Notice of Change in TennCare II Demonstration Amendment 20
The Commissioner of the Tennessee Department of Finance and Administration is providing official notification, pursuant to 42 CFR § 447.205 and 59 Fed. Reg. 49249, concerning intent to file an amendment to the TennCare II Demonstration. The amendment will be filed with the Centers for Medicare and Medicaid Services (CMS), a federal agency located in Baltimore, Maryland.
The State is required to meet certain advance notice obligations whenever an amendment to the TennCare demonstration is filed. This demonstration amendment, which will be known as “Amendment 20,” is being filed with a proposed effective date of January 1, 2014.
Amendment 20 consists of three components.
- Continued open enrollment in the At Risk Demonstration Eligibility Category. Under the terms of the currently approved waiver, this eligibility category is closed to new enrollment on December 31, 2013. The State is requesting to remove the December 31, 2013, end date for new applicants and continue open enrollment in this eligibility category through June 30, 2015. This will allow the State to continue to enroll and provide Home and Community Based Services (HCBS) to persons who have been determined financially eligible for long-term services and supports and who are at risk for institutionalization.
- Disproportionate Share Hospital (DSH) Alternative Plan. Beginning on October 1, 2013, Tennessee is the only state not provided a Disproportionate Share Hospital (DSH) allotment by 42 USC § 1396r-4. Therefore, the State is requesting authority to increase the Essential Access Hospital (EAH) Pool to account for the end of the State’s DSH allotment and to remove the EAH Pool from the list of pool payments that are subject to the annual cap of $540 million.
- Addition to the Public Hospital Supplemental Payment (PHSP) Pool. The State is requesting to add a new hospital to the Public Hospital Supplemental Payment (PHSP) Pool. That hospital is Erlanger Hospital in Chattanooga. Total funds in the PHSP pool will increase by $30 million annually.
It is our intention to submit this amendment to CMS with the request that it be approved in time for implementation to occur on January 1, 2014. We estimate that implementation of the amendment will result in an increase in aggregate annual expenditures of $52 million in State and Federal funds.
Copies of this notice will be available in each county office of the Tennessee Department of Human Services. Written comments may be submitted by email to Susie.Baird@tn.gov or may be mailed to Mr. Darin Gordon, Director, Bureau of TennCare, 310 Great Circle Road, Nashville, Tennessee 37243. Persons wishing to review copies of written comments received may submit their requests to the same email and/or physical address.