The U.S. Attorney's office is rejecting assertions by TennCare that the federal government is to blame for a bungled Medicaid application process in Tennessee that has spawned a lawsuit.
In a court filing on behalf of Secretary of Health and Human Services Sylvia Mathews Burwell, Assistant U.S. Attorney Mark Wildasin wrote that the burden lies with the state.
"Under the Medicaid statute, it is the state Medicaid agency, in this case TennCare, that at all times retains the ultimate responsibility to ensure that a reasonably prompt decision is made on applications, including ones that have been submitted in the first instance to the federally facilitated exchange in the state," Wildasin said.
The filing comes just before oral arguments at 1 p.m. this afternoon before U.S. District Judge Todd Campbell. Lawyers for the Tennessee Justice Center and two other nonprofits are asking the judge to force TennCare to set up a work-around until a behind-schedule $35.7 million computer system becomes operational. They are also asking the judge to grant the case class-action status, which would open the case up to other plaintiffs. TennCare is asking that the case be dismissed.
After the lawyer for TennCare, Michael W. Kirk of Washington, D.C., asserted that the plaintiffs should have named the federal government as a defendant, Campbell directed the U.S. attorney to weigh in on the legal dispute. Wildasin said the responsibility rests with TennCare for ensuring that Medicaid eligibility is determined by the time frames set in federal law.
"Although the Secretary thus respectfully disagrees with some of the legal and factual arguments presented by TennCare that appear to deny that responsibility, the Secretary's priority is to ensure that plaintiffs and other applicants for Medicaid benefits receive decisions on their applications in a timely manner," Wildasin wrote. "Accordingly, the Secretary affirms HHS's intention to continue to work with TennCare over the next few weeks to reach a resolution that would achieve this priority."
The lawsuit has nothing to do with Medicaid expansion. The controversy centers around how the state is processing and determining eligibility for people who might qualify for coverage under Tennessee's existing rules.
Tennessee recently stopped staffing state offices with personnel who could help people apply directly to TennCare for coverage and instead sent applicants to healthcare.gov. Critics say the move presents a barrier to people seeking coverage because not all TennCare programs can be applied for on healthcare.gov.
Reach Tom Wilemon at 615-726-5961 and on Twitter @TomWilemon.