This amendment changes the language from birth attendant to licensed direct entry midwife to better define the actual service provider that Montana Medicaid covers for reimbursement.

This amendment adds diagnosis related groups codes (DRGs) for the payment of long-acting reversible contraception (LARC) services.

This amendment continues "Disproportionate Share Hospital Replacement" supplemental payments to private hospitals.

Updates Part 2 (Coverage and Eligibility) and authorizes a new spend-down program for the medically needy.

Removes the three specified DSH pools and pool payment amounts for all inpatient hospitals, state operated hospitals, and woman and infant specialty hospitals and consolidates them into Pool D for non-government and non-psychiatric hospitals licensed within the State of Rhode Island, whose Medical Assistance inpatient utilization rate exceed I.0%.

Increases the inpatient hospital DRG base rate by the CMS Hospital Prospective Reimbursement Market Basket for the applicable period, as reported in the quarterly Healthcare Cost Review published by the IHS Market.

Continues to freeze rates for direct graduate medical education (DME), indirect graduate medical education (lME) and Catastrophic Aid payments for the state's next biennial budget (state fiscal years 2018 to 2019).

Updates the state's Resource Utilization Group (RUG) reimbursement system to version IV and Minimum Data Set (MDS) 3.0 to be consistent with Medicare. Additionally, the state made a technical correction to the state plan language to clarify that the state budget adjustment factor is30o/o, which was previously undefined as part of the methodology.

This SPA allows for the dispensing of certain brand name drugs instead of their generic counterparts under certain circumstances.

This SPA proposes to revise provision of Early & Periodic Screening Diagnostic & Treatment Services (EPSDT) services related to the expansion of behavioral health services provided to individuals under the age of 21.