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
Displaying 1 - 10 of 510
SDP Identifier:: TX_Fee_Oth_Renewal_20240901-20250831
State: Texas
Summary:
Behavioral Health Services (BHS) directed payment program for the rating period covering September 1, 2024 through August 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: IA_Fee_IPH.OPH_Amend_20230701-20240630
State: Iowa
Summary:
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 $534,243,548.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: IA_Fee_AMC_Amend_20230701-20240630
State: Iowa
Summary:
A uniform increase for physician and professional services at qualifying Iowa state-owned or operated professional services practices 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 $121,094,222.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: NM_Fee_IPH.OPH6_New_20240101-20240630
State: New Mexico
Summary:
The uniform dollar increase established by the state for inpatient and outpatient hospital services for hospitals in rural or underserved communities with active maternal/obstetric programs for the rating period January 1, 2024 through June 30, 2024, incorporated into the capitation rates through a separate payment term up to $10,936,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_IPH.OPH.BHI.BHO_Renewal_20230701-20240630
State: North Carolina
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital services 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 $4,053,353,828.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services, Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_IPH.OPH.BHI.BHO_Renewal_20240701-20250630
State: North Carolina
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $6,288,572,664.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services, Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_VBP_IPH.OPH2_Renewal_20240101-20241231
State: California
Summary:
Quality Incentive Pool for Designated Public Hospital systems for the rating period of January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $2,037,470,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: RI_Fee_HCBS_Renewal_20230701-20240630
State: Rhode Island
Summary:
Uniform increase for all contracted home care agencies providing homemaker and CAN services for the rating period covering July 1, 2023 through June 30, 2024, incorporated into the capitation rates through a risk-based rate adjustment or through a separate payment term up to $3,750,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MS_Fee_Oth_Renewal_20240701-20250630
State: Mississippi
Summary:
Uniform dollar increase established by the state for ground emergency ambulance services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $25,285,224.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NH_Fee_Oth1_Renewal_20240901-20250630
State: New Hampshire
Summary:
Minimum fee schedule established by the state for durable medical equipment for the rating period covering September 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
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