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 31 - 40 of 677
SDP Identifier:: NM_VBP.Fee_NF_Amend_20240701-20241231
State: New Mexico
Summary:
Amendment to the value-based payment and uniform increase established by the state for participating nursing facilities that demonstrate quality improvement for the rating period covering July 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, Value-based payment
Provider Class:
Nursing facility services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: IL_Fee_IPH5_New_20240101-20241231
State: Illinois
Summary:
The uniform increase for long term acute care hospitals established by the state for inpatient hospital services for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $1,750,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: IA_Fee_AMC_Amend_20220701-20230630
State: Iowa
Summary:
Uniform increase for physician and professional services provided at qualifying Iowa state-owned or operated professional services practices for the rating period covering July 1, 2022 through June 30, 2023, incorporated into the capitation rates through a separate payment term up to $113,808,126.
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:: IA_Fee_IPH.OPH_Amend_20220701-20230630
State: Iowa
Summary:
Uniform increase for inpatient and outpatient hospital services at qualifying Iowa state owned or operated teaching hospitals for the rating period covering July 1, 2022 through June 30, 2023, incorporated into the capitation rates through a separate payment term up to $481,979,441.
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:: WI_Fee_HCBS5_Amend_20240101-20241231
State: Wisconsin
Summary:
Uniform percentage increase established by the state for eligible home and community-based 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 $151,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
HCBS/personal care services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: UT_Fee_BHO_Renewal_20240701-20250630
State: Utah
Summary:
An alternative fee schedule established by the state for behavioral health outpatient services for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a risk-based adjustment.
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:: OK_Fee_IPH.OPH1_Amendment_20240401-20250630
State: Oklahoma
Summary:
Uniform increase for inpatient and outpatient hospital services at private, non-state government, and critical access hospitals for the rating period covering April 1, 2024 through June 30, 2025 incorporated in the capitation rates through a separate payment term of up to $1,262,703,035.
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:: MS_Fee.VBP_AMC_Renewal_20240701-20250630
State: Mississippi
Summary:
Uniform percentage increase and performance improvement initiative established by the state for professional services at an academic medical center 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 $29,526,177.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: OR_Fee_IPH.OPH5_New_20240101-20241231
State: Oregon
Summary:
Uniform dollar increase for inpatient and outpatient hospital services established by the state 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 $9,500,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Other
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: OR_Fee_IPH.OPH4_New_20240101-20241231
State: Oregon
Summary:
Uniform dollar increase for inpatient and outpatient hospital services, established by the state 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 $45,410,000.
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
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