TennCare Requested To Return Planned Cuts To State EMS

By Gary Gray
Reporter / Bristol Herald Courier
Published: September 19, 2008

The Tennessee Senate and House Government Operations Committee voted 25-0 on Wednesday to ask TennCare to return $4 million in planned cuts to state emergency medical services to its budget.

TennCare officials now have 10 days to respond. They do not have to replace the money and could instead choose to counter the recommendation. Should the recommendation be accepted, TennCare officials would submit a revised budget with the state’s Department of Finance and Administration citing reinstatement of funds to EMS providers.

The move comes about two weeks after Mark Vance, Sullivan County EMS operations manager, was suspended for speaking out against Gov. Phil Bredesen and his administration for going ahead with the cuts.

On Aug. 28, Vance told the Herald Courier that, “He [Bredesen] told me he would help us. He shook my hand. But it looks like he’s not a man of his word.”

Vance was not available for comment on Thursday.

Several calls placed to Bredesen’s office on Thursday for comment on the committee’s recommendation were not returned.

The planned cut, which would affect ambulatory services, was put into place after legislators adjourned in May following a lengthy session.

TennCare’s budget-tightening measure caught county EMS officials and communities across the state off guard, as they had already planned their budgets for the upcoming year, said Steve Godsey, Sullivan County mayor.

“I was at the hearing in Nashville Wednesday, and it was pretty clear that committee members wanted this money reinstated into the budget,” Godsey said. “Our county stands to lose almost $300,000. That could mean the loss of ambulances and other services.

“TennCare placed this under another type of heading in the budget. I don’t think they never intended to explain it, but it never really said they were eliminating secondary billing,” he added.

Providers whose patients had both Medicare and TennCare, Tennessee’s version of Medicaid, were receiving 80 percent of reimbursements from Medicare, which is a federal entity. A 20 percent match – the “secondary” billing to which Godsey referred – was being provided by a combination of state and federal funds, the $4 million coming from TennCare with a match from the federal government.

Two calls on Thursday to Marilyn Wilson, TennCare spokeswoman, also were not returned.

“It seems that the numbers keep changing, but we were told by TennCare that a total of around $4 million for our state’s emergency medical service providers was cut,” said state Sen. Rusty Crowe, R-Johnson City, who also is a committee member. “The federal government matches that by more than a 2-1 ratio, and the total of the 20 percent in one year is $12.6 million.”

Crowe said committee members asked Scott Pierce, TennCare’s chief financial officer: “Did you do this with dollars in mind as well as patients?”

“Their CFO said, ‘No,’ – he had not considered the long-term effect on patients in the future,” Crowe said.

During a news conference on Aug. 29, Terry Arnold, Carter County EMS director and president of the Northeast Tennessee EMS Director’s Association, gathered four other EMS officials in Blountville to publicly express their dissatisfaction with the cuts.

Like Vance, Arnold voiced his displeasure with the Bredesen administration.

On Thursday evening, he was cautiously optimistic that the funding will be replaced.

“I don’t think this is a done deal yet,” he said. “If they reinstate the money, we won’t have to make major cuts in a time when America is facing natural disasters and terrorists attacks. This would mean a lot to the average citizen in Northeast Tennessee, because we were going to have to cut services.”

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