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 501 - 510 of 677
SDP Identifier:: VA_VBP_NF_Amend_20220701-20230630
State: Virginia
Summary:
The quality payment established by the state for nursing facility services 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 $59,311,250.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: PR_Fee_PC1_Renewal_20230101-20230930
State: Puerto Rico
Summary:
Minimum fee schedule established by the state for primary care services that are covered at 75% of Medicare consistent with the requirements of the Consolidated Appropriations Act of 2023 for the rating periods covering January 1, 2023 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:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_Oth1_Renewal_20230101-20231231
State: California
Summary:
Uniform dollar increase established by the state for developmental screening services for the rating period covering January 1, 2023 through December 31, 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_Oth2_Renewal_20230101-20231231
State: California
Summary:
Uniform dollar increase established by the state for Family Planning services for the rating period covering January 1, 2023 through December 31, 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.AMC.PC.SP.NF_Renewal_20230101-20231231
State: California
Summary:
Uniform increases established by the state for eligible Designated Public Hospital Systems for the rating period covering July 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $1,982,556,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_PC.SP_Renewal_20230701-20240630
State: New Jersey
Summary:
The uniform dollar increase for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) screening 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:
Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_Oth2_Renewal_20220101-20221231
State: California
Summary:
Uniform dollar increase established by the state for Family Planning services for the rating period covering January 1, 2022 through December 31, 2022, 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:: NM_Proposal D 2021_Amendment
State: New Mexico
Summary:
The uniform percentage increase established by the state for qualified practitioners who are members of a practice plan under contract to provide professional services at a state-owned academic medical center 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 $49.9 million.
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:: NM_Proposal B 2021_Amendment
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 under contract that meet performance requirements on specified quality metrics 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 $80.3 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: FL_Fee_IPH.OPH3_Renewal_202221001-20230930
State: Florida
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital services at qualifying cancer hospitals for the rating period covering October 1, 2022 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $129,312,167.
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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