Updates the State's APG system for Outpatient Hospital Services.

Revises the reimbursement methodology for nursing facility services.

Incorporate the 2015 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes), with pricing, to the following fee schedules: Physician, Psychologist, Independent Radiology, and Behavioral Health Clinician.

Updates the Physician Radiology Fee Schedule by removing Current Procedural Terminology (CPT) codes: 77061 (Digital breast tomosynthesis; unilateral), 77062 (Digital breast tomosynthesis; bilateral) and 77063 (Screening digital breast tomosynthesis, bilateral).

Increases payment rates for private behavioral health clinics.

Updates the reimbursement methodology for autism spectrum disorder (ASD) services, allowing for a wider range of medically necessary ASD services to be reimbursed.

Under this SPA, outpatient hospital services are reimbursed using an ambulatory payment classification (APC) system based on Medicare's system but modified for Connecticut's Medicaid program.

This SPA provides for APM payments for dates of service from July 1, 2016 to June 30, 2017 to be equal to a clinic's standard medical Prospective Payment System (PPS) encounter rate plus an additional add-on payment per e-consult. Qualified FQHCs will bill e-consults separately from encounters using a modifier to track claim activity.

This SPA clarified language regarding state and federal background checks, added some provider types, expanded the scope of certain training, and clarified information regarding assistive technology.

This SPA proposes to increase the USVI Local Poverty Level.