Medicaid

Tennessee Poised to be First State to Request Medicaid Block Grant

Tennessee is on track to be the first state to request its Medicaid funding be provided in a lump sum payment, Politico reports. This comes after the Tennessee House passed legislation — HB1280/SB1428 — that directs the governor, through the commissioner of finance and administration, to request the block grant funding from the centers for Medicare and Medicaid services, with the appropriations indexed for inflation and population growth. The proposal faces an uphill battle, as U.S. Congressional Democrats have vowed opposition to such measures and the Trump administration is still trying to determine if it can legally provide states with this option.

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Tennessee Republicans Push for Medicaid Block Grants

Tennessee lawmakers on Wednesday advanced a measure that seeks a fixed amount of federal block grants to provide health care to lower-income and disabled residents, The Chattanooga Times Free Press reports. Under current law, Medicaid reimburses the state a fixed percentage on its Medicaid costs, with Tennessee receiving approximately $7.5 billion in federal money for its $12.1 billion Medicaid program, which state Republicans say gives little incentive to keep expenses under control because no state pays more than half the total cost, whereas the new bill — HB1280/SB1428 — would “convert the federal share of all medical assistance funding for this state into an allotment that is tailored to meet the needs of this state and that is indexed for inflation and population growth.” Though lawmakers remain optimistic regarding the advancement of the legislation, it is unclear whether Gov. Bill Lee will support the measure, given his opposition to Medicaid expansion and insistence on finding an alternative option to aid the estimated 167,000 Tennesseans without health coverage.

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Pain Clinic CEO Implicated in Medicaid Fraud Conspiracy

The former CEO of the recently shuttered Brentwood-based pain clinic company Comprehensive Pain Specialists (CPS) is accused of plotting to forge the signature of a dead patient so Medicaid could be billed in her name, The Tennessean reports. Former CPS CEO John Davis allegedly emailed about the forgery with an accomplice, Brenda Montgomery, as part of an illegal kickback scheme. Prosecutors have said that Davis’ prosecution has little to do with the direct operations of CPS and are primarily related to a “side agreement” he had with Montgomery, who was the head of a medical device company named CCC Medical Inc. Davis’ attorney has filed a motion for relief regarding the emails in question.

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Council of Economic Advisers Releases Report on Work Requirements for Social Programs

The Council of Economic Advisers recently released a report titled "Expanding Work Requirements in Non-Cash Welfare Programs," that addresses controversial work requirement issues according to a Whitehouse press release. In April, President Trump signed an executive order giving states more autonomy over their Medicaid programs, allowing them to request waivers to add stipulations such as work requirements. Kentucky was the first state to try and implement work requirements for Medicaid recipients, however, a federal judge vacated the approval, sending the state’s program back to the federal Department of Health and Human Services for further review. So far, four states' applications have been approved by the Centers of Medicare and Medicaid Services: Arkansas, Indiana, Kentucky and New Hampshire, while seven other states have applications pending: Arizona, Kansas, Maine, Mississippi, Utah, Ohio and Wisconsin. You can read the full report here.

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Trump Administration Unveils Medicaid Scorecard

The Trump Administration on Monday unveiled its initial version of a “scorecard” that compiles and publicizes data from states for both Medicaid and the Children’s Health Insurance Program (CHIP), The Washington Post reports. The scorecard will make public government measures of performance such as how long both state and federal health officials take when states request “waivers” to deviate from Medicaid’s ordinary rules and detailed, state-by-state averages on specific demographics and procedures/benefits utilized. The scorecard’s initial information is based on states that voluntarily report a series of measures about the health of their Medicaid and CHIP enrollees. You can view more information on the scorecard here

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