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Commission supports development of MCO–school contract addendum to resolve TennCare reimbursement issues
Summary
The commission supported staff language urging TennCare and managed care organizations to develop an addendum for contracts with school districts to clear a barrier to reimbursement for school‑based health services; BlueCare has drafted an addendum currently under internal review and will share it with Knox County Schools.
The commission voiced support for the development of a managed‑care‑organization (MCO) contract addendum to address obstacles that have prevented some school districts from seeking TennCare reimbursement for health services provided to TennCare‑covered students.
Matt Owen, director of policy, explained the work followed a request from members regarding an unresolved contract issue between TennCare, a managed care organization and Knox County Schools. Staff reported stakeholders agreed a contract addendum for MCOs to use with school districts could help resolve the issue. TennCare has met with Knox County Schools and BlueCare; BlueCare has drafted a contract addendum and is completing internal legal review and expects to share it with Knox County once review is complete. TennCare committed to testing the addendum with Knox County and to consider broader use if the test succeeds.
Because TennCare’s proposed approach aligns with staff recommendations, the commission’s final report included a statement supporting development of an MCO–school district contract addendum. The chair moved approval of the final report; the vice chair seconded. The commission approved the report by voice vote.
