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TennCare II

  • TennCare II - Amendment #18 (modified: 4 years ago)
    Tennessee resubmitted amendment #18 to the TennCare II demonstration to provide Assisted Care Living Facility services to individuals in the "CHOICES Group 3" subject to certain conditions being met. The federal public comment period will be opened from March 23, 2015 through April 21, 2015.
  • TennCare II - Amendment #24 (modified: 4 years ago)
    Tennessee submitted amendment #24 to the TennCare II demonstration to add two new service definitions to their Special Terms and Conditions (STCs). The federal public comment period will be opened from March 23, 2015 through April 21, 2015.
  • TennCare II - Amendment #26 (modified: 4 years ago)
    TennCare II is a statewide section 1115 demonstration that uses a managed care approach to provide services to Medicaid state plan and demonstration enrollees at a cost that does not exceed what would have been spent in a Medicaid fee-for-service program. The demonstration includes expenditure authority for pool payments which are currently approved through December 31, 2015. Amendment #26 proposes to change the expiration date for the pool payments from December 31, 2015 to June 30, 2016. The federal public comment period is open from May 15, 2015 through June 14, 2015.
  • TennCare II - Amendment #27 (modified: 3 years ago)
    Tennessee proposes to implement an integrated managed long-term services and supports program that will promote and support integrated, competitive employment and independent, integrated community living as the first and preferred option for individuals with intellectual and developmental disabilities. The new program will be called Employment and Community First CHOICES and will fully comport with standards applicable to person-centered planning and HCBS settings delivered under Section 1915(c) of the Social Security Act. The federal public comment period will be opened July 7, 2015 through August 5, 2015.
  • TennCare II - Amendment #28 (modified: 3 years ago)
    Tennessee submitted a request to amend its demonstration by eliminating the Standard Spend Down eligibility category that was approved in 2007 as a demonstration expenditure authority for adults who are aged, blind, disabled, or caretaker relatives and who meet spend-down requirements effective December 1, 2015. Individuals currently enrolled will be allowed to remain in the demonstration category until they undergo a re-verification process, at which point the state will assess their eligibility for any open category of TennCare coverage. Individuals who are not eligible for any open category will be disenrolled and referred to Medicare or the Marketplace. The federal public comment period will be open from October 16, 2015 through November 16, 2015.
  • TennCare II - Amendment #32 (modified: 1 year ago)
    Tennessee submitted a request to amend its demonstration on September 6, 2017. The state proposes to make changes to the demonstration as a result of Public Chapter Number 363 passed by the Tennessee General Assembly on May 4, 2017 and signed by Governor Haslam on May 11, 2017. Tennessee requests to establish a two-year pilot p roject provides an Medication Therapy Management (MTM) benefit to TennCare beneficiaries enrolled in a health home or patient-centered medical home (PCMH). Approximately 300,000 beneficiaries are enrolled in one of these two programs under TennCare. The stated goals for the pilot are to increase engagement of pharmacists and increase collaboration between pharmacists and primary care providers. The state also expects that MTM services will enhance the effectiveness of health homes and PCMH programs, improve health outcomes and quality of care for the enrollees. The public comment period will be open from September 22, 2017 through October 22, 2017
  • TennCare II - Amendment 33 (modified: 1 year ago)
    Tennessee proposes to amend its demonstration in order to modify the special terms and conditions (STC) that govern the state's supplemental payments to hospitals. The federal public comment period will be open from February 16, 2018 through March 17, 2018.
  • TennCare II - Amendment 37 (modified: 7 months ago)
    Tennessee proposes to amend its demonstration in order to establish two new benefits and two new benefit groups within the Employment and Community First CHOICES Program. The new benefits/groups integrate behavioral health services with home and community-based services, and are targeted to individuals who have both an intellectual or developmental disability and enhanced behavioral support needs. The federal public comment period will be open from November 23, 2018 to December 23, 2018.
  • TennCare II - Amendment 38 (modified: 6 months ago)
    Tennessee proposes to amend its demonstration to add community engagement requirements as a condition of eligibility for certain individuals age 19 through 64 who are enrolled in the parent/caretaker relative eligibility group. The federal public comment period will be open from January 8, 2019 to February 7, 2019.
  • TennCare II - Amendment 39 (modified: 2 months ago)
    Tennessee proposes to amend its TennCare demonstration to adjust certain services within the benefit package for some adults. TennCare is partially funded by state revenue generated from a non-recurring hospital assessment, which is due to expire on June 30, 2019. This amendment outlines specific changes that would be required in the absence of this funding. The federal public comment period will be open from April 23, 2019 to May 23, 2019.
  • TennCare II - SUD Amendment Request (modified: 1 year ago)
    Tennessee proposes to amend its demonstration in order to provide short-term substance use disorder (SUD) services in facilities that meet the definition of an institution for mental disease (IMD). The federal public comment period will be open from June 6, 2018 to July 6, 2018.
  • TennCare II Five Year Extension (modified: 3 years ago)
    Tennessee submitted an application to extend TennCare II, its 1115 demonstration that is set to expire on June 30, 2016. The current demonstration provides Medicaid coverage through a managed care delivery system for state plan mandatory and optional populations. There are also several populations in the demonstration who receive TennCare benefits through the demonstration, who are not traditionally eligible for the Medicaid program. The state is requesting a 5 year extension of its demonstration until June 30, 2021. Tennessee requests no changes to the demonstration, but requests that CMS continue to allow a waiver of retroactive eligibility to allow the state to not provide up to 90 days of Medicaid coverage prior to applying for TennCare. The federal public comment period will be open from January 7, 2016 through February 6, 2016.