NASHVILLE (AP) — A revamp of billing rules for Tennessee's TennCare program has left some rural health care clinics struggling to stay open.

The Tennessean reported Thursday that supplemental patient TennCare payments promised to rural clinics have been frozen for over a year. National and state health care organizations have told program officials that many clinics are in danger of closing.

TennCare spokeswoman Sarah Tanksley says the freeze is needed to create new billing procedures. The moratorium has been extended twice and is set to end in April. She says the state Comptroller's Office has noted fraud and waste are possible with current procedures.

Tanskey says clinics still are getting payments for program enrollees. But TennCare's per-office visit payments don't cover the entire cost of treating patients, which is where supplemental payments come in.

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Information from: The Tennessean, http://www.tennessean.com