Approved State Directed Payment Preprints

Amendment of 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 January1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $73.6 million.

Renewal of 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, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term of up to $34 million.

Uniform increase established by the state for Agency-Based Community Benefit services, for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment of up to $1.89million.

Uniform increase for Critical Access Hospitals as established by the state for outpatient services for the rating period, April 1, 2025 through March 31, 2026, incorporated into the capitation rates through a separate payment term up to $59,492,274.

Uniform increase established by the state for inpatient and outpatient hospital services provided by qualifying public academic health centers for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $975,888,000.

The Care Innovation and Community Improvement Program established by the state for the rating period covering January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a risk based rate adjustment and a separate payment term up to $29,025,000.

Uniform percentage increase payment arrangement for professional services at an academic medical center for rating periods covering January 1, 2026, through December31, 2026, incorporated in the capitation rates through a separate payment term amount of up to $35,572,805.

Uniform percentage increase payment arrangement for professional services at an academic medical center for rating periods covering January 1, 2026, through December31, 2026, incorporated in the capitation rates through a separate payment term amount of up to $38,000,000.

Uniform percentage increase of 2.9% per claim for inpatient hospital services for rating period covering July 1, 2024, through December 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment of up to $93,384.

Minimum fee schedule for non-public and county nursing facility services for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment of up to $1.85 billion.