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 621 - 630 of 677
SDP Identifier:: NY_Fee_HCBS4_Renewal_20220101-20221231
State: New York
Summary: A uniform dollar increase for direct care services delivered to individuals with intellectual and developmental disabilities by FIDA-IDD providers 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 $19.22 million.
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:: OR_Fee_IPH.OPH1_Renewal_20230101-20231231
State: Oregon
Summary: Uniform increase established by the state for inpatient and outpatient hospital services provided by Rural Type A/B 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 $146,000,000.
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:: OR_Fee_IPH.OPH2_Renewal_20230101-20231231
State: Oregon
Summary: Uniform increase established by the state for inpatient and outpatient hospital services provided by Diagnosis-Related Group (DRG) 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 $600,000,000.
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:: KS_Fee_AMC_New_20230101-20231231
State: Kansas
Summary: Uniform percentage increase established by the state for Teaching Professional Access Program eligible providers 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 $16,000,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: TN_Fee_NF_Renewal_20230101-20231231
State: Tennessee
Summary: Uniform increase for 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 $124,356,740.
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:: NY_Fee_IPH.BHI_Amend_20210401-20220331
State: New York
Summary: A uniform dollar increase for inpatient and outpatient services delivered by qualifying financially distressed hospitals for the rating period covering April 1, 2021 through March 31, 2022, incorporated into the capitation rates as a risk-based rate adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Inpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: VA_Fee_AMC_Amend_20210701-20220630
State: Virginia
Summary: The uniform increase established by the state for physicians affiliated with the practice plans of Virginia’s three allopathic medical schools: University of Virginia, Virginia Commonwealth University, and Eastern Virginia Medical Center, 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 $185.1 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: OH_Fee_Oth2_Amend2_20220101-20221231
State: Ohio
Summary: Uniform percentage increase for HCBS and personal services care established by the state utilizing 9817 American Recovery Plan (ARP) funding for the rating period covering January 1, 2022 to December 31, 2022 incorporated in the capitation rates through separate payment term of up to $66,384,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: NJ_Fee_IPH.OPH.AMC.PC.SP.BHI.BHO.D_Amend_20220701-20230630
State:
Summary: Alternative fee schedules established by the state for professional services provided by qualified providers affiliated with schools of medicine or dentistry who participate in the Medicaid Access to Physician Services (MAPS) program 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:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services, Dental services, Inpatient hospital service, Outpatient hospital service, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_IP_Renewal_20211001-20220930
State: Arizona
Summary: Value Based Payment for targeted Investment program established by the state for inpatient services provided at eligible hospitals for the rating period covering October 1, 2021 through September 30, 2022 and incorporated in the capitation rates through a separate payment term of up to $1.7 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
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