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Tennessee Medicaid Terminations


Problem Statement

In March 2019, Tennessee launched the TennCare Eligibility Determination System (TEDS), which was designed to streamline enrollment and redeterminations for Tennessee’s Medicaid program. The system’s launch was delayed for many years and plagued by technical setbacks. After its launch, many people’s Medicaid coverage was terminated. The reasons for these cuts are not completely understood, but are likely due to systemic defects—such as issues with interface design, inter-system communication, and underspecified notices to individuals. Advocates also said the redetermination process did not fully meet the accessibility needs of people with disabilities. Instead, it terminated people’s benefits or put them at risk of termination, even though reasonable accommodations should have existed. In 2020, the Tennessee Justice Center and partners filed a class-action lawsuit against the state, A.M.C. v. Smith.

Status of Issue

Litigation against the state is ongoing. The class-action lawsuit represents 35 adults and children across the state, and claims that “TennCare’s system for reevaluating eligibility is defective and fails to provide the notice and opportunity for hearing required by the Medicaid Act and the Constitution” and “TennCare’s eligibility redetermination process discriminates against people with disabilities.”

TennCare website

NHeLP lawsuit press release with complaint

At least 220,000 Tennessee kids faced loss of health insurance due to lacking paperwork - The Tennessean

Key Parties Involved & Contact

National Health Law Program (NHeLP)
Primary Advocate Contact: Elizabeth Edwards

Tennessee Justice Center
Primary Advocate Contact: Brant Harrell

National Center for Law and Economic Justice

Selendy Gay Elsberg, PLLC

Tennessee’s Division of TennCare



Related Resources

Key Questions Guide

This guide will help you start piecing together why and how benefits tech is being used and how it is impacting people.

Public Records Request Guide

This guide will help you think through how you can use public records requests to help find out why the state decided to implement a benefits technology system, how they implemented it, and how they are using it.

Fair Hearing Guide for Attorneys

A guide attorneys and advocates for using the fair hearing process to both challenge benefits tech decisions and gather information for further advocacy.

Fair Hearing Guide for People Getting Benefits

A guide for people have had their benefits denied, reduced, or terminated with public benefits technology used as part of the decision process.