Tennessee Governor-Elect ‘Vows’ To Restore Benefits To Eligible Beneficiaries Removed from TennCare
Tennessee Gov.-elect Phil Bredesen (D) has said he will help restore benefits to individuals who lost benefits under TennCare, Tennessee's Medicaid managed care program, but still remain eligible, the Memphis Commercial Appeal reports (Wade, Memphis Commercial Appeal, 12/6). The state has been conducting an eligibility reverification process, required by a waiver approved earlier this year by the federal government that allows the state to restructure TennCare eligibility and benefits. The waiver requires TennCare to reverify all non-Medicaid-eligible beneficiaries' eligibility; about 159,000 current beneficiaries are expected to be found ineligible under the new guidelines, according to state officials. The state sent out three batches of letters, beginning in July, asking beneficiaries to complete the reverification process at their local Department of Health Services office within 90 days. Beneficiaries who fail to respond to the reverification notices will be dropped from the program; many other beneficiaries will lose benefits under the program's new qualifications (Kaiser Daily Health Policy Report, 12/6). According to the Commercial Appeal, the reverification process "has been plagued" by understaffing, congested phone lines, computer outages and "other problems." State officials said they have added phone lines, hired additional staff and tried "various forms of outreach" to make sure beneficiaries were contacted (Memphis Commercial Appeal, 12/6). So far, 138,410 beneficiaries have lost benefits; more than 17,000 beneficiaries have appealed. TennCare advocates estimate 225,000 beneficiaries will lose their benefits when the process is complete, and many of them will still be eligible for the program because of health problems that will prevent them from buying private insurance (Kaiser Daily Health Policy Report, 12/6). Bredesen called the reverification process "clearly flawed," adding, "If someone is genuinely eligible for and needs TennCare under the new program and was dropped from the rolls because somehow they failed to go through the morass of that system, they should be able to get back on." However, Bredesen added that he does not know what the procedure to get eligible beneficiaries back in TennCare "is going to look like." Tony Garr, executive director of the Tennessee Health Care Campaign, said, "I'm so glad that he recognizes that eligible people are being cut off the program. That acknowledgment, in and of itself, is worth a lot. I applaud the governor-elect for making that consideration, and I hope he'll involve the advocates in getting it done" (Memphis Commercial Appeal, 12/6).
TennCare Reverification Deadline Must Be Extended, Editorial Says
It is "clear" that the Tennessee Department of Human Services "is not equipped to cut TennCare rolls" without removing beneficiaries "who deserve to remain" on the program, but TennCare officials "show no inclination to delay the process so they can fix the problem," a Memphis Commercial Appeal editorial states. It is "impossible to tell" how many beneficiaries were removed from TennCare because of "bureaucratic error," inability to "get through to DHS offices" or failure to receive information about the process, the Appeal contends. Many of the beneficiaries removed from TennCare have mental conditions that make the reverification process "difficult and complex," and resources to help those beneficiaries through the process "have not been adequate," the editorial says. "Despite acknowledgments by DHS workers that they have been overwhelmed by heavy caseloads, department officials have rejected calls for an extension," according to the editorial. The Appeal concludes, "The TennCare re-certification process needs to be extended now, so it can be done right" (Memphis Commercial Appeal, 12/7).