The Centers for Medicare & Medicaid Services (CMS) Medicaid managed care regulations at 42 C.F.R. § 438 govern how states may direct plan expenditures in connection with implementing delivery system and provider payment initiatives under Medicaid managed care contracts. CMS began reviews of state directed payment arrangements beginning with contract rating periods on or after July 1, 2017. For more information on state directed payments, please visit our Guidance Page. Persons with disabilities having problems accessing the Preprint PDF files may call 410-786-0429 for assistance.
Approved State Directed Payment Preprints
Results
Displaying 1 - 10 of 699
SDP Identifier:: PR_Fee_IPH_Renewal_20241001-20250930
State: Puerto Rico
Summary:
Uniform dollar increase established by the state for inpatient hospital services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a separate payment term up of to $123,350,308.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: TN_Fee_IPH.OPH4_Renewal_20250101-20251231
State: Tennessee
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital services for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a separate payment term of up to $3,204,114,577.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WI_Fee_HCBS3_Renewal_20250101-20251231
State: Wisconsin
Summary:
Uniform percentage increase established by the state for eligible home and community-based services for the rating period, January 1, 2025 through December 31, 2025,incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MI_Fee_AMC_Amend_20221001-20230930
State: Michigan
Summary:
Uniform dollar increase established by the state for professional services provided by practitioners employed or under contract with approved public entities for the rating period covering October 1, 2022 through September 30, 2023, and incorporated in the capitation rates through a separate payment term of up to $583,505,495.00.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: WI_Fee_HCBS2_Renewal_20250101-20251231
State: Wisconsin
Summary:
Uniform percentage increase established by the state for eligible home and community-based services for the rating period, January 1, 2025 through December 31, 2025,incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WI_Fee_HCBS4_Renewal_20250101-20251231
State: Wisconsin
Summary:
Uniform percentage increase established by the state for eligible home and community-based services for the rating period, January 1, 2025 through December 31, 2025,incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MI_Fee_BHI_Amend_20211001-20220930
State: Michigan
Summary:
Uniform dollar increase for psychiatric inpatient days for the rating period covering October 1, 2021 through September 30, 2022, and incorporated in the capitation rates through a separate payment term of up to $99 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: NH_Fee_Oth1_Renewal_20250701-20260630
State: New Hampshire
Summary:
Minimum fee schedule established by the state for durable medical equipment for the rating period covering July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_IPH.OPH3_Renewal_20241001-20250930
State: Arizona
Summary:
Uniform increase provided by the eligible public safety net hospital established by the state for inpatient and outpatient hospital services for the rating period covering October 1, 2024 through September 30, 2025, incorporated into the capitation rate through a separate payment term of up to $388,500,819.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NJ_VBP_IPH.OPH.BHI.BHO1_Renewal_20250701-20260630
State: New Jersey
Summary:
A pay-for-performance initiative focused on behavioral health performance improvement among acute care hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a separate payment term of up to $147,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services, Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
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