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
Florida
Uniform percentage increase established by the state for primary care services and specialty physician services at public hospitals for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $94,789,865.
Approval Date:
June 24, 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:
Primary care services
Specialty physician services
Michigan
Minimum fee schedule authorized for the administration and services of Methadone established by the state for behavioral health outpatient services for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation through a risk based rate adjustment.
Approval Date:
June 24, 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:
Behavioral health outpatient services
Ohio
The Care Innovation and Community Improvement Program established by the state for the rating period covering January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk based rate adjustment and a separate payment term up to $28,091,682.
Approval Date:
June 21, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2025
Payment Type:
Fee schedule
Value-based payment
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Other
Primary care services
Professional services at an academic medical center
Specialty physician services
Washington
The uniform percentage increase established by the state for inpatient and outpatient hospital services provided by eligible Critical Access Hospitals and Prospective Payment System Hospitals for the rating period January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term up to $1.818 billion.
Approval Date:
June 14, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
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:
June 13, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2025
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
Massachusetts
Uniform increase established by the state for eligible inpatient and outpatient hospital services for the rating period covering April 1, 2023 through December 31, 2023, incorporated into the capitation rates through a separate payment term up to $181,924,825.
Approval Date:
May 31, 2024
Effective Date:
April 1, 2023
Links:
State Rating Period:
April 1, 2023
-
December 31, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Florida
Uniform dollar increase established by the state for public emergency medical transportation services for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $200,000,000.
Approval Date:
May 30, 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:
Other
Florida
Uniform percentage increase established by the state for professional services at an academic medical center for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a separate payment term up to $326,033,561.
Approval Date:
May 30, 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:
Professional services at an academic medical center
Florida
Minimum fee schedule established by the state for primary care services and specialty physician services for the rating period, October 1, 2023 through September 30, 2024, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
May 30, 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:
Primary care services
Specialty physician services
South Carolina
Uniform percentage increase established by the state for professional services at an academic medic center for the rating period covering July 1, 2022 through June 30, 2023, incorporated in the capitation rates through a separate payment term of up to $153,400,000.
Approval Date:
May 30, 2024
Effective Date:
July 1, 2022
Links:
State Rating Period:
July 1, 2022
-
June 30, 2023
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Professional services at an academic medical center