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 71 - 80 of 677
SDP Identifier:: LA_Fee_HCBS2_Renewal_20240701-20250630
State: Louisiana
Summary:
Uniform dollar increase for pediatric home health nurses established by the state for home health services for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $3,307,280.
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:: LA_Fee_Oth1_Renewal_20240701-20250630
State: Louisiana
Summary:
Uniform increase for non-emergency medical transport providers for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $2,800,584.
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:: MA_VBP_IPH3_Amend_20230401-20241231
State: Massachusetts
Summary:
The Hospital Quality Incentive proposal for non-federal, non-state owned, public hospitals for inpatient hospital services for the rating period covering April 1, 2023 through December 31, 2024 incorporated into the capitation rates through a separate payment term of up to $93.8 million for April 1, 2023 through December 31, 2023 and $160.8 million for January 1, 2024 through December 31, 2024.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: MA_VBP_IPH.OPH2_Amend_20230401-20241231
State:
Summary:
The Integrated Care Incentive proposal for inpatient and outpatient hospital services at non-federal, non-state-owned, public hospitals for the rating period covering April 1, 2023 through December 31, 2024 through a separate payment term of up to $86.8 million for April 1, 2023 through December 31, 2023 and $148.8 million for January 1, 2024 through December 31, 2024.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: MA_VBP_BHI.BHO_Amend_20230101-20241231
State: Massachusetts
Summary:
The Behavioral Health Quality Incentive proposal for non-federal, non-state-owned, public hospitals for behavioral health inpatient and outpatient services for the rating period covering January 1, 2023 through December 31, 2024 incorporated in the capitation rates through a separate payment term of up to $60 million for January 1, 2023 through December 31, 2023 and $72 million for January 1, 2024 through December 31, 2024.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Renewal
Approval Period: Multiple Rating Period
SDP Identifier:: MA_Fee_BHO.Oth2_Renewal_20240101-20241231
State: Massachusetts
Summary:
The minimum fee schedule for behavioral health outpatient services, 24 hour diversionary substance use disorder services and behavioral health diversionary services including the Program for Assertive Community Treatment (PACT), Recovery Coach (RC) and Recovery Support Navigator (RSN) Services, Community Based Acute Treatment (CBAT), Acute Treatment Services (ATS), Clinical Stabilization Services (CSS), and Residential Rehabilitation Services (RRS) for the rating period covering January 1, 2024 through December 31, 2024, incorporated into 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, Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PA_Fee_BHI.BHO_Renewal_20250101-20251231
State: Pennsylvania
Summary:
The alternative minimum fee schedule established by the state for qualifying providers under specific American Society of Addition Medicine (ASAM) levels of care who provided substance use disorder (SUD) treatment for the rating period covering January 1, 2025 through December 31, 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:
Behavioral health inpatient service, Behavioral health outpatient services
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: PA_Fee_Oth_Renewal_20250101-20251231
State: Pennsylvania
Summary:
The minimum fee schedule for providers involved in the Integrated Community Wellness Center (ICWC) for the rating period covering January 1, 2025 through December 31, 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:
Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: MA_Fee_BHO.Oth4_Renewal_20230101-20231231
State: Massachusetts
Summary:
The uniform increase for behavioral health outpatient services and behavioral health diversionary services established by the state for the rating period covering January 1, 2023 through December 31, 2023, provided by the MA Behavioral Health Partnership, Senior Care Options (SCO), or One Care plans, incorporated into 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, Other
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NM_VBP.Fee_IPH.OPH6_New_20240701-20241231
State: New Mexico
Summary:
Uniform increase and value-based payment arrangement established by the state to implement the Healthcare Delivery Access Act, for inpatient and outpatient hospital services for the rating period July 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $750 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: New
Approval Period: Single Rating Period
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