week, 1,000 families will get letters reducing home health-nursing services.
This is your life. Take action.
What you can
- The letter from
your managed care company will give you a 10 warning before the reduction
or cuts happen.
- The reduction and
cuts will be deep. For many people, your hours will be reduced from168
hrs/week to less than 30 hrs/week.
- It does not matter
how sick you are. TennCare is planning on reducing your nursing services.
- Private duty nursing
has been re-defined as nursing services of 8 hours or more per day and
only for folks (adults 21 and older) who have a trach and need various
additional nursing assistance or a ventilator patient who is on a ventilator
for 12 or more hours per day. However, the new limits for trach and
ventilator patients limit nursing services to no more than 30 hrs/week
for nursing services.
- You managed care
company has already talked with your doctor to reduce your care.
- These initial letters
will deal with reducing nursing services for adults, but children will
- MR waiver enrollees
should not get a letter. If you do, call us immediately and let us know
that you are receiving MR waiver services.
- TennCare managed
car companies in middle Tennessee will realize large profits from these
new limits. Remember, managed care organizations get to keep monthly
capitation payments paid to them by TennCare for tens of thousands patients
who do not go to the doctor each month.
What you can
- If you want to
keep your nursing services during the appeal, you have to appeal within
the 10 day limit.
- Appeal only if
the hours offered by your managed care company are less than the new
- Call your doctor
and talk with your doctor about these drastic reductions/cuts.
- Whether you appeal
or not, call your state senator and your state representative and tell
them how these drastic reductions/cuts will impact your family. Also,
ask them to attend the TennCare Legislative Oversight Committee on Sept.
30, 1:30 PM, Room 12, Legislative Plaza, Nashville, TN
- Attend the TennCare
Legislative Oversight Committee in Nashville on Sept. 30, 1:30 PM, Room
12, Legislative Plaza.
- Call the Tennessee
Health Care Campaign, 1-877-431-7083
- If you are on the
MR waiver and received a letter about the reductions, immediately call
the Tennessee Justice Center at 1-877-608-1009.
- Be politically
active because this is your life and you must be an active player, not
a passive objects. The state is counting on you to accept what the managed
care company any will offer you, not to appeal and fight under the rules.
Why is this
- This is about money.
TennCare wants to guarantee profits for the managed care companies.
- TennCare is more
interested in guaranteeing profits for the managed care organizations
than they are in providing services.
- TennCare has a
reserve of $600 million state dollars. If this were used for medical
care, it would equal $1.8 billion state and federal dollars.
- The state is having
a revenue short-fall. For the 4th year in a role, the Governor wants
to use TennCare cuts to fund other state programs.
More more information,
see the attached Question
and Answers for answers to 12 important questions. Also go
to our web site, www.thcc2.org,
and click on Action Alerts for more information on these cuts in nursing
Tony Garr, firstname.lastname@example.org
Tennessee Health Care Campaign
1103 Chapel Ave.
Nashville, TN 37206
1-877-431-7083 Toll Free