State attorney general releases taxpayer-paid audit on health claims | Victor Ashe

CORRECTION: The Tennessee Attorney General's office released the taxpayer-paid audit on health care claims on July 1. The purpose of the audit by Healthcare Horizons was to identify claim errors resulting in incorrect payments and to assess underlying conditions contributing to any errors identified. 

Earlier, it was reported incorrectly in this space that the audit had not been released. 

Two years ago, state Rep. Martin Daniel raised questions about reimbursements by Tennessee for the state health care plan. It is administered by Blue Cross/Blue Shield and Cigna, and state government pays out hundreds of millions a year for claims.

The issues that have arisen started when ClaimInformatics, a medical auditing firm, issued a preliminary audit more than a year ago that reviewed the payments. It said that there were substantial differences among reimbursements for similar or even identical medical procedures that were difficult to explain or justify.

ClaimInformatics said more than $17 million was paid inappropriately or erroneously. Blue Cross and Cigna disagree with that conclusion.

Daniel met with staff for the state attorney general and state comptroller. They recommended a review and audit. Daniel placed $400,000 in the state budget to conduct an audit, and after a lengthy process, Healthcare Horizons in Knoxville (www.healthcarehorizons.com) won the contract in early 2021. Healthcare Horizons finished its work in late 2021 or early 2022.

The state Supreme Court will decide  who will be the state attorney general after Herb Slatery's term ends Aug. 31. But Gov. Bill Lee is expected to make a recommendation. Many expect the recommendation to be his CEO for operations, Brandon Gibson, an attorney and former judge on the appellate court from West Tennessee appointed by former governor Bill Haslam. She has been CEO since May 2020.

Stuart Hohl, candidate for County Commission, scored a coup last week when he became the only Democrat  to win a contribution from the Knox Area Realtors. His campaign received $1,500. He is opposed by Gina Oster, who is a Realtor. They are running in District 3 (Cedar Bluff and Amherst areas) in the Aug. 4 election. Early voting is underway and ends Saturday.

Other Knox candidates in the Aug. 4 county general election receiving contributions from Realtors are Glenn Jacobs for county mayor, Larsen Jay and Rhonda Lee for County Commission and Nick McBride for Register of Deeds.

Longtime former city police chief Phil Keith has been working as the interim executive director of the Tennessee Association of Police Chiefs since early April when the prior executive director resigned. There are 268 police chiefs in Tennessee and more than 1,000 members of the group.

Their 2022 annual meeting was last week in Chattanooga. Keith has been going to Nashville weekly for three months to run the state office and expects to continue until a new executive director is chosen, which could occur the end of August.

Birthdays 

July 29: Farragut Alderman Drew Burnette is 42. Shauna Godlevsky is 48. Kenny Fikes is 55. City Council member Lynne Fugate and her husband, Scott, are both 61. Michael Maddux is 61. TBI Director and former city police chief David Rausch is 60. Thomas Welborn is 74. Architect Beth Eason is 59.

July 30: Democratic DA candidate Jackson Fenner is 45. Blount Mansion director David Hearnes is 44. Steve Tatum is 72. Property Assessor John Whitehead is 74. State General Services Commissioner Christi Branscom is 57.

July 31: Sarah Howell is 35. Monica Armstrong is 26. Former city special events director Sue Clancy is 90. Retired banker Larry Martin is 75. Clarence Vaughn is 42.

Aug. 1: Bill Baxter, former TVA board chair, state economic development director and CEO Of Holston Gases, is 69. Ursula Bailey is 57. Attorney John Harber is 70. Gary Loe is 65. Pond Gap's David Williams is 70. Bill Murrah is 77. Former sheriff and GOP state executive committee candidate Tim Hutchison is 70. Attorney Arnold Cohen is 81.

Aug. 2: Businessman Jordan Mollenhour is 41. Retired East Tennessee development director Bob Freeman is 86.

Aug. 3: City Deputy Mayor Erin Gill is 36. Nathaniel Shelso is 34. Attorney Al Holifield is 62. Jane Jolley is 59. Respected dentist Don Henson is 65. West Hills activist Larry Silverstein is 67. Martha Coppock is 85. Artist Alex Smith is 35. Julieanne Foy, Lakeshore Foundation director, is 57.

Aug. 4: Former president Barack Obama is 61. Meghan, Duchess of Sussex and wife of Prince Harry, is 41.

Victor Ashe is a former Knoxville mayor and former ambassador to Poland. He is a columnist for Shopper News. 

This article originally appeared on Knoxville News Sentinel: State attorney general releases taxpayer-paid audit | Ashe