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 111 - 120 of 677
SDP Identifier:: AZ_Fee_AMC_Amend2_20221001-20230930
State: Arizona
Summary:
Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2022 through September 30, 2023, incorporated into the capitation rate through a separate payment term of up to $203.7 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_OPH_New_20240701-20250630
State: New Jersey
Summary:
A uniform dollar increase for acute care hospitals established by the state for outpatient hospital services for the rating period July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $543,923,045.
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:: NJ_VBP_Oth_Renewal_20240701-20250630
State: New Jersey
Summary:
A perinatal episode of care pilot established by the state for the rating period covering July 1, 2024 through June 30, 2025 incorporated into the capitation rates through a risk based rate adjustment and separate payment term of up to $3.5 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Other
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:: MO_Fee_AMC.PC.SP.D.Oth_Renewal_20240701-20250630
State: Missouri
Summary:
Uniform percentage increases for the professional services of designated providers affiliated with one of the qualifying hospitals 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 $42,885,009.17.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Dental services, Other, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_IPH.OPH1_Renewal_20240701-20250630
State: North Carolina
Summary:
Uniform dollar increase established by the state for inpatient and outpatient hospital services at ECU Health Medical Center for the rating period covering July 1, 2024through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $71,730,243.
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:: NC_Fee_IPH.OPH2_Renewal_20240701-20250630
State: North Carolina
Summary:
Uniform dollar increase established by the state for inpatient and outpatient hospital services at UNC Health Care System hospitals for the rating period covering July 1, 2024through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $134,409,751.
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:: RI_Fee_Oth_Renewal_20240701-20250630
State: Rhode Island
Summary:
Uniform increase established by the state for shared living services for the rating period July 1, 2024 through June 30, 2025, 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: SC_Fee_AMC_Renewal_20240701-20240630
State: South Carolina
Summary:
Uniform increase established by the state for physicians providing professional services employed by or under contracts with a South Carolina public medical university, academic medical center or its component units, or an SC Area Health Education Consortium (AHEC) Teaching Health System for the rating period covering July 1, 2024through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $145,000,000.
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:: TX_VBP.Fee_IPH.OPH.BHI_Amend_20240901-20250831
State: Texas
Summary:
Comprehensive Hospital Increase Reimbursement Program (CHIRP) for the rating period covering September 1, 2024 through August 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Behavioral health inpatient service, Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
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