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
Massachusetts
Uniform increase for behavioral health outpatient services, behavioral health diversionary services, and early intervention services established by the state for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 14, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Other
Massachusetts
Minimum fee scheduled established by the State for outpatient behavioral health services and behavioral health diversionary services for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 14, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Other
Massachusetts
Uniform increase for DMH-licensed Psychiatric Hospitals and all units with DMH-licensed beds within acute inpatient hospitals and all units that have DMH-licensed beds within applicable Chronic Disease and Rehabilitation Hospitals for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 13, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
New York
Uniform dollar increase for inpatient and outpatient services delivered by qualifying financially distressed hospitals for the rating period covering April 1, 2023 through March 31, 2024, incorporated in the capitation rates through a separate payment term of up to $1,559,329,241.
Approval Date:
July 13, 2023
Effective Date:
April 1, 2023
Links:
State Rating Period:
April 1, 2023
-
March 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Inpatient hospital service
Outpatient hospital service
New York
A value-based payment arrangement for hospitals providing labor and delivery services for the rating periods covering April 1, 2023 through March 31, 2025, incorporated in the capitation rates through a separate payment term of up to $14 million for the April 1, 2023 – March 31, 2024 rating period and up to $24 million for the April 1, 2024 – March 31, 2025 rating period.
Approval Date:
July 13, 2023
Effective Date:
April 1, 2023
Links:
State Rating Period:
April 1, 2023
-
March 31, 2025
Payment Type:
Value-based payment
Review Type:
New
Approval Period:
Multiple Rating Period
Provider Class:
Inpatient hospital service
Florida
Minimum fee schedule established by the state for primary care services and specialty physician services 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:
July 7, 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:
Primary care services
Specialty physician services
Nevada
Uniform increase for eligible professional services at designated academic medical centers 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 $26,217,616.58.
Approval Date:
July 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
Nevada
A uniform increase for inpatient hospital services rendered by public hospitals for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a separate payment term of up to $56,704,955.66.
Approval Date:
July 7, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Massachusetts
Minimum fee schedule for psychiatric services for enrollees under the age of 21 with Autism Spectrum Disorder or Intellectual or Developmental Disability (ASD/IDD) for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 6, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Massachusetts
Uniform increase established by the State for Behavioral Health Urgent Care (BHUC) for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 5, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services