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
Virginia
The amendment to the uniform percentage increase for services performed by physicians employed by or contracted with the non-state government owned general acute care hospital class for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $1,174,213.
Approval Date:
August 25, 2026
Effective Date:
July 1, 2025
Links:
Virginia
Uniform percentage increase for inpatient hospital and outpatient hospital services rendered by all non-state government owned hospitals (CRMC and Lake Taylor Transitional Care Hospital) 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 $74,610,061.
Approval Date:
August 18, 2026
Effective Date:
July 1, 2026
Links:
Virginia
Uniform percentage increase for physicians employed by or contracted with the non-state government owned general acute care hospital class services for rating periods covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $950,000.
Approval Date:
August 18, 2026
Effective Date:
July 1, 2026
Links:
Virginia
Uniform percentage increase for professional services at an academic medical center 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 $274,100,000.
Approval Date:
August 18, 2026
Effective Date:
July 1, 2026
Links:
Virginia
Uniform percentage increase for specialty physician services for rating periods covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $11,050,000.
Approval Date:
August 18, 2026
Effective Date:
July 1, 2026
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:
Virginia
Uniform percentage increase for professional services at an academic medical center, primary care services, and specialty physician services for physicians employed by or contracted with an acute care hospital chain with a level one trauma center in the Tidewater Metropolitan Statistical Area (MSA) in 2020 for rating periods covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term amount up to $19,650,774.
Approval Date:
July 21, 2026
Effective Date:
July 1, 2026
Links:
Virginia
The amendment of uniform percentage increase for professional services at an academic medical center for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $274,100,000.
Approval Date:
July 21, 2026
Effective Date:
July 1, 2025
Links:
Virginia
Uniform increase for inpatient and outpatient services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term up to $4,987,975,478.
Approval Date:
July 21, 2026
Effective Date:
July 1, 2025
Links:
Virginia
Uniform increase for inpatient and outpatient services for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a separate payment term up to $4,987,975,478.
Approval Date:
July 21, 2026
Effective Date:
July 1, 2026
Links: