Letter Sent To Senator Bill Hagerty (TN) via Email February 16th 2024:
Hello U.S. Sen. Bill Hagerty,
I’m at disabled adult that’s been encountering misconduct within the TennCare Health plan. One of the things that has remained difficult to understand is what exactly are my rights as a Medicaid beneficiary.
When I search online for resources detailing the rights of Medicaid beneficiaries I don’t find much. It would be really useful if there was a definitive list of Medicaid beneficiaries rights alongside references to each statue which grants those rights.
When I look at court cases and they talk about rights granting language in statutes, and evaluating which of those statutes actually grant rights which are privately enforceable – and any right that isn’t enforceable really isn’t a right now is it – the judges arguments get complicated and confusing.
As a disabled adult I need to understand what my rights are so that I can protect myself from further injury and disability. Right now I’m finding it incredibly difficult to understand what my rights as a Medicaid beneficiary actually are And what I am allowed to do to enforce consequences against bad actors who are violating my rights.
Sincerely,
Sean Smith
Senator Bill Hagerty’s response via email March 12th 2024:
Dear Mr. Smith,
Thank you for contacting my office about the problems you have encountered.
As much as I would like to work with you to resolve this matter, my ability to assist you with obtaining a resolution is limited because it comes under the direct authority of the State of Tennessee. Because I work for you at the federal level, I have no jurisdiction over matters under the auspices of the state government.
You can find out who serves your district by going to the Tennessee General Assembly website at http://www.capitol.tn.gov/. (Click on the tab Find My Legislator). For your convenience, their contact information is as follows:
Rep. Tom Leatherwood
425 Rep. John Lewis Way N.
Suite 574 Cordell Hull Bldg.
Nashville, TN 37243
Phone: (615) 741-7084
Fax: (615) 253-0294
rep.tom.leatherwood@capitol.tn.gov
Sen. Paul Rose
425 Rep. John Lewis Way N.
Suite 734 Cordell Hull Bldg.
Nashville, TN 37243
Phone: (615) 741-1967
Fax: (615) 253-0194
sen.paul.rose@capitol.tn.gov
Please do not hesitate to contact me for assistance with any federal issues.
Sincerely,
Bill Hagerty
My Response via email on March 12th 2024:
Hello Senator Bill Hagerty,
My inquiry was related to requesting to be provided a list of Medicaid beneficiaries rights that is explicit, concise, and also detailed, which cites the statutes related to each right. While medicaid programs are delivered to beneficiaries as state operated health plans, the laws governing them are federal. In addition, state plans are federally funded and compliance with federal legislation is required of state plans by federal law [42 U.S.C. 1396-1].
The failure to provide to medicaid beneficiaries a concise list of their rights is as much a federal failure as it is a state failure. One could argue in the defense of the States, that if Congress and CMS do not provide an explicit, concise, detailed list of medicaid beneficiaries rights and do not require state plans to provide such a lis , then it is not the responsibility of the States to communicate those rights to their plan beneficiaries. But that then begs the question, what is Congress’s intention with respect to disabled adults that are being abused and exploited by State medicaid health plans funded by federal grants? Is it the intent of Congress and it’s representatives to permit and reward health plan misconduct, or provide tools that allow regulation, private lawsuits, and others remedies to be effective?
The failure of ALL Parties, federal and state, to provide a concise and detailed list of medicaid beneficiaries rights makes it difficult for disabled adults and their caregivers to understand when the rights of disabled adult medicaid beneficiaries have been violated and as a result when and how to report such violations to Defend Disabled Adults From Abuse and Exploitation perpetrated by state operated medicaid plans.
Without such a concise and detailed list of medicaid beneficiaries rights, even federal agencies tasked to regulate the State operated medicaid programs are unable to properly perform their duties. The employees at those regulatory agencies are not provided an explicit, concise, and detailed explanation by which they can then accurately assess whether or not a complaint is worthy of investigation and what state plan conduct is in keeping with “the Nation’s proper goals regarding individuals with disabilities…to assure equality of opportunity, full participation, independent living, and economic self-sufficiency for such individuals” [42 U.S. Code § 12101(7)] .
This compromises the integrity of medicaid programs across all States as well as the federal regulatory agencies tasked to monitor and enforce compliance. As a consequence, State health plans, such as TennCare, receive federal funds to do a job that they are not doing and that is FRAUD. FEDERAL FRAUD in the amount of billions of dollars every year.
In Tennessee, Tenncare and it’s Managed Care Organizations are using federal funds to operate a state operated health plan that acts to defeat the purpose of the medicaid programs, as outlined by federal law, enacted by Congress.
To assert that a state operated health plan abusing a federally protected class of individuals and committing billions in fraud on an annual basis against the federal government is not a federal issue, is not simply incorrect, but utterly absurd.
I request that Senator Bill Hagerty and his peers in Congress assist myself and other disabled adults, by at least helping us obtain a list of our rights in an exhaustive, explicit, concise, and detailed format. Perhaps after becoming more attentive to the issue of disabled adult citizens being abused, exploited, injured, and killed by fraudulent state operated medicaid plans Senator Hagerty might try to render some type of aid, in a manner which is in keeping with “the Nation’s proper goals”.
Sincerely,
Sean Smith
6402 Baird lane
Bartlett TN 38135
(901) 522-5775
Defend The Disabled 