Updates Attachment 4.19-D to specify that, beginning with the 2017-2018 rate year, through July 31, 2020, the statewide weighted-average per diem rate for freestanding skilled nursing facilities, including subacute care units of freestanding skilled nursing facilities, shall increase at the rate of 3.62 percent annually, so long as the total Medi-Cal reimbursement does not exceed any applicable federal upper payment limit.

This amendment proposes to extend the Certified Public Expenditures (CPE) sunset date for Pre-School Supportive Health Services Program (PSSHP) to June 30, 2020.

This SPA implements a one-year supplemental payment for certain physician services using California Healthcare, Research and Prevention Tobacco Tax Act (Proposition 56 Tobacco Tax) funds allocated for the 2017-18 State Fiscal Year.

This amendment revises methodologies and standards for Intermediate Care Facilities for Persons with Developmental Disabilities (ICF/DD).

Reduces the Quality Assurance Supplement (QAS) percentage for the months of August and September 2017.

Continues the suspension of the inflation factor for inpatient hospital and nursing facility rates for the 4th quarter of Federal Fiscal Year (FFY) 2015 and the 1st , 2nd, and3'd quarters of FFY 2016.

This amendment was submitted to alter the payment rates for day 1 through 30 and days 31 and beyond for home health intermittent skilled nursing services, which resulted in an overall decrease in payment rates for these services.

This amendment was submitted to update physician and mid-level practitioner payment rates and service descriptions, which resulted in a decrease in State expenditures for Medicaid services.

This amendment proposes to extend the Certified Public Expenditures (CPE) sunset date for School Supportive Health Services Program (SSHP) to June 30, 2020.

This state plan amendment proposes to amend the provisions governing laboratory and radiology services to terminate coverage and reimbursement for proton beam radiation therapy rendered to recipients 21 years of age and older.