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 91 - 100 of 677
SDP Identifier:: NH_Fee_BHO_Renewal_20240901-20250630
State: New Hampshire
Summary:
Uniform dollar increase for community mental health programs for the rating period covering September 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term of up to $4,166,666.67.
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:: MA_Fee_IPH.OPH3_Renewal_20240101-20241231
State: Massachusetts
Summary:
Maximum Fee Schedule for MassHealth contracted acute hospitals (except for specialty cancer hospitals, freestanding pediatric hospitals for an inpatient discharge with a MassHealth DRG Weight of 3 or greater) 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:
Inpatient hospital service, Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_PC_Amend_20211001-20220930
State: Arizona
Summary:
The Targeted Investment program for Primary Care Providers established by the state for the rating period covering October 1, 2021 through September 30, 2022 incorporated in the capitation rates through a separate payment term of up to $21.7 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Primary care services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: AZ_VBP_BHO_Amend_20211001-20220930
State: Arizona
Summary:
The 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 $23.8 million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Value-based payment
Provider Class:
Behavioral health outpatient services
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: NV_Fee_IPH.OPH2_Amend_20240101-20241231
State: Nevada
Summary:
Uniform increase for eligible inpatient and outpatient services at eligible private hospitals for the rating period January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term up to $892,212,397.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Inpatient hospital service, Outpatient hospital service
Review Type: Amendment
Approval Period: Single Rating Period
SDP Identifier:: FL_Fee_PC.NF_New_20231001-20240930
State: Florida
Summary:
Uniform dollar increase established by the state for primary care services and pediatric nursing facility services for the rating period, October 1, 2023, through September 30,2024, incorporated into the capitation rates through a separate payment term of up to $15million.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Nursing facility services, Primary care services, Specialty physician services
Review Type: New
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_AMC_Renewal_20240701-20250630
State: North Carolina
Summary:
Uniform dollar increase established by the state for the professional services at academic medical centers 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$103,203,351.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Professional services at an academic medical center
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_OPH_Renewal_20240701-20250630
State: North Carolina
Summary:
Minimum fee schedule established by the state for laboratory services provided by in-state acute care hospitals and critical access hospitals for the rating period covering July1, 2024 through June 30, 2025, incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Outpatient hospital service
Review Type: Renewal
Approval Period: Single Rating Period
SDP Identifier:: NC_Fee_Oth1_Renewal_20240701-20250630
State: North Carolina
Summary:
Minimum fee schedule established by the state for public ambulance provider services for the rating period covering July 1, 2024 through June 30, 2025, 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:: NC_Fee_Oth2_Renewal_20240701-20250630
State: North Carolina
Summary:
Uniform dollar increase established by the state for local health department services 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 $79,100,000.
Approval Date:
Effective Date:
Links:
State Rating Period:
-
Payment Type:
Fee schedule
Provider Class:
Other
Review Type: Renewal
Approval Period: Single Rating Period
Results per page