Legal Aid Society of Middle Tennessee and the Cumberlands, Tennessee’s largest non-profit law firm, has announced it will provide free legal assistance to TennCare applicants whose applications have been tremendously delayed.
“Many of these people have foregone necessary medical treatments because of TennCare’s delayed response to their requests for coverage, a delay that has lasted 100 to 250 days—way beyond the federally mandated limit of 45 to 90 days,” said Gary Housepian, executive director of Legal Aid Society.
Legal Aid Society’s actions come on the heels of a September 2 preliminary ruling ordered by U.S. District Judge Todd Campbell of the Middle District of Tennessee requiring TennCare to provide hearings for any individual who has proof they applied more than 45 days ago (or 90 days for disability cases) and has not yet received a decision on their application. The injunction was in response to Wilson v. Gordon, the nation’s first challenge for a state’s refusal to implement the Affordable Care Act.
The Tennessee Justice Center, the Southern Poverty Law Center and the National Health Law Program filed Wilson v. Gordon in federal court on July 23 on behalf of Tennesseans who applied for TennCare through the Federal Marketplace and had not been given a decision in more than 45 days. Judge Campbell certified the case as a class action and is calling on the state to promptly adjudicate claims and hold hearings.
Individuals who have applied for TennCare on or after October 1, 2013 and have not received a final eligibility determination within 45 days (or 90 days if the case involves a disability determination) are urged to contact Legal Aid Society at 1-800-238-1443 for free assistance in obtaining TennCare coverage.
“We recognize how important access to health care is for our clients and for all Tennesseans,” Housepian said. “Affordable health care coverage allows individuals to receive essential preventative care and outpatient services, so that they are not waiting until injuries or illnesses become acute and must be treated in an emergency room. Simple procedures and screenings can make a profound difference in person’s health and quality of life – and, furthermore, are a much more prudent use of tax dollars.”
Housepian said a majority of individuals who receive TennCare are some of the state’s most vulnerable citizens. Children under age 20 and the elderly comprise nearly two-thirds of all TennCare enrollees.
“When applications are being delayed, babies are going without checkups, seniors’ nursing home applications are being stalled,” Housepian said. “With health care, time matters. It is unacceptable for people to wait months to know whether or not they will receive assistance to obtain the care they need now.”
In addition to contacting Legal Aid Society for help, the Tennessee Health Connection may also be able to provide assistance in expediting delayed TennCare applications. They can be contacted for free at 1-855-259-0701.