Advocacy Action Items for DBSA Tennessee
Below is the news release from Governor Haslam and our elected officials on cuts in services to Medicaid to be effective July 1, 2014. Tennesseans are loosing in every way as the expansion to Medicaid, with the huge funding it brings, is refused by Governor Haslam. I urge readers to use the contact information at the end of the release to inform our representatives and senators of the sufferings that will result by the implementation of Amendment 21.
Thank you, Larry, for bringing the announcement to our attention. [Larry Drain, Legislative Liaison for State Legislative Affairs, DBSA Tennessee]
Notice of Change in TennCare II Demonstration Amendment 21
The Commissioner of the Tennessee Department of Finance and Administration is providing official notification, pursuant to 42 CFR § 447.205 and 59 Fed. Reg. 49249, of intent to file an amendment to the TennCare II Demonstration, as well as corresponding amendments to the Medicaid State Plan. The amendments will be filed with the Centers for Medicare and Medicaid Services (CMS), a federal agency located in Baltimore, Maryland, with a Regional Office in The State is required to meet certain advance notice obligations whenever an amendment to the TennCare Demonstration is filed. This demonstration amendment, which will be known as “Amendment 21,” is being filed with a proposed effective date of July 1, 2014. The benefits listed in this notice are currently supported with non-recurring funds that have been made available through a hospital assessment fee scheduled to expire on June 30, 2014. Should the fee be renewed, the changes contained in Amendment 21 will not occur.
Amendment 21 will eliminate certain currently covered services and establish benefit limits on others. Children under 21 will not be affected by these changes. Eligibility for TennCare will not be affected by these changes. Pregnant women and institutionalized persons will not be affected by proposed benefit limits; however, they will be affected by the elimination of coverage for occupational therapy, speech therapy, and physical therapy.
The specific changes to be made are as follows:
• Implementation of a combined annual limit of 8 days per person for inpatient hospital and inpatient psychiatric hospital services
• Implementation of an annual limit on non-emergency outpatient hospital occasions of 8 per person (an “occasion” is a day)
• Implementation of a combined annual limit on health care practitioners’ office visits of 8 “occasions” per person (an “occasion” is a day)
• Implementation of an annual limit on lab and X-ray services of 8 occasions per person (an “occasion” is a day)
• Elimination of coverage for occupational therapy, speech therapy, and physical therapy
It is our intention to submit this amendment to CMS with the request that it be approved in time for implementation to occur on July 1, 2014. Corresponding State Plan Amendments will be filed, where appropriate. We estimate that implementation of the amendment and corresponding State Plan changes will result in a decrease in aggregate annual expenditures of $302,722,400 in State Fiscal Year 2015.
Copies of this notice will be available at county health departments in Tennessee, and on the TennCare website located online at http://www.tn.gov/tenncare/.
Written comments may be submitted by email to [email protected] or may be mailed to Mr. Darin Gordon, Director, Bureau of TennCare, 310 Great Circle Road, Nashville, Tennessee 37243. Persons wishing to review copies of written comments received may submit their requests to the same email and/or physical address.
Message from Brad Palmertree of the Tennessee Health Care Campaign
We knowwhat you're thinking. The biggest winner on Tuesday? Health reform. As you well know, the presidential election was a cloud hanging over the future of the Affordable Care Act, sometimes better known as "Obamacare."The election results settle key issues about the direction that healthcare will take in our nation. With no more hurdles before it, states now have the responsibility to implement the law swiftly and effectively.
So what happens now?
Insurance Exchanges
Exchanges are online marketplaces in which individuals and small businesses will purchase private insurance and take advantage of subsidies to help pay premiums. States should set up their own, but they can opt out and allow the federal government to do it for them. Tennessee has not made a decision.However, they must make a decision by November 16th. The governor favors a state exchange, but he's facing some push-back from colleagues in the General Assembly.
Medicaid (TennCare) Expansion
As you probably know, the Supreme Court ruled in June that states have the option to expand their Medicaid program. Again, Tennessee has not made a decision.This decision point could take a while because it needs to go through our state legislature's budget process (even though the Feds pay 100% of the expansion for the first 3 years & it slowly goes down to a permanent 90%). Many legislators have come out strongly against the expansion, and in fact legislation has already been introduced to prevent it.
Is that it?
We wish. At the federal level, there's a manufactured "fiscal cliff" that some economists say will send us into another recession. If Congress doesn't act by the end of the year, across-the-board spending cuts & tax hikes will take effect. Here's a really good, detailed explanation of what it means and what kind of budget cuts & tax hikes are included.
What does that mean for
our work?
Medicaid is incredibly vulnerable. Even the President has put Medicaid on the table when compromising for budget cuts. We must protect this important safety net for our most vulnerable neighbors.
Additionally, the Affordable Care Act could take some hits around the Prevention & Public Health Fund as well as the tax credits that will allow individuals to afford private insurance in 2014. We'll need to watch these conversations carefully to ensure we're not sacrificing these important investments.
What can I do?
SO GLAD YOU ASKED! Here are a few simple steps for you to take.
Call Gov. Haslam: or email him: . Let him know you support a state exchange AND the expansion of TennCare. Here are some talking points.
Call your state legislators & give them a call or email. Tell them to support Governor Haslam in his idea of a state-based exchange. Be
sure to mention that you don't like them leaving federal money on the floor to pay for an expansion of TennCare. Scroll down on this page for some great fact sheets on the benefits of TennCare expansion.
Share the word! Email, Facebook, & Twitter - use it all! Just use those little buttons in the upper-right corner of this message.
Support our work! You depend on us and we depend on you. This work can't happen without you. An investment in THCC means that your voice continues to be heard throughout the process of meaningful health reform implementation here in Tennessee.
This is your official election roundup! Keep reading to see what this
week's election results mean for health care in Tennessee.
Get caught up on your ACA education here.
Let's be friends! Stay in touch with THCC on Facebook & Twitter. We'll keep it interesting...promise.
THCC is a proud member of Community Shares.
Now that we can move forward with confidence, our work has never been moreimportant. We can't do it without you.
Are you looking for ways to give back to your community? Do you
haveexperience in web design? Or policy analysis? We're looking for a few
goodvolunteers. Contact us and let's become best friends!
1103 Chapel Ave. | Nashville, TN 37206 US
Thank you, Larry, for bringing the announcement to our attention. [Larry Drain, Legislative Liaison for State Legislative Affairs, DBSA Tennessee]
Notice of Change in TennCare II Demonstration Amendment 21
The Commissioner of the Tennessee Department of Finance and Administration is providing official notification, pursuant to 42 CFR § 447.205 and 59 Fed. Reg. 49249, of intent to file an amendment to the TennCare II Demonstration, as well as corresponding amendments to the Medicaid State Plan. The amendments will be filed with the Centers for Medicare and Medicaid Services (CMS), a federal agency located in Baltimore, Maryland, with a Regional Office in The State is required to meet certain advance notice obligations whenever an amendment to the TennCare Demonstration is filed. This demonstration amendment, which will be known as “Amendment 21,” is being filed with a proposed effective date of July 1, 2014. The benefits listed in this notice are currently supported with non-recurring funds that have been made available through a hospital assessment fee scheduled to expire on June 30, 2014. Should the fee be renewed, the changes contained in Amendment 21 will not occur.
Amendment 21 will eliminate certain currently covered services and establish benefit limits on others. Children under 21 will not be affected by these changes. Eligibility for TennCare will not be affected by these changes. Pregnant women and institutionalized persons will not be affected by proposed benefit limits; however, they will be affected by the elimination of coverage for occupational therapy, speech therapy, and physical therapy.
The specific changes to be made are as follows:
• Implementation of a combined annual limit of 8 days per person for inpatient hospital and inpatient psychiatric hospital services
• Implementation of an annual limit on non-emergency outpatient hospital occasions of 8 per person (an “occasion” is a day)
• Implementation of a combined annual limit on health care practitioners’ office visits of 8 “occasions” per person (an “occasion” is a day)
• Implementation of an annual limit on lab and X-ray services of 8 occasions per person (an “occasion” is a day)
• Elimination of coverage for occupational therapy, speech therapy, and physical therapy
It is our intention to submit this amendment to CMS with the request that it be approved in time for implementation to occur on July 1, 2014. Corresponding State Plan Amendments will be filed, where appropriate. We estimate that implementation of the amendment and corresponding State Plan changes will result in a decrease in aggregate annual expenditures of $302,722,400 in State Fiscal Year 2015.
