State of Tennessee (TennCare) (Nashville, TN)

Although the Pacific Health Policy Group (PHPG) was not involved in the creation of TennCare, we were retained in 2000 to provide technical assistance to the state's managed care program. We performed an operational audit of the state's administrative and medical appeals processes, and assisted TennCare in implementing federal consent decrees related to the program's operation.

In 2004, we assisted TennCare in conducting a competitive procurement for its managed behavioral program. In 2005-2006, we assisted the long-term care division within TennCare in develping the state's first comprehensive clinical assessment instrument for applicant's seeking nursing facility or HCBS waiver placement.