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:
Texas
Comprehensive Hospital Increase Reimbursement Program (CHIRP) for the rating period covering September 1, 2024 through August 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 28, 2025
Effective Date:
September 1, 2024
Links:
New Hampshire
Uniform dollar increase for community mental health program services for the rating period covering July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a separate payment term of up to $2,650,000.
Approval Date:
July 17, 2025
Effective Date:
July 1, 2025
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:
New Mexico
Renewal of a uniform increase for primary care services for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term amount of up to $26 million.
Approval Date:
July 17, 2025
Effective Date:
January 1, 2025
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:
Michigan
Uniform dollar increase for nursing facility services for the rating period covering January 1, 2025 through December 31, 2025 incorporated in the capitation rates through a separate payment term of up to $34,148,153.
Approval Date:
July 1, 2025
Effective Date:
January 1, 2025
Links:
North Carolina
Minimum Fee Schedule established by the state for eligible non-state government owned skilled nursing facilities for actual utilization of services for rating periods covering July1, 2025 – June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 1, 2025
Effective Date:
July 1, 2025
Links:
North Carolina
Minimum fee schedule established by the state for local health department services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount of up to $82,900,000.
Approval Date:
July 1, 2025
Effective Date:
July 1, 2025
Links:
New Hampshire
Uniform dollar increase for children’s inpatient and outpatient services with recognized children’s hospitals established by the state for rating periods covering July 1, 2025through June 30, 2026, incorporated in the capitation rates through a separate payment term amount of up to $1,309,591.
Approval Date:
July 1, 2025
Effective Date:
July 1, 2025
Links: