Tennessee Leads the Way by Being the First State to Propose Receiving Federal Medicaid Funding Through a Block Grant

Tennessee became the first state in the nation Tuesday to propose that $7.9 billion in federal funding for the state’s Medicaid program, known as TennCare, would be provided through a block grant.

The release of the 34-page proposal, TennCare II Demonstration Amendment 42, begins a 30-day public comment period, which will end on October 18, 2019.

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Tennessee’s Legal Counsel Asks Entire Sixth Circuit Court of Appeals to Reconsider Dismissal of Challenge to Refugee Resettlement Program

The Thomas More Law Center (TMLC) and Bursch Law PLLC filed a petition for rehearing by the entire Sixth Circuit Court of Appeals bench of a two-judge panel opinion dismissing Tennessee’s challenge to the constitutionality of the federal refugee resettlement program for lack of standing.

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Audit: Tennessee Taxpayers Lose Huge Sum After Nursing Home Inflates Expenses

  Tennessee taxpayers lost more than $3 million after a corporate-run nursing facility billed the state that much money for expenses not covered under Medicaid. This, according to a new audit Tennessee Comptrollers released this week. That corporation, AltaCare, is based out of Alpharetta, Georgia, according to Comptrollers. “The audit found that AltaCare included $3,224,767.49 of nonallowable home office expenses on the cost reports it submitted to the State of Tennessee,” Comptrollers wrote. “Cost reports are used to calculate a nursing facility’s Medicaid reimbursement rate and should only include expenses that are reasonable, allowable, and in accordance with state and federal rules, regulations, and reimbursement principles. Auditors determined that AltaCare’s home office cost reports submitted in 2014, 2015, and 2016 each contained nonallowable amounts. These included legal expenses, unsupported expenses, late fees, penalties, expenses not related to AltaCare, and donations.” Auditors also found that certain personal expenses of AltaCare’s director, Doug Mittleider, were also included on the 2015 cost report. These included expenses for his wife’s flight from Sanborn, New York to France, church donations, a veterinarian expense, a guitar center purchase, and other unspecified personal expenses, according to Comptrollers. “Because the home office cost reports include amounts allocated to…

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California Lawmakers Move to Expand Medicaid for Illegal Immigrants

by Kaylee Greene   The California Assembly voted 44-11 in favor of a bill last week that broadens state Medicaid coverage to include illegal immigrants to the tune of more than $3 billion annually. Under federal law, Medi-Cal, the state’s Medicaid program, provides health care to low-income citizens. Assembly Bill 4, if passed, would eliminate the existing citizenship requirements to receive benefits. The bill would “extend eligibility for full-scope Medi-Cal benefits to individuals of all ages, if otherwise eligible for those benefits, but for their immigration status, and would delete provisions delaying eligibility and enrollment.” In other words, under AB 4, illegal immigrants over 19 years old would receive the same full scope Medi-Cal benefits as taxpaying citizens, including keeping their chosen primary care provider. Though the proposal now travels to the state Senate, there is still debate among Democrats about which illegal immigrants should qualify for these benefits. Democratic Gov. Gavin Newsom, concerned over the $3.4 billion yearly increase from the bill, has advocated extending coverage for illegal aliens who are between 19 and 25 years old, costing about $98 million annually. His 2019-2020 budget already proposes $22.9 billion for Medi-Cal from the general fund of $100.7 billion. The…

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U.S. Rep. Green Introduces Bill to Allow States to Pilot Programs in Which Medicaid Recipients Use Swipe Card to Make Medical Purchases

  U.S. Rep. Dr. Rep. Mark Green (R-TN-07) on Tuesday introduced a bill to give Medicaid recipients more choice and power in their healthcare decisions. The Medicaid Improvement and State Flexibility Act would authorize states to begin pilot programs giving Medicaid recipients a “swipe card” with dollars on it designated for medical purchases, Green said in a press release. What is not spent from the card is returned to the holder at year’s end in the form of an Earned Income Tax Credit. Coupled with a catastrophic insurance plan, this ensures Medicaid recipients a safety net while at the same time introducing competition into the healthcare market that will improve the quality of care and drive down costs, the congressman said. “The Republican solution to our country’s healthcare crisis is more choice and better care,” Green said. “We need to move forward and utilize the power of markets to fix our broken system and help those in need. I hope Congressional leaders on both sides of the aisle recognize the need for patient choice and join this effort.” Green introduced his bill as House Democrats are promoting legislation to protect parts of the Affordable Care Act and lower prescription drug…

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Trump Administration Ends Unions ‘Skimming’ $100 Million a Year from Medicaid

by Bethany Blankley   A final rule change has been implemented by the Trump administration to ensure that Medicaid providers receive complete payments as required by law. The Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) released the Medicaid Provider Reassignment Regulation final rule that removes states from being able to divert portions of Medicaid provider payments to third parties – including unions – outside of the scope of what the statute allows. The final rule came after CMS considered more than 7,000 comments from the public, healthcare providers, unions, state agencies, and advocacy groups during the public comment period after the changes were proposed. “State Medicaid programs are responsible for ensuring that taxpayer dollars are dedicated to providing healthcare services for low-income, vulnerable Americans and are not diverted in ways that do not comply with federal law,” CMS Administrator Seema Verma said in a statement. “This final rule is intended to ensure that providers receive their complete payment, and that any circumstance where a state redirects part of a provider’s payment is clearly allowed under the law.” Section 1902(a)(32) of the Social Security Act generally prohibits states from making payments for…

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Social Justice Warriors at The Tennessean Publish Op-Ed Claiming ‘Tennessee Is a Racist State and So Is Its Legislature’

A progressive social justice warrior-community organizer has labeled the entire State of Tennessee as racist with the aid of The Tennessean, which ran her ranting op-ed Wednesday. Aftyn Behn describes herself as the statewide organizer of Indivisible for Tennessee and Kentucky. Her op-ed blaming the state – especially the General Assembly – for a host of social ills is available here. She says, Let me be clear: Tennessee is a racist state. Racism is in the air we breathe, permeating the State Capitol, codified in the legislation being passed at the detriment of women, communities of color, and the working poor. Our problem with racism in this state is wild and untamed, and Justin Jones has turned a mirror to the legislature and the gubernatorial administration, inviting them to look inward and prompt introspection towards their ideologically destructive agendas. Lawmakers are responsible for rising black maternity rates, not allowing ex-felons to vote and is “the motivation behind undermining years of tireless organizing efforts from women of color to pass Nashville’s Community Oversight Board,” among other social ills, she said. Not expanding Medicaid is also a part of her complaint. The Tennessee Star has reported on Justin Jones, who allegedly threw…

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Federal Agency Approves Ohio Work Requirement for Medicaid

The Centers for Medicare and Medicaid Services approved Ohio’s work rules for “able-bodied” recipients of Medicare Friday. Obamacare included a requirement that all 50 states expand Medicare eligibility to cover every individual whose income was up to 133 percent of the poverty line by January 1, 2014. In 2012, in a 5-4 decision, the Supreme Court voted to uphold much of the law while ruling the Medicaid expansion requirement unconstitutional. They found that the federal government couldn’t force the states to expand Medicaid with the threat of withdrawing existing Medicaid funding. Instead, each state would have the option to voluntarily opt into the expansion or not. After months of deliberation, then-Ohio Governor John Kasich announced he would push to accept the expanded Medicaid in March of 2013. The once tea-party supported governor faced significant conservative pushback and criticism for accepting the expansion, most significantly for its high cost and potential government overreach. In 2017, Kasich added provisions to the Medicaid expansion, but stipulated that certain work requirements be met before “able-bodied” men could use the program. They had to work 20 hours a week, be actively looking for a job, receiving education or training, or engaged in community service. These measures, while supported in the state, received significant pushback from advocacy groups who…

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Tennessee Gov. Bill Lee Wants More People to Fight Medicaid Fraud

Tennessee Republican Gov. Bill Lee reportedly wants more people to fight Medicaid fraud. Specifically, according to LocalMemphis.com, Lee wants more Tennessee Bureau of Investigation staff members on the trail of Medicaid fraud. “The TBI director hopes lawmakers approve a request for 26-more staffers in the agency’s Medicaid fraud control unit,” the website reported. “The group looks for wrongdoing in the state’s huge $12-billion Medicaid program TennCare, that takes up about 30 percent of the state budget.” The Tennessee Star has recently reported several TennCare fraud arrests. Tennessee officials, for instance, have announced the arrests of five people charged with TennCare fraud. According to press releases state officials put out this month: • Authorities charged a Sullivan County woman with TennCare fraud in connection with the sale of prescription drugs obtained through the state’s health care insurance program. • Authorities charged a Shelby County woman with TennCare fraud involving doctor shopping, which involves visiting multiple doctors in a short period of time to obtain controlled substances. • A Davidson County woman charged with TennCare fraud, meanwhile, must repay the state for benefits allegedly received through the healthcare insurance program in a plea deal in Shelby County, according to Tennessee officials. • A…

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Nine Years After Obamacare Passed, Agency Finds Numbers Were Wildly Off

by Jarrett Stepman   Democrats defeated Republicans in the Obamacare repeal fight by warning that 22 million Americans would be thrown off their health insurance. They pointed to data leaked from the Congressional Budget Office. Well, it turns out that data was completely wrong. According to a report by the Centers for Medicare and Medicaid Services released Wednesday, the Congressional Budget Office wildly overestimated the number of people who would lose their health insurance with the repeal of the individual mandate penalty. Initial estimates from the Congressional Budget Office said 14 million would drop off their health insurance coverage due to the elimination of the individual mandate. Then, during the height of the 2017 debate over repeal, progressives touted a leaked number from the Congressional Budget Office claiming that 22 million people would “lose” their insurance if Congress repealed the law. [ The liberal Left continue to push their radical agenda against American values. The good news is there is a solution. Find out more ] However, as health care analyst Avik Roy pointed out, what made this number so high was the inflated number of people expected to lose their insurance due to repeal of the mandate – about 73 percent to…

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Tennessee Media Continues Drumbeat for Medicaid Expansion, Despite Dire Warnings from Elsewhere

Several of Tennessee’s mainstream media outlets seem to continue a drumbeat for Medicaid expansion in the state, even though some groups have long said it’s a bad idea. In the past several weeks Nashville Public Radio and The Daily Memphian, among others, have promoted the idea of expanding Medicaid in the state. Nashville Public Radio, for instance, reported that Democrats in the Tennessee General Assembly want to move forward with expanded Medicaid this year. They think they can do it with new Republican Gov. Bill Lee during his first year in office. Writers for The Daily Memphian, meanwhile, profiled how House Minority Leader Karen Camper, D-Memphis, urged Lee to widen Medicaid coverage and take back the authority to negotiate a federal plan without state legislators’ approval. Last October, The Tennessee Star quoted the Nashville-based Beacon Center of Tennessee on the matter. Beacon is a free market think tank. In an op-ed, Beacon warned all Tennessee officials to resist temptations to expand Medicaid. Beacon Executive Vice President Stephanie Whitt, writing for KnoxNews.com, said there are several important matters to consider, not the least of which is the notion Tennessee gets free money. “This is not free money,” Whitt said. “Expansion would be paid for…

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A Federal Appeals Court Just Took a Big Swing at Planned Parenthood

by Kevin Daley   The 5th U.S. Circuit Court of Appeals lifted an injunction forbidding Texas from stripping Planned Parenthood of Medicaid funds Thursday, while stridently criticizing the abortion provider for its rhetoric and medical practices. “Planned Parenthood’s reprehensible conduct, captured in undercover videos, proves that it is not a ‘qualified’ provider under the Medicaid Act, so we are confident we will ultimately prevail,” Texas Attorney General Ken Paxton said in a statement after Thursday’s ruling. The case arose after a pro-life group called the Center for Medical Progress (CMP) released videos purporting to show Planned Parenthood violating medical and ethical standards codified in federal law and state regulations. Texas terminated its Medicaid provider agreement with Planned Parenthood shortly thereafter, citing infractions documented in the videos. In turn, Planned Parenthood asked a federal court to restore its Medicaid funding. Thursday’s ruling — which related to a jurisdictional issue in that case — is especially striking for its numerous rebukes of Planned Parenthood. Judge Edith Jones, a Ronald Reagan appointee, delivered the opinion. Perhaps the most noteworthy of the decision’s reprimands is a graphic depiction of post-abortion fetal remains taken from a CMP video on the fourth page of the opinion.…

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Missouri Federal Grand Jury Indicts 14 in Home Health Care Scam

A fraud scheme perpetrated on taxpayer-funded Medicare and Medicaid began to unravel with an anonymous tip alerting officials “that some Iraqis were fraudulently receiving home care services,” says a St. Louis Post-Dispatch report from earlier this month. Investigators examined billing records from several home health care companies that provide services to the elderly or infirmed. They then compared those to travel records for both the caregiver and the recipient of the care, finding that one or the other was out of the country at the time the care was allegedly provided. Two weeks ago, a federal grand jury indicted 14 involved in the $1.3 million fraud, reports the Post-Dispatch. The story was later picked up by a newsletter for the home health care industry. The 14 charged included employees of the agencies as well as clients, and they are: Kian Abdollah, 52 Mohammed Abdollah, 78 Dalia Ahmed, 27 Dena Ahmed, 30 Fatemeh Akbari, 73 Hala Alalewi, 38 Haider Albab, 75 Nouria Habeb, 67 Pegdah Heidari, 27 Tony Iyar, 57 Ghufran Abdallah Jaber, 51 Huda Mohammedjamil, 53 Hend Msallati, 33 Asal Yousif, 53 An investigation launched into one of the clients earlier this year began to shed light on the fraudulent activity. According…

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Minnesota DHS Provided Medicaid Benefits to Out-of-State and Incarcerated Individuals, Report Finds

A new report issued last week by the Minnesota Office of the Legislative Auditor found that the Department of Human Services (DHS) provided Medical Assistance (MA), or Medicaid, benefits to ineligible residents. While the report concluded that the DHS “generally complied” with eligibility requirements, there were numerous instances in which enrollees failed to report “changes in circumstances” that “likely would have affected their eligibility.” For instance, the audit found that “24 enrollees did not timely notify their county agency that they had permanently moved out of state and that MA coverage should have been terminated.” Additionally, DHS failed to “identify” that one enrollee was “later incarcerated,” and paid $6,308 in “medical payments to a managed care organization while this enrollee was incarcerated.” The state of Minnesota paid nearly $1.8 billion for health insurance coverage for an estimated 297,000 enrollees in 2017, but last week’s audit found that 15 percent of recipients were ineligible because they exceeded income limits. “For 15 of 100 sample cases (15 percent), the enrollee’s actual income for calendar year 2017 exceeded their income reported to the county agency and the household income limit set in federal law. Thus, these individuals would not have met income eligibility…

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Kavanaugh Joins Liberals to Protect Pro-Planned Parenthood Ruling

by Kevin Daley   The Supreme Court declined to review three cases relating to Republican efforts to defund Planned Parenthood at the state level Monday, over a vigorous dissent from Justice Clarence Thomas. The dissent was significant because it indicates that Justice Brett Kavanaugh sided with the high court’s liberal wing to deny review of a lower court decision that favored the nation’s largest abortion provider. “So what explains the Court’s refusal to do its job here?,” Thomas wrote. “I suspect it has something to do with the fact that some respondents in these cases are named ‘Planned Parenthood.’” “Some tenuous connection to a politically fraught issue does not justify abdicating our judicial duty,” Thomas added. “If anything, neutrally applying the law is all the more important when political issues are in the background.” [Read Justice Thomas’ dissent] Justices Samuel Alito and Neil Gorsuch joined the Thomas dissent, meaning there were three votes in favor of taking the case. Since four votes are needed for the Supreme Court to take up a case, the opinion indicates that Chief Justice John Roberts and Kavanaugh joined with the four liberals to deny review. This move could indicate that Roberts and Kavanaugh are…

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Audit: TennCare Gave Out Money to Dead People and People in Prison

TennCare gave out more than $700,000 to duplicate members and also to people who were already dead or incarcerated, according to a new state audit. All of those recipients were ineligible to receive TennCare money. The findings, released late last week, cover July 2016 through December 2017. Generally, TennCare must refund the federal share of Medicaid overpayments to the Centers for Medicare and Medicaid Services, auditors wrote. “TennCare should investigate providers who billed for services that took place after a member’s date of death or during a member’s incarceration to determine if fraud occurred,” auditors wrote. As for people in prison, auditors said “TennCare should work with the Tennessee Department of Correction and its incarceration data contractor to establish a more effective process for identifying and verifying TennCare members who are incarcerated and suspending those members immediately.” TennCare, auditors went on to say, should also retroactively recoup any payments made on behalf of incarcerated TennCare members. TennCare officials should weed out payments made to members with multiple TennCare identification numbers, auditors wrote. In a written response to auditors, TennCare officials said they concur with some of the findings. TennCare officials, though, said they disagreed with Comptrollers’ findings on payments to…

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Expanding Medicaid in Tennessee Brings Danger, Despite Mainstream Media Cheerleading

doc nurse senior patient

Mainstream media outlets across Tennessee continue to beat the drum for expanding Medicaid, hoping to sway most Volunteer State residents to see things their way. But, as The Tennessee Star reported, expanding Medicaid brings peril. A recent Tennessean article tried to make the case for expanded Medicaid. Opinion pieces in The Memphis Commercial Appeal and The Murfreesboro Post tried to do the same. The Tennessean, for instance, wrote about how voters in deep-red Utah, Nebraska, and Idaho approved ballot initiatives to expand Medicaid. “The results appear to show increasing non-partisan voter support for expansion, which was once a political lightning rod because of its legal framework under the Affordable Care Act, commonly known as Obamacare,” according to The Tennessean. “But, as nearly three-fourths of the nation have now expanded Medicaid, a critical question remains: Will Tennessee?” If the program were to expand, the paper went on to say, more than 300,000 Tennesseans would qualify for coverage. Tennessee, the paper added, loses out on about $1.4 billion in federal taxpayer funding per year. Writing for The Commercial Appeal, McKenzie Mayor Jill Holland told readers that state taxpayers would pay nothing if Tennessee expanded Medicaid. Hospitals, she said, would pay the state’s share of the…

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Dr. Mark Green Commentary: Liability Reform a Major Area for Healthcare Savings

by State Senator Dr. Mark Green (R-Clarksville)   In my third and final op-ed on the healthcare crisis facing America, I’ll discuss the last major problem causing the crisis as well as a solution to address it. You can read part one here, and part two here. Liability reform is a major area for saving billions of dollars. No one wants to be sued, causing doctors to go crazy ordering CAT scans and labs to make certain that if we are called to the witness stand, we can say we did everything we could. Frivolous lawsuits and exorbitant awards are costing providers and their insurance companies millions of dollars in insurance premiums. Those costs are then passed onto the patients in increased healthcare costs, and thus, increased insurance premiums. In some states, like Florida, three lawsuits and you lose your license. In a recent poll of emergency physicians, 65% said that they could save over $500 per 8-hour shift by decreasing unnecessary tests as a part of their defensive practice. Another 16% felt they could save between $200 and $500 dollars. I ran a level 2 trauma center that saw 75,000 patients a year. If we assume a conservative savings…

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Expanding Medicaid Perilous for Tennessee, Think Tank Warns

In a new op-ed, the Beacon Center of Tennessee, a Nashville-based free-market think tank, warned all Tennessee officials to resist temptations to expand Medicaid. Democratic gubernatorial candidate and former Nashville Mayor Karl Dean, for instance, is one of many politicians who want to make it happen. Beacon Executive Vice President Stephanie Whitt, writing for KnoxNews.com, said there are several important matters to consider, not the least of which is the notion Tennessee gets free money. “This is not free money,” Whitt said. “Expansion would be paid for with new federal taxpayer dollars, borrowed from our children and grandchildren, that are not guaranteed in the future. This could potentially put our state at risk to either shell out additional state taxpayer dollars to cover the expanded population or go through the painful process of kicking hundreds of thousands of people off the program.” Medicaid is expensive, Whitt said. TennCare costs Tennesseans $12 billion, eating up nearly a third of the state’s $37.5 billion total budget, she said. “To put that in perspective, Tennessee is spending approximately $32.8 million per day on TennCare,” Whitt said. “It is simply unrealistic to think we can expand our TennCare population by a minimum of 250,000…

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Dr. Mark Green Commentary: ‘Cost Shifting’ Is a Major Contributor to the Healthcare Crisis Today

Mark Green FRC endorsement

by State Senator Dr. Mark Green (R-Clarksville)   The healthcare crisis in America is rightly one of the top issues on voters’ minds this election cycle. Unfortunately, missing from all the political rhetoric from most candidates is what is actually causing it. This is my second article in a three-part series where I seek to address the root cause of the crisis. You can read the first part here. In addition to having the wrong incentives, the second problem affecting our healthcare system is the effect on health insurance and other payers when government sets the price so low. When Medicare and Medicaid say they will only pay X for this procedure, and X is substantially below the market equilibrium price, one of two things happens: Either providers stop supplying that service at the set price, or they increase the price charged to others–a process called cost shifting. The effect of cost shifting has devastated the health insurance industry. As the government pays less, physicians and hospitals raise the price for others, which leads to increased cost of care for those with health insurance. This increase is then in turn passed to their customers in increased cost. As the cost…

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Improper Medicaid Payments in Tennessee Part of Huge Nationwide Problem

A Knoxville nursing facility improperly billed Medicaid more than $20,000 for non-allowable expenses, according to an audit Tennessee Comptrollers released this week. That’s minuscule, though, compared to the massive amount of money Medicaid loses nationwide on improper payments. “In 2015, improper payments alone—which include things like payment for non-covered services or for services that were billed but not provided—totaled more than $29 billion according to the Government Accountability Office,” as cited on the National Conference of State Legislatures’ website. As for the Knoxville facility — Beverly Park Place Health and Rehab — auditors said it improperly billed Medicaid $22,032.85 for 134 hospital and therapeutic leave days when the facility was operating below 85 percent occupancy. Non-allowable expenses at the facility consisted of certain ambulance transportation expenses, sales tax expenses, radiology fees, and even marketing expenses, the audit said. Beverly Park Place spokeswoman Susette Williamson told The Tennessee Star in an emailed statement she and other staff members have corrected all deficiencies. “The items noted are a very small percentage of the volume for a non-profit health care provider of our size,” Williamson said. “Due to patient confidentiality requirements, our policy does not let us comment further on any issues which might…

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Letter to the Editor: The Way to Lower Healthcare Costs Is to Support and Elect Candidates Who Will Apply Free Market Principles

doc nurse senior patient

Dear Tennessee Star, During the U.S. Senate debate I was glad to see Congressman Marsha Blackburn speak out against single payer healthcare. Being in the healthcare industry professionally since 1980 and now as a health consultant focused on health care legislation and helping companies and individuals navigate health care costs, pricing and affordability and keeping legislators informed from the provider perspective of the hindrances to care as a result of government intrusion – I know that single payer health care has disastrous implications. Obamacare has taken us in the wrong direction since 2010 – limiting access to plans, skyrocketing double digit cost increases each year, a diminishing individual marketplace, disappearing insurance plans and greatly reducing provider choice – it has been in direct contradiction to the two promises given to the American Healthcare consumer – If you like your doctor, you can keep your doctor, and it will reduce the costs to consumers. It is unfortunate that many mainstream Democrats are taking a bad idea and setting the stage to make matters much worse. Now many Democrats support Senator Bernie Sanders’ proposal to nationalize our health care system via single payer – also known as “Medicare for All.” In reality,…

