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 61 - 70 of 677
SDP Identifier:: MA_VBP_PC2_New_20230401-20231231
State: Massachusetts
Summary:
Primary Care Sub capitated Arrangement established by the state for the rating period, April 1, 2023 through December 31, 2023, 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: New
Approval Period: Single Rating Period
SDP Identifier:: DC_Fee_OPH_New_20231001-20240930
State: District of Columbia
Summary:
The maximum fee schedule for outpatient hospital services established by the state for the rating period, October 1, 2023 through September 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:
Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: OR_Fee_BHO1_Renewal_20250101-20251231
State: Oregon
Summary:
Minimum fee schedule for behavioral health services furnished by qualified providers for the rating period covering January 1, 2025 through December 31, 2025, incorporated into 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:: OR_Fee_BHO2_Renewal_20250101-20251231
State: Oregon
Summary:
Uniform increase established by the state for behavioral health services furnished by qualified providers, including Traditional Health Workers, while providing Culturally and Linguistically specific services (CLSS) and certification standards for the rating period covering January 1, 2025 through December 31, 2025.
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:: OR_Fee_BHO3_Renewal_20250101-20251231
State: Oregon
Summary:
Uniform increase established by the state for behavioral health services furnished by qualified providers delivering services to members with co-occurring disorders (COD) for the rating period covering January 1, 2025 through December 31, 2025, incorporated into 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:: RI_VBP.Fee_PC_Renewal_20240701-20250630
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 July1, 2024 through June 30, 2025, 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:: RI_Fee_NF2_Amend_20240701-20250630
State: Rhode Island
Summary:
The uniform increase established by the state for nursing facility services for the rating period covering July 1, 2024 through June 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:
Nursing facility services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI.BHO3_Amend_20240101-20241231
State: Washington
Summary:
Uniform increase established by the state for behavioral health inpatient and outpatient services delivered by eligible providers for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI2.BHO2_Amend_20240101-20241231
State: Washington
Summary:
Uniform increase established by the state for behavioral health inpatient and behavioral health outpatient services for the rating period covering January 1, 2024 through December 31, 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 inpatient service, Behavioral health outpatient services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: IN_Fee_NF_New_20240701-20250630
State: Indiana
Summary:
A uniform increase for nursing facilities established by the state based on Medicaid nursing facility utilization and quality performance metrics for the rating period July 1,2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $180.7 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services
Review Type: New
Approval Period: Single Rating Period
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