Tennesseans and has earned customer satisfaction ratings above 90 percent for the past seven years.

Having taken on his role in 2006, Gordon is not only the longest serving TennCare director in state history but also is currently the longest serving director in the country. During the 12 years prior to his appointment, the position changed hands 10 times. Continue reading