Requests a full two-year exception to the federal requirement for a Recovery Audit Contractor (RAC).

Provides funding for supplemental Graduate Medical Education payments.

This will provide for reimbursement for long-acting reversible contraceptives (LARCs) inserted immediately after childbirth and prior to discharge from the hospital.

Continuing disproportionate share hospital payments to promote access at facilities with high volumes of Medicaid.

Continues safety net supplemental payments to county nursing facilities.

Authorizes an additional class of disportionate share of hospital payments that have low commercial payment ratio.

Continuing supplemental payments to promote access at facilities with high volumes of Medicaid.

Continuing disproportionate share hospital payments to enhance access at facilities in economically distressed areas.

This SPA revises the state plan to incorporate language that authorizes the state to enter into value-based contract arrangements with drug manufacturers through supplemental rebate agreements.

This SPA is adding a cost-based reimbursement process for school-based IEP direct services based on certified public expenditures including a process for quarterly reconciliation and final settlement based on actual expenditures.