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 11 - 20 of 641
SDP Identifier:: AZ_Fee_IP.OP.PC.SP.NF.HCBS.BHI.BHO.D_Renewal_20211001-20220930
State: Arizona
Summary: Uniform increase established by the state for Differential Adjusted Payments (DAP) program eligible providers for the rating period covering October 1, 2022 through September 30, 2023, and 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:
Behavioral health inpatient service, Behavioral health outpatient services, Dental services, HCBS/personal care services, Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_IPH.OPH.PC.SP.NF.HCBS.BHI.BHO.D_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform increase established by the state for Differential Adjusted Payments (DAP) program eligible providers for the rating period covering October 1, 2023 through September 30, 2024, and 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:
Behavioral health inpatient service, Behavioral health outpatient services, Dental services, HCBS/personal care services, Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_IPH.OPH1_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform increase for inpatient and outpatient hospital services at freestanding children’s hospitals with more than 100 licensed pediatric beds for the rating period covering October 1, 2023 through September 30, 2024, and incorporated in the capitation rates through a separate payment term of up to $71,331,662.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_IPH.OPH2_Amend_20221001-20230930
State: Arizona
Summary:
Uniform increase established by the state for acute inpatient and ambulatory outpatient services provided by Hospital Enhanced Access Leading to Health Improvements Initiative (HEALTHII) program eligible 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 $1.92 billion.
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:: AZ_Fee_IPH.OPH2_New_20231001-20240930
State: Arizona
Summary:
Uniform increase provided by the eligible public safety net hospital established by the
state for inpatient and outpatient hospital services for the rating period, October 1, 2023
through September 30, 2024, incorporated into the capitation rates through a separate
payment term up to $286.5 million.
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:: AZ_Fee_IPH.OPH2_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform increase established by the state for acute inpatient and ambulatory outpatient services provided by Hospital Enhanced Access Leading to Health Improvements Initiative (HEALTHII) program eligible 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 $2.259 billion.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_NF_Renewal_20231001-20240930
State: Arizona
Summary:
Uniform dollar increase established by the state for nursing facility services for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $ $95,851,058.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_BHO_Amend_20211001-20220930
State: Arizona
Summary:
The Targeted Investment program established by the state for behavioral health outpatient ambulatory focus areas for the rating period covering October 1, 2021 through September 30, 2022, and incorporated in the capitation rates through a separate payment term of up to $23.8 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_BHO_Renewal_20211001-20220930
State: Arizona
Summary: Targeted Investment program established by the state for behavioral health outpatient ambulatory focus areas for the rating period covering October 1, 2021 through September 30, 2022, and incorporated in the capitation rates through a separate payment term of up to $22.4 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_IP_Renewal_20211001-20220930
State: Arizona
Summary: Value Based Payment for targeted Investment program established by the state for inpatient services provided at eligible hospitals for the rating period covering October 1, 2021 through September 30, 2022 and incorporated in the capitation rates through a separate payment term of up to $1.7 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
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