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 381 - 390 of 677
SDP Identifier:: VA_Fee_IPH.OPH_Renewal_20231001-20240630
State: Virginia
Summary:
Uniform increase for inpatient and outpatient services at private acute care hospitals for the rating period covering October 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $2.333 billion.
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:: NJ_VBP_IPH.OPH.BHI.BHO1_Renewal_20240701-20250630
State: New Jersey
Summary:
A pay-for-performance initiative focused on behavioral health performance improvement among acute care hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term of up to $147,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services, Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_NF_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform dollar increase established by the state for nursing facility services for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $ $95,851,058.
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:: DE_Fee_NF_New_20230101-20231231
State: Delaware
Summary:
Uniform increase established by the state for nursing facility services 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 $25,464,731.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_BHO_Renewal_20230101-20230331
State: Massachusetts
Summary:
Uniform increase established by the State for Behavioral Health Urgent Care (BHUC) 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:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_BHO2_Renewal_20230101-20230331
State: Massachusetts
Summary:
Minimum Fee Schedule established by the State for the Program of Assertive Community Treatment (PACT) for the rating period covering January 1, 2023 through March 31, 2023, incorporated into 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:: MA_Fee_Oth_Renewal_20230101-20230331
State: Massachusetts
Summary:
The minimum fee schedule for Acute Treatment Services (ATS) and Clinical Support Services (CSS) (which may include individualized treatment services in a specialized setting), and Residential Rehabilitation Services (RRS) services established by the state for the rating period covering January 1, 2023 through March 31, 2023, incorporated into the capitation rates through a 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:: RI_Fee_OPH1_Renewal_20230701-20240630
State: Rhode Island
Summary:
Uniform increase established by the state for hospitals participating in the Rhode Island Medicaid Program, as defined in RIGL 40-8-13.4, for outpatient hospital services 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
Provider Class:
Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: RI_Fee_IPH.OPH_New_20230701-20240630
State: Rhode Island
Summary:
Uniform increase established by the state for eligible inpatient and outpatient hospital services, 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 $287,927,025.
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:: RI_Fee_Oth_Renewal_20230701-20240630
State: Rhode Island
Summary:
Uniform increase established by the state for shared living services 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
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
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