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 441 - 450 of 477
SDP Identifier:: WI_Fee_HCBS4_Renewal_20230101-20231231
State: Wisconsin
Summary: Uniform increase for Family Care and Family Care Partnership which is 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:: NC_Fee_OPH_Renewal_20220701-20230630
State: North Carolina
Summary: Minimum fee schedule for outpatient laboratory services provided by in-state acute care hospitals and critical access hospitals for the rating period covering July 1, 2022 through June 30, 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:
Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_AMC_Renewal_20230101-20231231
State: Washington
Summary: Uniform increase established by the state for qualified licensed professionals employed by the University of Washington and/or a member of its affiliated physician practice plans or employed by a public hospital or other public entity for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $90 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_HCBS_New_20230101-20231231
State: Vermont
Summary: Value-based payment arrangement for developmental disabilities services 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:
Value-based payment
Provider Class:
HCBS/personal care services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: vt-vbp-bho.oth-new-20230101-20231231
State: Vermont
Summary: Value-based payment arrangement for Vermont’s Northeastern Family Institute 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:
Value-based payment
Provider Class:
Behavioral health outpatient services, Other
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: KY_Fee.VBP_IPH.OPH.AMC_Amend_20230101-20231231
State: Kentucky
Summary: Uniform dollar increase with a quality performance payment arrangement established by the state for inpatient hospital services, outpatient hospital services, and professional services at an academic medical center for the rating period covering January 1, 2023 through December 31, 2023. The quality performance payment arrangement is incorporated in the capitation rates through a separate payment term of up to $323,362,543, and the uniform dollar increase is 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:
Inpatient hospital service, Outpatient hospital service, Professional services at an academic medical center
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: AZ_Fee_IP.OP.PC.SP.NF.HCBS.BHI.BHO.D_Renewal_20211001-20220930
State: Arizona
Summary: Uniform increase established by the state for Differential Adjusted Payments (DAP) program eligible providers for the rating period covering October 1, 2022 through September 30, 2023, and 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:
Behavioral health inpatient service, Behavioral health outpatient services, Dental services, HCBS/personal care services, Inpatient hospital service, Nursing facility services, Outpatient hospital service, Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_PC.BHO_Renewal_20211001-20220930
State:
Summary: Value based payment for targeted investment program established by the state for primary care and behavioral health outpatient focus areas for the rating period covering October 1, 2021 through September 30, 2022, and incorporated in the capitation rates through a separate payment term of up to $3.4 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services, Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WV_Fee_OTH1_Renewal_20220701-20230630
State: West Virginia
Summary: Uniform Increase for eligible Acute Care Hospitals established by the state for Physician and Specialty Physician Services 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 $35,413,059.
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:: AR_Fee_BHI_New_20220101-20221231
State: Arkansas
Summary: Uniform dollar increase for psychiatric residential treatment facilities not located in hospitals for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a separate payment term of up to $5,102,154.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service
Review Type: New
Approval Period: Single Rating Period
Results per page