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 531 - 540 of 677
SDP Identifier:: MA_VBP_IPH.OPH2_Renewal_20230401-20251231
State: Massachusetts
Summary:
Integrated Care Incentive proposal for non-state, public hospitals for the rating period covering April 1, 2023 to December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $86.8 million for the April 1, 2023 – December 31, 2023; $124 million for the January 1, 2024 – December 31, 2024; and $124 million for the January 1, 2025 – December 31, 2025.
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: Multiple Rating Period
SDP Identifier:: MA_VBP_IPH3_Renewal_20230401-20251231
State: Massachusetts
Summary:
The Hospital Quality Incentive proposal for the rating period covering January 1, 2023 through March 30, 2023, incorporated in the capitation rates through a separate payment term of up to $93.8 million for the April 1, 2023 – December 31, 2023; $134 million for the January 1, 2024 – December 31, 2024; and $134 million for the January 1, 2025 – December 31, 2025.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Multiple Rating Period
SDP Identifier:: IL_Fee_BHO3_New_20230101-20231231
State: Illinois
Summary:
Uniform increase established by the state for specific behavioral health outpatient services 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 $30 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_NF_Renewal_20230701-20240630
State: New Jersey
Summary:
Uniform increase for inpatient hospital services provided by Class II (publicly owned) nursing facilities with greater than 500 licensed beds 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 $14,747,200.
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:: NJ_Fee_IPH1_Renewal_20230701-20240630
State: New Jersey
Summary:
The uniform dollar increase for inpatient hospital services provided by Atlantic County 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 $68,929,587.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_IPH4_Renewal_20230701-20240630
State: New Jersey
Summary:
The uniform dollar increase for inpatient hospital services provided by Mercer County 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 $57,945,281.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_IPH6_Renewal_20230701-20240630
State: New Jersey
Summary:
The uniform dollar increase for inpatient hospital services provided by Passaic County 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 $49,488,138.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_IPH7_New_20230701-20240630
State: New Jersey
Summary:
The uniform dollar increase for inpatient hospital services provided at acute care and rehabilitation hospitals in Cumberland County 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 $30,308,732.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_IPH5_Renewal_20230701-20240630
State: New Jersey
Summary:
The uniform dollar increase for inpatient hospital services provided by Middlesex County 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 $170,305,003.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_IPH8_New_20230701-20240630
State: New Jersey
Summary:
The uniform dollar increase for inpatient hospital services provided by acute care and rehabilitation hospitals in Monmouth County 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 $160,993,241.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: New
Approval Period: Single Rating Period
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