This amendment updates provider qualifications for physical therapy, occupational therapy, speech therapy, audiology, and rehabilitative services.

This amendment implements the consultation of tribal health programs prior to the submission of any plan amendment in compliance with Section 1902(a) (73) of the Social Security Act as required at 5006(e)(2) of the American Recovery and Reinvestment Act.

This amendment requests an exception to the January 1, 2012, implementation date in regulation and requests a date of July 1, 2012, in order to allow time for the State to enter into a multi-state contract for selection of a Medicaid recovery audit contractor.

Updating Rate Tables.

The plan amendment revises the Medicaid maximum reimbursement rates for clinical laboratory services. This amendment did not require a tribal consultation.

The plan was amended to cover additional inpatient psychiatric and mental health days above the current limit of 24 days for individuals age 21 and above. The plan amendment has no direct impact on Indians, Indian Health programs, or Urban Indian Organizations.

The plan amendment will provide for payment of Medicaid personal care services in assisted living facilities on a per diem basis. No tribal consultation was required, therefore no direct impact on Indians, Indian Health programs, or Urban Indian organizations.

The amendment will add Provider Screening and Enrollment to the Medicaid Program. No tribal consultation was required.

The plan amendment allows individuals under the age of 21 to receive treatment for terminal illness in addition to hospice services. The plan amendment does not have a direct impact on Indians, Indian Health programs, or Urban Indian Organizations.

The Arkansas Title XIX State Plan was amended to allow Advanced Practice Nurses ( APN) to perform a psychiatric diagnostic assessment under the Rehabilitative Services for Persons with Mental Illness ( RSPMI). The Advanced Practice Nurse will be under the direct supervision of a psychiatrist.