This SPA amends the current Targeted Case Management State Plan Amendment for Public Health Nurse Home Visiting to include 3 additional counties.

This amendment includes the Private and Charter School Reimbursement Methodology for services outlined within the State Plan. 

Supplemental payment based on CY 2019 UPL for non-state public hospitals in cities with more than one million persons.

Reduces inpatient hospital, inpatient psychiatric and nursing facility rates, and freezes inflation adjustments for inpatient hospital and nursing facility services for SFY 2020

Proposes to allow the state to comply with the Medicaid Drug Utilization Review (DUR) provisions included in Section 1004 of the Substance Use-Disorder Prevention that promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (P.L. 115-271).

Revises the rate setting methodology for NYS Office of Alcoholism and Substance Abuse Services (OASAS) freestanding Chemical Dependence Rehabilitation (IPR) facilities

This amendment provides coverage of Diabetes Self-Management Education (DSME), Diabetes Prevention Programs (OPP) and Medical Nutrition Therapy (MNT), to New Jersey Medicaid beneficiaries who are referred by a licensed, registered or certified healthcare professional.

Implement cost containment via rate reduction for Non-Facility services

Provides temporary Vital Access Provider/ Safety Net Provider (V AP/SNP) enhanced payments to Island Nursing and Rehabilitation Center

SUPPORT Act Drug Utilization Review