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
New Jersey
Uniform dollar increase for inpatient hospital services provided by Middlesex County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $248,562,303.
Approval Date:
April 9, 2024
Effective Date:
July 1, 2024
Links:
New Jersey
Uniform dollar increase for inpatient hospital services provided by Monmouth County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $185,039,257.
Approval Date:
April 9, 2024
Effective Date:
July 1, 2024
Links:
New Jersey
Uniform dollar increase for inpatient hospital services provided by Cumberland County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $37,292,135.
Approval Date:
April 8, 2024
Effective Date:
July 1, 2024
Links:
New Jersey
Uniform dollar increase for inpatient hospital services provided by Essex County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $263,242,781.
Approval Date:
April 8, 2024
Effective Date:
July 1, 2024
Links:
New Jersey
Uniform dollar increase for inpatient hospital services provided by Hudson County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $107,475,883.
Approval Date:
April 8, 2024
Effective Date:
July 1, 2024
Links:
New Jersey
Uniform dollar increase for inpatient hospital services provided by Atlantic County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $85,436,770.
Approval Date:
April 5, 2024
Effective Date:
July 1, 2024
Links:
New Jersey
Uniform dollar increase for inpatient hospital services, outpatient hospital services, and behavioral health inpatient services provided by Bergen County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $383,396,201.
Approval Date:
April 5, 2024
Effective Date:
July 1, 2024
Links:
New Jersey
Uniform dollar increase for inpatient hospital services provided by Burlington County hospitals for the rating period, July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term up to $71,746,613.
Approval Date:
April 5, 2024
Effective Date:
July 1, 2024
Links:
California
Uniform increase established by the State for Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) eligible providers for the rating period covering January 1, 2023 through December 31, 2023, incorporated in the capitation rates through a separate payment term of up to $280,000,000.
Approval Date:
April 4, 2024
Effective Date:
January 1, 2023
Links:
California
Uniform increase for inpatient and outpatient services provided by private hospitals as defined in CA Welfare & Institutions Code § 14169.51(ap) 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 $7,187,256,629.
Approval Date:
April 4, 2024
Effective Date:
January 1, 2024
Links: