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Biden administration calls for major changes to Tennessee’s Medicaid block grant program

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Biden administration calls for major changes to Tennessee’s Medicaid block grant program


NASHVILLE — Citing vital considerations, President Joe Biden’s administration has instructed state TennCare officers it desires Tennessee to make a number of main modifications to the state’s Medicaid block grant waiver program that gives well being care to 1.6 million low-income youngsters, pregnant ladies, moms and disabled Tennesseans.

Federal Middle for Medicare and Medicaid Companies Deputy Administrator Daniel Tsai mentioned in his June 30 letter to TennCare Director Stephen Smith that whereas the company itself is evaluating a spread of actions, Gov. Invoice Lee’s administration taking the actions itself would considerably mitigate the middle’s considerations.

Federal and state officers are mentioned to have been in discussions for a while. The state has till Aug. 30 to reply to the requested modifications, that are geared toward preserving advantages that existed in 2021. A further interval of public remark would come earlier than the waiver would once more come earlier than the Middle for Medicare and Medicaid Companies for approval.

Michele Johnson, government director of the Tennessee Justice Middle, which together with the Tennessee Incapacity Coalition was amongst teams that opposed the block grant waiver, known as the federal company’s choice “excellent news for Tennesseans.”

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“The nation’s main medical specialists and the foremost affected person advocacy teams, together with the American Most cancers Society, American Coronary heart Affiliation and plenty of others, opposed the waiver due to the hurt that it will do to the 1.6 million Tennessee youngsters and adults who depend on TennCare,” Johnson mentioned in a press release.

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Facilities for Medicare and Medicaid Companies letter

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She mentioned all of the teams warned it will “injury the well being care system on which all of us rely, and would worsen the agricultural well being disaster throughout Tennessee.

“I believe they’re mainly saying we won’t go ahead with this plan,” Johnson mentioned in a cellphone interview concerning the Middle for Medicare and Medicaid Companies letter. “It violates the authorized commonplace. … Submit one other plan, and let’s have a look at if we are able to discover one thing that does not violate the regulation.”

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She additionally mentioned no different state sought such a deal, as a result of all of them “realized it will be unhealthy for his or her folks. Ready on a call has been a distraction, and now that’s behind us, we, hopefully, can all flip to developing with higher methods to enhance the well being and lives of Tennessee youngsters and households.”

Lee’s administration sought the waiver after Republican legislators in 2019 directed he accomplish that, based mostly on the concept it will assist get monetary savings, permitting the state to direct these funds into well being care applications and initiatives.

That got here following yearslong criticism by GOP lawmakers who’ve opted to not broaden the state’s Medicaid program below former President Barack Obama’s federal Inexpensive Care Act. The regulation gives federal funding to allow low-income, uninsured adults, aged 19-64, who do not qualify for Medicaid to get well being protection.

Tennessee’s waiver was submitted in 2020. Then-President Donald Trump’s administration permitted it on Jan. 8, 2021, days earlier than Trump left workplace. With Biden’s administration cool to the concept, in addition to plenty of congressional Democrats who charged each earlier than and afterward that the Middle for Medicare and Medicaid Companies had no authority to approve it, Lee’s administration didn’t implement the waiver, often called TennCare III.

“We’re at the moment reviewing the letter however are inspired by CMS’ continued help for the foremost ideas and priorities of TennCare III, which rewards Tennessee for the sound, environment friendly and efficient operation of the TennCare program through extra federal {dollars},” TennCare spokeswoman Amy Lawrence mentioned in a press release Thursday.

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Lawrence mentioned these {dollars} can then be reinvested to boost TennCare advantages and companies and serve extra Tennesseans in want.

Beneath Medicaid, the federal authorities pays roughly two-thirds of TennCare’s prices. There aren’t any spending caps on state Medicaid expenditures, so Tennessee might increase and even broaden the prevailing TennCare applications if it needs, relying on how far more of its personal cash the state was keen to place into it.

Beneath the block grant program, Tennessee would obtain a set quantity of funding however have extra flexibility in the way it spends it, with the state retaining a portion of any financial savings achieved in consequence and empowered to plow that into well being care and health-supportive initiatives.

Critics have charged the block grant program would endanger the well being and even lives of Tennesseans. Throughout a public remark interval in 2019, 9 of some 1,800 folks and organizations instructed the Middle for Medicare and Medicaid Companies they supported it.

Lee mentioned the poor exhibiting was a results of misinformation.

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Amongst different issues, Lee’s TennCare III waiver sought to have a closed method that restricted entry to sure pharmaceuticals and therapies based mostly on worth. It is usually utilized in non-public medical health insurance plans, with proponents saying it saves cash. Critics together with the Tennessee Incapacity Coalition mentioned it serves to take medical selections out of the palms of docs and sufferers within the identify of financial savings.

The Middle for Medicare and Medicaid Companies is recommending the state jettison that as nicely these different provisions:

— The Middle for Medicare and Medicaid Companies desires the state to submit a brand new financing and price range mannequin, based mostly on the normal, per-member, per-month cap as an alternative of the block grant permitted below the Trump waiver. The per-member, per-month mannequin is the sum of money paid or acquired on a month-to-month foundation for every particular person enrolled in a TennCare managed care plan.

— Modify the waiver’s particular phrases and situations part to “extra explicitly state” Tennessee can not lower advantages or protection in impact since Dec. 31, 2021, and not using a procedural modification topic to extra public remark interval and Middle for Medicare and Medicaid Companies approval.

— The Middle for Medicare and Medicaid Companies’ letter states it helps Tennessee’s coverage targets to broaden protection and advantages. However the letter says middle officers suggest that “as an alternative of the present framework for financial savings and funding,” the federal company will “work with the state on obligatory expenditure authorities to fulfill frequent targets.”

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— The Middle for Medicare and Medicaid Companies says that rather than the construction within the present waiver, the state “ought to embrace” a request for expenditure authority for state reinvestments for initiatives that the state want to help with price range neutrality financial savings. The company cites as examples grownup dental companies, expanded 12-month postpartum protection and enhanced home- and community-based companies.

“It is a enormous win for the incapacity advocacy group,” the Tennessee Incapacity Coalition mentioned in a press release. “The modifications that CMS is requesting tackle a few of the most distinguished points with TennCare III for Tennesseans with disabilities. This occurred as a result of so a lot of you spoke up, submitted public remark and arranged. That mentioned, it is extremely necessary that the incapacity group proceed to advocate and to push for truthful, accessible and high-quality well being care in Tennessee.”

Contact Andy Sher at asher@timesfreepress.com or 615-255-0550. Observe him on Twitter @AndySher1.





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Tennessee suspect in dozens of rapes gets 95 years for child sex abuse images and escape convictions

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Tennessee suspect in dozens of rapes gets 95 years for child sex abuse images and escape convictions


NASHVILLE, Tenn. (AP) — A Tennessee man accused in lawsuits of drugging and sexually assaulting dozens of women received a 95-year prison sentence Monday for other types of offenses: the production of child sex abuse images and an escape from an inmate transport van.

Judge J. Ronnie Greer in Greeneville called Sean Williams an unrepentant “organized, methodical sexual predator of women and children,” according to the Johnson City Press. Prosecutors said Williams, who was already in prison, had razor blades in his shoes on his way to court.

Williams, 53, congratulated a prosecutor for a ”dramatic performance” during Monday’s hearing in federal court and implied the images were faked or doctored. Williams laughed, shook his head and retorted when the judge said the only thing worse he could imagine would be being a serial killer.

Earlier this month, Johnson City officials voted to pay $28 million to settle a lawsuit filed by women under “Jane Doe” pseudonyms against the city and individual police officers that claimed police deliberately botched investigations over sexual assault allegations against Williams from 2018 to 2021.

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Williams has not yet been criminally charged as a result of the women’s allegations in the lawsuits.

This Sept. 19, 2020 photo shows a downtown Johnson City, Tenn. building where Sean Williams reportedly lived. (WJHL via AP, File)

The city and the officers have long denied corruption allegations, including a claim in the women’s lawsuit that Williams paid police to obstruct investigations into sexual assault allegations against him. The settlement broadly includes up to 400 women, including minors, who lodged any report of sexual abuse or trafficking to Johnson City Police from 2018 through December 2022, due to accusations of gender discrimination. The settlement still requires court approval.

A campus police officer at Western Carolina University in Cullowhee, North Carolina, found Williams asleep in his car in 2023 while he was fleeing a federal felon-possessing-ammunition charge in April 2021.

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His vehicle contained cocaine, methamphetamine, about $100,000 and digital storage devices with more than 5,000 images of child sexual abuse. Williams was also in possession of photos and videos showing him sexually assaulting at least 52 women at his Johnson City apartment while they were in an “obvious state of unconsciousness,” police wrote.

At least half a dozen names on folders containing videos of women were consistent with first names on a list labeled “Raped” that Johnson City officers had previously found in his apartment, a police affidavit said.

After being charged in connection with the child sexual abuse images, Williams in October 2023 escaped from a van taking him from a Kentucky detention center to a hearing in Tennessee. Authorities caught him in Florida more than a month later.

He was convicted in July of the van escape and in November of the child sex abuse images of a 9-month-old boy, a 4-year-old girl and a 7-year-old girl. Prosecutors said Williams also raped the children’s mothers while they were unconscious and that there were images and videos of them as well. Williams took the sexually explicit photos of one child in 2008 and the other two on separate occasions in 2020, all in his apartment, prosecutors said.

In Tennessee state court, Williams faces additional charges involving minors. In a North Carolina federal court, he’s charged with possessing child sexual abuse images and illegal drugs.

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Two other federal lawsuits against Johnson City and individual police officers are still pending over the investigation of sexual assault reports against Williams.





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Titans Could Have Trade Partner for First Pick

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Titans Could Have Trade Partner for First Pick


The Tennessee Titans are expected to receive some calls in regards to acquiring the No. 1 overall pick, and the team should certainly listen to what some suitors have to say.

One of the strongest candidates for a deal is the Las Vegas Raiders, according to Bleacher Report writer Gary Davenport.

“A trade with the Titans would all but certainly require Vegas including their first pick in 2026—an expensive proposition for a franchise with multiple needs on both sides of the ball,” Davenport writes.

“But playing in a division where three teams made the postseason last year, the Raiders aren’t going anywhere until they secure some stability at football’s most important position.”

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The Raiders would be willing to part ways with next year’s first-round pick if it means getting their preferred franchise quarterback, and there is reason to believe that could be Colorado quarterback Shedeur Sanders.

Tashan Reed and Vic Tafur of The Athletic point out why the Raiders would be interested in making Sanders their franchise quarterback.

“Sanders has a strong relationship (and had an NIL deal in college) with minority owner Tom Brady, has already met owner Mark Davis and should be comfortable in offensive coordinator Chip Kelly’s system, which blends NFL and college concepts,” Reed and Tafur wrote.

“He doesn’t have dynamic physical traits, but he’s mobile, accurate, has a good arm and displayed important intangibles such as leadership, poise and the ability to navigate adversity during his time at Jackson State and Colorado. In drafting him, Las Vegas hopes to end the revolving door it has had at QB since releasing Derek Carr in 2023.”

It would take a lot for the Titans to move down five spots in the draft, but if the Raiders are willing to pay up, it should pique Tennessee’s interest.

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Make sure you bookmark Tennessee Titans on SI for the latest news, exclusive interviews, film breakdowns and so much more!



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Titans Given Opportunity to Pursued Matthew Stafford

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Titans Given Opportunity to Pursued Matthew Stafford


The Tennessee Titans have found themselves among the mix of teams with lingering quarterback questions entering this offseason, and seem primed to address their need at the position one way or another in the coming months.

Following a turbulent campaign led by Will Levis and Mason Rudolph, the Titans will likely search far and wide for an improvement under center for 2025. Whether that be done through free agency, the draft, or a blockbuster trade, Tennessee will be digging for answers.

Could that answer for the Titans be Los Angeles Rams quarterback Matthew Stafford? Well, the idea just became a few inches more likely over the weekend.

According to Tom Pelissero of NFL Network, the Rams have permitted Stafford to speak with other teams around the league about his value –– leading to some believing the former Super Bowl champion could be in for a new team in 2025.

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The move is not a trade request from Stafford, nor a firm declaration from the Rams that they want to move off of him. If anything, the reported goal is for LA and their star quarterback to find a new contract agreement to keep the pairing in-house.

Yet, the door is at least cracked for the two-time Pro Bowler to find a new home, which snowballs into to some questions revolving around the Titans and their potential fit.

The idea of Stafford connecting with the Titans does look a bit outlandish on paper. For a quarterback to go from a team one win away from an NFC Championship appearance to being on the worst team in the NFL, that’d be a major 180-degree turn, especially heading into his age-37 season.

In the eyes of head coach Brian Callahan and the Titans offense, the hypothetical addition of Stafford does have an appeal. An experienced signal caller leading the way would be a much different approach than what Tennessee saw last year, and would likely lead to a bit more success in the standings.

However, for the two to potentially have a mutual fit with one another, the logistics have to work both ways. For Stafford, it’s hard to see that coming to fruition with Tennesssee when there’s a complimentary fit like the Rams in your back pocket.

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Can the Titans be ruled out of the running 100%? Anything can happen in the NFL, so maybe not. Yet, the odds of seeing Stafford calling Tennessee his next home might look a bit slim, to say the least.

Make sure you bookmark Tennessee Titans on SI for the latest news, exclusive interviews, film breakdowns and so much more!



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