Feds expected to extend TennCare talks
State officials expect to get an extension from federal officials to continue negotiations about TennCare, Tennessee's Medicaid program and costs of care for people who are uninsured.
Officials submitted a waiver extension request to the U.S Centers for Medicare and Medicaid Services on Dec. 22 — a routine process to get approval to run the program. The existing waiver ends on June 30.
Discussions have been ongoing, and include industry stakeholders, as the state looks to extend its current program. State and federal officials are concurrently negotiating the future of uncompensated care pools, which help hospitals offset costs. An extension of negotiations has been expected, observers said.
"We have been in conversations with CMS and, as expected, we anticipate a short-term extension will be granted in order to finalize any negotiations of terms regarding a more permanent waiver extension," said Kelly Gunderson, spokeswoman for TennCare.
Industry officials are closely monitoring the negotiations around the uncompensated care pools, some of which are federally funded, and Tennessee's disproportionate share hospitals (DSH) allotment — a mechanism by which the hospitals receive funding to help offset uncompensated care. The state's DSH allotments were established to help hospitals offset uncompensated care, or charity care for those who need treatment but cannot pay and are uninsured.
Uncompensated care pools have come under review by federal officials over the last year because more people were supposed to be covered under expanded Medicaid programs using federal funds under the Affordable Care Act. Insure Tennessee, Gov. Bill Haslam's coverage plan using federal Medicaid funding, failed in the 2015 and 2016 legislative sessions.
Discussions with federal officials about the uncompensated care pools are expected to continue in the coming weeks. Earlier this month, Gunderson said the agency did not expect a change to the DSH allotment but that "some of the other pools may look different."
In addition to the talks with CMS officials about TennCare and the uncompensated care pools the 3-Star Healthy Project, commissioned by House Speaker Beth Harwell, met with CMS officials this week about a two-phase proposal that focuses on finding ways to address the needs of uninsured veterans and those struggling with behavioral health issues.
TennCare entered into its 23rd year in 2016. The first half of its existence was marked by financial difficulties.
Darin Gordon, director and deputy commissioner of Health Care Finance and Administration in 2006, is leaving the post on June 30. Dr. Wendy Long, currently TennCare's chief medical officer, will take over.
A CMS spokesman did not respond to an inquiry about the status of the negotiations.
Reach Holly Fletcher at 615-259-8287 or on Twitter @hollyfletcher.