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 611 - 620 of 677
SDP Identifier:: HI-VBP-Fee-NF-Renewal-20230101-20231231
State: Hawaii
Summary:
• Pay for performance arrangement established by the state for public and private nursing facilities 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 $2.62 million;
• Uniform dollar increase established by the state for nursing facility services within government-owned nursing facilities 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 $32.14 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule, Value-based payment
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: KY_Fee.VBP_IPH.OPH.AMC_Renewal_20240101-20241231
State: Kentucky
Summary: * Uniform increase established by the state for inpatient and outpatient hospital services and professional services at an academic medical center for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a risk-based adjustment;
* Value-based payment established by the state for inpatient and outpatient hospital services and professional services at an academic medical center 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 $350,245,828.
* Value-based payment established by the state for inpatient and outpatient hospital services and professional services at an academic medical center 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 $350,245,828.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service, Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MI_Fee_NF_Renewal_20230101-20231231
State: Michigan
Summary: Uniform dollar increase for nursing facility 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 $28,600,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WI_Fee_Oth_Renewal_20230101-20231231
State: Wisconsin
Summary: The minimum and maximum fee schedules established by the state for the rating period covering January 1, 2023 through 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
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PR_Fee_IPH_Renewal_20230101-20230930
State: Puerto Rico
Summary: Uniform dollar increase for inpatient hospital services at qualifying short-term acute care (STAC) hospitals for the rating period covering January 1, 2023 through September 30, 2023 incorporated in the capitation rates through a separate payment term of up to $77,233,837
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:: PR_Fee_PC_Renewal_20230101-202300930
State: Puerto Rico
Summary: Uniform increase established by the state for eligible primary care services for the rating period covering January 1, 2023 through September 30, 2023 incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: CA_VBP_IPH.Oth_New_20220101-20241231
State: California
Summary: Value-based payment arrangement for providers of eligible organ and bone marrow transplant services for the rating periods covering January 1, 2022 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:
Value-based payment
Provider Class:
Inpatient hospital service, Other
Review Type: New
Approval Period: Multiple Rating Period
SDP Identifier:: WI_Fee_BHO_Renewal_20230101-20231231
State: Wisconsin
Summary: Minimum and maximum fee schedule for Sub-Acute Psychiatric Community-Based Psychiatric and Recovery Center Services for the rating period covering January 1, 2023 through 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
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: TN_Fee_IPH.OPH1_Renewal_20230101-20231231
State: Tennessee
Summary: Uniform increase established by the state for inpatient and outpatient services provided at eligible hospitals 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:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: TN_Fee_Oth1_Renewal_20230101-20231231
State: Tennessee
Summary: Uniform dollar increase established by the state for ground ambulance service 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
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