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
North Carolina
Uniform dollar increase established by the state for inpatient and outpatient hospital services at ECU Health Medical Center for the rating period covering July 1, 2024through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $71,730,243.
Approval Date:
October 24, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
North Carolina
Uniform dollar increase established by the state for inpatient and outpatient hospital services at UNC Health Care System hospitals for the rating period covering July 1, 2024through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $134,409,751.
Approval Date:
October 24, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Iowa
Uniform increase established by the state for eligible ground emergency medical, transportation providers for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
October 1, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
Illinois
Value based payment arrangement established by the state for eligible primary care and behavioral health providers contracted with the Egyptian Health Department for the rating periods covering January 1, 2024 through December 31, 2024.
Approval Date:
October 1, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Primary care services
Missouri
Minimum fee schedule for Community Mental Health Clinics established by the state for the rating period covering July 1, 2024 through June 30, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
October 1, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Rhode Island
Uniform increase established by the state for shared living services for the rating period July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk based rate adjustment.
Approval Date:
October 1, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
South Carolina
Uniform increase established by the state for physicians providing professional services employed by or under contracts with a South Carolina public medical university, academic medical center or its component units, or an SC Area Health Education Consortium (AHEC) Teaching Health System for the rating period covering July 1, 2024through June 30, 2025, incorporated in the capitation rates through a separate payment term of up to $145,000,000.
Approval Date:
October 1, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Professional services at an academic medical center
Texas
Comprehensive Hospital Increase Reimbursement Program (CHIRP) for the rating period covering September 1, 2024 through August 31, 2025, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
October 1, 2024
Effective Date:
September 1, 2024
Links:
State Rating Period:
September 1, 2024
-
August 31, 2025
Payment Type:
Fee schedule
Value-based payment
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
Outpatient hospital service
Wisconsin
Uniform percentage increase established by the state for eligible home and community-based service (HCBS) providers for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
October 1, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
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:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service