Tag: TennCare

Tennessee Legislature Approves Modified Block Grant for State’s Medicaid Program

Corinne Murdock

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

Federal Government Approves Tennessee’s Medicaid Proposal, Swapping a Block Grant for an Aggregate Cap

Corinne Murdock

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 Charge Fayette County and Mississippi Women with TennCare Fraud

Chris Butler

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

Murfreesboro Man and South Carolina Woman Charged with TennCare Fraud

Chris Butler

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

House TennCare Subcommittee Holds Summer Study on Controversial Medicaid Block Grant Proposal

Laura Baigert

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

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

Laura Baigert

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

Tennessee Officials Charge Even More People with TennCare Fraud

Chris Butler

  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

State Sen. Dickerson, Others in Pain Management Business Sued By United States, Tennessee for Allegedly Committing $25M in Medicare, TennCare Fraud

Jason M. Reynolds

  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

Georgia Residents Are Allegedly Robbing Tennessee Taxpayers Through TennCare Fraud

Chris Butler

  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

Yet Another Alabama Resident Charged with TennCare Fraud

Chris Butler

  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

Five Alabama Residents Arrested for Allegedly Getting TennCare Benefits

Chris Butler

  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

Law Enforcement Announces More TennCare Arrests in Knox, Williamson, and Blount Counties

Chris Butler

  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

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

Jason M. Reynolds

  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

Davidson and Gibson County Residents Busted for Allegedly Stealing from TennCare

Chris Butler

  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

Davidson County Residents Charged with TennCare Fraud

Chris Butler

  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

Two Tennessee Women Charged with TennCare Fraud in Separate Cases

Chris Butler

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

Hardin County Woman Charged with TennCare Fraud

Chris Butler

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

Tipton County Woman Charged with TennCare Drug Fraud

Chris Butler

.A Tipton County woman is charged with TennCare fraud in connection with the sale of prescription drugs paid for by the state’s health care insurance program, according to a press release from the Tennessee Department of Finance and Administration. The Office of Inspector General (OIG), with the assistance of the…

Read More

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

Jason M. Reynolds

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…

Read More

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

Chris Butler

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,”…

Read More

Tennessee Officials Announce a Slew of New TennCare Arrests

Chris Butler

Tennessee officials have announced the arrests of five people charged with TennCare fraud. According to press releases state officials put out this week: • 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, according…

Read More

Macon County Woman Charged with Using Children to Commit TennCare Fraud

Chris Butler

Tennessee officials charged a Macon County woman with fraudulently obtaining TennCare benefits, according to the state’s Department of Finance and Administration. That woman, Hanna L. Johnson, 30, of Red Boiling Springs, allegedly and falsely claimed two minor children as dependents. Without those children, Johnson would not qualify for TennCare, Tennessee…

Read More

State Rep. Timothy Hill: Medicaid Block Grants Are the Conservative Way to Expand TennCare Coverage

Laura Baigert

NASHVILLE, Tennessee – State Representative Timothy Hill is sponsoring HB 1280, which is the first step in the process of requesting Medicaid block grants for the funding of TennCare. The main reason Representative T. Hill is bringing the legislation, he told The Tennessee Star, is that block grants are the…

Read More

Weakley County Woman Charged with TennCare Fraud

Chris Butler

Authorities have charged a Weakley County woman with TennCare fraud. Officials with the Tennessee Office of Inspector General say the woman, Tina Mays, 44, of Gleason, fraudulently used the state’s health insurance program to obtain controlled substances, according to a state press release. The practice is otherwise known as doctor…

Read More

Jefferson County Woman Charged with TennCare Fraud

Chris Butler

Law enforcement officials have charged a Jefferson County woman with TennCare fraud. That woman, Consuelo Morales, 44, allegedly falsified her income to obtain healthcare insurance through the state program, according to a state press release. The Office of Inspector General with the assistance of the Jefferson City Police Department arrested Morales. A…

Read More

Woman Charged with TennCare Fraud for Sixth Time

Chris Butler

Authorities in Tennessee this week arrested and charged a Florida woman with TennCare fraud — for the sixth time. That woman, Desiree McIntyre, 29, of Ocala, Fla. faces three counts of TennCare fraud in Sullivan County by doctor shopping, according to the state’s Office of Inspector General. That particular offense…

Read More

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

Chris Butler

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…

Read More