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 591 - 600 of 677
SDP Identifier:: NY-Fee-OPH2-Renewal-20220401-20230331
State: New York
Summary:
The uniform increase for Critical Access Hospitals established by the state for outpatient services for the rating period covering April 1, 2022 through March 31, 2023, incorporated in the capitation rates through a separate payment term of up to $43,818,681.
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:: 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
SDP Identifier:: IL-Fee-IPH-OPH2-Amend-20220101-20221231
State: Illinois
Summary:
Uniform increase established by the state for inpatient and outpatient services at large non-state government 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 $396,200,000.
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:: NC-Fee-HCBS-BHO-Renewal-20230701-20240630
State: North Carolina
Summary:
Uniform dollar increase for home and community-based services and behavioral health outpatient services established by the state for the rating period covering July 1, 2023 through June 30, 2024, 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, HCBS/personal care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NY-Fee-HCBS-Renewal-20220401-20230331
State: New York
Summary:
The enhanced minimum fee schedule for home and community-based services approved through the state’s 1115 waiver for the rating period covering April 1, 2022 through March 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:: NY-Fee-HCBS5-New-20220401-20230331
State: New York
Summary:
The uniform increase for home and community-based services for eligible Health Home Providers for the rating period covering April 1, 2022 through March 31, 2023, incorporated in the capitation rates as a separate payment term of up to $280,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
HCBS/personal care services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: NM-Fee-OTH2-Renewal-20230101-20231231
State: New Mexico
Summary:
The uniform increase for EPSDT services established by the state for Private Duty Nursing and Home Health 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: FL-Fee-HCBS-BHO-Oth-New-20221001-20230930
State: Florida
Summary:
Uniform percentage increase established by the state for home and community-based services, behavioral health outpatient services, and eligible non-waiver services for the rating period covering October 1, 2022 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $296,534,267.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health outpatient services, HCBS/personal care services, Other
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: HI-VBP-Fee-IPH-OPH-Renewal-20230101-20231231
State: Hawaii
Summary:
• Pay for performance arrangement established by the state for public and private hospitals as defined in the preprint 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 $46.22 million;
• Uniform dollar increase established by the state for safety net hospitals owned and operated by a government agency 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 $78.1 million;
• Uniform percentage increase established by the state for inpatient and outpatient hospital services within privately-owned hospital provider classes for the rating period covering January 1, 2023 to December 31, 2023 incorporated in the capitation rates through a separate payment term of up to an estimated computable $166.69 million; and,
• Minimum and Maximum fee schedule established by the state for in-state general acute hospitals and children’s hospital services within in-state general acute hospital provider classes for the rating period of January 1, 2023 to December 31, 2023 incorporated in the capitation rates through a risk-based adjustment.
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: Renewal
Approval Period: Single Rating Period
SDP Identifier:: KS-Fee-IPH-OPH-Renewal-20230101-20231231
State: Kansas
Summary:
Uniform increase for eligible Kansas hospitals established by the state for inpatient and outpatient services 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 $408,981,220.
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
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