his SPA reduces the amount, duration and scope of dental services available to individuals over the age of twenty-one, limiting the dental benefit package to emergency and medically necessary oral surgery and palliative services and associated diagnostic services. The benefit changes apply to non-pregnant adults over the age of twenty-one (21), who are eligible for Medicaid's Basic or Enhanced plans.

This SPA clarifies that the State does not cover licensed or otherwise state-approved Freestanding Birth Centers as outlined in Section 2301 of the Affordable Care Act.

This SPA implements the Medicaid/CHIP Provider Screening and Enrollment provision under section 6401 of the Affordable Care Act and section 1866(j)(2)(A) of the Act to establish procedures under which screening is conducted with respect to providers of medical or other forms of service under Medicare, Medicaid and CHIP.

This SPA revises the payment methodology for health care-acquired conditions (HCAC) and other provider preventable conditions (OPPC).

This amendment proposes implementation of lead case management and enviromental lead investigation services for individuals who tested for elevated blood lead levels.

This amendment reduces Medicaid per diem reimbursement to nursing facilities by 5% for dates of service July 1, 2011 through June 30, 2013.

This amendment eliminates a 5% rate reduction; implements a hospital adjustment factor; and provides for disproportionate share hospital (DSH) payment redistribution methodology.

This SPA makes changes to the State Plan as a result of changes made to Indiana State Law by House Enrolled Act (HEA) 1001 (2011), including the implementation of an assessment fee on most hospitals, the revision of the reimbursement methodology for inpatient hospitals. The fees imposed will be utilized to cover the non-federal share of DSH payments as well as to increase Medicaid payment rates to the aggregate level of reimbursement that would be paid under Medicare payment principles.

This SPA makes changes to the State Plan as a result of Section 4107 of the Affordable Care Act that amends section 1905 of the Social Securoity Act to require coverage of counseling and pharmacotherapy for cessation of tobacco use by pregnant women.

The plan amendment clarifies the services and reimbursement methodology of substance abuse services covered under the Early and Periodic Screening, Diagnosis and Treatment (EPSDT) Program to recipients under the age of 21. The plan amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.