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
The uniform dollar increase for inpatient hospital services provided by Mercer County 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 $57,945,281.
The uniform dollar increase for inpatient hospital services provided by Passaic County 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 $49,488,138.
The uniform dollar increase for inpatient hospital services provided at acute care and rehabilitation hospitals in Cumberland County 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 $30,308,732.
The uniform dollar increase for inpatient hospital services provided by Middlesex County 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 $170,305,003.
The uniform dollar increase for inpatient hospital services provided by acute care and rehabilitation hospitals in Monmouth County 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 $160,993,241.
The uniform dollar increase for inpatient hospital services provided by general acute care hospitals and freestanding psychiatric hospitals in Camden County 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 $134,768,687.
A uniform percentage increase established by the state for qualified practitioners who are members of a practice plan under contract to provide professional services at a state- owned academic medical center 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 $64 million.
A uniform dollar increase for inpatient hospital services provided by Hudson County 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 $72,753,656.
The uniform dollar increase for inpatient hospital services provided by participating hospitals in Ocean County 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 $63,498,231.
The uniform dollar increase for inpatient hospital services provided by general acute care hospitals and non-general acute care hospitals in Burlington County 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 $60,600,614.