Tennessee Must Be Diligent in Restoring Benefits To Eligible Beneficiaries Removed from TennCare, Editorial Says

With Tennessee in the final stages of reverifying the eligibility of beneficiaries enrolled in TennCare, the state's Medicaid managed care program, a process is need to ensure those who are "unfairly cut" from the program do not need to wait until the next open enrollment period to have their benefits restored, according to a Tennessean editorial (Tennessean, 12/10). The state has been conducting an eligibility reverification process, required by a waiver approved earlier this year by the federal government that allows the state to restructure TennCare eligibility and benefits. The waiver requires TennCare to reverify all non-Medicaid-eligible beneficiaries' eligibility; about 159,000 current beneficiaries are expected to be found ineligible under the new guidelines, according to state officials. The state sent out three batches of letters, beginning in July, asking beneficiaries to complete the reverification process at their local Department of Health Services office within 90 days. Beneficiaries who fail to respond to the reverification notices will be dropped from the program; many other beneficiaries will lose benefits under the program's new qualifications. While the reverification process "has been plagued" by understaffing, congested phone lines, computer outages and "other problems," Tennessee Gov.-elect Phil Bredesen (D) has said he will help restore benefits to individuals who lost benefits erroneously (Kaiser Daily Health Policy Report, 12/9). The editorial notes that the Bredesen's comments are "encouraging," because many TennCare beneficiaries will have difficulty with the reverification process. The editorial concludes that the state "must be just as diligent in keeping eligible enrollees in the program as it is in cutting those who are ineligible" (Tennessean, 12/10).