Tag Archives: TennCare

Billboards urge Harwell to call vote on Insure TN

A statewide billboard campaign — funded by private citizens, including renowned Nashville philanthropist Martha Ingram — is pushing Harwell to bring Insure Tennessee to the House floor, reports The Tennessean. Harwell says she has no intention of doing so.

In a statement to The Tennessean, Harwell said Gov. Bill Haslam decided “not to pursue the implementation of Insure Tennessee.”

“As Speaker, I cannot unilaterally bring it to a vote,” Harwell said. “All bills go through the committee process, and this has failed to receive the support needed to advance.”

Citizens for Insure Tennessee are paying for 20 billboards in cities across the state, urging people to call on Harwell, R-Nashville, to bring Haslam’s Insure Tennessee to a vote.

“I’m just stunned by the leadership, or the lack of leadership, in the legislature,” said Renee Frazier, retired CEO of Shelby County Common Table Health Alliance, who donated to the campaign.

…Mary Falls and Sally Smallwood paid for three Nashville billboards in February and received feedback from private citizens from across the state who wanted to get involved. Billboards with Harwell’s number are also in Memphis, Knoxville, Chattanooga, the Tri-Cities, Tullahoma and other cities. Plus, The number of billboards in Nashville has increased to six.

“I’m involved in this because I’m so very disappointed by the actions of many members of the Tennessee legislature,” Ingram said. “I honestly don’t know how they sleep at night.”

Donations from more than 70 people across the state range from $10 to $4,200. Billboards can cost from a couple of hundred dollars to a couple of thousand, depending on the market. The cost of the billboards to the private donors is negligible compared to the impact Insure Tennessee would have on the state, Falls said.

TennCare pushing birth control for drug-abusing women

TennCare officials are pushing health care providers to prescribe birth control implants to mothers of children with drug dependency, reports WPLN.

The state’s prescription painkiller epidemic is the underlying problem. Babies born to mothers hooked on opiates often suffer withdrawals, known as neonatal abstinence syndrome. According to the latest figures, 93 percent of all NAS births in the state are to mothers on TennCare. The agency now spends $50 million a year on the related hospital bills as infants go through detox in a neonatal intensive care unit.

To make sure mothers don’t end up having a second child with the same condition, TennCare is prodding obstetricians to recommend long-acting birth control implants.

“We want to put in place the right incentives for that conversation to occur,” chief medical officer Vaughn Frigon says.“That’s really a conversation that’s best between the treating physician and the mother. But what we want to do is make sure that those contraceptives are available.”

TennCare has made it so doctors can get paid more for the procedure if its done while a new mother is still in the hospital. The agency has also made it easier for hospitals to keep the implants or intrauterine devices (IUD) on hand.

The latest TennCare data shows fewer women on prescribed painkillers taking birth control pills too. Among 30 to 34-year-olds, just 15 percent of those on prescribed opiates also were on contraceptives.

Women’s health groups are somewhat wary. Health officials have also been pushing birth control as women leave jail in some counties with particularly high instances of neonatal abstinence syndrome.

Pharmacy charged meds for dead to TennCare

NASHVILLE, Tenn. (AP) — A Nashville company will pay as much as $7.8 million in a settlement related to accusations that it charged Medicare and TennCare for medications for dead patients.

The Tennessean (http://tnne.ws/1MSqyYO ) reports U.S. Attorney for the Middle District of Tennessee David Rivera on Tuesday announced the settlement of the False Claims Act case involving Nashville Pharmacy Services, which specializes in dispensing HIV and AIDS medications.

According to a news release, the company billed Medicare and TennCare for medications for 15 patients after they had died and billed for medications for 22 people who didn’t have prescriptions.

The company didn’t admit liability, but will have to make contingency payments based on its revenue to the federal and state governments for the next five years. Rivera says those payments could reach $7.8 million.

Haslam eyes program to help intellectually disabled get jobs

By Lucas Johnson, Associated Press
NASHVILLE, Tenn. — Gov. Bill Haslam said Tuesday that a program to help people with intellectual disabilities find jobs makes sense, but he wants to learn more about it before investing $19 million.

