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
New Hampshire
The uniform dollar increase for inpatient discharges and outpatient visits to qualifying critical access hospitals for the rating period covering September 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $56,120,600.
Approval Date:
May 1, 2025
Effective Date:
September 1, 2024
Links:
State Rating Period:
September 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Nevada
Value-based payment established by the state for free standing nursing facilities for the rating period January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term up to $27,415,240.67.
Approval Date:
May 1, 2025
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Value-based payment
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services
Pennsylvania
Value-based payment arrangement for opioid use disorder for private acute care hospitals for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $35 million.
Approval Date:
May 1, 2025
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Value-based payment
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Outpatient hospital service
Puerto Rico
Uniform dollar increase established by the state for inpatient hospital services for the rating period, October 1, 2024 through September 30, 2025, incorporated into the capitation rates through a separate payment term up of to $123,350,308.
Approval Date:
April 29, 2025
Effective Date:
October 1, 2024
Links:
State Rating Period:
October 1, 2024
-
September 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Tennessee
Uniform percentage increase established by the state for inpatient and outpatient hospital services for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a separate payment term of up to $3,204,114,577.
Approval Date:
April 29, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Wisconsin
Uniform percentage increase established by the state for eligible home and community-based services for the rating period, January 1, 2025 through December 31, 2025,incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
April 29, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
Michigan
Uniform dollar increase established by the state for professional services provided by practitioners employed or under contract with approved public entities for the rating period covering October 1, 2022 through September 30, 2023, and incorporated in the capitation rates through a separate payment term of up to $583,505,495.00.
Approval Date:
April 24, 2025
Effective Date:
October 1, 2022
Links:
State Rating Period:
October 1, 2022
-
September 30, 2023
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Professional services at an academic medical center
Wisconsin
Uniform percentage increase established by the state for eligible home and community-based services for the rating period, January 1, 2025 through December 31, 2025,incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
April 24, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
Wisconsin
Uniform percentage increase established by the state for eligible home and community-based services for the rating period, January 1, 2025 through December 31, 2025,incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
April 24, 2025
Effective Date:
January 1, 2025
Links:
State Rating Period:
January 1, 2025
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
Michigan
Uniform dollar increase for psychiatric inpatient days for the rating period covering October 1, 2021 through September 30, 2022, and incorporated in the capitation rates through a separate payment term of up to $99 million.
Approval Date:
April 23, 2025
Effective Date:
October 1, 2021
Links:
State Rating Period:
October 1, 2021
-
September 30, 2022
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service