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
SDP Identifier:: UT_Fee_HCBS.BHI.BHO_Amend_20220701-20230630
A uniform percent increase for home and community based services providers, behavioral health providers, and school based services providers 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 $9,824,743.
SDP Identifier:: VT_VBP_HCBS.BHO.Oth_Renewal_20230101-20231231
The Value Based Payment for community mental health centers to deliver a continuum
of mental health services to adults and children via monthly case rates established by the
state for the rating period, January 1, 2023 through December 31, 2023, incorporated
into the capitation rates through a risk-based rate adjustment.
SDP Identifier:: VA_VBP_NF_Renewal_20240701-20250630
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.
SDP Identifier:: VA_Fee_IPH.OPH_Renewal_20240701-20250630
Uniform increase for inpatient and outpatient services at private acute care 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 $3.73 billion.
SDP Identifier:: NV_VBP.Fee_NF_New_20230101-20231231
Value-based payment established by the state for free standing nursing facilities for the rating period January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term up to $2.3 million.
SDP Identifier:: MI_Fee_HCBS3_Renewal_20231001-20240930
The uniform dollar increase established by the state for direct care workers providing personal care services to eligible enrollees for the rating period covering October 1, 2023 through September 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
SDP Identifier:: IA_Fee_IPH.OPH1_Renewal_20240701-20250630
Uniform increase for inpatient and outpatient hospital services provided at qualifying non-state owned or operated hospitals as defined in the Medicaid State Plan for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $1,478,197,798.
SDP Identifier:: IA_Fee_IPH.OPH_Renewal_20240701-20250630
Uniform increase for inpatient and outpatient hospital services provided at qualifying Iowa state-owned or operated teaching hospitals as defined in the Medicaid State Plan for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $601,938,536.64.
SDP Identifier:: MI_Fee_NF_Renewal_20240101-20241231
Uniform dollar increase for nursing facility services for the rating period covering January 1, 2024 through December 31, 2024 incorporated in the capitation rates through a separate payment term of up to $32,900,000.
SDP Identifier:: MI_Fee_HCBS1_Renewal_20240101-20241231
The uniform dollar increase established by the state for direct care workers providing personal care services to eligible enrollees for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.