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 641
SDP Identifier:: LA_Fee_IPH.OPH_Amend_20240701-20250630
State: Louisiana
Summary:
Uniform increase for in-state providers of inpatient and outpatient hospital services, excluding freestanding psychiatric hospitals, freestanding rehabilitation hospitals, and long-term acute care hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to$2,806,800,000.
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:: MA_VBP_IPH3_Amend_20230401-20241231
State: Massachusetts
Summary:
The Hospital Quality Incentive proposal for non-federal, non-state owned, public hospitals for inpatient hospital services for the rating period covering April 1, 2023 through December 31, 2024 incorporated into the capitation rates through a separate payment term of up to $93.8 million for April 1, 2023 through December 31, 2023 and $160.8 million for January 1, 2024 through December 31, 2024.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: \GA_Fee_IPH.OPH2_Amend_20230701-20240630
State: Georgia
Summary:
The uniform percentage increase for inpatient and outpatient hospital services furnished by eligible teaching hospitals established by the state 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 $936,920,135.
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:: AR_Fee_BHI_New_20220101-20221231
State: Arkansas
Summary: Uniform dollar increase for psychiatric residential treatment facilities not located in hospitals 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 $5,102,154.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: AR_Fee_HCBS.BHO.Oth_Amend2_20220101-20221231
State: Arkansas
Summary: The uniform percentage increase established by the state for certain providers of HCBS services 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 $54,542,328.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services, HCBS/personal care services, Other
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_AMC_Amend_ 20211001-20220930
State: Arizona
Summary:
Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2021 through September 30, 2022, incorporated into the capitation rate through a separate payment term of up to $158.6 million.
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:: AZ_Fee_AMC_Amend_20221001-20230930
State: Arizona
Summary:
Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2022 through September 30, 2023, incorporated into the capitation rate through a separate payment term of up to $203.8 million.
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:: AZ_Fee_AMC_Amend2_20221001-20230930
State: Arizona
Summary:
Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2022 through September 30, 2023, incorporated into the capitation rate through a separate payment term of up to $203.7 million.
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:: AZ_Fee_AMC_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2023 through September 30, 2024, incorporated into the capitation rate through a separate payment term of up to $238.60 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_HCBS.BHO1_Renewal_20221001-20230930
State: Arizona
Summary:
Uniform percentage increase to registered providers who provide qualifying HCBS and Behavioral Health Outpatient services for the rating period, October 1, 2022 through September 30, 2023, incorporated into the capitation rates through a separate payment term up to $385.1 million.
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
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