TennCare director says cuts put state on path to goal

The savings come from a set of controversial reforms that will end TennCare coverage for 191,000 adults and cut drug benefits for remaining enrollees.

“We’ve just unleashed as much change as TennCare has gone through in the last 10 years,” Hickey said at a news conference.

TennCare represents about $8.7 billion of the state’s almost $26 billion budget.

The changes started Aug. 1 with the process of trimming the TennCare rolls, a process that is nearing completion. About 121,000 people have lost TennCare coverage, while the remaining 70,000 slated cuts are in various stages of appeal, Hickey said.

Of the TennCare reforms, a five drug per month prescription limit and more use of cheaper generic drugs will provide the biggest savings.

Prescription savings are projected to make up $330 million of the $575 million in cuts sought. Cutting the rolls and other reforms slated to take effect Jan. 1 will make up the rest of the savings, Hickey said.

Getting to the point of implementing TennCare reform and reaching the cost savings goal has been a contentious battle.

TennCare costs were projected to grow $650 million this fiscal year. Gov. Phil Bredesen said the growth needed to be reduced by $575 million to avoid crippling cuts to other state services.

The state won federal court battles with the Tennessee Justice Center and other TennCare advocates seeking to block the cuts. Then the state won concessions on precription coverage and other issues spelled out in agreements the state had previously made with TennCare advocates.

Outside court the TennCare cuts were protested, including a long sit-in by TennCare enrollees and their supporters outside Gov. Phil Bredesen’s office.

Putting TennCare reforms into place has been more difficult than he expected, Hickey said.

“This has not been the year I anticipated,” he said. “We thought we were going to be able to get more concessions out of the advocates up front.”

Gordon Bonnyman of the Tennessee Justice Center, primary advocate for TennCare enrollees said his organization’s goal was fighting state mismanagement of the program.

“It’s just more of the same,” he said. “They are playing the blame game. Can’t anyone of them accept responsibility for the suffering they are causing?”

Hickey said TennCare will continue to face financial challenges as federal money paid to states for health care decreases, but that the program’s financial position is improving.

“The network was basically a broken down wagon stuck in the mud. Not it’s on track and ready to move forward.”

Hickey said a new ethics reporting system for its care providers will generate its first reports in the next several weeks.

The system requires TennCare contractors to affirm that they and their subcontractors are not paying state employees. And they must disclose information about their lobbying activities.

The new rules stem from the revelation earlier this year that TennCare contractor OmniCare paid then-state Sen. John Ford, D-Memphis roughly $420,000. Company officials said Ford was paid to expand its Medicaid-related business in other states, even though officials in those states have largely disputed the claim Ford was working outside Tennessee.

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On the Net:

Tennessee Department of Health: http://www2.tennessee.gov/health/

Tennessee Justice Center: http://www.tnjustice.org