For more information about TennCare, visit the Governor's Virtual TennCare Room.

The TennCare Oversight Division protects the public health and the integrity of the TennCare Program by overseeing, examining and monitoring Health Maintenance Organizations and Behavioral Health Organizations participating in the program. The division ensures that the HMOs and BHOs under contract with the state are in compliance with statutory and contractual requirements relating to their financial responsibility, stability and integrity. Click Here to read more...

Under state and federal law - called HIPAA (the Health Insurance Portability and Accountability Act) - certain "eligible" individuals cannot be denied health insurance even if they have pre-existing conditions. Click Here for the Department's legal bulletin on HIPAA. Click here for more...

• Monitoring Activities

• New: Selection Panel Meetings

• New Information
  Questions Regarding the Notice of Liquidation or the Liquidation of TCCN - Click Here

• New Information
  Questions Regarding the Notice of Liquidation or the Liquidation of Universal Care - Click Here
• New Information
  Questions Regarding the Notice of Liquidation or the Liquidation of Xantus - Click Here

• MCO Financial Reports
• Prompt Pay Compliance
• NAIC
• CMS
• TennCare Bureau
• Fraud & Abuse
• Examination Reports
• HMO Filing Checklist [pdf]
• BHO Filing Checklist [pdf]
• PLHSO Applications [pdf]
• 3rd Party Administrator Packet [pdf]
• MCO Contract to Audit Accounts [pdf]
• BHO Contract to Audit Accounts [pdf]

• Independent Review [pdf]
• Information Packet for Independent Review [pdf]
• Instructions/Form for Independent Review [pdf]
• Business Associate Agreement [pdf]
• Status of Independent Review Requests [pdf]
• Annual Independent Review Reports
• Amendment to Independent Reviews (Pub. Acts - 2002) [pdf]
• Independent Review Contacts [pdf]