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Boehner pushes back on Obamacare subsidies extension
The Hill
Speaker John Boehner is pushing back against the idea of Republicans simply continuing Obamacare subsidies if the Supreme Court cripples the law. At a press conference Thursday, Boehner was asked why a House GOP plan included repeal of the individual mandate, which would just be "veto bait" for President Barack Obama, and why Republicans would not just extend subsidies through the presidential election while looking for concessions elsewhere in exchange.
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Florida governor will not drop suit until feds decide on LIP proposal
Miami Herald
Florida Gov. Rick Scott will not drop his lawsuit against the federal government until the Obama administration makes a decision on the legislature's proposal for $2 billion in shared spending next year for hospital payments and a raise in Medicaid rates, according to a notice filed in the case this week.
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Lawmakers finally cut deal on Florida budget
Orlando Sentinel
Leaders of the Florida Legislature agreed to a nearly $80 billion state budget loaded with new projects late Monday, clearing the way for lawmakers to end months of squabbling and adjourn their special session Friday. At a meeting called for 11:15 p.m. in the Capitol, House and Senate negotiators said they had resolved the final sticking points, including earmarking nearly $20 billion in education spending, or about $7,097 per student for K-12 schools.
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California budget deal grants health coverage to children in US illegally
Los Angeles Times
Immigrant children who are in the country illegally would receive public healthcare coverage in California under a budget deal announced Tuesday by Gov. Jerry Brown and legislative leaders. An estimated 170,000 immigrants 18 and younger could qualify, marking another victory for advocates and lawmakers who have worked to make the state more welcoming to unauthorized residents.
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Tensions flare over Medicaid expansion in Kentucky
The State Journal
What started as a rosy Medicaid overview presentation turned into vitriolic criticism by state committee members attacking claims about Medicaid expansion in Kentucky in the report. Audrey Tayse Haynes, secretary for the Cabinet for Health and Family Services and Lisa Lee, commissioner for the Department for Medicaid Services, presented an overview of the state's Medicaid expansion Wednesday to the Medicaid Oversight and Advisory Committee at the Capitol Annex.

Since expanding, Medicaid's enrollment has leveled to between 815,000 and 850,000 Kentuckians statewide since June 2012 with 25,000 leaving and about 25,000 joining annually, Haynes reported.

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Managed-care Medicaid stats continue to divide lawmakers in Kentucky
The Independent Online
When Audrey Haynes sat down before the legislature's Medicaid Oversight and Advisory Committee on Wednesday, she expected the data she brought would persuade lawmakers Kentucky’s expansion of Medicaid has been good for the state. The secretary of the Cabinet for Health and Family Services, which administers the Medicaid program, also may have expected her statistics to ease unhappiness with the state's move to managed care for most Medicaid services. It didn't happen.
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Massachusetts state audit finds Medicaid spent $500 million needlessly
The Boston Globe
Massachusetts' Medicaid program spent more than $500 million over five years on improper or unnecessary payments, according to a state audit released Tuesday. State Auditor Suzanne M. Bump asserts that the state paid for services that should have been covered by the health insurers it contracts with to manage care. "It is troubling to see this amount of inefficiency," Bump said.
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Did you miss Webinar Wednesday: 'The Latest Trends in OHI Discovery and Cost Avoidance for Payers of Last Resort'?
MHPA
Download the presentation (PDF).
View and listen to the webinar recording.

For additional information, please contact Stephen N. Konsin, or visit www.syrtissolutions.com.

For copies of other past webinars, visit here.

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June 24 Webinar Wednesday: 'The New Frontier: Measuring Patient Engagement and Experience'
Avalere Health
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: Vice president of marketing and sales | Chalfont, PA
Project Transition
Project Transition enables people with serious mental illness, co-occurring substance use disorder and/or a dual diagnoses of SMI and IDD live meaningful lives in the community on terms they define. This position is responsible for the planning, development, and implementation of marketing and sales strategies. View the complete job description.

To apply, please email your resume to Adorable Harper.

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Job opportunity: Senior Medicaid Strategist | Raleigh-Durham, NC
North Carolina Department 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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Colby Horton, Vice President of Publishing, 469.420.2601
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