On Friday, the Division of TennCare expanded health care benefits for pregnant and postpartum TennCare members, according to the department.Read More
Chad Holman has been named the new chief of the Tennessee’s Office of Inspector General (OIG).Read More
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 More
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 More
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 More
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 More
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 More
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 More
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 More
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 More
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 More
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 More
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 More
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 More
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 More
Tennessee officials have charged people from Murfreesboro, Memphis, and Mississippi with TennCare fraud.Read More
Authorities this week charged women from Nashville, Marshall County, and South Carolina with TennCare fraud.Read More
Tennessee officials report they have charged residents of Lincoln, Shelby, and Sullivan counties with TennCare fraud.Read More
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 More
Authorities have charged four additional people from around Tennessee with TennCare fraud, including people from Coffee, Hardeman, and Madison counties.Read More
Tennessee officials have arrested women from Rutherford County and Somerville and charged them with TennCare fraud.Read More
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 More
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 More
Authorities charged a Lewisburg man with TennCare fraud and felony theft of property over $10,000, according to a state press release.Read More
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 More
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 More
TennCare is by far Tennessee’s largest entitlement program in terms of caseload and cost to the state.Read More
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…Read More
Tennessee officials have charged more people with alleged TennCare fraud in two separate cases, including a woman from Arkansas.Read More
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 More
Authorities have arrested two more people for TennCare fraud, and one of them is facing her third arrest on this charge.Read More
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…Read More
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…Read More
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 More
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 More
State Sen. Steven Dickerson (R-TN-20) is among those being sued by the federal government and Tennessee over alleged Medicare and TennCare fraud totaling at least $25 million. The United States and Tennessee on Monday filed a consolidated complaint in intervention alleging violations of the False Claims Act and the…Read More
People from Georgia are robbing the taxpayers of Tennessee by taking TennCare benefits to which, legally, they are not entitled. This, according to The Atlanta Journal Constitution, which said authorities are investigating 16 people in Georgia for receiving benefits from Tennessee’s Medicaid program. Those 16 Georgians likely couldn’t get…Read More
The Tennessee Office of Inspector General announced several new TennCare fraud arrests this week, including the arrest of one man who allegedly used TennCare to treat his Attention Deficit Hyperactivity Disorder. That man, Thomas William Biggs Jr., 44, of Nashville, was on the run for more than a year…Read More
Tennessee officials have charged yet another Alabama resident with TennCare fraud, according to a press release from the Tennessee Department of Finance and Administration’s website. This, even though only Tennessee residents are eligible for the TennCare program. Tennessee officials said they arrested Ladreamer Garrett, 27, of Bridgeport, Ala. and charged…Read More
Tennessee officials announced Monday they indicted five Alabama residents on charges of passing themselves off as Tennessee residents so they could qualify for TennCare. No one who lives out-of-state may legally qualify for these benefits. All five people fraudulently reported to Tennessee officials that they and their minor children…Read More
Tennessee officials have arrested more people on charges of TennCare fraud. According to a press release, authorities with the Office of Inspector General and the Knox County Sheriff’s Office charged a Loudon County woman in Knox County with doctor shopping for prescription drugs and using TennCare as payment for…Read More
Tennessee officials have announced several TennCare fraud arrests this month. • Authorities arrested a West Memphis, Ark, woman and charged her with TennCare fraud. They said this woman, Deniqueal S. Townsend, 34, falsely reported she was living in Tennessee to obtain healthcare insurance benefits from the program. The Office…Read More
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…Read More
State officials have arrested three more people for alleged TennCare fraud, according to new press releases from the Tennessee Department of Finance and Administration. The people arrested are from Davidson and Gibson counties, the press releases said. Authorities charged the Davidson County resident, Robert Lee Nesbitt, Jr. 54, with…Read More
Authorities have charged two Davidson County residents in separate TennCare fraud cases involving prescription drugs. The Office of Inspector General, with the assistance of the U.S. Drug Enforcement Agency, this week announced the arrest of Omar Adbirizak Hassan, 21 and Shannon Lynne Cannon, also known as Shannon L. Hammock, 36. Both are…Read More
Tennessee officials said in a press release this week that members of a Franklin-based facility committed fraud to get $6 million in TennCare benefits to which it was not entitled. The U.S. District Court for the Middle District of Tennessee this week made public a suit filed by Attorney General…Read More
Tennessee officials this week charged women with TennCare fraud in two separate cases. Officials charged a Hickman County woman with lying to the state to obtain TennCare healthcare insurance benefits, according to a press release from the Tennessee Department of Finance and Administration. The Office of Inspector General and the Hickman…Read More
A Davidson County woman is ordered to repay the state after she entered a plea agreement on charges involving TennCare fraud. This, according to a press release from the Tennessee Department of Finance and Administration. The Office of Inspector General this week announced that 38-year old Heather Ann Pitts of…Read More
A Hardin County woman is charged with allegedly lying about her residency in order to enroll in TennCare, according to the Tennessee Department of Finance and Administration. The Office of Inspector General (OIG), with the assistance of the Hardin County Sheriff’s Office, this week announced the arrest of Samantha J. Briley,…Read More