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 411 - 420 of 677
SDP Identifier:: NV_Fee_AMC_Renewal_20240101-20241231
State: Nevada
Summary:
Uniform increase for eligible professional services at designated academic medical 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 $31,968,227.74.
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_IPH.OPH2_New_20240101-20241231
State: Pennsylvania
Summary:
Uniform percentage increase for inpatient and outpatient services for qualifying classes of 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 $259.9 million.
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:: IA_Fee_AMC_Amend_20210701- 20220630
State: Iowa
Summary:
A uniform increase for physician and professional services at qualifying Iowa state- owned or operated professional services practices as defined in the Medicaid State Plan for the rating period covering July 1, 2021 through June 30, 2022, incorporated into the capitation rates through a separate payment term of up to $106,546,734.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: IA_Fee_IPH.OPH_Amend_20210701-20220630
State: Iowa
Summary:
A uniform increase to average commercial rate for inpatient hospital services and outpatient hospital services at qualifying Iowa state-owned or operated teaching hospitals as defined in the Medicaid State Plan for the rating period covering July 1, 2021 through June 30, 2022, incorporated into the capitation rates through a separate payment term of up to $468,662,600.
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:: PA_Fee_BHI.BHO_Renewal_20240101-20241231
State: Pennsylvania
Summary:
The alternative minimum fee schedule established by the state for qualifying providers under specific ASAM levels of care who provide substance use disorder (SUD) treatment for the rating period covering January 1, 2024 through December 31, 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:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PA_Fee_Oth_Renewal_20240101-20241231
State: Pennsylvania
Summary:
The minimum fee schedule for providers involved in the Integrated Community Wellness Center (ICWC) for the rating period covering January 1, 2024 through December 31, 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
SDP Identifier:: GA_Fee_Oth1_Renewal_20230701-20240630
State: Georgia
Summary:
The uniform percentage increase for physician and other eligible professional services 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 $210,433,377.
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:: TN_Fee_NF_Amend_20230101-20231231
State: Tennessee
Summary:
Uniform percentage 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 $174,025,614.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: TN_Fee_NF_Renewal_20240101-20241231
State: Tennessee
Summary:
Uniform percentage increase established by the state for nursing facility services 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 $47,523,042.
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:: NM_VBP_NF2_Renewal_20230101-20231231
State: New Mexico
Summary:
A value-based purchasing and uniform percent increase arrangement established by the state to increase nursing facility per diem rates by the market basket index (MBI) factor and to provide quality incentive payments for nursing facilities that meet performance requirements on specified quality metrics for the rating period covering January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
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