Persons enrolled in a Medicaid Waiver program are entitled to a timely decision
and notice about the services they request. Once a service is authorized, the person is entitled to receive the
service in the amount, frequency and duration authorized.
Federal
law requires the State to provide a process for appealing any adverse action or decision by the state Medicaid agency or
a Medicaid provider. Adverse actions are those actions by the state Medicaid agency or a Medicaid Waiver
provider that deny, reduce, terminate, or delay the authorization or the delivery of a Waiver service. Adverse
actions also include decisions that terminate or deny a person's continued eligibility and enrollment in a Medicaid
Waiver program.
More information about appeals, including how to file them, and
the rights guaranteed to all persons enrolled in the state's Medicaid and TennCare programs can be found at:
Tennessee's Bureau of TennCare (State Medicaid Agency) or
TennCare (Medicaid) Advocacy Program
