Approved State Directed Payment Preprints

Uniform percentage increase for professional services provided by qualified providers employed or contracted with the AtlantiCare health system which is affiliated with Stockton University’s nursing and allied health training programs for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term up to $50,611,881.

Minimum Fee Schedule for professional services provided by qualified providers affiliated with schools of medicine or dentistry who participate in the New Jersey Medicaid program for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a risk-based rate adjustment up to $472,781,615.

A value-based payment arrangement for hospitals providing labor and delivery services for the rating periods covering April 1, 2026 through March 31, 2027, and April 1, 2027 through March 31, 2028, incorporated in the capitation rates through a separate payment term amount up to $50 million for each rating period, for a total amount of $100,000,000.

Uniform increase for Critical Access Hospitals as established by the state for outpatient services for the rating period, April 1, 2026 through March 31, 2027, incorporated into the capitation rates through a separate payment term up to $59,492,274.

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 up to $1,750,000,000 per rating period.

Uniform percentage increase for physician and professional services provided at qualifying Iowa state-owned or operated professional services practices as defined in the Medicaid State Plan for rating periods covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount of up to$137,560,533.

Minimum and Maximum Fee Schedule for eligible behavioral health inpatient hospital services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $2,225,208 dollars.

Uniform Dollar Increase for inpatient hospital services for the rating period covering October 1, 2025 through September 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $76,100,308.

Minimum Fee Schedule for Community Mental Health Clinics established by the state for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based adjustment in the amount of $1,167,065.

The amendment to the uniform percentage increase for services performed by physicians employed by or contracted with the non-state government owned general acute care hospital class for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $1,174,213.