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 231 - 240 of 677
SDP Identifier:: IL_Fee_IPH.OPH_Renewal_20240101-20241231
State: Illinois
Summary:
Uniform increase established by the state for inpatient and outpatient services at hospitals participating in delivery system transformation programs approved by the state 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 $149,000,000.
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:: NC_Fee_AMC_Renewal_20230701-20240630
State: North Carolina
Summary:
Uniform dollar increase established by the state for the professional services at academic medical centers for the rating period covering July 1, 2023 through June 30, 2024 incorporated in the capitation rates through a separate payment term of up to $83,547,311.
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:: PR_Fee_IPH_Amend_20231001-20240930
State: Puerto Rico
Summary:
Uniform dollar increase for inpatient hospital services at qualifying short-term acute care (STAC) hospitals for the rating period covering October 1, 2023 through September 30, 2024 incorporated in the capitation rates through a separate payment term of up to $135,978,450.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_Oth_Renewal_20240101-20241231
State: Vermont
Summary:
Value-based payment arrangement for the High-Technology Nursing 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_BHI_Renewal_20240701-20250630
State: North Carolina
Summary:
Uniform dollar increase established by the state for eligible behavioral health inpatient services for the rating period, 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:
Behavioral health inpatient service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_HCBS_BHO_Renewal_20240701-20250630
State: North Carolina
Summary:
Uniform dollar increase and minimum fee schedule for home and community-based services and behavioral health outpatient services established by the state for the rating period, 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:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_NF.BHI_Renewal_20240701-20250630
State: North Carolina
Summary:
Minimum fee schedules established by the state for eligible non-state government owned skilled nursing facilities and inpatient behavioral health providers for actual utilization of services for the rating period, 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:
Behavioral health inpatient service, Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NH_Fee_IPH2.SP.BHI2_New_20230701-20240831
State: New Hampshire
Summary:
Minimum fee schedule for psychiatrists in a state-owned Institutions for Mental Diseases (IMD) established by the state for inpatient, specialty physician services and behavioral health inpatient services for the rating period, July 1, 2023 through August 31, 2024, 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 inpatient service, Inpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: NH_Fee_IPH.OPH2_New_20230701-20240831
State: New Hampshire
Summary:
Uniform dollar increase for children’s inpatient and outpatient services with recognized children’s hospitals established by the state for the rating period, July 1, 2023 through August 31, 2024, incorporated into the capitation rates through a separate payment term up to $1,668,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.AMC.PC.SP.NF_Renewal_20240101-20241231
State: California
Summary:
Uniform increases established by the state for eligible Designated Public Hospital Systems 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 $2,478,195,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
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