Legislation calls for Medicaid block grant waiver to construct an innovative plan that better serves the needs of TennCare recipients

(NASHVILLE, Tenn.), April 18, 2019 – Major legislation calling for Tennessee’s Commissioner of Finance and Administration to request a block grant waiver from the Centers for Medicare and Medicaid Services (CMS) to better serve recipients of the state’s TennCare program was approved by the Senate Commerce and Labor Committee this week.  Senate Bill 1428 is designed to maximize flexibility in constructing an innovative plan that serves the needs of Tennesseans, while ensuring the state continues to receive its full share of federal Medicaid dollars.  The overall goal is to provide an effective and innovative plan that is specific to the healthcare needs of all Tennesseans, while lowering costs and increasing access to patient-centered care.

The legislation requires the commissioner to submit the block grant waiver request to CMS within 180 days of the bill’s enactment.  The block grant must convert funding for the program into an allotment that is tailored to meet the needs of Tennesseans.  Coverage for the existing TennCare population would be maintained under the proposal.

The bill specifies that funds must be indexed for costs such as population and inflation growth.  Funding must remain at the level set, without any decrease in the federal share based on deflation or a reduction in population.  Administrative costs would be excluded, permitting the state to continue to draw federal matching funds for operating the program.  To provide maximum flexibility regarding pharmacy benefits, the amendment includes fluctuation of prescription drug costs, diabetic testing supplies, and over-the-counter medications. 

In addition, the proposal gives the state additional flexibility to serve other needy populations with distinct financial or healthcare needs.

The measure would become law upon Governor Lee’s signature.  It now goes to the Senate Health and Welfare Committee for consideration, and must also receive approval from the Finance, Ways and Means Committee before moving to the full Senate for a final vote.

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