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
Pennsylvania
The alternative minimum fee schedule established by the state for qualifying providers under specific ASAM levels of care who provide substance use disorder (SUD) treatment 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:
December 7, 2023
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Behavioral health outpatient services
Georgia
The uniform percentage increase for physician and other eligible professional services established by the state for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $210,433,377.
Approval Date:
November 30, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
Tennessee
Uniform percentage increase established by the state for nursing facility services for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $174,025,614.
Approval Date:
November 29, 2023
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
December 31, 2023
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services
Tennessee
Uniform percentage increase established by the state for nursing facility services 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 $47,523,042.
Approval Date:
November 29, 2023
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services
New Mexico
A value-based purchasing and uniform percent increase arrangement established by the state to increase nursing facility per diem rates by the market basket index (MBI) factor and to provide quality incentive payments for nursing facilities that meet performance requirements on specified quality metrics for the rating period covering January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a risk-based adjustment.
Approval Date:
November 28, 2023
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
December 31, 2023
Payment Type:
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services
Oklahoma
Uniform dollar increase for Oklahoma Universities Affiliated Physicians established by the state for the rating period covering April 1, 2024 through June 30, 2025, incorporated int the capitation rates through separate payment term of up to $127,410,566.
Approval Date:
November 27, 2023
Effective Date:
April 1, 2024
Links:
State Rating Period:
April 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Multiple Rating Period
Provider Class:
Professional services at an academic medical center
New Hampshire
Minimum fee schedule established by the state for durable medical equipment for the rating period covering July 1, 2023 through August 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment
Approval Date:
November 27, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
New Hampshire
Uniform dollar increase for community mental health programs including Assertive Community Treatment (ACT), New Hampshire Hospital (NHH) Discharges/Same-day Access and Follow-up, Timely Prescriber Services Following Intake, Illness Management and Recovery Services (IMR), and Specialty Residential Service Payment Enhancement for Individuals with Co-occurring Developmental Disabilities Discharged from Hospital for the rating period covering July 1, 2023 through August 31, 2024, incorporated into the capitation rates through a separate payment term of up to $5,833,333.
Approval Date:
November 27, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Hawaii
Uniform percentage increase established by the state for nursing facility services, community care foster homes (CCFH), and expanded adult residential care homes (E-ARCHs) for the rating period of July 1, 2022 to December 31, 2022, incorporated into the capitation rates through a separate payment term of up to $47,694,753.
Approval Date:
November 22, 2023
Effective Date:
July 1, 2022
Links:
State Rating Period:
July 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services
Other
Utah
Uniform percentage increase for outpatient hospital services for privately owned hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $227,855,207.
Approval Date:
November 17, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Outpatient hospital service