Approved State Directed Payment Preprints

Uniform increase for physicians affiliated with the practice plans of Virginia’s three allopathic medical schools: University of Virginia, Virginia Commonwealth University, and Eastern Virginia Medical Center, for the rating period covering July 1, 2023 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $67,025,000. 

Uniform increase for inpatient and outpatient services rendered by non-state government owned acute care hospitals for the rating period covering July 1, 2023 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $21,325,000. 

Uniform increase established by the state for physicians employed by or contracted with the non-state government owned general acute care academic medical center for the rating period covering October 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $1,297,500. 

Uniform increase for physicians affiliated with the practice plans of Virginia’s three allopathic medical schools: University of Virginia, Virginia Commonwealth University, and Eastern Virginia Medical Center, for the rating period covering October 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $201,075,000. 

Uniform increase for inpatient and outpatient services rendered by non-state government owned acute care hospitals for the rating period covering October 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $63,975,000. 

Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2023 through September 30, 2024, incorporated into the capitation rate through a separate payment term of up to $238.60 million. 

Uniform increase established by the state for acute inpatient and ambulatory outpatient services provided by Hospital Enhanced Access Leading to Health Improvements Initiative (HEALTHII) program eligible hospitals for the rating period covering October 1, 2023 through September 30, 2024, incorporated into the capitation rate through a separate payment term of up to $2.259 billion. 

Minimum fee schedule established by the state for outpatient laboratory services provided by in-state acute care hospitals and critical access hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment. 

The minimum fee schedule for Acute Treatment Services (ATS) and Clinical Support Services (CSS) (which may include individualized treatment services in a specialized setting), and Residential Rehabilitation Services (RRS) services established by the state for the rating period covering January 1, 2022 through December 31, 2022, incorporated into the capitation rates through a risk-based adjustment.

The uniform increase for behavioral health outpatient services and behavioral health diversionary services established by the state for the rating period covering January 1, 2023 through March 31, 2023, incorporated into the capitation rates through a risk-based adjustment.