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
New York
The uniform increase for home and community-based services for eligible Health Home Providers for the rating period covering April 1, 2022 through March 31, 2023, incorporated in the capitation rates as a separate payment term of up to $280,000.
Approval Date:
May 9, 2023
Effective Date:
April 1, 2022
Links:
State Rating Period:
April 1, 2022
-
March 31, 2023
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
Florida
Uniform percentage increase established by the state for home and community-based services, behavioral health outpatient services, and eligible non-waiver services 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 $296,534,267.
Approval Date:
May 5, 2023
Effective Date:
October 1, 2022
Links:
State Rating Period:
October 1, 2022
-
September 30, 2023
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
HCBS/personal care services
Other
Hawaii
• Pay for performance arrangement established by the state for public and private hospitals as defined in the preprint 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 $46.22 million;
• Uniform dollar increase established by the state for safety net hospitals owned and operated by a government agency 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 $78.1 million;
• Uniform percentage increase established by the state for inpatient and outpatient hospital services within privately-owned hospital provider classes for the rating period covering January 1, 2023 to December 31, 2023 incorporated in the capitation rates through a separate payment term of up to an estimated computable $166.69 million; and,
• Minimum and Maximum fee schedule established by the state for in-state general acute hospitals and children’s hospital services within in-state general acute hospital provider classes for the rating period of January 1, 2023 to December 31, 2023 incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
May 5, 2023
Effective Date:
January 1, 2023
Links:
State Rating Period:
No State Rating Period Date
-
No State Rating Period Date
Payment Type:
Fee schedule
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Kansas
Uniform increase for eligible Kansas hospitals established by the state for inpatient and outpatient 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 $408,981,220.
Approval Date:
May 5, 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
New Mexico
The uniform increase for EPSDT services established by the state for Private Duty Nursing and Home Health Providers 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:
May 5, 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:
Other
California
Uniform dollar increase established by the state for dental services 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:
May 4, 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:
Dental services
Illinois
Uniform increase established by the state for services provided by physicians employed by State-owned medical schools 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 $84,000,000
Approval Date:
May 4, 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:
Professional services at an academic medical center
North Carolina
Uniform increase established by the state for behavioral health outpatient services and other eligible provider services for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
May 4, 2023
Effective Date:
July 1, 2021
Links:
State Rating Period:
July 1, 2021
-
June 30, 2022
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Other
North Carolina
Uniform percentage increase established by the state for behavioral health outpatient services for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
May 4, 2023
Effective Date:
July 1, 2021
Links:
State Rating Period:
July 1, 2021
-
June 30, 2022
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
North Carolina
Uniform increase established by the state for home and community-based and behavioral health outpatient services for the rating period covering July 1, 2021 through June 30, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
May 4, 2023
Effective Date:
July 1, 2021
Links:
State Rating Period:
July 1, 2021
-
June 30, 2022
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
HCBS/personal care services