Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Government
December 19, 2016 12:00 AM

Renewed Tennessee Medicaid waiver will limit uncompensated-care funds

Virgil Dickson
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Tennessee Gov. Bill Haslam tried and failed to expand Medicaid last year.

    The Obama administration and Tennessee officials have broken their impasse over the future of federal funding that subsidizes uncompensated care provided by the state's hospitals.

    The funding pool is part of a larger waiver that allows the state to continue its Medicaid managed-care model, known as TennCare. Disagreements about the structure and amount of uncompensated-care funding has held up the renewal of the entire waiver for six months.

    TennCare was authorized in 2002 under a Section 1115 waiver that expired June 30 but has been extended several times. The CMS has now agreed to extend the waiver through June 30, 2021.

    Under the new agreement, the CMS will continue the uncompensated-care payments through June 30, 2017, at current levels, which have averaged around $500 million a year.

    During a one-year transition period, the total possible payments will ramp up to $708 million.

    After that, Tennessee must submit a revised methodology for distributing the money that limits the subsidies to care provided to people who wouldn't be eligible for Medicaid if the state agreed to expand the program under the Affordable Care Act.

    “Coverage is the best way to assure beneficiary access to healthcare for low income individuals, and uncompensated care pool funding should not pay for costs that would otherwise be covered in a Medicaid expansion,” Eliot Fishman, director of the CMS' State Demonstrations Group wrote in a letter to the state in November 2015.

    Tennessee hospitals are nervous about how the allocations will change. It's "a whole new ballgame with a new distribution system of funding for hospitals," said Craig Becker, CEO of the Tennessee Hospital Association. "We have some concerns about precisely how this will work, but we have a couple of years to work with state and federal officials to nail down details and secure needed funding for hospitals in the state."

    The CMS has increasingly resisted paying for healthcare for the uninsured now that most of them have access to coverage under the Affordable Care Act. That issue has been an obstacle to renewing waivers in other states, including California, Florida and Texas.

    California, Florida, Tennessee and Texas have heavily relied on uncompensated-care pools under Medicaid waivers.

    Last summer, Tennessee hired a consulting group at the request of the CMS to analyze the need for the pool. The firm found the funding remained critical to ensure access to care and would be necessary even if the state expanded Medicaid.

    “Even with Medicaid expansion, at least $229 million in uncompensated-care shortfall remains,” concluded the March 2016 report by the Public Consulting Group.

    Last year, the Tennessee Legislature rejected a proposal by Republican Gov. Bill Haslam to extend Medicaid coverage to 280,000 low-income residents.

    New attempts to expand Medicaid in Tennessee or in any other state are unlikely with the incoming Trump administration committed to repealing the Affordable Care Act.

    It's unclear how the new administration will view the uncompensated-care pools, but Republican congressional leaders and President-elect Donald Trump's pick for HHS secretary, U.S. Rep. Tom Price (R-Ga.), have signaled they are eager to restructure Medicare and Medicaid. It would be possible for either the administration or the state to initiate new negotiations on the waiver.

    TennCare members mostly are low-income pregnant women, children and people who are elderly or have a disability. The program covers approximately 20% of the state's population, 50% of the state's births and 50% of the state's children.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    Abortion clinic
    Idaho hospital halts obstetrical care as abortion laws become stricter
    mh_20160711p29_bills_i.jpg
    State, local governments pay off medical debt relief with COVID funds
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Modern Healthcare Alert: Sign up for this breaking news email to be kept in the loop as urgent healthcare business news unfolds.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing