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 51 - 60 of 677
SDP Identifier:: MA_Fee_BHO4_Renewal_20230101-20231231
State: Massachusetts
Summary:
Minimum Fee Schedule established by the State for the Program of Assertive Community Treatment (PACT) 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:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MS_Fee.VBP_IPH.OPH_Amend_20240701-20250630
State: Mississippi
Summary:
Uniform percentage increase and performance improvement initiative payments established by the state for eligible inpatient and 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 $1,540,423,694.
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: Amendment
Approval Period: Single Rating Period
SDP Identifier:: IL_Fee_OPH5_New_20240101-20241231
State: Illinois
Summary:
The uniform increase for critical access hospitals established by the state for outpatient 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 $13,500,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: KS_Fee_IPH.OPH2_New_20240101-20241231
State: Kansas
Summary:
Uniform percentage increase for inpatient and outpatient hospital services provided by eligible general hospitals, 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 $41,000,000.
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
SDP Identifier:: MI_Fee_HCBS2_Renewal_20241001-20250930
State: Michigan
Summary:
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, 2024 until September 30, 2025 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:: NM_Fee_Oth_New_20240101-20240630
State: New Mexico
Summary:
A uniform dollar increase established by the state for eligible public and government-owned emergency medical transport providers for the rating period covering January 1, 2024 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $7.72 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: MA_VBP_BHI.BHO2_New_20230101-20241231
State: Massachusetts
Summary:
Continuous Quality Improvement (CQI) value-based payment arrangement established by the state for inpatient and outpatient behavioral health services provided in private acute hospitals for the rating periods covering January 1, 2023 through December 31, 2024, incorporated into the capitation rates through a separate payment term of up to $4,393,000 in the Massachusetts Behavioral Health Partnership program.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: New
Approval Period: Multiple Rating Period
SDP Identifier:: MA_Fee_IPH_Renewal_20240101-20241231
State: Massachusetts
Summary:
Minimum Fee Schedule and Maximum Fee Schedule for inpatient hospital discharges from freestanding pediatric hospitals with a MassHealth DRG weight of 3.0 or greater and hospitals with a pediatric specialty unit with a MassHealth DRG weight of 3.0 or greater, using an approved State plan fee schedule for the rating period covering January 1, 2024 – December 31, 2024.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_VBP_PC2_Renewal_20240101-20241231
State: Massachusetts
Summary:
Primary Care Sub capitated Arrangement established by the state for the rating period, January 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:
Value-based payment
Provider Class:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NV_VBP_Oth_Renewal_20250101-20251231
State: Nevada
Summary:
Value based payment for Certified Community Behavioral Health Centers (CCBHCs) 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 $1,601,799.59.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
Results per page