Tenncare ‘glitch’ briefly cut insurance coverage for some disabled adults
Tenncare computer errors caused about 70 disabled adults to briefly lose state insurance coverage earlier this year, but the agency says the glitch has been fixed and insurance was restored for all.
Tenncare spokeswoman Sarah Tanksley said the errors occurred as enrollee data was moved into a new, modernized system for managing Tenncare. The errors affected some people who receive Tenncare because they qualify for Supplemental Security Income from the federal government.
Tanksley said most of the enrollees lost coverage for one or two days and Tenncare believes everyone has now been re-enrolled.
The coverage gap was so brief, she said, that some affected people may be “completely unaware that any mistake had occurred.”
But at least one person noticed. Cheryl Prince, who lives in the Memphis suburb of Germantown, said her disabled adult daughter lost coverage because of the “glitch” for a few days in July. Prince said she sought help from a state lawmaker after several calls to Tenncare didn’t fix the issue.
“They were very nice and polite on the phone,” Prince said. “But it wasn’t happening.” Prince’s daughter, whom she requested not be named, is a recipient of Supplemental Security Income, or SSI, a federal program that provides cash to millions of elderly, blind and disabled people.
If you receive SSI and live in Tennessee, you automatically qualify for the state Medicaid insurance program, which is known to most as Tenncare.
Eligibility for Tenncare is often complicated, but SSI recipients are among the simplest populations for which to determine eligibility.
If you get SSI, you get Tenncare. Despite this automatic qualification, Prince said she received a notice from Tenncare in early June saying her daughter would soon be cut from coverage. Tenncare told her to reapply for coverage, Prince said, so she reapplied on her daughter’s behalf within days. It didn’t work.
Over the next few weeks, as the end day of her daughter’s coverage drew closer, Prince filed a Tenncare appeal and continued to press the agency for answers.
In mid-july, her daughter went to see her doctor and was told she no longer had Tenncare coverage, Prince said.
Prince then contacted the office of state Sen. Brian Kelsey, R-memphis, whose staff reached out to Tenncare on her behalf. Within hours of the senator’s office getting involved, a Tenncare official told Prince the coverage had been cut off by a “glitch.”
Prince said her daughter’s coverage is now restored, but she questions what would have happened if she hadn’t pestered Tenncare and eventually involved a state senator.
“(My daughter) has someone like me to fight for her,” she said. “But a lot of these people don’t.”
Tenncare cannot comment directly on Prince’s daughter’s insurance due to medical privacy laws.
Tenncare glitch was growing pains
Ultimately, the glitch appears to have been growing pains for Tenncare, which earlier this year rolled out a modernized computer system called Tenncare Connect.
The new system, which spent five years in development and cost $400 million, is designed to allow Tenncare to better process applications, renewals and coverage while also allowing enrollees to manage their coverage online.
Tanksley, the agency spokeswoman, said the inadvertent cuts occurred in May as enrollee data was transferred from older systems into Tenncare Connect.
“When we discovered this error, we took immediate steps to correct it and reinstate any coverage that was erroneously turned off,” Tanksley said.
Brett Kelman is the health care reporter for The Tennessean. He can be reached at 615-259-8287 or at brett .kelman@tennessean.com. Follow him on Twitter at @brettkelman.