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 341 - 350 of 677
SDP Identifier:: NM_Fee_IPH.OPH1_Renewal_20240101-20240630
State: New Mexico
Summary:
Renewal of the uniform percentage increase established by the state for inpatient and outpatient services by for-profit/investor owned and government-owned hospitals 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:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_Fee_IPH.OPH2_Renewal_20240101-20240630
State: New Mexico
Summary:
Renewal of the uniform percentage increase established by the state for inpatient and outpatient services by not-for-profit hospitals 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:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_Fee_IPH.OPH3_Renewal_20240101-20240630
State: New Mexico
Summary:
Renewal of the uniform increase arrangement for trauma hospitals established by the state for inpatient and outpatient services for the rating period covering January 1, 2024through 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:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_Fee_IPH.OPH4_Renewal_20240101-20240630
State: New Mexico
Summary:
Renewal of the uniform percentage increase established by the state for inpatient and outpatient services provided by practice plans under contract to community hospitals that serve a disproportionate share of Native American enrollees 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:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_VBP.Fee_NF_Renewal_20240101-20240630
State: New Mexico
Summary:
Renewal of 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.
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:: OR_Fee_IPH.OPH3_Renewal_20240101-20241231
State: Oregon
Summary:
Renewal of uniform increase established by the state for inpatient and outpatient hospital services provided by qualifying Public Academic Health Centers 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 $809,000,000.
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:: OR_Fee_IPH.OPH2_Renewal_20240101-20241231
State: Oregon
Summary:
Renewal of uniform increase established by the state for inpatient and outpatient hospital services provided by Diagnosis-Related Group (DRG) 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 $703,000,000.
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:: OR_Fee_IPH.OPH1_Renewal_20240101-20241231
State: Oregon
Summary:
Renewal of uniform increase established by the state for inpatient and outpatient hospital services provided by Rural Type A/B 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 $146,000,000.
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:: RI_VBP.Fee_PC_Renewal_20230701-20240630
State: Rhode Island
Summary:
The value-based payment Patient Centered Medical Home (PCMH)-Kids initiative established by the state for eligible pediatric providers for the rating period covering July 1, 2023 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, Value-based payment
Provider Class:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_IPH.OPH_Renewal_20230101-20230331
State: Massachusetts
Summary:
Uniform increase established by the state for eligible inpatient and outpatient hospital services for the rating period covering January 1, 2023 through March 31, 2023, 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:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
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