Stimulus Bill -- Nationwide System of Medical Records?

[minnie61650]

This is the newest update I could find out about TennCare;
Even though TennCare statred in 1994 which was about 15 years ago there were about 150,000 members who may no longer be eligible for the program. These enrollees were subject to a 21-year old court order known as Daniels. TennCare was not given permission in the past to check the eligibility of these persons.

A new court ruling will now allow TennCare to remove those individuals who are no longer eligible.

Federal Court Grants State Relief from Long-Standing Court Order

Released on Thu, Jan 08, 2009 - 4:42 pm under Health Care TennCare State Will Be Able to Mitigate Budget Cuts

NASHVILLE – The State of Tennessee today received relief from U.S. District Court, resolving a long-standing court order that will help minimize planned budget cuts in TennCare’s effort to meet its budget reductions for next year. The court granted the state permission to check the eligibility of 150,000 TennCare members, some of whom may no longer be eligible for the program. They are all members of a class of enrollees subject to a members of a class of enrollees subject to a 21-year old court order known as Daniels.

“We appreciate that the court ruled quickly and fairly, allowing us to move forward in determining which of these individuals are still eligible for TennCare,” TennCare Director Darin J. Gordon said. “By allowing TennCare to remove those individuals who are no longer eligible, the court’s ruling will enable the state to reduce or avoid some of the budget reductions we otherwise would have had to make in the state’s effort to balance its budget during this difficult economic period.”

All Daniels class members were once eligible for Supplemental Security Income (SSI), a package of federal benefits that includes Medicaid. Due to the Daniels court order, the state was barred from re-determining their eligibility, effectively allowing non-eligible individuals to remain on the program. Although some of Daniels class members will remain eligible for TennCare, some will not for a variety of reasons. Those who no longer live in Tennessee, make too much money or are not now disabled. For example, an individual who was injured in a car accident but who through rehabilitation is able to return to work may not now be considered disabled by the Federal government’s standards and would no longer qualify.

TennCare estimates that the state spends about $1.2 billion annually to provide healthcare insurance for the 150,000 Daniels class members. Though the Bureau will not know how many of these individuals will still qualify until their eligibility is verified, if only 10 percent are found not to be eligible, the state could save as much as $120 million ($42 million of which is state funded) annually.

The state will begin identifying Daniels class members in TennCare and start a review process. For those who are no longer eligible for SSI, and have not filed an SSI appeal, the state will move to determine whether they meet other qualifications to be eligible for Medicaid.

Daniels class members will keep their benefits with no lapse in coverage during the determination process. The process is similar to one the court approved in 2005 for other TennCare members, which meets full approval of the federal Centers for Medicare and Medicaid Services (CMS), TennCare’s federal partner.

“This gives us hope that we may be able to realize savings that will help minimize cuts we will have to make,” Gordon said. “It’s simply a matter of fairness that we are allowed to take people off the program who no longer qualify to minimize the budget reductions we will have to make that will impact TennCare’s truly eligible members.

 

[TLSnell1981]

There are many patients that are uninsurable and poor... who no longer "qualify" for Tenncare. This was supposed to give these patients coverage.

What are the specific qualifications to be eligible for Tenncare?

 

[minnie61650]

Deleted.......
because I posted info for Cover Tennessee instead of TennCare which are 2 different coverages.

 

[minnie61650]

There are many patients that are uninsurable and poor... who no longer "qualify" for Tenncare. This was supposed to give these patients coverage.

Yes, but the ones who would no longer are like those in the example below:

Those who no longer live in Tennessee, make too much money or are not now disabled. For example, an individual who was injured in a car accident but who through rehabilitation is able to return to work may not now be considered disabled by the Federal government’s standards and would no longer qualify.<Snip>

For those who are no longer eligible for SSI, and have not filed an SSI appeal, the state will move to determine whether they meet other qualifications to be eligible for Medicaid

 

[mirmartinez]

The government will ration care. As I stated earlier....they will give you an appointment...to come back to set up an appointment....to decide who you need an appointment with...so they can give you an appointment for tests and then....another appointment to decide it you need additional tests... By that time....it may be too late for any treatment.

And that's only the beginning. The red tape government healthcare will bring...*shudders*

And people say we drink the koolaid

 

[TLSnell1981]

Just an FYI:
Cover Tennessee ( I guess it is no longer called TennCare)is for persons who live in Tenn. and do not have private insurance.

While this may be "accurate"...it's not true.

There is no list that specifically states....with few exeptions....who qualifies. There is NO state standard.

 

[TLSnell1981]

And people say we drink the koolaid

I'm going to let that slide. I've seen this first hand. No kool-aid involved.

 

[ameraumi]

While this may be "accurate"...it's not true.

There is no list that specifically states....with few exeptions....who qualifies. There is NO state standard.

A quick search found this: http://www.tennessee.gov/tenncare/mem-categories.html

If you scroll down it lists the TennCare standard. Looks like a list who qualifies to me. CoverTN also looks like a totally seperate program from TennCare and Medicaid.

Anyways back to the OP, no system is perfect. But I do welcome drs being able to use a central database to access patient records. I want all of DH's drs to see his records without wasting time waiting on faxes.

 

[minnie61650]

A quick search found this: http://www.tennessee.gov/tenncare/mem-categories.html

If you scroll down it lists the TennCare standard. Looks like a list who qualifies to me. CoverTN also looks like a totally seperate program from TennCare and Medicaid.

.

Thanks....

I could not find the TennCare link and thought they may have changed the name to CoverTN. I will go back and correct the post.

 

[TLSnell1981]

A quick search found this: http://www.tennessee.gov/tenncare/mem-categories.html

If you scroll down it lists the TennCare standard. Looks like a list who qualifies to me. CoverTN also looks like a totally seperate program from TennCare and Medicaid.

Anyways back to the OP, no system is perfect. But I do welcome drs being able to use a central database to access patient records. I want all of DH's drs to see his records without wasting time waiting on faxes.

This information should be used as reference only. To see if you may qualify for Medicaid, please contact your local Department of Human Services office or complete an application on line.

It's basically the same program as Tenncare.... different name.

In reality...the is no consistency. It lies under the control of mediaries.

This program has hurt healthcare and residents of Tennessee in numerous ways. It doesn't meet the needs of the patients and it is a financial burden on the taxpayers. It was a nice idea, but it doesn't work.

I don't care to give the control of my medical records over to anybody and everybody. I want the option to opt out.

 

[DisneyMomOK]

My fear is not that someone will have access to my medical information. And it is not that I do not want to make my doc's life easier. Of course I want the best medical care possible. That is why I only use 1 pharmacy, because they can figure out if anything will interact incorrectly.

But as is mentioned above, this is the first step towards socialized medicine. And telling people that no, they cannot have that treatment for what ever reason.

Lets hear this one more time:
...yes, that is what Daschle said to do, slip it into a bill so nobody notices it, and strike when the new administration is hot and can do no wrong.

And that is why the 130+ pages covering this section of the bill are the only pages left pristine, exactly as written in the original House legislation.

 

[tjlovespooh]

This is what our health care system is today!!
And now you know what poor people all over the country with no health insurance endure daily. My dh left medical practice for this very reason. Big insurance companies don't give a flying fig about any thing but making profits.
Does any one remember the poor woman who died sitting in a waiting room at a brooklyn hospital?

http://www.cnn.com/2008/US/07/01/waiting.room.death/

Camden NJ is one of the poorest communities in america, this happens daily. Every single day.
We have the highest infant mortality rate of any westernized country. Seniors have to choose between affording medicine and eating. I personally know 3 elderly ladies who take their heart medicine every other day because they can't afford a 30 day prescription.
And you're telling me this is the best we can do.

Sorry Our health care system stinks and no I am not saying nationalized Health care is the answer but you will never get me to believe that ours is wonderful. I've been in medicine in some form over 25 years and over 25 years it's gotten worse and more expensive. Administration after administration has swept the problem under the rug because no one wants to deal with it. so it keeps getting worse and worse.
Fine if the government isn't the answer than what is? Please don't say what we have now because it stinks. If one thing I'm sick of it's this continued fear to do any thing.

I'm not here to debate - but just wanted to share this article on comparing US infant mortality rate to other developed countries. Here's a quote:
"First, it's shaky ground to compare U.S. infant mortality with reports from other countries. The United States counts all births as live if they show any sign of life, regardless of prematurity or size. This includes what many other countries report as stillbirths. In Austria and Germany, fetal weight must be at least 500 grams (1 pound) to count as a live birth; in other parts of Europe, such as Switzerland, the fetus must be at least 30 centimeters (12 inches) long. In Belgium and France, births at less than 26 weeks of pregnancy are registered as lifeless. And some countries don't reliably register babies who die within the first 24 hours of birth. Thus, the United States is sure to report higher infant mortality rates. For this very reason, the Organization for Economic Cooperation and Development, which collects the European numbers, warns of head-to-head comparisons by country."

And here's a link to the article:
http://health.usnews.com/usnews/health/articles/060924/2healy.htm

 

[TLSnell1981]

This is the newest update I could find out about TennCare;
Even though TennCare statred in 1994 which was about 15 years ago there were about 150,000 members who may no longer be eligible for the program. These enrollees were subject to a 21-year old court order known as Daniels. TennCare was not given permission in the past to check the eligibility of these persons.

A new court ruling will now allow TennCare to remove those individuals who are no longer eligible.

Cluster-Daniels opens a whole new can of worms. There will be many who won't meet the "new" requirements...who actually should.

It will furthur reduce Tenncare roles. There isn't enough money. It doesn't work. Many are denied simply because the Governor has said to close enrollment. They qualify according to "guidelines and standards".

TennCare was implemented, replacing the state’s Medicaid program. TennCare covered three groups:
Group 1: Medicaid eligibles
Group 2: Uninsured people who lacked access to insurance and who continued to lack access
Group 3: Uninsurable people, meaning people who had been turned down for health insurance because of a health condition

01/2005

Governor Bredesen announced that he was making a strong effort to preserve some vestiges of the TennCare program, but that doing so would require removing adult Uninsured and Uninsurable persons who were currently on the rolls, as well as closing the non-pregnant adult Medically Needy categories. Children were to be protected. Some benefit restrictions for adults were also proposed.

Is this what we really want?

 

[ameraumi]

Do you seriously think there will not be some kind of changes made to the TennCare program if it becomes a National thing? Every state has their own program for the needy (and not just Medicaid). All those programs would need to be overhauled to fit the criteria Congress would set.

After what we have been through with DH, I welcome the idea of having drs get his medical records with one click of the computer. I also feel something needs to be done to make sure every American has ACCESS to AFFORDABLE insurance. I did not say "give" them insurance, but make the premiums realistic and not expensive.