Federal appeals court hears oral arguments in TennCare case
The Tennessee Justice Center lawyers told a three-judge panel of the 6th U.S. Circuit Court of Appeals that the TennCare cuts violate the due-process rights of beneficiaries.
But attorneys for the state of Tennessee disagreed, arguing that the disenrollment procedure meets all legal requirements, a position supported by a recent ruling issued by the federal Center for Medicare/Medicaid Services.
The state is asking the appeals court to reverse an earlier ruling by U.S. District Court Judge William J. Haynes, who said all TennCare recipients deserve a neutral hearing to consider wrongful termination.
The appeals court, which has already blocked Haynes’ decision, is expected to rule by June 1.
State attorneys said changing the disenrollment process to comply with Haynes’ order would require additional time and expense that the state cannot afford in its attempts to meet budget deadlines.
Chuck Cooper, attorney for the state, told the judges that every effort is being made to determine if TennCare recipients slated to lose their coverage can qualify for health benefits under some other Medicaid program.
Also, many beneficiaries will be allowed to file an appeal with the state if they believe — and can prove — that their coverage was wrongfully terminated, Cooper said.
Gordon Bonnyman, executive director of the Tennessee Justice Center, said the problem is that beneficiaries would be appealing their case in front of the same agency that is seeking to cut their coverage, an obvious conflict.
Bonnyman also argued that the state, which is mailing beneficiaries a 14-page document about the pending cuts, isn’t doing enough to make sure that the nearly 30,000 enrollees who are mentally ill understand what will be happening to them.
“The state knows the incapacities of this population,” Bonnyman said. “These are people who cannot be expected to fill out the right forms and request an extension of their benefits.”
But Cooper said the state has established a telephone hotline to help mentally ill people complete the forms. In addition, the state has hired a private mental health agency to send outreach workers to meet with mentally ill people and help them determine if they qualify for other Medicaid coverage.
The Justice Center has already conceded that little stands in the way of the Gov. Phil Bredesen’s plan to cut enrollees from TennCare. The state already has court approval to begin the preliminary steps leading to disenrollment, a process that would be difficult to undo.
The move is needed, Bredesen says, to save the state $500 million to $600 million in the coming year.
Even with the cuts, spiraling TennCare costs would force the state to put roughly $60 million more into the $8 billion program.
The governor recently released a plan to keep the cuts at about 225,000 people — sparing about 97,000 of the sickets enrollees — by trimming benefits and pumping another $100 million in state money into TennCare. A separate court hearing on this move is scheduled for early June.
The Justice Center has resisted that plan as well, saying it was politically crafted and doesn’t really promise a thing. Also, Bredesen has yet to receive approval from federal regulators.