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 51 - 60 of 641
SDP Identifier:: VT_VBP_BHO_Renewal_20240101-20261231
State: Vermont
Summary:
Value-based payment arrangement for the Applied Behavior Analysis (ABA) Tiered Payment Model for the rating periods covering January 1, 2024 through December 31, 2026, 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:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Multiple Rating Period
SDP Identifier:: VT_VBP_BHO_Renewal_20240101-20241231
State: Vermont
Summary:
Value-based payment arrangement for Vermont’s Northeastern Family Institute 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:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_BHO_New_20230101-20231231
State: Vermont
Summary: Value-based payment arrangement for the Applied Behavior Analysis (ABA) Tiered Payment Model 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:
Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: VA_VBP_NF_Renewal_20240701-20250630
State: Virginia
Summary:
The quality payment established by the state for nursing facility services 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 $144.1 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VA_VBP_NF_Renewal_20231001-20240630
State: Virginia
Summary:
The quality payment established by the state for nursing facility services for the rating period covering October 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $81.1 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VA_VBP_NF_Renewal_20230701-20230930
State: Virginia
Summary:
The quality payment established by the state for nursing facility services for the rating period covering July 1, 2023 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $27 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VA_VBP_NF_Amend_20240701-20250630
State: Virginia
Summary:
The quality payment established by the state for nursing facility services 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 $184.9 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: VA_VBP_NF_Amend_20220701-20230630
State: Virginia
Summary:
The quality payment established by the state for nursing facility services for the rating period covering July 1, 2022 through June 30, 2023, incorporated in the capitation rates through a separate payment term of up to $59,311,250.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Nursing facility services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: VA_Fee_SP_Renewal_20240701-20250630
State: Virginia
Summary:
Uniform increase for physician services provided by physicians who participate in Children’s Specialty Group, affiliated with Children’s Hospital of the King’s Daughters, for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $11,050,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VA_Fee_SP_New_20231001-20240630
State: Virginia
Summary:
Uniform increase for physician services provided by physicians who participate in Children’s Specialty Group, affiliated with Children’s Hospital of the King’s Daughters, for the rating period, October 1, 2023 through June 30, 2024, incorporated into the capitation rates through a separate payment term up to $11,050,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Specialty physician services
Review Type: New
Approval Period: Single Rating Period
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