Tennessee has received approval from the federal government for an unprecedented change in the Medicaid program which would convert the TennCare program to a block grant funding system. Tennessee is the first state to receive approval for block grant funding for its Medicaid program – in fact, it’s the only state that has ever asked to receive a block grant. Block grant funding could transform the TennCare program by providing Tennessee with a fixed amount of federal funding for the TennCare program in exchange for an increase in flexibility in how the funding is used and how the TennCare program is administered.
Since COVID-19 strong-armed its way to the forefront of the US media in March 2020, we’ve seen hundreds, even thousands of news stories, opinion pieces, and agency reports on related topics ranging from its impact on schools and employment to the CARES Act and other financial support. In the last several weeks, the development of a COVID-19 vaccine, its approval process, distribution priority groups, and the like have dominated headlines, and are weighing heavily on the minds of those in the LTC community – residents, employees, and leaders alike. We’ve outlined a breakdown of what’s happened to date, what’s coming next, and what you need to know.
Back in August, the Department of Health and Human Services announced the Provider Relief Fund, Performance-Based Incentive Plan (“Plan”), allocating up to $2 Billion dollars in relief to the LTC industry. Plan eligibility is open to nursing homes and skilled nursing facilities that are certified in the state in which they receive CMS reimbursement, and report data to CASPER, NHC, or POS. Whether, and how much funding is received, is tied to two measures of performance: 1) whether the facility’s COVID-19 infection rate is lower than its county’s rate, and 2) whether the facility’s COVID-19 mortality rate falls below a nationally established performance threshold for mortality among nursing home residents infected with COVID-19. Eligibility is determined on a monthly basis and is automatically evaluated based on the facility’s submission of data to the CDC; no specific or formal application is required!
Since the CARES Act took effect on March 25, 2020, there has been an unrelenting push for the passage of follow-up legislation to provide American businesses and individual citizens with additional Covid-relief. The Democrat-backed HEROES Act and the Republican HEALS Act emerged as the two competing bills most likely to succeed the CARES Act. However, to date, a divided Congress has not been able to secure passage of either legislative proposal due to interference from the White House and ongoing disagreements as to the scope of the financial relief to be provided and the degree of the legal immunity to be granted.
Here at Stotler Hayes Group we have seen firsthand how difficult the last eight months have been for those in the healthcare industry, including frontline health care workers, long term care residents and their loved ones. We are grateful for your hard work and sacrifice and we want to express our appreciation by giving back.