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
Georgia
The uniform percentage increase for inpatient and outpatient hospital services furnished by eligible teaching hospitals established by the state for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $936,920,135.
Approval Date:
March 21, 2024
Effective Date:
July 1, 2023
Links:
Pennsylvania
Value-based purchasing established by the state for eligible nursing facility services for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $15,000,000.
Approval Date:
March 21, 2024
Effective Date:
January 1, 2024
Links:
Washington
Uniform increase for hospitals owned or operated by a state university established by the state for inpatient and outpatient hospital services for the rating period, January 1, 2024through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $433 million.
Approval Date:
March 21, 2024
Effective Date:
January 1, 2024
Links:
Wisconsin
Uniform increase established by the state for eligible home and community-based service (HCBS) providers for the rating period covering July 1, 2023 through December 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
March 21, 2024
Effective Date:
July 1, 2023
Links:
Arizona
Uniform increase provided by the eligible public safety net hospital established by the
state for inpatient and outpatient hospital services for the rating period, October 1, 2023
through September 30, 2024, incorporated into the capitation rates through a separate
payment term up to $286.5 million.
Approval Date:
March 20, 2024
Effective Date:
October 1, 2023
Links:
Ohio
The uniform percentage increase for participating health systems affiliated with a public medical school established by the state for qualified practitioners for the rating period January 1, 2024 through December 31, 2024, incorporated into the capitation rates
through a separate payment term up to $20,000,000.
Approval Date:
March 20, 2024
Effective Date:
January 1, 2024
Links:
Ohio
The uniform percentage increase for participating health systems affiliated with a public medical school in Northeast class established by the state for qualified practitioners for the rating period January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a separate payment term up to $67,700,000.
Approval Date:
March 20, 2024
Effective Date:
January 1, 2024
Links:
Georgia
The uniform percentage increase for inpatient and outpatient hospital services furnished by eligible teaching hospitals established by the state for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $936,920,135.
Approval Date:
March 19, 2024
Effective Date:
July 1, 2023
Links:
Nebraska
Uniform increase for faculty or staff members of an academic medical institution of a public university established by the state for the rating period, January 1, 2024through December 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
March 19, 2024
Effective Date:
January 1, 2024
Links:
Nebraska
Uniform increase for staff and faculty dental providers at an academic dentistry institution of a public university established by the state for dental services for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based adjustment.
Approval Date:
March 19, 2024
Effective Date:
January 1, 2024
Links: