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 311 - 320 of 677
SDP Identifier:: TN_Fee_IPH.OPH1_Renewal_20240101-20241231
State: Tennessee
Summary:
Uniform percentage increase established by the state for eligible 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 $758,850,000.
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:: TN_VBP.Fee_AMC_Renewal_20240101-20241231
State: Tennessee
Summary:
Uniform percentage increase and value-based payments established by the state for professional services at an academic medical center for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $16,638,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_Fee_OTH2_Renewal_20240101-20240630
State: New Mexico
Summary:
Renewal of the uniform increase established by the state for EPSDT services for Private Duty Nursing and Home Health Providers for the rating period covering January 1, 2024 through June 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_Fee_HCBS_Renewal_20240101-20240630
State: New Mexico
Summary:
Renewal of the uniform increase established by the state for HCBS and personal care services for the rating period covering January 1, 2024 through June 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
SDP Identifier:: WA_Fee_BHO3_Renewal_20240101-20241231
State: Washington
Summary:
Renewal of the uniform increase established by the state for eligible providers delivering opioid treatment 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:
Fee schedule
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_OTH_Renewal_20240101-20241231
State: Washington
Summary:
Renewal of the uniform increase established by the state for publicly funded sexual and reproductive health family planning providers as designated by the Department of Health 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:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI2.BHO2_Renewal_20240101-20241231
State: Washington
Summary:
Renewal of the uniform increase established by the state for behavioral health inpatient and behavioral health outpatient 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:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_AMC_Renewal_20240101-20241231
State: Washington
Summary:
Renewal of a uniform increase established by the state for qualified licensed professionals employed by the University of Washington and/or a member of its affiliated physician practice plans or employed by a public hospital or other public entity 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 $109 million.
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:: TN_Fee_Oth_New_20230101-20231231
State: Tennessee
Summary:
Uniform percentage increase established by the state for eligible behavioral health services for the rating period, January 1, 2023 through December 31, 2023, 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:
Other
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: TN_Fee.VBP_PC_Renewal_20240101-20241231
State: Tennessee
Summary:
Uniform dollar increase and value-based payments established by the state for eligible primary care services for the rating period, 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, Value-based payment
Provider Class:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
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