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 581 - 590 of 677
SDP Identifier:: RI_VBP_PC_Renewal_20220701-20230630
State: Rhode Island
Summary:
The value-based payment Patient Centered Medical Home (PCMH)-Kids initiative established by the state for eligible pediatric providers 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:
Value-based payment
Provider Class:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_Fee_IPH.OPH.NF_New_20230101-20231231
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, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $200,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Nursing facility services, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: MI_Fee_HCBS2_Renewal_20221001-20230930
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, 2022 until September 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:
HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: KY_Fee.Oth2_Renewal_20220101-20221231
State: Kentucky
Summary:
Minimum fee schedule established by the state for outpatient pharmacy services for the rating period covering January 1, 2022 through December 31, 2022, 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: SC_Fee_AMC_Renewal_20230701-20240630
State: South Carolina
Summary:
Uniform increase established by the state for physicians providing professional services employed by or under contract with a South Carolina public medical university, academic medical center or its component units, or an SC Area Health Education Consortium (AHEC) Teaching Health System for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $133,000,000.
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:: MS_Fee_IPH.OPH_Amend_20210701-20220630
State: Mississippi
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital services for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a separate payment term of up to $533,110,956.00.
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_IPH.OPH_Amend2_20220701-20230630
State: Mississippi
Summary:
Uniform percentage increase established by the state for inpatient and outpatient hospital 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 $601,153,602.00.
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:: CA-Fee-PC-SP-BHO-Renewal-20230101-20231231
State: California
Summary:
Uniform dollar increases established by the state for specific services provided by network physicians 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, Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WV-Fee-IPH-OPH-AMC-PC-Amend-20220701-20230630
State: West Virginia
Summary:
The Uniform Increase for eligible Acute Care Hospitals established by the state for Inpatient, Outpatient, and 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 $343,997,344.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service, Primary care services, Professional services at an academic medical center
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: IL-Fee-AMC-Renewal-20230101-20231231
State: Illinois
Summary:
Uniform increase established by the state for services provided by physicians employed by State-owned medical schools 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 $145,400,000.
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
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