Approved State Directed Payment Preprints

Uniform increase established by the state for physicians providing professional services employed by or under contracts with a South Carolina public medical university, academic medical center or its component units, or an SC Area Health Education Consortium (AHEC) Teaching Health System for the rating period covering July 1, 2024through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $145,000,000.

Comprehensive Hospital Increase Reimbursement Program (CHIRP) for the rating period covering September 1, 2024 through August 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.

Uniform percentage increase established by the state for eligible home and community-based service (HCBS) providers for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment.

Uniform percentage increase for inpatient and outpatient hospital services established by the state 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 $399,220,710.

Uniform percentage increase for inpatient and outpatient hospital services established by the state 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 $875,434,461.

Uniform percentage increase for inpatient and outpatient hospital services established by the state 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 $235,544,261.

Uniform percentage increase for physician and other eligible professional services established by the state 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 $243,635,566.
 

GA-AIDE uniform percentage increase and performance improvement initiative for inpatient and outpatient hospital services established by the state 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 $586,314,764.

The value-based payment and uniform increase by the state for primary care, behavioral health outpatient, and justice involved clinic services for the rating period October 1, 2022 through September 30, 2023, incorporated into the capitation rates through a separate payment term up to $18.5 million.

Value Based Payment to meet or exceed the performance measure benchmarks on specific provider quality metrics for the inpatient and outpatient services to receive incentive payments for the rating period covering January 1, 2024 through December 31, 2025 for a multi-year period, incorporated in the capitation rates through a separate payment term of up to $60,000,000.