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
Georgia
Uniform percentage increase for inpatient hospital and outpatient hospital services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $921,004,517.
Approval Date:
March 2, 2026
Effective Date:
July 1, 2025
Links:
Georgia
Uniform percentage increase for inpatient hospital services and outpatient hospital services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $111,701,295.
Approval Date:
March 2, 2026
Effective Date:
July 1, 2025
Links:
Georgia
Uniform percentage increase for inpatient hospital and outpatient hospital services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $1,908,259,031.
Approval Date:
February 27, 2026
Effective Date:
July 1, 2025
Links:
Georgia
Uniform percentage increase for inpatient hospital services and outpatient hospital services for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $453,391,741.
Approval Date:
February 25, 2026
Effective Date:
July 1, 2025
Links:
Georgia
Uniform percentage increase for professional services at an academic medical center established by the state for the rating period covering July 1, 2025 through June 30,2026, incorporated in the capitation rates through a separate payment term of up to$239,351,323.31.
Approval Date:
February 3, 2026
Effective Date:
July 1, 2025
Links:
Georgia
Uniform percentage increase for inpatient hospital and outpatient hospital services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $363,586,833.
Approval Date:
February 3, 2026
Effective Date:
July 1, 2025
Links:
Georgia
Uniform percentage increase for inpatient hospital services and outpatient hospital 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 $155,676,891.
Approval Date:
January 27, 2026
Effective Date:
July 1, 2025
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:
Georgia
Uniform percentage increase for outpatient hospital services, primary care services, specialty physician services, behavioral health outpatient services, dental services, and providers providing EPSDT services, established by the state for the rating period covering July 1, 2023, through June 30, 2024, incorporated in the capitation rates through a rate adjustment of up to $5,700,000.
Approval Date:
November 14, 2024
Effective Date:
July 1, 2023
Links:
Georgia
Uniform percentage increase for inpatient and outpatient hospital services established by the state 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 $399,220,710.
Approval Date:
September 19, 2024
Effective Date:
July 1, 2024
Links: