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VOL. 129 | NO. 143 | Thursday, July 24, 2014

Health Advocacy Groups File Lawsuit Against State

AP

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NASHVILLE (AP) – Three advocacy groups filed a class action lawsuit on Wednesday accusing the state of Tennessee of failing to provide certain services required by the federal health care law.

The lawsuit by the Southern Poverty Law Center, the Tennessee Justice Center and the National Health Law Program follows a letter from the Centers for Medicare and Medicaid Services that was sent to state officials last month, accusing them of failing to meet requirements under the health care law.

The lawsuit says the state isn't providing in-person assistance and is forcing applicants to apply for TennCare – the state's expanded Medicaid program – through the federal Health Insurance Marketplace website, which was not designed for that purpose.

The lawsuit also accuses the state of failing to let people know within 45 days if they're eligible for Medicaid and doesn't provide a hearing if there's a delay in the eligibility decision.

Dave Smith, a spokesman for the governor, said in an email that because of the pending litigation, "it'd be inappropriate to comment at this time."

Sam Brooke, senior staff attorney for the Southern Poverty Law Center, said plaintiffs are asking the court to tell TennCare "that they must follow the law."

"The lawsuit is simple," he said. "It is time for the state to take responsibility, and to start protecting the health of the residents."

Jane Perkins, legal director for the National Health Law Program, which closely monitors Medicaid enrollment, said Tennessee is a "national outlier" that is doing the least to help its residents obtain Medicaid coverage.

"It's among the worst, if not the worst, in the entire country," Perkins said.

Plaintiff Melissa Wilson, a caretaker of three young grandchildren, has kidney failure and requires regular blood transfusions. She said it's been more than 160 days since she first applied for TennCare, and there still hasn't been a determination in her application.

Wilson said she's supposed to take 17 medications daily but can only afford three of them.

"Even with my job, one of the medications cost more than half of what I bring home in a month," she said. "I can't afford to pay for all my medicines while also supporting my family."

According to the CMS letter dated June 27, of seven critical success factors required of states, Tennessee has met only one – the ability to receive and process application files from the health insurance marketplace.

Federal officials gave the state 10 days to submit a correction plan.

"We remain available to work with you to answer any questions and to provide technical assistance," CMS deputy director Cindy Mann said in the letter.

TennCare spokeswoman Kelly Gunderson told The Associated Press in an email earlier this month that "there are numerous aspects of the letter with which we do not agree and we are currently working on our response to CMS."

She didn't specify what the state disagreed with in the letter.

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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