This amendment proposes to change the reimbursement methodology for nursing facilities. The State will no longer pay a Provisional Rate after a nursing facility changes ownership. A cap was also added on the allowable professional liability insurance cost.

This SPA adds to the scope of services to children, youth and families, modifies service modalities and revises reimbursement methodology for Community Behavioral Health Rehabilitation Services (CBHRS).

This SPA updates reimbursement rates for inpatient psychiatric services for individuals under the age of 21, removes language restricting eligible providers to non-profits, removes language targeting individuals with a serious emotional disturbance for service eligibility, and corrects a previous error of placement of this reimbursement methodology in Attachment 4.19-8.

Reimbursement update for Hospice Rates.

This SPA amends and updates the State's APG system for Outpatient Hospital Services.

Revises the interim rate setting process for critical access hospitals.

This SPA adds King and Snohomish Counties to Washington's Health Home Program, as authorized under Section 2703 of the Patient Protection and Affordable Care Act (1945 of the Social Security Act). Individuals eligible to receive health home services include Medicaid participants who have one chronic condition and are at risk of developing another.

Reimbursement update for Nursing Facility IGT Program.

This SPA covers the implementation of the Potentially Preventable Readmissions (PPR) program to reduce preventable readmissions, encourage hospitals to improve the level of care provided during a patient's inpatient admission, and improve the discharge planning process in hospitals participating in the Medicaid program.

This SPA continues a stop loss/stop gain provision that was enacted on July 1, 2013 to prevent large swings (either up or down) in hospital reimbursements.