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 71 - 80 of 641
SDP Identifier:: GA_Fee_IPH.OPH2_Renewal_20240701-20250630
State: Georgia
Summary:
Uniform percentage increase for inpatient and outpatient hospital services established by the state 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 $875,434,461.
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:: GA_Fee_IPH.OPH3_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:: GA_Fee_IPH.OPH3_Renewal_20240701-20250630
State: Georgia
Summary:
Uniform percentage increase for inpatient and outpatient hospital services established by the state 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 $235,544,261.
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:: GA_Fee_OPH.PC.SP.BHO.D.Oth_New_20230701-20240630
State: Georgia
Summary:
Uniform percentage increase for outpatient hospital services, primary care services, specialty physician services, behavioral health outpatient services, dental services, and providers providing EPSDT services, established by the state for the rating period covering July 1, 2023, through June 30, 2024, incorporated in the capitation rates through a rate adjustment of up to $5,700,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services, Dental services, Other, Outpatient hospital service, Primary care services, Specialty physician services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: GA_Fee_Oth1 _Amend_20210701-20220630
State: Georgia
Summary:
Uniform percentage increase for physician and other eligible professional services established by the state for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a separate payment term of up to $129,984,744.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: GA_Fee_Oth1_Renewal_20230701-20240630
State: Georgia
Summary:
The uniform percentage increase for physician and other eligible professional services 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 $210,433,377.
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:: GA_Fee_Oth1_Renewal_20240701-20250630
State: Georgia
Summary:
Uniform percentage increase for physician and other eligible professional services established by the state 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 $243,635,566.
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:: GA_VBP.Fee_IPH.OPH_Renewal_20230701-20240630
State: Georgia
Summary:
The GA-AIDE uniform increase and performance improvement initiative for inpatient and outpatient hospital services 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 $463,642,464.
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:: GA_VBP.Fee_IPH.OPH_Renewal_20240701-20250630
State: Georgia
Summary:
GA-AIDE uniform percentage increase and performance improvement initiative for inpatient and outpatient hospital services established by the state 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 $586,314,764.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: HI_Fee_NF.Oth_Amend_20220701-20221231
State: Hawaii
Summary:
Uniform percentage increase established by the state for nursing facility services, community care foster homes (CCFH), and expanded adult residential care homes (E-ARCHs) for the rating period of July 1, 2022 to December 31, 2022, incorporated into the capitation rates through a separate payment term of up to $47,694,753.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services, Other
Review Type: Amendment
Approval Period: Single Rating Period
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