CMS Gives TennCare More Flexibility in Serving Beneficiaries

Under the new “block grant” waiver, the Tennessee Medicaid program will be able to service patients with less federal oversight. CMS approved the waiver for 10 years.

CMS has approved the State of Tennessee’s “block grant” waiver request for TennCare, its Medicaid program, so that the state can administer the program with less federal oversight and more flexibility.

Tennessee requested the waiver, dubbed TennCare 1115 for the section of the Social Security Act that makes it possible, after the state General Assembly passed a law in 2019 directing Gov. Bill Lee’s administration to negotiate with CMS.

The program requires that TennCare maintain the current levels of service and populations served, but gives the agency increased flexibility to add new benefits without prior approval from CMS. Any savings the state achieves under the yearly cap will be eligible to be shared with Tennessee as long as certain quality and access metrics are achieved.

CMS has approved the waiver for 10 years and requires General Assembly approval before it goes into effect. Gov. Lee's administration plans to submit the package to the General assembly shortly and approval is expected.

Because this impacts HME providers in the state, the American Association for Homecare submitted comments on the proposal and worked with Tennessee HME stakeholders and TennCare leadership to ensure the program includes strong oversight mechanisms while maintaining patient benefits and access to care.

More information can be found in an FAQ from TennCare.

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