MAC Meeting Agenda
July 19, 2007 at 1 p.m.
OHCA Board Room
4545 N. Linicoln, Suite 124
Oklahoma City, OK 73105
I. Welcome, Roll Call, and Public Comment Instructions
II. Approval of minutes of the May 17, 2007 Medical Advisory Committee Meeting [attachment]
III. Financial Report: Anne Garcia, Chief Financial Officer [attachment]
IV. O-EPIC Marketing Update: Joyce Reed, Vice President of Strategy, Griffin Communications
V. Program Operations & Benefits Update: Becky Pasternik-Ikard, Director [attachment]
VI. Provider Services Support Update: Paul Keenan, MD, Director [attachment]
VII. Focus on Excellence Update: Khanita Jefferson, Opportunities for Living Life
VIII. Action Items: Joanne Terlizzi, Director of Health Policy
1. Pharmacy - Rules are revised to require written prescription be printed on tamper-proof paper in order to qualify for FFP. [attachment]
OHCA INITITATED MODIFICATIONS
2. Perinatal Task Force Recommendations
(a) Child Health: High Risk Reimbursement [attachment]
Rules are revised to allow additional reimbursement to providers treating a member who is confirmed to be medically/obstetrically "high risk" and allow additional ultrasounds and non stress tests needed beyond the basic benefit.
(b) Genetic Counselors [attachment]
Rules are revised to allow OHCA to contract directly with licensed genetic counselors.
(c) Lactation Specialist [attachment]
Rules are revised to allow OHCA to contract directly with lactation specialists.
(d) Licensed Clinical Social Workers (LCSW) [attachment]
Rules are revised to allow OHCA to contract directly with LCSWs.
3. Faxed Signatures [attachment]
Rules are revised to allow faxed signatures on all SoonerCare applications.
4. Adult Therapies [attachment]
Rules are revised to allow physical, occupational and speech therapies for adults in outpatient hospital based settings.
5. O-EPIC Employer Sponsored Insurance (ESI) and Individual Plan (IP) [attachment]
Rules are revised to expand current O-EPIC ESI and IP qualification from 185% of the Federal Poverty Level to 200%.
6. Family Planning Waiver (FPW) [attachment]
Rules are revised to clarify that a member: (1) has the option to enroll in SoonerPlan only even if they may be otherwise eligible for SoonerCare and (2) may not receive FPW benefits if he/she has had a sterilization procedure.
DHS INITITATED MODIFICATION
7. Developmental Disabilities Services Division (DDSD) [attachment]
DDSD rules are revised to: (1) reflect current residential support options through the DDSD Home and Home and Community-Based Services (HCBS) Waiver program as approved by the Centers for Medicare and Medicaid Services (CMS); and (2) provide a new residential support option known as community transition services (CTS).
Minutes from OHCA Board Meetings [April] [May]
Provider Update [Summer]
X. New Business