Recovery Auditor Contractor.

Creates Integrated Care Model for Health Care Delivery Systems.

Mental Health Rate Changes.

Discontinue covering claims for dual eligible beneficiaries.

Allows optometrists to participate in the New Jersey Medicaid Electronic Health Records (EHR) Incentive Program.

Updates Language Regarding Section 6032 of the Deficit Reduction Act of 2005.

By means of this SPA, New Jersey brings its State Plan into compliance with Section 1903(r) of the Act and 42 CFR 435.960, which requires States to have an eligibility determination system that provides data matching with other State's medical assistance systems through the Public Assistance Reporting Information System (PARIS). New Jersey began using PARIS in 2008.

Provider Screening and Enrollment.

This amendment proposed to change the drug ingredient cost reimbursement from Average Wholesale Price (AWP) minus 17. 5% to Wholesale Acquisition Cost (WAC) minus 1%. This amendment is a straight line reimbursement adjustment as it equalizes the WAC metric to the current AWP metric.

Updates Durable Medical Equipment provisions to increase the prior authorization amount.