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Report: Tennessee to Get Tough with Planned Parenthood

Planned Parenthood

Tennessee officials may soon have the power to stop Medicaid dollars from going to clinics in Tennessee that perform abortions. This is meant to curb the power and influence of Planned Parenthood in Tennessee, according to a new article in Bloomberg. “The move signals growing GOP interest in using administrative means to rein in providers that offer abortion and underscores state confidence in the Trump administration’s friendliness to the conservative policy priority,” the website reported. Nationwide, the group received $543.7 million in taxpayer money in fiscal year 2016. Medicaid funds generally can’t get used to cover most abortions under the Hyde Amendment, Bloomberg reported. The Tennessee Star has requested state officials give specific information about how much money abortion providers in Tennessee have received through Medicaid during the past three fiscal years. The Star expects to receive that information sometime next week. Tennessee officials are asking the Centers for Medicare & Medicaid Services to block providers that performed more than 50 abortions in the past year from its Section 1115 Medicaid waiver, Bloomberg reported. The publication quoted an unidentified spokeswoman for the state’s Medicaid program TennCare. “Public comments on the request close Sept. 23,” Bloomberg reported. TennCare pays for health care…

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Republican Dave Joyce Releases Bizarre Campaign Ad Distancing Himself from Trump

David Joyce

In a risky political move, Rep. Dave Joyce recently tried to distance himself from President Trump in a congressional district that the president won by 12 percentage points in the 2016 Election. Joyce, who is seeking reelection in Ohio’s 14th Congressional District, recently released an ad in which he touts his vote against repealing the Affordable Care Act. “When Republican leaders in Congress tried to take away protections for pre-existing conditions, I said no,” Joyce states. “I won the the fight to fund the Great Lakes restoration, and when President Trump tried to take it away, I said no again.” “I’m Dave Joyce, and I approve this message, because I’ll do what’s right for northeastern Ohio, even if it means standing up to my own party,” the ad concludes. Joyce, however, regularly voted to repeal Obamacare before Trump took office, and his campaign website used to tout a record of voting for repeal more than 30 times, Cleveland.com reports. In a state that Trump won by by 8 points, the ad seems out of place, leaving Joyce’s spokesman, Dino DiSanto to explain that “Joyce will do what is right for his district, no ifs and or buts—doesn’t matter party affiliation…

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This New Health Plan Expansion Is a Godsend for Small Businesses Like Mine

business meeting

by Kalena Bruce   Last month, the Trump administration took a concrete step to lower skyrocketing health care costs for middle-class families like mine. The Department of Labor issued a final rule expanding association health plans, which allow small businesses like my farm to band together with others to negotiate bulk rates on health care costs. Association health plans are not new, but they have been nearly regulated out of existence over the last decade by state regulations and Obamacare. For instance, Obamacare required small businesses buying coverage through association health plans to offer “essential health benefits,” which are expensive and often include unnecessary frills like obesity screening and drug rehab. This puts small business plans at a competitive disadvantage with those of their big business competitors, which don’t have to comply with essential health benefits and many other onerous Obamacare regulations. The result: The number of small businesses offering health insurance for their employees fell by about one-quarter between 2010 and 2017. For my family of three, I now pay $700 a month in premiums, not including the deductible and copays, for Spartan coverage. These cost increases eat a portion of my revenue that would otherwise be reinvested into my business. Hardest hit have…

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Kentucky Governor Matt Bevin: Work Requirement for Medicaid Brings the Program Back to Its Purpose

Gov. Matt Bevin said Monday that Kentucky’s new work requirements repurposes Medicaid for those who are truly in need, just as the program originally intended. Mr. Bevin, Kentucky Republican, said Medicaid has expanded far beyond those who are unable to work and receive medical coverage through an employer, and now includes many people capable of making some contribution.

