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 31 - 40 of 641
SDP Identifier:: WA_Fee_BHO3_New_20230101-20231231
State: Washington
Summary: The uniform increase established by the state for eligible providers delivering opioid treatment 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:
Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI2.BHO2_Renewal_20240101-20241231
State: Washington
Summary:
Renewal of the uniform increase established by the state for behavioral health inpatient and behavioral health outpatient services for the rating period covering January 1, 2024 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:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI2.BHO2_New_20230101-20231231
State: Washington
Summary: Uniform increase established by the state for behavioral health inpatient and behavioral health outpatient 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:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI2.BHO2_Amend_20240101-20241231
State: Washington
Summary:
Uniform increase established by the state for behavioral health inpatient and behavioral health outpatient services for the rating period covering January 1, 2024 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:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI.BHO3_Renewal_20250101-20251231
State: Washington
Summary:
Uniform increase established by the state for behavioral health inpatient and outpatient services delivered by eligible providers for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI.BHO3_New_20240101-20241231
State: Washington
Summary:
The uniform increase established by the state for behavioral health inpatient and outpatient services delivered by eligible providers for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI.BHO3_Amend_20240101-20241231
State: Washington
Summary:
Uniform increase established by the state for behavioral health inpatient and outpatient services delivered by eligible providers for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_AMC_Renewal_20240101-20241231
State: Washington
Summary:
Renewal of a uniform increase established by the state for qualified licensed professionals employed by the University of Washington and/or a member of its affiliated physician practice plans or employed by a public hospital or other public entity 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 $109 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:: WA_Fee_AMC_Renewal_20230101-20231231
State: Washington
Summary: Uniform increase established by the state for qualified licensed professionals employed by the University of Washington and/or a member of its affiliated physician practice plans or employed by a public hospital or other public entity 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 $90 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:: VT-VBP-Oth1-New-20230101-20231231
State: Vermont
Summary:
The value-based payment arrangement for community-based residential substance use treatment facilities 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:
Value-based payment
Provider Class:
Other
Review Type: New
Approval Period: Single Rating Period
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