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
SDP Identifier:: Fl-Fee-Pc-Sp-Renewal-20221001-20230930
Minimum fee schedule established by the state for primary care services and specialty physician services for the rating period covering October 1, 2022 through September 30, 2023 incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: Nv-Fee-Amc-Renewal-20230101-20231231
Uniform increase for eligible professional services at designated academic medical centers 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 $26,217,616.58.
SDP Identifier:: Nv-Fee-Iph-Amend-20220101-20221231
A uniform increase for inpatient hospital services rendered by public hospitals for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a separate payment term of up to $56,704,955.66.
SDP Identifier:: Ma-Fee-Bhi2-Renewal-20220101-20221231
Minimum fee schedule for psychiatric services for enrollees under the age of 21 with Autism Spectrum Disorder or Intellectual or Developmental Disability (ASD/IDD) for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: Ma-Fee-Bho-New-20220101-20221231
Uniform increase established by the State for Behavioral Health Urgent Care (BHUC) for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: Ma-Fee-Bho2-Renewal-20220101-20221231
Minimum Fee Schedule established by the State for the Program of Assertive Community Treatment (PACT) for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: WI_Fee_IPH.OPH_Renewal_20230101-20231231
The uniform increase for hospital access payments 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 $450,413,343.00.
SDP Identifier:: Ri-Fee-Nf2-Renewal-20220701-20230630
Uniform increase 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 risk-based rate adjustment.
SDP Identifier:: RI_Fee_IPH4_Renewal_20220701-20230630
Uniform increase established by the state for all hospitals participating in the Rhode Island Medicaid Program, as defined in RIGL 40-8-13.4, for inpatient hospital services for the rating period covering July 1, 2022 through June 30, 2023, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: RI_Fee_OPH1_Renewal_20220701-20230630
Uniform increase established by the state for hospitals participating in the Rhode Island Medicaid Program, as defined in RIGL 40-8-13.4, for outpatient hospital services for the rating period covering July 1, 2022 through June 30, 2023, incorporated in the capitation rates through a risk-based rate adjustment.