Tenncare launches $400M Medicaid application system

NASHVILLE – It is a big day for the poor and the sick in Tennessee, even if they don’t know it yet.

Tenncare has quietly launched an expensive and long-overdue Medicaid application system over the weekend, potentially transforming how some of Tennessee’s most vulnerable residents obtain medical coverage and other benefits.

Officials confirmed the Tenncare Connect system – designed to quickly process applications online or by phone – went live on the morning of March 16. This application system, which has been federally mandated since 2014, is built upon a computer infrastructure that cost about $400 million, mostly covered by the federal government.

Tenncare officials were coy about the launch of new system. Tenncare Director Gabe Roberts said much of the new system has worked behind the scenes for months and the final milestone was to roll out the Tenncare Connect web portal to the entire state.

But officials worried they risked a technological collapse – not unlike what happened in initial days of Obamacare – if the web portal fully launched before it was ready.

“We’ve got this huge amount of time, and this huge amount of money invested in this system,” Roberts said. “Every though (the web portal) is a relatively small part of the overall system, it’s overwhelmingly the part people are going to see. So we have to make sure we are comfortable with it and ready to go.”

The Tennessee Justice Center, a nonprofit law firm, said last week it had already received complaints about the computer program at the core of the new application system.

“We’re scared to death those problems are only going to get worse,” said Chris Coleman, an attorney for the Tennessee Justice Center. “Because we’ve been flooded with calls from the counties where they have been piloting (the new system), and even things that were working before are not working now.”

There appear to be at least some problems at the new Tenncare call center. According to public records provided by the Justice Center, Tenncare financially penalized KEPRO, the company running the call center, for not processing calls quickly or accurately enough. Tenncare penalized the company $142,000 in February and threatened to withhold another $197,000 at the beginning of March.

Tenncare officials said the call center problems were minor and should not hamper the application system overall. If anything, Roberts said, the penalties show that Tenncare is holding its vendors accountable to ensure the new system is successful.

Tenncare Connect consists largely of three major components: The web portal, which can be used to apply for online; a call center, which handles applications over the phone; and an internal computer system – the Tennessee Eligibility Determination System, or TEDS – which officials call the “brain” of the new application system.

The web portal and the call center use TEDS to determine if applicants are eligible for Tenncare or the social services by analyzing a complicated mix of income and medical variables. TEDS interfaces with more than 100 outside sources, including the IRS and Social Security Administration, to verify applicants’ information, said Hugh Hale, Tenncare’s chief information officer.