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 461 - 470 of 677
SDP Identifier:: AZ_Fee_AMC_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2023 through September 30, 2024, incorporated into the capitation rate through a separate payment term of up to $238.60 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:: AZ_Fee_IPH.OPH2_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform increase established by the state for acute inpatient and ambulatory outpatient services provided by Hospital Enhanced Access Leading to Health Improvements Initiative (HEALTHII) program eligible hospitals for the rating period covering October 1, 2023 through September 30, 2024, incorporated into the capitation rate through a separate payment term of up to $2.259 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:: NC_Fee_OPH_Renewal_20230701-20240630
State: North Carolina
Summary:
Minimum fee schedule established by the state for outpatient laboratory services provided by in-state acute care hospitals and critical access hospitals 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:: MA_Fee_Oth_Renewal_20220101-20221231
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, 2022 through December 31, 2022, 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:: MA_Fee_BHO.Oth_Renewal_20230101-20230331
State: Massachusetts
Summary:
The uniform increase for behavioral health outpatient services and behavioral health diversionary 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:
Behavioral health outpatient services, Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NV_Fee_AMC_Amend_20210101-20211231
State: Nevada
Summary:
Uniform increase for eligible professional services at designated academic medical centers for the rating period for the rating period covering January 1, 2021 through December 31, 2021, incorporated in the capitation rates through a separate payment term of up to $15,967,295.18.
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:: NV_Fee_IPH.OPH_Renewal_20230101-20232131
State: Nevada
Summary:
Uniform percent increase for inpatient and outpatient hospital services at non-state governmentally owned hospitals 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 $206,534,166.73.
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:: IA_Fee_IPH.OPH_Renewal_20230701-20240630
State: Iowa
Summary:
Uniform increase for inpatient 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, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $479,417,115.
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:: IL_Fee_NF2_Renewal_20230101-20231231
State: Illinois
Summary:
Uniform dollar increase for nursing facilities based on quality weighted Medicaid days 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 $56 million.
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:: LA_Fee_OTH1_Amend_20230701-20240630
State: Louisiana
Summary:
Uniform increase for non-emergency medical transport 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 $2,800,584.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Amendment
Approval Period: Single Rating Period
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