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 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 $875,434,461.
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
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 $235,544,261.
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
Georgia
Uniform percentage increase for physician and other eligible professional 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 $243,635,566.
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:
Other
Georgia
GA-AIDE uniform percentage increase and performance improvement initiative 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 $586,314,764.
Approval Date:
September 19, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Arizona
The value-based payment and uniform increase by the state for primary care, behavioral health outpatient, and justice involved clinic services for the rating period October 1, 2022 through September 30, 2023, incorporated into the capitation rates through a separate payment term up to $18.5 million.
Approval Date:
September 16, 2024
Effective Date:
October 1, 2022
Links:
State Rating Period:
October 1, 2022
-
September 30, 2023
Payment Type:
Fee schedule
Value-based payment
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Other
Primary care services
Kansas
Value Based Payment to meet or exceed the performance measure benchmarks on specific provider quality metrics for the inpatient and outpatient services to receive incentive payments for the rating period covering January 1, 2024 through December 31, 2025 for a multi-year period, incorporated in the capitation rates through a separate payment term of up to $60,000,000.
Approval Date:
September 16, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2025
Payment Type:
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
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:
September 13, 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:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Inpatient hospital service
Outpatient hospital service
Massachusetts
The proposal requiring that Managed Care Organizations (MCO) share savings/losses with MCO-administered Accountable Care Organizations (ACO) for the rating period covering January 1, 2022 – December 31, 2022.
Approval Date:
September 11, 2024
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Primary care services
Massachusetts
The proposal requiring that Managed Care Organizations (MCO) share savings/losses with MCO-administered Accountable Care Organizations (ACO) for the rating period covering January 1, 2023 – March 31, 2023.
Approval Date:
September 11, 2024
Effective Date:
January 1, 2023
Links:
State Rating Period:
January 1, 2023
-
March 31, 2023
Payment Type:
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Primary care services
Rhode Island
Uniform increase established by the state for eligible outpatient hospital 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:
September 11, 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:
Outpatient hospital service