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 331 - 340 of 677
SDP Identifier:: KY_Fee_Oth_Renewal_20240101-20241231
State: Kentucky
Summary:
Uniform dollar increase established by the state for eligible ground ambulance providers for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a through a separate payment term of up to $61,159,581.
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:: MI_Fee_IPH.OPH_Renewal_20231001-20240930
State: Michigan
Summary:
Uniform increase established by the state for inpatient and outpatient hospital services for the rating period covering October 1, 2023 through September 30, 2024 incorporated into the capitation rates through a separate payment term up to $4,775,089,580.
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_Fee_BHI.BHO2_Renewal_20240101-20241231
State: Tennessee
Summary:
Uniform percentage increase established by the state for eligible behavioral health inpatient and outpatient services at Comprehensive Child and Family Treatment agencies (CCFT) 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
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: TN_Fee_IPH.OPH3_New_20230101-20231231
State: Tennessee
Summary:
Uniform percentage increase established by the state for eligible inpatient and outpatient hospital services for the rating period, January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a separate payment term up to $344,047,623.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: KY_Fee.VBP_IPH.OPH_Renewal_20240101-20241231
State: Kentucky
Summary:
Uniform increase and value-based payment established by the state for inpatient and outpatient hospital services for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a through a separate payment term of up to $2,427,458,497.
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:: HI_VBP.Fee_NF_Renewal_20240101-20241231
State: Hawaii
Summary:
- Pay for performance arrangement established by the state for public and private nursing facilities as defined in the preprint 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 $2.71 million; and,
- Uniform dollar increase established by the state for nursing facility services within government-owned nursing facilities 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 $32.96 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: HI_VBP.Fee_IPH.OPH_Renewal_20240101-20241231
State: Hawaii
Summary:
- Pay for performance arrangement established by the state for public and private hospitals as defined in the preprint for the rating period covering January 1, 2024 through December 31, 2024 incorporated in the capitation rates through separate payment term of up to $46.15 million;
- Uniform dollar increase established by the state for safety net hospitals owned and operated by a government agency 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 $86.46 million;
- Uniform percentage increase established by the state for inpatient and outpatient hospital services within privately-owned hospital provider classes for the rating period covering January 1, 2024 to December 31, 2024 incorporated in the capitation rates through a separate payment term of up to $162.2 million; and,
- Minimum and Maximum fee schedule established by the state for in-state general acute hospitals and children’s hospital services within in-state general acute hospital provider classes for the rating period of January 1, 2024 to December 31, 2024 incorporated in the capitation rates through a risk-based adjustment.
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:: TX_Fee_Oth1_Amend_20230901-20240831
State: Texas
Summary:
Rural Access to Primary and Preventative Services (RAPPS) for the rating period covering September 1, 2023 through August 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: Amendment
Approval Period: Single Rating Period
SDP Identifier:: KY_Fee.VBP_IPH.OPH.AMC_Renewal_20250101-20251231
State: Kentucky
Summary:
- Uniform increase established by the state for inpatient and outpatient hospital services and professional services at an academic medical center for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based adjustment; and,
- Value-based payment established by the state for inpatient and outpatient hospital services and professional services at an academic medical center for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $380,395,158.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service, Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_VBP.Fee_IPH.OPH_Amend_20230101-20231231
State: New Mexico
Summary:
Amendment: the uniform increase for inpatient and outpatient hospital services and performance-based quality payments established by the state for hospitals that provide guaranteed access to care for Native Americans through the Indian Health Service for the rating period covering January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a separate payment term of up to $193 million.
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: Amendment
Approval Period: Single Rating Period
Results per page