Gov. Bill Lee said Thursday that $100 million in state-funded loans are available to help counties affected by Hurricane Helene.
The program, dubbed Helene Emergency Assistance Loans, or HEAL, is funded by TennCare Shared Savings, the governor said. Carter, Claiborne, Cocke, Grainger, Greene, Hamblen, Hawkins, Jefferson, Johnson, Sevier, Sullivan, Unicoi and Washington counties can opt-in to the no-interest loans.
Read the full story
Tennessee Governor Bill Lee announced that TennCare and CoverKids members under age two will be eligible to receive up to 100 diapers per month as part of the TennCare Diaper Benefit beginning Wednesday.
TennCare is Tennessee’s Medicaid program, while CoverKids offers free health coverage for pregnant women and children who do not have insurance and do not qualify for TennCare.
Read the full story
More than 63,000 eligibility checks are still pending but more than 967,000 individuals are renewed and nearly 508,000 are ineligible following the full year review of TennCare cases.
The analysis of more than 1.5 million members comes after the federal COVID-19 pandemic eligibility check pause between March 2020 to March 31, 2023.
Read the full story
Over the past few budget years, Tennessee has received TennCare reserves that have covered the state’s end-of-year budget shortfalls.
This budget year, Senate Finance Chair Bo Watson vowed the budget would be adjusted for lower-than-expected tax and use fee collections. The budget came in at $52.8 billion, lower than the past two years.
Read the full story
As Tennessee lawmakers investigate the possibility of just saying no to federal education funds and the ties that come with them, the state’s Federal Funding Working Group co-chair told The Tennessee Star that completely letting go probably isn’t going to happen.
“No, I don’t think that’s feasible,” said State Senator Jon Lundberg (R-Bristol) in an interview this week with The Star.
Read the full story
Tuesday morning on The Tennessee Star Report, host Michael Patrick Leahy welcomed State Representative Scott Cepicky (R-TN-Culleoka) in studio to discuss legislation victory with TennCare and bringing common sense to third-grade retention law.
Read the full story
Governor Bill Lee (R-TN) announced Monday during his State of the State address he would propose boosting support for women in unplanned pregnancies through various programs, including an expansion in funding for crisis pregnancy care centers to $100 million, widening Medicaid eligibility for pregnant women and parents, and granting additional paid family leave time for state employees.
Tennessee’s “trigger” law that bans abortion, titled the Human Life Protection Act, took effect August 25, two months after the U.S. Supreme Court overturned Roe v. Wade.
Read the full story
TennCare currently has $1.1 billion in its reserves and expects it to cost $500 million of those reserves over the next year as it redetermines Medicaid eligibility for those additional 500,000 members who joined the plan over the past three years.
During the COVID-19 pandemic, states were not allowed to remove those who are no longer eligible for the program as previous. Starting on April 1, states must start that redetermination process and will have a year to complete it.
Read the full story
A recently released audit shows the Hall Medical Clinic in Waynesboro received more than $300,000 in TennCare funding payments due to underreporting the payments the clinic received.
In an audit conducted by the Tennessee Comptroller’s Office, the clinic was found to have not reported $621,775 in payments and 2,340 TennCare visits to the clinic between 2017 and 2021.
Read the full story
The United States will have 100 million residents on Medicaid in the next 72 days, according to the Foundation for Government Accountability, meaning that nearly one-third of all Americans will be on the program for health care.
Over the past three years, states have been prevented from removing recipients from the program through a federal COVID-19 emergency. Now, the date when states can begin to re-registering recipients when that emergency ends on April 1.
Read the full story
Throughout the federal COVID-19 emergency, Tennessee’s Medicaid service TennCare and programs like it across the country have been barred from removing those who initially qualified for services.
Starting on April 1, however, the emergency will end and so will the federal matching dollars that went into the program. TennCare served 1.4 million residents in early 2020 and, after hitting a projected peak of 1.7 million members this spring, expects TennCare enrollment to go back down to 1.4 million by April 2025.
Read the full story
A man who is accused of abusing the Tennessee Medicaid system is now in custody, according to the Tennessee Bureau of Investigation (TBI).
“An investigation by special agents with the Tennessee Bureau of Investigation’s Medicaid Fraud Control Division into fraudulent TennCare time sheets has resulted in the arrest of a TennCare recipient in Bethel Springs,” TBI said.
Read the full story
The State of Tennessee is a finalist in three categories for awards from the National Association of State Chief Information Officers (NASCIO).
Read the full story
Lindsey Horner, considered the “most wanted” person for TennCare fraud, was arrested Friday, according to a press release by the Tennessee Department of Finance and Administration (F&A).
The Tennessee Office of Inspector General (OIG), in a joint effort with the Benton County Sheriff’s Office, announced that the 39-year-old Big Sandy, Tennessee, was charged with TennCare fraud and theft of services. The TennCare fraud charge is a class D felony, and the theft of services charge is a class C felony, the press release notes.
Read the full story
On Friday, the Division of TennCare expanded health care benefits for pregnant and postpartum TennCare members, according to the department.
Read the full story
Chad Holman has been named the new chief of the Tennessee’s Office of Inspector General (OIG).
Read the full story
TennCare reportedly overpaid nearly $300,000 of taxpayer money to a Shelbyville physician, according to a report that Tennessee Comptrollers released Thursday. The reported cited Joseph Howard Rupard for failing to accurately report TennCare visits and payments submitted to the state of Tennessee.
Read the full story
A west Tennessee primary care clinic overcharged TennCare — and, by extension, taxpayers — more than $4.7 million, according to an audit that Tennessee Comptrollers published late last week.
Officials who oversaw that company, the Grove Primary Care Clinic, closed all three of their facilities in 2019. They did this one day after state auditors announced they would examine the company’s finances.
Read the full story
BlueCross BlueShield of Tennessee (BCBST), which received nearly $1 billion in vendor payments from the State of Tennessee during fiscal year 2021 related to state employee healthcare benefits and is one of the Managed Care Organizations handling the state’s TennCare program is enforcing a COVID-19 vaccine mandate and not allowing religious accommodations for some of its employees.
Information was provided to The Tennessee Star by a long-term employee of BCBST, the Tennessee-based independent licensee of the Blue Cross Blue Shield Association, on the condition of anonymity for fear of losing their job.
According to the Tennessee Department of Finance & Administration, two convicted Tennessee women have been ordered by the Office of Inspector General (OIG) to repay the State of Tennessee on charges involving TennCare fraud.
Read the full story
Lieutenant Governor Randy McNally (R-Oak Ridge) appears to have a change of heart on the possibility of expanding Medicaid in Tennessee. According to reports, the White House’s latest plan to expand subsidized coverage caught McNally’s fancy.
Via the American Rescue Plan, President Joe Biden promised that if states expanded their Medicaid programs they’d receive more federal dollars to cover the program. McNally’s spokespersons have indicated that he is open to this option.
Read the full story
U.S. President Joe Biden has decided he wants to change certain terms that former U.S. President Donald Trump put in place on Medicaid, and that could affect TennCare. TennCare is the state of Tennessee’s Medicaid program.
Read the full story
Monday morning on the Tennessee Star Report, host Michael Patrick Leahy welcomed Tennessee State Senator Jack Johnson to the newsmakers line to weigh in on the Medicaid block grant and the legalities of Joe Biden’s refugee resettlement executive order.
Read the full story
Despite the past year’s events, Governor Bill Lee had plenty of good news for Tennesseans in his State of the State Address. The General Assembly appeared to agree with the governor’s assessments – at many points throughout the address, their socially-distanced, masked audience rose to applaud Lee.
“Scripture has a lot to say about those crossroads and what to do on the heels of suffering. Where do we find promise in this season?” opened Lee. “The promise is found in perseverance which produces character that leads to hope. Tennesseans will know tonight that tragedy has no hold on who we are or where we are headed. Tragedy won’t define us, it won’t rob us of the opportunity that 2021 holds.”
Read the full story
Tennessee Democrats have made multiple pleas to President Joe Biden’s administration, seeking to rescind federal approval for Tennessee’s Medicaid block grant waiver, which is set to allow the state to receive Medicaid funding in a lump sum.
Under the new funding mechanism known as a block grant, Tennessee would receive federal money for the state Medicaid program, TennCare, all at once instead of periodically.
Read the full story
Tennessee’s General Assembly approved the Medicaid waiver, granting the state to apply federal healthcare funding to an aggregate gap model of spending. The legislature filed the bill when it first convened on Tuesday. Just three days after the bill’s introduction, legislators took their final votes on Thursday and Friday. The six subcommittees who reviewed the waiver all recommended its passage over the course of a few days.
The waiver allows the state to establish a self-imposed, fixed budget to last over a ten-year period, known as TennCareIII. It also allows the state to reserve a portion of the unused funds and apply them to other government programs, with potential for those savings to be matched with additional federal funds for healthcare programs.
Read the full story
The federal government approved Tennessee’s proposed Medicaid aggregate cap, granting a lump sum for a self-imposed, fixed budget. The ten-year agreement, referred to as “TennCare III,” is the first of its kind nationwide. It also allows for the state to reserve any unused funds and apply them to other government programs, with up to 55 percent of those savings potentially matched by additional federal funds for state health programs.
The Centers for Medicare and Medicaid Services (CMS) described the measure as an “innovative financing approach.” Unlike what various reports claimed, federal officials explicitly stated that this agreement wasn’t a block grant. This agreement allows the state government to be flexible with its spending cap under certain circumstances – like last year’s pandemic and related unemployment crisis.
Read the full story
Tennessee officials have charged two women in separate cases, one from Fayette County and another from Mississippi, with TennCare fraud.
Authorities charged Shuvonda Barnett, 36, of Rossville, with 48 counts of TennCare fraud and two counts of theft of services over $10,000 but under $60,000, according to a Tennessee Department of Finance and Administration press release.
Read the full story
Tennessee officials have charged two out-of-state women with TennCare fraud in separate cases.
The women live in Kentucky and Virginia. Per state law, only Tennessee residents may participate in the TennCare program. The taxpayer-funded TennCare is Tennessee’s version of Medicaid.
Read the full story
Authorities have charged a Murfreesboro man and a South Carolina woman with TennCare fraud, according to two statements the Tennessee Department of Finance and Administration released last week.
Authorities charged that Murfreesboro man, William Weed, 40 with TennCare fraud, a Class D felony, in connection with allegedly selling prescription drugs obtained using TennCare healthcare insurance benefits.
Read the full story
Tennessee officials have charged people from Murfreesboro, Memphis, and Mississippi with TennCare fraud.
Read the full story
Authorities this week charged women from Nashville, Marshall County, and South Carolina with TennCare fraud.
Read the full story
Tennessee officials report they have charged residents of Lincoln, Shelby, and Sullivan counties with TennCare fraud.
Read the full story
Authorities have indicted the former Controller of a TennCare-funded facility for allegedly stealing nearly $120,000, according to an audit Tennessee Comptrollers released Tuesday.
Read the full story
Authorities have charged four additional people from around Tennessee with TennCare fraud, including people from Coffee, Hardeman, and Madison counties.
Read the full story
Tennessee officials have arrested women from Rutherford County and Somerville and charged them with TennCare fraud.
Read the full story
Tennessee Office of Inspector General officials has announced the indictment of a Georgia woman on charges of TennCare fraud and theft of services under $10,000, which are felonies.
Read the full story
Authorities have charged a Benton-area woman with TennCare fraud for allegedly using her deceased husband’s TennCare benefits to obtain a prescription, according to the Tennessee Department of Finance and Administration.
Read the full story
Authorities charged a Lewisburg man with TennCare fraud and felony theft of property over $10,000, according to a state press release.
Read the full story
Authorities have charged a Lewisburg woman with TennCare fraud for allegedly selling pills obtained using benefits of TennCare, the state’s healthcare insurance program.
