Congressman Cohen Asks Governor Lee to Help Resolve Dispute Threatening TennCare Children’s Health

MEMPHIS – Congressman Steve Cohen (TN-09) today wrote to Governor Bill Lee asking him to help resolve an impasse in contract negotiations between BlueCross BlueShield of Tennessee and Methodist LeBonheur Healthcare that could result in the state’s most vulnerable children losing access to necessary services and therapies within weeks.

The letter explains that, if the parties do not reach an agreement before the end of December, BlueCare and TennCare Select enrollees will lose access to Methodist Le Bonheur, which would be particularly harmful for children with special health care needs:

The letter reads in part:

“The apparent impasse between BlueCross and Methodist Le Bonheur poses a serious risk to all TennCare recipients but especially for the children whose needs can only be met at Le Bonheur. Surgeries are being cancelled, and parents are terrified that their children will no longer be able to receive the specialized care that Le Bonheur has provided throughout their children’s lives. The situation is completely unacceptable.  

“The legal and moral responsibility for meeting TennCare children’s medical needs ultimately rests with state government. Tennessee must not allow thousands of its most vulnerable children to be held hostage to a dispute between state contractors. Under the TennCare Waiver, the state is responsible for ensuring that its managed contractors maintain provider networks that afford children timely access to EPSDT services that meet the high standards demanded by federal law. As federal guidance makes clear, if a child needs care that is not otherwise available, ‘the state would need to develop a payment methodology for the service, supply or equipment, including the possibility that payment may need to be made using a single-service agreement with an in-state provider or an out-of-state provider who will accept Medicaid payment [emphasis added].’  

“I request you to do all that you can to bring together BlueCross and Methodist Le Bonheur—both of which receive hundreds of millions of dollars from the state—to settle their dispute so that my constituents and neighbors will retain access to the care they need. If a timely resolution is not achieved, I ask you to direct the Division of TennCare to expeditiously make such special arrangements as are necessary for TennCare children to continue receiving specialized care at Le Bonheur that is not otherwise available in the region. I also urge you to reassure anxious families that the state will step in to ensure that their children will have uninterrupted access to the care they need.”

See the entire letter here.

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