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 percentage 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 $6,288,572,664.
Approval Date:
July 26, 2024
Effective Date:
July 1, 2024
Links:
New Mexico
The uniform dollar increase established by the state for inpatient and outpatient hospital services for hospitals in rural or underserved communities with active maternal/obstetric programs for the rating period January 1, 2024 through June 30, 2024, incorporated into the capitation rates through a separate payment term up to $10,936,000.
Approval Date:
July 26, 2024
Effective Date:
January 1, 2024
Links:
California
Quality Incentive Pool for Designated Public Hospital systems for the rating period of January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a separate payment term of up to $2,037,470,000.
Approval Date:
July 24, 2024
Effective Date:
January 1, 2024
Links:
Rhode Island
Uniform increase for all contracted home care agencies providing homemaker and CAN services for the rating period covering July 1, 2023 through June 30, 2024, incorporated into the capitation rates through a risk-based rate adjustment or through a separate payment term up to $3,750,000.
Approval Date:
July 23, 2024
Effective Date:
July 1, 2023
Links:
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:
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:
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:
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:
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:
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: