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
Minimum Fee Schedule established by the state for eligible non-state government owned skilled nursing facility admission days based on actual utilization services for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a risk-based rate adjustment of up to $5,650,000.
Approval Date:
June 16, 2026
Effective Date:
July 1, 2026
Links:
Virginia
Quality Payment/Pay for Performance for nursing facility services for rating periods covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount of up to $184,900,000.
Approval Date:
June 16, 2026
Effective Date:
July 1, 2026
Links:
Ohio
Uniform percentage increase for qualified practitioner services at an academic medical center, primary care and specialty physician services, and dental services, as well as a value-based performance payment to providers who attain quality performance target(s), for the rating period covering January 1, 2026 through December 31, 2026, incorporated into capitation rates via a separate payment term up to $23,716,304.
Approval Date:
June 12, 2026
Effective Date:
January 1, 2026
Links:
State Rating Period:
January 1, 2026
-
December 31, 2026
Payment Type:
Fee schedule
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Dental services
Other
Primary care services
Professional services at an academic medical center
Specialty physician services
Florida
Uniform percentage increase for professional services at an academic medical center for the rating period covering October 1, 2025 through September 30, 2026, incorporated in the capitation rates through a separate payment term amount up to $442,867,123.
Approval Date:
June 9, 2026
Effective Date:
October 1, 2025
Links:
Kansas
Uniform increase for professional services at an academic medical center provided by Qualified Licensed Professionals as established by the state for the rating period covering January 1, 2026 through December 31, 2026, incorporated into the capitation rates through a separate payment term up to $16,000,000.
Approval Date:
June 8, 2026
Effective Date:
January 1, 2026
Links:
Maryland
Uniform percentage increase and value-based payment established by the state for professional services at an academic medical center for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a separate payment term amount of up to $47,900,869.
Approval Date:
June 8, 2026
Effective Date:
January 1, 2026
Links:
New Hampshire
Value-based payment for eligible community mental health centers established by the state for behavioral health outpatient services for the rating period covering July 1, 2026 through June 30, 2027, incorporated in the capitation rates through a risk-based rate adjustment up to $7,350,000.
Approval Date:
June 8, 2026
Effective Date:
July 1, 2026
Links:
California
Skilled Nursing Facility (SNF) Workforce and Quality Incentive Program (WQIP) established by the state for eligible providers for the rating period covering January 1, 2025 through December 31, 2025, incorporated in the capitation rates through a separate payment term amount up to $304,825,403.
Approval Date:
June 3, 2026
Effective Date:
January 1, 2025
Links:
New Jersey
Uniform increase for inpatient hospital services, outpatient hospital services, and behavioral health inpatient services provided by Camden County hospitals for the rating period covering July 1, 2025 through June 30, 2026, incorporated in the capitation rates through a separate payment term amount of up to $582,557,535.
Approval Date:
June 2, 2026
Effective Date:
July 1, 2025
Links:
Pennsylvania
Minimum Fee Schedule for nursing facility services for the rating period covering January 1, 2026 through December 31, 2026, incorporated in the capitation rates through a risk-based rate adjustment of up to $1,850,000,000.
Approval Date:
June 2, 2026
Effective Date:
January 1, 2026
Links: