Victory for Caregivers

New law expands the right to information

By Christina Clift
On June 6, 2019 A new state regulation went into effect that aims to help Tennessee's hospitals to integrate family caregivers into their loved ones’ medical records.  This only makes sense, since according to The Tennessee AARP, sixty percent of Tennesseans 45 and older are currently providing unpaid care for a loved one.  That’s nearly one million people that are caregivers for a family member. 

The Caregiver Advise, Record, Enable, or CARE, Act requires hospitals to inform family caregivers when their loved ones have been discharged from the hospital.

“The CARE Act is designed to improve communication and coordination between medical facilities and caregivers,” said Kim Daugherty, Executive Director of the Aging Commission of the Mid-South, “and is a step forward for improving healthcare in our state.”

In 2015, a telephone survey found more than 80 percent of registered voters in the state, age 45 and older, supported the CARE Act. In addition to household chores, family caregivers increasingly are performing medical and nursing tasks, such as managing multiple medications, administering injections and using special equipment. 

But despite that, these family caregivers were not kept informed on changes in their loved ones care by hospital staff.  This legislation removes barriers and facilitates communication by mandating that all Tennessee hospitals must comply with a patient's wish to give updates about their healthcare to designated individuals.

The Tennessee AARP, the state Department of Health and the Hospital Association of Tennessee worked to craft the regulation.  Similar CARE Act provisions have either been adopted or are under consideration in 40 states.  The CARE act provides for:

    The name of the family caregiver to be documented in a patient’s medical record upon being admitted to a hospital.

    The family caregiver is notified when a loved one is to be discharged to another facility or returning home.

    The facility must provide an explanation and live instruction of the medical tasks that need to be done for that patient.

With the passage of the CARE Act, caregivers will be more informed on how they can help their loved one and know when and where they are being discharged.  The enactment of this regulation puts even more control in the patients hands and gives them a stronger voice on who is involved with their care.

On the Road Again

Drive for Our Lives bus visits Memphis

By Allison Donald
Save My Care is a grassroots community of Americans from all fifty states who have come together as a movement to oppose the repeal of the Affordable Care Act, and push for positive solutions for our health care challenges.  As a result of their work and the work of countless organizations like the Memphis Center for Independent Living and ADAPT the bill to repeal and replace the Affordable Care Act never made it out of the Senate.  The Drive for Our Lives bus tour is a continuation of the Save My Care movement which aims educate and engage in civic outreach to protect our healthcare.   

On Thursday the Drive for Our Lives bus returned to Memphis in front of City Hall with Diana Baker, a nurse, Faith Pollan, Planned Parenthood representative and myself, representing Mid-South ADAPT and MCIL. The program was telling real stories of Tennesseans who have been affected the Affordable Care Act.   

Diane Baker spoke about being a nurse at a rural hospital and the desperate need for them to remain open. Hospitals like the Copper Basin Medical Center in Polk County are at risk of closing due to lack of funding. Copper Basin Medical Center is the only critical access hospital in Polk County, Tenn. Many other rural hospitals across Tennessee will meet this fate and the people who rely on this hospital for medical treatment will suffer because there means of getting help has been forced to close its doors.

This healthcare debate ultimately is about people like Faith Pollan who chose to use the services provided by Planned Parenthood have an abortion and take charge of her own reproductive health.  Planned Parenthood guided her through one of the most difficult decisions a woman may have to make.  It is important for us as disability community to stand with organizations such as Planned Parenthood. Organizations such as this one allow women with disabilities access to care who may not have health insurance and cannot afford some aspects of prenatal care.

In Tennessee people receiving Long Term Supports and Services make up 3% of Medicaid enrollees, but account for 20% of the cost.  The services provided by Medicaid that help people with disabilities live in the community are at risk of being cut severely if law makers choose to constitute block grants.  If we did not have those provision in the Affordable Care Act then we will be forced into nursing and our liberty and freedom as Americans will be taken away.  Mid-South ADAPT and MCIL are working to gather support for the Disability Integration Act (HR 2472) and (S910).  This piece of civil rights legislation will make it a mandate that people with disabilities receive supports and services that allows us to live, work, and play in our respective communities.  We realize that we even though we may have won the battle the fight for our lives is not over.

If you would like to join us in the fight to protect our healthcare you can visit www.savemycare.org for more details and to find out where the next stop on the Drive for Our Lives bus tour will be.

The Arc Warns that the Senate Republican Health Care Legislation Continues to Pose a Severe Threat to People with Disabilities

From the Arc:

Washington, DC – The Arc released the following statement following the release of the updated Senate Republicans’ health care legislation discussion draft: 

“A new draft, new talking points, same devastating impact on people with intellectual and developmental disabilities. It is disheartening to know that Senators were in their districts for the last week, yet the pleas of their constituents with disabilities have been ignored with the latest draft of this legislation. This response to the extensive and impressive outreach from the disability community is an insult to people with disabilities and their families. 

“The Better Care Reconciliation Act is an assault on people with disabilities and we implore Senators to do the right thing and oppose this bill. A vote in favor of this bill is a vote against the progress of the disability rights movement and constituents who rely on Medicaid for their independence,” said Peter Berns, CEO of The Arc.

On June 22, 2017, the Senate Budget Committee released a discussion draft of health care reform legislation, the “Better Care Reconciliation Act of 2017” (“Senate bill”). The Congressional Budget Office (CBO) released an analysis of the cost of the bill and the impact on health care coverage. CBO found that at least 22 million fewer individuals would have health care coverage by 2026. CBO also found that the Senate bill cuts Medicaid by $772 billion over 10 years, but the most severe cuts do not begin to take effect until 2025. Starting in 2025, the cuts are billions more than the cuts in the House bill and would increase significantly over time. CBO found that, compared to current law, Medicaid would decrease by 35% in 2036. 

The current discussion draft from the Senate did include a woefully inadequate home and community based four-year demonstration program for rural states.  A total of $8 billion is available over four years.  In contrast, the discussion draft retains the $19 billion dollar cut made to the Community First Choice Option which is a program available to any state that chooses the option with no end date.    

The Arc advocates for and serves people with intellectual and developmental disabilities (I/DD), including Down syndrome, autism, Fetal Alcohol Spectrum Disorders, cerebral palsy and other diagnoses. The Arc has a network of over 650 chapters across the country promoting and protecting the human rights of people with I/DD and actively supporting their full inclusion and participation in the community throughout their lifetimes and without regard to diagnosis.

Editor’s Note: The Arc is not an acronym; always refer to us as The Arc, not The ARC and never ARC. The Arc should be considered as a title or a phrase.

###

SAVE MY CARE!

Save My Care Bus Tour in Memphis this Monday

The Save My Care Bus Tour is a two-month, cross-country tour focused on telling the stories of the more than 30 million Americans who will lose their health care under Congress’ dangerous repeal plan. 

So far, the bus has held 31 rallies in 14 states and traveled 7,457 miles telling the stories of the more than 30 million Americans who will lose their health care under Congress’ dangerous repeal plan.

Memphis Stop: February 27, 2017 12:00pm-2:00pm

Navy Park South Second Street and GE Patterson
Memphis, TN 38103

SAVEMYCARE.ORG

ADAPT Diary Day 1

Pappas Rehabilitation Hospital for Children & Judge Rotenberg Center

By Allison Donald
Two hundred members of National ADAPT traveled to Canton, Massachusetts on Halloween to visit the Pappas Rehabilitation Hospital for Children and the Judge Rotenberg Center.  Both facilities have much in common.  Both facilities are surrounded by picturesque neighborhoods.

