WASHINGTON — Congressmen Steve Cohen (TN-09) and Jim Cooper (TN-05) today applauded the Biden administration’s Center for Medicare and Medicaid Services (CMS) for ask Tennessee to redesign major changes that would have turned Tennessee’s Medicaid program, known as TennCare, into a block grant. This demand makes it more likely that the state will create a Medicaid program that provides better care and access to Tennesseans in need.
Congressman Cohen has been a harsh critic of Governor Bill Lee’s efforts to block the TennCare grant. He wrote to state and federal authorities seeking to prevent it ahead of the Trump administration’s decision to approve the block grant waiver. Congressman Cohen also wrote to then-President-elect Biden asking him to reverse the approval of the block grant waiver. He also wrote directly to TennCare and expresses his concerns to the most recent federal public comment period. After reviewing public comments, CMS said it had “significant concerns about the components of the demonstration and whether they further Medicaid goals and should be supported under the authority of Section 1115.”
Congressman Cohen issued the following statement:
“I am thrilled to see that the Centers for Medicare and Medicaid Services have agreed that the people of Tennessee deserve a fully funded TennCare program that seeks to serve the interests of elderly, disabled, and low-income residents of our state. The “flexibility” sought by Republicans would have prompted the state to cut benefits so cost savings could be redirected elsewhere. This decision is a victory for Tennessee and for all Tennessees who opposed this plan.
Congressman Cooper issued the following statement:
“The Biden administration did the right thing by listening to the concerns raised by the people of Tennesse during the public comment period. As I’ve said all along, Tennessee needs to go back to the drawing board. The capped funding, the closed drug formulary and the unregulated use of so-called “shared savings” should never have been approved. If Tennessee really wants to prioritize the health of Tennessees, they should have expanded Medicaid. It’s time to step up a gear. »
In his letter To the state, CMS is proposing the following changes to the TennCare III Waiver:
- Calls on the state to submit a new model for funding and budget neutrality, based on a traditional cap per member per month, instead of a global cap (i.e. a block grant). Additionally, Tennessee is expected to amend its rules to more explicitly state that Tennessee may not reduce benefits or coverage effective December 31, 2021 without modification to the demonstration, subject to an additional public comment period and the CMS approval.
- Instead of allowing Tennessee to unilaterally redirect Medicaid funding to other programs, CMS is asking the state to include in the demonstration amendment a request for spending authority for state reinvestments for initiatives that the state would like to support with budget neutral savings (e.g. adult dental services, extension of postpartum coverage to 12 months, and improved home and community services; etc.).
- Eliminate the closed formulary, which allows TennCare to restrict the drugs it covers instead of having to cover all FDA-approved drugs like in other states.
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