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 21 - 30 of 677
SDP Identifier:: AZ_Fee_NF_Renewal_20241001-20250930
State: Arizona
Summary:
Uniform dollar increase established by the state for nursing facility services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a separate payment term up to $92,400,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.AMC.PC.SP.NF_Renewal_20250101-20251231
State: California
Summary:
Uniform increases established by the state for eligible Designated Public Hospital Systems for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $3,865,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.NF_Renewal_20250101-20251231
State: California
Summary:
Uniform dollar increase established by the state for inpatient and outpatient hospital services at District Hospitals for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $842,391,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_VBP_IPH.OPH_Renewal_20250101-20251231
State: California
Summary:
Quality Incentive Pool for District and Municipal Public Hospital Systems for the rating period of January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $178,517,000.
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:: CA_VBP_IPH.OPH2_Renewal_20250101-20251231
State: California
Summary:
Quality Incentive Pool for Designated Public Hospital systems for the rating period of January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $3,463,690,000.
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:: KY_VBP.Fee_IPH.OPH.AMC2_New_20250101-20251231
State: Kentucky
Summary:
Uniform dollar increase and value-based payment established by the state for inpatient and outpatient hospital services and professional services at an academic medical center for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $135,747,624.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service, Professional services at an academic medical center
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: OR_Fee_ Oth2_Renewal_20250101-20251231
State: Oregon
Summary:
Uniform dollar increase for ground emergency medical transportation for privately-owned providers, established by the state for the rating period covering January 1, 2025, through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $27,629,600.
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:: OR_Fee_ Oth_Renewal_20250101-20251231
State: Oregon
Summary:
Uniform dollar increase for governmental units providing ground emergency medical transportation, established by the state for the rating period covering January 1, 2025, through December 31, 2025, incorporated in the capitation rates through a separate payment term of up to $23,069,255.
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:: TN_Fee_IPH.OPH4_New_20240101-20241231
State: Tennessee
Summary:
Uniform percentage increase established by the state for eligible inpatient and outpatient hospital services for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term of up to $1,602,057,288.50.
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:: NM_VBP.Fee_NF2_Amend_20240701-20241231
State: New Mexico
Summary:
Amendment to 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: Amendment
Approval Period: Single Rating Period
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