Stockard on the Stump: House Speaker sought postponement of TennCare contracts

September 2, 2022 7:01 am
Speaker of the House Cameron Sexton at Gov. Bill Lee's 2021 State of the State. (Photo: John Partipilo)

Speaker of the House Cameron Sexton at Gov. Bill Lee’s 2021 State of the State. (Photo: John Partipilo)

At the request of House Speaker Cameron Sexton, the Legislature’s Fiscal Review Committee put off action recently on a set of managed care organization contracts with TennCare, the state’s Medicaid insurance program.

Fiscal Review Director Krista Lee Carsner said in an email obtained by the Tennessee Lookout that Speaker Sexton requested postponement.

Sexton confirmed Thursday he asked for the delay and in a statement said, “This request by TennCare would be a record ninth extension, and as speaker, my responsibility is to make sure we are getting good value for our tax dollars on patient care. We will do our due diligence in making sure we have transparency and accountability within this program. These TennCare contracts are some of the most profitable contracts for insurance companies in America. Having more oversight over the department will ensure we maximize patient care.”

Some members of the Fiscal Review Committee said they heard concerns from colleagues about the postponement after the contracts were pulled from their Aug. 24 agenda. Other committee members said they understand the state still has more time to approve the contracts, which would be with Amerigroup, United Healthcare Plan, BlueCare and TennCare Select.

TennCare spokeswoman Amy Lawrence said the items on the agenda were amendments to existing managed care contracts and not related to the agency’s most recent procurement.

An email obtained by the Tennessee Lookout shows House Speaker Cameron Sexton asked to delay a decision on managed care contracts with TennCare, the state’s Medicaid program. Sexton said the halt was part of an effort to conduct “due diligence in making sure we have transparency and accountability within this program.

A piece of legislation backed last session by Sexton would have given a contract to Centene Corp., even though it didn’t win a bid with TennCare to provide coverage for a dual enrollment plan serving people eligible for both Medicaid and Medicare. Centene has also come under fire nationwide, spending more than $1 billion to settle Medicaid lawsuits with several states.

Sexton said in April the legislation would address the “lack of transparency” in the managed care organization contracting process and stop 20,000 enrollees from losing “trusted insurers.”

TennCare disputed Sexton’s assertion, saying nobody would lose coverage under their plan. The bill was expected to cost the state $2.8 million in the first year and $30 million in the third year and afterward.

At the time, Rep. Jason Hodges, a Clarksville Democrat, called it a form of “bid rigging.”

Ultimately, Rep. Charlie Baum, a Murfreesboro Republican sponsoring the House version of the bill, amended it to remove Centene from the language. Initially, his bill would have allowed enrollees to stay with their insurance carriers, including Centene and two others that didn’t receive a new contract, Cigna and Humana.

The bill would have been stymied in the Senate, though, because its sponsor, Sen. Todd Gardenhire, R-Chattanooga, had no plan to move it. He disagreed with the premise and sat on it even after it was amended and moved through the House.

Rural officials await state planning funds

West Tennessee leaders say work is ahead of schedule on the Blue Oval City site where Ford is planning a $5.6 billion electric truck and battery plant. 

But you know it wouldn’t be right if something wasn’t holding up the locals.

The immediate hurdle appears to be bidding for an engineering firm to work with counties and cities around the Memphis Regional Megasite in Haywood County. The Department of Economic and Community Development put out a request for proposals but then pulled it back because professionals kept asking more questions and the state couldn’t come up with the right specifications for the bid, according to Haywood County Mayor David Livingston.

The department, which didn’t respond to questions Thursday, wants to hire one engineering firm to work with local governments surrounding Blue Oval City to handle major projects. The Legislature approved $5 million for planning and engineering as part of the Blue Oval project.

Until the Department of Economic and Community Development moves on the bidding, though, everyone is stuck waiting for the money.

“It’s holding up things because they have not selected anybody and they withdrew their request for proposals,” Livingston says.

State Sen. Page Walley, a Brownsville Republican, agrees, saying he believes a meeting with Gov. Bill Lee is needed to spur the release of that “off-site” planning money.

Haywood County needs to improve its sewer treatment plants and intake lines, and the federal government has allotted $3.5 million, plus $600,000 for Stanton, while the city of Brownsville has approved $24 million to improve its facilities.

