Tennessee health system sues state Medicaid program over alleged underpayments

Erlanger Health System is suing the state's Medicaid program, TennCare, over claims that the program is choosing to give profits to insurers over health systems.

The provider alleges that the program violates a law requiring TennCare to pay the average rate it awards in-network providers to out-of-network providers, like Erlanger, according to the Tennessee Outlook. Instead, Erlanger claims it was paid the lowest in-network rates. 

Filed Nov. 12, the most recent lawsuit asks judges to throw out a 2008 rule that allows TennCare to pay out-of-network providers 74 percent of Medicare's outpatient emergency rates and 57 percent of its inpatient rates. 

The suit marks the third time Erlanger has sued the state since 2009 over alleged payment concerns through TennCare.

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