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
Florida
Uniform percentage increase for primary care services and specialty physician services for rating period covering February 1, 2025 through September 30, 2025, incorporated in the capitation rates through a separate payment term amount of up to $54,198,082.67.
Approval Date:
November 14, 2025
Effective Date:
February 1, 2025
Links:
Florida
Uniform percentage increase for professional services at an academic medical center for rating periods covering October 1, 2024 through January 31, 2025, incorporated in the capitation rates through a separate payment term amount of up to $113,819,515.
Approval Date:
November 14, 2025
Effective Date:
October 1, 2024
Links:
Florida
Uniform dollar increase for publicly owned or operated emergency medical transportation provider services for rating period covering February 1, 2025 through September 30, 2025, incorporated in the capitation rates through a separate payment term amount of up to $133,333,334.
Approval Date:
November 14, 2025
Effective Date:
February 1, 2025
Links:
Florida
Minimum Fee Schedule established by the state for eligible ground emergency transportation services for the rating period covering July 1, 2025 through June 30, 2026,incorporated in the capitation rates through a risk-based rate adjustment of up to $45,528,378.
Approval Date:
November 14, 2025
Effective Date:
July 1, 2025
Links:
Florida
Uniform percentage increase for professional services at an academic medical center for rating periods covering February 1, 2025 through September 30, 2025, incorporated in the capitation rates through a separate payment term amount of up to $227,639,029.
Approval Date:
November 14, 2025
Effective Date:
February 1, 2025
Links:
Maryland
Minimum Fee Schedule for primary care services for the rating period covering January1, 2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $10,750,000.
Approval Date:
November 14, 2025
Effective Date:
January 1, 2026
Links:
Maryland
Population-based payment for primary care services for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount of up to $29,300,000.
Approval Date:
November 14, 2025
Effective Date:
January 1, 2026
Links:
New Hampshire
Uniform dollar increase for inpatient and outpatient hospital services to qualifying non-critical access hospitals for rating periods covering July 1, 2025 through June 30, 2026,incorporated in the capitation rates through a separate payment term amount of up to$104,752,459.
Approval Date:
November 14, 2025
Effective Date:
July 1, 2025
Links:
Nebraska
Uniform increase for non-state owned or operated hospitals established by the state for inpatient and outpatient hospital services for the rating period, January 1, 2025 through December 31, 2025, incorporated into the capitation rates through a separate payment term of up to $1,410,710,373.
Approval Date:
November 14, 2025
Effective Date:
January 1, 2025
Links:
New Jersey
Uniform increase for nursing facility services provided by Class II (publicly owned) nursing facilities with greater than 500 licensed beds for the rating period, July 1, 2025 through June 30, 2026, incorporated into the capitation rates through a separate payment term up to $18,207,438.
Approval Date:
November 14, 2025
Effective Date:
July 1, 2025
Links: