Posted on April 1, 2014
Tennessee lawmakers remain committed to find a permanent fix
WASHINGTON – After working with state and federal officials, U.S. Senators Bob Corker (R-Tenn.) and Lamar Alexander (R-Tenn.) today announced that the Centers for Medicare and Medicaid Services (CMS) has granted a portion of TennCare’s waiver request that provides Tennessee an additional $80 million for the Essential Access Hospital payments in the absence of Tennessee Medicaid disproportionate share hospital (DSH) program funding for this current fiscal year. The waiver also adds Erlanger Medical Center in Chattanooga to the Public Hospital Supplemental Payment (PHSP) Pool, which includes $30 million of funding for the hospital.
“I’m pleased CMS has granted a portion of TennCare’s waiver request, ensuring Tennessee hospitals can continue to provide uninsured and low-income patients with vital health care services,” Corker said. “While this partial waiver is only a temporary fix, I remain committed to working with Senator Alexander to find a permanent solution as soon as possible so Tennessee patients, doctors and hospitals are not faced with this uncertainty each year.”
“These dollars help Tennessee’s hospitals provide care for Tennesseans who need help the most,” said Alexander. “There’s no reason in the world why Tennessee should be the only state without this kind of payment. I’ll continue to work with Senator Corker on a permanent solution.”
Tennessee is the only state in the nation that does not have permanent access to the Medicaid DSH program. In January, the entire Tennessee delegation wrote to Marilyn Tavenner, Administrator for the Centers for Medicare and Medicaid Services, expressing strong support for TennCare’s waiver request, which expired on September 30, 2013.
When TennCare was created through a waiver in 1994, the state agreed to eliminate the Medicaid DSH payment, believing the majority of the uninsured and uninsurable would be covered through the new TennCare. Unfortunately, costs began to escalate quickly and continue to grow, and by 2005, the TennCare coverage experiment ended.
Tennessee hospitals provided more than $700 million in unreimbursed TennCare costs last year. In addition to the unreimbursed costs, Tennessee hospitals provided $970 million in charity care and lost an additional $730 million on services provided to Medicare enrollees. This resulted in over $2.4 billion in unreimbursed cost from charity care and government funded health care programs.
In past years, with the strong bipartisan and bicameral support of the Tennessee Congressional delegation, Congress passed legislation that included a partial payment of the Medicaid DSH reimbursement for Tennessee hospitals.