This amendment will provide supplemental payments to the University of North Carolina Health Care System hospitals up the Medicare upper payment limit.

This amendment proposes to revise the reimbursement methodologies for physician drugs to Average Sales Price (ASP) plus 6% or where there is no ASP, to Average Wholesale Price (AWP) less 10 percent and for the contraceptive drugs Implanon and Mirena, to Wholesale Acquisition Cost (WAC) plus 6 percent. The state also proposes to freeze reimbursement rates for the Physician Drug Program effective for state fiscal years 2010 - 2012 as indicated in the SPA.

This amendment proposes to clarify the description of prescribed drugs, revise the reimbursement methodology for North Carolina Estimated Acquisition Cost (NCEAC) for prescribed drugs and establish a 4 rate tier generic dispensing fee structure for reimbursement.

This amendment proposes to revise the payment methodology for nursing facility services.

This amendment will discontinue the pharmacy Opt-In program, which requires recipients receiving more that eleven prescriptions per month to remain at one pharmacy.

This amendment revises the dispensing fee for brands, and the generic dispensing fee 4 rate tier structure.

This amendment implements supplemental payments for hospitals participating in the Supplemental Hospital Offset Payment Program (SHOPP).

The Oklahoma Title XIX State Plan has been amended to reflect the approved reimbursement methodology for Public Health Nurses that provide a limited scope of services in government owned or operated public health clinics to the State Plan.

The Oklahoma Title XIX State Plan has been amended to reflect the approved supplemental payment reimbursement methodology for Hospital Level 1 Trauma Outpatient Centers in the State Plan.

This amendment provides for continuing payment adjustrnents to Oklahoma State University Medical Center in Talsa County.