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
Tennessee
Uniform Percentage Increase for inpatient and outpatient hospital services for the rating period covering, January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term up to $3,204,114,577.
Approval Date:
March 31, 2026
Effective Date:
January 1, 2026
Links:
Wisconsin
Uniform percentage increase established by the state for eligible home and community-based services for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount up to $147,000,000.
Approval Date:
March 30, 2026
Effective Date:
January 1, 2026
Links:
Wisconsin
Uniform percentage increase established by the state for eligible home and community-based services 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$91,000,000.
Approval Date:
March 30, 2026
Effective Date:
January 1, 2026
Links:
Wisconsin
Minimum Fee Schedule for home and community-based services 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 $231,000,000.
Approval Date:
March 30, 2026
Effective Date:
January 1, 2026
Links:
No state
Uniform percentage increase established by the state for eligible home and community-based services 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$115,000,000.
Approval Date:
March 30, 2026
Effective Date:
January 1, 2026
Links:
Michigan
Uniform increase established by the state for primary care and specialty physician services provided by practitioners employed or under contract with approved public entities, for the rating period covering October 1, 2025 through September 30, 2026, incorporated in the capitation rates through a separate payment term up to$610,000,000.
Approval Date:
March 27, 2026
Effective Date:
October 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 rates through a risk based adjustment up to $150,850,000.
Approval Date:
March 26, 2026
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:
Amendment
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
Illinois
Uniform increase established by the state for inpatient services at hospitals participating in delivery system transformation programs approved by the state for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term up to $190,000,000.
Approval Date:
March 26, 2026
Effective Date:
January 1, 2026
Links:
Oregon
Minimum fee schedule for behavioral health outpatient services furnished by qualified providers for the rating period covering January 1, 2026 through December 31, 2026,incorporated into the capitation rates through a risk-based adjustment.
Approval Date:
March 26, 2026
Effective Date:
January 1, 2026
Links:
Florida
Uniform Percentage Increase for inpatient and outpatient hospital services for rating periods covering October 1, 2024 through January 31, 2025, incorporated in the capitation rates through a separate payment term amount up to $138,445,303.
Approval Date:
March 20, 2026
Effective Date:
October 1, 2024
Links: