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Proposal would cut Ohio Medicaid coverage for some
pregnant women

The Associated Press via The Charlotte Observer
Ohio state senators are taking a hard look at a proposal in Republican Gov. John Kasich's budget that would eliminate Medicaid health coverage for certain pregnant women and others who the administration says can get insurance through the federal marketplace. Democrats and several Republican senators have questioned the plan, suggesting that rolling back coverage for some low-income, pregnant women conflicts with the state's efforts to combat infant mortality.
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Conservatives to unveil Obamacare replacement
The Hill
Another Republican Obamacare replacement plan is coming out as a Supreme Court decision looms. The conservative Republican Study Committee will be announcing its Obamacare replacement plan, the American Health Care Reform Act. A previous version of the bill was released by the RSC in 2013. It repealed Obamacare and included tax breaks to help people afford insurance, as well as funding for state high-risk pools aimed at people with pre-existing conditions.
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Florida legislators offer up concessions as session opens
Tampa Bay Times
A contrite Florida legislature returned to the capital Monday with a series of concessions and the goal of quieting the bitter intraparty feud over health care that sent lawmakers into overtime.
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Louisiana's financing plan for Medicaid expansion receives final passage
The Associated Press via The Times-Picayune
If Louisiana's next governor wants to expand the state Medicaid program to tap into billions of available federal health care dollars, state lawmakers have given him a way to help pay for it. The Senate voted, 31-8, Monday for the financing tool contained in legislation by Republican House Speaker Chuck Kleckley. The vote gave final passage to the measure, which was earlier approved by the House and can't be vetoed by Gov. Bobby Jindal.
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Utah Medicaid expansion negotiations ongoing
KSL-TV
Utah lawmakers continue to work on a plan to cover the state's uninsured but don't anticipate striking any kind of deal before August. Upon failing for a second year to come up with a feasible alternative to the full Medicaid expansion outlined in the Affordable Care Act of 2010, a team of four lawmakers, Utah Gov. Gary Herbert and Lt. Gov. Spencer Cox set out in March to negotiate a deal.
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Alabama House passes bill to create long-term care networks
The Associated Press via Miami Herald
The Alabama House on Thursday passed a bill that would establish integrated care networks to allow more Medicaid recipients to stay in their homes instead of nursing homes. Senate Majority Leader Greg Reed said the legislation could cut Medicaid costs by $1.5 billion from 2018 to 2028 while also allowing more Medicaid recipients to receive home-based care.
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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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