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
Puerto Rico
Uniform dollar increase for inpatient hospital services at qualifying short-term acute care (STAC) hospitals for the rating period covering January 1, 2023 through September 30, 2023 incorporated in the capitation rates through a separate payment term of up to $77,233,837
Approval Date:
April 26, 2023
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
September 30, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Wisconsin
Minimum and maximum fee schedule for Sub-Acute Psychiatric Community-Based Psychiatric and Recovery Center Services for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
April 25, 2023
Effective Date:
January 1, 2023
Links:
State Rating Period:
No State Rating Period Date
-
No State Rating Period Date
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
California
Value-based payment arrangement for providers of eligible organ and bone marrow transplant services for the rating periods covering January 1, 2022 through December 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
April 25, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2024
Payment Type:
Value-based payment
Review Type:
New
Approval Period:
Multiple Rating Period
Provider Class:
Inpatient hospital service
Other
Tennessee
Uniform dollar increase established by the state for ground ambulance service 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:
April 21, 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
Tennessee
Uniform increase established by the state for inpatient and outpatient services provided at eligible hospitals 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:
April 21, 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 York
A uniform dollar increase for direct care services delivered to individuals with intellectual and developmental disabilities by FIDA-IDD providers 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 $19.22 million.
Approval Date:
April 19, 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:
HCBS/personal care services
Oregon
Uniform increase established by the state for inpatient and outpatient hospital services provided by Rural Type A/B hospitals 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 $146,000,000.
Approval Date:
April 18, 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
Oregon
Uniform increase established by the state for inpatient and outpatient hospital services provided by Diagnosis-Related Group (DRG) hospitals 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 $600,000,000.
Approval Date:
April 18, 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
Kansas
Uniform percentage increase established by the state for Teaching Professional Access Program eligible providers 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 $16,000,000.
Approval Date:
April 14, 2023
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
December 31, 2023
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Professional services at an academic medical center
Tennessee
Uniform increase for nursing facilities 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 $124,356,740.
Approval Date:
April 14, 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:
Nursing facility services