TennCare Officials Prepare to Drop 52,000 Beneficiaries, Pending Judge’s Approval

Tennessee officials may begin removing ineligible members from TennCare, the state's Medicaid managed care program, as early as this week, the Nashville Tennessean reports. In a Nov. 9 court hearing, state officials said that they had identified 25,000 TennCare beneficiaries with "invalid addresses" and another 27,000 beneficiaries who have failed to pay their TennCare premiums for at least four months. While Medicaid-eligible TennCare members do not pay premiums, other beneficiaries, such as uninsured adults and people deemed "uninsurable" because of pre-existing medical conditions, do. By removing these 52,000 members from TennCare, officials said they may be able to lengthen the time period before the program exceeds its 1.5 million enrollee cap set by the state's Medicaid waiver. With the TennCare rolls growing at a rate of 10,000 new beneficiaries per month, state officials had expected to reach the cap by February 2002. The move also will save the program an average of $173 per month for each member removed from TennCare, which is expected to "overspend" its budget by $37.5 million by June 30 -- the end of the fiscal year. At the hearing, state officials and lawyers representing TennCare enrollees worked on developing a protocol for removing members from the program. If U.S. District Judge William Hence, who is meeting Nov. 13 with the two groups, approves the procedure, "termination notices" could be sent starting this week (Snyder, Nashville Tennessean, 11/10). Last month, Haynes blocked a plan, proposed by Tennessee Gov. Don Sundquist (R), to close TennCare enrollment to uninsurable adults and ordered the appointment of a special master to oversee the state's process of verifying eligibility (Kaiser Daily Health Policy Report, 11/6). In February, Haynes approved a plan for the state to remove "ineligible" beneficiaries who were in state prison, had access to employer-sponsored coverage or had moved out of state. Since then, more than 5,500 people have been dropped from TennCare (Nashville Tennessean, 11/10).