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
Oklahoma
Uniform increase for inpatient and outpatient hospital services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $1,087,525,595.
Approval Date:
July 31, 2026
Effective Date:
July 1, 2025
Links:
Virginia
Uniform percentage increase for nursing facility like services provided to individuals under 21 for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $3,589,920.
Approval Date:
July 31, 2026
Effective Date:
July 1, 2026
Links:
Utah
Uniform percentage increase for outpatient hospital services for state teaching hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term up to $87,324,137.
Approval Date:
July 27, 2026
Effective Date:
July 1, 2025
Links:
Florida
Minimum Fee Schedule for dental services for the rating period covering October 1,2025 through September 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment up to $150,000.
Approval Date:
July 27, 2026
Effective Date:
October 1, 2025
Links:
Louisiana
Uniform dollar increase for traditional, in-network non-emergency medical transportation (NEMT) providers, for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $2,259,096.
Approval Date:
July 27, 2026
Effective Date:
July 1, 2026
Links:
Utah
Uniform percentage increase for professional services at an academic medical center for state teaching hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term of up to $58,211,235.
Approval Date:
July 23, 2026
Effective Date:
July 1, 2025
Links:
Utah
Uniform percentage increase for inpatient hospital services for state teaching hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term of up to $90,390,149.
Approval Date:
July 23, 2026
Effective Date:
July 1, 2025
Links:
Massachusetts
Performance improvement initiative for the Clinical Quality Incentive for the rating periods covering January 1, 2025 through December 31, 2027, incorporated into the capitation rates through a separate payment term of up to $800,000,000 for calendar year (CY) 2025, $150,000,000 for CY 2026, and $150,000,000 for CY 2027.
Approval Date:
July 23, 2026
Effective Date:
January 1, 2025
Links:
New Mexico
Maximum Fee Schedule for eligible non-contract providers for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 21, 2026
Effective Date:
January 1, 2026
Links:
Delaware
Minimum Fee Schedule for nursing facility services for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment up to $24,348,968.
Approval Date:
July 21, 2026
Effective Date:
January 1, 2026
Links: