Extension of TennCare Demonstration

At A Glance

A shorter version of this notice is available at TennCare Asks to Keep the Waiver.

Overview

TennCare is a Medicaid demonstration program that has operated under waivers of certain provisions of federal law since 1994. The principle being “demonstrated” by TennCare is that a state can organize its Medicaid program under a managed care model without spending more than the Medicaid program would have spent in the absence of the demonstration program and without compromising quality of care. 

The Centers for Medicare and Medicaid Services (CMS) is the federal agency that oversees TennCare. CMS authorizes TennCare to operate for set periods of time referred to as “approval periods.” TennCare’s current approval period is scheduled to expire on June 30, 2016. To ensure that the TennCare Demonstration may continue past the expiration date, the State requested an extension from CMS on December 22, 2015. The State asked that the Demonstration—including all of its existing authorities and waivers—be extended from July 1, 2016, through June 30, 2021.

Public Notice Process

The Bureau of TennCare has taken a variety of steps to ensure that members of the public are aware of the application to extend the TennCare Demonstration. These measures include the development and maintenance of this webpage, as well as published notices in the newspapers of widest circulation in Tennessee cities with 50,000 or more residents and the Tennessee Administrative Register. The Bureau has also addressed the extension of the TennCare Demonstration in communications with a variety of stakeholders, including the Tennessee General Assembly, Tennessee’s Medical Care Advisory Committee, advocacy organizations, and TennCare’s provider network. The Bureau notified its Facebook friends and Twitter followers of the extension application on November 12, 2015.

Public Input Process

TennCare invited members of the public to offer comments regarding the extension application from November 12, 2015, through December 14, 2015. Comments received during the public input period were reviewed and considered in preparing the final draft of the extension application. The deadline for a comment to be considered as part of the application has now passed. Nevertheless, suggestions for the extension may still be sent to public.notice.tenncare@tn.gov.

Extension Application

TennCare's extension application. This comprehensive document consists of seven main parts:

  1. Historical Narrative Summary of the TennCare Program
  2. Narrative Description of Changes Being Requested
  3. Requested Waivers and Expenditure Authorities
  4. Summaries of EQRO Reports, MCO and State Quality Assurance Monitoring, and Other Documentation of the Quality of and Access to Care Provided Under the Demonstration
  5. Financial Data
  6. Interim Evaluation Report
  7. Documentation of the State’s Compliance with the Public Notice Process

Copies of the extension application are also available in each county office of the Tennessee Department of Health.

TennCare Page on CMS Web Site

As the federal agency with oversight authority over all Medicaid programs, CMS offers its own online resources regarding the TennCare Demonstration. Interested parties may view these materials at http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/Waivers.html?filterBy=tennessee#waivers.