Approved State Directed Payment Preprints

Uniform increase established by the state for eligible outpatient hospital, primary care, and specialty providers of designated postpartum visit services for the rating period, April 1, 2024 through March 31, 2025, incorporated into the capitation rates through a separate payment term up to $15,750,000.

Minimum fee schedule established by the state for primary care services and laboratory services that are covered at 100% 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.

Value-based payment arrangement for the Applied Behavior Analysis (ABA) Tiered Payment Model for the rating periods covering January 1, 2024 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment.

The Value Based Payment for community mental health centers to deliver a continuum of mental health services to adults and children via monthly case rates established by the state for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment.

Uniform increase for in-state providers of inpatient and outpatient hospital services, excluding freestanding psychiatric hospitals, freestanding rehabilitation hospitals, and long-term acute care hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to$2,806,800,000.

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, 2022 through September 30, 2023, incorporated into the capitation rate through a separate payment term of up to $203.7 million.

A uniform dollar increase for acute care hospitals established by the state for outpatient hospital services for the rating period July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $543,923,045.

A perinatal episode of care pilot established by the state for the rating period covering July 1, 2024 through June 30, 2025 incorporated into the capitation rates through a risk based rate adjustment and separate payment term of up to $3.5 million.

Uniform percentage increases for the professional services of designated providers affiliated with one of the qualifying hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $42,885,009.17.

The quality payment established by the state for nursing facility services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $184.9 million.