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
California
Uniform dollar increase for inpatient and outpatient services provided by eligible network children’s hospitals in the Children's Hospital Increased Reimbursement Program (CHIRP) for the portion of the rating period covering July 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term amount of up to $115,000,000.
Approval Date:
July 28, 2025
Effective Date:
July 1, 2024
Links:
New Mexico
A uniform increase for HCBS and personal care services for the rating period covering July 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term amount of up to $77.52 million.
Approval Date:
July 17, 2025
Effective Date:
July 1, 2024
Links:
Wisconsin
Uniform dollar increase for ground emergency ambulance services 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:
July 17, 2025
Effective Date:
January 1, 2024
Links:
New Mexico
A uniform increase for primary care services for the rating period covering July 1, 2024through December 31, 2024, incorporated in the capitation rates through a separate payment term amount of up to $7 million.
Approval Date:
July 1, 2025
Effective Date:
July 1, 2024
Links:
Oregon
Uniform dollar increase for dental services for the rating period covering January 1,2025 through December 31, 2025, incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
July 1, 2025
Effective Date:
January 1, 2025
Links:
Oregon
Value based payments for dental providers for the rating period covering January 1,2025 through December 31, 2025, incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
July 1, 2025
Effective Date:
January 1, 2025
Links:
Oregon
Value based payments for dental providers for the rating period covering January 1,2025 through December 31, 2025, incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
July 1, 2025
Effective Date:
January 1, 2025
Links:
Nebraska
Uniform increase for non-state owned or operated hospitals established by the state for inpatient and outpatient hospital services for the rating period, January 1, through December 31, 2024, incorporated into the capitation rates through a separate payment term of up to $705,533,735.
Approval Date:
June 24, 2025
Effective Date:
July 1, 2024
Links:
Maryland
Population-based payment for primacy care services 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:
June 23, 2025
Effective Date:
July 1, 2025
Links:
Maryland
Minimum Fee Schedule for primary care services for the rating period covering January1, 2025 through December 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
June 23, 2025
Effective Date:
July 1, 2025
Links: