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
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Displaying 41 - 50 of 641
SDP Identifier:: CA_VBP_IPH.OPH2_Amend_20210101-20231231
State: California
Summary:
Quality Incentive Pool for Designated Public Hospital systems for the rating periods covering January 1, 2021 through December 31, 2023, incorporated in the CY 2023 capitation rates through a separate payment term of up to $2,040,316,388.17.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Multiple 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:: CA_VBP_IPH.Oth_New_20220101-20241231
State: California
Summary: Value-based payment arrangement for providers of eligible organ and bone marrow transplant services for the rating periods covering January 1, 2022 through December 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Other
Review Type: New
Approval Period: Multiple Rating Period
SDP Identifier:: CA-Fee-D-Renewal-20230101-20231231
State: California
Summary:
Uniform dollar increase established by the state for dental services for the rating period covering January 1, 2023 through December 31, 2023, 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:
Dental services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA-Fee-PC-SP-BHO-Renewal-20230101-20231231
State: California
Summary:
Uniform dollar increases established by the state for specific services provided by network physicians for the rating period covering January 1, 2023 through December 31, 2023, 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 outpatient services, Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: DC_Fee_IPH_New_20231001-20240930
State: District of Columbia
Summary:
The maximum fee schedule for inpatient hospital services established by the state for the rating period, October 1, 2023 through September 30, 2024, 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:
Inpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: DC_Fee_OPH_New_20231001-20240930
State: District of Columbia
Summary:
The maximum fee schedule for outpatient hospital services established by the state for the rating period, October 1, 2023 through September 30, 2024, 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:
Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: DE_Fee_NF_New_20230101-20231231
State: Delaware
Summary:
Uniform increase established by the state for nursing facility services 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 $25,464,731.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: FL_Fee_AMC_Renewal_ 20231001-20240930
State: Florida
Summary:
Uniform percentage increase established by the state for professional services at an academic medical center for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $326,033,561.
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:: FL_Fee_AMC_Renewal_20221001-20230930
State: Florida
Summary:
Uniform percentage increase established by the state for professional services at an academic medical center for the rating period covering October 1, 2022 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $265,157,436.
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
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