Approved State Directed Payment Preprints

Uniform increase for inpatient and outpatient hospital services for critical access hospitals and general hospitals for rating period January 1, 2025, through December 31,2025, incorporated in the capitation rates through separate payment term of up to $998,000,000.

Uniform increase established by the state for eligible inpatient and outpatient hospital services for the rating period covering January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term of up to $600,000,000.

The uniform dollar increase for inpatient discharges and outpatient visits to qualifying critical access hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount of up to $94,725,164.

Uniform increase established by the state for qualified licensed professionals employed by a state university owned or operated hospital or affiliated practice, state owned and operated school of dentistry, or public hospital district for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $132,480,000.

Uniform percentage increase for physician services by physicians employed by or contracted with a private acute care type 2 hospital system with at least one level 2trauma center as of January 2022 located in Lord Fairfax Health District and Northwest Health Planning Region, for the rating period, July 1, 2025 through June 30, 2026,incorporated in to the capitation rates through a separate payment term of up to$5,098,995.

Uniform increase for inpatient and outpatient services rendered by non-state government owned acute care hospitals for the rating period covering July 1, 2025, through June 30, 2026, incorporated in the capitation rates through a separate payment term of up to $74,610,061.

Uniform increase established by the state for inpatient and outpatient hospital services provided by Rural Type A/B hospitals for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $190,000,000.

Uniform percentage increase for inpatient and outpatient services for qualifying classes of hospitals for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $424,720,803.

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 up to $2,335,007,317.

Behavioral Health Services (BHS) directed payment program, which is a uniform increase for Community Mental Health Centers and Local Behavioral Health Authorities, for the rating period covering September 1, 2025 through August 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment.