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Notice of Change in TennCare II Demonstration
Amendment 23

The Commissioner of the Tennessee Department of Finance and Administration is providing official notification, pursuant to 59 Fed. Reg. 49249, of intent to file an amendment to the TennCare II Demonstration.  The demonstration amendment will be filed with the Centers for Medicare and Medicaid Services (CMS), a federal agency located in Baltimore, Maryland, with a Regional Office in Atlanta, Georgia.   

The State is required to meet certain advance notice obligations whenever an amendment to the TennCare Demonstration is filed.  This demonstration amendment, which will be known as “Amendment 23,” is being filed with a proposed effective date of August 1, 2014.

The subject of the amendment is prenatal care for pregnant women who have been determined Presumptively Eligible for TennCare.  The state has always provided full TennCare benefits to these women, consistent with our managed care approach and the statement in our TennCare Demonstration Waiver that all services are considered pregnancy-related services. 

CMS has advised the state that it needs to submit a waiver amendment to clarify that non-ambulatory services (e.g., inpatient hospitalizations) can continue to be covered by Medicaid for pregnant women during a period of Presumptive Eligibility.  In order to keep in place our long-term practice of providing a full range of services to pregnant women during a period of Presumptive Eligibility, we are therefore requesting an amendment to the TennCare Demonstration that would provide the expenditure authority to continue providing these services.

This amendment will not result in any changes in expenditures.

Copies of this notice will be available in each county office of the Tennessee Department of Health.  Written comments may be submitted by email to or may be mailed to Mr. Darin Gordon, Director, Bureau of TennCare, 310 Great Circle Road, Nashville, Tennessee 37243.  Persons wishing to review copies of written comments received may submit their requests to the same email and/or physical address.