TennCare Pausing Terminations durning COVID-19

TennCare also stopping involuntary disenrollments from LTSS

TennCare Advocates,

We wanted to take an opportunity to update our advocacy partners on a few decisions TennCare has made in light of the COVID-19 emergency.  To start, for the duration of the emergency, TennCare is pausing terminations for both Medicaid and CoverKids with exceptions for voluntary terminations and cases where a member is no longer a resident. Redeterminations will continue only to the extent a member can be automatically renewed through the ex parte process. The effective date for this pause is March 18 so anyone who was enrolled as of that date will maintain coverage through the end of the national emergency.  This includes members who received continuation of benefits pending appeal as of that date. Regarding the 90-day termination period, this pause will not impact that process currently. If an individual who submits information during the 90-day reconsideration period is ultimately approved, we will continue to fill any gap in coverage back to the date of termination, just as we have done voluntarily for the last several years.

We have also implemented several Long-Term Services and Supports (LTSS) policy changes including the pause of all involuntary disenrollments from LTSS programs. To ensure continued access to these important services, we are allowing all assessments (PAEs, PASRRs) to be performed remotely. We continue to work closely with our partners and have issued guidance to MCOs, AAADs, and providers, and have worked with DIDD to issue guidance to their support coordination and provider agencies. All of these updates are available on the TennCare Coronavirus webpage at  https://www.tn.gov/tenncare/information-statistics/tenncare-information-about-coronavirus.html.

TennCare has always encouraged anyone who thinks they may be eligible to apply and TennCare Connect will remain open and accessible to anyone seeking to do so.  As you know, online, phone, mail, and in person are all options to apply and we will closely monitor the availability of each of those options as we move forward.  Specific to the application process, TennCare will begin taking self-attestation of eligibility criteria, including income and resources, on a case-by-case basis when documentation is not available due to the coronavirus pandemic.  We have also temporarily simplified the presumptive eligibility process so that applications and signatures can be completed by phone during this emergency; however, anyone who gains or has recently gained eligibility through the presumptive process will still need to apply in order to maintain their eligibility status.

On the medical side, we are also in constant contact with provider groups and stakeholders on ways to support impacted providers and have already taken steps to ensure services are not disrupted.  For example, we have already significantly expanded telehealth policies and guidance regarding services is updated on our website as soon as it becomes available.  Additionally, we have authorized automatic reauthorizations for ongoing home health and private duty nursing services for at least 60 days.  This authorization is temporary and will be reevaluated as we continue to work with our health plans during this period.    

Finally, to secure additional flexibilities related to the COVID-19 emergency, TennCare has submitted an 1135 waiver to CMS.  If approved, TennCare will gain several regulatory flexibilities targeted toward providers and designed to ensure sufficient health care services are available to serve our members.

Again you can find up-to-date information on the TennCare Coronavirus webpage at https://www.tn.gov/tenncare/information-statistics/tenncare-information-about-coronavirus.html.

Please don’t hesitate to reach out if you have any questions.

Thanks

Sarah

Sarah Tanksley Stockton

Director of Communications

310 Great Circle Rd., Nashville, TN 37243

p. 615-507-6457 c.615-767-4109

sarah.tanksley@tn.gov tn.gov/tenncare