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 21 - 30 of 641
SDP Identifier:: AZ_VBP_PC_Amend_20211001-20220930
State: Arizona
Summary:
The Targeted Investment program for Primary Care Providers established by the state for the rating period covering October 1, 2021 through September 30, 2022 incorporated in the capitation rates through a separate payment term of up to $21.7 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Primary care services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_PC_Renewal_20211001-20220930
State: Arizona
Summary: Value Based Payment for the targeted investment program for Primary Care Providers established by the state for the rating period covering October 1, 2021 through September 30, 2022 incorporated in the capitation rates through a separate payment term of up to $21.1 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_PC.BHO_Renewal_20211001-20220930
State:
Summary: Value based payment for targeted investment program established by the state for primary care and behavioral health outpatient 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 $3.4 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services, Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP.Fee_PC.BHO.Oth_New_20221001-20230930
State: Arizona
Summary:
The value-based payment and uniform increase by the state for primary care, behavioral health outpatient, and justice involved clinic services for the rating period October 1, 2022 through September 30, 2023, incorporated into the capitation rates through a separate payment term up to $18.5 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Behavioral health outpatient services, Other, Primary care services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_D_Renewal_20240101-20241231
State: California
Summary:
Uniform dollar increase established by the state for dental services for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Dental services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.AMC.PC.SP.NF_Renewal_20230101-20231231
State: California
Summary:
Uniform increases established by the state for eligible Designated Public Hospital Systems for the rating period covering July 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $1,982,556,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.AMC.PC.SP.NF_Renewal_20240101-20241231
State: California
Summary:
Uniform increases established by the state for eligible Designated Public Hospital Systems for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $2,478,195,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.NF_New_20230101-20231231
State: California
Summary:
Uniform dollar increase established by the state for inpatient and outpatient hospital services at District Hospitals for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $200,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.NF_Renewal_20240101-20241231
State: California
Summary:
Uniform dollar increase established by the state for inpatient and outpatient hospital services at District Hospitals for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $207,290,924.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH1_Renewal_20230101-20231231
State: California
Summary:
Uniform increase for inpatient and outpatient services provided by private hospitals as
defined in CA Welfare & Institutions Code § 14169.51(ap) for the rating period covering
January 1, 2023 through December 31, 2023, incorporated in the capitation rates through
a separate payment term of up to $5,392,730,897.
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
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