Approved State Directed Payment Preprints

Uniform dollar increase for inpatient hospital services provided by Hudson 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 $107,475,883.

Uniform dollar increase for inpatient hospital services provided by Atlantic 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 $85,436,770.

Uniform dollar increase for inpatient hospital services, outpatient hospital services, and behavioral health inpatient services provided by Bergen 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 $383,396,201.

Uniform dollar increase for inpatient hospital services provided by Burlington 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 $71,746,613.

Uniform increase established by the State for Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) eligible providers 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 $280,000,000.

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, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $7,187,256,629.

Amendment of a value-based purchasing and uniform percent increase arrangement established by the state to increase nursing facility per diem rates by the market basket index (MBI) factor and to provide quality incentive payments for nursing facilities that meet performance requirements on specified quality metrics for the rating period covering January 1, 2024 through June 30, 2024, incorporated into the capitation rates through a risk-based adjustment.

Uniform percentage increase for inpatient and outpatient services with designated public hospitals 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 $224.1 million.

Uniform increase for professional services at an academic medical center provided by Qualified Licensed Professionals 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 $16,000,000.

The value-based payment and uniform increase established by the state for participating nursing facilities that demonstrate quality improvement for the rating period covering January 1, 2024 through June 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.