Updates the physicians' and other practitioners', and tuberculosis clinic fee schedules.

Updates the State's Tribal Consultation Requirements.

Provides for a three percent inflationary increase for nursing facility services, incorporates limits to the various components of the per diem rate, updates leave day definitions, and identifies the changes to income that must be offset against costs.

Updates the effective date of rates for home health services to July 1, 2016.

To clarify service descriptions and reimbursement methodologies for Inpatient Psychiatric Hospital Services for Individuals under Age 21.

Updates the effective date of optometry rates to July 1, 2016.

Updates the effective date of speech pathology rates to July 1, 2016.

This SPA ends the Health Home program authorized and Section 2703 of the Patient Protection and Affordable Care Act.

Updates language ralated to the Vermont Shared Savings Program to refer to year 3 of the program, and to implement a program integrity audit at the end of year 3.

Clarifies the maximum amount to be paid for Medicare Part B coinsurance and deductibles for services provided by rural health clinics and federally qualified health centers.