The plan amendment updates the physician and other licensed practitioners fee schedule, including all components of the effective date language in the State Plan. The amendment change does not have a direct impact on Indians, Indian Health Programs, or Urban Indian organizations.

This plan amendment removes the reimbursement for supplemental payments for governmental ambulance providers from the state plan. The plan amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.

The plan amendment removes the reimbursement for supplemental payments for public owned dental providers under EPSDT. The amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.

The plan amendment implements a two percent rate reduction for early and periodic screening, diagnosis and treatment (EPSDT) therapy providers. The plan amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.

The plan amendment is required by Section 6411 of the Affordable Care Act pertaining to Medicaid Recovery Audit Contractor (RC) program. There will not be a direct impact on tribes, therefore tribal consultation was not required.

The plan amendment clarifies the orthotic and prosthetic services available under Early and Periodic Screening, Diagnosis and Treatment (EPSDT) recipients under the age of 21. The amendment change does not have a direct impact on Indians, Indian Health programs, or Urban Indian Organizations.

The plan amendment updates the physicians and other practitioners' fee schedule. The plan amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian organizations.

The plan amendment updated the Medicaid Birthing Center Fee Schedule and removed outdated language in the state plan. The amendment change does not have a direct impact on Indian, Indian Health programs, or Urban Indian organizations.

The plan amendment updates the fee schedule for durable medical equipment prosthetics, orthotics, and supplies. The plan amendment does not have a direct impact on Indians, Indian Health programs or Urban Indian organizations.

Which the State establishes supplemental payments for services provided by physicians at Virginia freestanding children's hospitals with greater than 50 percent Medicaid inpatient utilization in state fiscal year 2009 for furnished services provided on or after July 1, 2011. The SPA also eliminates the 4 percent reduction for all procedures set through the resource-based relative value scale (RBRVS) process effective for dates of service on or after July 1, 2011.