All hospitals impacted by the Tennessee Medicaid Rate Variation project did not submit their signed amendments to adjust their rates by the August 15, 2014 deadline.
Accordingly, MCOs will cancel, withdraw, and otherwise invalidate all amendments that enacted rate changes associated with the rate corridors for Year 2 of the variation project period beginning 7/1/2014.
It is the intention of the State, working with THA and others, to have all hospitals in compliance with the agreed upon variation project. The effort is not being abandoned.
In the interim, MCO contract negotiations should be working within the corridor established by the completed first year of Rate Variation, as below:
- Inpatient routine and high cost routine: 40% of Medicare to 93% of Medicare
- Outpatient: 78% of Medicare - >150% of Medicare
In addition, the rate variation project set the following corridors for these specialized services:
- Cardiac surgery: 32% of Medicare – 83% of Medicare
- Neonatal services: 4% of Medicare – 174% of Medicare
- Other specialized: 49% of Medicare – 164% of Medicare
These specialized services accounted for 31% of total Inpatient spend in the Aon model.