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 221 - 230 of 677
SDP Identifier:: MA_Fee_BHO_Renewal_20230401-20231231
State: Massachusetts
Summary:
Uniform increase established by the State for Behavioral Health Urgent Care (BHUC) 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 outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_BHO2_Renewal_20230401-20231231
State: Massachusetts
Summary:
Minimum Fee Schedule established by the State for the Program of Assertive Community Treatment (PACT) for the rating period covering April 1, 2023 through December 31, 2023, incorporated into the capitation rates through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_BHO.Oth_Renewal_20230401-20231231
State: Massachusetts
Summary:
The uniform increase for behavioral health outpatient services and behavioral health diversionary services established by the state for the rating period covering April 1, 2023 through December 31, 2023, incorporated into the capitation rates through a risk-based 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_Oth_Renewal_20230401-20231231
State: Massachusetts
Summary:
The minimum fee schedule for Acute Treatment Services (ATS) and Clinical Support Services (CSS) (which may include individualized treatment services in a specialized setting), and Residential Rehabilitation Services (RRS) services established by the state for the rating period covering April 1, 2023 through December 31, 2023, incorporated into the capitation rates through a risk-based 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:: LA_Fee_IPH.OPH_Renewal_20240701-20250630
State: Louisiana
Summary:
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.
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:: LA_Fee_IPH.OPH1_Renewal_20240701-20250630
State: Louisiana
Summary:
Uniform increase for inpatient and outpatient hospital services by eligible in-state hospital providers of long-term acute care, psychiatric services, and rehabilitation services for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $54,400,000.
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:: CA_Fee_NF_Renewal_20240101-20241231
State: California
Summary:
Uniform increase established by the State for Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) eligible providers 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 $295,393,244.
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:: IA_Fee_AMC_Renewal_20240701-20250630
State: Iowa
Summary:
Uniform 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 the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $137,560,533.79.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_IPH.OPH.AMC.PC.SP_Renewal_20240101-20241231
State: Vermont
Summary:
Value-based payment arrangement for the Vermont Medicaid Next Generation (VMNG) ACO program 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:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_HCBS_Renewal_20240101-20241231
State: Vermont
Summary:
Value-based payment arrangement for developmental disabilities services 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:
Value-based payment
Provider Class:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
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