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
Florida
Uniform percentage increase established by the state for inpatient and outpatient hospital services at qualifying cancer hospitals for the rating period covering October 1, 2022 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $129,312,167.
Approval Date:
September 7, 2023
Effective Date:
October 1, 2022
Links:
Florida
Uniform dollar increase established by the state for public emergency medical transportation services for the rating period covering October 1, 2022 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $138,539,043.
Approval Date:
August 30, 2023
Effective Date:
October 1, 2022
Links:
Florida
Uniform increase established by the state for inpatient and outpatient hospital exemption payments for the rating period covering October 1, 2020 through September 30, 2021, incorporated in the capitation rates through a separate payment term up to $240,107,394.00
Approval Date:
July 18, 2023
Effective Date:
October 1, 2020
Links:
Florida
Minimum fee schedule established by the state for primary care services and specialty physician services for the rating period covering October 1, 2022 through September 30, 2023 incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 7, 2023
Effective Date:
October 1, 2022
Links:
Florida
Uniform percentage increase established by the state for home and community-based services, behavioral health outpatient services, and eligible non-waiver services for the rating period covering October 1, 2022 through September 30, 2023, incorporated in the capitation rates through a separate payment term of up to $296,534,267.
Approval Date:
May 5, 2023
Effective Date:
October 1, 2022
Links: