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
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Displaying 401 - 410 of 677
SDP Identifier:: RI_Fee_IPH_Renewal_20230701-20240630
State: Rhode Island
Summary:
Uniform increase established by the state for all hospitals participating in the Rhode Island Medicaid Program, as defined in RIGL 40-8-13.4, for inpatient 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:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: RI_Fee_NF2_Renewal_20230701-20240630
State: Rhode Island
Summary:
Uniform increase established by the state for nursing facility 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:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: RI_Fee_OPH_Renewal_20230701-20240630
State: Rhode Island
Summary:
Uniform increase established by the state for all 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:: PA_Fee_AMC_Renewal_20240101-20241231
State: Pennsylvania
Summary:
The uniform increase for professional services furnished by physician practice plans affiliated with a medical school located in Philadelphia and accredited by the Liaison Committee on Medical Education 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 $9,085,139.
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_VBP_IPH2_Renewal_20240101-20241231
State: Pennsylvania
Summary:
The value-based payment arrangement providing incentive payments to acute care general hospitals that implement Race, Ethnicity, and Language data collection or social risk screening 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 $30 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:: AZ_Fee_IPH.OPH.PC.SP.NF.HCBS.BHI.BHO.D_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform increase established by the state for Differential Adjusted Payments (DAP) program eligible providers for the rating period covering October 1, 2023 through September 30, 2024, and 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 inpatient service, Behavioral health outpatient services, Dental services, HCBS/personal care services, Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_IPH.OPH1_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform increase for inpatient and outpatient hospital services at freestanding children’s hospitals with more than 100 licensed pediatric beds for the rating period covering October 1, 2023 through September 30, 2024, and incorporated in the capitation rates through a separate payment term of up to $71,331,662.
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:: MI_Fee_PC.SP_Renewal_20231001-20240930
State: Michigan
Summary:
Uniform increase established by the state for primary care and specialty physician services provided by practitioners employed or under contract with approved public entities, for the rating period covering October 1, 2023 through September 30, 2024, incorporated int the capitation rates through a separate payment term of up to $580,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MS_Fee_IPH.OPH_Amend_20230701-20240630
State: Mississippi
Summary:
Uniform percentage increase established by the state for 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 $1,522,313,885.00.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_IPH.OPH.BHI.BHO_Amend_20220701-20230630
State: North Carolina
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital services and behavioral health inpatient and outpatient hospital services at eligible acute care and critical access hospitals for the rating period covering July 1, 2022 through June 30, 2023, incorporated in the capitation rates through a separate payment term of up to $2,596,485,198.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services, Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
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