The Republican governor heard from state health officials during a week of budget hearings at the state Capitol. He’s scheduled to hear from 26 state agencies as he crafts his annual spending proposal that will likely top $34 billion.

State health officials on Tuesday told Haslam that the job service would target people receiving home- and community-based services through TennCare, the state’s version of Medicaid, and that it’s part of a unique program where “employment and independent living is the first and preferred option” in assisting Tennesseans with intellectual and developmental disabilities.

Haslam told reporters following the hearing that he favors the program but wants to dig down further and understand how it will work.

“Obviously, $19 million is a big chunk of new money,” he said. “The program does make sense to me.”
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Haslam: Insure TN is still dead

Gov. Bill Haslam says gestures of support for Insure Tennessee since the last legislative session – including resolutions approved by city councils in Chattanooga and Knoxville recently – haven’t changed the hearts and minds of Republican state legislators. So he has no intention of trying for passage of the modified Medicaid expansion plan in 2016.

Gubernatorial quote from the Times-Free Press:

“There’s been a statewide effort to rally the cause, but I haven’t noticed a changing public opinion and definitely haven’t seen a change in our legislature.”

“My sense is there will be a lot of people waiting to see what happens in the ’16 presidential election — just, again, to be as honest as I can — before they’ll do that,” Haslam said. “We would still love it to happen. We still think it’s the right thing to do. Nothing I’ve seen since then (the 2015 session) has changed my mind.”

Ramsey sees ‘zero chance’ for Insure TN revival

The Tennessee Justice Center brought its campaign to revive Gov. Bill Haslam’s Insure Tennessee proposal to Kingsport this week, reports the Times-News under the headline, “Insure Tennessee is dead, but don’t tell that to advocates.”

Within the article, Lt. Gov. Ron Ramsey is quoted as saying Insure Tennessee has “zero chance” of getting through the Legislature next year.

“There’s nothing to prevent a legislator from bringing it forward,” Ramsey said of Insure Tennessee. “There’s a possibility that one of the Democrats will bring it forward, but I think most people are in the same boat I’m in, that we’re a year away from a presidential election, and things are going to change in Washington one way or the other and I think most of the Republican candidates are saying they want to give states their Medicaid money in block grants and let them design their own program with no strings attached. I think we’re one year away from that.”

Statewide TennCare fraud bust: 24 arrested

News release from Department of Finance and Administration
NASHVILLE, Tenn. – A statewide round-up of suspects has netted two dozen arrests of suspects charged with TennCare fraud. The suspects are charged in various counties on numerous TennCare fraud charges, including under-reporting income, living out of state, failing to disclose resource information and transferring property in order to qualify for TennCare, doctor shopping, presenting forged prescriptions or selling prescriptions. all received using TennCare benefits.

The Office of Inspector General (OIG) conducted a statewide roundup concluded today, with special agents fanning out across the state to crack down on those who had an outstanding warrant for TennCare fraud. The roundup is part of a new approach to take people into custody soon after an indictment by a grand jury and to locate and arrest fugitives.

“We want everyone to know that if someone is involved in committing TennCare fraud, the chance of getting caught has increased substantially,” Inspector General Manny Tyndall said. “Our office will investigate, prosecute, and arrest those who abuse the TennCare program. It should also be noted that investigations and arrests have been expedited because of the efforts of local law enforcement agencies to assist the OIG in combatting combat TennCare fraud.”

OIG Special Agent teams were positioned in all three grand divisions of the state—East, Middle, West—with a list of individuals wanted along with identifying information and warrants. The toughest task was finding the people they were trying to serve, because so many had multiple addresses.

Those arrested are:
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TennCare transition: Another contractor replaced after poor performance

TennCare has replaced the vendor that ran a problem-plagued call center for state residents checking on their Medicaid eligibility, according to The Tennessean.

