Medicaid prohibition on payments to institutions or entities located outside of the United States.

Revises the plan language regarding tribal consultation and removes the marketing provision of MCOs, PIHPS, PAHPS, and or PCCM programs.

Changes the method of assessing the provider tax on tursing facilities and clarifies existing methodologies in the OK state plan.

Provides for a 3.25% reduction in reimbursement for Inpatient Hospital Services.

Provides for a 3.25% reduction in reimbursement for Psychiatric Residential Treatment Facilities.

Makes changes to the Disproportionate Share Hospital state plan language to conform to guidance related to Federal DSH audit rules.

Revision to the current rate and reimbursement structure for the Regular Nursing Facilities, Regular ICF's/MR, Acute Care ICF's/MR, Aids Nursing Facilities and Ventilator Add on Rates.

Adjusts the state supplementary payments for aged, blind and disabled individuals effective on or after February 1, 2010.

Eliminates payment for three surgical errors known as "never events", eliminates payment for certain hospital acquired conditions identified as non-payable by Medicare and adds Anesthesiologiest Assistants as compensable provider type effective on or after February 1, 2010.

Updates the fee schedule for durable medical equipment, prosthetics, orthodics and supplies.