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
Maryland
Uniform percentage increase and value-based payment established by the state for professional services at an academic medical center for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount of up to $47,900,869.
Approval Date:
June 8, 2026
Effective Date:
January 1, 2026
Links:
Maryland
Minimum Fee Schedule for primary care services for the rating period covering January1, 2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $10,750,000.
Approval Date:
November 14, 2025
Effective Date:
January 1, 2026
Links:
Maryland
Population-based payment for primary care services for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount of up to $29,300,000.
Approval Date:
November 14, 2025
Effective Date:
January 1, 2026
Links:
Maryland
Uniform percentage increase and value-based payment established by the state for professional services at an academic medical center, primary care services, specialty physician services, and qualifying practitioner services for the rating period covering January 1, 2025 through December 31, 2025 incorporated in the capitation rates through a separate payment term amount up to $42 million.
Approval Date:
June 23, 2025
Effective Date:
January 1, 2025
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:
Maryland
Uniform percentage increase and value-based payment established by the state for professional services at an academic medical center, primary care services, specialty physician services, and qualifying practitioner services for the rating period covering January 1, 2022 through December 31, 2024 incorporated in the capitation rates through a separate payment term of up to $37.8 million.
Approval Date:
February 10, 2023
Effective Date:
January 1, 2022
Links: