TennCare, the state’s Medicaid program received a second extension on its operating agreement with the federal government last week. The two sides have been unable to compromise over an accounting rule, which could cost the state 400-million dollars over three years.
The federal government wants local governments to stop using Medicaid dollars to pay hospitals for losses incurred from caring for both Medicaid patients and the uninsured. Those dollars are called ‘certified public expenditures.’ The government agreed to not implement the rule until next May, but has tried to cap the amount of those dollars in TennCare.
Tennessee’s congressional delegation sent a letter last week to the federal Medicaid agency saying the move was unfair. U-S Senator Bob Corker, who dealt with TennCare while he was state finance commissioner, says the Tennessee delegation has been working hard on the negotiations.
“The issue still continues to be this Certified Public expenditure issue and the federal government wants to put a cap on that and obviously we don’t want that to happen and the level at which TennCare’s operated already is way within the federal budget cap for Tennessee.”
TennCare enrollees will continue to keep their coverage while the two sides negotiate, but the long awaited reopening of the medically needy category will be delayed. That category is for those nearly bankrupted by high medical bills.
TennCare operates under a waiver from the federal Medicaid program, which allows it to, among other things, expand eligibility to those above poverty levels. That waiver expired June 30th but has been extended through August 15th.