District Judge Names Special Master To Oversee Negotiations on Removing Children from TennCare

Negotiations between Tennessee officials and advocates on how to provide early periodic screening diagnosis and treatment, or EPSDT, services to children enrolled in TennCare, the state's Medicaid managed care program, will be overseen by a Nashville physician, the Nashville Tennessean reports. U.S. District Court Judge John Nixon appointed Dr. Richard Carter as special master on Feb. 26 (Lewis, Nashville Tennessean, 3/6). In December, Nixon, ruling in a lawsuit filed by the Tennessee Justice Center, said that Tennessee must move all TennCare beneficiaries under age 21, who make up 40% of total enrollment, into a separate program because the state has failed to provide adequate EPSDT services to them. Nixon said he would appoint a special master to develop a solution to comply with the order. Tennessee officials had expressed concern that moving the children out of TennCare would end the managed care aspect of the program or the program altogether. But in a clarification issued in February, Nixon said his ruling did not mean the end of TennCare, saying the ruling did not prevent the state from serving children through a managed care program (Kaiser Daily Health Policy Report, 2/11). State Attorney General Paul Summers has appealed Nixon's ruling, but no hearings have been set (Park, Chattanooga Times & Free Press, 3/6).

Moving Forward
Carter, who was the medical director of Access MedPLUS, a now-bankrupt TennCare health plan that the state is liquidating, said he will work with state officials and advocates to "come up with a plan both parties think will work to achieve EPSDT compliance." While at Access MedPLUS, Carter helped to improve delivery of EPSDT services, the Tennessean reports (Nashville Tennessean, 3/6). Noting that Nixon has ordered that a plan be presented to the court by the end of May, Carter said, "The judge has given us 90 days, and we're attempting to hit that goal. I think we've got a lot of work to do and I'm going to do the very best I can." Nixon took nominations from the state and the Justice Center for the special master position. While neither side had suggested Carter for the position, both said they would work with him. Michele Johnson of the Tennessee Justice Center said, "We're happy the judge has appointed someone so we can move forward to improve care for TennCare children." TennCare spokesperson Lola Potter said, "We're going to work with [Carter] any way we can" (Chattanooga Times & Free Press, 3/6).