The Pappas Rehabilitation Hospital for Children and the Judge Rotenberg Center are isolated and controlled.   In the case of the Judge Rotenberg Center allegations of abuse have been made for years and they have used electric shock on people.  The children locked away are out of sight, out of mind. These young children and adults are seemingly forgotten because they are in a “safe” environment with professionals who could watch them so the neighbors can sleep at night.

The administrations of both facilities were caught off guard by ADAPT’s visit.  The Pappas Rehabilitation Hospital for Children was more receptive to National ADAPT when they were informed that all we wanted was to bring the kids some candy for Halloween.  It gave members of Massachusetts ADAPT an opportunity continue to put pressure on the state to adopt budget policies that would make it possible for institutionalized children to be at home with their families. 

This was in stark contrast to the reception National ADAPT received at the Judge Rotenberg Center.  As members of National ADAPT ascended onto the front steps and packed the entrance the staff looked confused about who we were and why we didn’t line the road and protest like other groups had.  The tension between Judge Rotenberg Center employees ratcheted up once the police arrived and they realized we were not going anywhere.

ADAPT kept up constant chants.  We wanted the administration and residents alike to know that the torture of people with disabilities is egregious and should not and would be tolerated in any circumstance. 

National ADAPT put the Pappas Rehabilitation School for Children and Judge Rotenberg Center on notice. ADAPT and disability rights activists are watching and they will be held accountable for the treatment of people with disabilities. FREE OUR PEOPLE!

Tennessee finally closing the Medicaid Gap?

The Three-Star Healthcare Taskforce Pilot Program for Tennessee

The Three-Star Healthcare Taskforce released an outline of a Medicaid expansion plan today. The process has taken far too long and has been costly for the state of Tennessee, but finally our state may have an insurance proposal that could close the coverage gap.

The Taskforce was created by Speaker Beth Harwell to address the Legislature overlooking the issue of Medicaid Expansion in the state of Tennessee. The Three-Star Healthcare Taskforce has been hearing from the federal Center for Medicare and Medicaid Services about the proposal.

The proposal is called a “Pilot” program and may be adopted as soon as April of next year. The first phase of the plan would be to cover about 140,000 people in Tennessee without insurance by diagnosis, and expand the program if it meets goals set for the first six months. The proposal includes employment and job training services for enrollees.

Phase two would be rolled out in January of 2018 at the earliest. The second phase will close the coverage gap and be paid for by the federal government through the Affordable Care Act and the Tennessee Hospital Association will pick-up the balance.

Tennessee Long-Term Care Program begins July 1

Employment and Community First Program offers options to institutions

June 30
Starting this Friday, individuals with intellectual disabilities and developmental disabilities not currently receiving Medicaid waiver services can apply for the new Employment and Community First program.

The new Employment and Community First program is an effort to serve more people and expand options in long-term services and supports with TennCare.

The ECF program opens for applications this Friday, July 1, 2016. Referrals for enrollment cannot be accepted before Friday. However, starting Friday, you can fill out a "self-referral online form" on the TennCare homepage to apply for the program. The form will be posted and available at:

https://tcreq.tn.gov/tmtrack/ecf/index.htm

You may apply by completing the self-referral form at the link above; but if you need help or have questions you can call the agencies listed below. Applicants who have Medicaid but are not sure who the MCO is may call the Tennessee Health Connection line 1-855-259-0701.

Applicants who already have Medicaid and are enrolled with Amerigroup or BlueCare should contact their Managed Care Organization with questions or if you need assistance completing the self-referral form. You can find the information about how to call your MCO on your insurance card.

Applicants who already have Medicaid and are enrolled with United HealthCare Community Plan should contact Dept. of Intellectual and Developmental Disabilities Regional Intake Offices with questions or if you need assistance completing the self-referral form.

Applicants who do not have Medicaid should contact Dept. of Intellectual and Developmental Disabilities Regional Intake Offices with questions or for assistance completing the self-referral form for both ECF CHOICES and applying for Medicaid. The DIDD contact information is below:

DIDD Regional Intake Office Contact information:

West Tennessee Regional Office Office of Intake (866) 372-5709
Middle Tennessee Regional Office Office of Intake (800) 654-4839
East Tennessee Regional Office Office of Intake (888) 531-9876 

If you are currently on the waiting list for home- and community-based services (HCBS) through the Medicaid waiver you should receive a letter about the new program the first week it begins. The letter should tell you to use the self-referral form on the TennCare website, starting July 1. Based on the information DIDD currently has about you they may automatically refer you to the ECF CHOICES program in an active or deferred category.

Caregivers and Alzheimer's

Fifth Annual Alzheimer’s Caregiver Conference

By Bobbie Fields
 
The Fifth Annual Alzheimer’s Caregiver Conference was about becoming an empowered caregiver. It can feel overwhelming to take care of a person with dementia, and may harm both if the caregiver is neglected.

Alzheimer’s is a disease of the brain that causes problems with memory, thinking and behavior. It is not a normal part of aging. The disease may cause a person to become confused, get lost in familiar places, misplace things or have trouble with language.

Brent Worthington, a former primary caregiver, is the author of “Things you never want to hear your grandmother say.”  He spoke about his experience with caring for his grandmother. Mr. Worthington said there were times when he had to be creative in order to get her to eat, bathe, dress and go to bed.

Dr. Brandon C. Baughman, Ph. D, Board Certified in Clinical Neuropsychology at the Semmes-Murphy Neurologic and Spine Institute; talked about the forms of Alzheimer’s such as Vascular dementia, Parkinson’s disease, Down Syndrome and Huntington’s disease just to name a few. He said more than 5 million Americans have Alzheimer’s disease, which is the most common form of dementia accounting for 60 to 80 percent of all cases. That includes 11% of those age 65 and older and a third of those 85 and older. The disease also impacts more than 15 million family members, friends and caregivers.

For a caregiver to take good care of their family; they must also take care of themselves. There are ten signs of caregiver stress: denial, anger, social withdrawal, anxiety, depression, exhaustion, sleeplessness, irritability, lack of concentration and health problems. For caregivers who may have these signs, the Alzheimer’s Center has a 24/7 Support Helpline:  (800) 272-3900.

If you want to know more about Alzheimer’s Community Resources and the effect on caregivers; you can call the Alzheimer’s Association at (800) 272-3900 or visit the website alz.org. For information regarding Living Wills and Forms please call Ms. Jerry Ashley at (901) 415-3464 (Voicemail/leave message).  

Health Care Task Force in Memphis

Plan to be at the hearing on Monday, May 9

Short Notice - Just released yesterday, the House Health Care Task Force has been scheduled for next week - Monday, May 9, from 3 to 5:PM. The meeting will be on the campus of the University of Memphis in the third-floor Fountain View Room of the University Center, 499 University Street, Memphis, TN 38111.

Speaker Harwell’s Healthcare Task Force is hearing testimony about a proposed alternative to Insure Tennessee for coverage of those currently in the Medicaid gap. Those in the gap are mostly working people who cannot afford premiums of health insurance.  The Task Force is hearing testimony on a replacement plan for Insure Tennessee to provide access to affordable health care for the 280,000 people in the gap in Tennessee.

This two hour hearing for all of the region of West Tennessee, including the City of Memphis is clearly not enough. However, this may be the only opportunity for people in west Tennessee to hear testimony on the issue. Make plans to be at the hearing if you can.

YOU CAN CONTACT THE TASK FORCE:
Office of Representative Cameron Sexton, Chairman (615) 741-2343
Rep.Cameron.Sexton@capitol.tn.gov

TennCare Redetermination

What is redetermination and how will it affect millions of Tennesseans healthcare coverage?

By Allison Donald

Redetermination is the process by which the Tennessee Department of Human Services (DHS) evaluates the ongoing eligibility status of TennCare Medicaid and TennCare Standard enrollees. Starting in December, TennCare entered into the final phase of the redetermination process. 

There have been many challenges during this process that has left many Tennesseans confused and without medical coverage. This year’s redetermination process will look different than in previous years.  DHS workers are said to be helping fill out and fax renewal packets.  Enrollees who do not have a caseworker they can contact, may call the Tennessee HealthCare Campaign (THCC) with basic questions about the Renewal Packet, but there may lengthy wait times.

The state is required to extend coverage for all enrollees who can be determined by review of records already available to the state.  Also, the state is required to send enrollees notices that are pre-populated with any information already available to the state to give enrollees an opportunity to provide any missing information. 

The state must also provide assistance in person or by phone for the redetermination.  The enrollee is required to keep TennCare informed of any changes in contact information.  The enrollee must report any changes in income, household composition and must respond to the redetermination notice within 30 days. Enrollees also must provide supporting documentation, as requested by the state. 
According to TennCare Division of Healthcare Finance and Administration, “All Medicaid agencies like TennCare are required to redetermine the eligibility of members on at least an annual basis. Due to the many complicated changes to Medicaid that took place starting January 1, 2014, the federal government encouraged Medicaid agencies to suspend redetermination efforts in order to focus on other tasks. Most Medicaid agencies – including TennCare suspended redetermination efforts.”

Phase one of the redetermination process began in May and September for approximately 720,000 individuals.  TennCare used SNAP data (food stamps) data gathered by DHS to redetermine eligibility.  No one lost eligibility as part of phase one.
October through December was the start of phase 2 of the redetermination process TennCare sent notice to 300,000 selected enrollees.  The notice asked individuals to sign and return a form if their circumstances changed since their last eligibility review.   Phase 2 involves a confirmation mailing in which,  enrollees must complete the form and fax or mail it to TennCare to complete the redetermination process. It is especially important that all notices are returned to the address and fax number noted on the notice.  In Phase 2, even if individuals are not able to complete the forms he or she will remain in TennCare.

Phase 3 started in November of 2015 with a pilot group of 10,000.  This step will require enrollees to respond to extensive requests for information (RFI).  It will affect people due for redetermination, whose eligibility was not redetermined in phase 1 or 2.  If the enrollee fails to respond to the notices in Phase 3, TennCare will be terminated.

The initial barrier that has complicated this process is that the state is three years behind with its review of enrollees. The challenges vary; they may include the individuals not having their current address in the state system to ensure the state mails these notices to the correct address.  Notices are very confusing and must be read carefully to understand what steps to take. 

If a person has had a change in either their household income or family size since last applied for TennCare, they will need to sign the notice and return it to the state within 30 days.  For families with multiple members on TennCare, they will need to complete each form and return it to the state. 

Individuals may find it difficulty mailing or faxing information back to the state.  If a person fails to complete Phase 3 they will lose their TennCare.  If this should happen and they are still eligible, they will have to reapply through the Federal Marketplace System. Keep in mind that the Federal Marketplace doesn’t properly screen for every TennCare and Medicaid category.  This will make it very difficult for many who are currently on TennCare to get their coverage back. 

If you are experiencing any difficulty during the process please feel free to contact the Tennessee Justice Center (TJC) at tnjustice.org.

Open enrollment for Affordable Care Act Insurance ends this month

More than a Quarter-Million Tennesseans choose Obamacare

The deadline for choosing a plan through the Affordable Care Act is at the end of this month and already more than 236,000 Tennesseans have signed up for Obamacare coverage. To find out if you are eligible for coverage, renew coverage or to sign-up for coverage you may visit HealthCare.gov.

The U.S. Department of Health and Human Services reports that over eleven million US citizens have signed-up through HealthCare.gov for health insurance. The Affordable Care Act made health insurance coverage more available to people with disabilities because of the elimination of the “pre-existing condition” restrictions.