“Wastewater is the 500-pound gorilla in the room,” Livingston quips. But he’s not really joking. 

When people flush, the crap’s gotta go somewhere.

Missing guidance from the state and “planning, planning, planning”: West Tennessee leaders say the Tennessee Department of Economic and Community Development are stalling on contracts to commence with infrastructure projects necessary to handle Ford’s Blue Oval City.

One of the things being delayed is a regional sewer project, and local governments are “at a standstill” trying to decide how to proceed “because you don’t want to buy a pig in poke,” according to Livingston.

Officials aren’t even certain what the state is talking about when it says it wants counties in Southwest Tennessee to treat wastewater on a regional basis. Does it mean multi-county, multi-city, what?

“And we really don’t have a lot of guidance on that,” Livingston says.

Walley confirms local leaders are “frustrated” as they seek quicker approval of water and wastewater treatment projects, as well as the planning money approved during the Blue Oval special session in 2021.

“There’s this tension between how much do we cooperate and collaborate with each other versus compete for opportunity with each other from these cities and counties,” Walley says.

Discussions are underway, nevertheless, between Tipton, Haywood and Fayette counties about how to go at it on a multi-county basis. But this all requires a lot of details to work out, Livingston points out.

Tipton County Mayor Jeff Huffman is in the same place, saying the state hasn’t come out with the guidelines to apply for the money.

“So it’s still sitting there. There’s a lot of emphasis on planning, planning, planning. Use this time while they’re building the plant to do your community planning,” Huffman says.

He points out small small towns such as Stanton and Mason could raise the taxes “high enough” to bring in the resources for infrastructure.

Huffman also notes that “no template” exists to build water and sewer lines in response to growth around a state-owned industrial park.

Building a sewer system isn’t the only part of the equation, either. Rates would have to be set up to make sure the system pays for itself, and the question is whether those would be the same for every customer or on a county-by-county basis.

What happens if Tipton has inordinate growth and needs to treat 5 million gallons of wastewater daily but Haywood needs to treat only 1 million gallons a day? But if Livingston sells Haywood’s treatment capacity, then he’s limiting the county’s ability to grow. Or he could draw a line and say he’s not selling a thing.

“There’s just a tremendous amount of things that have to be worked through with regards to it, not just the regulatory phase but the practical how is this thing going to work,” Livingston says. “It’s easy to get out here and say treat wastewater on a regional basis. That’s easy as hell. Anybody can say that. But what the heck does that mean, how does it work on a day-to-day basis and who’s gonna pay for it?”

Sen. Page Walley, R-Bolivar (Photo: Tennessee General Assembly)

Right now, though, county leaders are leery of taking the mantle because they don’t know whether they’re designing a system for themselves or the entire region.

Livingston and other county leaders are dealing with those kinds of sexy questions as 2025 approaches and Ford Motor Co. and SK Innovation prepare to open the massive electric truck and battery factories.

“There’s a lot of cooks in the kitchen, and you know what happens when you’ve got a lot of cooks in the kitchen? It’s a mess,” he adds.

Somebody’s probably going to burn the biscuits and then blame another cook.

He’s confident, though, that local leaders will work things out.

Only 11 months since the Ford announcement, construction is ahead of schedule.

The Blue Oval City is expected to transform the region, bringing high-paying jobs, business and housing development, a stronger tax base and a better quality of life.

Walley, meanwhile, says talk about residential construction is “very robust.” Workers at the 5,800-employee plant are expected to come from a 75-mile radius, but they could also come from outside the state. And those who start making technician wages are likely to want to buy new houses and other goods.

There’s a lot of cooks in the kitchen, and you know what happens when you’ve got a lot of cooks in the kitchen? It’s a mess.

– Haywood County Mayor David LIvingston on infrastructure for Ford's Blue Oval City

“What people don’t understand is this is a life-changing event for West Tennessee, literally. This is gonna change the landscape of West Tennessee for 50 years or longer than that probably,” Livingston says. “Because the electric car revolution, and it is a true revolution, is the wave of the future.”

From a practical standpoint, he adds, “You can’t sell a $500 suit to somebody who makes $11 an hour.”

The real phoenix?

Shelby County voters thought they’d gotten rid of District Attorney General Amy Weirich when Steven Mulroy defeated her in the Aug. 4 election.

