Tag Archives: insurance

Hospitals plan post-election push for Insure Tennessee

By Eric Schelzig, Associated Press
NASHVILLE, Tenn. — The Tennessee Hospital Association, a key supporter of Republican Gov. Bill Haslam’s unsuccessful effort to expand Medicaid in the state, is planning a new push to pass the measure once this year’s presidential election is over.

The members of the hospital group had pledged to cover the entire $74 million state share of Haslam’s Insure Tennessee proposal, which would have drawn down $2.8 billion in federal Medicaid funds over two years.

But Republican lawmakers rejected Haslam’s plan last year amid fears that it was too closely linked to President Barack Obama’s signature health care law.

THA President Craig Becker said the group is spending about $400,000 to found a nonprofit called Tennesseans for a Responsible Future that is aimed at gathering support for passing the measure once Obama leaves office next year.

“It really is to kind of offset some of the misconceptions and certainly to educate our legislators to what Insure Tennessee is and what it isn’t,” Becker said. “And what it isn’t is Obamacare.”
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Ramsey: Insure TN, medical marijuana bills DOA

Lt. Gov. Ron Ramsey tells the Kingsport Times-News that bills on Insure Tennessee and medical marijuana don’t have a chance of passage this session.

“This is 2016 and we’re going to have a new president in November one way or the other,” Ramsey said in a recent meeting with members of the Times-News Editorial Board. “Every Republican presidential nominee has basically said that we will give the money to the states in block grants and allow us to design our own (Medicaid) program. … They would say, ‘Here’s your $3.1 billion and design your own plan.’ I think we can do that. … Even TennCare (the state’s current Medicaid program) experts say that is the case. … The timing is bad now, (Gov. Bill Haslam, a Republican) is not going to bring (Insure Tennessee) back up.”

But Ramsey also noted House and Senate Democrats will try something to bring Insure Tennessee back up for consideration.

…Concerning a new push to have medical marijuana in Tennessee, Ramsey said: “I don’t think it has a prayer.”

Insure TN demonstrators mark opening session

NASHVILLE, Tenn. (AP) — Protesters advocating for the passage of Gov. Bill Haslam’s Medicaid expansion proposal packed the state Capitol on Tuesday, singing, chanting and waving signs as lawmakers who defeated the measure last year returned for the first day of the legislative session.

The plan, called Insure Tennessee, which would extend health coverage to 280,000 Tennesseans, was defeated by fellow Republicans in the Legislature who balked at supporting a measure tied to President Barack Obama’s health care law.

Despite the protesters’ enthusiasm, there appears to be little chance the heavy GOP majorities in both chambers will change their mind as they head into this year’s election season. All 99 House seats are up this fall, as are 16 of 33 Senate seats.

Haslam hasn’t been optimistic about reviving the proposal, remarking recently that “it wasn’t like we just barely lost” last year.

The governor is hoping to have better luck this year with a proposal in a completely different area: Education. Haslam is putting forth a proposal that establishes individual administrative boards at each of the six four-year schools under the Tennessee Board of Regents system.

A proposal to boost state revenues for road projects faces an uncertain fate among lawmakers, who are wary about approving the state’s first gas tax hike in 25 years, especially during an election season.

The Senate began its first floor session with a moment of silence in honor of the sailor and four Marines killed in a shooting rampage in Chattanooga in July.

…The House also swore in three new Republican members: Gary Hicks of Rogersville, Jamie Jenkins of Somerville and Jason Zachary of Knoxville.

State penalizes three for insurance fraud

News release from Department of Commerce and Insurance
NASHVILLE – The Tennessee Department of Commerce and Insurance (TDCI) announces disciplinary actions today against three former Tennessee licensees for misappropriation, failure to report administrative actions, and felony convictions involving fraud.

The punishments were the result of months of work by TDCI’s Insurance Fraud Investigations and Legal teams who ensure the protection of Tennesseans by holding licensees who are engaged in unlawful activity accountable for their misdeeds.

“In announcing these actions today, we hope Tennessee insurance consumers recognize that TDCI is here to help,” said TDCI Assistant Commissioner Michael Humphreys. “Every day our investigators and attorneys are tracking down alleged wrongdoing in order to protect Tennessee insurance consumers. If something doesn’t feel right, we encourage Tennesseans to contact our office for assistance.”

Details of the cases include:

John Paul Kill (Peachtree Corners, Ga.): As a result of a default hearing on Oct.15, 2015, an Order issued by an Administrative Law Judge (ALJ) became Final on Nov. 4, 2015, revoking John Paul Kill’s insurance producer license and imposing a $100,000 civil penalty. The penalty was based on a finding of 48 violations of the Tennessee insurance code for conduct involving the misappropriation of insurance premiums. The ALJ found that on 11 different occasions Kill collected premiums from clients for truck insurance, kept the funds, and never purchased policies totaling over $50,000 in misappropriated premiums. In addition, Kill was convicted of insurance fraud in the United States District Court for the Northern District of Georgia for misappropriating approximately $3,700,000 collectively from a total of 800 trucking companies across 22 states.

Richard Christopher Ferrell (Nashville, Tenn.): A Final Order issued by an ALJ and effective Nov. 5, 2015, revoked Richard Christopher Ferrell’s insurance producer license and imposed a $5,000 civil penalty for failing to report administrative actions that occurred in several other states. Ferrell was found to have committed five violations of Tennessee Insurance law. The violations began with the suspension of his Maine non-resident insurance producer license for encouraging a client to submit an inaccurate address to receive a reduced health insurance rate. Several other states took administrative actions when it was discovered that Ferrell failed to report actions taken in other states, including his failure to report to TDCI.

John Winston Fisher (Nashville, Tenn.): A Final Order, effective Nov. 11, 2015, has been issued revoking John Winston Fisher’s public adjuster license and imposing a $2,000 civil penalty. Pursuant to a default hearing held on Oct. 22, 2015, an ALJ found Fisher to have violated Tennessee insurance law for having been convicted of two felonies involving fraud. On Jan. 20, 2015, Fisher was convicted in the United States District Court for the Middle District of Tennessee for two federal felony counts of Mail Fraud. Fisher was sentenced to five years in prison and ordered to pay $582,836.23 in restitution to State Farm Insurance Company. The initial indictment contained facts charging Fisher with conspiracy to burn down a residential building and present a false claim for fire insurance coverage.

The Final Orders may be appealed in Chancery Court within 60 days of the Final Order.

About the Tennessee Department of Commerce and Insurance: TDCI is charged with protecting the interests of consumers while providing fair, efficient oversight and a level field of competition for a broad array of industries and professionals doing business in Tennessee. Our divisions include the Athletic Commission, Consumer Affairs, Tennessee Corrections Institute, Emergency Communications Board, Fire Prevention, Insurance, Tennessee Law Enforcement Training Academy, Peace Officers Standards and Training, Regulatory Boards, Securities, and TennCare Oversight.

TN uninsured rate down to 6.6% (426,301 people)

About 6.6 percent of Tennesseans are now uninsured, the lowest rate since 2004 just before a major cut in TennCare enrollment, according to a report from the University of Tennessee Center for Business and Economic Research.

Further from the Commercial Appeal:

The annual UT survey indicates that 426,301 Tennesseans are without health coverage this year, down from 472,008 last year and 611,368 in 2013. The decrease coincided with the establishment of the Health Insurance Marketplace established as part of the federal Affordable Care Act, the study says.

The number of uninsured children has dropped by more than half since 2013, and 98.5 percent of Tennessee children are currently insured through either public or private coverage. Over the same period, the number of uninsured adults has decreased by approximately 152,000, and the 8.2 percent rate of uninsured adults is the lowest recorded in the survey since 2004.

Affordability is the predominant reason why people fail to obtain insurance, with 9 out of 10 families citing it as a reason for their lack of coverage.

Nashville attorney Michele Johnson, executive director of the Tennessee Justice Center, said the new report “is certainly good news for all of us that, thanks to the Affordable Care Act, the number of Tennesseans without insurance has declined. Unfortunately, the ACA does not reach 280,000 Tennesseans who would benefit from Governor Haslam’s Insure Tennessee program.”

Note: The full 2015 report is HERE.

Harwell: Legislature will ‘re-visit’ Insure TN

House Speaker Beth Harwell said Monday that the state legislature likely will revisit Medicaid expansion in January but lawmakers still have major concerns that likely will keep it from passing, reports the Commercial Appeal.

Harwell said she believes Gov. Bill Haslam is leaning toward not asking the legislature in 2016 to approve the state’s first gasoline tax hike in 26 years, although he toured the state this summer outlining the need for more transportation funding.

But she thinks his Medicaid expansion plan, Insure Tennessee, may get another look. “I think we will revisit heath care again. I’m not telling you that Insure Tennessee has some magic bullet to be passed this year but I do think there will be continued discussion.”

Harwell said Republicans… have “legitimate concerns and I think if we’re going to see something passed, we’re going to have to address them.”

She said those concerns include caps on enrollment in the expansion program, designed under the federal Affordable Care Act to cover more uninsured working poor. “We were told it would be a program for about 280,000. The reality is there are about 400,000 people who qualify,” she said.

…And the speaker said that while Tennessee hospitals heavily support Medicaid expansion because they will benefit financially, many doctors in her district called her in opposition.

“I would have liked to have seen a disenrollment plan on the front end, with some kind of safety net built in because you can’t take (coverage) away from people without a transition plan. I think what would be palatable to a supermajority is if this were given to us in a block grant and we could devise a program the way we wanted without federal strings attached. I do think we could, given the expertise in health care in Nashville and Memphis, we could design a program that would be more cost effective.”

TN Supremes order $16M tax refund to insurance companies

News release from Administrative Office of the Courts
Nashville, Tenn. – In a unanimous opinion, the Tennessee Supreme Court ruled today that the Tennessee Department of Commerce and Insurance must refund more than $16 million in taxes paid by five groups of out-of-state insurance companies.

Tennessee, like every other state except Hawaii, has adopted a retaliatory tax statute unique to the insurance industry. The statute, which is designed to equalize tax burdens across state lines, protects each state’s domestic insurance companies against discriminatory or excessive taxes that may be imposed when doing business in other states.

The way the statute works is that if “State A” charges higher fees, taxes, or fines against “State B’s” insurance companies when they do business in “State A,” then “State B” can impose a retaliatory tax on “State A’s” insurance companies when they do business in “State B.”
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House District 14 post-election spin: Insure TN a loser, school choice a winner

News release from Americans for Prosperity-Tennessee
NASHVILLE, Tenn. — The unofficial results are in and Jason Zachary has been elected to the open seat for Tennessee House District 14. The candidates were similar on most issues, except whether or not Tennessee should expand Medicaid under Obamacare.

Governor Haslam proposed the Insure Tennessee plan during the special legislative session at the beginning of the year. Insure Tennessee was promptly defeated in the Senate Health Committee and again each time the supporters sought to resuscitate it.

The defining issue of Obamacare’s Medicaid expansion proved to be all the Zachary camp needed to pull off a big victory. It didn’t hurt that Zachary was also firmly opposed to raising the gas tax, while his opponent was not nearly as resolute on the issue.

“The voters have spoken: HD14 served as a referendum on big government,” said Andrew Ogles, state director of Americans for Prosperity Tennessee. “If Gov. Haslam is serious about improving the lives of hard working Tennesseans, then he needs to stop forcing liberal policies like Insure TN and increases to the Gas Tax and focus on job creation and growing the Tennessee economy.”

News release from Tennessee Federation for Children
Nashville, Tenn. (August 12, 2015) – The Tennessee Federation for Children PAC (TFC PAC) congratulates Jason Zachary on defeating Karen Carson in the special election primary for state House District 14, and commends both candidates for running a positive, issue-focused campaign.

Jason Zachary’s pledge to fight for children against the special interests of the education bureaucracy follows in the footsteps of the previous officeholder, Ryan Haynes, who stepped down this year to serve as chairman of the Tennessee state Republican Party.

“We saw in 2014 and 2012 that voters want legislators who support choice in education,” said Tony Niknejad, director for the Tennessee Federation for Children PAC. “Defeating a challenger with an 11-year political career is difficult, but Zachary’s determination to put parents in charge of their children’s education clearly resonated with the Republican voters of West Knox and Farragut.”

GOP voters have lined up behind school choice. Earlier this year, a poll performed by OnMessage, Inc. found that 69% of GOP Primary voters support an opportunity scholarship program that gave parents the right to use tax-dollars to send their child to a school that best serves his or her needs. The polling memo from OnMessage, Inc. can be found here: http://bit.ly/17rPyJk.

More recently, school choice has made the news as an issue that unites nearly every Republican candidate for President.

“With 13 of the Presidential candidates in the news all emphasizing and re-emphasizing their strong support for school choice, it’s really no surprise that Jason Zachary won. There’s simply not many Republican voters left when you espouse a position that’s contrary to Ted Cruz, Jeb Bush, Marco Rubio, Rand Paul, Bobby Jindal, Scott Walker and others,” added Niknejad. “Both Hillary Clinton and Bernie Sanders have taken positions opposing school choice. We expect 2016 will be a very exciting election year for Tennessee.”

Statement from House Speaker Beth Harwell:
“I appreciate both candidates’ willingness to step forward and serve the people of the 14th district. With no opponent in the general election, I want to welcome Jason Zachary to the Tennessee General Assembly and the House Republican Caucus, and I look forward to working with him.”

TN on short list for ‘Captive Domicile of the Year’

News release from state Department of Commerce and Insurance
NASHVILLE – The Tennessee Department of Commerce and Insurance (TDCI) proudly announces that Tennessee has been named to the shortlist of finalists for the U.S. Captive Domicile of the Year Award as part of the U.S. Captive Services Awards.

Open to all states with active captive legislation in the US, the awards recognize and reward those captive insurance providers who have excelled in the past year. Now in their fourth year, the U.S. Captive Services Awards are organized by London-based Captive Review magazine, which covers the global captive insurance community.

“We’re thrilled that Tennessee has been included for the second consecutive year on the shortlist for U.S. Captive Domicile of the Year,” said TDCI Commissioner Julie Mix McPeak. “This honor demonstrates that Tennessee’s commitment to captive insurance is drawing national attention while bolstering the state’s economy. We congratulate our fellow nominees.”

TDCI’s Captive Insurance Section is responsible for regulating the state’s captive insurance industry. A captive insurance company represents an option for many corporations and groups that want to take financial control and manage risks by underwriting their own insurance rather than paying premiums to third-party insurers.

In 2011, the State of Tennessee revamped its captive insurance regulations. Nearly four years into revamping Tennessee’s captive regulations, Tennessee is home to 78 captive insurance companies that include 207 cell companies.

Results will be announced Aug. 10 in Burlington, Vermont.

Ohio governor urges Medicaid expansion in TN

Probable Republican presidential candidate John Kasich, who as Ohio governor successfully pushed Medicaid expansion in his state, said in Nashville Thursday that he hopes Gov. Bill Haslam can do the same in Tennessee.

From The Tennessean:

“I’m very big on Haslam, I think he’s really smart. But you have to all work those people in the legislature, and you’ve got to tell them this is what it’s all about,” Kasich said in speaking with several doctors and administrators at Vanderbilt University Medical Center.

“The problem that a lot of you have is you get upset with them, and then when they don’t do what you want them to do, then you go and you support them. You’re all the same: You’re all worried about whether they’re going to like us the next day. Either you mean it or you don’t.”

…”Part of the problem is people develop an ideological opposition and then don’t want to be confused by the facts,” Kasich said.

“I think we are a healthier state, a more inclusive state, a better state and a more unified state as a result of this. I think you’ll get it done here. I don’t know who holds it up. But it’s always a struggle.”

At the same time, Kasich said states should have some flexibility in how they spend their money: For Ohio, people are eligible for Medicaid if they earn up to 138 percent of the federal poverty line. Kasich said there are discussions about dropping that to 100 percent, then combining the leftover funds with a “modest state subsidy” to help people earning between 100 percent and 138 percent of the federal poverty level purchase coverage on the private health care exchange.

Opponents to any form of Medicaid expansion in Tennessee disagreed with Kasich’s analysis. Justin Owen of The Beacon Center of Tennessee, a conservative think tank that successfully helped defeat Insure Tennessee this year, blasted Kasich for expanding Medicaid in Ohio.

“Gov. Kasich’s Medicaid expansion under Obamacare has been an abysmal failure. Rather than come to our state and shill for Tennessee to duplicate Ohio’s disasters, Gov. Kasich should go back home and try to fix the mess he’s created,” Owen said in a statement.
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