Posted on 03/02/2006 3:36:50 PM PST by SmithL
NASHVILLE - Tennessee has prevailed in its dispute with the federal government over more than a half-billion dollars in health-care funds, freeing up the state to rescind its planned "hard limits" on TennCare patient visits, Gov. Phil Bredesen announced Wednesday.
The federal Centers for Medicare and Medicaid Services on Tuesday evening exhausted its appeals in an attempt to recover $550 million from Tennessee's defunct nursing home bed tax.
Under that 1992-2001 plan, the state had levied a bed tax on nursing homes, used the revenue to leverage federal matching funds, and then gave the nursing home residents a rebate.
The state had kept about $50 million in reserve in the event that the U.S. Department of Health and Human Services appeals board had ruled against Tennessee. The state can now use that $50 million to lift the planned limits on the number of doctor visits, hospital stays and tests covered by TennCare, Bredesen said.
"That's a major win, and I can't tell you how pleased I am about it," Bredesen told reporters after announcing the development in a speech to state Chamber of Commerce and Industry. "I think it really softens and mitigates a lot of the legitimate criticism that was out there about the package that we had."
The budget presented by Bredesen earlier this month had estimated $55 million in savings by limiting TennCare patients to 12 doctor visits per year and 20 days of hospitalization.
State funds cover about a third of the $7.5 billion budget for TennCare, the state's expanded Medicaid program that covers 1.2 million poor, uninsured and disabled individuals. Bredesen last year removed about 191,000 adults from TennCare and cut benefits for thousands of others to help stem escalating costs.
Because the state can now spend the $50 million reserve fund, the limits will no longer begin on July 1 as planned, Bredesen said. Instead, non-pharmaceutical "soft limits" will be placed on patients, meaning they will have to get approval before exceeding the preset number of visits.
Greg Becker, president of the Tennessee Hospital Association, said the elimination of the hard limits plan is "great news for us."
Hospitals will still have to deal with insured patients who have been disenrolled from TennCare, but avoiding the hard limits will ensure chronically ill patients get better treatment, Becker said.
Bredesen said winning the appeal will strengthen the TennCare program.
"If we do it right and control it right, I think TennCare will remain a very good health-care system for people who have serious illnesses and need the use of additional services," he said.
Did Tennessee ever cave and implement a state income tax?
HELL NO! And we never will.
TennCare is a scam and we need to stop it soon.
No.
Like Canada's failed "universal health care" system, TennCare is good to keep around as an audio-visual aid when discussing why government-controlled health care is a nightmare. That $50 million won't last TennCare very long, believe me, and then the collapse of the system will continue on schedule.
Thanks for the replies -- and hang tough!
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.