The state awarded a $56.5 million contract this year to Automated Health Systems Inc. to run the Tennessee Health Connection through 2018. Previously, Cognosante LLC held a three-year contract valued at $31 million to operate the call center.

State residents had complained that the call center could not answer their questions, and the association that represents Tennessee nursing homes had notified TennCare it was not processing resident applications in a timely manner.

“This transition to a new call center vendor is another example of the state continuously improving processes and customer experience and holding our contracted vendors accountable,” said Kelly Gunderson, a spokesperson for TennCare. “This transition was seamless to our applicants and members and will result in improved customer service for our callers.”

The call center contract is separate from the $35.7 million computer system that Northrop Grumman was supposed to build for TennCare to determine Medicaid eligibility according to new income guidelines.

TennCare canceled that contract and is in the process of finding another vendor. Tennessee’s government has a history of dealing with failed computer systems across state agencies.

Haslam avoiding the president’s Nashville visit to promote Obamacare

Gov. Bill Haslam will not appear with President Obama when the nation’s leader visits Nashville Wednesday to promote the Affordable Care Act, better known as Obamacare, even though the governor is pushing use of the law to expand Medicaid in Tennessee.

Haslam spokesman David Smith — a day after a reporter’s initial inquiry on whether Haslam would attend the event – responded Tuesday with a cryptic email reply and no elaboration: “The governor is not planning to be at the airport or the event.”

A Tennessean story obseres the lack of elaboration and that Haslam has no publicly-scheduled events that would conflict with joining Haslam. (Note: Just maybe it has something to do with the governor figuring that an appearance with Obama won’t help his already poor prospects of changing Republican legislator minds on the matter?)

The newspaper also reports that U.S. Health and Human Services Secretary Sylvia Burwell, who negotiated with Haslam and his administration in approving his modified Medicaid expansion plan known as Insure Tennessee, said in an interview the president’s speech “will herald national progress on health care reforms while outlining improvements he’d still like to implement” – presumably including Medicaid expansion.

“I think it’s broadening in terms of the progress we’ve made, and turning to going forward and the progress that we can make and believe we can make together in terms of access … and affordability,” Burwell said.

More on Obama visit to Nashville

President Barack Obama will discuss his signature health care law Wednesday at Taylor Stratton Elementary School in Madison, reports The Tennessean.

Although the closed event is at a school, Obama chose a city local leaders frequently tout as the health care capital of the country for his latest speech on the Affordable Care Act.

The politics of the law, also known as “Obamacare,” might not be popular throughout Tennessee. But the Democratic stronghold of Nashville — combined with the health insurance and hospital giants that call Middle Tennessee home — offers a prominent stage for any presidential address on health care, Nashville Mayor Karl Dean said.

“Nashville is the health care management capital of the United States. This is where there are more health care management companies, there’s great health care facilities like Saint Thomas. It’s a natural place for this discussion to take place,” Dean said Monday after an event at Saint Thomas Midtown Hospital.

“People look to Nashville to find solutions about health care, so I think that’s probably why he chose to come here.”

…U.S. Rep. Jim Cooper, D-Nashville, said Monday he’s proud the president is coming back to Nashville.

“He likes coming here and it’s only an hour or so flight from Washington,” Cooper said. “And Tennessee’s a good state. He wants to make sure that we’re on the right track.”

Further from the News Sentinel:
The presidential visit to Tennessee comes just one week after the U.S. Supreme Court handed the Obama administration a major victory in a 6-3 ruling that upheld tax subsidies given to Americans to make health insurance affordable.

The decision has resulted in calls for Tennessee legislators to take another look at Gov. Bill Haslam’s failed Insure Tennessee proposal, which would provide hundreds of thousands of low-income Tennesseans with federally subsidized health care. State legislators killed the proposal during a special session earlier this year.

…Wednesday’s visit is Obama’s second to Tennessee this year. In January, he traveled to Pellissippi State Community College in Knoxville, where he proposed two years of tuition-free community college for students, and to Clinton, where he launched a manufacturing innovation hub.