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
Wisconsin
The minimum and maximum fee schedules established by the state for the rating period covering January 1, 2024 through December 31, 2024, incorporated in the capitation rates through a risk-based adjustment.
Approval Date:
December 21, 2023
Effective Date:
January 1, 2024
Links:
Indiana
Minimum Medicare fee schedules established by the state for eligible primary care services, specialty physician services, behavioral health outpatient services, and durable medical equipment for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
December 20, 2023
Effective Date:
January 1, 2024
Links:
Nebraska
Uniform increase established by the state for professional services of staff and faculty dental providers at an academic dentistry institution of a public university for the rating period covering July 1, 2023 through December 31, 2023, incorporated as an adjustment to risk-based capitation rates.
Approval Date:
December 20, 2023
Effective Date:
July 1, 2023
Links:
Indiana
Minimum fee schedules established by the state for eligible primary care services, specialty physician services, nursing facility services, behavioral health outpatient services, dental services and durable medical equipment for the rating period, January 1, 2024 through December 31, 2024, incorporated into the capitation rates through a risk-based rate adjustment.
Approval Date:
December 20, 2023
Effective Date:
January 1, 2024
Links:
Mississippi
Uniform dollar increase established by the state for ground emergency ambulance services for the rating period, July 1, 2023 through June 30, 2024, incorporated into the capitation rates through a separate payment term up to $20,616,966.
Approval Date:
December 19, 2023
Effective Date:
July 1, 2023
Links:
Puerto Rico
Uniform dollar increase for inpatient hospital services at qualifying short-term acute care (STAC) hospitals for the rating period covering October 1, 2023 through September 30, 2024 incorporated in the capitation rates through a separate payment term of up to $102,978,450.
Approval Date:
December 15, 2023
Effective Date:
October 1, 2023
Links:
Rhode Island
Uniform increase established by the state for all hospitals participating in the Rhode Island Medicaid Program, as defined in RIGL 40-8-13.4, for inpatient hospital services for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
December 15, 2023
Effective Date:
July 1, 2023
Links:
Rhode Island
Uniform increase established by the state for personal care and combined personal care/ homemaker services for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
December 15, 2023
Effective Date:
July 1, 2023
Links:
Rhode Island
Uniform increase established by the state for personal care and combined personal care/ homemaker services for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
December 15, 2023
Effective Date:
July 1, 2023
Links:
Rhode Island
Uniform increase established by the state for all hospitals participating in the Rhode Island Medicaid Program, as defined in RIGL 40-8-13.4, for inpatient hospital services for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
December 15, 2023
Effective Date:
July 1, 2023
Links: