Implements the Affordable Care Acts provision to raise payments for services furnished by PCP.

SPA will permit Virginia to participate in a three-year Demonstration that allows States to enroll individuals eligible for both Medicare and Medicaid ("dual eligibles") into managed care organizations that provide all Medicare and Medicaid benefits and supplementary services, through a seamless, integrated program.

Makes supplemental payments equal to the average commercial rate (ACR) minus regular physician payments for physician practices affiliated with publically-funded medical schools in the Tidewater area (Eastern Virginia Medical School).

Implement an Express Lane eligibility determination for children who qualify under the new categorical group identified in SPA-13-002 based on the income eligibility determination in the SNAP program.

Changes in pharmacy coverage.

Payments to Primmy Care Physicians.

Implements the federally authorized enhanced Medicaid payment for primary care services.

Implements federal requirement to use the National Provider Identifier (NPI) when submitting claims to the Medicaid program consistent with 1902(kk)(7).

Updates the medical review process for determining that a person cannot reasonably be expected to be discharged and return home, and to update Form 4246.

Adds Advanced Practice Nurses, Peer Support Specialists and Mental Health Interns as providers under the Mental Health Rehabilitation section of the Medicaid state plan.