Implements alternative payment methodologies (APM) for delivery services provided by Federally Qualified Health Center (FQHC) personnel in the acute care general hospital inpatient setting, and the payment by managed care organizations (MCO) to FQHCs and Rural Health Clinics (RHC) of rates that are not less than the Department of Human Services' Fee-for-Service provider specific Prospective Payment System (PPS) rate to RHCs and/or FQHCs that participate in the MCO network.

This SPA will allow charter schools and tribal schools to participate in the School Based Health Services (SBHS) Program.

Adjust premiums for persons who are eligible under the Medicaid for Employed Persons with Disabilities (MEPD) group. These Premiums are adjusted as often as annually according to state law which ties the maximum premium to the average state employee's health insurance premium.

This SPA proposes to bring Iowa into compliance with the actual acquisition cost reimbursement requirements in the Covered Outpatient Drug final rule with comment.

To implement a fee-for-service (FFS) Medicaid payment system for specialty mental health services provided to American Indian and Alaska Native (AI/AN) Medicaid enrollees. Currently, AI/AN enrollees must access specialty mental health services through a managed care system. SPA 17-0016 will allow mental health agencies to provide services to AI/AN enrollees on an FFS basis. AI/AN enrollees will have the choice to opt in to managed care mental health services or remain in the FFS system. Qualified mental health providers will be able to serve AI/AN enrollees and be paid through the FFS system.

This eligibility SPA increases the standards for the optional State supplementary payment program.

Incorporates the Single State Agency SPA into United States Virgin Island's Medicaid State Plan in accordance with the Affordable Care Act.

This amendment will bring the District of Columbia into compliance with the reimbursement requirements of the Covered Outpatient Drug final rule with comment period (CMS-2345-FC) (81 FR 5170). Specifically, the District of Columbia proposes shifting from Estimated Acquisition Cost (EAC) to Actual Acquisition Cost (AAC) by using the National Average Drug Acquisition Cost (NADAC) plus a professional dispensing fee of $11.15. In addition, the SPA addresses coverage policies of covered outpatient drugs.

Reimbursement update for Eligibility Groups-Mandatory Coverage Former Foster Care Children.

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