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
Washington
Uniform increase established by the state for publicly funded sexual and reproductive health family planning providers as designated by the Department of Health for the rating period covering January 1, 2026, through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment up to $100,000.
Approval Date:
December 23, 2025
Effective Date:
January 1, 2026
Links:
Massachusetts
The Hospital Performance Improvement Initiative proposal for the rating period covering January 1, 2025 through December 31, 2027, incorporated in the capitation rates through a separate payment term of up to $125 million for calendar year (CY) 2025, $125 million for CY 2026, and $125 million for CY 2027.
Approval Date:
December 22, 2025
Effective Date:
January 1, 2025
Links:
Arizona
Uniform percentage increase established by the state for Differential Adjusted Payments (DAP) program eligible providers for the rating period covering October 1, 2025 through September 30, 2026, and incorporated in the capitation rate through a risk based adjustment.
Approval Date:
December 18, 2025
Effective Date:
October 1, 2025
Links:
State Rating Period:
October 1, 2025
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September 30, 2026
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Behavioral health outpatient services
Dental services
HCBS/personal care services
Inpatient hospital service
Nursing facility services
Outpatient hospital service
Primary care services
Specialty physician services
Ohio
Population-based payment established by the state for Mobile Response and Stabilization Services (MRSS) program providers for the rating period, January 1, 2026through December 31, 2026, incorporated into the capitation rates through a separate payment term up to $48,885,706.
Approval Date:
December 18, 2025
Effective Date:
January 1, 2026
Links:
Utah
Uniform percentage increase for professional services at an academic medical center for state teaching hospitals for the rating period covering July 1, 2024 through June 30,2025, incorporated in the capitation rates through a separate payment term of up to$49,595,750.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Utah
Uniform percentage increase for inpatient hospital services for privately owned hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $215,202,266.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Utah
Uniform percentage increase for inpatient hospital services for state teaching hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $72,369,807.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Utah
Uniform percentage increase for outpatient hospital services for privately owned hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $236,890,588.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Utah
Uniform percentage increase for outpatient hospital services for state teaching hospitals for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $78,467,552.
Approval Date:
December 18, 2025
Effective Date:
July 1, 2024
Links:
Georgia
Uniform percentage increase and performance improvement initiative for inpatient hospital services and outpatient hospital services for the rating period covering July 01,2025 through June 30, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $385,534,011.
Approval Date:
December 17, 2025
Effective Date:
July 1, 2025
Links: