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
Washington
Renewal of the uniform increase established by the state for eligible providers delivering opioid treatment services for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
February 8, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Washington
Renewal of the uniform increase established by the state for publicly funded sexual and reproductive health family planning providers as designated by the Department of Health for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
February 8, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
Washington
Renewal of the uniform increase established by the state for behavioral health inpatient and behavioral health outpatient services for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
February 8, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Behavioral health outpatient services
Tennessee
Uniform dollar increase and value-based payments established by the state for eligible primary care services for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
February 5, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Primary care services
Tennessee
Uniform percentage increase established by the state for eligible behavioral health services for the rating period, January 1, 2023 through December 31, 2023, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
February 5, 2024
Effective Date:
July 1, 2023
Links:
State Rating Period:
January 1, 2023
-
December 31, 2023
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Other
New Jersey
A pay-for-performance initiative focused on maternal health performance improvement among acute care hospitals licensed to provide Labor and Delivery Services for the rating period covering July 1, 2024 through June 30, 2025, incorporated into the capitation rates through a separate payment term of up to $63,000,000.
Approval Date:
February 2, 2024
Effective Date:
July 1, 2024
Links:
State Rating Period:
July 1, 2024
-
June 30, 2024
Payment Type:
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
North Carolina
Minimum fee schedule for non-state government owned skilled nursing facility admission days for the rating period, July 1, 2022 through June 30, 2023, incorporated into the capitation rates through an adjustment to base rates.
Approval Date:
January 31, 2024
Effective Date:
July 1, 2022
Links:
State Rating Period:
July 1, 2022
-
June 30, 2023
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services
Arizona
Uniform percentage increase to registered providers who provide qualifying HCBS and Behavioral Health Outpatient services for the rating period, October 1, 2022 through September 30, 2023, incorporated into the capitation rates through a separate payment term up to $385.1 million.
Approval Date:
January 24, 2024
Effective Date:
October 1, 2022
Links:
State Rating Period:
October 1, 2022
-
September 30, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
Ohio
Uniform increase established by the state for inpatient and outpatient services provided by in-state hospitals for the rating period covering January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $1.762 billion.
Approval Date:
January 23, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service
Ohio
Uniform percentage increase for inpatient and outpatient services at the University of Toledo Medical Center for the rating period covering January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $44,400,000.00.
Approval Date:
January 23, 2024
Effective Date:
January 1, 2024
Links:
State Rating Period:
January 1, 2024
-
December 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
Outpatient hospital service