State Medical Care Advisory Committee - Tribal Consultation Requirements.

This SPA amends the State's approved Title XIX State Plan to reduce the current Medicaid reimbursement methodology for limited distribution specialty pharmacies from average wholesale price (AWP) minus 14.2 percent to 16.5 percent, cover generic over-the-counter drugs when medically necessary without the option of prior authorization for brand name drugs and cover active pharmaceutical ingredient (API) drugs.

This amendment changes out-of-state hospital base rate amounts from a percentage of the in-state base rate to a specific dollar amount base rate for each hospital classification.

This SPA transmitted a proposed amendment to your approved Title XIX State plan to address Section 6411 of the Affordable Care Act regarding the Medicaid Recovery Audit Contractors (RAC) program.

This SPA transmitted a proposed amendment to your approved Title XIX State plan to implement section 4107 of the Affordable Care Act. This Affordable Care Act provision amended section 1905(a)(4) of the Social Security Act to add a new subsection (D) to provide Medicaid coverage of comprehensive tobacco cessation services for pregnant women. including both counseling and pharmacotherapy. without cost sharing.

This SPA transmitted a proposed amendment to your approved Title XIX State plan to implement Section 6401(a) of the Affordable Care Act . This Affordable Care Act provision amended section 18660) of the Social Security Act to add a new paragraph ''(2) Provider Screening."

Establishes that One or More Qualified Hospitals are Determining Presumptive Eligibility, and that the State is Providing Coverage for Individuals Determined Presumptively Eligible.

Updates Citizenship and Non-Citizenship Eligibility.

Disregards an amount equal to premiums paid for private/commercially available health insurance when determining the eligibility of persons in the Qualified Medicare Beneficiaries, Specified Low-income Medicare Beneficiaries, Qualifying Individuals, Working Disabled, or Aged and Disabled eligibility groups.

Updates the amounts of nursing facility Supplemental payments funded by an AZ nursing facility assessment.