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TACIR supports TennCare‑MCO contract addendum to enable school‑based service reimbursement
Summary
TACIR endorsed development of a contract addendum for managed care organizations and school districts to resolve reimbursement barriers for TennCare‑covered health services provided in schools; BlueCare has drafted an addendum for review.
TACIR voiced support for creating a TennCare managed‑care organization (MCO) contract addendum to address a reported contract issue that prevented a school district from seeking TennCare reimbursement for health services delivered in schools.
Director of Policy Dr. Matt Owen explained the request originated from legislators who raised an unresolved contract problem that blocked reimbursement for school‑based health services to TennCare‑eligible students. Staff reported stakeholders, including TennCare and the MCOs, agreed a contract addendum could help resolve the issue; TennCare committed to testing an addendum with Knox County Schools and BlueCare.
The staff update noted BlueCare drafted a school addendum that is undergoing internal legal review and anticipates sharing it with Knox County once review is complete. Because TennCare’s planned approach aligns with staff recommendations, the final report states the commission supports development of an MCO‑school contract addendum to improve school‑based service reimbursement.
Commissioners approved the report by voice vote, and the staff will monitor the pilot with Knox County and MCOs.
