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
Utah
Uniform percentage increase for inpatient hospital services for privately owned hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $215,202,266.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Utah
Uniform percentage increase for inpatient hospital services for state teaching hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $72,369,807.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Utah
Uniform percentage increase for outpatient hospital services for privately owned hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $236,890,588.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Utah
Uniform percentage increase for outpatient hospital services for state teaching hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $78,467,552.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Georgia
Uniform percentage increase and performance improvement initiative for inpatient hospital services and outpatient hospital services for the rating period covering July 01,2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $385,534,011.
Approval Date:
December 17, 2025
Effective Date:
July 1, 2025
Links:
Michigan
A uniform dollar increase established by the state for direct care workers providing personal care services to eligible enrollees for the rating period covering October 1, 2025through September 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
December 17, 2025
Effective Date:
October 1, 2025
Links:
Ohio
Uniform percentage increase for qualified practitioner services at a non-academic medical center and a value-based performance payment to providers who attain quality performance target(s), for the rating period covering January 1, 2025 through December31, 2025, incorporated into the capitation rates through a separate payment term up to$10,714,286.
Approval Date:
December 17, 2025
Effective Date:
July 1, 2025
Links:
Ohio
Uniform percentage increase for qualified practitioner services at a non-academic medical center and a value-based performance payment to providers who attain quality performance target(s), for the rating period covering January 1, 2025 through December31, 2025, incorporated into the capitation rates through a separate payment term up to$9,785,483.
Approval Date:
December 17, 2025
Effective Date:
July 1, 2025
Links:
Ohio
Uniform percentage increase for qualified practitioner services at a non-academic medical center and a value-based performance payment to providers who attain quality performance target(s), for the rating period covering January 1, 2025 through December31, 2025, incorporated into the capitation rates through a separate payment term up to$7,118,634.
Approval Date:
December 17, 2025
Effective Date:
July 1, 2025
Links:
Massachusetts
Uniform increase established by the State for Behavioral Health Urgent Care (BHUC) 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:
December 11, 2025
Effective Date:
January 1, 2025
Links: