Tennessee is the state of ‘too little, too late’ for its many poor citizens. The Haslam Administration, encouraged by the Republican supermajority in the legislature, decided early on not to set up its own healthcare exchange under the Affordable Care Act. This meant that TennCare, our current state Medicaid program, would have to coordinate closely with the healthcare.gov site from the beginning. We deliberately opted out of access to information that would be enormously useful even if we didn’t expand Medicaid.
In a seemingly unrelated move, the Haslam Administration decided to move the TennCare application process from the Department of Human Services to the TennCare Bureau. The Department of Human Services has physical offices throughout the state; for the TennCare Bureau, only a mailing address is available. You can also reach them by phone or fax. Computer kiosks are now available at all DHS offices to apply for coverage through healthcare.gov, and DHS employees can give minimal assistance to prospective clients who are not familiar with computers.
Meanwhile, DHS and Tenn Care employees are experiencing nightmares of their own, because the state computers cannot interface properly with healthcare.gov. The administration had apparently understood this problem in December 2012, when they entered into a three year, $35.7 million dollar contract ($32 in federal money) with Northrup-Grumman, a global cyber security contractor. Northrup-Grumman, though it has a Healthcare IT branch, is principally noted for building aircraft and drones for the Department of Defense. DOD is notorious for its cost overruns and extended timetables, something Tennessee can hardly afford. Anyway, the Tennessee Eligibility Determination System, or TEDS, is not complete, and as of March 14, 2014 there was no set completion date. – The result is that TennCare is having to work from incomplete files, which are all its system can accept from the federal government.
So what happens if an individual gets a letter from Healthcare.gov saying he/she is eligible for TennCare? DHS and TennCare employees have been given a ‘Desk Guide for Medicaid 2014’, which they have shared with concerned non-profits. The fortunate individual is told,
TennCare is continuing to work daily with the Marketplace to add everyone’s eligibility into our system. When TennCare adds your eligibility, it will be effective as of January 1st (or the date that is on your letter). They hope to have your eligibility in the system within the next 2-3 weeks. After TennCare shows you eligible, you’ll get an approval letter from them that tells you other information about TennCare. If you need care before you get your letter, you can ask them to pay you back for any service TennCare covers. The TennCare Solutions Unit can help you file a reimbursement appeal to be paid back for your care you get AFTER you get your approval letter from TennCare.
Don’t you just LOVE the care the governor and legislature lavish on poor, sick, and confused citizens?