Increases HCBS 1915(i) rates by three and a half percent .

Updates the Accountable Communities section.

Update both the benefit and reimbursement pages for the targeted case management (TCM) services describing the Childhood Lead Poisoning Prevention program.

Revises the payment methodologies for the Children's Behavioral Health Initiative (CBHI).

This revises reimbursement for nursing facility services.

Increases the hospitals triage rate from $50 to $70 for rural hospitals and from $50 to $60 for all other hospitals.

To implement a statewide fee schedule reimbursement for case management services in accordance with 2018 Iowa Acts, Senate File 2418, section 132.

To assure CMS that the State is in compliance with the requirements at 42 CFR 435.923 (Authorized Representatives).

This SPA was submitted to add a Dental Services Pay for Performance supplemental payment program.