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
Georgia
Uniform percentage increase for inpatient hospital 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 $1,908,259,031.
Approval Date:
February 27, 2026
Effective Date:
July 1, 2025
Links:
Massachusetts
Performance improvement initiative for community behavioral health center services for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term amount up to $15,497,672.
Approval Date:
February 26, 2026
Effective Date:
January 1, 2024
Links:
Ohio
Uniform percentage increase for qualified practitioner services at an academic medical center and a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025through December 31, 2025, incorporated into capitation rates through a separate payment term of up to $41,019,224.
Approval Date:
February 18, 2026
Effective Date:
July 1, 2025
Links:
New Jersey
Uniform percentage increase for professional services provided by qualified providers employed or contracted with the AtlantiCare health system which is affiliated with Stockton University’s nursing and allied health training programs for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term up to $50,611,881.
Approval Date:
February 18, 2026
Effective Date:
July 1, 2025
Links:
Ohio
Uniform percentage increase for inpatient and outpatient hospital services, and a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025 through December 31, 2025, incorporated into capitation rates via a separate payment term up to$73,626,919.
Approval Date:
February 18, 2026
Effective Date:
July 1, 2025
Links:
Ohio
Uniform percentage increase for inpatient and outpatient hospital services, and a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025 through December 31, 2025, incorporated into capitation rates via a separate payment term up to$11,644,644.
Approval Date:
February 18, 2026
Effective Date:
July 1, 2025
Links:
Ohio
Uniform percentage increase for inpatient and outpatient hospital services, and a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025 through December 31, 2025, incorporated into capitation rates via a separate payment term up to$7,678,571.
Approval Date:
February 18, 2026
Effective Date:
July 1, 2025
Links:
Ohio
Uniform percentage increase for inpatient and outpatient hospital services, and a value-based performance payment to providers who attain quality performance target(s), starting July 1, 2025 for the rating period covering January 1, 2025 through December 31, 2025, incorporated into capitation rates via a separate payment term up to$125,000,000.
Approval Date:
February 18, 2026
Effective Date:
July 1, 2025
Links:
Kentucky
Uniform dollar increase for eligible government-owned or operated ground ambulance services for rating periods covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount up to$32,564,448.
Approval Date:
February 5, 2026
Effective Date:
January 1, 2026
Links:
Delaware
Uniform increase for inpatient and outpatient hospital services and behavioral health inpatient and outpatient services for rating periods covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term amount up to $309,503,881.
Approval Date:
February 4, 2026
Effective Date:
January 1, 2025
Links: