Approved State Directed Payment Preprints

Uniform increase provided by the eligible public safety net hospital established by the
state for inpatient and outpatient hospital services for the rating period, October 1, 2023
through September 30, 2024, incorporated into the capitation rates through a separate
payment term up to $286.5 million.

The uniform percentage increase for participating health systems affiliated with a public medical school established by the state for qualified practitioners for the rating period January 1, 2024 through December 31, 2024, incorporated into the capitation rates
through a separate payment term up to $20,000,000.

The uniform percentage increase for participating health systems affiliated with a public medical school in Northeast class established by the state for qualified practitioners for the rating period January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $67,700,000.

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.

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.

Uniform increase for staff and faculty dental providers at an academic dentistry institution of a public university established by the state for dental services for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based adjustment.

A value-based payment program for State-operated and private organizations contracted as Community Mental Health Centers for behavioral health outpatient services for the rating period, April 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $46,316,476

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.

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.

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.