The Medicaid/TennCare section of the Division of State Audit, under an agreement with the TennCare Bureau of the Department of Finance and Administration, provides examination services for the state's TennCare program.

In 1994, Tennessee moved most of its Medicaid program under a managed care waiver approved by the Health Care Financing Administration. The waiver program is called TennCare.

Go to TennCare Rules at: http://tennessee.gov/sos/rules/1200/1200-13/1200-13.htm

The Contractor Risk Agreements between the state and each Managed Care Organization (MCO) and Behavioral Health Organiztion (BHO) require that an audit of its business transactions be performed by a licensed certified public accountant. The agreement for such audits shall be subject to prior approval of the Comptroller of the Treasury and must be submitted on standard "Contract to Audit Accounts." These forms are available at the Comptroller Forms page. From time to time, the TennCare Bureau requests that the Division of State Audit provide special review or other attestation work for various aspects of the TennCare Program. In addition to TennCare examinations, the group also sets reimbursement rates for and conducts examinations of Medicaid long-term care facilities. Long-term care is excluded from the services provided under contract by the TennCare managed care organizations.

In addition to TennCare work, the Medicaid/TennCare section also performs examinations of the Tennessee state employees group insurance program.

Download the Tennessee Medicaid Level I Nursing Facility Cost Report Template (TNLevel1CR.xls). (Please select Save As after clicking the link. Requires a minimum of Microsoft Excel 97). Microsoft Excel is a registered trademark of the Microsoft Corporation.

Download the Tennessee Medicaid Owners' Compensation Ranges (comp08.xls). Note: There are two sheets on this file; the first sheet is for nursing facilities and the second is for parent companies. (Please select Save As after clicking the link. Requires a minimum of Microsoft Excel 97). Microsoft Excel is a registered trademark of the Microsoft Corporation.

Download the Medicaid Level II NF pro-forma rate worksheet (proforma.xls). Note: File updated on 2/29/02. (Please select Save As after clicking the link. Requires a minimum of Microsoft Excel 97). Microsoft Excel is a registered trademark of the Microsoft Corporation.

Contact Information

Assistant Director

Gregg Hawkins, CPA Gregg.Hawkins@state.tn.us

Managers

Clare Tucker, CPA, CGFM Clare.Tucker@state.tn.us

Donna Crutcher, CPA Donna.Crutcher@state.tn.us

Julie Rogers, CPA, CISA Julie.A.Rogers@state.tn.us