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 371 - 380 of 677
SDP Identifier:: NV_VBP_Oth_Renewal_20240101-20241231
State: Nevada
Summary:
Value based payment for Certified Community Behavioral Health Centers (CCBHCs) 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 $1,522,848.22.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PA_Fee_AMC2_Renewal_20240101-20241231
State: Pennsylvania
Summary:
Uniform increase for professional services furnished by eligible physician practices 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 $38 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:: PA_Fee_NF_Renewal_20240101-20241231
State: Pennsylvania
Summary:
Minimum fee schedule for non-public and county nursing facility services for the rating period covering January 1, 2024 through 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
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PA_Fee_Oth4_Renewal_20240101-20241231
State: Pennsylvania
Summary:
Uniform dollar increase for qualifying private duty nursing services delivered by eligible providers for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through risk-based 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:: PA_VBP_IPH_Renewal_20240101-20241231
State: Pennsylvania
Summary:
Value-based payment arrangement focused on potentially preventable admissions for private acute care 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 $45 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PA_VBP_OPH_Renewal_20240101-20241231
State: Pennsylvania
Summary:
Value-based payment arrangement for opioid use disorder for private acute care 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 $35 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: UT_Fee_HCBS.BHI.BHO2_Renewal_20230701-20240630
State: Utah
Summary:
A uniform percent increase for home and community-based services providers, behavioral health providers, and school based services providers 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 $9,962,925.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services, HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: UT_Fee_OPH2_Amend_07012022-06302023
State: Utah
Summary:
Uniform percentage increase for outpatient hospital services in state teaching hospitals 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 $30,903,041.03.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: UT_Fee_BHO_Renewal_20230701-20240630
State: Utah
Summary:
An alternative fee schedule established by the state for behavioral health outpatient services for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a risk-based 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:: VA_Fee_IPH.OPH_Renewal_20230701-20230930
State: Virginia
Summary:
Uniform increase for inpatient and outpatient services at private acute care hospitals for the rating period covering July 1, 2023 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $778 million.
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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