Approved State Directed Payment Preprints

Uniform dollar increase established by the state for inpatient and outpatient hospital services at eligible district hospitals for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term up to $842,391,000.

Value-based payment established by the state for eligible primary care services for the rating period covering January 1, 2024 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount up to $97,000,000.

Uniform increase established by the state for physicians providing professional services employed by or under contracts with the South Carolina public medical university, academic medical center or its component units, or a South Carolina Area Health Education Consortium (AHEC) Teaching Health System for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term up to $160,028,404.

Comprehensive Hospital Increase Reimbursement Program (CHIRP), which has components consisting of both uniform increases and pay for performance for eligible hospitals, for the rating period covering September 1, 2026 through August 31, 2027, incorporated in the capitation rates through a risk-based rate adjustment up to $9,148,763,141.

Comprehensive Hospital Increase Reimbursement Program (CHIRP), which has components consisting of both uniform increases and pay for performance for eligible hospitals, for the rating period covering September 1, 2025 through August 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment up to $9,148,763,142.

Texas Incentive Physicians and Professional Services (TIPPS), which has components consisting of both uniform increases and pay for performance for eligible providers, for the rating period covering September 1, 2026 through August 31, 2027, incorporated in the capitation rates through a risk-based rate adjustment up to $643,788,875.

Uniform percentage increase established by the state for inpatient and outpatient hospital services for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term up to $2,575,731,483.

Rural Access to Primary and Preventative Services (RAPPS), which is a uniform increase for Rural Health Clinics, for the rating period covering September 1, 2026 through August 31, 2027, incorporated in the capitation rates through a risk-based rate adjustment up to $15,121,852.

Population-based payment established by the state for Medicaid managed care enrollees attributed to eligible primary care providers who have active New York State Patient Centered Medical Home (PCMH) recognition for the rating period, April 1, 2026 through March 31, 2027, incorporated into the capitation rates through a separate payment term up to $197,946,940.

Uniform increase for inpatient and outpatient services delivered by qualifying financially distressed hospitals for the rating period, April 1, 2026 through March 31, 2027, incorporated into the capitation rates through a separate payment term up to $1,840,384,156.