Putting Medicaid in the Larger Budget Context: An In-Depth Look at Three States in FY 2015 and 2016
Alaska
McDowell Group, Inc., The Role of the Oil and Gas Industry in Alaska’s Economy - Prepared for Alaska Oil and Gas Association (Juneau, Alaska: McDowell Group, Inc., May 2014), http://www.aoga.org/sites/default/files/news/aoga_final_report_5_28_14_0.pdf.
Scott Goldsmith, Federal Spending in Alaska: Running Out of Steam? Web Note No. 11 (Anchorage, Alaska: Institution of Social and Economic Research, May 2012), http://www.iser.uaa.alaska.edu/Publications/webnote/2012_05_09-WebNote11FederalSpending.pdf.
Alaska Oil and Gas Competitiveness Review Board, Alaska’s Oil and Gas Competitiveness Report 2015 (Alaska Oil and Gas Competitiveness Review Board, February 27, 2015), http://dor.alaska.gov/Oil-Gas-Competitiveness-Review-Board.
Bureau of Economic Analysis, Regional Data – GDP & Personal Income, “Real GDP in chained dollars 2007-2014” accessed September 24, 2015. http://www.bea.gov/iTable/iTable.cfm?reqid=70&step=1&isuri=1&acrdn=1#reqid=70&step=1&isuri=1.
Caroline Shultz, “Employment Forecast for 2015, Statewide,” Alaska Economic Trends 35, no. 1 (Jan 2015): 4-7, http://labor.state.ak.us/trends/jan15.pdf.
Alaska Department of Revenue, Revenue Sources Book Spring 2015 (Alaska: Alaska Department of Revenue Tax Division, April 3, 2015), http://www.tax.alaska.gov/programs/documentviewer/viewer.aspx?1143r.
“Fiscal 50: State Trends and Analysis,” The Pew Charitable Trusts, accessed June 11, 2015, http://www.pewtrusts.org/en/multimedia/data-visualizations/2014/fiscal-50#ind0.
Gunnar Knapp, An Introduction to Alaska Fiscal Facts and Choices - Prepared for presentation at Building a Sustainable Future: Conversation with Alaskans (Anchorage, Alaska: University of Alaska Anchorage Institute of Social and Economic Research, June 5, 2015), http://gov.alaska.gov/Walker_media/documents/20150605_an-introduction-to-alaska-fiscal-facts-and-choices.pdf.
Another unusual aspect of Alaska’s budget is revenue generated from investment activity, representing over 46 percent of total revenue in 2014. Alaska’s total reserves, approximately $64 billion, are comprised of three funds: Permanent Fund, Statutory Budget Reserve Fund ($1.65 billion), and the Constitutional Budget Reserve Fund ($10.13 billion). The Permanent Fund, which accounts for 90 percent of investment earnings, provides direct payouts in the form of dividends to Alaskan residents. In June 2015, Alaska’s Permanent Fund reserves totaled $52.8 billion after accounting for the dividend transfer. Only about 2.4 percent of investment income from the funds accrued to unrestricted General Fund in 2014 for state funded services.
Alaska Permanent Fund Corporation, Fund News – Permanent Fund up 4.9 percent (Alaska: Alaska Permanent Fund Corporation, August 20, 2015), http://www.apfc.org/home/Content/pressroom/pressStory2009.cfm?story=Permanent%20Fund%20up%204%2E9%20percent&s=1&i=606.
Alaska Office of the Governor, Governor Walker Signs Budget Bills into Law: FY16 $1.1 Billion Less than FY15; $200 Million Vetoed (Juneau, Alaska: Alaska Office of the Governor, July 1, 2015), https://www.omb.alaska.gov/ombfiles/16_budget/PDFs/PR_15-90_Governor_Walker_Signs_Budget_Bills_into_Law_07012015.pdf.
This assumes the state does not utilize reserves from the Permanent Fund. The state’s constitution, which established the fund, prohibits utilizing the principal, but does not prohibit use of earnings for funding state operations.
Alaska Office of the Governor, State of the Budget Speech (Juneau, Alaska: Alaska Office of the Governor, January 22, 2015), http://gov.alaska.gov/Walker/press-room/full-press-release.html?pr=7061.
Alaska Office of the Governor, Medicaid Reform and Expansion Gains Support (Juneau, Alaska: Alaska Office of the Governor, April 9, 2015), http://gov.alaska.gov/Walker/press-room/full-press-release.html?pr=7120.
Alaska Office of the Governor, Governor Releases Amended Endorsed Budget (Juneau, Alaska: Alaska Office of the Governor, February 5, 2015), http://gov.alaska.gov/Walker/press-room/full-press-release.html?pr=7072.
Alaska Office of the Governor, Governor Walker Introduces Medicaid Bill (Juneau, Alaska: Alaska Office of the Governor, March 17, 2015), http://gov.alaska.gov/Walker/press-room/full-press-release.html?pr=7098.
The Alaska House Majority, Finance Committee Tables Medicaid Expansion Bill (Juneau, Alaska: Alaska House Majority, May 14, 2015), Accessed at: http://www.housemajority.org/2015/05/14/finance-committee-tables-medicaid-expansion-bill/.
Alaska Office of the Governor, Governor Walker Signs Budget Bills into Law (Juneau, Alaska: Alaska Office of the Governor, July 2015), http://gov.alaska.gov/Walker/press-room/full-press-release.html?pr=7261.
The Alaska House Majority, Alaska Legislature Takes Governor to Court Over Unconstitutional Action (Juneau, Alaska: Alaska House Majority, August 18, 2015), Accessed at: http://www.housemajority.org/2015/08/18/alaska-legislature-takes-governor-to-court-over-unconstitutional-action/.
Associated Press, “Judge rejects call to block Alaska governor from expanding Medicaid,” Modern Healthcare (August 28, 2015,) http://www.modernhealthcare.com/article/20150828/NEWS/308289998?utm_source=modernhealthcare&utm_medium=email&utm_content=20150828-NEWS-308289998&utm_campaign=financedaily.
Alaska Office of the Governor, Administration Implements Healthy Alaska Plan (Juneau, Alaska: Alaska Office of the Governor, September 1, 2015), http://gov.alaska.gov/Walker/press-room/full-press-release.html?pr=7259.
It is one of two states (Hawaii is the other) for which the federal government adjusts its calculation of the federal poverty level to account for an elevated cost of living. In 2015, the federal poverty level for a family of three is $20,090 for 48 states and D.C. For Alaska that level is set at $25,120, about 25 percent higher.
Office of the Assistant Secretary for Planning and Evaluation, 2015 Poverty Guidelines (Washington, DC: U.S. Department of Health and Human Services, September 2015), http://aspe.hhs.gov/2015-poverty-guidelines.
Alaska Department of Health and Social Services, The Healthy Alaska Plan: A Catalyst for Reform (Alaska: Alaska Department of Health and Social Services, February 2015), http://dhss.alaska.gov/HealthyAlaska/Documents/Healthy_Alaska_Plan_FINAL.pdf.
Ibid.
Ibid.
Alaska Health Care Commission, Findings on Health Care Cost, Pricing and Reimbursement in Alaska (Alaska: Alaska Health Care Commission), http://dhss.alaska.gov/ahcc/Documents/AHCCFindings-HealthCareCosts.pdf.
Ibid.
“Alaska Medicaid Coordinated Care Initiative (AMCCI),” Alaska Department of Health and Social Services Division of Health Care Services, accessed October 6, 2015, http://dhss.alaska.gov/dhcs/Pages/amcci/default.aspx.
Deb Taylor, PK Wilson, Terri Gagne and Clarissa Moon, Alaska Medicaid Coordinated Care Initiative – PowerPoint Presentation for January – March 2015 Stakeholder Meetings (Alaska: Department of Health and Social Services Alaska Division of Health Care Services, March 17, 2015), http://www.alaskaccn.com/files/QuickSiteImages/Alaska_Medicaid_Coordinated_Care_Initiative__Overview__2015-03-17.pdf.
Alaska Department of Health and Social Services, Agnew::Beck Consulting, Health Management Associates and Milliman Inc., Medicaid Redesign and Expansion in Alaska: Environmental Assessment, Partner Input and Next Steps PowerPoint Presentation (Alaska: Alaska Department of Health and Social Services, September 2, 2015), http://dhss.alaska.gov/HealthyAlaska/Documents/redesign/MCDRE%20Webinar%20Update%20on%20Round%201%20Session%209-2-15.pdf.
Health Management Associates, Healthy Alaska Plan: Preliminary Draft Environmental Assessment Appendices (Health Management Associates, August 31, 2015). http://dhss.alaska.gov/HealthyAlaska/Documents/redesign/Preliminary%20Draft%20Environmental%20Assessment_APPENDICES_9-1-15_HMA_FINAL.pdf.
Alaska Office of the Governor, Administration Implements Healthy Alaska Plan (Juneau, Alaska: Alaska Office of the Governor, September 1, 2015), http://gov.alaska.gov/Walker/press-room/full-press-release.html?pr=7259.
Alaska Department of Health and Social Services, Request for Proposals: RFP 06 160000002 (Anchorage, Alaska: Department of Health and Social Services, July 14, 2015), https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=177572.
Alaska Department of Health and Social Services, Request for Proposals: RFP 2015-0600-3125 (Anchorage, Alaska: Department of Health and Social Services, April 30, 2015; https://aws.state.ak.us/OnlinePublicNotices/Notices/View.aspx?id=176626.
California
Mac Taylor, The 2015-16 Budget: California’s Fiscal Outlook. (Sacramento, California: California’s Legislative Analyst’s Office, November 2014), http://www.lao.ca.gov/reports/2014/budget/fiscal-outlook/fiscal-outlook-111914.pdf.
Bureau of Labor Statistics, State and Area Employment, Hours, and Earnings from the Current Employment Statistics Survey, “Total Nonfarm Employment (Series ID: SMS06000000000000001) December 2007 through August 2015”accessed October 6, 2015, http://data.bls.gov/cgi-bin/dsrv.
“Economy at a Glance,” Bureau of Labor Statistics, accessed October 6, 2015, http://www.bls.gov/eag/eag.ca.htm.
Bureau of Labor Statistics, Employment, Hours, and Earnings from the Current Employment Statistics Survey, accessed October 6, 2015, http://data.bls.gov/cgi-bin/dsrv.
“Economy at a Glance,” Bureau of Labor Statistics, accessed October 6, 2015, http://www.bls.gov/eag/eag.ca.htm.
The Kaiser Family Foundation State Health Facts. Data Source: States Continue to Feel Recession’s Impact (Washington, DC: Center for Budget and Policy Priorities, June 27, 2012), accessed September 29, 2015, https://www.kff.org/state-category/demographics-and-the-economy/state-fiscal-distress/.
California State Controller’s Office, Bottom Line: What the Numbers Mean (California: California State Controller’s Office, July 10, 2014), http://www.sco.ca.gov/eo_2014_07_summary_analysis_numbers.html.
California Department of Finance, California State Enacted Budget Summary 2013-2014 (California: California Department of Finance), http://www.ebudget.ca.gov/home.php?selectedYear=2013-14.
California Department of Finance, California 2015-2016 State Enacted Budget (California: California Department of Finance), http://www.ebudget.ca.gov/home.php?selectedYear=2015-16.
California Department of Finance, California State Budget Summary 2015-2016 (May Revision). (California: California Department of Finance), http://www.ebudget.ca.gov/home.php?selectedYear=2015-16.
U.S. Census Bureau, 2010 American Community Survey 1-Year Estimates, “Health Insurance Coverage Status (S2701),” accessed October 6, 2015, http://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_10_1YR_S2701&prodType=table.
For LIHP beneficiaries with incomes at or below 133% FPL, federal funds were available to match county expenditures at the state’s regular federal medical assistance percentage (FMAP) rate. Matching funds were not capped for these beneficiaries because the state could have covered this optional group without a waiver. However, counties had the option to expand coverage up to 200% FPL; counties had the option to cap enrollment for these beneficiaries since federal funds were only available to match county expenditures up to a maximum $630 million for those over 133% FPL.
California Department of Health Care Services, Medi-Cal 2020: Key Concepts for Renewal (California: California Department of Health Care Services, March 27, 2015), http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ca/ca-bridge-to-health-reform-pa.pdf.
California Department of Health Care Services, California’s Low-Income Health Program Transitions Hundreds of Thousands of New Members to Medi-Cal (DHCS) News Release (California: California Department of Health Care Services, December 31, 2013), http://www.dhcs.ca.gov/formsandpubs/publications/opa/Documents/2013/13-07%20LIHP%20Medi-Cal%20Expansion%2012-31-13%20Final%20Version.pdf.
Ibid.
Ibid.
Rachel Garfield, Melissa Majerol and Katherine Young, Coverage Expansions and the Remaining Uninsured: A Look at California During Year One of ACA Implementation (Washington, DC: Kaiser Family Foundation, May 2015), https://www.kff.org/health-reform/report/coverage-expansions-and-the-remaining-uninsured-a-look-at-california-during-year-one-of-aca-implementation/.
Ibid.
Centers for Disease Control and Prevention, “National Health Interview Survey Early Release Program,” State Tables 2013 and 2014. Available at: http://www.cdc.gov/nchs/data/nhis/earlyrelease/State_estimates_insurance_2013_2014.pdf.
Rachel Garfield, Melissa Majerol and Katherine Young, Coverage Expansions and the Remaining Uninsured: A Look at California During Year One of ACA Implementation (Washington, DC: Kaiser Family Foundation, May 2015), https://www.kff.org/health-reform/report/coverage-expansions-and-the-remaining-uninsured-a-look-at-california-during-year-one-of-aca-implementation/.
Jocelyn Guyer, Naomi Shine, Robin Rudowitz and Alexandra Gates, Key Themes From Delivery System Reform Incentive Payment (DSRIP) Waivers in 4 States (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, April 2015), https://www.kff.org/medicaid/issue-brief/key-themes-from-delivery-system-reform-incentive-payment-dsrip-waivers-in-4-states/.
California Department of Health Care Services, Medi-Cal 2020: Key Concepts for Renewal (California: California Department of Health Care Services, March 27, 2015), http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ca/ca-bridge-to-health-reform-pa.pdf.
Jocelyn Guyer, Naomi Shine, Robin Rudowitz and Alexandra Gates, Key Themes From Delivery System Reform Incentive Payment (DSRIP) Waivers in 4 States (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, April 2015), https://www.kff.org/medicaid/issue-brief/key-themes-from-delivery-system-reform-incentive-payment-dsrip-waivers-in-4-states/.
Centers for Medicare & Medicaid Services, Managed Care in California (Washington, DC: Centers for Medicare & Medicaid Services, 2014), http://www.medicaid.gov/medicaid-chip-program-information/by-topics/delivery-systems/managed-care/downloads/california-mcp.pdf.
California Department of Health Care Services, Medi-Cal Managed Care Program Fact Sheet - Managed Care Models (California: California Department of Health Care Services), http://www.dhcs.ca.gov/provgovpart/Documents/MMCDModelFactSheet.pdf.
California Department of Health Care Services, Medi-Cal 2020: Key Concepts for Renewal (California: California Department of Health Care Services, March 27, 2015), http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ca/ca-bridge-to-health-reform-pa.pdf.
The expansion excluded dual eligible beneficiaries (i.e., those enrolled in Medi-Cal and Medicare) as well as beneficiaries receiving long-term care services.
California Department of Health Care Services, Medi-Cal 2020: Key Concepts for Renewal (California: California Department of Health Care Services, March 27, 2015), http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/ca/ca-bridge-to-health-reform-pa.pdf.
Kaiser Commission on Medicaid and the Uninsured, California's"Bridge to Reform" Medicaid Demonstration Waiver (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, October 2011), https://www.kff.org/health-reform/fact-sheet/californias-bridge-to-reform-medicaid-demonstration-waiver/.
California Department of Health Care Services, Managed Care Implementation For Seniors And Persons With Disabilities Monitoring Dashboard (California: California Department of Health Care Services, January 2013), http://www.dhcs.ca.gov/individuals/Documents/MMCD_SPD/ChartsRptsData/SPD_Dashboard_Jan2013.pdf
Carrie Graham, Elaine Kurtovich, Stephanie Taube, Lhasa Ray and Rachel Arguello, Transitioning Beneficiaries with Complex Care Needs to Medicaid Managed Care: Insights from California. (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, July 2013), https://www.kff.org/medicaid/issue-brief/transitioning-beneficiaries-with-complex-care-needs-to-medicaid-managed-care-insights-from-california/.
Carrie Graham, Diana McDonnel, Kira Foster and Susan Ivey, The Transition of Senior and People with Disabilities to Medi-Cal Managed Care: The beneficiary perspective – Prepared for the California HealthCare Foundation and the California Department of Health Care Services (California: Health Research for Action at the University of California – Berkley, March 2014), http://www.healthresearchforaction.org/sites/default/files/SPDTransitions_FNL_Rpt_Web%20Mar%2014.pdf.
“Seniors & Persons with Disabilities (SPD) Regional and Imperial Model Implementation,” California Department of Health Care Services, accessed September 3, 2015, http://www.dhcs.ca.gov/individuals/Pages/SPDRegional_Imperial_Imp.aspx.
Kaiser Commission on Medicaid and the Uninsured, Health Plan Enrollment in the Capitated Financial Alignment Demonstrations for Dual Eligible Beneficiaries. (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, August 2015), https://www.kff.org/medicaid/fact-sheet/health-plan-enrollment-in-the-capitated-financial-alignment-demonstrations-for-dual-eligible-beneficiaries/.
California Department of Health Care Services, Cal Medi-Connect Monthly Enrollment Dashboard (California: California Department of Health Care Services, July 2015), http://www.calduals.org/wp-content/uploads/2015/07/CMC-Enrollment-Dashboard-July-2015-Final.pdf.
California Department of Health Care Services. Coordinated Care Initiative Executive Summary (California: California Department of Health Care Services, August 2013), http://www.calduals.org/wp-content/uploads/2014/04/1-CCI-Overview_April2014.pdf.
One of the federal requirements related to the use of provider taxes in Medicaid requires that the tax be broad-based. Currently the state taxes MCOs on the revenue received from their Medi-Cal managed care plans only.
For more information on the tax, see the following LAO brief:
California Legislative Analyst’s Office, Overview of MCO Tax, Selected Other Tax Increase Options, and IHSS Issues (California: California Legislative Analyst’s Office, July 2015), http://www.lao.ca.gov/handouts/health/2015/Overview-of-MCO-Tax-070215.pdf.
For further information on the requirements see the following brief:
Kaiser Commission on Medicaid and the Uninsured, Medicaid Financing Issues: Provider Taxes (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, May 2011), https://www.kff.org/medicaid/fact-sheet/medicaid-financing-issues-provider-taxes/.
This change, Substance Abuse Services moving to an Organized Delivery System operated by counties, is described in the main Budget Survey Report as movement to a PHP arrangement in FY 2016, because in federal terms the program falls under a PIHP. However, the state notes this arrangement isn’t a PIHP in a traditional sense.
Tennessee
Bureau of Labor Statistics, State and Area Employment, Hours, and Earnings from the Current Employment Statistics Survey, “Total Nonfarm Employment (Series ID: SMS47000000000000001) December 2007 through August 2015”accessed October 6, 2015, http://data.bls.gov/cgi-bin/dsrv.
Tennessee Department of Labor & Workforce Development, Tennessee’s Unemployment Rate for July 5.7% (Tennessee: Tennessee Department of Labor & Workforce Development, August 20, 2015), https://www.tn.gov/workforce/news/17178.
“Economy at a Glance,” Bureau of Labor Statistics, accessed October 6, 2015, http://www.bls.gov/regions/southeast/tennessee.htm#eag.
Center for Business and Economic Research, Tennessee Business and Economic Outlook: Spring 2015 (Knoxville, Tennessee: Center for Business and Economic Research, 2015), http://cber.bus.utk.edu/tefs/spr15.pdf.
Tennessee Department of Finance and Administration, July Revenues (Tennessee: Tennessee State Government, August 13, 2014), https://www.tn.gov/news/16951.
Governor Bill Haslam, The Budget: Fiscal Year 2015-2016 (Tennessee: Office of the Governor, February 2014), http://tn.gov/assets/entities/finance/budget/attachments/2016BudgetDocumentVol1.pdf.
Ibid.
The new eligibility limits apply to CHOICES Group 3, which covers adults who don’t qualify for a nursing facility level of care, but need in home supports to delay or prevent the need for nursing facility care; individuals determined eligible using institutional eligibility standards are to be grandfathered.
“To Qualify for CHOICES,” TennCare Division of Health Care Finance & Administration, accessed October 6, 2015, https://www.tn.gov/tenncare/article/to-qualify-for-choices.
Staff Report, “7 things that Gov. Haslam’s budget would do in Tennessee,” The Tennessean (February 10, 2015,) http://www.tennessean.com/story/news/politics/2015/02/09/budget-highlights-tennessee-haslam-2015-2016/23148499/.
Erik Schelzig, “Legislature approves Haslam’s $33.8B budget,” knoxblogs.com, http://wapp.capitol.tn.gov/apps/BillInfo/default.aspx?BillNumber=HB1374&GA=109 /.
Chris Kardish, “Why Medicaid Expansion Has Reached a Standstill,” Governing (April 2015,) http://www.governing.com/topics/health-human-services/gov-medicaid-expansion-standstill.html.
Tennessee Division of Health Care Financing and Administration, Insure Tennessee (Tennessee: Tennessee Division of Health Care Financing and Administration), https://www.tn.gov/tenncare/article/insure-tennessee.
Kaiser Commission on Medicaid and the Uninsured, Proposed Medicaid Expansion in Tennessee (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, January 2015), https://www.kff.org/medicaid/fact-sheet/proposed-medicaid-expansion-in-tennessee/.
Andy Sher, “Gov. Haslam's Insure TN plan hits fierce opposition from Republicans in House, Senate committees,” Times Free Press (February 4, 2015,) http://www.timesfreepress.com/news/local/story/2015/feb/04/gov-haslams-insure-tn-plan-hits-fierce-opposition-republicans-house-senate-committees/286385/.
The Kaiser Family Foundation State Health Facts. Data Source: Tricia Brooks, Joe Touschner, Samantha Artiga, Jessica Stephens and Alexandra Gates, Modern Era Medicaid: Findings from a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP as of January 2015 (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, January 20, 2015), accessed September 29, 2015, https://www.kff.org/health-reform/state-indicator/medicaid-income-eligibility-limits-for-adults-as-a-percent-of-the-federal-poverty-level/.
Northrop Grumman, Northrop Grumman Selected to Set Up, Sustain Tennessee's Medicaid and Children's Health Insurance Eligibility System (McLean, Virginia: Northrop Grumman, July 9, 2013), http://phx.corporate-ir.net/phoenix.zhtml?c=112386&p=irol-newsArticle&ID=1836280.
“How Do I Apply for TennCare?” Tennessee Division of Health Care Finance & Administration, accessed October 6, 2015, https://www.tn.gov/tenncare/topic/how-to-apply.
Southern Poverty Law Center, SPLC Lawsuit: Tennessee Deprives Residents of Medicaid Coverage (Montgomery, Alabama: Southern Poverty Law Center, July 22, 2014), https://www.splcenter.org/news/2014/07/23/splc-lawsuit-tennessee-deprives-residents-medicaid-coverage.
“How to file an eligibility appeal?” Tennessee Division of Health Care Finance & Administration, accessed October 6, 2015, https://www.tn.gov/tenncare/topic/how-to-file-an-eligibility-appeal.
Tennessee State Government, Tennessee to Go in New Direction for Medicaid Eligibility Determination System (Tennessee: Tennessee State Government, January 12, 2015), https://news.tn.gov/node/13420.
In 2015, TennCare MCOs include BlueCare Tennessee, UnitedHealthcare and Wellpoint; BlueCare also operates TennCare Select.
CMS approved an amendment to Tennessee’s Section 1115 waiver July 23, 2009, to incorporate long term services and supports into comprehensive managed care, implementing Tennessee’s Long Term Care Community Choices Act of 2008.
Tennessee State Government, TennCare Receives Federal Approval for Long-Term Care Community Choices Act (Tennessee: Tennessee State Government, July 23, 2009), https://news.tn.gov/node/2273.
Bureau of TennCare, Budget Reductions/Impact for July 1, 2015 - Memorandum to TennCare Managed Care Organizations (Nashville, Tennessee: Department of Finance and Administration, June 4, 2014), https://www.uhccommunityplan.com/content/dam/communityplan/healthcareprofessionals/providerinformation/TN-Provder-Information/TN_MCO_Budget_Reduction_Notice.pdf.
“Episodes of Care,” Tennessee Division of Health Care Finance & Administration, accessed October 6, 2015, http://www.tn.gov/hcfa/topic/episodes-of-care.
Bureau of TennCare, Budget Reductions/Impact for July 1, 2015 - Memorandum to TennCare Managed Care Organizations (Nashville, Tennessee: Department of Finance and Administration, June 4, 2014), https://www.uhccommunityplan.com/content/dam/communityplan/healthcareprofessionals/providerinformation/TN-Provder-Information/TN_MCO_Budget_Reduction_Notice.pdf.
Ibid.
Incarcerated individuals in a suspended status are eligible for inpatient hospitalizations to be reimbursed by TennCare and not billed to the correctional facility.
