The purpose of this SPA is to extend the period of transitional rates for one large public Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICF/IID) that provide continuous nursing coverage to medically fragile populations for an additional year.

This SPA provides for supplemental payments, funded by a Quality Assurance Fee (QAF), for private hospital outpatient services for the service period of January 1, 2017 to June 30, 2019.

Revises methodologies and standards for Inpatient Hospital rates.

To clarify the settings in which home health services may be provided in compliance with the home health final rule.

This amendment rebases costs used for calculating nursing facility payment rates.

This amendment reverses the 4.00% rate decrease that was applied to fee-for-service inpatient hospital payment rates other than Diagnosis Related Group (DRG) outlier payment rates on July 1, 2016 for all hospitals other than critical access hospitals, hospitals located in frontier, rural and densely settled rural counties, and state-operated psychiatric hospitals.

This amendment provides for supplemental payments, funded by a quality assurance fee, for private hospital inpatient services for the service period of January 1,2017 to June 30,2019.

Reimbursement update for DOH Dental.

Incorporates the MAGI-Based Income Methodologies into Puerto Rico's state plan in accordance with the Affordable Care Act.

Reimbursement update for Skilled Nursing & Intermediate Care Services.