Although our state has not expanded Medicaid to provide coverage to working Tennesseans that do not qualify for the Affordable Care Act subsidies, Tennessee still ranked eleventh of the 38 US states that use the Healthcare.gov marketplace. Tennessee Health Care Campaign estimates that 280,000 Tennessee residents remain in the “coverage gap,” because our state has failed to adopt Medicaid expansion or pass Governor Haslam’s Insure Tennessee legislation. The total tax money lost by not expanding Medicaid is approaching $2 billion, thousands of lost jobs, closing hospitals and higher taxes in our state.

The U.S. Department of Health and Human Services reports Marketplace Signups and Tax Credits in Tennessee:

* 82 percent of Tennessee consumers who were signed up qualified for an average tax credit of $213 per month through the Marketplace.

* 60 percent of Tennessee Marketplace enrollees obtained coverage for $100 or less after any applicable tax credits in 2015, and 92 percent had the option of doing so.

* In Tennessee, consumers could choose from 5 issuers in the Marketplace in 2015 – up from 4 in 2014.

* Tennessee consumers could choose from an average of 71 health plans in their county for 2015 coverage – up from 48 in 2014.

* 78,571 consumers in Tennessee under the age of 35 are signed up for Marketplace coverage (34 percent of plan selections in the state).  And 64,705 consumers 18 to 34 years of age (28 percent of all plan selections) are signed up for Marketplace coverage.

1. Florida-1,569,551

2. Texas-1,108,935

3. North Carolina-558,892

4. Georgia-517,715

5. Pennsylvania-412,914

6. Virginia-387,470

7. Illinois-348,346

8. Michigan-324,359

9. New Jersey-260,323

10. Missouri-258,696

11. Tennessee-236,000

USA-11,400,000

Health Care Coverage Gap Townhall Meeting

Contact state legislator about the Insure Tennessee

By Tim Wheat

The Tennessee Health Care Campaign held a Townhall meeting on Insure Tennessee at the Benjamin Hooks Memphis Public Library Tuesday night from 6 to 8 p.m. About 30 people came out to hear the plan for improving health and keeping billions of dollars from leaving our state. People were asked to write House Speaker Beth Harwell and their state representatives to get Insure Tennessee back on the legislative agenda for 2016.

The town hall meeting began with a video produced by the Tennessee Justice Center that described the problem in Tennessee of the coverage gap. Residents of Tennessee with fixed and very low income are covered by the state Medicaid program called TennCare; most people can afford coverage and benefit from the Affordable Care Act’s subsidy; however, over 280,000 Tennesseans, including 24,000 Tennessee Veterans, fall into the gap between TennCare and subsidy.

Tony Garr with the Tennessee Health Care Campaign gave a brief history of how our state got to this point. He noted that over 60,000 residents of Shelby County will fall in the coverage gap that Insure Tennessee is intended to protect. He was clear that Insure Tennessee is not Obamacare and has no cost to taxpayers.

Mr. Garr quoted a University of Tennessee study that showed Insure Tennessee would bring over $1.2 billion into the state. The reverberation of this advantage would not only be in public health, but could prevent hospitals from closing and would add more than 15,000 jobs to the Tennessee economy. The Tennessee Department of Mental Health estimated that they would save $40 million.

Mr. Garr showed that these figures are not hypothetical. Kentucky, although a smaller state than Tennessee, has expanded its Medicaid program and has saved $802 million and created 40,000 new jobs. In the first year of Medicaid expansion, Kentucky had $6 billion in state savings from uncompensated care alone.

“America gets little for the high health care costs we pay,” said Rick Donlon of Resurrection Health. “Not accepting Insure Tennessee has real-life repercussions for Memphis. This city is suffering already from a two-tier health care system. They say you should be careful driving down Wolf River Parkway with your window down, you may get a heart-stent.”

Dr. Tom Cooper of the University of Tennessee gave a view from his perspective working in the Emergency Room. He pointed out that the people in the coverage gap are working citizens that have jobs and want to keep them. Uncompensated care is often delayed and more expensive, and it is those with insurance that are absorbing the cost.

