Comptroller finds fault with TennCare paperwork pile

The state Comptroller’s Office says TennCare’s 98-page renewal form is making it harder than necessary for low-income Tennesseans to maintain their subsidized government health coverage, reports WPLN.

After conducting an investigation requested by House Speaker Beth Harwell, the state agency has issued a memo suggesting a list of changes.

Enrollees have to provide 17 full pages of personal and financial information, even though the Comptroller says TennCare already knows some of what it’s requesting.

“TennCare’s packets make IRS tax forms look like a picnic by comparison,” Michele Johnson of the Tennessee Justice Center said in a statement. “We get calls from lawyers and doctors trying to help their clients and patients, and even they can’t understand the forms. They are especially hard on seniors and people with disabilities.”

That issue assumes enrollees even receive the form. Eva Kelly in Clarksville says her so-called “redetermination” form never arrived this year, though she seemed to be getting other mail from TennCare.

“There was no reason they wouldn’t have had my address,” Kelly said. “And I was not told they needed me to turn in a new address.”

The delays have ripple effects on other government benefits like Social Security. Kelly says because of her interruption, her monthly disability check was reduced, and she was forced to pull from a small burial savings account to pay her monthly bills.

Further, the Times Free Press notes that TennCare officials told auditors they don’t know how many enrollees in the health coverage program lost Medicaid coverage due to paperwork snarls and confusion.

 By late 2018 or 2019, TennCare officials hope to have the issues addressed with a new computer system. After encountering problems with one vendor in 2015 and starting anew with another company, that’s when the project is expected to be done.

All other states already have the systems, mandated under the federal Affordable Care Act, up and running.

Note: The comptroller’s memorandum is HERE. 

Press release from the comptroller’s office

The Tennessee Comptroller’s Office has completed a review of TennCare’s current process for redetermining Medicaid eligibility in the State of Tennessee. The review was prompted by a request from House Speaker Beth Harwell (R-Nashville), who became concerned by recent media reports surrounding the redetermination process.

Comptroller auditors examined TennCare’s history with the redetermination process and how it changed to meet the requirements of the Affordable Care Act. The ACA required states to annually assess a member’s Medicaid eligibility based on new income standards.

TennCare is currently developing a computer-based system to determine eligibility, but that system will not be fully online until early 2019. In the meantime, TennCare received permission from the Centers for Medicare & Medicaid Services (CMS) to use other methods for redetermining eligibility, including mailing a 98-page packet to members’ homes.

Comptroller auditors reviewed a series of problems and concerns which have been raised by TennCare members. Members have identified issues with coverage being terminated without warning, lengthy call center wait times, coverage being temporarily lost when packets are returned by the due date, and other problems.

The review includes information on each of these concerns and, in several cases, a recommendation on how the concern can be addressed. For example, Comptroller auditors suggest that TennCare consider providing enrollees with a self-addressed, postage-paid envelope to return their redetermination packet.

The Comptroller’s Office has submitted its review to Speaker Harwell and posted the report on the Comptroller’s website.