TennCare Officials Report Progress Responding to Audit that Identified Potential Ineligible Beneficiaries

TennCare, Tennessee's Medicaid managed care program, has made "incredible progress" correcting problems found by an audit, Deputy State Finance Commissioner John Tighe, who oversees the program, told state lawmakers on May 7, the AP/Memphis Commercial Appeal reports (Sharp, AP/Memphis Commercial Appeal, 5/8). According to an annual audit by the state Office of Comptroller, between July 1, 2000, and June 30, 2001, TennCare paid $7 million to provide care to inmates, even though the state is separately responsible for such costs. The audit also found that TennCare spent $48 million on health services for individuals who did not live in Tennessee and $465 million on services for beneficiaries whose eligibility could not be confirmed because they listed P.O. box addresses on their applications instead of a street address. TennCare paid about $2 million to the state Department of Children's Services to provide health care, even though other health plans already had been paid to provide the services. The program also spent more than $700,000 to enroll state employees, who are covered by another state health plan (Kaiser Daily Health Policy Report, 4/26).

Addressing the Audit
Testifying before the House Finance Committee, Tighe said that since the audit was conducted, program officials have reduced the number of out-of-state beneficiaries from 20,000 to 8,800 (Lewis, Nashville Tennessean, 5/8). Out-of-state enrollment will never reach zero, he added, because TennCare is required to cover some people who move out of state, such as college students and people who move to care for an ill relative (AP/Memphis Commercial Appeal, 5/8). In response to the audit, the program also has ceased paying for inmates' health care, Tighe said, but he added that individuals released on parole may qualify for TennCare coverage because of income levels (Nashville Tennessean, 5/8). Regarding the 130,000 beneficiaries who listed P.O. boxes as their addresses, Tighe said that according to files maintained by the program, only 8,000 individuals had listed only a P.O. box address and the remaining individuals had listed a street address as well as a P.O. box. He added that the 8,000 individuals who listed only a P.O. box were being checked for eligibility. Tighe said that 1,100 state employees have been dropped from the program. However, some children of state employees remain eligible for the program. Some of the problems the audit uncovered are due to the outdated computer system TennCare uses, Tighe said (AP/Memphis Commercial Appeal, 5/8). The current system was purchased in the 1970s; a new system is scheduled to be in place by October 2003 (Kaiser Daily Health Policy Report, 4/26).