That in itself is a dramatic change for TennCare, which has largely been run unilaterally by the administration. It brought praise, expressions of hope and some questions from key players in the legislature. Tighe told a joint meeting of the House and Senate finance committees he needs to know by May 30 whether the legislature will fully fund TennCare II so he can begin making the changes.
Lawmakers have yet to come up with a way to balance the state budget.
TennCare was launched in 1994 as a replacement for Medicaid, a program that simply reimbursed providers to treat people who met income and other standards of need required by federal law. It changed the system to managed care for 800,000 Medicaid eligible Tennesseans and for 500,000 who were uninsured or unable to get insurance because of pre-existing conditions. Managed-care companies are paid a set amount for each enrollee and assume responsibility for cost overruns. One of the pressing issues with the restructuring, Tighe said in asking for a speedy approval of funds, is to see whether the changes will be enough to keep BlueCross BlueShield of Tennessee in the program. The giant insurer serves about half of TennCare's enrollees statewide and had announced it might withdraw from the program on July 1.