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 471 - 480 of 677
SDP Identifier:: FL_Fee_IPH.OPH2_Renewal_20221001-20230930
State: Florida
Summary:
Maximum fee schedule established by the state for eligible inpatient and outpatient hospital services for the rating period covering October 1, 2022 through September 30,2023, 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:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: GA_Fee_IPH.OPH2_Renewal_20230701-20240630
State: Georgia
Summary:
The uniform percentage increase for inpatient and outpatient hospital services furnished by eligible teaching hospitals 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 $865,295,240.
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:: AZ_Fee_IPH.OPH2_Amend_20221001-20230930
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, 2022 through September 30, 2023, incorporated into the capitation rate through a separate payment term of up to $1.92 billion.
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:: VA_VBP_NF_Renewal_20230701-20230930
State: Virginia
Summary:
The quality payment established by the state for nursing facility services for the rating period covering July 1, 2023 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $27 million.
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
SDP Identifier:: VA_VBP_NF_Renewal_20231001-20240630
State: Virginia
Summary:
The quality payment established by the state for nursing facility services 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 $81.1 million.
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
SDP Identifier:: NM_VBP_IPH.OPH_Renewal_20230101-20231231
State: New Mexico
Summary:
Uniform increase for inpatient and outpatient hospital services and performance-based quality payments established by the state for hospitals that provide guaranteed access to care for Native Americans through the Indian Health Service for the rating period covering January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a separate payment term of up to $133 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NY_Fee_OPH1_Renewal_20230401-20240331
State: New York
Summary:
The uniform increase for Sole Community Hospitals established by the state for outpatient services for the rating period covering April 1, 2023 through March 31, 2024, incorporated in the capitation rates through a separate payment term of up to $121,377,916.
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:: NY_Fee_OPH2_Renewal_20230401-20240331
State: New York
Summary:
The uniform increase for Critical Access Hospitals established by the state for outpatient services for the rating period covering April 1, 2023 through March 31, 2024, incorporated in the capitation rates through a separate payment term of up to $49,576,895.
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:: IA_Fee_AMC_Renewal_20230701-20240630
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, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $116,808,663.
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:: IL_Fee_IPH.OPH2_Renewal_20230101-20231231
State: Illinois
Summary:
Uniform increase established by the state for inpatient and outpatient services at large non-state government 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 $630,200,000.
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
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