Copies of this notice will be available at county health departments in Tennessee, and on the TennCare website located online at http://www.tn.gov/tenncare/.
Written comments may be submitted by email to [email protected] or may be mailed to Mr. Darin Gordon, Director, Bureau of TennCare, 310 Great Circle Road, Nashville, Tennessee 37243. Persons wishing to review copies of written comments received may submit their requests to the same email and/or physical address.
Message from Brad Palmertree of the Tennessee Health Care Campaign
We knowwhat you're thinking. The biggest winner on Tuesday? Health reform. As you well know, the presidential election was a cloud hanging over the future of the Affordable Care Act, sometimes better known as "Obamacare."The election results settle key issues about the direction that healthcare will take in our nation. With no more hurdles before it, states now have the responsibility to implement the law swiftly and effectively.
So what happens now?
Insurance Exchanges
Exchanges are online marketplaces in which individuals and small businesses will purchase private insurance and take advantage of subsidies to help pay premiums. States should set up their own, but they can opt out and allow the federal government to do it for them. Tennessee has not made a decision.However, they must make a decision by November 16th. The governor favors a state exchange, but he's facing some push-back from colleagues in the General Assembly.
Medicaid (TennCare) Expansion
As you probably know, the Supreme Court ruled in June that states have the option to expand their Medicaid program. Again, Tennessee has not made a decision.This decision point could take a while because it needs to go through our state legislature's budget process (even though the Feds pay 100% of the expansion for the first 3 years & it slowly goes down to a permanent 90%). Many legislators have come out strongly against the expansion, and in fact legislation has already been introduced to prevent it.
Is that it?
We wish. At the federal level, there's a manufactured "fiscal cliff" that some economists say will send us into another recession. If Congress doesn't act by the end of the year, across-the-board spending cuts & tax hikes will take effect. Here's a really good, detailed explanation of what it means and what kind of budget cuts & tax hikes are included.
What does that mean for
our work?
Medicaid is incredibly vulnerable. Even the President has put Medicaid on the table when compromising for budget cuts. We must protect this important safety net for our most vulnerable neighbors.
Additionally, the Affordable Care Act could take some hits around the Prevention & Public Health Fund as well as the tax credits that will allow individuals to afford private insurance in 2014. We'll need to watch these conversations carefully to ensure we're not sacrificing these important investments.
What can I do?
SO GLAD YOU ASKED! Here are a few simple steps for you to take.
Call Gov. Haslam: or email him: . Let him know you support a state exchange AND the expansion of TennCare. Here are some talking points.
Call your state legislators & give them a call or email. Tell them to support Governor Haslam in his idea of a state-based exchange. Be
sure to mention that you don't like them leaving federal money on the floor to pay for an expansion of TennCare. Scroll down on this page for some great fact sheets on the benefits of TennCare expansion.
Share the word! Email, Facebook, & Twitter - use it all! Just use those little buttons in the upper-right corner of this message.
Support our work! You depend on us and we depend on you. This work can't happen without you. An investment in THCC means that your voice continues to be heard throughout the process of meaningful health reform implementation here in Tennessee.
This is your official election roundup! Keep reading to see what this
week's election results mean for health care in Tennessee.
Get caught up on your ACA education here.
Let's be friends! Stay in touch with THCC on Facebook & Twitter. We'll keep it interesting...promise.
THCC is a proud member of Community Shares.
Now that we can move forward with confidence, our work has never been moreimportant. We can't do it without you.
Are you looking for ways to give back to your community? Do you
haveexperience in web design? Or policy analysis? We're looking for a few
goodvolunteers. Contact us and let's become best friends!
1103 Chapel Ave. | Nashville, TN 37206 US