[{"_1":2,"_100":-5,"_101":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6284645,"mediaKeyId","2577191-2b17410d9b60658ce6aee51e0c1c302f","parentId",2577191,"title","TennCare director details FY‑25 budget, shared‑savings investments and rising pharmacy costs to Health and Welfare Committee","audioSeconds",3794,"startMs",3067000,"endMs",6861000,"viewUrl","/Search/View?dp=1&key=2577191-2b17410d9b60658ce6aee51e0c1c302f&start=3067&end=6861","thumbnailUrl","https://assets.pipeline.soar.com/2577191-2b17410d9b60658ce6aee51e0c1c302f/thumbnail_3067000.jpg","articleUrl","/articles/6284645/Tennessee/TennCare-director-details-FY25-budget-sharedsavings-investments-and-rising-pharmacy-costs-to-Health-and-Welfare-Committee","mediaUrl","https://secure.pipeline.soar.com/6284645-9d1772c454681da64a3676ba843b69b7/orig.mp4?Expires=1775968453&Signature=HUietTZDjUgmqjt8yKM3YMYRZkizzfZ6YB2vJ2WiQbIBgIoRoCG4IItOvcdiHlGa8V5TR2s7dS8QSh~-8a5NT8x0gyKKxXABRxulCGsuz0F0v8LDSqX8rTyqTHmAF29x0Xrfr5H90Ziu8Um2LFVod8XGVV9W6A~zyai0fcB3czWKkJFd3t7lrVBR59-fVPPl4pdCg4fWWhsNkY38pf17yFsencqyq9t7cdIHEem27bAHFui8uiwkP0CsPOq3bD7-6hUPV8fIX5xL4Nm2IwUNeQYg8LyLPo2iAwJf2BB~waDU39zW7jBbWR21Z22H9rYf02NMBD058xYcrk9ReZU2dA__&Key-Pair-Id=KUT5TJCACFTXG","author","TN State Legislature","date","2025-03-12T00:00:00Z","article","TennCare Director Steven Smith and senior agency officials presented the agency’s FY‑25 budget to the Senate Health and Welfare Committee and described how funds from the TennCare 3 waiver’s shared savings would be used to expand long‑term care services, stabilize workforce shortages and address other program needs.

Smith said the TennCare 3 waiver has produced nearly $1 billion in shared savings in its first three years, money the agency is using for a mix of nonrecurring and targeted recurring investments. The agency has proposed using $100 million of year‑three shared savings for hurricane relief to impacted communities and proposed allocating $240 million toward long‑term care initiatives, including enrollment growth for Choices program participants and improvements in home‑and‑community‑based services (HCBS).

As part of the FY‑25 request, TennCare proposed additional capacity for the Choices program — including funding to serve an additional 2,000 people in Choices 3, which supports adults with physical disabilities and seniors at risk of institutionalization — and workforce supports for providers. In his remarks, Smith described a workforce and retention proposal that the agency framed as a $50 million effort (described in the hearing record as “$10 million per year for five years”) to be distributed to providers serving affected populations; TennCare also proposed $50 million in grants for nursing facility infrastructure and workforce needs. TennCare said those would be administered as grant programs, similar to last year’s rural health resiliency grants run through the Department of Health.

The presentation also flagged pharmacy trend increases driven largely by rising use of GLP‑1 drugs (brand names such as Ozempic and Wegovy). Dr. Victor Wu, TennCare’s chief medical officer, told senators TennCare already covers GLP‑1 drugs for certain indications for adults and children (for example, diabetes) and that new FDA‑approved indications have expanded use for adults; TennCare officials told the committee the budget includes approximately $2.6 million in state funds to cover obesity‑only treatment under new criteria and that the broader pharmacy trend increase reflects many new indications and increased utilization.

Smith described the Choices 3 enrollment experiment as a success: the agency enrolled roughly 1,750 new members and observed that enrollment delayed higher‑cost institutional placement by an average of 13 months, producing an estimated $60 million per year in ongoing savings; because of that demonstrated savings, TennCare proposed returning that portion of funding to the general fund while continuing the program investments that produced the savings.

The agency also reviewed long‑standing financing mechanisms. Sen. Hale summarized the hospital assessment proposal — continuing the assessment at 6% — which TennCare said generates state matching dollars and federal draws that fund supplemental payments and support core TennCare services. In committee discussion later, TennCare’s CFO, Zane Seals, and staff explained how an increased hospital assessment would affect HMO premium tax flows: the MCOs are expected to pay additional premium tax as the assessment increases, generating state budget authority that draws federal matching funds.

Committee members asked detailed questions about access and adequacy, including dental provider shortages, network adequacy, and whether rate increases and managed‑care negotiations are producing improvements in provider participation. Smith and staff pointed to multiple channels of recent provider investment — negotiated MCO rate changes, pandemic era enhanced federal funds, hospital assessment flows and other actions — and provided aggregate figures showing recurring and nonrecurring provider investments in recent years. Zane Seals explained the HMO premium tax mechanics and quantified the expected state and federal flows tied to the increased hospital assessment.

After discussion the committee voted to approve the budget motion by roll call. The committee recorded nine ayes and advanced the budget in committee.

TennCare agreed to provide committee members copies of the presentation slides and follow up with requested data on enrollment utilization, network adequacy metrics, and the status of proposed and unobligated shared‑savings commitments.","mediaType","Video","parentTitle","Senate Health and Welfare Committee\tMar 12, 2025\t1:16 PM","oneSentenceSummary","TennCare Director Steven Smith told the Senate Health and Welfare Committee that TennCare 3 has generated nearly $1 billion in shared savings over three years and presented FY‑25 proposals to expand Choices program capacity, fund workforce and nursing facility grants, and address rising pharmacy costs tied to GLP‑1 drugs.","taxTitle","Health and Welfare, Senate, Committees, Legislative, Tennessee","taxId",29601,"location","Tennessee","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6284650,"Senate committee advances bill to make it easier for provider agencies to hire family caregivers for TennCare recipients",1310,658000,1968000,"/Search/View?dp=1&key=2577191-2b17410d9b60658ce6aee51e0c1c302f&start=658&end=1968","https://assets.pipeline.soar.com/2577191-2b17410d9b60658ce6aee51e0c1c302f/thumbnail_658000.jpg","/articles/6284650/Tennessee/Senate-committee-advances-bill-to-make-it-easier-for-provider-agencies-to-hire-family-caregivers-for-TennCare-recipients","https://secure.pipeline.soar.com/6284650-cf013f466ee1627c69edb759873faf29/orig.mp4?Expires=1775968453&Signature=lTJoG2JzfljIgEVihaPcwB-oU0aXQnzietISyt7L26K28BThx94N4lNxlS-eendKCwsnIo2qP5h7cScg42N1Sz6VCOu1SjLM3XzMhOeYqR8P6-Uxk7Emv~QaQ3WBKT3e-VilcnVXEpAPFAPgablXLOsE~RysWyDWTJPjqmxpcR-yj74EH90QaxQynjLeIqYy1HNvL4VbeGz~qyuh20p3Yu1BaTC~xXSOkmCTc-lFoq2cqCduRbilgpdoeGwYx04EVsFIk0dVSxIt3zfUZtT6m8hjIrrfOhjl4XvWoe7bwlH3t1FWcsqh1JFLHS6Bt-SmOHtEonZ0Vx12x15bqK7V3A__&Key-Pair-Id=KUT5TJCACFTXG","The Tennessee Senate Health and Welfare Committee advanced Senate Bill 1178 on a unanimous voice and roll-call vote after testimony from TennCare officials and a family caregiver.

The bill, sponsored in the Senate by Sen. Akbari, would require TennCare and the Department of Disability and Aging to develop guidance on how a Medicaid-participating provider agency may hire a family member to provide home- and community-based services and long-term supports for a loved one with a disability. A floor amendment changed language to make the rules prospective and adjusted wording related to conservatorship so the bill would not apply retroactively to existing conservatorship arrangements.

The measure grew from lawmakers’ concerns about a workforce shortage in home- and community-based services (HCBS) and long-term supports and services (LTSS). Supporters argued that allowing provider agencies to hire qualified family members would help fill gaps when agencies cannot supply a worker and would reduce negative outcomes for people with disabilities and their caregivers, such as financial insecurity or lost employment.

TennCare representatives described how the policy would operate under existing program rules. James Held, legislative liaison with TennCare, said the amendment aligns with current TennCare and DDA policy and retained conservative reciprocal language intended to fit agency rules. Katie Evans, chief of long term services and supports at TennCare, said it was possible the change could increase expenditures in some situations but that she and TennCare staff expected the fiscal impact to be small because many services are already funded when a person is approved; the change primarily affects who provides funded services rather than adding new funded services. TennCare also described oversight mechanisms: provider agencies, not the consumer-directed program, would hire family caregivers, allowing agency supervision, background checks and agency monitoring; managed care organizations would continue medical necessity determinations and care coordination.