Democrats there craved a new outlook in the DA’s office, contending Mulroy would bring compassion to prosecution.

Weirich, however, refused to go quietly and was to be sworn in Thursday as special counsel for District Attorney Mark Davidson in Judicial District 25, serving nearby Fayette, Hardeman, Lauderdale, McNairy and Tipton counties.

Her job will include litigation support and training, victim/witness services, legislative affairs, media relations, policy and procedure, community outreach and public awareness campaigns. It sounds like Weirich won’t be running the show, but she’ll be in the show, which is better than being out of work.

Two-month job

The McMinn County Commission appointed former Commissioner David Crews to fill the vacant District 1 seat of former state Sen. Mike Bell for two months.

Crews, who lost a re-election bid in the Republican primary in early August, is expected to be nothing but a short-term seat holder. He won’t be eligible for a pension but could seek health insurance for two months, though some might question whether that’s worth the headache.

McMinn County leaders opted against putting Republican Adam Lowe in the seat because he has a Democratic opponent, Patricia Waters, in November. For Crews, the appointment was a reward for all of his years on the commission.

Bell, meanwhile, spent his first day on the job as legislative liaison for the Tennessee Wildlife Resources Agency getting up to date on technology, agency rules, email messages and dove hunting. He must have left work early to test a dove field in Westmoreland. But when you’re a former senator, what is a supervisor to do?

The now-former senator says he has a streak of being in a dove field every opening day dating back to 1977.

“I don’t care if I kill a dove. As long as I keep my streak alive, I’m OK,” he says.

As long as he’s not shooting over a baited field, the top brass won’t mind. He could probably get out of it, though, what do you think?

Cade Cothren and his hair leave the federal courthouse in Nashville following his arraignment on conspiracy charges. (Holly McCall)
Cade Cothren and his hair leave the federal courthouse in Nashville following his arraignment on conspiracy charges. (Holly McCall)

“Can you dig it?”

Two questions linger in the wake of indictments against former House Speaker Glen Casada and his ex-Chief of Staff Cade “The Bearded Wonder” Cothren.

The first one is: Where did Cothren get that style? The full beard seems a bit of a stretch when it’s 95-plus degrees every day, and the hair with a bur cut on the sides and foot-long locks on the top? I hear he puts it in a bun sometimes. Come on, man.

Of course, he was always on the cutting edge. Remember, when a local publication named him one of Nashville’s most eligible bachelors? No doubt, the women are flocking now that he’s facing 20 federal counts for fraud, bribery, etc. According to testimony before the Registry of Election Finance, at least one of his girlfriends didn’t mind being used for underhanded purposes.

The second thing is: According to a news report from the Tennessean, former Rep. Robin Smith, who has already pleaded guilty to fraud in the case and is singing like a bird, inadvertently referred to “Matthew Phoenix,” the central fake figure (Cade Cothren) in the Phoenix Solutions investigation as “Matthew Cyrus” when talking to federal informants in the House of Representatives. She then tried to fix that statement by saying “Cyrus” was his middle name.

Remember, when a local publication named Cade Cothren one of Nashville’s most eligible bachelors? No doubt, the women are flocking now that he’s facing 20 federal counts for fraud and bribery.

How she came to call him Cyrus is unclear. But wasn’t that the name of the gang leader in the cult movie classic, “The Warriors” back in the late ’70s? We all know what happened to Cyrus. He had a vision: With 60,000-string gang members, they could take over New York City.

“Can you dig it?” he roared at a supposed secret gathering.

Moments later, he was assassinated and the killer blamed it on the Warriors, who then had to fight their way back to Coney Island, leading to two of the best movie lines of all time: “I want them all. I want all the – Warriors.”

And, from the mousy weirdo who shot Cyrus, “Warriors, come out to play-ay.” 

Let’s get this straight: Nobody wants to be Cyrus. Everybody wants to be the Warriors.

“It’s survival in the city when you live from day to day.”

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Sam Stockard
Sam Stockard

Sam Stockard is a veteran Tennessee reporter and editor, having written for the Daily News Journal in Murfreesboro, where he served as lead editor when the paper won an award for being the state's best Sunday newspaper two years in a row. He has led the Capitol Hill bureau for The Daily Memphian. His awards include Best Single Editorial and Best Single Feature from the Tennessee Press Association.