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March 19, 2020
Tennessee Justice Center Files Class Action Seeking Reinstatement of TennCare for Families Wrongfully Cut off by the State, Left Unprotected Against Pandemic.
Thirty-five children and adults from across Tennessee have filed a class action in the federal court in Nashville challenging the state for wrongfully terminating people’s health insurance under Tennessee’s Medicaid program, known as TennCare. The people impacted include medically fragile children, frail seniors, and adults with severe disabilities.
The lawsuit, A.M.C. et al. v. Smith, charges that the state has used a defective process to redetermine the eligibility of families enrolled in TennCare. The plaintiffs say they and many others were terminated without notice, many only learning they did not have coverage after seeking medical care. Many who tried to appeal were denied an opportunity to correct the state’s mistakes and regain their health coverage. Several of the plaintiffs are people with severe disabilities who say that TennCare screens them out by failing even to consider eligibility for categories meant for people with disabilities. They also charge that TennCare demands information and documents already in state files, which makes it especially difficult for people with disabilities to complete the complicated process.
The individually named plaintiffs all had their TennCare coverage improperly terminated by the state since the launch of a new TennCare computer system a year ago, according to the lawsuit. Despite assurances by state officials that the new system, TEDS, would work and solve the problems that have plagued TennCare eligibility for six years, people who are eligible for TennCare were still losing health coverage, the suit states. With the assistance of the Tennessee Justice Center, most were able to navigate the state’s byzantine processes to reinstate their health insurance before the lawsuit began but still owe their doctors for medical costs incurred during the time they wrongfully did not have TennCare coverage.
Michele Johnson, Executive Director of the Tennessee Justice Center, said regarding the case, “The hardships and dangers experienced by the families that brought this case show how dangerous loss of health coverage can be even in the best of times. The harm is even greater now, when the state’s defective systems have left thousands of Tennessee’s most vulnerable children and adults at heightened risk from COVID-19. There is an urgent need to reinstate coverage to prevent suffering, or worse.”
Soon after the plaintiffs who remained without TennCare notified the state that they would ask the court for an emergency order to reinstate coverage for them and thousands of other eligible Tennesseans, the state confirmed that the remaining plaintiffs’ benefits had been wrongly terminated in the first place and reinstated their coverage. But thousands of other Tennesseans in the same position remain without the TennCare coverage to which they are entitled and are exposed to significant dangers from being uninsured during this extraordinary health emergency, the plaintiffs claim.