Committee members pressed on oversight and on whether a family caregiver would lose pay while pursuing conservatorship. Sen. Massey asked whether a paid family caregiver would lose funding during conservatorship proceedings; TennCare offered to follow up with additional detail. Sen. Watson asked about the scale of fraud, waste or abuse tied to paid family caregivers; TennCare said it does not yet have complete data on how many family members are employed through agencies and that tracking such arrangements can be difficult, but that provider-agency oversight is intended to mitigate risk. Several members, including Sen. Massey, said Tennessee’s protections for vulnerable people and provider monitoring provide confidence that abuses would be limited and caught when they occur.

A family member, Billy Boywood, testified in support and described the financial and personal sacrifices his family made to care for a medically complex child, arguing that paying qualified family caregivers saves the state money by avoiding institutional care.

The bill drew a fiscal-question exchange on the record. Senator Hensley noted a fiscal note labeled “not significant”; TennCare said it had not submitted a separate fiscal impact under amended guidelines. TennCare and committee leaders characterized the change as primarily guidance and rule changes, not a broad new funding commitment. The sponsor and TennCare said hiring would occur through provider agencies rather than consumer-directed programs so agencies retain responsibility for oversight and background checks.

On a roll-call vote the committee recorded nine ayes and no nays; the bill was advanced to the calendar.

Copies of the amendment text and TennCare’s guidance offer were requested during the hearing; TennCare indicated staff would follow up with additional details for members who raised specific procedural questions.","The Senate Health and Welfare Committee voted unanimously to advance Senate Bill 1178 after amendments clarifying conservatorship language and requiring guidance from TennCare and the Department of Disability and Aging on how provider agencies may hire family members to provide home- and community-based services.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6284640,"Committee approves amendment requiring Dept. of Health to collaborate on maternal mental‑health continuing education",183,413000,596000,"/Search/View?dp=1&key=2577191-2b17410d9b60658ce6aee51e0c1c302f&start=413&end=596","https://assets.pipeline.soar.com/2577191-2b17410d9b60658ce6aee51e0c1c302f/thumbnail_413000.jpg","/articles/6284640/Tennessee/Committee-approves-amendment-requiring-Dept-of-Health-to-collaborate-on-maternal-mentalhealth-continuing-education","https://secure.pipeline.soar.com/6284640-9a13e8f3af893080801880a653849d69/orig.mp4?Expires=1775968453&Signature=FAE7q5Gc66Kxu5uXIBuG7PGpN6pyy-AOvL3dfz-WbUNjkb-X06P4I1t8mcTvjBy5MIQERpOWPq-mewg-iqYKKHomhcI9OibCSVkZYnaS8TQHZRfPn2xfAnW-La8~s7hnVPW~cdhwgiK37Xk9UCoUQkBpJFxGNiu4bNRbKBfyKAQzKL~WtAA4b9SaxwDmoAtWs2jVK0F-nGH1QSkVBc9nU~rgTttMP1ZxpsjQ5LBnf3-n7shQz76HYs1rHwY~czB2fn9V~0F-GNWdtQA7ZvlHLV7R9s1huPVd9sEsj5NaQpvAumE1XqbzYMEdelKVeWPV51tUoTl9UYW-kRSjuLBCTw__&Key-Pair-Id=KUT5TJCACFTXG","The Senate Health and Welfare Committee approved an amendment to a medical occupations bill that requires the Department of Health to collaborate with professional boards to identify or create a continuing education program on maternal mental health and for those boards to accept that course for continuing‑education credit.

Sen. Lamar described the amendment as directing the Department of Health to work with the Board of Medical Examiners, the Board of Osteopathic Examination and the Board of Psychology to provide training or information on maternal mental health. The language also requires the involved boards to accept the course as continuing education credit and to periodically update the curriculum to reflect new research. The sponsor told the committee the Department already has material to offer the coursework, and on that basis the bill was reported with a fiscal note described as not significant.

Sen. Massey and other members voiced support and emphasized the bill’s intent to improve maternal health education for clinicians while noting the distinction between the bill’s policy significance and a ‘not significant’ fiscal note. The committee approved the amendment and moved the bill to the calendar by voice and roll call; the committee recorded nine ayes.

The amendment text is recorded in committee files as amendment 4786. The bill will next appear on the Senate calendar for further floor action.","Senators approved an amendment to a medical occupations bill directing the Department of Health to work with boards to develop and accept continuing education on maternal mental health; sponsors said the department already has materials so the change carries no significant fiscal note.","actionData","errors"]

Article not found

TennCare director details FY‑25 budget, shared‑savings investments and rising pharmacy costs to Health and Welfare Committee

Senate committee advances bill to make it easier for provider agencies to hire family caregivers for TennCare recipients

Committee approves amendment requiring Dept. of Health to collaborate on maternal mental‑health continuing education