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 651 - 660 of 677
SDP Identifier:: UT_Fee_BHO_Renewal_20220701-20230630
State: Utah
Summary: Alternative fee schedule established by the state for behavioral health services 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 outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHI2.BHO2_New_20230101-20231231
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, 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 inpatient service, Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_BHO3_New_20230101-20231231
State: Washington
Summary: The uniform increase established by the state for eligible providers delivering opioid treatment services 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
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_Oth_Renewal_20230101-20231231
State: Vermont
Summary: Value-based payment arrangement for the High-Technology Nursing Program 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:
Value-based payment
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_IPH.OPH.AMC.PC.SP_Renewal_20230101-20231231
State: Vermont
Summary: Value-based payment arrangement for the Vermont Medicaid Next Generation (VMNG) ACO program 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:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service, Primary care services, Professional services at an academic medical center, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: VT_VBP_BHO_New_20230101-20231231
State: Vermont
Summary: Value-based payment arrangement for the Applied Behavior Analysis (ABA) Tiered Payment Model 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:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_PC_Renewal_20230101-20231231
State: Washington
Summary: Uniform increase established by the state for primary care services for all eligible 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:
Primary care services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: HI_Fee_PC.SP.Oth_Renewal_20230101-20231231
State: Hawaii
Summary: Minimum fee schedule established by the state for primary care services, specialty physician services, obstetricians, gynecologists, nurse practitioners, advance practice registered nurses, and physician assistants as defined in the preprint 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, Primary care services, Specialty physician services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_BHO_Renewal_20211001-20220930
State: Arizona
Summary: Targeted Investment program established by the state for behavioral health outpatient ambulatory focus areas 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 $22.4 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: WA_Fee_OTH2_Renewal_20230101-20231231
State: Washington
Summary: Minimum fee schedule established by the state for trauma center physician services 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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