Medicaid Redetermination


About Redetermination

Starting in 2017, Medicaid eligibility redeterminations are required on an annual basis for persons in the DIDD waivers except those receiving standalone Supplemental Security Income (SSI).  ISCs will be responsible for working with the person and/or the authorized representative to complete the packets on an annual basis and submitting them for approval.  The expectation is these will be completed around the annual ISP planning meeting as they will be due again on the same date in each subsequent year.

It’s important to stress that given the large number of reviews to be completed, it will take a team effort on the part of DIDD, ISCs, providers and the people we support to ensure continuation of services.  As DIDD’s waivers are closed to new enrollment, failure to complete the redetermination packet will result in disenrollment after a period of time.  Those who are disenrolled will not be able to re-enter the DIDD waivers.

In an effort to for all who may be involved to understand the basics of this process, some of the steps are listed below.

  1. DIDD has already received the list of persons requiring an annual redetermination.  This information has been distributed to ISC agencies
  2. ISCs should take the redetermination packet to the annual ISP planning meeting or other face-to-face visit and work with the person and/or representative payee to complete the packet
  3. Once completed, the packet must be faxed to Maximus, which is the TennCare contractor charged with reviewing the completed applications.  The toll free fax number is listed on the packet
  4. Packets must be faxed one a time, and must include the person’s name and social security number on every page of the document
  5. The ISC agency is to maintain a copy of the fax confirmation for each person submitted as evidence the packet was submitted in a timely manner
  6. By the 10th calendar day of the month, each ISC agency should submit a report in excel format containing the name, date of renewal completion, and the fax confirmation date to a designated DIDD contact in the region

Redetermination Resources

TennCare has several resources to assist those who want to learn more about the process.  A recording of the webinar, as well as detailed FAQs can be found here.

DIDD has created FAQs for the process going forward starting calendar year 2018.  These can be found here.

Need Assistance?

Each region has staff identified to work with ISCs and service providers where necessary to assist and monitor the submissions. If you have questions, please contact the following:

East Regional Office:
Christie Ellis

Middle Regional Office:
Lucretia Baxa

West Regional Office:
Linda Hall

Central Office:
Annette Caldwell Binkley

Timothy Hickman