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
Michigan
The 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, 2022 through September 30, 2023, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
September 25, 2023
Effective Date:
October 1, 2022
Links:
State Rating Period:
October 1, 2022
-
September 30, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
Michigan
The uniform dollar increase established by the state for direct care workers providing personal care services to eligible enrollees 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:
September 25, 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:
HCBS/personal care services
Missouri
Minimum and maximum fee schedules established by the state for outpatient hospital services for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
September 25, 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
Oklahoma
Uniform increase for inpatient and outpatient hospital services at private, non-state government, and critical access hospitals for the rating period covering April 1, 2024 through June 30, 2025 incorporated in the capitation rates through a separate payment term of up to $1,262,703,035.
Approval Date:
September 25, 2023
Effective Date:
April 1, 2024
Links:
State Rating Period:
April 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
Virginia
The minimum fee schedule established by the state for Durable Medical Equipment providers for the rating period covering July 1, 2023 through September 30, 2023, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
September 25, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
September 30, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
New Hampshire
The uniform dollar increase for inpatient discharges and outpatient visits to qualifying critical access hospitals for the rating period covering July 1, 2023 through August 31, 2024, incorporated in the capitation rates through a separate payment term of up to $49,000,000.
Approval Date:
September 22, 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:
Inpatient hospital service
Outpatient hospital service
New Mexico
A uniform percentage increase and quality incentive payment established by the state for inpatient and outpatient hospital services provided by Safety Net Care Pool hospital providers for the rating period covering January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a separate payment term of up to $69,000,000.
Approval Date:
September 22, 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:
Inpatient hospital service
Outpatient hospital service
Texas
Comprehensive Hospital Increase Reimbursement Program (CHIRP) directed payment for the rating period covering September 1, 2023 through August 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
September 20, 2023
Effective Date:
September 1, 2023
Links:
State Rating Period:
September 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
Outpatient hospital service
Arizona
Uniform percentage increase, entitled Access to Professional Services Initiative, established by the state for qualified practitioners affiliated with one of the designated hospitals for the rating period covering October 1, 2021 through September 30, 2022, incorporated into the capitation rate through a separate payment term of up to $158.6 million.
Approval Date:
September 18, 2023
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:
Professional services at an academic medical center
Florida
Uniform percentage increase established by the state for professional services at an academic medical center for the rating period covering October 1, 2022 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $265,157,436.
Approval Date:
September 15, 2023
Effective Date:
October 1, 2022
Links:
State Rating Period:
October 1, 2022
-
September 30, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Professional services at an academic medical center