Approved State Directed Payment Preprints

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.