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Kentucky Becomes First State to Require Work for Medicaid Benefits Days After Trump Administration Gives Green Light to New Policy

Governor Matt Bevin of Kentucky, a Republican, announced in a news conference on Friday that Kentucky Medicaid recipients will have to either work or be in a jobs training program to continue receiving benefits. Bevin’s announcement comes just days after the Trump administration said it will allow states to impose work requirements for Medicaid recipients, as Fox News reported: “Our policy guidance was in response to states that asked us for the flexibility they need to improve their programs and to help people in achieving greater well-being and self-sufficiency,” Verma said, noting the agency has received demonstration project proposals from 10 states: Arizona, Arkansas, Indiana, Kansas, Kentucky, Maine, New Hampshire, North Carolina, Utah and Wisconsin. The test programs, according to CMS, could make work, “skills training, education, job search, volunteering or caregiving” a requirement for Medicaid for “able-bodied, working-age adults.” It would not apply to those getting benefits due to a “disability, elderly beneficiaries, children, and pregnant women.” Kentucky’s new work requirements mandate that able-bodied adult recipients participate in at least 80 hours of “employment activities,” (jobs training, education and community service) each month. “Kentucky’s waiver, submitted for federal approval in 2016, requires able-bodied adult recipients to participate in at least 80 hours a month of “employment activities,”…

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Representative Diane Black Praises Trump Administration’s Call to Reinstate Medicaid Work Requirements

The Trump Administration signaled Thursday that it would once again allow states to impose work requirements for some Medicaid recipients. Gubernatorial hopeful Representative Diane Black (R-TN-06) released a statement supporting the decision: As Chairman of the Budget Committee, I have pushed for work requirements for able-bodied, adult Medicaid recipients. I’m thrilled President Trump agrees and has announced he will give states the flexibility to create work-based health care programs that fit the needs of our individual states. I’m confident that we in Nashville know more about what the people of Tennessee need than bureaucrats in Washington. When I’m elected Governor, I will immediately request a waiver from HHS to allow Tennessee to impose work requirements for able-bodied, adult Medicaid recipients. It’s not just about protecting taxpayer dollars from fraud and abuse; it’s about creating a culture of work and the dignity that comes from that work. Having grown up in a family that had to work hard for everything we had, I know that work is the only way up in this great country. Black is currently well in the lead of the five-way field of Republican candidates vying to be the next governor of Tennessee, according to in the…

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Dr. Bryan Merrick Makes His Case To Top Federal Officials for Reinstatement into Medicare System

Dr. Bryan Merrick and his attorney Roy Herron met in Baltimore on Thursday with top federal officials at the Centers for Medicare and Medicaid Services (CMS), the part of the Department of Health and Human Services responsible for administering the Medicare program, to make the case for the reinstatement of his Medicare billing privileges. As The Tennessee Star reported, the well respected West Tennessee family practice doctor’s Medicare billing privileges were revoked in March under an abusive Obama-era regulation over a reported $670 in billing errors. Late last month, Senator Lamar Alexander (R-TN) called on Senator Orrin Hatch (R-UT) to hold hearings at the Senate Finance Committee he chairs to consider revoking the regulation. Earlier in October, McKenzie, Tennessee Mayor Jill Holland wrote a letter to Senator Alexander asking him to hold hearings of the Senate Health, Education, Labor, and Pensions Committee he chairs to consider revoking the regulation, but Alexander noted that Hatch’s Senate Finance Committee has jurisdiction over Medicare and Medicaid issues. Last week, former Congressional candidate Dr. George Flinn wrote President Trump a letter requesting that he instruct CMS to amend the regulation. “We had a good meeting. We felt like the officials listened carefully and asked…

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Commentary: GOP Health Care Plan Would Fundamentally Change Medicaid

Obscured by the largely over pre-existing conditions, the Obamacare rewrite by the House of Representatives would usher in the most significant changes ever to one of America’s largest entitlement programs. The American Health Care Act faces almost-certain major changes in the Senate. But as passed by the House, it would phase out the Medicaid expansion created…

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