Supplemental payment for medical education.

Medical Reimbursement for Administration of Vaccines under the Pediatric Immunization Program.

HCDS Revisions.

Asset verification system.

This amendment provides for a per diem increase to nursing facility and HIV nursing facility reimbursement rates by granting a trend adjustment resulting in an increase of five dollars and fifty cents ($5.50) effective for dates of service beginning July 1, 2009.

This amendment provides for trend factors, revises the utilization adjustment for all hospitals except for safety net hospitals and children's hospitals, clarifies disproportionate share hospital (DSH) calculation to allow for payment up to 100% of DSH allotment, and defines the DSH cap.

This amendment provides for the inclusion of the ICF/MR CPE Protocol in Missouris Medicaid State Plan, as requested by the Centers for Medicare and Medicaid Services.

Annual assurance of the pharmacy program adherence to the requirements of federal regulation.

Add detoxification to services available under the Comprehensive Substance Treatment and Rehabilitation Services Section.

Revises the methodology for paying crossover claims for part B outpatient hospital claims for all, but public hospitals operated by the Missouri Department of Mental Health.