The Joint Annual Report (JAR) is a key source of data used by TennCare to calculate supplemental pool payments for hospitals. Over time, THA has received many questions from facilities regarding the TennCare supplemental payment methodology and this data source. On July 22, 2020, THA staff presented a webinar that walks through the JAR form and discusses the data elements used in the calculations and how they are used. A recording of the webinar is available as well as a slide deck and other materials that were used in the presentation.
Myers and Stauffer recently created a new presentation explaining the Medicaid DSH Audit process for the SFY 2016 audit that is currently underway. The narrated presentation includes an overview of the CMS audit policy, a detailed review and explanation of the data required for the audit and an explanation of changes in place for 2016. The presentation also provides a recap of prior year audits and includes a Frequently Asked Questions segment.
Detailed Overview updated May 2019
Background information related to implementation of the Tennessee Medicaid Hospital Rate Variation project. The goal of the project is to mitigate excessive variation in reimbursement for essentially the same routine inpatient and outpatient services provided by Tennessee hospitals participating in Tennessee Medicaid managed care networks.
NEW! In November 2021, Guidehouse reviewed the new DRGs that CMS added since the last classification update of DRGs in 2016 that reviewed the service categories used for the rate variation implementation. The updated Service Class Map is available under Resources in this section, and all changes are highlighted. Changes include classifying new DRGs as specialized or routine and updating general categories.