This SPA amendment, the state is updating the process within the state plan benefits’ Quality Improvement System.

Proposes to update the state plan to clarify the recipient direct reimbursement program and specify the conditions for payment.

the ASC fee schedule utilized for payment purposes shall be updated to reflect the latest January 1 Medicare ASC fee schedule.

2.0% rate increase for outpatient hospital services per state budget bill, effective July 1, 2022. The amendment also modifies payments for new and out-of-state hospitals by creating more accurate groupings for calculating out-of-state and new hospital rates, effective September 1, 2022

2.0% rate increase for inpatient hospital services.

Updates the language for Rural Health Center's Alternative Payment Methodology rate setting process, adds a scope of service rate adjustment process, adds a process to ensure Rural Health Centers are paid at least their per visit Prospective Payment System rate by Managed Care Entities, and adds language for setting rates for new Rural Health Centers.

Supplemental Payments for Hospital Inpatient Services

This amendment expands adult dental coverage.