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 state teaching 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 $65,624,968.
Approval Date:
November 16, 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:
Inpatient hospital service
Utah
Uniform percentage increase for inpatient 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 $6,220,407.
Approval Date:
November 16, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Utah
Uniform percentage increase for inpatient hospital services for state teaching hospital claims 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 $2,844,861
Approval Date:
November 16, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Utah
Uniform percentage increase for inpatient 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 $54,219,238.
Approval Date:
November 16, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Utah
Uniform percentage increase for inpatient hospital services for state teaching 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 $23,869,669.
Approval Date:
November 16, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Oregon
The uniform increase established by the state for ground emergency medical transportation 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 $21,763,449.
Approval Date:
November 15, 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:
Other
Tennessee
Value-based payment arrangement established by the state for eligible home and community-based service (HCBS) providers for the rating periods covering January 1, 2022 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $50,000,000.
Approval Date:
November 15, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2024
Payment Type:
Value-based payment
Review Type:
Amendment
Approval Period:
Multiple Rating Period
Provider Class:
HCBS/personal care services
New Jersey
A perinatal episode of care pilot established by the state for the rating period covering July 1, 2023 through June 30, 2024 incorporated int the capitation rates through a risk-based rate adjustment and separate payment term of up to $3 million.
Approval Date:
November 13, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
New Jersey
A perinatal episode of care pilot established by the state for the rating period covering July 1, 2022 through June 30, 2023, incorporated into the capitation rates through a risk-based rate adjustment and a separate payment term of up to $3 million.
Approval Date:
November 13, 2023
Effective Date:
July 1, 2022
Links:
State Rating Period:
July 1, 2022
-
June 30, 2023
Payment Type:
Value-based payment
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Other
Nebraska
A uniform increase for practitioners who are acting in the capacity of an employee or contractor of the Public Academic Medical Institutions for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
November 7, 2023
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
December 31, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Professional services at an academic medical center