Plan reduces reimbursement rates for physician and certified registered nursing assistants rendering anesthesia services by 3.4 percent.

Provides supplemental reimbursements, funded by certified public expenditures, to eligible governmental entities providing ground emergency medical transportation services.

Updates certain State plan pages, including non-discrimination practices, methods of assuring high quality care, removal of language on guidelines for assessing costeffectiveness of employer-based group health plans, and the definition of a claim.

Provides hospice services to children eligible for Medicaid and children eligible for the Medicaid expansion Children Health Insurance Program.

Adds language that allows Maryland to redistribute disproportionate share payments that exceed hospitals specific DSH limit.

Updates the State Plan language and reduces fees paid to various practitioners by one percent.

Updates the State Plan to reflect the practice of andreimbursement for HIV targeted case management.

Eliminates outdated language related to lead poisoning treatment.

Prohibits payments for items or services provided under the Medicaid State Plan or under a Medicaid Waiver to any financial institution or entity located outside of the U.S.

This SPA extends outpatient psychiatric care as a physician service through video telemental health technologies for eligible individuals in designated rural areas.