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:: NC-Fee-BHO-Oth-Amend-20210701-20220630
Uniform increase established by the state for behavioral health outpatient services and other eligible provider services for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: NC-Fee-BHO-Amend-20210701-20220630
Uniform percentage increase established by the state for behavioral health outpatient services for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: NC-Fee-HCBS-BHO-Amend-20210701-20220630
Uniform increase established by the state for home and community-based and behavioral health outpatient services for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: NC-Fee-NF-BHO-Amend-20210701-20220630
Uniform increase established by the state for nursing facility services and behavioral health outpatient services for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: NM-Fee-HCBS-Renewal-20230101-20231231
The uniform increase for HCBS and personal care services for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: CA-Fee-D-Renewal-20230101-20231231
Uniform dollar increase established by the state for dental services for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: IL-Fee-AMC-Amend-20220101-20221231
Uniform increase established by the state for services provided by physicians employed by State-owned medical schools 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 $84,000,000
SDP Identifier:: LA-Fee-OTH1-New-20230701-20240630
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 $5,618,693.
SDP Identifier:: VT-VBP-Oth1-New-20230101-20231231
The value-based payment arrangement for community-based residential substance use treatment facilities for the rating period covering January 1, 2023 through December 31,2023, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: LA-Fee-BHO-New-20230701-20240630
Uniform increase for licensed mental health 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 $22,602,400.