Approved State Directed Payment Preprints

Uniform increase for professional medical services at an academic medical center for rating periods covering July 1, 2025, through June 30, 2026, incorporated in the capitation rates through a separate payment term amount of up to $11,331,455.

Minimum Fee Schedule for behavioral health inpatient service and behavioral health outpatient service for the rating period covering January 1, 2026 through December 31,2026, incorporated in the capitation rates through an alternative fee schedule of up to$633,562,966.

Uniform increase by the state for primary care, behavioral health outpatient, and justice involved clinic services for the rating period October 1, 2025 through September 30, 2026, incorporated into the capitation rates through a separate payment term up to $50 million.

Uniform percentage increase for inpatient and outpatient hospital services for rating periods covering October 1, 2023 through September 30, 2024, incorporated in the capitation rates through a separate payment term amount of up to $452,805,524.

Uniform percentage increase for inpatient hospital services and outpatient hospital services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $155,676,891.

Uniform percentage increase for inpatient and outpatient hospital services, provided by non-profit adult hospitals located in Hamilton County that are affiliated with a public medical school and that maintain a Level 1 trauma designation, 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 $205,754,578.

Renewal of a uniform increase for primary care services for the rating period covering January 1, 2026 through December 31, 2026, incorporated into the capitation rates through a separate payment term of up to $26 million.

Primary Care Sub Capitated Arrangement established by the state for the rating period, January 1, 2025 through December 31, 2027, incorporated into the capitation rates through a risk-based adjustment.

Uniform percentage increase for inpatient and outpatient hospital services provided at qualifying Iowa state-owned or operated teaching hospitals as defined in the Medicaid State Plan for the rating period covering July 1, 2025 through June 30, 2026,incorporated in the capitation rates through a separate payment term amount of up to$704,664,323.

The uniform dollar increase for primary care services to meet Healthy Steps model fidelity for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $98,385.