Update the Medically Needy Income Levels and to also update the standards for the Optional State Supplement Beneficiaries eligibility group.

Adds services of community health workers as a covered benefit under preventive services.

Administrative adjustments.

New locations that can process presumptive eligibility for pregnant women.

Reimbursement methodology for outpatient hospital services.

Proposes to allow the state to directly negotiate supplemental Value Based Purchasing (VBP) agreements with drug manufacturers. This SPA will be used by the state in particular to address the hepatitis C (HCV) virus patient population by allowing it to contract with a manufacturer(s) under a subscription model, allowing the state to purchase an unlimited amount of HCV direct-acting antivirals as needed for a fixed fee and time period. Once approved, this SPA will be the 4th Value Based Purchasing Supplemental Rebate Agreement that CMS has authorized.

Continues supplemental payments to New York City's Health + Hospitals.

This SPA adds Substance Use Disorder (SUD) peer support services to the Medicaid State Plan.

Amending the Medicaid State Plan to reflect Iowa's current payment methodology showing when multiple therapy services are received on the same day.

This amendment revised the inpatient hospital reimbursement methodology for specialty acute spine\/brain injury treatment specialty and rehab hospitals.