This SPA proposes to amend Attachment 4.19B of the Medicaid State Plan in order to revise the fee schedule Medical equipment, Devices and Supplies (MEDS). Changes include the addition and deletion of codes and changes to code descriptions on the MEDS fee schedule consistent with Healthcare Common Procedure Coding System (HCPCS) updates.

Revise the reimbursements for durable medical equipment.

This SPA transmitted an amendment to your approved Title XIX State Plan regarding outpatient hospital reimbursements. Specifically, this SPA makes two technical changes to the State Plan: (1) to alter the data sources used to estimate prospective payments and (2) to correct the placement of language describing payment to hospital-based physicians which applies to both critical and non-critical access acute care hospitals.

This SPA transmitted an amendment to your approved Title XIX State Plan regarding physician reimbursement and the Physician Feedback and Incentive Award. Specifically, this SPA updates State Plan language to provide better details regarding physician reimbursement.

This SPA amends the State's approved Title XIX State Plan to assure compliance with federal protections for Native Americans in Medicaid and CHIP services, as directed in a CMS State Medicaid Directors letter dated January 22, 2010. As amended, the State Plan now provides assurance that the State adheres to the required tribal consultation process.

Proposed to raise the personal needs allowance (PNA) for institutionalized individuals subject to post-eligibility requirements at 42 CFR 435.733. The PNA is increased for aged, blind and disabled individuals from $40 to $45 per month for an individual and from $80 to $90 per month for a couple; for AFDC-related adults and children from $40 to $45 per month, and for individuals eligible under 42 CFR 435.222 from $40 per month to N/A in accordance with changes made by the Affordable Care Act.

Proposed to raise the personal needs allowance (PNA) for institutionalized individuals subject to post-eligibility requirements at 42 CFR 435.733. The PNA is increased for aged, blind and disabled individuals from $45 to $50 per month for an individual and from $90 to $100 per month for a couple; for AFDC-related adults and children from $45 to $50 per month.

This amendment continues hospital reimbursement adjustments related to potentially preventable readmissions (PPR) and potentially preventable complications (PPC) through March 31, 2015.

Proposed amendment to your approved Title XIX State plan to elect the option in §214 of the Children's Health Insurance Program Reauthorization Act of 2009, Public Law No. 111-3. This option allows State to provide full Medicaid coverage to otherwise eligible alien children or pregnant women lawfully residing in the United States.

This SPA implements Section 1902(a)(80) of the Social Security Act and Section 6505 of the Affordable Care Act P.L. 111-148 barring payments for services or items provided under the state plan or a waiver to a financial institution or entity outside of the United States.