This SPA proposes to revise the state plan to reimburse for inpatient and outpatient hospital services, also the state will continue to pay hospitals for services provided to Medicaid recipients for inpatient and outpatient services utilizing the reimbursement methods in effect on September 30, 2016.

Increases the total number of visits that an Indian Health Services.

Eliminate the total supplemental payments pool for graduate medical education payments to qualifying acute care hospitals.

Adds a provision that limits rates from dropping below prior SFY rates and (2) Proposes an additional $650,000 to be allocated to special care nursing facilities for the period January 1, 2014 through June 30, 2014.

Reduces the inflation factor for inpatient hospital services from 2% to 1% for FY 2017 and makes specialized nursing care reimbursement fully prospective.

Updates the utilization trend for the outpatient hospital upper payment limit in State Fiscal Year 2018.

Extends the Ambulatory Patient Group (APG) methodology for freestanding clinics and ambulatory surgery center services from January 1, 2016 through December 31, 2017.

Expands coverage and allow reimbursement for chiropractors' services for all Medicaid eligible individuals.

This amendment clarifies the limitation on agents used for cosmetic purposes or hair growth will only be covered when the state has determined that use to be medically necessary.

Revises the reimbursement methodology for inpatient hospital rates and methodologies for measurement year 2016 pay for performance program updates.