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
Mississippi
Uniform dollar increase established by the state for ground emergency ambulance services 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 $25,285,224.
Approval Date:
July 22, 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
New Hampshire
Minimum fee schedule established by the state for durable medical equipment for the rating period covering September 1, 2024 through June 30, 2025, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
July 19, 2024
Effective Date:
September 1, 2024
Links:
State Rating Period:
September 1, 2024
-
June 30, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
Kansas
Uniform increase for inpatient and outpatient hospital services provided by Border City Children’s Hospitals and Large Public Teaching Hospitals for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $10,000,000.
Approval Date:
July 18, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
New York
Uniform increase for inpatient and outpatient services delivered by qualifying financially distressed hospitals for the rating period, April 1, 2024 through March 31, 2025, incorporated into the capitation rates through a separate payment term up to $1,855,352,776.
Approval Date:
July 18, 2024
Effective Date:
April 1, 2024
Links:
State Rating Period:
April 1, 2024
-
March 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
Outpatient hospital service
Ohio
Uniform percentage increase for inpatient and outpatient hospital services, provided by non-profit adult hospitals located in Hamilton County that are affiliated with a public medical school and that maintain a Level 1 trauma designation, for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $253,500,000.
Approval Date:
July 18, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Other
Outpatient hospital service
Florida
Uniform percentage increase established by the state for inpatient and outpatient hospital services at qualifying cancer hospitals in Region 6 and Region 11 for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $114,215,247.
Approval Date:
July 15, 2024
Effective Date:
October 1, 2023
Links:
State Rating Period:
October 1, 2023
-
September 30, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Other
Florida
Uniform percentage increase established by the state for eligible dental services for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $100,000.
Approval Date:
July 15, 2024
Effective Date:
October 1, 2023
Links:
State Rating Period:
October 1, 2023
-
September 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Dental services
New Jersey
A minimum and maximum fee schedule for qualifying out-of-state pediatric hospital inpatient services established by the state for the rating period July 1, 2023 through June 30, 2024, incorporated into the capitation rates through a risk based rate adjustment, and through a separate payment term up to $2,705,308.
Approval Date:
July 15, 2024
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
South Carolina
Uniform increase established by the state for inpatient and outpatient hospital services 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 $2,506,527,190.
Approval Date:
July 12, 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
Virginia
Uniform increase for physician services provided by physicians who participate in Children’s Specialty Group, affiliated with Children’s Hospital of the King’s Daughters, for the rating period, October 1, 2023 through June 30, 2024, incorporated into the capitation rates through a separate payment term up to $11,050,000.
Approval Date:
July 10, 2024
Effective Date:
October 1, 2023
Links:
State Rating Period:
October 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Specialty physician services