U.S. flag

An official website of the United States government

Approved State Directed Payment Preprints

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.

Results

Displaying 561 - 570 of 776

Arizona

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, 2023 through September 30, 2024, incorporated into the capitation rate through a separate payment term of up to $2.259 billion. 

Approval Date: October 25, 2023
Effective Date: October 1, 2023
State Rating Period: October 1, 2023 - September 30, 2024
Payment Type: Fee schedule
Review Type: Renewal
Approval Period: Single Rating Period
Provider Class: Inpatient hospital service Outpatient hospital service

North Carolina

Minimum fee schedule established by the state for outpatient laboratory services provided by in-state acute care hospitals and critical access hospitals 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: October 23, 2023
Effective Date: July 1, 2023
State Rating Period: July 1, 2023 - June 30, 2024
Payment Type: Fee schedule
Review Type: Renewal
Approval Period: Single Rating Period
Provider Class: Outpatient hospital service

Massachusetts

The minimum fee schedule for Acute Treatment Services (ATS) and Clinical Support Services (CSS) (which may include individualized treatment services in a specialized setting), and Residential Rehabilitation Services (RRS) services established by the state for the rating period covering January 1, 2022 through December 31, 2022, incorporated into the capitation rates through a risk-based adjustment.

Approval Date: October 20, 2023
Effective Date: January 1, 2022
State Rating Period: January 1, 2022 - December 31, 2022
Payment Type: Fee schedule
Review Type: Renewal
Approval Period: Single Rating Period
Provider Class: Other

Massachusetts

The uniform increase for behavioral health outpatient services and behavioral health diversionary services established by the state for the rating period covering January 1, 2023 through March 31, 2023, incorporated into the capitation rates through a risk-based adjustment.

Approval Date: October 20, 2023
Effective Date: January 1, 2023
State Rating Period: January 1, 2023 - March 31, 2023
Payment Type: Fee schedule
Review Type: Renewal
Approval Period: Single Rating Period
Provider Class: Behavioral health outpatient services Other

Nevada

Uniform increase for eligible professional services at designated academic medical centers for the rating period 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 $15,967,295.18.

Approval Date: October 20, 2023
Effective Date: January 1, 2021
State Rating Period: January 1, 2021 - December 31, 2021
Payment Type: Fee schedule
Review Type: Amendment
Approval Period: Single Rating Period
Provider Class: Professional services at an academic medical center

Nevada

Uniform percent increase for inpatient and outpatient hospital services at non-state governmentally owned 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 $206,534,166.73. 

Approval Date: October 20, 2023
Effective Date: January 1, 2023
State Rating Period: January 1, 2023 - December 31, 2023
Payment Type: Fee schedule
Review Type: Renewal
Approval Period: Single Rating Period
Provider Class: Inpatient hospital service Outpatient hospital service

Iowa

Uniform increase for inpatient and outpatient hospital services at qualifying Iowa state-owned or operated teaching hospitals 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 $479,417,115.

Approval Date: October 19, 2023
Effective Date: July 1, 2023
State Rating Period: July 1, 2023 - June 30, 2024
Payment Type: Fee schedule
Review Type: Renewal
Approval Period: Single Rating Period
Provider Class: Inpatient hospital service Outpatient hospital service

Illinois

Uniform dollar increase for nursing facilities based on quality weighted Medicaid days 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 $56 million. 

Approval Date: October 19, 2023
Effective Date: January 1, 2023
State Rating Period: January 1, 2023 - December 31, 2023
Payment Type: Fee schedule
Review Type: Renewal
Approval Period: Single Rating Period
Provider Class: Nursing facility services

Louisiana

Uniform increase for non-emergency medical transport providers 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 $2,800,584. 

Approval Date: October 19, 2023
Effective Date: July 1, 2023
State Rating Period: July 1, 2023 - June 30, 2024
Payment Type: Fee schedule
Review Type: Amendment
Approval Period: Single Rating Period
Provider Class: Other

Florida

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: October 18, 2023
Effective Date: October 1, 2022
State Rating Period: October 1, 2022 - September 30, 2023
Payment Type: Fee schedule
Review Type: Renewal
Approval Period: Single Rating Period
Provider Class: Inpatient hospital service Outpatient hospital service