Approved State Directed Payment Preprints

Uniform dollar increase for inpatient hospital services, outpatient hospital services and behavioral health inpatient services provided by general acute hospitals and a private acute psychiatric inpatient hospital in Union County for the rating period, July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a separate payment term up to $213,769,468.

The uniform dollar increase for inpatient hospital services and outpatient hospital services provided by Gloucester County hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term up to $70,954,562.

Minimum and maximum fee schedule for inpatient and outpatient hospital services for children’s hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a risk-based adjustment.

Uniform percentage increase for qualified practitioner services at an academic medical center, primary care and specialty physician services, and dental services, as well as a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025 through December 31, 2025, incorporated into capitation rates via a separate payment term up to$11,858,152.

Uniform percentage increase for inpatient and outpatient hospital services, and for qualified practitioner services at an academic medical center, and a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025 through December 31, 2025, incorporated into capitation rates via a separate payment term up to $116,141,150.

Uniform percentage increase for inpatient hospital services and outpatient hospital services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $111,701,295.

Uniform percentage increase for inpatient hospital and outpatient hospital services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $1,908,259,031.

Performance improvement initiative for community behavioral health center services for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term amount up to $15,497,672.

Uniform percentage increase for professional services provided by qualified providers employed or contracted with the AtlantiCare health system which is affiliated with Stockton University’s nursing and allied health training programs for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term up to $50,611,881.

Uniform percentage increase for qualified practitioner services at an academic medical center and a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025through December 31, 2025, incorporated into capitation rates through a separate payment term of up to $41,019,224.