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 521 - 530 of 677
SDP Identifier:: LA_Fee_IPH.OPH_Renewal_20230701-20240630
State: Louisiana
Summary:
A uniform percent increase for in-state providers of inpatient and outpatient hospital services (excluding freestanding psychiatric hospitals, freestanding rehabilitation hospitals, and long-term acute care hospitals) 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 $2,735.9 million.
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:: OK_Fee_IPH.OPH_Renewal_20240401-20250630
State: Oklahoma
Summary:
Uniform percent increase for inpatient and outpatient hospital services at trauma hospitals for the rating period covering April 1, 2024 through June 30, 2025 incorporated in the capitation rates through a separate payment term of up to $520,040,434.
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_IPH.OPH2_Renewal_20230701-20240630
State: North Carolina
Summary:
Uniform dollar increase established by the state for inpatient and outpatient hospital services at UNC Health Care System hospitals 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 $130,368,333.
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:: MA_VBP_BHI.BHO_Renewal_20230101-20251231
State: Massachusetts
Summary:
The value based payment arrangement for non-state, public hospitals that contract with the Commonwealth’s Prepaid Inpatient Health Plan (PIHP) to enhance the quality of behavioral health services provided on an outpatient and inpatient basis to MassHealth members for the rating period covering January 1, 2023 to December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $60 million for the January 1, 2023 – December 31, 2023; $60 million for the January 1, 2024 – December 31, 2024; and $60 million for the January 1, 2025 – December 31, 2025.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Renewal
Approval Period: Multiple Rating Period
SDP Identifier:: MA_VBP_IPH3_Renewal_20230101-20230331
State: Massachusetts
Summary:
The Hospital Quality Incentive proposal for the rating period covering January 1, 2023 through March 31, 2023, incorporated in the capitation rates through a separate payment term of up to $40.2 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_VBP_IPH.OPH2_Renewal_20230101-20230331
State: Massachusetts
Summary:
Integrated Care Incentive proposal for non-state, public hospitals for the rating period covering January 1, 2023 to March 31, 2023, incorporated in the capitation rates through a separate payment term of up to $37.2 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MS_Fee.VBP_AMC_Renewal_20230701-20240630
State: Mississippi
Summary:
Uniform percentage increase established by the state for the professional services at an academic medical center 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 $39,420,290.00; Performance improvement initiative established by the state for the professional services at an academic medical center 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 $39,420,290.00.
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:: NC_Fee_Oth1_Renewal_20230701-20240630
State: North Carolina
Summary:
Minimum fee schedule established by the state for public ambulance provider 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_Oth2_Renewal_20230701-20240630
State: North Carolina
Summary:
Uniform dollar increase established by the state for local health department 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 $55,500,000.
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:: NC_Fee_BHI_Renewal_20230701-20240630
State: North Carolina
Summary:
Uniform dollar increase established by the state for behavioral health inpatient 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:
Behavioral health inpatient service
Review Type: Renewal
Approval Period: Single Rating Period
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