Here are six things to know.
1. The Tennessee Medical Association and The Litigation Center of the American Medical Association and State Medical Societies are financially backing legal action by Tennessee primary care physicians, according to a news release.
2. The physicians, the release states, have filed a lawsuit challenging a federal rule, which has resulted in what the state and national medical associations deem unfair payment recoupments.
3. The issue stems from an audit of the state’s Medicaid program, TennCare, conducted last year. The audit was based on criteria set by the CMS four years ago and resulted in an attempt to collect millions of dollars from Tennessee physicians, mostly in rural, underserved areas, who received enhanced Medicaid payments under the ACA, according to the release.
4. Last October, the plaintiffs filed a joint complaint in the federal district court of Middle Tennessee arguing the federal regulation CMS passed to implement the enhanced Medicaid primary care physician payment program was arbitrary and unfairly impacted certain primary care providers, according to the release.
5. TMA’s board has agreed to help finance the legal fees of the plaintiffs, the release states, and the AMA’s litigation center pledged to match and double the monetary contribution from TMA at TMA’s request.
6. CMS did not offer a comment on the issue.
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