Tennessee Gives Financially Troubled TennCare MCO $2M Advance To Pay Providers
Universal Care of Tennessee, an insurance company participating in TennCare, Tennessee's Medicaid managed care program, on April 2 received an advance payment of $2 million from the state that will allow the financially troubled insurer to pay providers, the Nashville Tennessean reports. Last week, Universal instructed its bank to stop payments on checks issued to providers that had yet to be cashed, but with the advance payment, the insurer "reversed course" and reissued the checks. The funds come one week after the state threatened to cancel Universal's TennCare contract (Lewis, Nashville Tennessean, 4/3). Last week, the state Department of Commerce and Insurance said that because of the company's history of late payments to providers, inadequate claims-processing system and negative net worth of $42 million, the state is considering ending the company's TennCare contract, meaning that the company will be placed either in state-supervised rehabilitation or in liquidation. If Universal Care cannot resolve its problems by April 19, its TennCare beneficiaries on May 1 would be shifted into TennCare Select, a backup fee-for-service program administered by BlueCross BlueShield of Tennessee (Kaiser Daily Health Policy Report, 3/27).
Disclosing HMO Records
In other TennCare news, state Reps. Bobby Sands (D) and Bill Clabough (R) have introduced a bill that would require TennCare MCOs that are in state supervision or receivership to publicly disclose their financial records if at least 51% of their revenue comes from TennCare. The bill comes in response to the various TennCare MCOs, such as Access MedPLUS, that became insolvent or went into state receivership last year and were not required to make their financial records public because they are private organizations. Sands and Clabough said the bill would allow the public to learn how TennCare funds are spent and possibly why the MCOs failed. The Tennessean reports there remains some dispute over whether the bill would make "proprietary" information, such as operating expenses or reimbursement levels, public. BlueCross BlueShield of Tennessee is working on an amendment to the bill that would omit information such as contract language and fee schedules from public disclosure requirements (Cheek, Nashville Tennessean, 3/31).