A Graduate Assistant at the University of Memphis told the audience that he is in the coverage gap. Steven Payne just checked on his health care cost and found that it would be 32% of his annual income. He said he has no coverage but supports Insure Tennessee so that working residents can get the health care they need. 

Contact state officials:

Governor Bill Haslam
1st Floor State Capitol
Nashville, TN 37243
615-741-2001
Bill.Haslam@tn.gov

House Speaker Beth Harwall
301 6th Ave. North Suite 19 Legislative Plaza
Nashville, TN 37243
speaker.beth.harwell@capitol.tn.gov

Find my legislator: www.capitol.tn.gov/legislators/ 



See photos from the event.

TennCare Pink Slips

Please let us know if you get a re-determination notice

From The Tennessee Justice Center: Phase 3 re-determinations begin with mass mailings tomorrow, December 1. This phase will result in the termination of coverage for those unable to meet deadlines for the completion of complex paperwork, or who are found to be ineligible. We are concerned about the risk that large numbers of eligible people will lose their coverage.

If you see or hear of any TennCare pink notices received please contact us right away. MCIL and the Tennessee Justice Center wish to see the notice and we will plan a 1-hour webinar for advocates within a week of seeing the phase 3 notice. The Tennessee Justice Center webinar will be designed to share information that will aid advocates in helping clients through this arduous process.

Thank you for your help with this and remember to put the December 8, Insure Tennessee town hall meeting, on your calendar for 6 to 7:30 pm at the Benjamin Hooks Public Library, 3030 Poplar. 

Contact MCIL: 901-726-6404

Verify your address with TennCare

A note from Hope Johnson:

People on TennCare or any of the Medicare Savings Programs (QMB, SLMB) need to call TN Health Connection to verify their correct address.  THC is starting to send out recertification letters to everyone.  Anyone who doesn't respond, will get cut off.

The Bureau of TennCare is currently working to redetermine eligibility for our members.  This year’s redetermination process will look different than in previous years due to CMS allowing states to use several options for streamlining the eligibility redetermination process.

In May and September the state redetermined eligibility for approximately 720,000 individuals through the first phase of this streamlined process.  In Phase 1, TennCare performed a SNAP match in cooperation with the Department of Human Services.  We were able to redetermine eligibility for this population using SNAP data that was available to us.  Most of these individuals were provided notice in May that they had been redetermined eligible and their TennCare would continue.  A second smaller group were notified in September.  No members lost eligibility as part of Phase 1.

As Phase 2 of our redetermination process, TennCare will be sending notice to an additional group of selected members giving them the opportunity to self-attest that they have not had a change in circumstances since their last eligibility review.  These letters will be mailed in October, November and December.  Individuals can complete the form and fax or mail it to TennCare to complete the redetermination process.  No members will lose eligibility as part of Phase 2.

We ask for your help in working with your clients to submit these notices back to TennCare.  It is especially    important that all notices are returned to the address and/or fax number noted on the notice.  As a reminder, these are individual notices, so each family member will receive their own form to fill out and send back in.

Phase 3 of the redetermination process will start December 1st.  This step will be familiar to most people since it is similar to the historic redetermination that has been performed by TennCare.  Individuals due for redetermination, whose eligibility was not redetermined in phase 1 or 2 will be mailed a renewal packet and asked to complete the packet and return it to TennCare within 30 days. The returned information will be reviewed and the member will be provided notice whether they are still eligible for TennCare.  If they are determined not to be eligible or they do not respond to the notice, they will receive advance notice of termination.

We ask for your help in working with your clients to submit the requested documentation to the specified address or fax number within the appropriate timeline.

Tennessee Division of Health Care Finance & Administration
310 Great Circle Rd  |  Nashville, TN, 37243 T: 615-507-6459  |  tn.gov/tenncar