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Feds accuse Tennessee of failing to provide services required by health care law

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NASHVILLE, Tennessee — Tennessee health officials said Wednesday they disagree with a letter from the Centers for Medicare and Medicaid Services that accuses the state of failing to provide certain services as required by the federal health care law.

According to the 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 on Wednesday 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.

One of the main criticisms is the state's delay in bringing a $35 million computer system online.

In the letter, Mann said her agency had expressed concerns for the past nine months about continued delays and the "downstream impact" on the state's ability to enroll Medicaid-eligible people.

Darin Gordon is the director of TennCare, the state's expanded Medicaid program that covers 1.2 million Tennesseans.

He told The Tennessean newspaper in a recent interview that he would have liked to have seen better performance from Northrop Grumman, the company that won the bid to build the $35 million computer system.

"Out of their total $35 million contract, they've been paid $5 million," Gordon said. "They met those deliverables to get paid that $5 million, but they haven't met the others. That's why they haven't been paid."

Gordon said TennCare's project management team had "grown skeptical" of the company's ability to predict benchmarks toward bringing the system online. He said the state will contract with another company to audit Northrop Grumman's progress and provide projections for when it will be ready.

Other concerns expressed in the letter note Tennessee does not provide people with in-person assistance, and the state has not set up a program that allows hospitals to temporarily enroll people in Medicaid if they are presumed eligible.

Tennessee stopped providing state personnel to help people sign up for Medicaid and, instead, began directing them to use healthcare.gov, the federal health exchange.

Michele Johnson, executive director of the Tennessee Justice Center, a leading advocate for TennCare enrollees, said the exchange wasn't designed to assess eligibility in all the categories that Tennessee Medicaid covers.

"And that impacts babies, it impacts pregnant women, and it impacts children who are very sick," she said.

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