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 211 - 220 of 677
SDP Identifier:: VA_VBP_NF_Renewal_20240701-20250630
State: Virginia
Summary:
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 $144.1 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VA_Fee_IPH.OPH_Renewal_20240701-20250630
State: Virginia
Summary:
Uniform increase for inpatient and outpatient services at private acute care 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 $3.73 billion.
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:: NV_VBP.Fee_NF_New_20230101-20231231
State: Nevada
Summary:
Value-based payment established by the state for free standing nursing facilities for the rating period January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term up to $2.3 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Nursing facility services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: MI_Fee_HCBS3_Renewal_20231001-20240930
State: Michigan
Summary:
The uniform dollar increase established by the state for direct care workers providing personal care services to eligible enrollees for the rating period covering October 1, 2023 through September 30, 2024, 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:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: IA_Fee_IPH.OPH1_Renewal_20240701-20250630
State: Iowa
Summary:
Uniform increase for inpatient and outpatient hospital services provided at qualifying non-state owned or operated hospitals as defined in the Medicaid State Plan for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $1,478,197,798.
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:: IA_Fee_IPH.OPH_Renewal_20240701-20250630
State: Iowa
Summary:
Uniform increase for inpatient and outpatient hospital services provided at qualifying Iowa state-owned or operated teaching hospitals as defined in the Medicaid State Plan for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $601,938,536.64.
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:: MI_Fee_NF_Renewal_20240101-20241231
State: Michigan
Summary:
Uniform dollar increase for nursing facility services for the rating period covering January 1, 2024 through December 31, 2024 incorporated in the capitation rates through a separate payment term of up to $32,900,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MI_Fee_HCBS1_Renewal_20240101-20241231
State: Michigan
Summary:
The uniform dollar increase established by the state for direct care workers providing personal care services to eligible enrollees for the rating period covering January 1, 2024 through December 31, 2024, 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:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VA_Fee_Oth2_Renewal_20240701-20250630
State: Virginia
Summary:
Uniform increase established by the state for physicians employed by or contracted with the non-state government owned general acute care hospital 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 $1,100,000.
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:: MA_Fee_BHI2_Renewal_20230401-20230930
State: Massachusetts
Summary:
Minimum fee schedule for psychiatric services for enrollees under the age of 21 with Autism Spectrum Disorder or Intellectual or Developmental Disability (ASD/IDD) for the rating period covering April 1, 2023 through December 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 inpatient service
Review Type: Renewal
Approval Period: Single Rating Period
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