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 241 - 250 of 677
SDP Identifier:: VA_Fee_IPH.OPH.NF_Renewal_20240701-20250630
State: Virginia
Summary:
Uniform increase for inpatient and outpatient services rendered by non-state government owned 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 $90,600,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VA_Fee_AMC_Renewal_20240701-20250630
State: Virginia
Summary:
Uniform increase for physicians affiliated with the practice plans of Virginia’s three allopathic medical schools: University of Virginia, Virginia Commonwealth University, and Eastern Virginia Medical Center, 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 $224,900,000.
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:: MO_Fee_IPH_Renewal_20240701-20250630
State: Missouri
Summary:
Minimum and maximum fee schedules established by the state for inpatient hospital 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:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MO_Fee_OPH_Renewal_20240701-20250630
State: Missouri
Summary:
Minimum and maximum fee schedules 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 risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VA_Fee_Oth_Renewal_20240701-20250630
State: Virginia
Summary:
The minimum fee schedule established by the state for Durable Medical Equipment providers for the rating period covering July 1, 2024 through June 30, 2025, 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: KS_Fee_IPH.OPH3_Renewal_20240101-20241231
State: Kansas
Summary:
Uniform increase for inpatient and outpatient services provided by eligible hospitals as established by the state for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $397,295,435.
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:: NJ_Fee_IPH.BH2_Renewal_20240701-20250630
State: New Jersey
Summary:
Uniform dollar increase for inpatient hospital services and behavioral health inpatient services provided by Ocean County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $83,912,896.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_IPH9_Renewal_20240701-20250630
State: New Jersey
Summary:
Uniform dollar increase for inpatient hospital services provided by Passaic County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $69,563,799.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_VBP.Fee_IPH.OPH5_Renewal_20240101-20240630
State: New Mexico
Summary:
A uniform percentage increase and quality incentive payment established by the state for inpatient and outpatient hospital services provided by Safety Net Care Pool hospital providers for the rating period covering January 1, 2024 through June 30, 2024, incorporated into the capitation rates through a separate payment term of up to $34,500,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: SC_Fee_Oth_Renewal_20240701-20250630
State: South Carolina
Summary:
Uniform increase established by the state to dispensing fees for Independent Community Pharmacies 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 $9,500,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
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