Rural Health Clinic Remains Unaffected by Moratorium

The Cumberland River Medical Clinic has remained unaffected by the TennCare special payments moratorium.

Marketing Director of Cumberland River Hospital Candie Power said the moratorium stops TennCare payments to eight newly opened rural clinics.

“[The special payments] make up the difference between what TennCare pays and the actual cost of the visit,” Power said. “So it is important to cover that gap. For instance, TennCare may only pay 25 percent of what the actual charge to the clinic is.”

Power said the moratorium began in October 2017 and was only to last six months. Tennessee has extended the moratorium twice.

“Tennessee decided not to do the Medicaid expansion and receive extra federal funds,” Power said. “So when they did that they were unable to then give those funds to the new clinics that are open since 2017.”

The Cumberland River Medical Clinic became a designated rural health clinic in May 2014, before the moratorium started.

Power said the moratorium has put a strain on rural communities across the state.

“It is harder for [rural clinics] to get in contract with different insurance companies. So say that a large clinic or hospital is able to get in contract and negotiate the payments from TennCare,” Power said. “So they perhaps get more money on the dollar, if you will, than these small rural clinics can. Because they are not able to negotiate, they just don’t see as many patients.”

Power said in order for the new rural clinics to thrive, the moratorium must end.

“It is very important rural areas for them to have the rural clinics available for that underserved population,” Power said. “So it’s very important to end this because those clinics need to stay open. And the only way that they are going to stay open is to stop the moratorium.”

The moratorium is scheduled to end in April, but it may be extended once more.