Current Tenncare Select WLS Surgeons?

Hi TN Friends! My sister is interested in having WLS. I had my surgery over 8 months ago and my surgeon (Dr Hruska) cant take her because tenncare wont pay unless you live in an ajoining county. We live in Rutherford County. She could go to Davidson, Wilson, Williamson... that may be all. Does anyone know what surgeons are currently taking tenncare select and also accepting new patients? she is working on getting a case manager, but wants to do some research now too. thanks in advance! Rachel 270/159

I am sorry to hear about Tenncare. I knew was changing because Dr. Hruska is my surgeon and I live in Shelbyville. Michelle( the dietician) told me at the hospital that this was changing. Getting a case manager does help, I have one. I hope you get some more answers. Lisa

Hi Rachel, tell your sister that is a good idea to get a case manager with tenncare i have one and she has been so much help.What type surgery does she want to have?I finnaly found one to take my tenncare DR Houston at cinntennial in nashville.He is out of network but agreed to take me and maybe he will be taking more tenncare people.I am having the lap band surgery.I hope this helps. Eva

Hi Rachel I am on TennCare Select, and I am seeing Dr. Glen Birkitt in Bristol. He has a very long waiting list, but I hear he is worth the wait. I know it is a long drive. It's about 204 miles for me to drive. I had the same thing happen to me with Dr.Hruska. There is alot of other doctors that do take the TennCare but TennCare does not have them listed. I don't have the list with me right now...but I will try and get back with you on this. GOD bless you and your sister. I know how she feels !!! Oh Yeah Dr. Birkitt's # is 423-968-1861. Brenda

This was in The Tennessean 11/11/04. Bredesen puts deadline on TennCare cuts or he will begin dismantling program In a high-stakes match with health insurance for 430,000 Tennesseans on the table, TennCare advocates have one more card to play before Gov. Phil Bredesen folds his hand and does away with the state's troubled TennCare program. That card, which Bredesen gives a 1-in-5 chance, is last-minute talks with the attorney he says is trying to block the cost-saving changes that are needed to save TennCare. ''It's not 50-50. It's a 20% chance'' that a compromise can be reached, Bredesen said yesterday, hours after he announced he would end TennCare unless a deal could be reached with enrollee advocates in seven days. The governor, who had hoped to maintain TennCare with capped benefits, yesterday spoke of how his wife had taught him to ''play the hand that you get dealt,'' and said he had little choice but to dismantle the state's decade-old experiment with universal health care. ''TennCare was, and is, a wonderful dream,'' Bredesen said. ''It appears this morning that the dream is over.'' Bredesen plans to return to basic Medicaid, which is what was in place before 1994 and exists in most other states. Tennesseans slated to lose coverage will be alerted starting in January, Bredesen said. They include up to 70,000 children and those who got on TennCare because they were uninsured, uninsurable or medically needy -- that is, low-income people who have such high medical bills that they qualify for an optional Medicaid category. Roughly 900,000 Tennesseans who are poor, have disabilities or are elderly would continue to qualify for Medicaid. Irma Sealey, 46, said she was disheartened that thousands of enrollees, like herself, risk losing the health care they rely on for chronic and life-threatening illnesses. ''I realize it's an expensive proposition, but how do you say that a human life is not valuable?'' said Sealey, who for nearly a decade has relied on TennCare to pay for $990 in monthly medications to treat her epilepsy, heart and blood problems. ''Nobody should have to be in my shoes. There's no excuse. We take care of things overseas and we can't take care of our own people. It's not right. It's just not right. And I want someone to look my daughter in the eye if something happens to me and tell my daughter why my life doesn't count.'' Sealey, a Summertown resident, added, ''The people of Tennessee elected all of these officials to represent us, and today 430,000 of us were not represented.'' Bredesen said he reluctantly came to the decision to end TennCare after being faced with mounting costs, particularly in prescription drugs; a reduction in federal funds; and cumbersome federal litigation brought on by the nonprofit Tennessee Justice Center. Those court decrees are blocking the governor's preferred plan to keep all 1.3 million people enrolled but with limited benefits. No enrollee will lose medical care immediately, Bredesen said, and a breakthrough could develop over the next week as negotiations continue with the Justice Center. ''I want to be clear this is a faint glimmer of hope, not a bright light,'' Bredesen said. The Justice Center, in an 11th-hour letter sent Tuesday night to Bredesen, asked for seven days to continue ''good-faith'' discussions on the court decrees. Gordon Bonnyman, the center's executive director, said the problem was not his advocacy and legal battles surrounding TennCare, but the fact that the governor's plan would mean hundreds of thousands of people would lose their safety net without the ability to get coverage elsewhere. ''I understand that this is a public program and it has got to live within a budget. No one more passionately desires this program to survive and to be reformed than I and the other people I work with. But you don't do it with fingerpointing.'' Bonnyman said he still believed that he and the governor could find common ground to make TennCare a more efficiently managed program and keep down costs without radical cuts. ''We're willing to sit and roll up our sleeves and work with anybody to try to identify what can be done to save the program.'' The two sides could begin meeting as early as today, but Bredesen was not optimistic. He said he believed Bonnyman's hope was to fund TennCare as is, with a tax increase -- something that Bredesen said was not in the cards. The governor is already planning a six-month wind-down period ending by the middle of next year. Tennessee taxpayers are expected to save a half-billion dollars next fiscal year over what TennCare would cost if nothing changed, TennCare Director J.D. Hickey said. But the state will still spend roughly $2.7 billion for the Medicaid program, about the same amount Bredesen had expected TennCare to cost under his alternate plan that would have provided for limited benefits. TennCare was started with high hopes that the state could expand Medicaid coverage to more people with the same amount of money by using managed-care principles. At the rate it's going, the $7.8 billion program, whi*****ludes $2.5 billion in state money, could eat up 91% of new tax dollars in 2008, consultants told the governor. State lawmakers were generally receptive to Bredesen's plan of last resort. They will get their first shot at it during an emergency-planned TennCare Oversight Committee meeting at 10:30 a.m. Wednesday. Staff Writer Jay Hamburg contributed to this story.