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 121 - 130 of 641
SDP Identifier:: RI_Fee_IPH.OPH_Renewal_20240701-20250630
State: Rhode Island
Summary:
Uniform increase established by the state for eligible inpatient and outpatient hospital services, for the rating period July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term of up to $281,032,815.
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:: RI_Fee_HCBS2_Renewal_20240701-20250630
State: Rhode Island
Summary:
Uniform increase established by the state for personal care and combined personal care/homemaker services for the rating period covering July 1, 2024 through June 30, 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:: TX_Fee_Oth1_Renewal_20240901-20250831
State: Texas
Summary:
Rural Access to Primary and Preventative Services (RAPPS) for the rating period covering September 1, 2024 through August 31, 2025, incorporated in 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:: TX_VBP_NF_Renewal_20240901-20270831
State: Texas
Summary:
Quality Improvement Payment Program (QIPP) for the rating period covering September 1, 2024 through August 31, 2027, incorporated in 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: Multiple Rating Period
SDP Identifier:: PR_Fee_PC1_Amend_20231001-20240930
State: Puerto Rico
Summary:
Minimum fee schedule established by the state for primary care services and laboratory services that are covered at 75% of Medicare consistent with the requirements of the Consolidated Appropriations Act of 2023 for the rating period covering October 1, 2023through September 30, 2024 incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Primary care services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: RI_Fee_HCBS1_Renewal_20240701-20250630
State: Rhode Island
Summary:
Uniform increase established by the state for personal care and combined personal care/homemaker services for the rating period covering July 1, 2024 through June 30, 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:: CA_VBP_IPH.OPH_Renewal_20240101-20241231
State: California
Summary:
Quality Incentive Pool for District and Municipal Public Hospital Systems for the rating period of January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $172,099,711.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_IPH.OPH2_Renewal_20220101-20221231
State: Massachusetts
Summary:
Minimum Fee Schedule and Maximum Fee Schedule for inpatient hospital discharges from freestanding pediatric hospitals with a MassHealth DRG weight of 3.0 or greater and hospitals with a pediatric specialty unit with a MassHealth DRG weight of 3.0 or greater, using an approved State plan fee schedule for the rating period covering January1, 2022 – December 31, 2022.
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:: MA_Fee_BHO.Oth2_Renewal_20230101-20230331
State: Massachusetts
Summary:
Minimum fee scheduled established by the State for outpatient behavioral health services and behavioral health diversionary services for the rating period covering January 1, 2023 through March 31, 2023, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services, Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_IPH_Renewal_20230101-20230331
State: Massachusetts
Summary:
Minimum Fee Schedule and Maximum Fee Schedule for inpatient hospital discharges from freestanding pediatric hospitals with a MassHealth DRG weight of 3.0 or greater and hospitals with a pediatric specialty unit with a MassHealth DRG weight of 3.0 or greater, using an approved State plan fee schedule for the rating period covering January1, 2023 – March 31, 2023.
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
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