MAC Meeting Agenda

July 19, 2007 at 1 p.m.
OHCA Board Room
4545 N. Linicoln, Suite 124
Oklahoma City, OK 73105

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Tentative Agenda

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

FEDERAL MANDATE

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]

DUR Board Meeting Agendas [June] [July]

Provider Update [Summer]

IX. Discussion

X. New Business

XI. Adjourn