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 191 - 200 of 677
SDP Identifier:: MA_VBP_IPH.OPH5_New_20230101-20230331
State: Massachusetts
Summary:
The Hospital Quality Incentive proposal for the rating period covering January 1, 2023 through March 31, 2023, incorporated in the capitation rates through a separate payment term of up to $37.5 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_HCBS3_Renewal_20230401-20231231
State: Massachusetts
Summary:
Uniform increase established by the state for eligible home and community-based service (HCBS) providers for the rating period covering April 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:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_HCBS2_Renewal_20230101-20231231
State: Massachusetts
Summary:
Uniform increase established by the state for eligible home and community-based service (HCBS) providers 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:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MS_Fee.VBP_IPH.OPH_Renewal_20240701-20250630
State: Mississippi
Summary:
Uniform percentage increase and performance improvement initiative payments established by the state for inpatient and outpatient hospital 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 $1,565,840,324.
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:: NY_Fee_PC_New_20240401-20250331
State: New York
Summary:
Minimum fee schedules established by the state for eligible primary care providers who have active New York State Patient Centered Medical Home (PCMH) recognition for assigned members for the rating period, April 1, 2024 through March 31, 2025, incorporated into the capitation rates through a separate payment term up to $203,730,871.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Primary care services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: FL_Fee_PC.SP2_Renewal_20231001-20240930
State: Florida
Summary:
Uniform percentage increase established by the state for primary care services and specialty physician services at public hospitals for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $94,789,865.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MI_Fee_BHO_New_20231001-20240930
State: Michigan
Summary:
Minimum fee schedule authorized for the administration and services of Methadone established by the state for behavioral health outpatient services for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation 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:: OH_VBP.Fee_AMC.PC.SP.Oth_Amend_20240101-20241231
State: Ohio
Summary:
The Care Innovation and Community Improvement Program established by the state for the rating period covering January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk based rate adjustment and a separate payment term up to $28,091,682.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Other, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_IPH.OPH2_New_20240101-20241231
State: Washington
Summary:
The uniform percentage increase established by the state for inpatient and outpatient hospital services provided by eligible Critical Access Hospitals and Prospective Payment System Hospitals for the rating period January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term up to $1.818 billion.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: WI_Fee_HCBS2_Renewal_20240101-20241231
State: Wisconsin
Summary:
Uniform percentage increase established by the state for eligible home and community-based service (HCBS) providers for the rating period, January 1, 2024 through December 31, 2024, 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:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
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