Hospital group CEO says she’s ‘Cautiously optimistic’ about TennCare block grant

Local News

NASHVILLE, Tenn. (WKRN) – “Cautiously optimistic” is the way a key stakeholder describes the massive plan to change funding for the state’s Medicaid program Tenncare

The words came Thursday at a hearing about the plan that affects one-point four million low-income Tennesseans on the program.

Comments were less harsh than those from earlier statewide public meetings about what’s called the TennCare block grant waiver.

The plan is to get a set amount of money yearly from the federal Medicaid program instead of the current system of funding based on how much is spent on TennCare.

The state also wants the federal government to share the annual savings it gets from TennCare being run under projected costs by Medicaid officials.

“I would say we are cautiously optimistic,” said Dr. Wendy Long, who once led TennCare taking before recently becoming CEO of the Tennessee Hospital Association whose members rely heavily on TennCare payments.

Dr. Long said she’s optimistic because the plan could potentially cover more low-income Tennesseans who are eligible for TennCare.

She’s cautious “about what’s not in the plan.”

They are things like written assurances not to change eligibility and benefits for TennCare enrollees and lack of detail in the pharmacy section of the block grant proposal.

“We think we probably need to see some assurances that drugs proven to be superior than other drugs in the particular therapeutic category will be covered,” added Dr. Long.

She also wants opportunities to weigh in again before lawmakers as the unprecedented request moves forward with likely changes.

More testimony came from the head of the state’s disability coalition who supported the goals of the funding changes but reminded lawmakers of what at stake.

“TennCare for us is not just health insurance, its a lifeline,” said executive director Carol Westlake. “But whenever we talk about savings, people with disabilities get nervous because people with disabilities are the most expensive and the most vulnerable enrollees in TennCare and Medicaid in general.

Thursday’s testimony is just part of what Tenncare is digesting as it designs the new plan affecting one-point for million Tennesseans. 

The plan currently being discussed is called a first draft

TennCare plans to submit an updated proposal on November 20th for the federal government approval.

After that, state lawmakers must also approve.

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