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 281 - 290 of 677
SDP Identifier:: OK_Fee_Oth2_New_20240401-20250630
State: Oklahoma
Summary:
Uniform increase for physicians and other qualifying practitioners established by the state for the purpose of using funds generated by the Supplemental Hospital Offset Payment Program (SHOPP) fee which establishes a managed care provider incentive pool to support healthcare quality assurance and access improvement initiatives for the rating period, April 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $134,330,110.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: OR_Fee_BHO1_Renewal_20240101-20241231
State: Oregon
Summary:
Renewal of the uniform increase established by the state for behavioral health services furnished by qualified providers for the rating period covering January 1, 2024 through December 31, 2024, 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:: OR_Fee_BHO2_Renewal_20240101-20241231
State: Oregon
Summary:
Renewal of the uniform increase established by the state for behavioral health services furnished by qualified providers for the rating period covering January 1, 2024 through December 31, 2024, 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:: OR_Fee_BHO3_Renewal_20240101-20241231
State: Oregon
Summary:
Renewal of uniform increase established by the state for behavioral health services furnished by qualified providers delivering services to members with co-occurring disorders (COD) for the rating period covering January 1, 2024 through December 31, 2024, 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:: \GA_Fee_IPH.OPH2_Amend_20230701-20240630
State: Georgia
Summary:
The uniform percentage increase for inpatient and outpatient hospital services furnished by eligible teaching hospitals established by the state 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 $936,920,135.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: NE_Fee_AMC_Renewal_20240101-20241231
State: Nebraska
Summary:
Uniform increase for faculty or staff members of an academic medical institution of a public university established by the state for the rating period, January 1, 2024through December 31, 2024, 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:
Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH1_Renewal_20230101-20231231
State: California
Summary:
Uniform increase for inpatient and outpatient services provided by private hospitals as
defined in CA Welfare & Institutions Code § 14169.51(ap) for the rating period covering
January 1, 2023 through December 31, 2023, incorporated in the capitation rates through
a separate payment term of up to $5,392,730,897.
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:: IL_Fee_IPH.OPH3_Renewal_20240101-20241231
State: Illinois
Summary:
Uniform increase established by the state for inpatient and outpatient services at eligible
Illinois hospitals 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
$4,674,700,000.00
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:: PA_Fee_IPH.OPH_Renewal_20240101-20241231
State: Pennsylvania
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital services for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $2,335,007,317.
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_HCBS2_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 until 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
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