Proposes to modify the outpatient hospital reimbursement effective August 1, 2011.

House File 649, as authorized by the IA General Assembly, modified the maximum amount of disproportionate share hospital payments that could be paid to Broadlawns Medical Center.

Results in all smoking cessation products (legend and nonprescription) being covered by IA Medicaid for all members. Sections in PPACA require coverage for pregnant women by 10/1/10 & for all members by 1/1/14. IA will cover all members beginning 11/1/11.

Proposes to amend/clarify state plan language for home health agencies, community mental health centers, and maternal health centers in response to the CMS corrective action plan for approved SPA MS-09-021.

Implements removal of coverage for agents when used for- anorexia, weight loss or weight.

This amendment eliminates graduate medical education (GME) payments to out-of-State hospitals, reduces GME payments to in-State hospitals, and imposes payment reductions for health care-acquired conditions per section 2702 of the Affordable Care Act.

Proposes to apply site of service differential to reimbursement for physician services in facility settings effective September 1, 2011.

The State is assuring compliance with Section 4107 of the Patient Protection and Affordable Care Act (Affordable Care Act), P.L. 111-148, in providing tobacco cessation services for pregnant women.

This change per the request of CMS in the letter dated November 21, 2011, to Jennifer Vermeer as attached) removes from coverage in the Non-prescription Drugs portion of the Pharmacy Program area, four categories of products that do not meet the definition of a covered outpatient drug as defined by section 1927 (k) (2) of the Social Security Act (SSA). These products will be covered under medical supplies.

Implement the required triennial inpatient hospital rebase and recalibration are required by rule.