Approved State Directed Payment Preprints

Uniform increases established by the state for eligible Designated Public Hospital Systems for the rating period covering July 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $1,982,556,000. 

The uniform dollar increase for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) screening services for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.

Uniform percentage increase established by the state for inpatient and outpatient hospital services at qualifying cancer hospitals for the rating period covering October 1, 2022 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $129,312,167.

The uniform percentage increase established by the state for qualified practitioners who are members of a practice plan under contract to provide professional services at a state-owned academic medical center for the rating period covering January 1, 2021 through December 31, 2021, incorporated in the capitation rates through a separate payment term of up to $49.9 million. 

A value-based purchasing and uniform percent increase arrangement established by the state to increase nursing facility per diem rates by the market basket index (MBI) factor and to provide quality incentive payments for nursing facilities under contract that meet performance requirements on specified quality metrics for the rating period covering January 1, 2021 through December 31, 2021, incorporated in the capitation rates through a separate payment term of up to $80.3 million.

The value-based payment and uniform increase established by the state for participating nursing facilities that demonstrate quality improvement for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a risk-based rate adjustment.

The uniform increase arrangement for trauma hospitals established by the state for inpatient and outpatient services for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a risk-based rate adjustment.

The uniform increase for inpatient and outpatient hospital services and performance-based quality payments established by the state for hospitals that provide guaranteed access to care for Native Americans through the Indian Health Service for the rating period covering January 1, 2021 through December 31, 2021, incorporated in the capitation rates through a separate payment term of up to $86.4 million.

Uniform increase established by the state for inpatient and outpatient services at hospitals participating in delivery system transformation programs approved by the state for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $160,300,000.

Uniform increase established by the state for inpatient and outpatient services at eligible Illinois hospitals for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $4,008,000,000.