This aligns dental benefit language with recently-approved SPA.

This update the methodology for the person-centered medical home (PCMH) program.

The 2016 Healthcare Common Procedure Coding System (HCPCS) changes (additions, deletions and description changes) to the Independent Radiology fee schedule to remain compliant with the Health Insurance Portability and Accountability Act (HIPAA).

This reduces and adjust the payment methodology for Durable Medical Equipment (DME) in order to comply with section 1903(i)(27) of the Social Security Act, as amended by provisions in P.L. 114-255, which limit federal financial participation (FFP) to the amount that Medicare Part B would have paid for specified DME items, incorporating the Medicare Competitive Bidding Program payment amounts.

This SPA amends Attachment 4.19-B of the Medicaid State Plan to update the reimbursement methodology for attendant care services provided in the Community First Choice Program pursuant to section 1915(k) of the Social Security Act to conform to the permissible hourly wages for attendants set forth in the applicable collective bargaining agreement. If no collective bargaining agreement is in effect at the time a service is provided, the permissible hourly wages will be in accordance with the most recent collective bargaining agreement.

Revised fee schedule for Laboratory Services.

Revises the Family Planning Clinic, Ambulatory Surgical Center, Behavioral Health Clinic, and Rehabilitation Clinic fee schedules.

Updated language related to payment of claims to be consistent with current methodology for cost avoidance and cost savings programs.

This proposes to cease quarterly supplemental payments to qualifying private hospital partners of Type One hospitals for dates of service on or after October 1, 2018. This also proposes that effective October 1, 2018, supplemental payments will be issued to qualifying private hospitals for outpatient services provided to Medicaid patients.

This provides assurance that the state complies with statutory requirements in section 1906, Health Insurance Premium Payment (HIPP) program, and section 1906A, HIPP for Kids premium assistance program.