Read the full story
The House TennCare Subcommittee took on the controversial topic of the block grant proposal, hearing from key stakeholders in a two-hour summer study conducted last Thursday.
Read the full story
TennCare is by far Tennessee’s largest entitlement program in terms of caseload and cost to the state.
Read the full story
Authorities have charged yet another out-of-state resident with TennCare fraud, and this time the alleged culprit is from North Carolina. According to a press release, officials with the Tennessee Office of Inspector General this week announced the arrest of Julie Carpenter of Mitchell County, North Carolina. The arrest is the result of a joint effort with the Mitchell County Sheriff’s Office of North Carolina. Authorities transported her to the sheriff’s office of Johnson County, Tenn. where they have her housed, according to a press release. Carpenter is charged with one count of obtaining benefits through TennCare despite not qualifying for the program and one count of theft of services over $10,000, the press release went on to say. “Investigators say Carpenter reported that she had custody of her son when in fact the paternal grandparents of the child had court-ordered custody elsewhere,” according to the press release. “Additionally, it was discovered that Ms. Carpenter was not a resident of Tennessee and was in fact residing in Mitchell County, North Carolina. Carpenter continued to report this status to TennCare over a period of approximately a year and a half. Had Carpenter properly reported her household composition or out of state residency,…
Read the full story
Tennessee officials have charged more people with alleged TennCare fraud in two separate cases, including a woman from Arkansas.
Read the full story
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.
Read the full story
Authorities have arrested two more people for TennCare fraud, and one of them is facing her third arrest on this charge.
Read the full story
In another blow for taxpayers, Tennessee officials have announced the arrest of yet another person charged with TennCare fraud. The Office of Inspector General, with help from the Henderson County Sheriff’s Office, this week announced the arrest of Paula Hutcherson, 50, of Parsons. Authorities charged her with two counts of TennCare fraud and five counts of obtaining and/or attempting to obtain a controlled substance by fraud, according to a press release. “Hutcherson, who works in the medical field, called in a prescription for Ambien, a Schedule IV controlled substance, to a pharmacy by using the name of a provider she did not have permission to use and knowingly used the name of a TennCare enrollee in order to use their TennCare benefits to pay for the prescriptions,” the press release said. District Attorney General Jody Pickens is prosecuting. TennCare fraud is a Class D felony punishable by up to four years in prison per charge, the press release said. The OIG, which is separate from TennCare, began full operation in February 2005 and has investigated cases leading to more than $3 million being repaid to TennCare, with a total estimated cost avoidance of more than $163.6 million for TennCare, according to…
Read the full story
The number of people state officials have charged with TennCare fraud continues to grow, meaning state taxpayers still subsidize alleged waste, fraud, and abuse out of the program. This, according to two press releases the Tennessee Office of Inspector General released this week. Authorities charged a Wilson County woman with TennCare fraud in both Wilson and Davidson counties because of the woman’s alleged doctor shopping for controlled substances. OIG officials said that woman, Datha Kimberly Robertson, 26, of Lebanon, used TennCare to doctor shop for the painkiller Oxycodone. A Wilson County indictment accuses her of three counts of fraudulently using TennCare to doctor shop. “Upon posting bond, Robertson was arrested for the second time in Davidson County, where she faced an indictment charging her with two counts of TennCare fraud for doctor shopping for the painkiller Hydrocodone; and, one count of obtaining a controlled substance by fraud,” according to the press release. “Authorities say that during a six-week period, Robertson had five visits to a hospital emergency room, doctor’s offices and urgent care. In each of the incidents, she used TennCare to obtain controlled substances, while failing to disclose that she’d received previous similar drugs. The charges in both…
Read the full story
A Mississippi woman allegedly committed more than $250,000 worth of TennCare fraud, according to Tennessee officials, and she must pay that money back.
Read the full story
The Bureau of TennCare overpaid more than $600,000 to a now-closed health care clinic in Madisonville, according to an audit Tennessee Comptrollers released Monday.
Read the full story