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 131 - 140 of 677
SDP Identifier:: KS_VBP_IPH.OPH_Renewal_20240101-20251231
State: Kansas
Summary:
Value Based Payment to meet or exceed the performance measure benchmarks on specific provider quality metrics for the inpatient and outpatient services to receive incentive payments for the rating period covering January 1, 2024 through December 31, 2025 for a multi-year period, incorporated in the capitation rates through a separate payment term of up to $60,000,000.
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:: TX_VBP.Fee_IPH.OPH.BHI_Renewal_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 outpatient services, Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_VBP_PC_Renewal_20220101-20221231
State: Massachusetts
Summary:
The proposal requiring that Managed Care Organizations (MCO) share savings/losses with MCO-administered Accountable Care Organizations (ACO) for the rating period covering January 1, 2022 – December 31, 2022.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_VBP_PC_Renewal_20230101-20230331
State: Massachusetts
Summary:
The proposal requiring that Managed Care Organizations (MCO) share savings/losses with MCO-administered Accountable Care Organizations (ACO) for the rating period covering January 1, 2023 – March 31, 2023.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: RI_Fee_OPH_Renewal_20240701-20250630
State: Rhode Island
Summary:
Uniform increase established by the state for eligible outpatient hospital 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:
Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: RI_Fee_OPH1_Renewal_20240701-20250630
State: Rhode Island
Summary:
Uniform increase established by the state for eligible outpatient hospital 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:
Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_BHO.Oth1_New_20240101-20241231
State: Vermont
Summary:
Value based payment arrangement for Children’s Integrated Services (CIS) providers established by the state for the rating period 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, Other
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_IPH.OPH_Amend_20210701-20220630
State: Georgia
Summary:
Uniform percentage increase for inpatient and outpatient hospital 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 $234,676,123.
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:: NM_VBP.Fee_NF2_Renewal_20240701-20241231
State: New Mexico
Summary:
Renewal of a value-based purchasing and uniform percent increase arrangement established by the state to increase nursing facility per diem rates by the market basket index (MBI) factor and to provide quality incentive payments for nursing facilities that meet performance requirements on specified quality metrics for the rating period covering July 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
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