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CMS releases landmark Medicaid managed care rule;
Myers weighs in on MLR, quality ratings

MHPA
MHPA president and CEO Jeff Myers commented in a number of stories covering the release of the long-awaited Medicaid managed care proposed rule by CMS. Read them all here:
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Florida Senate offers healthcare coverage compromise
The Associated Press via The Washington Times
Republican leaders in the Florida Senate offered up a revamped health care proposal Tuesday in an effort to end a budget stalemate that threatens to shut down state government, but the proposal was immediately rejected by Gov. Rick Scott and House GOP leaders. Legislators are scheduled to return to the state Capitol next week for a 20-day special session where they are expected to pass a new state budget.
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White House 'disappointed' over Florida Medicaid-expansion impasse
Miami Herald
President Barack Obama's two-day stop in Miami has nothing to do with Florida's upcoming special legislative session forced by a disagreement over how to fund healthcare. But the White House couldn't avoid a reporter's question Wednesday about the president's opinion on the opposition from statehouse Republicans to expanding Medicaid under Obamacare.
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Ohio governor says he's not an Obamacare hypocrite
CNN
VideoBrief Would-be presidential candidate John Kasich, defended his expansion of Medicaid under the Affordable Care Act on Wednesday, while slamming President Barack Obama's signature law at the same time. Kasich, a second-term governor of Ohio, told CNN's Jake Tapper on "The Lead" that his support of a Medicaid expansion under the Affordable Care Act, or Obamacare, did not amount to support for the Obamacare itself.
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Colorado aims to reduce diabetes, costs for Medicaid clients
The Associated Press via KUSA-TV
Colorado health officials are launching a diabetes prevention campaign for people covered by Medicaid, a state and federal healthcare program for low-income residents. The state Department of Public Health and Environment said Wednesday the program aims to reduce diabetes rates and healthcare costs by teaching people how to manage or avoid the condition.
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June 10 Webinar Wednesday: 'Integrating High-Risk Member Care with Risk Adjusted Revenue for Medicaid Members and Dual Eligibles'
PopHealthCare
Taking a holistic approach to integrated programs in high-risk population management can provide true value to members, the plans and the providers serving them. Please join Eddie Gilmartin, vice president, product and business development for PopHealthCare, who will offer groundbreaking programs in high-risk population management that drive rapid, large and demonstrable improvements in member quality of life and satisfaction, while helping its partnering health organizations realize appropriately enhanced revenues, enhanced quality scores and reduced medical costs.
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June 17 Webinar Wednesday: 'The Latest Trends in OHI Discovery and Cost Avoidance for Payers of Last Resort'
Syrtis Solution
Why "pay and chase" when you can cost avoid? It's not easy to discover if a Medicaid enrollee has primary commercial coverage at the point of sale — costing time and money, chasing reimbursements for claims that others should have paid. On average less than 17 percent of the dollars billed to primary insurers are paid back to Medicaid plans that paid claims in error.

This webinar will focus on a very unique and powerful data source that has the potential to revolutionize the way Pharmacy & Medical OHI (Other Health Information) is discovered. Cost avoidance is more attainable than ever before. Capture savings by having the latest active insurance coverage information available to you, in real time.

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Philadelphia Asthma Summit set for June 26
U.S. Housing and Urban Development
The Philadelphia Asthma Summit will take place from 8 a.m. to 4 p.m. on Friday, Jun 26, at the Children's Hospital of Philadelphia. This is the fifth asthma summit that the U.S. Housing and Urban Development has hosted in collaboration with federal, state and local partners.

While each meeting is unique, the overall intent is to advance the conversation locally (state or region) around securing sustainable financing for in-home services targeting children disproportionately impacted by asthma. This Philadelphia Asthma Summit is designed to meet this intent with a specific focus on promoting the value of home-based interventions for children with poorly controlled asthma and reimbursement mechanisms for these services by healthcare insurers for children in low-income households.

Health plans participating in the meeting will hear perspectives and experiences from other health plans serving Medicaid populations. The meeting agenda includes a "Payers' Perspectives Panel" featuring Family Health Network (Barbara Hay, Retired COO), Keystone First (Dr. Lily Higgins, Medical Director) and Aetna Better Health (Dr. Guerra-Garcia, Chief Medical Officer).

RSVP here.

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Job opportunity: Senior Medicaid Strategist | Raleigh-Durham, NC
North Carolina Dept of Health and Human Services
The Senior Medicaid Strategist has responsibility for the execution of the day to day activities in all efforts related to implementing Medicaid Reform for DMA. This position acts a project manager by directing internal and external resources to successfully operationalize reform policy. This individual will report directly to the DHHS Deputy Secretary for DMA.

For more details and to apply: click here.

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Job opportunity: RN, manager, Clinical Health Services,
pre-authorization | Detroit

Aetna
Aetna seeks an experienced RN with managed care, leadership and prior authorization expertise. Reinforces clinical philosophy, programs, policies and procedures. Ensures implementation of tactics to meet strategic direction for cost and quality outcomes. Creates direction and communicates a business case for change by focusing on and addressing key priorities to achieve business results. Identifies opportunities to implement best practice approaches and introduce innovations to better improve outcomes.

Visit here and search for requisition #24937BR to learn more and apply.

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MHPA's Industry NewsBrief
Colby Horton, Vice President of Publishing, 469.420.2601
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