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The following post is our brief guide around the context and major financing and coverage principles of the Tennessee waiver (TennCare III). Given the import of the formulary flexibilities to many of our clients, we have “carved out” (to use a Medicaid pun) that discussion for a future post (coming this week!)
On Friday January 8
th, in the final days of the Trump Administration, CMS announced approval of a first-in-the-nation waiver that would permit Tennessee to transition from Medicaid’s longstanding, open-ended financing model to a modified “block grant” model – a financing system under which the Federal government has agreed to commit a discrete amount of dollars to the state, adjusted only by enrollment growth and pre-established inflation factors. Within this “aggregate cap” approach, Tennessee would have greater reins to modify coverage, benefits, and payment outside of established Fed ....

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